Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology, Pharmacology, and Therapeutics > Exam 3 Medications > Flashcards

Exam 3 Medications Flashcards

1
Q

acetaminophen

A

Drug Class: APAP

Indication: mild to moderate pain

MOA: inhibits prostaglandin synthesis (COX activity)

Onset/duration: 15 min/4 hr

Elimination: hepatic

Adverse Effects: liver toxicity b/c of highly reactive metabolite (NAPQI); unintentional overdoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ibuprofen

A

Drug Class: NSAID

Indication: pain r/t inflammation

MOA: inhibits cyclo-oxygenase

Onset/duration: 60 min/4-6 hr

Elimination: hepatic, then renal

Adverse Effects:

  • COX1>COX2 = bleeding
  • COX2>COX1 = thrombosis/stroke
  • all NSAIDS: renal toxicity, elevated BP/CV risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

morphine

A

Drug Class: opioid (gold standard)

Indication: moderate to severe pain

MOA: mu-opioid receptor agonist

3:1::oral:parenteral potency ratio

Onset: 30 min (PO); 5 min (IV)
Duration: 4 hrs; T1/2 = 2-4 hr

Elimination: glucuronidation

  • Morphine-3-glucuronide (M3G); neurotoxicity/hyperalgesia)
  • Morphine-6-glucuronide (M6G); analgesia, 1% of product)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

fentanyl

A

Drug Class: opioid

Indication: moderate to severe pain

MOA: mu-opioid receptor agonist

Onset:
IV - instantaneous
transdermal - 12-24 hrs
transmucosal - 5-15 min
Duration:
IV - 30-60 min
transdermal - 72 hrs

Elimination: via CYP3A4 to inactive metabolites (fentanyl and nonfentanyl)
T1/2 = 2 hrs (IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

naloxone

A

Drug Class: opioid reversal agent

Indication: opioid reversal

MOA: mu-opioid-receptor antagonist

Duration: 1h (IV), longer (SC)

Elimination: hepatic (T1/2 = 1-2 hr)

Adverse Effects: hyperalgesia, withdrawal syndrome, seizure, CV instability

Interactions: opioid agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tramadol

A

Drug Class: opioid

Indication: mild to moderate pain

MOA: weak mu-opioid agonist; weak NE/5HT reuptake inhibition

Elimination: O-demethylated to active metabolite (M1) via CYP2D6
-Renal/hepatic dosing based on CYP2D6/3A4 enzymes

IV controlled substance

Side Effects: sedation, dizziness, dry mouth, nausea, constipation, respiratory depression, seizure risk

Adverse Rxns: hypersensitivity rxns

Interactions: CNS depressants, carbamazepine, MAO-inhibitors, serotonin/norepinephrine-reuptake inhibitors (SSRI/SNRI), tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

anticonvulsants (general)

A

Indication: neuropathic/chronic pain syndromes

MOA: prevent bursts of action potentials on injured nerves by modulating/inhibiting sodium or calcium channels

  • require upward/downward titration
  • great variability in therapeutic response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pregabalin or gabapentin

A

Drug Class: anticonvulsant

Indication: neuropathic/chronic pain

MOA: calcium channel modulation

Elimination: renal

Adverse Effects: sedation, weight gain, peripheral edema, dizziness

Interactions: other CNS depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

carbamazepine (tegretol)

oxcarbazepine (trileptal)

A

Drug Class: anticonvulsant

Indication: neuropathic/chronic pain

MOA: AED - sodium channel inhibitors

Elimination: auto-induction (increased rate of metabolism)

Adverse Effects: SIADH/hyponatremia, sedation, dizziness, nausea, leukopenia or thrombocytopenia (2%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

duloxetine

venlafaxine

A

Drug Class: SNRIs

Indication: neuropathic pain, some musculoskeletal syndromes

MOA: selective serotonin/norepi reuptake inhibition

Metabolism:

duloxetine: CYP2D6, 1A2
venlafaxine: CYP2D6 to active metabolite

Adverse Effects: N/V, suicide, withdrawal syndromes, serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

amitriptyline

nortriptyline

A

Drug Class: TCAs

Indication: neuropathic/chronic pain

MOA: tricyclic antidepressants - serotonin, noepi reuptake inhibition

Elimination: hepatic metabolism, then renal elimination - no dosing adjustments

Adverse Effects: secondary amines assoc. w/ anticholinergic effects than tertiary amines; decreased seizure threshold, orthostasis, QTc prolongation, serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

procain

lidocaine

A

Drug Class: local anesthetic

Indication:

