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Advanced Pharm > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Alzheimers meds

A

1st- donepezil (Aricept)

  • for low agitation clonazepam (Klonopin)
  • for mod/severe memantine (Namenda)
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2
Q

CNS analgesia, fever reducer

-toxic intermediate metabolite

A

acetaminophen

-no anti-inflammatory or antiplatelet effects

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3
Q

aerosolized corticosteriods

A

budesonide (Pulmicort) and fluticasone (Flovent)

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4
Q

SABA

A

albuterol sulfate
rescue (<2x/week)
-s/e tachy, tremors

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5
Q

LABA

A

Advair (fluticasone and salmeterol)

  • twice daily use
  • maintenance
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6
Q

Parkinson’s meds

A
  • benztropine (cogentin)
  • carbidopa (Levodopa)
  • haloperidol (haldol)
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7
Q

benztropine (cogentin)

A

treats parkinsonian symptoms (extrapyramidal) seen with psych drugs
-watch for abnormal involuntary movements

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8
Q

what and how does benztropine (Cogentin) work

A

mood stabilizer, anticonvulsant, seizures

-potentiates GABA

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9
Q

side effects and caution with benztropine (Cogentin)

A

s/e CNS, ataxia

-caution with bone marrow depression, induce drug metabolism

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10
Q

what and how does carbidopa (Levodopa work)

A
  • PD med

- crosses BBB and is decarboxylated into dopamine

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11
Q

side effects and caution with carbidopa (Levodopa)

A

monitor renal/liver/cardiac fxn

-s/e hallucinations, dizziness, dyskinesia, depression

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12
Q

chlorpromazine (thorazine)

A
  • typical antipsychotic
  • blocks central dopaminergic receptors
  • treats positive symptoms (tardive dyskinesia)
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13
Q

s/e of chlorpromazine (thorazine)

A

HA, tremors, bradycardia, bronchospasm, SIADH, heat intolerance, eye rolling, twisted neck

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14
Q

what and how does clonazepam (klonopin) work

A
  • long acting benzo
  • acts at GABA
  • often used for seizures
  • can treat alc withdrawal
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15
Q

caution and side effect with clonazepam (klonopin)

A

s/e drowsiness, CNS depression, hepatotoxicity

-need to taper

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16
Q

antidote to clonazepam (klonopin)

A

flumazenil

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17
Q

clonidine (catapres)

A
  • central a-agonist, dec sympathetic outflow
  • treats HTN, ADHD, drug withdrawal
  • stimulates frontal lobe to control limbic system
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18
Q

what and how does clozapine (clozaril) work

A
  • atypical antipsychotic
  • antagonize serotonergic activity
  • pos and neg symptoms
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19
Q

s/e and caution with cloapine (clozaril)

A
  • s/e strong sedative, anticholinergic effects, postural hypotension, seizures
  • WATCH FOR METABOLIC SYNDROME (AGRANULOCYTOSIS)- WEEKLY CBC
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20
Q

dantrolene

A
  • treats malignant hyperthermia (fever and muscle rigidity), neuroleptic malignant syndrome, serotonin syndrome
  • muscle relaxant
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21
Q

what is and how does diazepam (valium) work

A
  • benzo, acts at GABA, multiple bioactive metabolites

- antiepileptic, muscle relaxant, ETOH withdrawal

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22
Q

s/e and caution with diazepam (valium)

A

s/e drowsiness, CNS depression, hepatotoxicity

-need to taper

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23
Q

antidote for diazepam (valium)

A

flumazenil

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24
Q

what is and how does donepezil (aricept) work

A
  • acetylcholinesterase inhibitor
  • 1st line for Alz
  • metabolized in liver
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25
Q

s/e and caution with donepezil (aricept)

A

s/e N/V/D, weight loss, muscle cramping, rhabdomyolysis

  • caution with preg, peptic ulcers, seizures, asthma
  • avoid other cholinergics/anticholinergs
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26
Q

what is and how does epi work

A
  • b adrenergic agonist (b1 inc HR and FOC, b2 bronchodilation, uterine relax)
  • g protein complex, 2nd messenger system
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27
Q

fentanyl

A

ultra short acting synthetic opioid analgesic, powerful

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28
Q

fluoxetine (Prozac)

