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NS373—Pharmacology > Exam 3 Drug Info > Flashcards

Exam 3 Drug Info Flashcards

1
Q

Barbituates schedule

A

“C-II
C-IV”

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2
Q

barbituates action

A

CNS depressant
intensifies GABA

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3
Q

long and short acting barbituate drugs

A

long acting: phenobarbital
short acting: pentobarbital

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4
Q

long acting barbituates indications

A

sedation; seizures

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5
Q

intermediate acting barbituates indication

A

sustained sedation

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6
Q

short acting barbituates indications

A

induce sedation; anesthesia adjunct

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7
Q

vitamin deficiency caused by barbituates

A

vit D & B

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8
Q

barbituates cause ____tension and _____cardia

A

hypotension
bradycardia

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9
Q

barbituates restrictions

A

“NO alcohol
NO other CNS depressants
discontinue slowly”

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10
Q

benzodiazepines schedule

A

C-IV

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11
Q

benzodiazepnies action

A

intensifies GABA

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12
Q

benzodiazepines indications (4)

A

“anxiety
pre-anesthesia enhancement
seizures
acute status epilepticus”

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13
Q

benzodiazepine route for acute status epilepticus

A

nasal spray

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14
Q

barbituates severe adverse effects

A

“addiction
dependence
resp depression
hepatotoxicity
tissue necrosis c IV
hallucinations & nightmares
CNS depression: hypnosis; coma; death”

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15
Q

benzodiazepines severe adverse effects

A

“depression
abnormal heart rhythm
CNS depression
resp depression”

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16
Q

benzodiazepines contraindications (4)

A

“glaucoma
drug abuse
liver disease
suicidal thoughts”

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17
Q

benzodiazepine antagonist/antidote

A

flumazenil (Romazicon)

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18
Q

midazolam schedule

A

C-IV

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19
Q

midazolam indications (3)

A

“preoperative
eases anesthesia induction
conscious sedation”

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20
Q

zoipidem schedule

A

C-IV

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21
Q

zoipidem action

A

increases GABA
CNS depressant

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22
Q

zoipidem indication

A

insomnia

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23
Q

nocturnal eating is an effect of…

A

zoipidem

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24
Q

zoipidem severe adverse effects

A

“depression & suicidal thoughts
severe neuropsychiatric reaction
hallucinations
sensory distortion
sleepwalking”

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25
Q

monitor pts on zoipidem for _____ risk

A

fall

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26
Q

when to take zoipidem

A

before sleeping

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27
Q

MAOI action

A

“inhibit monoamine oxidase
norepin, epin, sero, dopa rise”

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28
Q

MAOIs can cause _____reflexia

A

hyper

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29
Q

MAOI severe adverse effects

A

“hypertensive crisis
tyramine: sweating; tremors; bounding HR; increased BP; increased temp”

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30
Q

MAOI restrictions

A

NO vasocontrictors
NO cold meds
NO tyramine containing foods

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31
Q

SNRI action

A

sero, norepin, epin reuptake

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32
Q

SNRIs can cause _____cardi

A

tachy

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33
Q

SNRI severe adverse effects (2)

A

suicidal ideation—esp children, adolescents,
young adults

serotonin syndrome

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34
Q

SSRI action

A

block reuptake of sero
enhances sero transmission @ synapse

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35
Q

SSRI severe adverse effects (3)

A

suicidal ideation
seizures
serotonin syndrome

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36
Q

class of antidepressants more expensive than TCAs with fewer side effects

A

SSRIs

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37
Q

imipramine action

A

block reuptake of norepin. & sero.

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38
Q

antidepressant with bone marrow suppression

A

imipramine

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39
Q

imipramine severe adverse effects (2)

A

cardiac toxicity
seizures

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40
Q

clinical response in ___ weeks for imipramine

A

2-4 weeks

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41
Q

chlorpromazine action (5)

A

block dopamine receptors
limit brain stimuli
anticholinergic
antihistamine
alpha-adrenergic blocking

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42
Q

chlorpromazine indications

A

schizophrenia
psychosis

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43
Q

chlorpromazine severe effects

A

EPS
NMS
photophobia

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44
Q

clinical response in ___ weeks with chlorpromazine

A

3-6

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45
Q

Nonphenothiazine (1st gen)
Typical antipsychotic

A

haloperidol (Haldol)

