Ch 9, 10, 12, 13 Flashcards
1
Q
Mechanism of benzodiazapines
Diazepam=valium
A
Binds to GABA receptors to open CL channel and enhance IPSP
2
Q
Effects of Benzodiazepines
A
Decr Anxiety, sedation, hypnosis, anticonvulsant, muscle relaxant
3
Q
Benzodiazepine uses
A
Anxiety, seizure, muscle spasm or strain, sleep disorder (not psychosis)
4
Q
Benzodiazepine side effects
A
drowsiness, confusion, psychological and physical dependence
5
Q
Zolpindim (Ambien) action
A
Acts on GABA receptors, used for ANXIETY only
6
Q
Ambien side effects
A
nightmares, agitation, headache, drowsiness
7
Q
Paxil, Desyrel, Zoloft, Prozac mechanism (SSRI)
A
inhibit reuptake of serotonin and inhibit NE, M1 receptors
8
Q
Paxil, Desyrel, Zoloft, Prozac action (SSRI) uses:
A
anxiety only
9
Q
Paxil, Desyrel, Zoloft, Prozac action (SSRI) side effects
A
headaches, dizziness, nervousness, (slow onset, up to 2 weeks) no dependence
10
Q
Buspirone (Buspar) acts on
A
serotonin receptors, not much known about
11
Q
Barbituates (phenobarbital) mechanism
A
Formerly used to sedate and induce sleep by binding to GABA receptors to open Cl channels
12
Q
Barbituates (phenobarbital) uses
A
used to be for sedation, no is an anticonvulsant
13
Q
Barbituates (phenobarbital) side effects
A
drowsiness, impaired concentration, mental and physical decr. drug hangover (**induces cytochrome p450 and therefor decr duration of other drugs action)
14
Q
Withdrawal effect of barbituates or phenobarbitol
A
tremors, anxiety, weakness, vomiting, seizures, delirium, cardiac arrest
15
Q
Non barbiturate sedative: Chloral Hydrate uses
A
sedative and hypnotic (1-6hrs)
**Is a non barbiturate sedative
16
Q
Chloral hydrate side effects
A
GI irritation, unpleasant taste sensation
17
Q
Ethanol effects
A
anti anxiety and sedative
18
Q
Ethanol metabolism
A
to acetate by aldehyde dehydrogenase, which can be blocked by disulfiram->unpleasant effects
19
Q
Psychomotor stimulants
A
Methylxanthines, cocaine, nicotine, amphetamine
20
Q
Hallucinogens
A
Lysergic Acid diethylamide (LSD)
THC in marijuana
Phencyclidine
21
Q
Examples of methylxanthines
A
theophylline in tea, theobromine in cocoa, caffeine in drinks..
22
Q
Methylxanthine mechanism
A
stimulate cerebral cortex leading to anxiety and tremors
Pos ionotropic effect
Mild diuretic
Incr gastric HCL secretion
23
Q
methylxanthine uses
A
in asthma (theophylline)
24
Q
Methylxanthine side effects
A
INSOMNIA, anxiety, agitation, vomiting, convulsions (100 cups coffee=cardiac arrhythmia)
25
Nicotine actions
Low dose=ganglionic stimulation (CNS: euphoria, relaxation, improve attention,)
High dose=ganglionic blocker (respiratory paralysis)
26
nicotine side effects
incr irritability, tremors, diarrhea, incr HR, incr BP
27
nicotine withdrawal
physical dependence=high
anxiety, headaches, insomnia
**Average cigarette=6-8mg nicotine. lethal dose=60mg or 10 cigs at once
28
Cocaine actions
blocks reuptake of norepinephrine stimulating CNS, euphoria, hallucination, paranoia
29
Cocaine uses
local anesthetic (causes vasoconstriction)
30
Cocaine side effects
1. anxiety in form of hypertension, tachycardia, sweating and insomnia
2. depression post CNS stim
3. arrhythmia->seizure->death
31
Amphetamine mechanism
Blocks reuptake of NE leaving more in synaptic space= CNS stim=incr vigilance, decr fatigue, decr apeptite
32
Amphetamine uses
1. ADHD (methylphenidate or Ritalin HCL)
| 2. NARCOLEPSY
33
Amphetamine CNS side effects
vertigo, insomnia, confusion, tremors, hyperreflexia, tolerance leading to dependence
34
Amphetamine CVS side effects
hypertension, palpitation, arrhythmia, angina pain
35
Amphetamine GIT side effects
nausea, diarrhea, anorexia
36
LSD mechanism