A

SSRI- depression, OCD, bulimia

  • s/e HA, drowsiness, sexual dysfunction, GI upset
  • drug/drug interactions
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29
Q

halothane (halogenated gas)

A

inhaled anesthesia

  • monitor for hepatotoxicity
  • risk of malignant hyperthermia if given with succinylcholine
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30
Q

type and what does haloperidol (haldol) treat

A
  • typical antipsychotic
  • dopamine antagonist
  • avoid long term
  • treats pos symptoms
  • watch for abnormal movements
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31
Q

how to treat EPS and parkinsons symptoms

A

cogentin

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32
Q

how to treat neuroleptic malignant syndrome

A

dantrolene

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33
Q

lidocaine

A
  • can be used in spinals, epidurals (give with epi if you want a longer effect)
  • Na channel blocker
  • caution in areas of bod with low blood supply
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34
Q

first line tx for bipolar

A

lithium (lithobid)

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35
Q

how and what is lithium (lithobid) used for

A
  • manic phase or maintenance of BD

- interfere with NaK atpase

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36
Q

risks with lithium (lithobid)

A
  • risk for drug induced nephrogenic diabetes

- frequent blood tests, renal fxn, thyroid, CBC, EKG, electrolytes

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37
Q

lopressor (metoprolol)

A

b1 antagonist

  • decreases HR and FOC
  • treats angina
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38
Q

what is memantine (namenda) used for

A

moderate to severe AD

-acts as NMDA receptor

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39
Q

s/e and cautionn with memantine (namenda)

A

s/e GI, drowsiness, HA, hallucinations, aggression

-dont use with amantadine, ketamine, robitussin DM!!!!!!

40
Q

midazolam (versed)

A
  • sedative with amnestic

- blocks substance p (slow severe pain)

41
Q

antidote for midazolam (versed)

A

flumazenil- benzo antagonist, short half life

42
Q

flumazenil reverses what 3 meds

A
  • clonazepam (klonopin)
  • diazepam (valium)
  • midazolam (versed)
43
Q

how and what is phenobarb used for

A
  • increase Cl influx at GABA
  • tx seizures and in OR
  • often used for kiddos
44
Q

s/e and caution with phenobarbital

A
  • s/e drowsiness, withdrawal, fatigue
  • caution with CNS depression, need to taper
  • watch for growth spurts (monitor levels Q3 months)
45
Q

propanolol (inderal)

A
  • a and b blocker
  • crosses BBB
  • pts at risk of depression and fatigue
  • caution in pts with asthma or HTN
46
Q

sertraline (zoloft)

A

SSRI

  • for depression and bulimia
  • monitor for serotonin syndrome
  • caution with driving
47
Q

what is and s/e of trancyclpromine (parnate)

A

MAOI, tricyclic antidepressant

-s/e ortho hypo, wt gain, sexual dys, insomnia

48
Q

all the cautions with tranylcypromine (parnate)

A
  • avoid tyramine (risk of HTN and seizures)
  • risk of serotonin syndrome if given with SSRI
  • exacerbate hypoglycemia
  • -exacerbate sympathomimetics
49
Q

how do tricyclic antidepressants work

A

inhibit reuptake of serotonin and norepi

50
Q

5 classes of tricyclics

A

MAOI, SSRI, SNRI, NDRI, SNDI

51
Q

SSRIs

A
  • imipramine
  • elavil (amitriptyline)- chronic pain
  • dont give to seizure patients
52
Q

wellbutrin (buproprion)

A

NDRI

  • smoking cessaion, not cardiotoxic
  • used when SSRI caused sexual dysfunction
53
Q

use and how does valproic acid (depakote) work

A
  • increases available GABA

- tx seizures, bipolar (2nd line)

54
Q

caution and s/e with valproic acid (depakote)

A

s/e GI, pancreatitis, tremor, sedation

  • caution with liver toxicity, preg women, dec drug metabolism
  • monitor LFTs, CBC
55
Q

adrenergic agonists

A

clonidine, dopamine, epinephrine, norepi, phenylephrine

56
Q

adrenergic antagonists

A

propanolol (inderal)

57
Q

cholinergic antagonists

A

atropine, scopalamine

58
Q

what is phenylephrine and what does it treat

A

A1 receptor agonist

  • vasoconstriction, inc BP, def HR and FOC
  • decongestant, shock
59
Q

side effect of phenlephrine

A

arrhythmia, HF, HTN crisis, blurred vision

-caution with MAOI (increased sympathomimetic effect)

60
Q

what can’t you give with fluoxetine (prozac)

A

MAOIs- risk for serotonin syndrome

**need to taper

61
Q

a- agonist in the CNS

A

reduces the responses of the sympathetic nervous system.