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46
Q

haloperidol indications

A

schizophrenia
psychosis

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47
Q

halperidol severe effects

A

opposite effect in some pts

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48
Q

antipsychotic with less sedation & anticholinergics

A

halperidol

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49
Q

interventions for halperidol

A

raise dose of seizure drugs taken

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50
Q

atypical antipsychotics indications

A

schizophrenia
psychosis
+ and - symptoms

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50
Q

which antipsychotics cause wt gain

A

atypicals

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51
Q

atypical antipsychotics severe effects

A

seizures
photosensitivity
NMS

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52
Q

which antipsychotics are less likely to cause EPS

A

atypicals

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53
Q

lithium action

A

increases receptor sensitivity to serotonin

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54
Q

lithium indications

A

bipolar
manic symptoms

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55
Q

lithium severe adverse effects

A

cardiovascular collapse
coma

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56
Q

caution for lithium

A

dehydration

pts on diuretics

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57
Q

what to monitor for lithium pts

A

Na+

labs ever 2 weeks

maintenance every month

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58
Q

lithium therapeutic range

A

0.6-1.5 mEq/L

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59
Q

__________ can cause lithium toxicity

A

dehydration

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60
Q

methylphenidate schedule

A

C-II

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61
Q

methylphenidate indications

A

ADHD
narcolepsy

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62
Q

severe effect of methylphenidate

A

paradoxical hyperactivity

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63
Q

anticonvulsants action

A

blocks Na+ channels

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64
Q

anticonvulsants indications (2)

A

partial or focal seizures
migraines

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65
Q

severe effects of anticonvulsants (4)

A

teratogenic—cleft palate; spina bifida
hepatitis
hematological disorders
Stevens Johnson syndrome

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66
Q

anticonvulsants pregnancy category

A

D

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67
Q

hydantoins action (3)

A

inhibit Na+ influx
prevent disruptive neuron firing
stabilize cell membranes

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68
Q

hydantoins indications (2)

A

seizures
dysrhythmias

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69
Q

antiseizures causing thrombocytopenia, leukopenia, agranulocytosis

A

hydantoins

70
Q

hydantoins severe effects

A

teratogenic—cleft palate; heart defects
inhibition of insulin release
interference c folid acid absorption
dysrhythmias
Stevens Johnson syndrome
gingival hyperplasia

71
Q

NEVER mix hydantoins with _______

ALWAYS give with _______

A

dextrose

saline

72
Q

line interventions for hydantoins

A

flush before/after

give at large vein or central line

73
Q

hydantoins therapeutic range

A

10-20 mcg/ml

74
Q

hydantoin pregnancy category

A

D

75
Q

valproic acid action

A

increases GABA

76
Q

valproic acid indications

A

variety of seizures
migraines

77
Q

severe effects of valproic acid (4)

A

teratogenic
prolonged bleeding time
pancreatitis
hepatotoxicity

78
Q

valproic acid pregnancy category

A

D & X

79
Q

2 types of antiparkinson drugs

A

anticholinergics

dopaminergics

80
Q

caution with anticholinergics…

A

in pts taking other anticholinergics (TCAs, phenothiazines)

81
Q

dopaminergics indications

A

some sx: tremor, bradykinesia, gait, muscle rigidity

82
Q

severe effects of dopaminergics

A

cardiovascular effects
psychosis
NMS c quick withdrawal

83
Q

dopaminergics contraindications

A

melanoma
psychosis
narrow angle glaucoma

84
Q

dopaminergic pts should avoid…

A

vit B6

85
Q

2 types of muscle relaxants

A

centrally acting

direct acting

86
Q

spasmolytic drugs

A

centrally acting relaxants

87
Q

indications for muscle relaxants

A

muscle spasm

88
Q

pt cannot take (2) with centrally acting relaxants

A

alcohol

CNS depressants

89
Q

dantrolene action

A

acts on muscle fibers
interferes c Ca+
prevents contraction

90
Q

dantrolene severe effects

A

hepatitis
hepatotoxicity with contraceptives

91
Q

increase fluid intake to prevent crystalline urine & painful urination

A

dantrolene

92
Q

opioid agonist schedule

A

mostly C-II

93
Q

opioid agonist action

A

binds to opioid receptors in CNS

94
Q

opioid agonist indications

A

severe pain
antitussive

95
Q

transdermal opioid

A

fentanyl

96
Q

severe effects of opioid agonists

A

resp depression/apnea
tolerance/dependence
withdrawal sx
anaphylaxis

97
Q

contraindications for opoid agonists (6)

