8-4 PHARMACOLOGICAL PROFILES Flashcards
What is a class of drugs that cause a dose-dependent depression of the central nervous system function, inducing sedation, sleep, and unconsciousness with increasing doses.
Sedatives and hypnotics
What class of drugs includes agents such as barbiturates, benzodiazepines, and melatonin agonists?
sedatives and hypnotics
Which sedative and hypnotic agent:
- has anticonvulsive properties
- depresses the sensory cortex
- decrease motor activity
- alter cerebellar function
- produces drowsiness, sedation, hypnosis
barbiturates
What are the uses of barbiturates?
- used as a sedative
- seizures, management of generalized tonic-clonic, status epilepticus, partial seizures
What are the adverse effects of barbiturates?
- CNS: somnolence (excessive sleepiness)
- Respiratory: hypoventilation
- GI: nausea
- CV: bradycardia
- agitation, confusion, nightmares
What are the two examples of barbiturates?
- phenobarbital
- thiopental
Anti-anxiety drugs are divided into what two categories?
- benzodiazepines
- non- benzodiazepines
Most benzodiazepines cause generalized ___________.
These agents have no ______ properties.
- CNS depression
- analgesic
Action for anti-anxiety medications:
-Act on brain’s dopamine and serotonin receptors
Benzo or non-benzo?
non-benzo
Action for anti-anxiety medications:
-bind to specific benzodiazepine receptors in the GABA receptor
Benzo or non-benzo?
benzo
What is the use of anti-anxiety medications?
-management of various forms of anxiety, including generalized anxiety disorder
Long term use of benzodiazepines: withdrawal syndrome after as little as ____ weeks of therapy.
4-6
What are the contraindications of anti-anxiety medications?
- should not be used in comatose patients, pre-existing CNS depression, or with severe pain
- acute narrow angle glaucoma
- not to be taken with alcohol, tricyclic antidepressants, antipsychotics
What pregnancy class are anti-anxiety medications? What is the pregnancy class for BuSpar and Zolpidem?
- class D
- class B
Examples of benzodiazepines?
-Alprazolam
Xanax
Examples of benzodiazepines?
-Diazepam
Valium
Examples of benzodiazepines?
-Lorazepam
Ativan
Examples of non-benzodiazepines?
-Buspirone hydrochloride
Bu Spar
Examples of non-benzodiazepines?
-hydroxyzine
Atarax
What has a higher risk of dependency: non- benzos or benzos?
Benzos
What are the classes of antidepressants?
(6) TMSSSD
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOI)
- Selective serotonin reuptake inhibitors (SSRI)
- Serotonin-norepinephrine reuptake inhibitors (SNRI)
- Serotonin reuptake inhibitor/antagonist
- Dopamine/norepinephrine reuptake inhibitor
Which antidepressant matches this action:
-Increases levels of norepinephrine and serotonin by inhibiting their reuptake, and block the action of acetylcholine
TCAs, tricyclic antidepressants
Which antidepressant matches this action:
-Inhibits the activity of monoamine oxidase resulting in increased endogenous neuro-hormones
MAOI
monoamine oxidase inhibitors
Which antidepressant matches this action:
increases serotonin by inhibiting neuronal uptake to CNS
SSRI
Selective serotonin reuptake inhibitors
What are the uses of anti-depressant class medications?
- depressive sx
- anxiety (class dependent)
- OCD
- smoking cessation=bupropion-wellbutrin
Wellbutrin is contraindicated in patients with?
seizure disorders
When educating your patient on anti-depressant use, ensure they do not take what supplement?
St. johns wart
Examples of anti- depressants:
-amitriptyline (tricyclic)
Elavil
Examples of anti- depressants, what is the medication used for the MAOI class?
Nardil
Examples of anti- depressants:
-what medication is used for the serotonin reuptake inhibitor/antagonist?
trazadone (desyrel)
Examples of anti- depressants:
-what two medications are used for the serotonin-norepinephrine reuptake inhibitor/antagonist?
- venlafaxine
- duloxetine
Examples of anti- depressants:
-what medication is used for the dopamine/norepinephrine reuptake inhibitor?
bupropion/ wellbutrin
Examples of anti- depressants: selective serotonin reuptake inhibitors (SSRI)
-citalopram
celexa
Examples of anti- depressants: selective serotonin reuptake inhibitors (SSRI)
-fluoxetine
prozac
Examples of anti- depressants: selective serotonin reuptake inhibitors (SSRI)
-sertraline
zoloft
Examples of anti- depressants: selective serotonin reuptake inhibitors (SSRI)
-paroxetine
paxil
What class of anti-depressants is the first line medication?
SSRIs
What class of medication is defined by this action: -block dopamine receptors in the brain, alters dopamine release and turnover
Antipsychotics
Antipsychotics are classified as what two types?
- typical (1st generation)
- atypical (2nd generation)
What are the uses of antipsychotics?
-treatment of acute and chronic psychoses
Use of clozapine is limited to?
-schizophrenia unresponsive to conventional therapy
Chlorpromazine is also used in the treatment of?
-intractable hiccups
What are the contraindications for antipsychotics?
- not recommended for use in severely depressed patients
- hypotension
Example of antipsychotics:
- haloperidol
What generation?
haldol
-1st gen, typical
Example of antipsychotics:
-prochlorperazine
What generation?
Compazine
-1st gen, typical
Example of antipsychotics:
-quetiapine
What generation?
seroquel
-2nd gen, atypical
Example of antipsychotics:
-olanzapine
What generation?
zyprexa
-2nd gen, atypical
What are the two classes of CNS stimulants?
- amphetamines
- anorexiants
Which class of medication produces:
- CNS and respiratory stimulation
- dilated pupils
- increased motor activity
- mental alertness
- diminished fatigue
CNS Stimulants
What are the uses of CNS stimulants?
treatment of
- narcolepsy
- ADHD
Examples of amphetamines:
-methylphenidate HCL
Concerta
Examples of amphetamines:
-dextroamphetamine
Adderall
Example of anorexiants:
-phentermine
Ionamin
What class of medications reduces the excitability of the neurons on the brain?
Anticonvulsants
What are the five types of seizures?