MOA: inhibit sodium channels and impulse conduction along axons (penetration depends on molecular size, lipid solubility, degree of ionization)

Adverse Effects: systemic absorption - bradycardia, heart blocks, cardiac arrest, hypotension

*topical or spina/epidural

Adverse Effects:
(spinal/epidural) - autonomic blockade that disrupts GI/GU; (fecal incontinence/retention, hypotension, HA, hematoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

lidocaine patches

A

Drug Class: local

Indication: post-herpetic neuralgia

MOA: inhibit Na channels; impose non-depolarizing conduction block of action potential

  • minimal systemic effects
  • co-analgesic in combo with opioid, antidepressant, anticonvulsant
  • 12 hrs off patch/day; up to 3 at a time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

adverse effects of opioids

A

CNS: dependence/abuse, sedation, psychotomimetic, vertigo, myoclonus, resp. depression, neurocognitive

GI: constipation, nausea

GU: urinary retention

Integumentary: flushing, urticaria, pruritis

Metabolic: stimulate ADH, prolactin, somatotropin, loss of libido

Cardiovascular: hypotension, reflex tachycardia

Ocular: miosis

Immune: decreased fxn with chronic dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

amoxicillin

A

Drug Class: penicillin

Indication: G+ infections and some G- aerobes

MOA: PBP binding

Absorption: acid stable with good bioavailability, not impaired by food

Distribution: most tissue/body fluid

Elimination: renally unchanged

Adverse Effects: CNS, allergic rxn, interstitial nephritis

Interactions: warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

amoxicillin + clavulanate

A

Drug Class: penicillin + B-lactamase inhibitor

clavulanate has no antibacterial activity by itself - beta lactamase inhibitor

17
Q

cephalexin

A

Drug Class: cephalosporin

Indication: susceptible strains of bacteria (ex: staphylococci and streptococci - skin infections)

MOA: PBP binding. 1st gen

Distribution: most tissy/body fluid (T1/2 = .5-1hr)

Elimination: renal

Adverse Effects: C. difficile, allergic rxn

18
Q

cefepime

A

Drug Class: cephalosporin

Indication: susceptible strains of G+/-

MOA: PBP binding. 4th gen.

Dose: IV or IM ONLY

Distribution: most tissue/body fluid, CSF (T1/2 = 2h)

Elimination: renal

Adverse Rxns: encelphalopathy, seizures, thrombophlebitis, allergic rxn

19
Q

imipenem

A

Drug Class: carbapenem

Indication: susceptible strains of G+ cocci, G- bacilli and cocci, mixed aerobic/anaerobic infections. extremely broad spectrum.

MOA: PBP binding

Dose: IV or IM ONLY

Distribution: widely distributed including CSF (T1/2 = 1h)

Elimination: renal

Adverse Effects: superinfections

Interactions: valproate (reduces levels, precipitating seizures)

20
Q

vancomycin

A

Drug Class: glycopeptide

Indication: MRSA, MRSE, susceptible strains of G+ in pts with B-lactam allergy

MOA: binds to cell wall synthesis precursor molecules

Dose: oral is for C. diff infections. Draw trough immediately before infusing next dose.

Distribution: well distributed in tissue/fluids (T1/2=6h)

Elimination: renal

Adverse Effects: renal failure/nephrotoxicity, ototoxicity (reversible), red man syndrome from rapid IV infusion

21
Q

doxycycline

A

Drug Class: tetracycline

Indication: broad, wide variety of G+ and G-. First line for rickettsial diseases. active against MRSA.

MOA: binds to #0S ribosomal unit to disrupt bacterial protein synthesis

Distribution: wide, poor CSF penetration

Elimination: HEPATIC

Adverse Effects: photosensitivity, superinfection, tooth discoloration, long-bone in premature infants

Interactions: warfarin, lithium; calcium, magnesium, and iron decrease absorption (includes food - give doxy 1 hr before or 4 hrs after)

22
Q

azithromycin

A

Drug Class: macrolide

Indication: susceptible G+ and G- bacteria strains

MOA: binds to 50S ribosomal subunit to disrupt protein synthesis

Distribution: most tissue/fluid (T1/2 = 60h)

