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Pharmacology 283 > Exam 2 drugs > Flashcards

Exam 2 drugs Flashcards

1
Q

Albuterol

A

Category Class:
-B2 agonist
-Adrenergic agonist
Indication:
-Asthma/COPD (causes bronchodilation)
Interactions
-Becomes nonselective at high dose

A=adregenic
A=asthma

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2
Q

Amantadine

MOA, SE, NI

A

Category Class:
-Dopamine Agonist
MOA:
-Inc dopamine action
Indication:
-Parkinsons
-Flu (not recommended)
SE:
-don’t discont abruptly
-anticholinergic effects
-invedo reticularis ****
NI:
-Drug tolerance inc quickly. Only temporary improvement of symptoms.

men have bad skin
am= an ticholinergic

AD-> DA- dop ag

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3
Q

Atropine
CI x3
Route x4

A

Category Class:
-anticholinergic
Indication:
-Brady, pre op
-Reversal agent cholingeric
CI:
-BPH/Glaucoma
-MG
SE:
-Memory impair/coma
-See adrenergic
Route:
-IV: symptomatic bradycardia
-PO Drop: dec saliva (pre op/palliative)
-Ophthalmic: mydriasis/cycloplegia (pre-op)
-IM: reversal for chol OD

pine and coal are opposites. reversal cholinergic

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4
Q

Barbituates

MOA, CI, SE. NI x3

A

Category Class:
-CNS Depressants
MOA:
-GABA stim
Indication:
-Antiepileptic, sedative, hypnotic
-(NOT ANESTHETIC)
CI:
-PG, other sedatives (Inc ETOH/opioids)
SE: MANY
-resp depr, brady, ataxia (FALL)
-dependence (use 2 weeks or less)
-REM rebound (vivid dreams), hangover, skin eruption, constipation
-paradoxical effects
-dec OC effect
NI:
-NO reversal agent (use benzos)
-Narrow ther. Range
-Class II, III, IV

Barbarians=gaba. cns dep

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5
Q

Phenobarbital

A

Long acting
Class IV
AED

SEE BARBS

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6
Q

Benzos (Pam, Azep, Azolam)

Ind, SE, Rev

A

Category Class:
-CNS depressant
MOA:
-GABA stim
Indication:
-sedative (DTs)
-epilepsy/spasms
-insomnia
-anesthesia/hypnotic effect
SE: same as barbs
-resp depr, brady, ataxia (FALL)
-dependence (use 2 weeks or less)
-REM rebound (vivid dreams), hangover, skin eruption, constipation
-paradoxical effects
-dec OC effect
Route:
PO/IM/IV
NI:
REVERSAL: Flumazenil

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7
Q

Midzolam

A

pre op

see benzos

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8
Q

chlordiazepoxide

A
  • DTs (prophylactic)
  • scheduled and PRN
  • long onset of action
  • SAFEST

see benzos

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9
Q

Azeps

A

AED (acute epilepsy)

  • IV only
  • *-tolerance=adjust dose @ 6 mos**

see benzos

AzEP= AED

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10
Q

benztropine

A

Category Class:
-Anticholinergic (CNS)
MOA:
-Inhibit release of Ach in CNS
Indication:
-PARKINSONS
CI:
-Alzheimers/MG
SE:
-PNS anticholinergic effects
-Dystonia

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11
Q

CAINE (procaine/lidocaine)

MOA, interactions

A

Category Class:
-Regional anesthetic
-Na channel blocker
MOA:
-Prevent conduction of nerve impulses @ —–injection site
Route:
-injection
Interactions
-May need benzos/opioids for sedative

cAiNe= NA

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12
Q

Cannabidiol CBD oil drop

A

Category Class:
-AED
Indication:
-severe/rare epilepsy (2 types)
CI:
-Children <2 yrs
SE:
-Sleep/sed, lethargy, weakness
-Liver failure
-Anorexia
-Diarrhea
-rash
NI:
-Sched V (no risk)
-NO euphoria/psychoactive (THC