serotonin agonist at presynaptic receptor in midbrain
37
LSD side effects
nausea, weakness, psychosis
38
LSD hallucination treatment via
haloperidol
39
THC mechanism
Unknown mechanism
40
LSD actions
Activates sympathetic NS
1. pupil dilation
2. Incr BP
3. Piloerection
4. Incr body temp
5. hallucination (color)
6. mood alteration
41
Amphetamine actions
CNS stim=incr vigilance, decr fatigue, decr apeptite
42
THC actions
Euphoria then drowsiness and relaxation
- Impairs short term memory
- Decr muscle strength
- Incr Appetite
- dry mouth
- visual hallucinations
-used to control vomiting in chemotherapy patients
43
THC side effects
Incr HR
Decr BP
tolerance
44
PCP mechanism
Inhibits reuptake of dopamine, serotonin and NE
45
PCP side effects
1. Hypersalivation
2. Anesthetic (similar to ketamine)
3. extremity numbness, slurred speech
4. leads to hostile and abberant behavior
46
PCP side effects
tolerance
47
Tricyclic antidepressants
(AMINE) Imiprimine and desimipramine
48
TCA mechanism
Blocks NE and serotnin reuptake
49
TCA uses
severe depression (panic attacks)
50
Medication used for bed wetting
imipramine for children over 6
51
TCA side effects
```
Anticholinergic effects-
dry mouth
constipation
blurred vision
urinary retention (inhibits PS)
orthostatic hypertension
```
52
TCA drug interactions
MAO inhibitors- mutual enhancement for HT, hyperpyrexia, convulsions, and coma
Ethanol=toxic
53
SSRIs
Fluoxetine (prozac)
54
SSRI mechanism
inhibits serotinin reuptake w/out anticholinergic anti histamine or alpha blockers
55
SSRI uses
```
major depression**
Bulemia Nervosa**
OCD
Panic attacks
PMS
```
56
SSRI side effects
nausea, anxiety, sexual dysfunction
57
MAOI
Phenelizine=nardil
58
MAOI mechanism
prevents excess NE and 5-HT from getting inhabited in the cleft
59
MAOI uses
depression, anxiety, phobia
60
MAOI side effects
HT crisis
**Tyramine induced HT
MAO w/ tyramine foods=HT
ex: cheese, red wine, beer, chicken liver, anchovies
61
meds for OD MAOI
prazosin (alpha 1 blocker)
62
Schizophrenia
overactive cerebral dopaminergic neurons
63
MC schizo drugs
respiridone, clozapine, haloperidol, thiothixine
64
Chloropromazine and scopolamine are used for
nausea and vomiting
65
anti dopamine drugs side effects
```
parkinsonain effect
tardive dyskinesia
anticholinergic effects
drowsy
confused
```
66
MU receptor
Primary, central and peripheral receptors
67
Kappa receptor
dorsal horn of spinal cord
68
Sigma receptor
less specific
69
Delta receptor
peripheral NS
70
Morphine acts on what receotor
MU
71
Morphine uses
Pain, cough, diarrhea *decr motility
72
Morphine mechanism
hyperpolarizes membrane preventing NT release/AP
73
Morphine side effects
```
severe respiratory depression
sedation
**constipation and vomiting
urinary retention
incr IC pressure
addiction
```
74
Meperidine (demerol) receptor
Kappa
75
Demerol actions
respiratory depression
cerebreal vessel dilation
incr CSF pressure
smooth muscle contraction
76
Demerol side effects
tremor, hyperactive reflexes, hypotension(histamine)
77
Methadone mechanism and receptor
synthetic drug, mimics morphine via MU receptor-less euphoria, longer duration
78
Methadone use
to control withdrawal effects of heroin and morphine addicts
79
Heroin mechanism
synthetic morphine-3x potency
passess BBB more rapidly=more euphoria
fat suluble
80
withdrawal effects of opiate addicts
```
lacrimation
rhinorrhea
yawning
sweating
weakness
tremor
nausea and vomiting
fatalities are rare
```
81
Codeine mechanism
antitussive activity-prevent or relieve cough
82
codeine uses
in cough drugs can be combined with tylenol
83
Vicodin
hydrocodone bitartrate (class III)
84
don't use codeine with
wet cough
85
Primary epilepsy is
idiopathic-hereditary?