Elimination: hepatic MORE than renal

Adverse Effects: ototoxicity, dysrhythmia (Torsades de Pointes), allergic rxn

Interactions: warfarin, medications that affect heart rhythm

23
Q

gentamicin

A

Drug Class: aminoglycoside

Indication: serious infections by aerobic G- bacilli

MOA: binds to 30S ribosomal subunit to disrupt protein synthesis

Dose: IV and IM. NO PO

Distribution: well distributed in ECF, crosses placenta, concentrates in renal and inner ear cells (T1/2 = 2h)

Elimination: renally unchanged

Adverse Effects: irreversible ototoxicity, nephrotoxicity; hypersensitivity

Interactions: penicillins (synergy - don’t mix in IV bag); neuromuscular blockers, ototoxins, nehprotoxins

24
Q

linezolid

A

Drug Class: oxazolidinone

Indication: severe infections by MDR G+ organisms (VRE, MRSA)

MOA: Binds to 50S ribosomal subunit (23-S portion) to disrupt protein synthesis. 1st in class.

Elimination: hepatic met. w/ renal excretion

Adverse Effects: bone marrow suppression (need CBC weekly), hepatotoxicity

Interactions: tyramine, MAO inhibitors (hypotension), SSRIs (serotonin syndrome)

25
Q

clindamycin

A

Drug Class: other

Indication: susceptible anaerobes and some G+ aerobes

MOA: binds to 50S ribosomal subunit to disrupt protein synthesis (overlaps macrolide site)

Dose: intravaginally for bacterial vaginosis

Distribution: most tissue/fluid (T1/2 = 3h)

Elimination: hepatic met., active and inactive metabolites excreted in bile and urine

Adverse Effects: C. diff –> pseudomembranous colitis, cardiovascular effects w/ rapid IV, hypersensitivity rash, hepatotoxocitiy, blood dyscrasias

26
Q

levofloxacin

A

Drug Class: fluoroquinolone

Indication: susceptible G- and some G+, atypicals

MOA: inhibits DNA gyrase and topoisomerase 4, preventing DNA replication and cell division

Absorption: rapid/complete absorption

Distribution: wide - concentrates in urine, stool, bile, saliva, prostate, bone (T1/2 = 5-7h)

Elimination: hepatic met., renal excretion

Adverse Effects: phototoxicity, QT prolongation, tendonitis w. rare tendon rupture

Interactions: warfarin, drugs that affect heart rhythm, calcium

27
Q

metronidazole

A

Drug Class: other

Indication: susceptible anaerobes (C.diff), some protozoal infections, bacterial vaginosis

MOA: causes strand breaks in DNA structure

Dose: loading dose and maintenance dose

Elimination: hepatic met. (CYP3A4), then renal > biliary excretion (T1/2 = 6-8h)

Adverse Effects: pancreatitis, avoid 1st trimester

Interactions: ethanol, warfarin, phenobarbital, phenytoin

AVOID all alcohol - disulfiram-like rxn with violent vomiting

28
Q

co-trimoxazole

A

Drug Class: other (trimethoprim + sulfamethoxazole)

Indication: susceptible organisms. effective against MRSA, but resistance is evolving

MOA: synergistic effect on folic acid metabolism

Elimination: hepatic met. then renal excretion

Adverse Effects: hyperkalemia, crystalluria w. renal damage

Avoid if sulfonamide allergy

Drink 8-10 glasses water/day to dilute urine

29
Q

sulfamethoxazole

A

Drug Class: sulfonamide

Indication: susceptible G+ cocci, G- bacilli

MOA: inhibits folic acid synthesis required for growth

Dose: only available in combination with trimethoprim

Distribution: well absorbed, distribution to all tissues including pleural and ocular

Elimination: hepatic met. via acetylation, renal excretion of inactive but potentially dangerous metabolites

Adverse Effects: kernicterus (bilirubin accumulation in brain), Stevens-Johnson Syndrome, blood dyscrasia, hemolytic anemia, avoid w. sulfonamide allergy

Interactions: phenytoin, warfarin, sulfonylureas

30
Q

trimethoprim

A

Drug Class: other

Indication: susceptible G+ bacilli and G- bacilli, some protozoa

MOA; inhibits folic acid synthesis required for growth

Distribution: completely absorbed w/ widespread distribution including placental transfer. lipophilic (cross blood-brain barrier)

Elimination: renally unchanged, concentrating in urine

Adverse Effects: N/V, glossitis, stomatitis. avoid in pregnancy/lactation/folate deficiency. hyperkalemia

Pathophysiology, Pharmacology, and Therapeutics (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions