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Pharmacy > 8.4 Pharmacological Profile > Flashcards

8.4 Pharmacological Profile Flashcards

1
Q

What’s the action of long acting barbiturates?

A
  • sedative
  • hypnotic
  • anti convulsant properties
  • depress sensory cortex
  • decrease motor activity
  • altar cerebellar function
  • produce drowsiness
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2
Q

What are the subdivisions of anti anxiety drugs?

A
  • Benzodiazepines (short term only)

- non- benzodiazepines

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3
Q

What are the classes of antidepressants?

A
  • Tricyclic (TCAs)
  • Monoamine Oxidase Inhibitors (MAOI)
  • Selective Serotonin Reuptake (SSRI)
  • Serotonin-norepinephrine (SNRI)
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4
Q

What are the actions of TCA?

A

Increase levels of norepinephrine and serotonin by inhibiting their reuptake and blocking the action of acetylcholine

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5
Q

What is the action of MAOI?

A

inhibits the activity of monoamine oxidase resulting in increased endogenous neuro-hormones

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6
Q

What is the action of SSRI?

A

Increase serotonin by inhibiting neuronal uptake to CNS

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7
Q

When shouldn’t you give TCA’s

A
  • hypersensitivity to formulation
  • within 14 days of MAOI’s administration
  • acute recovery from MI
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8
Q

What receptors do Antipsychotics block?

A
  • dopamine receptors in the brain
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9
Q

Use of Stimulants

A

Treatment of narcolepsy and as adjunctive treatment in the management of ADHD

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10
Q

Examples of Anticonvulsives

A
  • Diazepam
  • Lorazepam
  • Midazolam
  • Clonazepam
    • Phenytoin
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11
Q

What medication acts as an antiemetic mainly by diminishing motion sickness?

A

Meclizine

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12
Q

Examples of Antiemetics

A
  • Prochlorperazine
  • Chlorpromazine
  • Metoclopramide
  • Ondansetron
  • Prochlorperazine
  • Promethazine
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13
Q

Examples of Antivertigo medications

A
  • Meclizine
  • Diphenhydramine
  • Benzodiazepines
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14
Q

What is the action of Local Anesthetics?

A

Inhibits transport of ions across neuronal membranes, thereby preventing initiation and conduction of normal nerve impulses

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15
Q

Action of Ketamine

A

Non competitive antagonist of glutamate, causing neuro-inhibition and anesthesia where the patient is dissociated form the surrounding

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16
Q

Examples of Local Anesthesia

A
  • lidocaine

- bupivacaine

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17
Q

Example of general anesthesia

A

ketamine

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18
Q

What are the classes of analgesics

A
  • salicylate
  • non- salicylate
  • NSAID
  • urinary analgesics
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19
Q

Action of salicylates

A
  • dilates peripheral blood vessels (cools body)

- prolongs bleeding by inhibiting aggregation of platelets

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20
Q

Uses of salicylates

A
  • relief of mild to moderate pain
  • reduction of body temp
  • inflammatory conditions
  • decreases risk of MI
  • prevention and treatment of blood clots
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21
Q

Contraindications of salicylates

A
  • pregnancy

- bleeding disorders

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22
Q

Examples of salicylates

A

ASA

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23
Q

Adverse effects of non salicylates

A
  • severe hepatic impairment or severe active liver disease
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24
Q

Contraindications of non salicylate

A
  • Hepatoxicity: acute liver failure

- do not exceed 4g daily

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25
Q

Patient management of non-salicylate

A
  • can be administered w/o food
  • safe for pregnancy
  • asses alcohol use
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26
Q

Examples of non salicylates

A
  • acetaminophen

- benzocaine- menthol

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27
Q

Action of NSAIDs

A

Inhibit COX-1 and COX-2 (non selective) or Cox-2 (selective) which is responsible for prostaglandin synthesis

  • anti-inflammatory
  • analgesic
  • antipyretic
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28
Q

Adverse effects of NSAIDs

A
  • Nausea, vomiting

- increase risk of heart attack or stroke

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29
Q

Contraindication for Celecoxib

A

Sulfa allergy

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30
Q

Contraindication for Ibuprofen

A
  • peptic ulcer
  • GI bleed
  • HTN
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31
Q

When should you stop NSAIDS?