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13
Q

edrophonium

A

Indication:
-Diagnosing MG: v short-acting

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14
Q

epinephrine

indication x3
CI x2
NI

A

Category Class:
-Adrenergic Agonist
-A1, B1, B2 receptors (nonselective)
Indication:
-Allergic RXN (IM) Anaphylaxis
-Cardiac arrest, severe hypotension (shock) (IV)
-Airway Obstruction: Aerosol
—-ADRENERGIC NONSELCTIVE
CI:
-Glaucoma
-BPH
SE:
-Extravasation
-Adrenergic SE
Route:
I-V/IM
NI:
-Bronchoconstriction, Inc HR
-Rapid onset/Short duration
-Can’t cross BBB

Reversal: fentolamine

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15
Q

Flumazenil

A

reversal for OD on benzos

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16
Q

Gabapentin

MOA, 2nd ind, SEx3 types,

A

Category Class:
-AED
-Promote GABA release
Indication:
-Seizures/epilepsy
2nd indications
Neuro pain: restless leg syndrome, fibromyalgia, phantom pain, paresthesia
SE:
-CNS: drowsy/dizzy, conf, dep/suic, ataxia -(FALL)
-Angioedema
-GI: NV, diarrhea, constipation

pent=PANT, restless leg syndrome, phantom pain, paresthsia

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17
Q

Inhalation Anesthetics (NO/isoflurane)

SE- meds?>?

A

Category Class:
-Inhalation Anesthetic
Indication:
-Surgery
SE:
-Anesthesia awareness
-OD: resp dep, HypoT, brady dysrhythmia
-HA/confusion, NV
-shivering/chills— give blankets post op
-MALIGNANT HYPERTHERMIA (give dantrolene)
–watch for liver failure

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18
Q

Nitrous Oxide

A

Inhalation gas anesthetic

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19
Q

Isoflurane

A

Inh volatile liquid

  • no metabolism, elim by vent
  • reversal agent: deep breathing/vent/int

Inhalation anesthetic

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20
Q

Interferon-beta 1a/1b
SE x5

A

Indication:
-MS
SE:
-Flu like
-Myalgia, arthralgia, muscle spasms
-Depression, suicidal ideation, dizziness,
fatigue
Route:
-A-SQ/IM
-B: SQ

pain, suic, dizzy, fatigue

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21
Q

IV anesthetics
etomidate/ketamine/propofol

A

Indication:
Rapid onset, short duration

22
Q

Propofol

A
  • inc risk of infection, use w/in 6 hrs
  • CI: allergy to egg/soy beans

IV anesthetic

Fail pro- allergy

23
Q

Ketamine

A

SE: paradoxical effects
–hallucinations/delirium/confusion

IV anesthetic

Special K
Kaylan is a paradox

24
Q

Methylphenidate

A

Category Class:
-Amphetamine like
Indication:
-ADHD
-Narcolepsy
MOA:
-Inc DOP/NOR
–inc attention span, cognitive performance
CI:
-lactation
SE:
-Tics (report to provider)
-Dysrhythmia/ in BP (monitor)
-Anorexiant- monitor weight
Route:
-PO/transdermal
NI:
-FDA Class II
-Giver early in day
PE:
-avoid alcohol/caffeine/Nic
-sugarless gum for dry mouth
-taper off to avoid withdrawal