A

head injury
resp disorders
shock
hypotension
morphine—biliary tract spasms (gallbladder)
Percodan—aspirin contraindications

98
Q

withhold opioids & notify Dr if RR < __

A

12

99
Q

give opioid IV push over ____ mins

A

4-5

100
Q

attaches to Mu receptor

A

buprenorphine

101
Q

attaches to Kappa receptor

A

pentazocine

butorphanol

102
Q

used for labor pain

A

butorphanol

103
Q

severe effects of partial opioid agonists

A

dependence

104
Q

partial opioid agonists may be combined with _____

A

naloxone (Narcan)

105
Q

naloxone action

A

reverses effects of opioids:
resp depression, sedation, hypotension,
analgesia

106
Q

naloxone indications

A

opioid overdose
RR <10

107
Q

interventions for naloxone

A

keep resuscitation equipment closeby
may require several doses

108
Q

antimigraine drugs action

A

vasoconstricts cranial vessels

109
Q

antimigraine routes (3)

A

PO
SQ
nasal spray

110
Q

antimigraine severe effects (4)

A

hypertension

coronary artery vasospasm

angina

chest pressure

111
Q

antimigraine caution (3)

A

heart disease

liver disease

hypertension

112
Q

antimigraines work within…

A

10-20 mins

113
Q

types of non opioid analgesics

A

NSAIDS

salicyclates

COX-2 inhibitors

acetaminophen

114
Q

acetaminophen action

A

inhibits prostaglandin synthesis

115
Q

acetylcysteine (Mucomyst)

A

antidote to acetaminophen

116
Q

lidocaine severe effects (3)

A

convulsions
resp depression
cardiac arrest

117
Q

early sign of lidocaine toxicity

A

CNS excitement

118
Q

sometimes __________ is added to lidocaine to prevent bleeding, but NEVER give this in the…

A

epinephrine

fingers, toes, ears, nose, penis

119
Q

propofol route

A

IV drip

120
Q

propofol severe effects (2)

A

apnea
resp depression/arrest

121
Q

MUST use resp ventilation (2)

A

propofol (Diprovan)

succinylcholine (Anectine)

122
Q

propofol onset/duration

A

onset: 40-60 sec
duration: 10-15 min

123
Q

succinylcholine action

A

temporary flaccid paralysis

124
Q

indications for succinylcholine (4)

A

adjunct to sedation
surgery
intubation
mechanical ventilation

125
Q

succinylcholine severe effects (4)

A

resp depression/arrest
apnea
bronchospasm
arrhythmias

126
Q

alpha adrenergic agonist PO indication

A

cold/allergy

127
Q

alpha adrenergic agonist IV indication

A

shock

128
Q

alpha adrenergic agonist eye drop indication

A

pupil dilation for exam

129
Q

alpha adrenergic agonist intranasal indication

A

congestion

130
Q

alpha adrenergic agonist severe effects (5)

A

palpitations
dysrhythmias
dyspnea
pulmonary edema
hyperglycemia

131
Q

alpha blockers action

A

act on vascular smooth muscle
decreases BP

132
Q

beta blockers action

A

decrease rate/force of heart
slow conduction through AV node

133
Q

beta blockers indication

A

hypertension

134
Q

beta blockers severe effects (4)

A

heart failure
arrhthmias
bronchospasm
depression

135
Q

decreased libido

A

beta blockers

136
Q

bethanechol indication

A

atonic bladder postop/postpartum

137
Q

pilocarpine indications (2)

A

PO—dry mouth

eye drops—glaucoma

138
Q

antidote to cholinergics

A

atropine

139
Q

pyridostigmine indication

A

myasthenia gravis

140
Q

donepezil indication

A

Alzheimer’s

141
Q

atropine action (2)

A

blocks vagus stimulation—increases HR
paralyzes iris sphincter (pupil dilation)

142
Q

atropine indications (3)

