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PHARM 327 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Anticholinergic Medications

A

Tolterodine tartrate [Detrol]: Increases bladder capacity and decreases desire/urge to go. They also increase the frequency of bladder contractions.

Side Effects: Dry mouth, constipation, vision impairment, confusion, cognitive dysfunction, tachycardia, decreased sweating, and heat prostration.

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2
Q

Urinary Analgesics

A

Phenazopyridine (Pyridium): Relieve pain, burning sensation, frequency, urgency

Side effects/adverse reactions: Headache, dizziness, GI distress, Contact lens, urine discoloration (Orange and stains), Skin pigmentation.

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3
Q

Urinary Stimulants

A

Bethanechol (Urecholine): Increases bladder tone of the detrusor muscle usually producing a contraction sufficiently strong to urinate

Side effects/adverse reactions: GI distress, abdominal cramps, Headache, dizziness.

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4
Q

Crystalloids

A

Solutions that contain fluids & electrolytes. They freely cross capillary walls

Treats: Dehydration, Electrolyte imbalances, Short-term maintenance fluids, and Early plasma expansion (Shorter duration of action).

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5
Q

Colloids

A

Solutions that contain proteins or other large molecules. Increase osmolarity without dissolving in the solution. Plasma expanders which pull fluids from the interstitial space into the plasma. Used with patients in Dematos, or pt in fluid overload

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6
Q

Potassium Blood Levels

A

Extracellular K+ levels 3.5 to 5 mEq/L

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7
Q

Treatment for Hypokalemia

A

K+ replacement PO or IV (NEVER push K+)

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8
Q

Treatment for Hyperkalemia

A

Stop all K+ sources, food, meds & lower extracellular K+ levels
Calcium salts (calcium gluconate), insulin & glucose, oral or rectal sodium polystyrene sulfonate (Kayexalate), or dialysis.

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9
Q

Benzodiazepines

A

Lorazepam (Ativan), Diazepam (Valium), Midazolam (Versed):
Inhibits GABA neurotransmission by binding to specific benzodiazepine receptors. Treat anxiety, insomnia, seizures, status epilepticus, alcohol withdrawal, muscle spasms, preoperatively.

Side Effects: Drowsiness, dizziness, ataxia, confusion, amnesia, blurred vision, bradycardia, hypotension

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10
Q

Antipsychotics

A

Block dopamine receptors in the brain.

Typical groups of antipsychotics: Phenothiazines (Block norepinephrine), Nonphenothiazines (Block only the neurotransmitter dopamine)

Atypical antipsychotics: Treats schizophrenia and other psychotic disorders (Block dopamine and serotonin receptors)

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11
Q

Typical Antipsychotics

A

Phenothiazines: Chlorpromazine (Thorazine)
Nonphenothizaines: Haloperidol (Haldol)

Adverse Reactions: Extrapyramidal syndrome, Acute dystonia, Akathisia, Tardive dyskinesia, Neuroleptic malignant syndrome

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12
Q

Atypical Antipsychotics

A

Quetiapine (Seroquel), Aripiprazole (Abilify): Block serotonin and dopaminergic D4 receptors.

Adverse Reactions: Drowsiness, headache, unsteady gait, insomnia, depression, weight gain, dyslipidemia, diabetes mellitus

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13
Q

Mood Stabilizers Basic Info.

A

Used for bipolar, manic episodes, schizophrenia, and psychosis

Side Effects: Memory impairment, Hypotension, dysrhythmias, GI distress

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14
Q

Mood Stabilizers #1

A

Lithium: Alteration of ion transport in muscle and nerve cells; Increased receptor sensitivity to serotonin

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15
Q

Mood Stabilizers #2

A

Quetiapine (Seroquel): Combination of dopamine and serotonin type antagonism.

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16
Q

MAO Inhibitors

A

Block monoamine oxidase enzyme. Monoamine oxidase enzyme inactivates norepi, dopamine, epi, and serotonin.

Side Effects: Anticholinergic effects, hypertensive crisis from tyramine interaction.

Interactions: CNS stimulants such as vasoconstrictors, phenylephrine, pseudoephedrine, and foods containing tyramine.