- psychomotor
- tonic clonic
- myoclonic
- absence
- epilepsy
Which type of seizure is described as: may experience an aura with perceptual alterations and hallucination
psychomotor seizures
Which type of seizure is described as: alternate contraction and relaxation of muscles
tonic clonic
Which type of seizure is described as: sudden, forceful contraction involving the musculature of the trunk, neck, and extremities
myoclonic seizures
What type of seizure is described as:
A brief loss on consciousness during which physical activity ceases
absence seizures (petit mal)
What type of seizure is described as: permanent and recurrent seizure disorder
epilepsy
What are the uses for anticonvulsants?
decrease the incident and severity of seizures of various etiologies
What is an adverse effect of anticonvulsants that is considered a medical emergency?
Steven-Johnson syndrome
What is the pregnancy classification for anticonvulsants?
pregnancy class D
Benzodiazepines are used to treat status epilepticus, what is the drug regime of choice?
-lorazepam 4 mg IV
and
-midazolam 10 mg IM
Examples of benzodiazepines anticonvulsants:
-diazepam
valium
Examples of benzodiazepines anticonvulsants:
-lorazepam
ativan
Examples of benzodiazepines anticonvulsants:
-midazolam
versed
Examples of benzodiazepines anticonvulsants:
-clonazepam
klonopin
Examples of anticonvulsants:
-phenytoin
dilatin
Examples of anticonvulsants:
-ethosuximide
zarontin
Examples of anticonvulsants:
-valproic acid
depakote
Which type of anti-emetic acts on the chemoreceptor trigger zone to inhibit nausea and vomiting?
Phenothiazines
Which three medications act as an antiemetic mainly by diminishing motion sickness?
- dimenhydrinate
- scopolamine
- meclizine
Which anti-emetic works by blocking the effects of serotonin at 5-HT3 receptor sites?
ondansetron
Which class of medication works primarily by inhibiting the chemoreceptor trigger zone or by depressing the sensitivity of the vestibular apparatus of the inner ear?
anti-emetic
Which medication class is described as used for: prophylaxis or treatment of nausea or vomiting
antiemetic
Which medication class is described as being used for: treatment of vertigo
antivertigo
What are contraindications of antiemetics?
-not recommended for patients with CNS depression
What is the pregnancy drug class for anti emetics?
Class X
Examples of antiemetics, phenothiazine types:
-prochlorperazine
-compazine
Examples of antiemetics, phenothiazine types:
-chlorpromazine
thorazine
Examples of antiemetics
-metoclopramide
reglan
Examples of antiemetics
-ondansetron
zofran
Examples of antiemetics
-promethazine
Phenergan
Examples of antivertigo medications
-meclizine
antivert
Examples of antivertigo medications
-diphenhydramine
Benadryl
Examples of antivertigo medications
-benzodiazepines (2)
- ativan
- valium
What medication class best describes this action: -removes the feeling or sensation
anesthetic
What medication class best describes this action: -alleviates or relieves the pain from a patient
analgesic
Which class of medication is described as: inhibiting transport of ions across neuronal membranes, thereby preventing initiation and conduction of normal nerve impulses
local anesthetics
Which medication is a non-competitive antagonist of glutamate at the N-methyl-D-aspartate (NMDA) receptor-cation channel complex, causing neuro-inhibition and anesthesia?
-patient is dissociated from the surrounding?
ketamine
Which medication is used to induce anesthesia in hypotensive patients or those likely to develop hypotension due to hypovolemia?
ketamine
Ketamine typically increases BP, HR, and cardiac output by increasing?
sympathetic tone
Which anesthetic excites the opioid receptors within the insular cortex, putamen, and thalamus, producing analgesia?
ketamine
How long is the IM anesthetic effect for ketamine?
3-4 minutes
Local anesthetics are utilized to produce a:
loss of sensation prior to minor painful procedures
Adverse reactions:
ketamine
- pt with ischemic heart disease
- prolonged emergence from anesthesia
Contraindications:
-ketamine
- known or suspected schizophrenia
- increases risk of laryngospasm, pt’s with airway instability, prior airway surgery are at higher risk
What is the dose of ketamine for analgesia IV?
-For IM?
- 10 to 20 mg IV
- 20 to 40 mg IM
What is the dose for ketamine for induction of anesthesia IV?
-IM?
- 1 to 2 mg/kg
- 4 to 6 mg/kg
Examples of anesthetics:
-lidocaine
xylocaine
Examples of anesthetics:
-bupivacaine
Marcaine
Examples of anesthetics:
-ketamine
ketalar
What is the IV anesthesia induction drug of choice for most non-trauma patients?
Propofol
Which medication is often selected to induce anesthesia in patients with hemodynamic instability because of its rapid onset without changes in BP , cardiac ouput, or HR?
Etomidate
What is the most hemodynamically neutral of the sedative-hypnotic agents used to induction of general anesthesia?
Etomidate
What are the sub classes of non-narcotic analgesics/anti-inflammatory/antipyretics?
- salicylate
- non salicylate
- nonsteriodal anti-inflammatory drugs (NSAIDs)
- urinary analgesics
What class of medications action is: inhibition of prostaglandins, dilates peripheral blood vessels (cools body), prolong bleeding by inhibiting aggregation of platelets?
salicylates
What are the uses of salicylates?
- relief mild to moderate pain
- reduction of body temperature
- inflammatory conditions
- decrease risk of myocardial infarction
- prevention and treatment of blood clots
What are the adverse effects of salicylate class medications?
- gastric upset
- heart burn
- nausea/vomiting
- anorexia
- GI bleed
- reye syndrome in children with chickenpox/flu
These are examples of what class of medication: -aspirin: bayer, ecotrin, enteric coated aspirin
salicylate
What is the action for non-salicylate class medications?
- analgesic
- antipyretic
What are the uses for non-salicylate class medications?
- relieve mild to moderate pain
- reduce body temperature
- arthritis
What are the adverse effects for non-salicylate class medications?
- urticaria
- hemolytic anemia
- hepatoxicity
- allergy to acetaminophen
- severe hepatic or liver disease
What is the maximum recommended daily dose of acetaminophen?
> 4g daily
What is the generic name for cepacol?
benzocaine-menthol
Which class of medications if defined as this action and is a anti-inflammatory, analgesic, and antipyretic: -inhibit the action of the enzyme cyclooxygenase which is responsible for prostaglandin synthesis
nonsteriodal anti-inflammatory drugs (NSAIDs)
What are the uses for NSAIDs?