Meth=amphetimine…ADHD, CNS stim

25
Modafinil/armodafinil
Category Class: -Amphetamine like (CNS stim) Indication: -ADHD/narcolepsy -**Jet Lag, sleep apnea** CI: -**Depression -lactation** SE: -Tics (report to provider) -Dysrhythmia/ in BP (monitor) -Anorexiant- monitor weight NI: -Schedule IV (less risky) -Giver early in day PE: -avoid alcohol/caffeine/Nic -sugarless gum for dry mouth -taper off to avoid withdrawal mode to finish. Helps ADHD and most- narc, jet lag, apnea
26
Neostigmine MOA, Indication x2
Category Class: -**Cholinterase inhibitor** MOA: -Prevent destruction of ACh Indication: -**Reversal for vecuronium -Short acting acute MG** SE: -**Cholinergic effects on PNS**
27
Phenytoin SEx5, routex2, NI, PE, In
Category Class: -AED (suppress Na+ influx) Indication: -Epilepsy/seizures CI: -PG SE: -Pink/red **urine** -**HA**/dizzy/hypotension/syncope -**Gingival** hyperplasia (check ups) -**Hirsutism** -Blood **dyscrasia** Route: -PO: **shake for 2 min**s -IV: tubing w/ inline filter (**extravasation**) NI: -Same time daily -Narrow ther range PE: -Stop if rash- maybe **SJS** -Don't stop abruptly Interactions -Dec **Warfarin** -Dec **OC** Please Hang Grandmas Hair Down Stairs With Others
28
Prednisone
Category Class: -**corticosteroid** Indication: -**MS exacerbated** predator- steroids NS-MS
29
pyridostigmine
MOA: -Prevent destruction of ACh Indication: -**MG** (intermediate and maintenance) SE: -**Cholinergic** effects PNS
30
NM blocker succinylcholine/vecuronium/pancuronium I x3, AEx3, SE x1
Category Class: -NM blocker (paralytic) MOA: -**Ach agonist -Depolarizes muscle**s Indication: -**Surgery** (no analgesic/sedative effect) -Short term procedure that req **flaccidity** -(intubation/ventilation) -**ECT** SE: -**Hyperkalemia** AE: -**Resp dep, sleep apnea, malignant -hyperthermia** NI: -Doesn’t cross BBB -Short acting SUCC=NO REVERSAL VEC=**Nystigmine**
31
Theophylline Cat Class, I x3, SE
Category Class: **Analeptic**: resp stimulant MOA: Stim brain stem **-bronchodilator/anti-inflammation** Indication: **Neonatal Apnea** (IV) CNS Depressant OD (**EMER resp depression**) (IV) Bronchodilator (asthma, COPD, status asthmaticus) (IV/PO)- **reverses corticosteroid resistance/when B2 doesn't work** SE: - **CNS**: restlessness/tremors/twitching/insomnia/seizure - --N/V, HA, dysrhyth-? hypoT, cardio collapse, GI bleed, inc BG - **Diuresis**, **tinnitus**, tachy, dysrhythmia - dependence/withdrawal Route: IV/PO NI: Narrow ther range (toxicity risk) Theo= baby name. not crying. resp stim Hay, Nadia and Vlad did have some cool children. god bless hallelujah HA, NV, dysrhyth, hypoten, seizure, cardio collapse, GI bleed, hyperglycemia
32
Valproic Acid MOA, SE x3, NI
Category Class: -AED (anticonvulsant) -**Suppress Ca++ influx** Indication: -Epilepsy/seizures CI: -PG -Children \<2 yrs SE: -CNS: dizzy, ataxia, diplopia, imp cog, -nervousness (FALL) -**Pancreatitis** (abd pain, NV) -**Thrombocytopenia** (check platelet counts) NI: -Check serum levels. Narrow ther range
33
Vecuronium/pancuronium
Category Class: -NM blocker (paralytic) MOA: -Competitive agonist Ach -Nondepolarizing paralysis Indication: -Surgery (no analgesic/sedative effect) -Short term procedure that req flaccidity (intubation/ventilation) -ECT SE: -Histamines (allergic-like rxn) NI: Doesn’t cross BBB Antihistamines ready MUST USE NYSTYGMINE for REVERSAL
34
Zolpidem