A
  • prolonged bleeding

- dark stools

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32
Q

Examples of NSAIDs

A
  • Ibuprofen
  • Ketorolac
  • Naproxen
  • Celecoxib
  • Meloxicam
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33
Q

Examples of COX2 inhibitor NSAIDS

A
  • celecoxib

- meloxicam

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34
Q

Action of narcotic analgesics

A

Bind to opiate receptors in the CNS where they act as agonists of endogenously occurring opioid peptides. The result is alteration to perception of and response to pain

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35
Q

Use of Narcotic analgesics

A

short term management of moderate to severe pain

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36
Q

Adverse effects of narcotic analgesics

A
  • constipation

- respiratory depression

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37
Q

When shouldn’t you give narcotic analgesics

A
  • head injury

- ICP

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38
Q

Patient management of narcotic analgesics

A
  • avoid use of narcotics and benzodiazepines or other CNS depressants when possible
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39
Q

Examples of narcotic analgesics

A
  • codeine
  • fentanyl
  • morphine
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40
Q

Action of Naloxone

A
  • competitive antagonist that bind to the opioid receptors with higher affinity than agonist but does not activate the receptor.
  • This effectively blocks the receptor, preventing the body from responding to opiates and endorphins
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41
Q

Withdrawal sx of opioids

A

pain, tachycardia, HTN, fever, sweating, abdominal cramps, diarrhea, nausea, vomiting, agitation and irritability

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42
Q

Contraindications for naloxone

A
  • hypersensitivity to naloxone
  • CAD
  • pregnant women
  • opioid dependent patients
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43
Q

How do H1 antihistamines work?

A

binds to histamine H1 receptors in mast cells

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44
Q

What is the difference between 1st and 2nd generation antihistamines

A
  • 1st generation has more side effects such as drowsiness

- 2nd generation has few CNS side effects

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45
Q

Use of H1 antihistamines

A
  • treat allergic reactions
  • insomnia
  • motion sickness
  • vertigo
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46
Q

Use of H2 antihistamines

A
  • binds to H2 receptors in upper GI tract
  • treats gastric acid conditions
  • some relief of Parkinson-like reaction
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47
Q

Contraindications/warnings of antihistamine

A
  • pregnancy

- counseled on operating heavy machinery

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48
Q

Examples of 1st generation antihistamine

A
  • diphenhydramine
  • hydroxyzine
  • promethazine
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49
Q

Examples of 2nd generation antihistamine

A
  • cetirizine
  • fexofenadine
  • loratadine
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50
Q

How do decongestants work?

A

Induces vasoconstriction of the blood vessels in the nose, throat and paranasal sinuses

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51
Q

Active ingredients in decongestants

A
  • pseudoephedrine

- phenylephrine

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52
Q

What adverse effect can decongestants cause due to vasoconstriction

A
  • HTN

- paired with antihistamines, may lessen effect but do not cancel each other out

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53
Q

Contraindications/ warnings of decongestants

A
  • not recommended for pregnancy

- over use of topical can cause rebound nasal congestion

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54
Q

Examples of decongestants

A
  • oxymetazoline (afrin, don’t use for more than 3 days)
  • pseudoephedrine
  • phenylephrine
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55
Q

Action of beta2 agonist (bronco dilators)

A

Beta2 receptors are in bronchial smooth muscle and when stimulated cause relaxation (dilation) of bronchioles

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56
Q

What can beta2 agonists be used for?

A

Reversible air way obstruction caused by:

  • bronchial asthma
  • exercise induced bronchospasm
  • emphysema
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57
Q

Excessive use of beta2 agonists may cause what?

A
  • excessive use may result in paradoxical bronchospasm

- tachycardia

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58
Q

Contraindication/ Caution/ Warnings of beta2 agonists

A
  • cardiac arrhythmias
  • beta blockers my inhibit the effect of beta2 agonists
  • caution with DM, may cause increase blood glucose
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59
Q

Patient management of beta2 agonists

A

Provide a spacer and face mask

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60
Q

muscarinic antagonists relieve sx and manage what?