62
Q

MAOI meds

A

deprenyl and tranylcypromine/parnate ( use if tricyclics fail), watch for liver toxicity

63
Q

theophylline

A

phosphodiesterase inhibitor

  • promotes bronchodilation
  • increases cyclic AMP
64
Q

what does ach stimulate

A

both nicotinic and muscarinic receptor

65
Q

atropine

A

cholinergic antagonist, antimuscarinic (blocks parasympathetic effect)
-use with severe bradycardia

66
Q

scopalamine

A

cholinergic antagonist

-antimuscarinic, sedating, blocks short term memory

67
Q

succinylcholine

A

neuromuscular blocker (paralytic)

  • depolarizes nicotinic receptor at neuromusc junction
  • ***malignant hyperthermia
68
Q

alpha adrenergic response

A

vasoconstriction, intestinal relaxation, pupil dilation

69
Q

beta 1 adrenergic response

A

inc HR, inc force of contraction

70
Q

beta 2 adrenergic response

A

vasodilation, bronchodilation, intestinal/uterine/bladder relax

71
Q

sympathetic receptor

A

adrenergic

72
Q

parasympathetic receptor

A

muscarinic

73
Q

ach acts first on what type of receptor

A

nicotinic

74
Q

warfarin (Coumadin)

A

anticoagulant

  • monitor ptt
  • reverse with vit K
75
Q

don’t mix coumadin with

A

asa, hepatic dx, hyperthyroid, antifungals

76
Q

aldactone (spironolactone)

A

K sparing diuretic use in HF, edema, endometriosis

-caution in renal dx, B blockers, NSAIDS, ACE inhibitors

77
Q

Baclofen

A

GABA receptor agonist

  • muscle relaxant
  • treat withdrawal
78
Q

cimetidine (tagamet)

A
  • antihistamine and antacid

- potentiates effects of anticoagulants and sedation, lots of med interactions!!!

79
Q

codeine

A
  • mild/moderate pain
  • cough suppressant
  • sometimes given with tylenol
80
Q

too much dopaminergic tx of Parkinson’s can cause

A

psychosis

81
Q

carbamazepine (Tegretol)

A
  • typical antiepileptic, treats Bipolar
  • potentiates GABA
  • caution with bone marrow depression
82
Q

concerta (methylphenidate)

A

stimulant med for ADHD

  • child needs to have drug holidays in order to grow
  • sympathomimetic (want for hyperthermia)
83
Q

dextromethorphan

A

-OTC cough meds
=robitussin
-interacts at NMDA receptor in brain
-can’t give with Namenda or elderly

84
Q

digoxin

A
  • treats afib and CHF
  • indirectly supports vagus nerve
  • inhibits NaK atpase
  • need good K levels
85
Q

droperidol

A
  • neuroleptic
  • increases sensitivity to opioids
  • used in anesthesia
86
Q

flumazenil (Romazicon)

A

-reverses Versed

87
Q

guaifenesin

A
  • mucinex

- watch for multi-symptom OTC meds

88
Q

ketoconazol

A

azol antifungal

-many drug/drug interactions

89
Q

Lasix

A
  • loop diuretic

- monitor electrolytes

90
Q

leukotriene antagonists

A

-block leukotriene response in allergic asthma

91
Q

narcan

A

blocks opioids

92
Q

rivastigmine (Exelon)

A

for Alzheimers

93
Q

tranylcypromine (parnate)

A

-MAOI

94
Q

tricyclic antidepressants

A
  • antimuscarinic effects
  • low BP effects
  • antihistamine, sedation
95
Q

kindling effect

A

-a trigger which sets off seizure or bipolar episode

Advanced Pharm (2 decks)

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