A

pre-op to reduce salivation
antispasmotic to treat peptic ulcers
bradycardia

143
Q

paralytic ileus

A

atropine

144
Q

somnolence

agitation

bradycardia

syncope

vitamin D & B deficiency

laryngospasm

inflammation (IM)

addiction

resp depression

hallucinations & nightmares

tissue necrosis (IV)

CNS depression - coma, death

A

barbituates

145
Q

weakness

amnesia

ataxia

disorientation

blurred vision

depression

abnormal heart rhythm

CNS & resp depression

A

benzodiazepines

146
Q

daytime sedation

amnesia

nocturnal eating

suicidality

neuropsychiatric reaction

hallucinations

sensory distortion

sleepwalking

A

zoipidem (sedative/hypnotic)

147
Q

ortho hypotension

delirium

mania

vertigo

hyperreflexia

hypertensive crisis

A

MAOI

148
Q

erectile dysfunction

suicidality in adolescents

serotonin syndrome

A

SNRIs

149
Q

insomnia

anticholinergic effects

anorexia

weight changes

sexual dysfunction

suicidality

seizures

serotonin syndrome

A

SSRIs

150
Q

sexual dysfunction

ortho hypotension

bone marrow suppression

anticholinergic effects

cardiac toxicity

seizures

A

imipramine (TCA)

151
Q

extrapyramidal symptoms

sedation

ortho hypotension

vertigo

neuroleptic malignant

photophobia

A

chlorpromazine (phenothiazine)

152
Q

weight gain

sedation

ortho hypotension

hyperglycemia

seizures

photosensitivity

neurleptic malignant

A

atypical antipsychotics

153
Q

muscle weakness

hand tremors

tinnitus

blurred vision

cardio collapse

coma

A

lithium (manic mood stabilizer)

154
Q

insomnia

nervousness

weight loss

paradoxical hyperactivity

A

methylphenidate (CNS stimulant)

155
Q

bone marrow suppression

teratogenic (cleft palate, spina bifida)

hepatitis

heme disorders

Stevens Johnson

A

anticonvulsants

156
Q

thrombocytopenia

leukopenia

agranulocytosis

hyperglycemia

nystagmus

teratogenic (cleft palate, heart defects)

insulin inhibition

folic acid inhibition

Stevens Johnson

dysrhythmias

gingival hyperplasia

A

hydantoins

157
Q

tinnitus

teratogenic

prolonged bleeding

pancreatitis

hepatotoxicity

A

valproate

158
Q

dyskinesias

red/brown sweat and urine

cardio effects

psychosis

neurleptic malignant with quick withdrawal

A

dopaminergics

159
Q

myalgia

BP change

rash

hepatitis

hepatotoxicity c contraceptives

A

dantrolene (centrally acting relaxant)

160
Q

hypotension

sedation

blurred vision

euphoria

constipation

apnea

dependence

withdrawal sx

A

opioids

161
Q

ureteral spasm

heart palpitations

A

opioid partial agonists

162
Q

erratic BP

reversal of analgesia

A

naloxone (opioid antagonist)

163
Q

chest pressure

hypertension

angina

coronary artery vasospasm

A

antimigraines

164
Q

hypotension

convulsions

resp depression

cardiac arrest

A

lidocaine

165
Q

apnea

respiratory arrest

hypotension

A

propofol (general anesthesia)

166
Q

resp depression/arrest

bronchospasm

arrhythmias

A

succinylcholine (neuromuscular junction blocker)

167
Q

nervousness

restlessness

tremors

urinary retention

palpitation

dyspnea

pulmonary edema

hyperglycemia

A

alpha-adrenergic agonists

168
Q

hypotension

dyspepsia

A

prazosin (alpha blocker)

169
Q

bradycardia

hypotension

decreased libido

heart failure

arrhythmias

bronchospasm

depression

A

beta blockers

170
Q

(eyes)

stinging

burning

tearing

redness

A

pilocarpine (direct-acting cholinergic agonist)

171
Q

pupil dilation

paralytic ileus

A

atropine (anticholinergic)

172
Q

why does pyridostigmine help myasthenia gravis?

A

allows ACh to accumulate at receptor site

173
Q

signs of cholinergic toxicity (5)

A

flushing

sweating

salivation

nausea

abd cramps

NS373—Pharmacology (18 decks)

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