A
  • Relief of bronchial asthma

- management of COPD

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61
Q

Adverse effects of anticholinergic

A
  • Red as a beet (flushed face/sleepy)
  • blind as bat (blurred vision)
  • stuffed as a pipe (stuffed as a pipe)
  • mad as a hatter (confusion)
  • Hot as a hare (increased HR/body temp)
  • Dry as bone (dry mouth)
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62
Q

Contraindication/warning of muscarinic antagonist/anticholinergics

A
  • arrhythmias

- use in pregnancy if potential benefit outweighs risk

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63
Q

Examples of muscarinic antagonist/anticholinergics

A
  • ipratropium

- tiotropium

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64
Q

What is Leukotriene?

What does a leukotriene antgonist result in?

A
  • Leukotriene is a broncho constrictive substance released by body during inflammation
  • Antagonist results in bronchodilation
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65
Q

Mast cell stabilizer stop the release of a substance that causes what in the respiratory tract?

A
  • bronchoconstriction

- inflammation

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66
Q

What conditions do Leukotriene Antagonist and Mast Cell stabilizer treat?

A
  • treatment of asthma

- treatment of COPD

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67
Q

Contraindication/warning/caution of leukotriene antagonist and mast cell stabilizer

A
  • acute asthma/bronchospasms

- ASA sensitive asthmatics

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68
Q

Action of Inhaled Corticosteroids

A
  • suppressing inflammation

- decrease inflammatory process in the air way through inhibiting multiple different inflammatory cytokines

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69
Q

What is a common condition caused from inhaled corticosteroids?
How do you prevent it?

A
  • Candida Albicans (yeast infection)

- patient should rinse mouth with water after using inhaler

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70
Q

Contraindication of inhaled corticosteroids

A

caution with compromised immune system

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71
Q

Action of antitussives

A
  • central acting: depresses cough center

- peripheral acting: anesthetize stretch receptors

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72
Q

What does an antitussive do?

A

relieves non productive cough

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73
Q

Adverse effects of codeine

A
  • respiratory depression
  • euphoria
  • sedation
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74
Q

Contraindication/warnings/caution of antitussives

A
  • persistent cough (greater than 2 weeks)

- codeine with respiratory disorders

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75
Q

Examples of Antitussives

A
  • benzonatate

- codeine sulfate

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76
Q

Action of mucolytic

A
  • loosens and mobilize thick mucus from respiratory system
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77
Q

How does an expectorant work?

A

reduces viscosity of tenacious secretions by increasing respiratory tract fluid

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78
Q

Contraindications of mucolytic and expectorants

A

persist cough

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79
Q

Example of expectorant

A

guaifenesin

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80
Q

How do antiarrhythmics work?

A

Decrease symptomatology, increases hemo-dynamic performance

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81
Q

Action of Class 1 Antiarrhythmic

A

depresses myocardial excitability to electrical stimuli thus decreasing pulse rate

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82
Q

Action of Class 2 Antiarrhythmic

A

Beta blockers block stimulation of beta receptors of the heart

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83
Q 
How does Amiodarine affect the heart?
What class antiarrhythmic is it?
A
  • Amiodarone blocks potassium channels in the heart.
  • This is used for ventricular dysrhythmias and atrial fibrillation
  • Class 3 antiarrhythmic
84
Q

Action of Class 4 Antiarrhythmic

A

Verapamil blocks calcium channels which are critical in the production of muscle contraction and electrical conduction

85
Q

Use of antiarrhythmics

A

treats cardiac arrhythmias

86
Q

Examples of antiarrhythmic

A
  • lidocaine
  • amiodarone
  • metoprolol
87
Q

Action of nitrates

A

Direct relaxing effect on smooth muscle of blood vessels

88
Q

Contraindications/warning of nitrates

A

postural hypotension

89
Q

When should you not give nitrates

A
  • BP below 100 systolic, do not give

- do not use with dick meds

90
Q

Examples of nitrates

A

Nitroglycerin

91
Q

HTN guidelines

A 
Normal: 120/80
Elevated: 120-129/80
Stage 1: 130-139/80-89
Stage 2: 140/90
Higher value between systolic and diastolic determines the stage
92
Q

Step care regimen for HTN

A
  • Step 1: Life Style Changes
  • Step 2: Use of thiazide diuretic
  • Step 3: Increase dose of drugs or combine 2
  • Step 4: combine 2-3 of step 3
93
Q

Which medication is used to control 80% of patients with HTN

94
Q

How do Ace Inhibitors/ARBs lower blood pressure?