-Arthritis
-mild to moderate pain
dysmenorrhea
-fever reduction
Which medication class has the adverse effects of:
- GI: nausea and vomiting
- may increase risk of heart attack or stroke
NSAIDs
What are the adverse effects of celecoxib?
- dyspepsia
- renal function
What are the adverse effects of ibuprofen?
effects on platelets and their role on clotting
-increased risk with higher doses
What is the contraindication of celecoxib?
allergy to sulfonamides
What is the contraindication for ibuprofen?
- peptic ulcer
- GI bleed
- hypertension
What are the examples of ibuprofen?
- motrin
- advil
What are the examples of indomethacin?
indocin
What are the examples of ketolorac?
toradol
What are the examples of naproxen?
- aleve
- naprosyn
What are the examples of celecoxib?
celebrex
What are the examples of meloxicam?
mobic
What is the first line treatment for gout?
indomethacin
Which NSAID is used for once a day dosing?
Mobic
Which NSAID is used for acute pain and given in the clinic IM?
What is the dose?
- toradol
- 30-60 mg
What is the action for the urinary anesthetic/analgesic class of medications?
pyridium is a topical bladder and urethral anesthetic and analgesic through unknown mechanism
What is the use of the urinary anesthetic/analgesic class medication pyridium?
bladder analgesic used to treat pain associated with UTI
What is the dose for pyridium?
100 mg TID for 5 days as needed for dysuria
What should you warn your patient about when using pyridium?
- urine turns a reddish-orange color
- this can stain underwear
What is the example of phenazopyridine?
pyridium
What class of medication is described by this action: -opioids bind to opiate receptors in the CNS where they act as agonists of endogenously occurring opioid peptides (endorphins). The result is alteration to the perception of and response to pain.
Narcotic analgesics
What is the use for narcotic analgesics?
short term management of moderate to severe pain
What are the adverse effects of narcotic analgesics?
- respiratory depression
- light-headedness
- constipation
- nausea/vomiting
What are the contraindications of narcotic analgesics?
- head injury/increased ICP
- hypoxia
- hepatic impairment
What is the example of fentanyl?
sublimaze
What is the example of hydromorphone?
dilaudid
What is the example of methadone?
dolophine
What is the example of morphine sulfate?
MS Contin
What is the example of oxycodone?
oxycontin
What are the examples of hydrocodone?
- norco
- lortab
- vicodin
What class of medication is described by this action: -an opioid antagonist is a receptor antagonist that acts on opioid receptors. binds to the opioid receptors with higher affinity than agonists but do not activate receptors, preventing the body from responding to opiates and endorphins.
narcotic antagonist
What is the use for a narcotic antagonist?
Overdose of a narcotic
What is the adverse effect of narcotic antagonists?
acute opioid withdrawal
Where are the highest amount of histamines found?
- basophils (WBC)
- mast cells
produce vasodilation of arterioles and increased permeability of capillaries and venule, which allow fluid to escape into the surrounding tissue resulting in localized swelling
histamine
Which class of medication is described by this action: -work by binding to histamine H1 receptors in mast calls, smooth muscle, and endothelium in the body as well as the brain. suppress the histamine-induced wheal response (swelling) and flare response (vasodilation)
H1 anit-histamines
What are the uses of H1 anti-histamines?
- treat allergic reactions
- may be used to treat insomnia, motion sickness, vertigo
- urticaria
- adjunctive therapy for anaphaylactic reactions and angioedema (swelling of the eyes)
Where do H2 antihistamines bind to?
-histamine receptors in the upper GI tract, primarily the stomach
What are the uses of H2 antihistamines?
-treat gastric conditions (peptic ulcers/acid reflux)
What antihistamine may also help with the relief of parkinson-like reactions?
diphenhydramine
What is an example of hydrozyine?
atarax
What is an example of promethazine?
phenergan
What is an example of cetirizine HCL?
zyrtec
What is an example of fexofenadine?
allegra
What is an example of loratadine?
claritin
What class of medications reduces swelling of nasal passages and enhances drainage of sinuses?
decongestant
Which class of medication action is described as: act by enhancing norepinephrine and epinephrine or adrenergic activity by stimulating the alpha-adrenergic receptors. This induces vasoconstriction of the blood vessels of the nose, throat, paranasal sinuses, which results in reduced inflammation and mucus formation in these areas.
decongestants
What are the uses of decongestants?
- common cold
- hay fever
- allergies
- sinus congestion/pressure
What are the contraindications for decongestants?
- use with caution with hypertension, DMII(type 2 diabetes), increased intraocular pressure
- may worsen prostatic hyperplasia/urinary obstruction
What is the example of oxymetazoline HCL?
Afrin
Which class of medications is defined by this action: release stimulants and reuptae inhibitors
Which class of medications is defined by this action: release stimulants and reuptake inhibitors that increase the levels of endogenous catecholamines,
bronchodilators
Where are Beta 2 receptors located?
When stimulated they cause relaxation (dilation) of what?
- bronchial smooth muscle
- bronchioles
What are the uses of bronchodilators?
reversible airway disease caused by bronchospasm due to
- asthma
- bronchitis
- emphysema
- obstructive pulmonary disease
What are the adverse effects of bronchodilators?
- excessive use can cause paradoxical bronchospasm
- nausea, vomiting, restlessness
- tachycardia, increase respiration
- nervousness, headache, palpitations
What are the contraindications of bronchodilators?
- cardiac arrhythmias, narrow angle glaucoma
- may inhibit effects of beta 2 agonist
Use albuterol (beta 2 agonist) with cause in patients with? It may increase what?
- diabetes mellitus
- may increase serum blood glucose
What are examples of albuterol sulfate?
- proventil
- ventolin
- pro air
What are examples of levalbuterol HCL?
-xopenex
What class of medication is described by this action: -antagonizes acetylcholine receptors, producing bronchodilation.
-muscarinic antagonists
What are the uses of muscarinic antagonists?
symptomatic relief or prevention of bronchial asthma and the management of COPD
What are the adverse effects of anticholinergics (muscarinic antagonists)?