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17
Q

Selective Serotonin Reuptake Inhibitors (SSRIs)

A

Fluoxetine (Prozac), Sertraline (Zoloft): Block uptake of the neurotransmitter serotonin.

Side Effects: Dry mouth, GI distress, Erectile dysfunction

Side effects often decrease over 1 to 4 weeks.

Serotonin syndrome: anxiety, agitation, delirium, diaphoresis, tachycardia, hypertension, hyperthermia, gastrointestinal distress, tremor, muscle rigidity, myoclonus, and hyperreflexia

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18
Q

Uses for SSRIs

A

Major depression
Anxiety disorders
Obsessive-compulsive disorder
Panic disorders, phobias
Posttraumatic stress disorder
Prevention of migraine headaches
Decrease premenstrual tension syndrome
Eating disorders
Substance use disorder

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19
Q

Tricyclic Antidepressants

A

Amitriptyline (Elavil): Blocks uptake of norepinephrine and serotonin in the brain. Blocks histamine receptors. Blocks cholinergic receptors

Side Effects: Drowsiness, dizziness, blurred vision (Anticholinergic). Dry mouth and eyes, GI distress (Anticholinergic). Urinary retention, sexual dysfunction (Anticholinergic) cardiotoxicity. Extrapyramidal Side Effects (EPS). Neuroleptic Malignant Syndrome (NMS)

20
Q

TCAS Interactions

A

MAOIs may lead to toxic psychosis, cardiotoxicity

Antithyroid drugs may increase dysrhythmias

21
Q

General Seizure Medication

A

Phenytoin (Dilantin): Most widely used AED. Selectively inhibits sodium channels. Used for Epilepsy, partial, and tonic-colonic seizures.

Adverse Effects: Confusion, Nystagmus, Sedation, Gingival Hyperplasia, Teratogen, Dysrhythmias, Hematopoietic complications, and Skin Rash.

22
Q

Keppra

A

Levetiracetam: Used to treat complex partial seizures. Less drug interactions were noted with this medication than with other anticonvulsants.

Adverse Effects: Drowsiness/dizziness, Depression, Rash

23
Q

Metabolism of Phenytoin

A

The capacity of the liver to metabolize phenytoin is limited. Relationship between dosing and plasma levels is unusual…..difficult to maintain safe & effective dosing

24
Q

Antiseizure Drug

A

Stabilize nerve cell membranes. Suppress abnormal electric impulses in the cerebral cortex

Specific types of action: Suppress sodium influx. Suppress calcium influx. Enhance the action of GABA.

25
Q

Parkinson Disease Treatment

A

Dopamine Replacement
Dopamine Agonists
MAO-B Inhibitors
COMT Inhibitors

26
Q

Dopamine Replacement Med

A

Levodopa (Dopar) [Carvidopa/Levodopa (Sinemet)]: Converts to dopamine in the brain

Causes the “On-off” phenomenon, which means any time during dosing interval there is an off period

Adverse Effects: Nausea & Vomiting, Dyskinesias, Head bobbing, Tics, Grimacing, Ballismus, Chorea, Postural hypotension, Drowsiness, Impulsiveness, Psychosis, Severe depression with suicidal ideation

27
Q

Dopamine Agonists Medication

A

Pramipexole (Mirapex): Dopamine receptor agonist. Binds selectively to D2 and D3 receptors

Early Stage Parkinson’s: Mirapex used alone
Advanced Parkinson’s: Mirapex + levodopa

Adverse Effects: Sleep Attacks, Nausea, Dizziness, Daytime somnolence, Insomnia, Hallucinations

28
Q

MAO-B Inhibitor Medication

A

Selegiline (Eldepryl): Inhibits MAO-B from inactivating dopamine. High doses can inhibit MAO-A and increase the risk for hypertensive crisis as can foods high in tyramine (aged cheese, red wine, bananas)

Adverse Effects: Insomnia, Orthostatic hypotension, Dizziness, Suicidal ideations.

29
Q

COMT Inhibitors

A

Entacapone (Comtan): Inhibits the COMT enzyme which inactivates dopamine. Prevent peripheral degradation of levodopa, allowing a higher concentration to cross the blood-brain barrier.

