Exam 3 Drug Info Flashcards
1
Q
Barbituates schedule
A
“C-II
C-IV”
2
Q
barbituates action
A
CNS depressant
intensifies GABA
3
Q
long and short acting barbituate drugs
A
long acting: phenobarbital
short acting: pentobarbital
4
Q
long acting barbituates indications
A
sedation; seizures
5
Q
intermediate acting barbituates indication
A
sustained sedation
6
Q
short acting barbituates indications
A
induce sedation; anesthesia adjunct
7
Q
vitamin deficiency caused by barbituates
A
vit D & B
8
Q
barbituates cause ____tension and _____cardia
A
hypotension
bradycardia
9
Q
barbituates restrictions
A
“NO alcohol
NO other CNS depressants
discontinue slowly”
10
Q
benzodiazepines schedule
A
C-IV
11
Q
benzodiazepnies action
A
intensifies GABA
12
Q
benzodiazepines indications (4)
A
“anxiety
pre-anesthesia enhancement
seizures
acute status epilepticus”
13
Q
benzodiazepine route for acute status epilepticus
A
nasal spray
14
Q
barbituates severe adverse effects
A
“addiction
dependence
resp depression
hepatotoxicity
tissue necrosis c IV
hallucinations & nightmares
CNS depression: hypnosis; coma; death”
15
Q
benzodiazepines severe adverse effects
A
“depression
abnormal heart rhythm
CNS depression
resp depression”
16
Q
benzodiazepines contraindications (4)
A
“glaucoma
drug abuse
liver disease
suicidal thoughts”
17
Q
benzodiazepine antagonist/antidote
A
flumazenil (Romazicon)
18
Q
midazolam schedule
A
C-IV
19
Q
midazolam indications (3)
A
“preoperative
eases anesthesia induction
conscious sedation”
20
Q
zoipidem schedule
A
C-IV
21
Q
zoipidem action
A
increases GABA
CNS depressant
22
Q
zoipidem indication
A
insomnia
23
Q
nocturnal eating is an effect of…
A
zoipidem
24
Q
zoipidem severe adverse effects
A
“depression & suicidal thoughts
severe neuropsychiatric reaction
hallucinations
sensory distortion
sleepwalking”
25
monitor pts on zoipidem for _____ risk
fall
26
when to take zoipidem
before sleeping
27
MAOI action
"inhibit monoamine oxidase
norepin, epin, sero, dopa rise"
28
MAOIs can cause \_\_\_\_\_reflexia
hyper
29
MAOI severe adverse effects
"hypertensive crisis
_tyramine_: sweating; tremors; bounding HR; increased BP; increased temp"
30
MAOI restrictions
NO vasocontrictors
NO cold meds
NO tyramine containing foods
31
SNRI action
sero, norepin, epin reuptake
32
SNRIs can cause \_\_\_\_\_cardi
tachy
33
SNRI severe adverse effects (2)
suicidal ideation—esp children, adolescents,
young adults
serotonin syndrome
34
SSRI action
block reuptake of sero
enhances sero transmission @ synapse
35
SSRI severe adverse effects (3)
suicidal ideation
seizures
serotonin syndrome
36
class of antidepressants more expensive than TCAs with fewer side effects
SSRIs
37
imipramine action
block reuptake of norepin. & sero.
38
antidepressant with bone marrow suppression
imipramine
39
imipramine severe adverse effects (2)
cardiac toxicity
seizures
40
clinical response in ___ weeks for imipramine
2-4 weeks
41
chlorpromazine action (5)
block dopamine receptors
limit brain stimuli
anticholinergic
antihistamine
alpha-adrenergic blocking
42
chlorpromazine indications
schizophrenia
psychosis
43
chlorpromazine severe effects
EPS
NMS
photophobia
44
clinical response in ___ weeks with chlorpromazine
3-6
45
Nonphenothiazine (1st gen)
Typical antipsychotic
haloperidol (Haldol)
46
haloperidol indications
schizophrenia
psychosis
47
halperidol severe effects
opposite effect in some pts
48
antipsychotic with less sedation & anticholinergics
halperidol
49
interventions for halperidol
raise dose of seizure drugs taken
50
atypical antipsychotics indications
schizophrenia
psychosis
+ and - symptoms
50
which antipsychotics cause wt gain
atypicals
51
atypical antipsychotics severe effects
seizures
photosensitivity
NMS
52
which antipsychotics are less likely to cause EPS
atypicals
53
lithium action
increases receptor sensitivity to serotonin
54
lithium indications
bipolar
manic symptoms
55
lithium severe adverse effects
cardiovascular collapse
coma
56
caution for lithium
dehydration
pts on diuretics
57
what to monitor for lithium pts
Na+
labs ever 2 weeks
maintenance every month
58
lithium therapeutic range
0.6-1.5 mEq/L
59
\_\_\_\_\_\_\_\_\_\_ can cause lithium toxicity
dehydration
60
methylphenidate schedule
C-II
61
methylphenidate indications
ADHD
narcolepsy
62
severe effect of methylphenidate
paradoxical hyperactivity
63
anticonvulsants action
blocks Na+ channels
64