Category Class: -**Nonbenzo hypnotic** MOA: -GABA stim Indication: -**Insomnia** (short term/PRN \<10 days) CI: -**Sleep apnea, chronic resp disorder, -Children, lact, PG -Other CNS Dep** SE: -HT, hangover, HA, lightheaded (**FALL**) Route: -PO/SL NI: -long duration of action (8 hrs) zzzzzs
35
CNS Depressants CIx4, SE, NI
CI: -**sleep apnea/resp dis -other resp depressant -low BP/HR -HX of substance abuse** SE: -resp depression -low BP/brady/cardiac arrest -dependence/withdrawal **Anterograde amnesia** -light headed/ataxia/HA/blurred vision -depression/suicidal ideation -constipation -dec libido NI: -taper off -don’t ed or get consent after dose -FALL risk. Get 8hrs sleep -**prophylactic laxative, inc fiber, inc H2O**
36
Adrenergic Agonists/anticholinergic CI, SEx9
Indication: - reverse cholinergic - Parkinsons CI: Glaucoma BPH SE: HT (inc BP)- look for pulmonary edema/dyspnea Tachycardia- dysrhythmia/palpitations BPH: urinary retention BBB (lg dose): FALL Mydriasis: glaucoma/photophobia **Hypercoag: DVT, PE, CVA, MI** Low GI: poor absorp, N/V, constipation, xerostomia, hypoactive bowel Blood shunting: acute kidney inj, ischemic bowel, cold skin Glycogenolysis: hyperglycemia in DM
37
Cholinergic Agonists CI, precautions, SE: musc/nic,cns
CI: -**PG/Lact -GI/GU obstruction** Caution **w/" -Seizures -PUD -asthma -Brady/ low BP** SE: -Inc Muscarinic Stim -HA/Dizziness (low BP) -Miosis: blurred vision, dec accom, FALL -bronchoconstrict: SOB, low bronchial secretions -CV: low BP/HR -GI: inc secretions/motility. (Diarrhea/cramps/hyperactive) -GU: Urgency, inc frequency, stress incontinence -Exocrine: inc salivation/lacrimation In Nicotinic: -muscle cramps/fasciculations (spasms) Inc CNS -seizure
38
dantrolene
Indication: Reversal agent for **malignant hyperthermia (after inhalation anesthetics) -watch liver failure**
39
Diphenhydramine/promethazine Cat class, MOA, I, 2nd ind, CI, SE, AE, NI, In
Category Class: Antihistamines (**1st gen**) MOA: Prev histamine release in small BV/nerves Indication: Rhinitis (relieves itch, sneeze, allergy, anaphylaxis, motion sickness, insomnia) 2nd indication: **Insomnia/motion sick** CI: **PG, lactation, newborns, children, elderly Anti chol: BPH/glaucoma/HTN** SE: Cross BBB, CNS dep: drowsy/dizzy/fatigue, coordination, FALL Antichol effects (PNS) AE: Toxicity: **paradoxical**: excitation, hallucination, seizure Route: PO/IV/IM NI: **Watch breathing.** (CNS dep, resp dep) **VS (**antichol effects) **I/Os**- dec output Interactions Avoid other CNS depressants No combo meds- decongestants, A1 agonists **Promthazine: vesicant**
40
Cetirizine/fexofenadine
Category Class: Antihistamine **2nd gen** Indication: Rhinitis (**dec sedative/anticholinergic effect)** Route: Nasal spray/PO eenie meenie 2ndary
41
Ephedrine/Pseudephedrine cat class, MOA, I, CI, prec, SE, NI, PE, IN
Category Class: **Decongestant** MOA: Nonspecific A1 agonist Indication: Rhinitis (peripheral vaso con- dec swelling, stuffy, rhinorrhea CI: **Antidepressants** Glaucoma/BPH Precautions: -**vaso contstrict (cva, dysrhyth, tachy, HTN, CAD, RF)** **Adrenal; (inc BG- DM)** SE: -worsening HTN,BPH, tachy **CNS: restless, jittery, nervous** Route: PO, nasal spray, opthalmic, IM, SQ, IV NI: Check BP before dose **AVOID SUPINE (tilt head forward, sniff gently**) Taper to avoid rebound congestion PE: Avoid freq use (paradoxical congestion) Interactions Avoid CNS stimulants OD risk with OTC
42
Menthol
