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Drugs Step 1 > Drugs Last Day > Flashcards

Drugs Last Day Flashcards

1
Q

Reduce craving for alcohol - mech?

A

Naltrexone - block Mu receptor

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2
Q

1st Line Treat Alcohol Withdrawal

A

Benzodiazepines

  • Long acting = chlordiazepoxide
  • Long acting = diazepam
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3
Q

Treat GAD?

A 
Venlafaxine/duloxetine = SNRI
Fluoxetine/sertraline/citalopram/paroxetine = SSRI
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4
Q

Treat GAD w/ bu…

A

Buspirone = bus = slow onset of action (2 weeks)

  • partial agonist 5HT-1A receptor
  • few sedative effects
  • no tolerance, dependence
  • no muscle relaxant or anticonvulsant properties
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5
Q

Treat Panic Disorder:

A

Pt is not acutely symptomatic: SSRI

Acute need: benzodiazepine (bad for pt’s w/ substance abuse past, also tolerance issue)

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6
Q

Amitriptyline overdose

A

TCA overdose = tachy, delirium, dilated, flushed, sweating

  • inhibit reuptake of NE & Serotonin
  • die due to Na+ channel inhibition = arrhythmias
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7
Q

Sleep hygiene vs. Stimulus control

A

Hygiene: avoid naps, avoid caffeine after lunch; dark bedroom & cool; don’t exercise b4 bedtime
Stimulus: Bed only for sex & sleep, leave after 20 minutes; go to bed only when sleepy; fixed wake-up time

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8
Q

Tachy, HTN, dilated, agitation, seizure, myocardial ischemia

A

Cocaine intoxication - blocks presynaptic reuptake

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9
Q

Treat Obsessive-Compulsive

A

SSRI + Cognitive-Behavioral therapy

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10
Q

Treat specific phobias: fear of elevator

A

Behavioral therapy: exposure, systematic desensitization

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11
Q

Tremors, anxiety, perceptual disturbances, psychosis, insomnia
Seizure, tachy, palpitations

A

Benzodiazepine withdrawal

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12
Q

N/V, abdominal cramps, muscle aches

Dilated pupils, yawning, lacrimation, hyperactive bowel

A

Heroin withdrawal

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13
Q

Increased appetite, hypersomnia, severe depression (crash), intense psychomotor retardation

A

Cocaine withdrawal

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14
Q

Tremors, anxiety, agitation, delirium, psychosis

Seizures, tachy, palpitations

A

Alcohol withdrawal

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15
Q

Olanzapine side effects

A

Atypical Antipsychotic

  • weight gain
  • dyslipidemia
  • hyperglycemia
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16
Q

Schizophreniform disorder

A

1month-6months = same symptoms as schizophrenia

- functional decline not required

17
Q

Pica

A

Compulsive consumption of nonfood or non-staple food source for 1+ month

18
Q

Treat Otitis Media

  • Strep pneumo
  • H. flu
  • M. catarrhalis
A

Amoxicillin + clavulonic acid
Cephalosporins

If recurrent in kids: tympanostomy tubes

19
Q

Name the SNRI’s

A

Venlafaxine

Duloxetine

20
Q

Name the SSRI’s

A

Sertraline
Citalopram
Fluoxetine
Paroxetine

21
Q

Drug classes to avoid in elderly?

A 
TCA
Barb/Benzo
Antiarrhythmics
1st gen antihistamines
Alpha blockers (orthostatic hypotension)
Sulfonylureas
Muscle relaxants
22
Q

Lithium

A

Treat Bipolar

  • Ebstein anomaly
  • narrow TW
  • tremor = early side effect
23
Q

Low volume of distribution…

A

High molecular weight
High plasma protein binding
Hydrophilicity
High charge

24
Q

If C1 C4 esterase inhibitor levels are low, don’t use…

A

ACE inhibitor - increased bradykinin - increased angioedema

25
Q

Treat shock after ceftriaxone w/ low BP?

A

Epi

26
Q

Isoniazid is metabolized by…

A

Acetylation

27
Q

Neuroleptic malignant syndrome vs.

Serotonin syndrome

A

Both: Mental status, hyperthermia, autonomic instability
NMS: rigidity
SS: hyperreflexia, clonus, shivering

28
Q

Sledge hammer

Funnel

A

MAOinhibitors
Sledge hammer = Selegiline = MAOB inhibitor
Phenelzine = MAO nonselective inhibitor
Tyramine - cheese, wine = usually degraded by MAOA but if on inhibitor = sympathomimetic effect
3rd line for Depression only for recalcitrant
Can cause HTN crisis or resistant HTN

29
Q

Buspirone vs.

Bupropion

A

Buspirone: treat GAD; anxious if I miSS the Bus = Serotonin agonist at 5-HT1A
Buproprion: atypical antidepressant
- also reduce urge to smoke
- NO Sexual SE’s
- SE: Seizure - can’t use in anorexia/bulimia

30
Q

Mirtazapine vs.

Trazodone

A 
Mirtazapine: atpyical antidepressant + a2 antagonist
 - increase release NE & 5-HT
 - SE: weight gain (good for elderly)
 - SE: sedation (good for insomnia)
Trazodone: atypical antidepressant
 - treat insomnia; block 5-HT and alpha2
 - PRIAPISM
31
Q

Treat insomnia, nothing else going on

A

Ramelteon

- melatonin agonist - few SE’s

32
Q

Name the 2nd generation anti-histamines

A

Fexofenidine
Cetirizine
Loratidine dine zine dine
SE: far less than 1st gen; less lipophilic; don’t enter BBB as easily

33
Q

1st Generation Histamine blockers & SE

A 
Chlorpheniramine
Diphenhydramine
Dimenhydrinate
   - zine
SE: anti-cholinergic, sedation, weight gain, easily cross BBB, anti-alpha1 adrenergic = hypotension/postural

Drugs Step 1 (5 decks)

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