A
  • by dilating or increasing the size of the arterial blood vessels
95
Q

Adverse effects of Ace Inhibitors

A
  • postural or orthostatic hypotension
  • Angioedema in african american patients
  • dry, hacking cough in 5-20% of patients
96
Q

Examples of ace inhibitors

A
  • lisinopril
  • captopril
  • enalapril
  • ramipril
97
Q

Examples of ARB

A
  • losartan

- telmisartan

98
Q

Action of calcium channel blocker

A

act by causing peripheral vasodilation

99
Q

What are the 2 types of calcium channel blockers

A
  • Dihydropyridines

- Non-dihydropyridines

100
Q

Use of dihydropyridines

A
  • potent vasodilators that have little or no negative effect upon cardiac contractility or conduction
  • primarily for HTN
101
Q

Use of non-dihydropyridines

A

-less potent vasodilators but have a greater depressive effect on cardiac conduction and contractility

102
Q

Patient management of calcium channel blockers

A
  • much more effective in older and in black patients with HTN
103
Q

Use of beta blocker

A
  • HTN

- angina pectoris

104
Q

Should you stop beta blockers abruptly

A

Absolutely not

105
Q

Examples of beta blockers

A

Ends in (-olol)

  • metoprolol
  • propranolol
  • atenolol
106
Q

When should diuretics be administered?

How often will patient need to void?

A
  • administer early in the day to prevent nocturnal diuresis

- need to void often the first few weeks

107
Q

Contraindications/warning of diuretics

A
  • sulfa allergy
  • kidney disease
  • electrolyte imbalance
108
Q

Examples of loop diuretics

A
  • Furosemide
109
Q

Examples of thiazide diuretics

A
  • HCTZ

- chlorthalidone

110
Q

Most commonly prescribed antihyperlipidemics

111
Q

How do antihyperlipidemics work?

A

Reduction of blood lipids

112
Q

Labs for patients on anti hyperlipidemics

A
  • LFT
  • Lipid Panel
  • Chemistry
113
Q

Examples of statins

A
  • atorvastatin

- simvastatin

114
Q

Action of antacids

A
  • neutralize or reduce acidity
115
Q

Adverse reactions of antacids

A
  • laxative effect and produce diarrhea
116
Q

Contraindications/ warning of antacids

A
  • Sodium Containing: Patients with cardiovascular problems such as HTN or CHF
117
Q

Examples of antacids

A
  • aluminum hydroxide gel
  • magnesium hydroxide
  • calcium carbonate
118
Q

H2 receptors are located where?

How do H2 antagonists affect the body?

A
  • H2 receptor cells are in stomach

- reduces secretion of gastric acid

119
Q

H2 antagonist treats what conditions

A

gastric and duodenal ulcers

120
Q

Examples of H2 antagonists

A
  • Cimetidine
  • Famotidine
  • Ranitidine
121
Q

Action of proton pump inhibitors

A
  • blocks final step in production of gastric acid
122
Q

Uses of proton pump inhibitors

A
  • GERD
  • heart
  • Ulcers w/ H pylori
123
Q

How are proton pump inhibitors administered?

A

30-60 minutes before a meal

before breakfast and before dinner

124
Q

proton pump inhibitors has a risk of causing what condition

A
  • risk of osteoporosis resulting from high dose
125
Q

Examples of proton pump inhibitors

A
  • esomeprazole
  • omeprazole
  • pantoprazole
126
Q

Action of anti diarrheal

A

decrease intestinal peristalsis which is usually increased with diarrhea

127
Q

Examples of antidiarrheal

A
  • loperamide
128
Q

Action of anti-flatulents

A

defoaming action disperses and prevents formation of mucus surrounded gas pockets in intestine

129
Q

What do anti-flatulents help relieve?