- flushed face (red as a beet)
- blurred vision (blind as a bat)
- urinary retention (stuffed as a pipe)
- confusion (mad as a hatter)
- hallucinations (mad as a hatter)
- increased HR/body temp (hot as a hare)
- dry mouth (dry as a bone)
What are the contraindications of muscarinic antagonist anticholingergics?
- peptic ulcer
- seizure
- arrhythmias
- hyperthyroid
- caution with >60 yr olds
What is the example of ipratropium?
atrovent
What is the example of tiotropium?
spiriva
Which class of medication is described by this action: -broncho constrictive substance released by the body during inflammation. Antagonist results in bronchodilation
leukotriene antagonist
What class of medication is described by this action: -inhibit the release of substances that cause bronchoconstriction and inflammation from the mast cells in the respiratory tract
mast cell stabilizer
What are the uses of luekotriene antagonist and mast cell stabilizers?
- treatment of asthma
- treatment of COPD
What are the adverse effects of luekotriene antagonist and mast cell stabilizers?
- headache
- dizziness
- unpleasant taste
- fatigue
What are the contraindications of luekotriene antagonist and mast cell stabilizers?
- acute asthma/bronchospasm
- aspirin-sensitive asthmatics
What is the example of a luekotriene antagonist?
-generic and brand name?
montelukast (singular)
What is an example of a mast cell stabilizer?
-generic and brand name?
cromolyn (nasalcrom)
Which class of medications is described by this action:
- produce profound and varied metabolic effects, in addition to modifying the normal immune response and suppressing inflammation
- decrease inflammatory process in the airway through inhibiting multiple different inflammatory cytokines
inhale corticosteriods
What are the uses for larger doses of inhaled corticosteriods used for?
anti-inflammatory, immunosuppressive, or anti-neoplastic(drugs that treat cancer) activity
What are the uses for inhalant corticosteriods?
-chronic management of reversible airway disease (asthma)
What are the uses for intranasal and ophthalmic corticosteriods?
used in management of chronic allergies and inflammatory conditions
What are the contraindications for inhaled corticosteriods?
- throat irritation
- cough
- candida albicans (yeast infection)
inhale corticosteriods
What is the example of budesonside?
pulmicort
inhale corticosteriods
What is the example of fluticasone?
flovent
Which class of medication is classified into central acting and peripheral acting?
-antitussives
What is the action for central acting antitussives?
depresses cough center
What is the action for peripheral acting antitussives?
anesthetize stretch receptors
What are the uses of antitussives?
-relieve a non productive cough
What are the adverse effects of antitussives?
-drugs with codeine- respiratory depression, euphoria, sedation
What are the contraindications of antitussives?
- premature infants
- caution with persistent or chronic cough
- caution when using codeine in respiratory disorders
Antitussives
What is the example of benzonatate?
tessalon pearls
Antitussives
What is the example of benzonatate?
tessalon pearls
Antitussives
What is the example of dextromethorphan?
robitussin
Antitussives
What is the example of diphenhydramine?
benadryl
What class of medication is defined by this action: loosens and mobilizes thick mucus from respiratory system
mucolytic
What class of medication is defined by this action: raises thick mucus from respiratory system
expectorant
What is the use of mucolytic class medications?
bronchopulmonary disease
What is the use of expectorant class medications?
common cold
What is an example of a mucolytic class medication?
-acetylcysteine (mucomyst)
What is the example of an expectorant class medication?
-guaifenesin (tussin, mucinex)
What is defined as an abnormal electric current in the heart?
cardiac arrhythmias
Which class of medication is defined by these actions:
- blockade of Na of K channels
- raise the potential threshold
- block beta receptor stimuli
- block calcium channels
antiarrhythmics
Which class of antiarrhythmic is defined as:
- depresses myocardial excitability to electrical stimuli, thus decreasing the pulse rate.
- lidocaine raises the threshold in the ventricular myocardium
- some arrhythmias have too much stimuli and lidocaine will depress the threshold of the muscle
class 1
Which class of antiarrhythmic is defined as:
- beta blockers block stimulation of the beta receptors of the heart
- adrenergic neurohormones stimulate the beta receptors and increase the heart rate
class 2
Which class of antiarrhythmic is defined as:
- amiodarone blocks potassium channels in the heart
- this is used for ventricular dysrhythmias and atrial fibrillation
class 3
Which class of antiarrhythmic is defined as: -verapmil blocks calcium channels which are critical in the production of muscle contraction and electrical conduction
class 4
Antiarrhythmia class medications are used to treat cardiac arrhythmias such as?
- premature ventricular contractions
- tachycardia
- premature atrial contractions
- ventricular dysrhythmias
- atrial fibrillation and atrial flutter
Antiarrhythmia class medications: lidocaine HCL example
xylocaine
Antiarrhythmia class medications: amiodarone example
cordarone
Antiarrhythmia class medications: which medication is a beta blocker
metoprolol (lopressor)
Antiarrhythmia class medications: which medications are calcium channel blockers?
- verapamil
- diltiazem
What is defined as “decrease in oxygen supply to the heart muscle resulting in chest pain or pressure””?
angina
What class of medications is defined by this action: -direct relaxing effect on smooth muscle of blood vessels (both arterial and veins)
nitrates
Nitrate medications is a subclass of which class of medication?
antianginal
What are the use of nitrate class medications?
treatment of angina pectoris
What are the adverse effects of nitrate class medications?
- headache
- hypotension
- dizziness, vertigo
What are the contraindications of nitrate class medications?
- postural hypotension
- closed angle glaucoma
- right sided heart failure
Do not give nitroglycerin if the BP is?
<100 mg systolic
You should not use nitrate class medication in combination with medications that are used for?
erectile disfunction
What class of medication is nitroglycerin?
nitrate, antianginal
What are the guidelines for a normal BP?
- systolic: <120
- diastolic: <80
What are the guidelines for an elevated BP?
- systolic: 120-129
- diastolic: 80
What are the guidelines for stage 1 elevated BP?
- systolic: 130 to 139
- diastolic: 80 to 89
What are the guidelines for stage 2 elevated BP?
- systolic: at least 140
- diastolic: at least 90
What is step 1 in the step-care regimen of BP?