86
secondary epilepsy
trauma, hypoglycemia, meningitis
87
epilepsy meds mechanism
binds to GABA to keep Cl channels open and hyper polarize the cell
88
Dilantin mechanism
decrease Na and Ca in cells
89
Dilantin uses
tonic clonic seizure-grand mal
status epilepticus
for all partial seizures
90
Dilantin Side effects
nystagmus and ataxia
nausea and vomiting
GINGIVAL HYPERPLASIA-gums grow over teeth (MC side effect)
91
Dilantin interactions
inhibited by chloramephenicol, dicumoral, cemetidine,
92
Dilantin is stimulated by
carbamazepine, oral contraceptives, quinidine, doxycycline
93
Anticonvulsant med
Carbamazepine (tegretol)
Phenobarbital
ethosuxamide
94
Carbamazepine mechanism
blocks Na channels to inhibit AP to brain
95
Carbamazepine uses
partial seizures and tonic clonic seizures
96
Carbamazepine side effects
stupor, coma, respiratory depression
97
Phenobarbital mechanism
allows Cl into the cells
98
Phenobarbitol uses
anti-epileptic thru GABA
99
Phenobarbital side effect
sedation, ataxia, nystagmus, veritgo, vomiting
100
ethosuxamide mechanism
reduces propagation of abnormal electrical activity in the brain
101
ethosuxamide uses
petit mal seizures
102
ethosuximide side effects
nausea, vomiting, drowsiness, lethargy
103
3 types of insulin
Lispro- short acting-20min
NPH- intermediate-6hrs
Glargine, Detemir- Long lasting (hospitals)-24hrs
104
Human insulin
70% NPH 30% Human
105
Insulin side effects
Less glucagon production, cortisol, regular blood sugar
| allergies, weight gain
106
Oral DM type II oral med
Sulfonylurea
Meglitinide
biguanides
thiozolidenedones
107
Sulfonylurea 2 types
1. primary: tolbutamide (orinase) 6-12hrs
| 2. second generation(glucotrol) 24 hrs
108
Sulfonylurea actions
stim insulin release from pancreas
reduce liver glucose production
incr peripheral insulin sensitivity
109
Sulfonyurea side effects
hypoglycemia
GI disturbance, weight gain
Glyburide-safe in pregnancy
110
Biguanide oral drug
Metformin-glucophage
| inhibits liver glucose production
111
Meglitinide analogs
repaglinide-stimulate pancreatic insulin release for 2 hs
112
Biguanide-Metformin
inhibits liver glucose production and slows sugar absorption for 6 hrs
113
Thiozolidinediones-rosiglitazone
incr peripheral insulin sensitivity for 24hrs
114
Sulfonylurea side effects
weight gain, hypglycemia, hyperinsulinemia
115
meglitinide side effect
hypoglycemia, weight gain
116
biguanide side effect
GI disturbance, lactic acidosis
117
thiozolidinediones side effect
hepatotoxicity, weiht gain, anemia, headache, MI
118
diurectic effect
increase urine flow and incr Na and Cl excretion, loss of water, dear ECF
119
Uses for diuretic
CHF
hepatic ascites
nephrotic syndrome
premenstrual edema
120
Carbonic anhydrase inhibitor
acetazolamide
121
acetazolamide mechanism
inhibits carbonic anhydrase enzyme on prox tubule
| reduces HCO3 reabsorption and inhibits H excretion
122
Acetazolamide uses
glaucoma, epilepsy, **mountain sickness
123
Acetazolamide side effects
metabolic acidosis
K depletion
renal stone formation
drowsiness
124
loop of hence diuretic
furosemide(lasix)
125
lasix mechanism
inhibits Na/K/Cl cotransport in luminal membrane in ascending loop to decr reabsorption of Na, K, Cl