Adverse Effects: Affects liver function (Tasmar). Dark yellow-orange urine. Can intensify the effects of levodopa.

30
Q

Alzheimer’s Medication

A

Individual Cholinesterase Inhibitors
Donepezil (Aricept): Blocks the breakdown of acetylcholine by acetylcholinesterase.

Adverse Effects: Nausea, Vomiting
Diarrhea, Dizziness, Headache. Overall, it was pretty well-totaled by patients.

31
Q

Musculoskeletal Medication

A

Acetylcholinesterase Inhibitors
Skeletal Muscle Relaxants

32
Q

Acetylcholinesterase Inhibitors

A

Neostigmine (Short-acting), Pyridostigmine (Intermediate-acting): Blocks the action of acetylcholinesterase to increase available acetylcholine

Side Effects: Miosis, Blurred vision, Bradycardia, Hypotension, GI distress, Nausea, vomiting

33
Q

Skeletal Muscle Relaxants

A

Cyclobenzaprine (Flexeril), Baclofen (Lioresal): Relax skeletal muscles. Used for muscle pain and fracture pain.

Side Effects: Anticholinergic effects (blurred vision, dry mouth, tachycardia, urine retention, constipation). Drowsiness, dizziness, Headache, nervousness, confusion, GI distress, unpleasant taste, Dysrhythmias

34
Q

Prostaglandin Analogs

A

Latanoprost (Xalatan): First-line medications for glaucoma. Facilitate aqueous humor outflow (relax the ciliary muscle)

Adverse Effects: Harmless heightened brown pigmentation of the iris, Hypertrichosis, Blurred vision, Burning/stinging

35
Q

Cholinergic Agonist (Senses)

A

Pilocarpine: similar action as parasympathetic neurotransmitter acetylcholine. Can cause systemic parasympathomimetic effects: cardiac irregularities, diarrhea, respiratory depression

Adverse Effects: Sweating

36
Q

Beta Blockers (Senses)

A

Timolol (Timoptic): First-line medication for glaucoma. Decrease production of aqueous humor by the ciliary body.

Adverse Effects: Blurred vision, Stinging, Photophobia, Conjunctivitis

37
Q

Alpha2-Adrenergice Agonists (Senses)

A

Brimonidine (Alphagan): Reduces aqueous humor production. May delay optic nerve degeneration.

Adverse Effects: Dry mouth, Ocular hyperemia (engorgement of ocular blood vessels), Burning/stinging, Foreign body sensation

38
Q

Anticholinergic Agents (Senses)

A

Isopto Atropine: Allows for observation of the interior of the eye. Eye examination or surgery.

Adverse Effects: Blurred vision, Photophobia, Increased risk of angle-closure glaucoma, Dry mouth, Constipation, Fever, Tachycardia

39
Q

General Side Effects/Adverse Reactions of all Anticancer Meds

A

Bone marrow suppression/myelosuppression: Low RBC (anemia), Low WBC (leukopenia), Low platelet count (thrombocytopenia)

AND

Fatigue, Infertility, Stomatitis, Alopecia, GI Disturbances, Anorexia, Nausea /vomiting, Diarrhea

40
Q

Vaccines

A

Attenuated virus
Toxoids
Conjugate vaccines
Recombinant subunit vaccines
Adjuvant
mRNA

41
Q

Attenuated Virus

A

Live, weakened microorganisms.

EX: MMR, Varicella

42
Q

Toxoids

A

Inactivated toxins that stimulate antitoxin formation but can’t produce disease.

EX: Tetanus

43
Q

Conjugate Vaccines

A

require a protein or toxoid from an unrelated substance that can then be recognized by the immune system.

EX: Meningists

44
Q

Recombinant Subunit Vaccines

A

DNA is injected into another cell or organism where it then replicates.

EX: Hep B

45
Q

Adjuvant

A

substance added to the vaccine to increase the immune response. Often an aluminum salt. Rigorously tested for safety. Require less antigen to produce a dose of the vaccine.

EX: Influenza, polio

46
Q

mRNA

A

Works by introducing a piece of mRNA that corresponds to a viral protein, usually a small piece of a protein found on the virus’s outer membrane.

EX: Covid-19 vaccince

PHARM 327 (2 decks)

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