Life style changes
- salt restriction
- weight reduction
- exercise
- stress reduction
- sleep
What is step 2 in the step-care regimen of BP?
use of medications
-diuretics are used to control 80% of pts
What is step 3 in the step-care regimen of BP?
increase dose of drugs or combine 2 drugs
What is step 4 in the step-care regimen of BP?
combine 2-3 drugs
What are the sub classes of anti-hypertension medications?
- ace inhibitors, ARBs
- diuretics
- calcium channel blockers
- beta blocker
Which subclass of anti-hypertension medications action is defined as: -lower blood pressure by dilating or increasing the size of the arterial blood vessels
ACE inhibitors, ARBs
What is the use of ACE inhibitors, ARBs?
treatment of hypertension
Which class of anti-hypertension medications is the 1st line indication in the treatment of hypertension in patients with diabetes?
ACE inhibitors, ARBs
What are the adverse effects of ACE inhibitors, ARBs?
- postural or orthostatic hypotension
- ACE-I: angioedema, hyperkalemai
- dry hacking cough, less common with ARBs
What are the contraindications for ACE inhibitors, ARBs?
- caution with renal or hepatic disease
- electrolyte imbalance
What are examples of ACE-inhibitor medications?
- lisinopril
- captopril
- enalapril
- ramipril
Which subclass of anti-hypertension medications is defined by this action: -these agents act by causing peripheral vasodilation (it inhibits calcium from getting into the muscle cells to cause contraction)
calcium channel blockers
What are the uses of calcium channel blockers?
- treating HTN
- atrial cardiac arrhythmias
What are the two categories of calcium channel blockers?
- dihydropyridines
- non-dihydropyridines
Which class of calcium channel blockers is this:
- potent vasodilators
- little or no negative effect upon cardiac contractility or conduction
- primarily used for treatment of HTN
dihydropyridines
Which class of calcium channel blockers is this:
- less potent vasodilators
- have a greater depressive effect on cardiac conduction and contractility
- used for treatment of chronic stable angina, cardiac arrhythmias, and proteinuria reduction
non-dihydropyridines
What are the adverse effects for dihydropyridines?
- HA
- lightheadedness
- flushing
- peripheral edema
What are the adverse effects of nondihydropyridines
- constipation
- bradycardia
- heart failure/block
Which type of anti-hypertensive is much more effective in the older and black patients?
calcium channel blockers
These medications are an example of what type of calcium channel blocker?
- nifefipine
- felodipine
- nicardipine
- amlodipine
dihydropyridines
What type of calcium channel blockers are these medications?
- verapamil
- diltiazem
non-dihydropyridines
Which anti-hypertension class is defined by this action: -compete with adrenergic neurotransmitters for adrenergic receptor sites
beta blockers
Which anti-hypertensive medication is used for:
- management of hypertension
- angina pectoris
- tachyarrhythmia
- hypertrophic subaortic stenosis
- migraine headache
- CHF
beta blockers
What are the adverse effects of beta blockers?
- orthostatic hypotension
- bradycardia
- bronchospasm
Which class of anti-hypertension medications are these:
- metoprolol
- propanolol
beta blockers
What are the 5 classes of diuretics?
- carbonic anhydrase inhibitor
- loop diuretics
- osmotic diuretics
- potassium sparing
- thiazide
Which class of diuretics is defined by this action? - inhibit the action of carbonic anhydrase which leads to the excretion of sodium, potassium, bicarbonate, and water
carbonic anhydrase inhibitor
Which class of diuretics is defined by this action? - increase excretion of sodium and chloride by inhibiting the re-absorption of these ions in the distal proximal tubules and the loop of henle.
loop diuretics
Which class of diuretics is defined by this action? -Increase the density of the filtrate in the glomerulus; prevents re-absorption of water. Salt and chloride follow water.
osmotic diuretics
Which class of diuretics is defined by this action? -Decreases the re-absorption of sodium and water in the kidney and increase potassium retention.
Potassium sparing
Which class of diuretics is defined by this action? -Inhibit re-absorption of sodium and chloride ions in the kidney
Thiazide
What are the uses of diuretics?
- open angle glacoma
- edema due to CHF, cirrhosis of the liver or renal disease
- hypertension
What are the adverse effects of diuretics?
- fluid and electrolyte imbalance
- hypertension
- arrhythmias
Which class of diuretics is this medication?
-acetazolamide
What is it used for?
Carbonic anhydrase inhibitor
-used for the management of idiopathic intracranial hypertension and elevated pressure (glaucoma)
Which class of diuretics is this medication?
-furosemide (lasix)
-Bumetanide
What is it used for?
Loop diuretics
-Management of edema associated with CHF, cirrhosis of the liver, or renal disease
Which class of diuretics is this medication?
-mannitol
What is it used for?
Osmotic diuretics
-used for the management of elevated intracranial pressure and cerebral edema
Which class of diuretics is this medication?
-spironolactone
What is it used for?
Potassium sparing
-used as additional therapy for hypertension
Which class of diuretics is this medication?
-hydrochlorothiazide
-chlorthalidone
What is it used for?
Thiazide
-one of the first line indications for managing hypertension in the absense of any contraindication
What is the preferred medication to use whenever a thiazide diuretic is used?
chlorthalidone
What is a fat like substance in the blood?
Lipid
What are the two types of lipids?
- cholesterol
- triglycerides
What does LDL and HDL stand for?
- low density lipoprotein
- high density lipoprotein
What are the 3 types of hyperlipidemias?
- HMG-CoA (statins)
- bile acid seqeustrates
- fenofibrate (tricor)
Which class of antihyperlipemia is defined by this action: -inhibit an enzyme involved in cholesterol synthesis
Statins
Which class of antihyperlipemia is defined by this action: - bind cholesterol in the GI tract
bile acid sequestrates
Which class of antihyperlipemia is defined by this action: -reduces VLDL and stimulates the catabolism of triglyeriderich lipoproteins, which results in the decrease in plasma triglycerides and cholesterol
fenofibrate
What are adverse effects of hyperlipedemias?
- constipation
- abdominal cramps
- nausea
- rhabdomyolysis
- liver dysfunction
Which initial labs should you get before starting your patient on antihyperlipidemias?
- LFT
- lipid panel
- chemistry
Which antihyperlipedemias medications are statins?
- atorvastatin
- simvastatin
Which class of hyperlipedemias are these medications?