126
Loop diuretics incr _____ content in urine
Ca
127
Lasix is used in
Emergency situation such as pulmonary edema due to CHF or hypercalcemia
128
lasix side effects
ototoxicity
hyperuricemia-gout
acute hypovolemia
hypokalmeia
129
Distal tubule diuretic
thiazide (esidrix)
130
Esidrix mechanism
Incr Na K Cl excretion
Incr Ca reabsorption
Dec blood volume
131
Esidrix uses
hypertension
CHF
Edema with nephrotic syndrome
132
Esidrix side effects
```
hypokalemia
hyperuricemia
orthostatic hypotension
hypercalcemia
allergic rxn
```
133
K sparing diuretic
spironolactone (aldactone)
134
Aldactone mechanism
synthetic aldosterone antagonist inhibiting K secretion and Na reabsorption from distal and collecting tubules
135
Aldactone uses
often in combination with esidrix or lasix
136
aldactone side effects
hormonal activity-gynecomastia in males and menstrual issues in females
Hyperkalemia, nausea, lethargy
137
Ca inhibitor diuretic
Diamox
138
Loop diuretic
lasix
139
thiazide diuretic
esidrix
140
K sparing diuretic
aldactone
141
B blocker (olol) mechanism
reduce BP by decree CO and decor renin
142
B blocker uses
Mod hypertension
| hypertensive patients with other diseases such as MI, angina, glaucoma, HA
143
B blocker side effect
fatigue, lethargy, hypotension, decr libido
decr serum HDL, incr plasma triglycerides
144
ACE inhibitors
Captopril, Enalapril, lisinopril (opril)
145
ACE inhibitor mechanism
Decr peripheral vascular resistance by vasodilation due to blocking ACE to form Angitensin II without incr CO
146
ACE inhibitor uses
hypertensive and CHF with other diuretics
147
ACE inhibitor side effects
dry cough, hyperkalemia, skin rash, hypotension and fever
148
Angiotensin II receptor antagonist
Losartan, valsartan
149
Angiotensin II receptor antagonist effects
produce arteriolar and venous dilation-less cough than ACE inhibitors-fetotoxic
150
Ca channel blocker
Verapamil, nifedipine, nicardipine, diltiazin
151
Ca channel blocker mech
Ca channel antagonists block Ca movement into cells
152
Ca channel blocker uses
hypertensive patients with asthma, diabetes, engine, PVD
153
Ca channel blocker side effects
```
constipation
vertigo
HA
fatigue
hypotension
```
154
alpha 1 adrenergic blockers
prazosin, oxazosin, terazosin (osin)
155
alpha 1 blockers
alpha 1 antagonists block a-1 receptors decreasing peripheral vascular resistance and decor BP by relaxation of vascular smooth muscles
156
alpha 1 adrenergic blocker side effects
postural hypotension, reflex tachycardia, syncope
157
alpha 2 adrenergic agonists
Catapres, aldomet
158
alpha 2 agonist mech
dimities central adrenergic outflow decreasing peripheral vascular resistance and decree BP
159
alpha 2 agonist uses
mild and moderate hypertension
160
alpha 2 agonist side effects
sedation, drowsiness
161
vasodilators
hydralazine, apresoline, loniten
162
vasodilation mech
smooth muscle relaxant
163
vasodilation uses
mod to severe hypertension-emergency?
164
vasodilation side effects
HA, nausea
165
Hydrazine side effect
lupus like syndrome
166
Minoxidil side effect
hypertrichosis (body hair growth)
167
Hypertensive emergency use
Sodium Nitroprusside
IV only-poisonous if oral