A
  • excess gas
130
Q

examples of anti-flatulents

A

Simethicone

131
Q

Adverse reactions of laxatives

A

obstruction of esophagus, stomach, small intestine and colon may occur

132
Q

Examples of bulk forming laxatives

A
  • psyllium

- methylcellulose

133
Q

Examples of emollient laxatives

A
  • mineral oil (enema)
134
Q

Examples of fecal softener

A

Docusate calcium

135
Q

Examples of hyperosmolar

A
  • glycerin

- polyethylene glycol

136
Q

Example of Irritant or stimulant laxative

A
  • Bisacodyl

- senna

137
Q

examples of saline laxative

A

magnesium citrate

138
Q

Adverse effect of hemorrhoid agents

A
  • may lead to atrophy of affected tissues
139
Q

Examples of hemorrhoid agents

A
  • hydrocortisone

- proctocream

140
Q

Use of insulin

A
  • controlling type 1 DM

- can be used for type 2 DM

141
Q

Adverse reactions of insulin

A

Hypoglycemia- too much insulin with not enough glucose

142
Q

How can a patient become hypoglycemic

A
  • Pt eats too little food
  • Insulin dose is incorrectly measured
  • increase in physical activity
  • Infection may change dose requirement
143
Q

Sulfonylureas (antidiabetic) stimulate what organ to do what?

A

Stimulating beta cells of pancreas to make more insulin, lowering blood glucose

144
Q

Adverse reactions of antidiabetics

A
  • GI upset

- Hypoglycemia

145
Q

What hormone influences every organ and tissue in the body?

146
Q

What should you consider when giving thyroid medicine

A
  • overdose

- hyperthyroidism

147
Q

How long will efforts of thyroid hormone replacement take?

A
  • may not be apparent for 6 weeks, early effects may be apparent as soon as 48 hours
148
Q

Examples of thyroid medication

A

levothyroxine

149
Q

Use of male hormones

A

Replacement therapy for testosterone deficiency (hypogonadism)

150
Q

Actions of contraception’s

A

inhibits ovulation

151
Q

Difference between progestin and progesterone

A 
Progestin= synthetic
Progesterone= natural
152
Q

Examples of oral contraceptives

A
  • Progestin only pills (POP)
    • norethindrone
    • Drospirenone
  • Combined estrogen-progestin (COC)
  • Monophasic (COC): fixed dose of estrogen and progestin through cycle
  • Biphasic and Triphasic (COC) delivers hormones similar levels of naturally produced
153
Q

Uses of oral contraceptives

A
  • prevents pregnancy
  • regulation of menstrual cycle
  • dysmenorrhea
  • reduce acne
154
Q

Adverse reaction of oral contraceptives

A

-Venous thromboembolism (COC)

155
Q

Define Bactericidal

A

Drugs that kill bacteria

156
Q

Define Bacteriostatic

A

Drugs that slow or retard the multiplication of bacteria

157
Q

Define broad spectrum antibiotic

A

effective against both gram negative and gram positive bacteria

158
Q

Define super infection

A

bacteria or fungal microorganism not affected by antibiotic being used for treatment

159
Q

Use of sulfonamides

A
  • UTIs caused by e coli
  • staphylococcus aureus
  • MRSA
160
Q

What condition and allergy should you consider with sulfonamides

A
  • caution with G6PD

- Sulfa allergy

161
Q

Examples of drugs containing sulfonamide

A
  • celecoxib

- furosemide

162
Q

Contraindications for sulfonamide

A
  • not used near end of pregnancy
  • caution with bronchial asthma
  • contraindicated for patients with allergy and G6PD
163
Q

What medication is similar to PCN but will work if its PCN resistant?

A

Cephalosporines

164
Q

What age should tetracyclines not be given?

A

9 years and younger, could cause permanent teeth discoloration

165
Q

Examples of tetracyclines

A

Doxycycline

166
Q

What medication class is an alternate to PCN for strep and treats chlamydia?

A

Macrolides

167
Q

Examples of macrolides

A
  • azithromycin

- erythromycin

168
Q

fluoroquinolone should only be used to treat what conditions if no other treatment is available?