- cholestyramine
- colestipol
- colesevelam
bile acid sequestrates
Which class of medication is defined by this action: -neutralize or reduce the acidity of the stomach and duodenal contents by combining with hydrochloric acid and producing salt and water?
antacids
Aluminum and calcium containing antacid products tend to produce?
constipation
Antacids that contain _____ have these adverse reactions:
- constipation
- intestinal impaction
- anorexia
- weakness
- tremors
- bone pain
aluminum
Antacids that contain _____ have these adverse reactions:
- severe diarrhea
- dehydration
- hypermagnesemia
magnesium
Antacids that contain _____ have these adverse reactions:
- rebound hyperacidity
- metabolic alkalosis
- hypercalcemia
- vomiting
- confusion
- neurologic impairment
calcium
Which type of antacid has an adverse effect of systemic alkalosis, rebound hypersecretion
sodium bicarbonate
These medications are examples of what type of medications:
- aluminum hydroxide gel
- magnesium hydroxide (milk of magnesia)
- calcium carbonate
- calcium carbonate/magnesium hydroxide
- sodium citrate/citric acid
antacids
Which medications class is defined as: -inhibit the actions of histamine at histamine H2 receptor cells of the stomach, which then reduces the secretion of gastric acid
Histamine H2 antagonist
These medications are what class of medication
- cimetidine
- famotidine
- ranitidine
Histamine H2 Antagonist
Which class of medications if defined by this action: - suppress gastric acid secretion by blocking the final step in the production of gastric acid be the gastric mucosa
proton pump inhibitors
Which type of antacid is used for:
- GERD
- pathological hyper-secretory conditions
- erosive esophagitis
- ulcers with H. pylori
Proton pump inhibitors
These medications are what class of medications:
- esomeprazole
- omeprazole
- pantoprazole
- rebeprazole
- lansoprazole
-proton pump inhibitor
Which class of medication is defined as this action: -decrease intestinal peristalsis
anti-diarrheal
You should not use anti-diarrheal medications in diarrhea associated with organisms?
- E coli
- salmonella
- shigella
Loperamide is an example of what class of medications?
anti-diarrheal
Which class of medication is defined by this action: -disperses and prevents the formation of mucus-surrounded gas pockets in the intestine
antiflatulents
Simethicone is what class of medication
antiflatuents
What are the 6 types of laxatives?
- bulk producing
- emollient
- fecal softeners
- hyperosmolar
- irritant or stimulant
- saline
Which type of laxative is defined by the action:
-not digested by the body and therefore adds bulk and water to the contents of the intestines. The added bulk in the intestines stimulates peristalsis.
bulk producing
Which type of laxative is defined by the action:
-lubricate the intestinal walls and soften the stool, enhancing passage of fecal material
emollient
Which type of laxative is defined by the action:
-promote water retention in the fecal mass and soften the stool
fecal softners
Which type of laxative is defined by the action:
-dehydrate local tissue, causes irritation and increase peristalsis
hyperosmolar
Which type of laxative is defined by the action:
- increase peristalsis by direct action on the intestine
irritant or stimulant
Which type of laxative is defined by the action:
-attract or pull water into the intestine, thereby increasing pressure in the intestine followed by an increase in peristalsis
saline
These medications are which type of laxative?
- psyllium metamucil
- methylcellulose
- polycarbophil
- wheat dextrin
bulk forming
These medications are which type of laxative?
-mineral oil (enema)
emollient
These medications are which type of laxative?
-docusate sodium (colace)
fecal softner
These medications are which type of laxative?
- glycerin
- polyethylene glycol (PEG): GoLYTELEY, miraLAX
- lactulose
- sorbitol
hyperosmolar
These medications are which type of laxative?
- bisacodyl (dulcolax)
- senna
irritant or stimulant
These medications are which type of laxative?
- magnesium citrate
- milk of magnesia
saline
Excessive or prolonged use of hemorrhoid agents may lead to?
atrophy of the tissues
These medications are examples of what class?
- hydrocortisone
- cortifoam 10%
- proctocream HC 2.5%
- pramzine
- tux pads
hemorrhoid agents
What stimulates peripheral glucose uptake and stimulates the synthesis of glycogen by the liver
insulin
What promotes protein synthesis and helps the body store fat by preventing its breakdown for energy?
insulin
What are the 5 types of anti diabetics?
- sulfonylureas
- biguanides
- glucosidase inhibitors
- meglitinides
- thiazolidinediones
What type of anti-diabetic class is defined by this action: -lower blood glucose by stimulating beta cells of the pancreas to make more insulin
sulfonylureas
What type of anti-diabetic class is defined by this action: -reduces hepatic glucose production and increases insulin sensitivity in muscle and fat cells
biguanides
What type of anti-diabetic class is defined by this action: -lower blood sugar by delaying digestion of carbs and absorption
-glucosidase inhibitors
What type of anti-diabetic class is defined by this action: - stimulates release of insulin
meglitinides
What type of anti-diabetic class is defined by this action: -decrease insulin resistance and increase insulin sensitivity
thiazolidinediones
Which anti-diabetic class may result in lactic acidosis, especially in patients with renal impairment?
biguanides
Which anti-diabetic class can cause or exacerbate CHF?
thiazolidinediones
Which anti-diabetic class is not recommended in patients who have an allergy to sulfonamides?
sulfonylureas
Which type of anti-diabetic is this medication?
-glyburide
sulfonylureas
Which anti-diabetic class is this medication? -metformin
biguanides
Which anti-diabetic class is this medication? -pioglitazone
thiazolidinediones
Which hormones are principally concerned with increasing the metabolic rate of tissue and, influence every organ and tissue in the body?
thyroid hormones
Myocardial infarction and thyrotoxicosis are contraindications of what class of medication?
thyroid medications
What is the medication used for thyroid hormones?
levothyroxine (synthroid)
Which hormone aids in the development and maintenance of secondary sex characteristics?
-male hormones
What are class is used for:
- replacement therapy for testosterone deficiency
- breast cancer in females
- delayed puberty in males
male hormones
What are the adverse reactions of male hormones?
- breast enlargement in males
- testicular atrophy
- inhibition of testicular function
- cardiovascular conditions
- impotence
What medication is an example of male hormones?