anticonvulsants indications (2)
partial or focal seizures
migraines
65
severe effects of anticonvulsants (4)
teratogenic—cleft palate; spina bifida
hepatitis
hematological disorders
Stevens Johnson syndrome
66
anticonvulsants pregnancy category
D
67
hydantoins action (3)
inhibit Na+ influx
prevent disruptive neuron firing
stabilize cell membranes
68
hydantoins indications (2)
seizures
dysrhythmias
69
antiseizures causing thrombocytopenia, leukopenia, agranulocytosis
hydantoins
70
hydantoins severe effects
teratogenic—cleft palate; heart defects
inhibition of insulin release
interference c folid acid absorption
dysrhythmias
Stevens Johnson syndrome
gingival hyperplasia
71
NEVER mix hydantoins with \_\_\_\_\_\_\_
ALWAYS give with \_\_\_\_\_\_\_
dextrose
saline
72
line interventions for hydantoins
flush before/after
give at large vein or central line
73
hydantoins therapeutic range
10-20 mcg/ml
74
hydantoin pregnancy category
D
75
valproic acid action
increases GABA
76
valproic acid indications
variety of seizures
migraines
77
severe effects of valproic acid (4)
teratogenic
prolonged bleeding time
pancreatitis
hepatotoxicity
78
valproic acid pregnancy category
D & X
79
2 types of antiparkinson drugs
anticholinergics
dopaminergics
80
caution with anticholinergics…
in pts taking other anticholinergics (TCAs, phenothiazines)
81
dopaminergics indications
some sx: tremor, bradykinesia, gait, muscle rigidity
82
severe effects of dopaminergics
cardiovascular effects
psychosis
NMS c quick withdrawal
83
dopaminergics contraindications
melanoma
psychosis
narrow angle glaucoma
84
dopaminergic pts should avoid…
vit B6
85
2 types of muscle relaxants
centrally acting
direct acting
86
spasmolytic drugs
centrally acting relaxants
87
indications for muscle relaxants
muscle spasm
88
pt cannot take (2) with centrally acting relaxants
alcohol
CNS depressants
89
dantrolene action
acts on muscle fibers
interferes c Ca+
prevents contraction
90
dantrolene severe effects
hepatitis
hepatotoxicity with contraceptives
91
increase fluid intake to prevent crystalline urine & painful urination
dantrolene
92
opioid agonist schedule
mostly C-II
93
opioid agonist action
binds to opioid receptors in CNS
94
opioid agonist indications
severe pain
antitussive
95
transdermal opioid
fentanyl
96
severe effects of opioid agonists
resp depression/apnea
tolerance/dependence
withdrawal sx
anaphylaxis
97
contraindications for opoid agonists (6)
head injury
resp disorders
shock
hypotension
morphine—biliary tract spasms (gallbladder)
Percodan—aspirin contraindications
98
withhold opioids & notify Dr if RR \< \_\_
12
99
give opioid IV push over ____ mins
4-5
100
attaches to Mu receptor
buprenorphine
101
attaches to Kappa receptor
pentazocine
butorphanol
102
used for labor pain
butorphanol
103
severe effects of partial opioid agonists
dependence
104
partial opioid agonists may be combined with \_\_\_\_\_
naloxone (Narcan)
105
naloxone action
reverses effects of opioids:
resp depression, sedation, hypotension,
analgesia
106
naloxone indications
opioid overdose
RR \<10
107
interventions for naloxone
keep resuscitation equipment closeby
may require several doses
108
antimigraine drugs action
vasoconstricts cranial vessels
109
antimigraine routes (3)
PO
SQ
nasal spray
110
antimigraine severe effects (4)
hypertension
coronary artery vasospasm
angina
chest pressure
111
antimigraine caution (3)
heart disease
liver disease
hypertension
112
antimigraines work within…
10-20 mins
113
types of non opioid analgesics
NSAIDS
salicyclates
COX-2 inhibitors
acetaminophen
114
acetaminophen action
inhibits prostaglandin synthesis
115
acetylcysteine (Mucomyst)
antidote to acetaminophen
116
lidocaine severe effects (3)
convulsions
resp depression
cardiac arrest
117
early sign of lidocaine toxicity
CNS excitement
118
sometimes __________ is added to lidocaine to prevent bleeding, but NEVER give this in the…
epinephrine
fingers, toes, ears, nose, penis
119
propofol route
IV drip
120
propofol severe effects (2)
apnea
resp depression/arrest
121
MUST use resp ventilation (2)
propofol (Diprovan)
succinylcholine (Anectine)
122
propofol onset/duration
onset: 40-60 sec
duration: 10-15 min
123
succinylcholine action
temporary flaccid paralysis
124
indications for succinylcholine (4)
adjunct to sedation
surgery
intubation
mechanical ventilation
125
succinylcholine severe effects (4)
resp depression/arrest
apnea