Category Class: Anti tussive Indication: Dry, unproductive cough (local anesthtic) Route: Cough lozenge
43
Benzonatate/dextromethorphan MOA, Indication, SE
Category Class: Nonopioid antitussive MOA Suppresses cough center in medulla Sim to opioid but NO ANALGESIA Indication: Dry, unproductive cough SE: Drowsy, dizzy, euphoria Benzo: PO gel rx Dextro:OTC lozenge/syrup
44
Codeine
Category Class: Antitussive, opioid (cns suppressant) MOA: Suppress cough by **inc cough threshold in CNS** CI: **Resp disease, ETOH, head trauma** SE: **Drowsy, resp dep, dizzy, FALL, nausea, constipation, hypotension** NI: **Prodrug** Abuse risk Interactions Usually taken with AH, decongestants, expectorants
45
guaifenesin/dextromethorphan
Category Class: expectorant MOA Inc resp tract fluid Indication: Mucus (dry) CI: Children under 4 Route: PO NI: Inc water intake PE: OD with OTC cold meds ---Dextromethorphan Non opioid AT, productive cough SE: drowsy/dizzy
46
-terol
Category Class: Bronchodilator B2 Agonist MOA: **Dec Histamines, inc ciliary activity** CI: **PG, tachy, hyperthyroidism** SE: **B1 activation**: tachy, dysryth, angina, HTN, palp -nervousness, tremors, HA, inc BG NI: **DON’T inc FREQ-** call provider, paradoxical air resistance Use before Inh corticoster ----Albuterol/lev MDI/Neb Short acting- RESCUE Salmeterol Diskus DPI Long acting- MAINTENANCE
47
-opium
Category Class: Anticholinergic bronchodilator MOA: Antichol- PNS CI: Peanut allergy, glaucoma, BPH SE: NO cardiac AE (bc local effect)- if lg, look for antichol Route: maintenance PE: Rinse mouthm allow 5 mins btw Interactions Opium+albuterol=synergist
48
-onide/-sone
Category Class: **Glucocorticoid (give to stop - feedback)** MOA: **Anti inflammation** CI: **PG, URI** SE: **Dry nasal mucosa, epistaxis (give saline nasal spray)** **Inc BG (insulin), leukocytosis (unk infection)** **H2O/Na ret: hypokalemia (heart failure/edema/HTN), in IOP (glaucoma)** **Adrenal- Must wean! Osteoporosis: take vit D, Ca++, exercise)** Route: Nasal spray NI: Scheduled (NOT PRN), maintenance Give loading dose 7-21 days for peak effect Shorten length to prevent opportunistic infection (candidiasis) ----IV: Methyl prednisone Inc loading dose. For acute exacerbation, inflamm disorders PO: Meth/prednisone Wean off IV, end stage maintenance DPI/MDI: budesonide/fluticasone Mainentance therapy (avoid OD) Takes 1-4 weeks for max result -if with B2 agonist, take 2nd Nasal Spray: budesonide/fluticasone -UR inflammation/congestion w allergic rhinitis Did Evan Bring Lily Her Inflammation Already? OMG
49
Montelukast
Category Class: Leukotriene modifiers MOA: Inflammation mediator (dec effect LT) - dec inflamm, edema, mucus-\> bronchodil Indication: Maintenance therapy bronchodilation CI: \<1 yr SE: Dep, suicide, liver failure
50
Acetylcysteine
Category Class: Mucolytic MOA: Dec protein structure bronchial secretions Indication: CF, COPD, bronchitis CI: \< 7ys SE: Dizzy, drowsy, ortho stat, tachy, hepatotox Route: Inh (mucolytic) 2- IV/PO: acetaminohen OD/liver failute 3- PO prevent nephrotox before and after IV contrast dye NI: Inc H2O intake Rotten egg smell- liquid PO
51
Supplemental O2
Indication: Continuous need, PRN for DOE/QHS, acute SOB CI: SE: Vasoconstriction, loss of hypoxic drive (give neb with pressurized air to COPD) Route: Tank, condenser, piped NI: Safety hazard

Pharmacology 283 (6 decks)

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