-methyltestosterone
Estrogen is secreted by the?
ovarian follicle
Which hormone is important in the development and maintenance of the female reproductive system and actions include:
- protein anabolism
- thinning of the cervical mucus
- inhibitions of ovulation
estrogens
Progestin is secreted by?
- corpus luteum
- placenta
- adrenal cortex
Which hormone is necessary for the development of placenta and inhibit the secretion of pituitary gonadotropins, which prevents maturation of the ovarian follicle and ovulation?
progestin
Which type of oral contraceptives are:
- norethindrone
- drospirenone
- levonorgestrel
Progestin only pills
POPs
What is the emergency contraceptive?
levonorgestrel
What is the single dose regimen of levonorgestrel?
-one 1.5 mg tablet taken ASAP/within 72 hours
What is the two dose regimen of levonorgestrel?
- one .75 mg tablet taken ASAP/within 72 hours
- a second .75 mg dose taken 12 hours after the first dose
What are the types of combined estrogen-progestin oral contraceptives (COC)?
- monophasic
- biphasic
- triphasic
Which type of COC is defined as:
fixed dose of estrogen and progestin throughout the cycle
monophasic
Which type of COC is defined as:
deliver hormones similar to the levels naturally produces by the body to provide lower doses with the same degree of effectiveness
-biphasic and triphasic
Which type of oral contraceptive has adverse reactions such as:
- headaches
- venous thromboembolism
COC
What is defined as:
requires oxygen to survive
aerobic
What is defined as:
able to live without oxygen
anaerobic
What is defined as:
drugs that slow or retard the multiplication of bacteria
bactericidal
What is defined as:
-drugs that kill bacteria
bacteriostatic
What is defined as:
-drugs effective against both gram negative and gram positive bacteria
broad spectrum
What is defined as:
-non-pathogenic microorganisms within or on the body
normal flora
What is defined as:
an overgrowth of bacteria or fungal microorganisms not affected by the antibiotic being used for treatment
superinfection
The effectiveness of the individual antibiotics depends on what factors?
- location of infection
- ability of the antibiotic to reach the site of infection
- ability of the bacteria to resist or inactivate the antibiotic
Which class of antibiotics is defined by this action: -primarily bacteriostatic caused by sulfonamide antagonism to para-aminobenzoic acid. Once the bacteria multipication is slowed the body's immune system is able to rid the bacteria.
sulfonamides
Which type of antibiotic is used to treat:
- UTI caused by E. Coli
- staphlyococcus aureus (including methicillin-resistant)
- kelbsiella enterobacter
sulfonamides
Which type of antibiotic should not be used in patients with G6PD?
Sulfonamides
These medications are an example of what class of antibiotic?
- celecoxib
- glyburide
- furosemide
- acetazolamide
sulfonamides
Silver sulfadiazine is topical and used to treat? what class of antibiotic?
- burns
- sulfonamides
Trimethoprim/sulfamethoxazole (bactrim) is what class of antibiotic?
sulfonamides
Which class of antibiotics is defined by this action: -prevent bacteria from using a substance that is necessary for the maintenance of the bacteria's outer wall
Penicillins
Which class of antibiotic is used for:
- anthrax
- septicemia
- meningitis
- intra-abdominal infections
- gonorrhea
- syphilis
- pneumonia
- cellulitis
- otitis media
- acute sinusitis
- strep
penicillin
What class of antibiotic are these medications:
- Amoxicillin
- Amoxicillin/clavulanate (augmentin)
- Pen VK
penicillin
Which class of antibiotic is defined by this action: -affect the bacterial cell wall, making it defective and unstable. similar to the action of PCN
cephalosporins
Which class of antibiotic is structurally and chemically related to PCN but will work on bacteria that has become resistant to PCN?
cephalosporins
Which class of antibiotic is used for:
- streptococci
- staphylococci
- citrobacter
- gonococci
- shigella
- clostridia
cephalosporins
Cehphalexin is what generation of cephalosporins?
1st generation
How many generations of cephalosporins are there?
5
Concerning cephalosporins, progression from the 1st generation to later generations show an increase coverage of?
gram negative microorganisms
Which class of antibiotic is defined by this action: -inhibit bacterial protein synthesis, which is necessary for reproduction
tetracyclines
What class of antibiotic is used for:
- acne
- rickettsia
- malaria
- chlamydia trachomatis
tetracyclines
Which tetracycline is used for the treatment of chlamydia?
doxycycline
Which class of antibiotic should not be given to children under 9, as it may cause permanent discoloration of the teeth?
tetracyclines
What are the 3 types of tetracycline medications?
- doxycycline
- tetracycline
- minocycline
Which class of antibiotic is defined by this action: -bind to cell membrane and cause changes in protein synthesis
macrolides
Which class of antibiotic is used for:
- community acquired pneumonia
- skin infections
- otitis media
- alternate to PCN for strep throat
- mycoplasma pneumonia
- chlamydia
- H. pylori
macrolides
Which macrolide is the 1st line therapy for chlamydia?
azithromycin
What is the treatment for H. pylori?
-Clarithromycin in combination with amoxicillin and a PPI
What class of antibiotics are these medications:
- azithromycin
- erythromycin
- clarithromycin
- teithromycin
macrolides
Which class of antibiotic is defined by this action: -exert their bactericidal effect by interfering with an enzyme needed by bacteria for synthesis of DNA. This interference prevents cell reproduction, leading to death of bacteria
fluoroquinolones
Which class of antibiotic is used for:
- lower respiratory infection (bronchitis)
- atypical pneumonia
- UTI
- acute pyelonephritis
- diverticulitus
- STDs (not 1st line)
fluoroquinolones
Which class of antibiotic has adverse reactions such as:
- tendinitis
- tendon rupture
- peripheral neuropathy
fluoroquinolones
Which class of antibiotic have these contraindications:
- children younger than 18
- history of seizures
- history of heat arrhythmias
fluoroquinolones
These medications are examples of what class of antibiotic:
- ciprofloxacin
- levofloxacin
fluoroquinolones
Which class of antibiotic is defined by this action: -exert their bactericidal effect by blocking a step in a protein synthesis necessary for multiplication. They disrupt the functional ability of the bacterial cell membrane, causing cell death.
aminoglycosides
What class of antibiotic is used for:
- bacterial menigitis in combo with PCN or ampicillin
- complicated UTIs
- usually used in a hospital setting
- primarily gram negative use
aminoglycosides
What are the adverse reactions of aminoglycosides?