A
  • UTI
  • bacterial bronchitis
  • bacterial sinusitis
169
Q

What tendon might rupture while taking fluoroquinolones?

170
Q

Examples of fluoroquinolones

A

ciproflaxin

171
Q

What are aminoglycosides used for?

A

primarily gram negative bacteria

172
Q

Adverse reactions to taking aminoglycosides

A

ototoxicity

173
Q

Examples of aminoglycosides

A

gentamycin

174
Q

Uses of carbapenems

A
  • hospital acquired pneumonia
  • meningitis
  • pyelonephritis
175
Q

Contraindications/warnings of carbapenems

A
  • seizure disorder
  • steven johnson syndrome
  • renal impairment
176
Q

Examples of carbapenems

177
Q

Uses of amebicides, antiprotozoal and nitroimidazole

A

gynecologic infections: bacterial vaginosis, trichomoniasis including treatment of asymptomatic partners

178
Q

What should not be used with Amebicide, Antiprotozoal, and Nitroimidazole?

A
  • use of alcohol or propylene glycol containing products during or within 3 days of therapy discontinuation
179
Q

Example of Amebicide, Antiprotozoal, and Nitroimidazole

A
  • metronidazole
180
Q

Lincosamide Is considered bacteriostatic but is bactericidal against what?

A
  • some strains of staphylococci
  • streptococci
  • anaerobes such as Bacteroides fragilis
181
Q

Examples of lincosamide

A

clindamycin

182
Q

How do antivirals work?

How many infections do they work against?

A
  • inhibit viral replication

- have limited use because they are effective against small number of specific vital infections

183
Q

What viruses do antivirals treat?

A
  • herpes
  • HIV
  • influenza
  • Hep C
184
Q

Examples of antivirals

A
  • acyclovir
  • valacyclovir
  • oseltamivir
185
Q

Antifungals may be what 2 things?

A
  • may be fungicidal or fungistatic
186
Q

What tests must you perform while using antivirals?

A

periodic liver function tests

187
Q

Absorption of ketoconazole is impaired when drug is taken with what?

A
  • histamine antagonist

- antacids

188
Q

Examples of antifungals

A
  • clotrimazole
  • tolnaftate
  • ketoconazole
  • terbinafine
189
Q

What do muscle relaxers do?

A
  • relieve acute painful MSK conditions attributed to sedative effect
190
Q

How does cyclobenzaprine reduce muscle spasms?

A

effects on muscle tone

191
Q

What is the exact mode of diazepam in terms of MSK conditions?

A
  • unknown but does have sedative effects
192
Q

Examples of muscle relaxers

A
  • cyclobenzaprine
  • methocarbamol
  • diazepam
  • baclofen
193
Q

Action of corticosteroids

A
  • anti-inflammatory action
194
Q

What disorders can corticosteroids help with?

A
  • auto immune disorders
195
Q

What happens if you stop corticosteroids abruptly

A
  • could be potentially life threatening as administration shuts off pituitary release of hormones
196
Q

Examples of corticosteroids

A
  • hydrocortisone
  • prednisone
  • dexamethasone
197
Q

Action of antimigraine

A

acts on intracranial blood vessels and trigeminal system; causes vasoconstriction and reduces neurogenic inflammation

198
Q

What conditions should be considered when giving anti migraines?

A
  • arrhythmias

- Wolff-Parkinson-White disease

199
Q

examples of antimigraine

A

sumatriptan

200
Q

Action of scabicide

A
  • paralysis and death of pests
201
Q

Examples of scabicide

A

permethrin

202
Q

Where should you not use topical steroids?

A

face, groin or axilla

203
Q

What growths are keratolytics used for?

A
  • epidermis growths such as warts
204
Q

Contraindications keratolytic

A
  • warts with hair
  • genital or facial warts
  • mucous membrane
  • infected skin
205
Q

examples of keratolytic

A
  • podofilox

- salicylic acid

206
Q

Types of Nicotine replacement therapy

A
  • patch
  • gum
  • inhaler
  • nasal spray
  • lozenge

Pharmacy (3 decks)

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