Exam 2 Flashcards by Rhina Lavigne

List common examples of NSAID medications used in the treatment of mild to moderate pain

Aspirin, ibuprofen, naproxen, keterolac, Mobic

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What organ are NSAIDS potentially toxic to if the max daily dose or chronic habitual use of the medication occurs

Kidney

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What is the max daily allowance of ibuprofen in mg for an adult patient

2400 MG

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What is the primary advantage of using a selective cox-2 like celecoxib (celebrex) for chronic pain management? What is the specific ADR risk?

Advantage- less GI problems
Specific ADR- risk for thromboembolism (MI, Stroke)

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Is acetaminophen an NSAID

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What is the max amount of acetaminophen daily in mg for an adult patient

4000 MG

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What organ is acetaminophen potentially toxic to if the max daily dose or chronic habitual use of the medication occurs

Liver

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What is the antidote to an overdose of acetaminophen

Acetylcysteine

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What is gout

Metabolic disorder of purine metabolism

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What vitamin is especially helpful in the treatment or prevention of gout

Vitamin C 1,000 mg daily

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What are the 3 main medications used in the treatment of gout

Colchicine- DOC in acute episode, adverse GI effects with higher doses (diarrhea)

Probenecid (2nd line)- lowers uric acid level

Allopurinol- lowers formation of uric acid by inhibiting conversion of xanthine to uric acid

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In the treatment of gout what class of medications does allopurinol belong to

Xanthine oxidase inhibitors

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What class of medications is the first line choice for migraine headaches

Triptan family (sumatriptan)

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What medications can decrease inflammation around the facial nerve associated with Bell’s palsy

Steroids

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What is the primary medication used in the treatment of Parkinson’s disease

Levodopa/carbidopa

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What anticholinergic medication is used in Parkinson’s disease to help reduce the extra movements, tremors, improve muscle control etc

Benztropine

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What neuromuscular blocking agent is associated with malignant hyperthermia

Succinylcholine

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What is the family name of neuromuscular blocking agents (paralytics)

Uronium family (vecuronium etc)

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What is the most important safety assessment needed for a child or adolescent taking the non stimulant ADHD drug atomoxetine

Suicidal ideations

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What is the medication given to neonates to reduce apneic spells

Xanthine

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What is a side effect of stimulant medications used in the treatment of ADHD that might necessitate a med holiday

Weight loss, growth abnormalities

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What is drug of choice for epilepsy

Phenytoin

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What is the treatment for malignant hyperthermia

Dantrolene

What is an example of a commonly prescribed muscle relaxer

Cyclobenzaprine, methocarbamol

Are there any special considerations or risks associated with the medication tramadol

Serotonin syndrome when combined with SSRI Contraindications- severe renal or hepatic dysfunction

What is the antidote to an overdose of opiates

Naloxone

What are medications used in the treatment of sleep

Ambien (ZOLPIDEM) Lunesta (ESZOPICLONE)

Antidote for overdose of benzodiazepines

Flumazenil

What are important things to know about the medication phenytoin

PO is safest route Therapeutic level is 10-20 mcg/ml Not for IM use DOC for chronic seizures Should not exceed 50 mg/min, incompatible with dextrose Patients need to rinse mouth after oral use

What is drug of choice for status epilepticus

Benzodiazepines

What is a potentially serious adverse drug reaction to several antiepileptic medications

Steven Johnson syndrome

What are the signs and symptoms of that adverse drug reaction

Painful rash Flu like symptoms

What is the drug of choice or class of choice for the treatment of migraine headaches

The triptan family. DOC- sumatriptan Avoid nicotine with Triptans

What are some prophylactic treatments for migraine headaches

Beta blockers, estrogen therapy, TCA

How do you know if the treatment for migraines is working?

Less reported migraines

What is Parkinson’s disease? What neurotransmitter is deficient?

CNS dopamine neuron degeneration in mid brain Dopamine is deficient Acetylcholine is excessive

What anti seizure med is used for neuropathic pain

Gabapentin

What is the drug of choice for Parkinson’s disease? Why is it a combo treatment?

Levidopa/carbidopa Carbidopa keeps liver from breaking down levidopa too quickly

What drug to drug or drug to food/vitamin interactions do you have to be concerned about with carbidopa/levidopa

Vitamin B6 High protein foods

What medication or class of medication would be potentially beneficial to a patient with physical manifestations of Parkinson’s like pill rolling, shuffling gait, or tremors

Benztropine (it is anticholinergic)

What is the primary neurotransmitter deficiency in Alzheimer’s disease

Acetylcholine

What needs to be increased in Alzheimer’s patients and how can we do that

Increase acetylcholine Use cholinesterase inhibitor DONAZEPIL

What is second line medication used in the treatment of Alzheimer’s disease

MDMA (mementine)

What are the three terms or classes of medications that describe the word sympathomimetic

Adrenergic Alpha agonists Beta agonists

What are five terms or classes of medications that describe the word sympatholytic

Anti adrenergic Alpha agonist Beta antagonist Alpha blockers Beta blockers

List uses for adrenergic medications

Stimulate HR Contractility Conduction Bronchodilate in the lungs Adrenergic=adrenaline

What are examples of direct catecholamines and what are some uses for these medications

Epinephrine Dopamine Norepinephrine

What are common side effects of medications that are agonist of the sympathetic nervous system

Orthostatic hypotention Tachycardia

List common uses for cholinergic medications

Reverse muscle relaxants in OR Diagnose and treat MG

What is the medication used in the diagnosis of MG

Edrophonium Tensilon test

What is the antidote for a cholinergic crisis

Atropine (an anticholinergic)

What are the common side effects of cholinergic medications or substances

Sludgem + Brady

What are the common side effects of anticholinergic medications

Dry mouth Tachycardia Decreased GI and GU function

What medications are inhaled or general anesthesia

Benzodiazepines, opiates, barbiturates, propofol, ane drugs, nitrous oxide

What medications are considered local anesthesia

Caines family

What medications are used for conscious sedation

Ketamine, benzodiazepines

Define malignant hyperthermia and list the treatment recommended

Uncommon, but potentially fatal adverse reaction Treatment is DANTROLENE