- nephrotoxicity
- ototoxicity
- neurotoxicity
Pre-existing hearing loss is a contraindication in what class of antibiotic?
aminoglycosides
What class of antibiotic are these medications:
- gentamycin
- neomycin
aminoglycosides
Which class of antibiotic is defined by this action: -inhibits bacterial cell wall synthesis by binding to several of the penicillin binding proteins, which in turn inhibit the final step in the cell wall synthesis
carbapenems
What are enzymes that confer resistance to most beta-lactam antibiotics?
Extended spectrum beta-lactamses (ESBL)
What are: enzymes that open the beta-lactam ring, inactivating the antibiotic?
beta-lactmases
Which class of antibiotic is used for:
- severe infections with drug resistant organisms
- hospital acquired pneumonia
- meningitis
- prosthetic joint infection
- necrotizing soft tissue infections
- pyelonephritis
carbapenems
Which class of antibiotic has adverse reactions such as:
- anemia
- seizure
- renal failure
- C. Diff
carbapenems
These medications are examples of what class of antibiotics?
- imipenem
- meropenem
- ertapenem
carbapenems
What class of antibacterial drug inhibits protein synthesis and causes cell death; is used for anaerobic bacterial infections, gynecologic infections (bacterial vaginosis, trichomoniasis), intra-abdominal infections, skin infections, and antiprotozoal therapies?
amebicide, antiprotozial, and nitroimidazole
These medications are examples of what class of antibiotic?
- metroniadazole (flagyl)
- tinidazole
- nimorazole
- dimetridazole
amebicide, antiprotozial, and nitroimidazole
Which class of antibiotic is defined by this action:
- disrupts protein synthesis and causes changes in teh cell wall surface, which decrease adherence of bacteria to host cells and increases intracellular killing of organisms
- exerts an extended post-antibiotic effect against some strains
lincosamide
Which class of antibiotic is used for:
- MRSA
- purulent cellulitis or abscess (peritonsilar abscess)
- toxic shock syndrome
- bite wounds
lincosamide
These medications are examples of what class of antibiotic?
- clindamycin
- lincomycin
What class of drug is used for:
- herpes
- influenza A/B
- chronic Hep c
- HIV
anti virals
These medications are examples of what class of drug?
- acyclovir
- vancyclovir
- penciclovir
- oseltamivir
anti viral
What is a colorless plant that lacks chlorophyll?
fungus
Infections from fungus are called?
mycotic infections
What type of drug is used for:
- tinea pedis
- tinea cruris
- tinea corporis
- onychomycosis
antifungals
The absorption of ketozonazole is impaired when the drug is taken with?
- histamine antagonist
- antacids
These medications are examples of what class of drug?
-clotrimazole
-tolnaftate
are they topical or systemic?
- anti-fungal
- topical
These medications are examples of what class of drug? -ketoconazole -fluconazole -terbinafine Are they topical or are they systemic?
- anti-fungal
- systemic
Which class of medication is defined by these uses:
- various acute and painful musculoskeletal conditions
- back pain
- neck pain
- lumbar muscle spasms
muscle relaxers
What is the most common reaction of muscle relaxers?
drowsiness
These medications are examples of what class of medication?
- cyclobenzaprine
- methocarbamol
- metaxalone
- diazepam
- baclofen
muscle relaxers
Which class of medication is described by this action:
- these hormones are secreted from the adrenal cortex
- the potent anti-inflammatory action makes these drugs useful in the treatment of many types of inflammatory and autoimmune disorders
corticosteriods
What class of medications is used for:
- rheumatic disorders
- arthritis
- bursitis
- allergic reactions
- COPD/ asthma exacerbation
- SLE and other autoimmune disorders
corticosteriods
Which class of medications may cause these adverse reactions with long term use?
signs and sx of cushing syndrome such as
-a buffalo hump
-moon face
-oily skin
-acne
corticosteriods
These medications are examples of what type of drug class?
- prednisone
- hydrocortisone
- triamcinolone
- methylpresnisolone
- dexamethasone
corticosteriods
Which class of medication is defined by this action:
- acts on intracranial blood vessels and sensory nerves of the trigeminal system
- causes vasoconstriction and reduces neurogenic inflammation
anitmigraine
These medications are examples of what type of drug?
- rizatriptan
- sumatriptan
antimigraine
Which class of medication is defined by this action? -inhibits sodium ion influx through nerve cells remembrance channels in parasites resulting in delayed repolarization and thus paralysis and death of the pest
scabicide
This medication is an example of what class of drug? -permethrin
scabicide
What are the three actions of topical anti-infective class drugs
- antibiotic
- antifungal
- antiviral
These medications are an example of what type of anti-infective?
- bacitracin
- mupirocin
antibiotic
These medications are an example of what type of anti-infective?
- clotrimazole
- ketoconazole
- miconazole
anti-fungal
These medications are an example of what type of anti-infective?
- acyclovir
- penciclovir
antivirals
Which antiseptic affects a wide range of microorganisms, including both gram positive and gram negative?
chlorhexidine gluconate
What is often preferred over iodine solution or tincture because it is less irritating to the skin?
povidone-iodine
These medications are examples of what class of drug?
- chlorhexidine gluconate
- povidone-iodine
antiseptics/germicides
What class of medication is defined by this action:
- exert localized anti-inflammatory activity
- reduce itching, redness, swelling
topical corticosteriods
What class of medications is used for:
- psoriasis
- dermatitis
- rashes
- eczema
- insect bite reactions
- first/second degree burns
- sunburns
topical corticosteriods
These medications are examples of which type of drug
- hyrdocortisone 1%
- triamcinoline 0.1%
topical corticosteriods
What class of medication is defined by this action: -removes excess growth of the epidermis disorders such as warts
keratolytic
What type of medication is used for:
- removal of warts
- calluses
- corns
- seborrheic keratoses
keratolytic
What are the contraindications of keratolytic medications?
- use on moles, birthmarks, warts with hair growth
- use on genital or facial warts
- mucous membranes
- infected skin
These medications are examples of what class of drug:
- podofilox 0.5%
- salicylic acid gel 17%
keratolytic