bronchospasm
arrhythmias
126
alpha adrenergic agonist PO indication
cold/allergy
127
alpha adrenergic agonist IV indication
shock
128
alpha adrenergic agonist eye drop indication
pupil dilation for exam
129
alpha adrenergic agonist intranasal indication
congestion
130
alpha adrenergic agonist severe effects (5)
palpitations
dysrhythmias
dyspnea
pulmonary edema
hyperglycemia
131
alpha blockers action
act on vascular smooth muscle
decreases BP
132
beta blockers action
decrease rate/force of heart
slow conduction through AV node
133
beta blockers indication
hypertension
134
beta blockers severe effects (4)
heart failure
arrhthmias
bronchospasm
depression
135
decreased libido
beta blockers
136
bethanechol indication
atonic bladder postop/postpartum
137
pilocarpine indications (2)
PO—dry mouth
eye drops—glaucoma
138
antidote to cholinergics
atropine
139
pyridostigmine indication
myasthenia gravis
140
donepezil indication
Alzheimer's
141
atropine action (2)
blocks vagus stimulation—increases HR
paralyzes iris sphincter (pupil dilation)
142
atropine indications (3)
pre-op to reduce salivation
antispasmotic to treat peptic ulcers
bradycardia
143
paralytic ileus
atropine
144
somnolence
agitation
bradycardia
syncope
vitamin D & B deficiency
laryngospasm
inflammation (IM)
addiction
resp depression
hallucinations & nightmares
tissue necrosis (IV)
CNS depression - coma, death
barbituates
145
weakness
amnesia
ataxia
disorientation
blurred vision
depression
abnormal heart rhythm
CNS & resp depression
benzodiazepines
146
daytime sedation
amnesia
nocturnal eating
suicidality
neuropsychiatric reaction
hallucinations
sensory distortion
sleepwalking
zoipidem (sedative/hypnotic)
147
ortho hypotension
delirium
mania
vertigo
hyperreflexia
hypertensive crisis
MAOI
148
erectile dysfunction
suicidality in adolescents
serotonin syndrome
SNRIs
149
insomnia
anticholinergic effects
anorexia
weight changes
sexual dysfunction
suicidality
seizures
serotonin syndrome
SSRIs
150
sexual dysfunction
ortho hypotension
bone marrow suppression
anticholinergic effects
cardiac toxicity
seizures
imipramine (TCA)
151
**extrapyramidal symptoms**
sedation
ortho hypotension
vertigo
neuroleptic malignant
photophobia
chlorpromazine (phenothiazine)
152
weight gain
sedation
ortho hypotension
hyperglycemia
seizures
photosensitivity
neurleptic malignant
atypical antipsychotics
153
muscle weakness
hand tremors
tinnitus
blurred vision
cardio collapse
coma
lithium (manic mood stabilizer)
154
insomnia
nervousness
weight loss
paradoxical hyperactivity
methylphenidate (CNS stimulant)
155
bone marrow suppression
teratogenic (cleft palate, spina bifida)
hepatitis
heme disorders
Stevens Johnson
anticonvulsants
156
thrombocytopenia
leukopenia
agranulocytosis
hyperglycemia
nystagmus
teratogenic (cleft palate, heart defects)
insulin inhibition
folic acid inhibition
Stevens Johnson
dysrhythmias
gingival hyperplasia
hydantoins
157
tinnitus
teratogenic
prolonged bleeding
pancreatitis
hepatotoxicity
valproate
158
dyskinesias
red/brown sweat and urine
cardio effects
psychosis
neurleptic malignant with quick withdrawal
dopaminergics
159
myalgia
BP change
rash
hepatitis
hepatotoxicity c contraceptives
dantrolene (centrally acting relaxant)
160
hypotension
sedation
blurred vision
euphoria
constipation
apnea
dependence
withdrawal sx
opioids
161
ureteral spasm
heart palpitations
opioid partial agonists
162
erratic BP
reversal of analgesia
naloxone (opioid antagonist)
163
chest pressure
hypertension
angina
coronary artery vasospasm
antimigraines
164
hypotension
convulsions
resp depression
cardiac arrest
lidocaine
165
apnea
respiratory arrest
hypotension
propofol (general anesthesia)
166
resp depression/arrest
bronchospasm
arrhythmias
succinylcholine (neuromuscular junction blocker)
167
nervousness
restlessness
tremors
urinary retention
palpitation
dyspnea
pulmonary edema
hyperglycemia
alpha-adrenergic agonists
168
hypotension
dyspepsia
prazosin (alpha blocker)
169
bradycardia
hypotension
decreased libido
heart failure
arrhythmias
bronchospasm
depression
beta blockers
170
(eyes)
stinging
burning
tearing
redness
pilocarpine (direct-acting cholinergic agonist)
171
pupil dilation
paralytic ileus
atropine (anticholinergic)
172
why does pyridostigmine help myasthenia gravis?
allows ACh to accumulate at receptor site
173
signs of cholinergic toxicity (5)
flushing
sweating
salivation
nausea
abd cramps
