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Pharm > Exam 4 Blueprint > Flashcards

Exam 4 Blueprint Flashcards

1
Q

Barbiturates

A
  • stronger than benzos

- phenobarbital (luminal)

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2
Q

Benzodiazepines

A
  • most frequently used
  • African Americans have a higher risk of toxicity
  • diazepam (Valium)
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3
Q

Antidote for diazepam (Valium)

A

Flumazenil (romazicon)

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4
Q

Acute withdrawal syndrome

A
  • abrupt cessation

- causes nausea, headache, malaise, vertigo, nightmares

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5
Q

TCAs

A
  • bad side effects
  • interacts with many drug classes
  • doses should be delivered at bedtime
  • imipramine (tofranil)
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6
Q

MAOIs

A
  • bad drug..many interactions
  • can cause htn crisis of taken with TCA
  • no tyramine foods allowed
  • phenelzine (Nardil)
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7
Q

Tyramine containing foods

A
  • aged cheese
  • avocados
  • chocolate
  • wine
  • aged meats
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8
Q

Drug used to treat HTN crisis

A

Pentolamine (regitine)

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9
Q

SSRIs

A
  • better drug because less adverse effects than TCAs and MAOIs
  • suicide risk especially in adolescents
  • fluoxetine (Prozac)
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10
Q

Neuroleptics

A
  • not called tranquilizers anymore
  • block dopamine
  • can cause neuro malignant syndrome
  • typical: chlorpromazine (Thorazine)
  • atypical: clozapine (clozaril)
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11
Q

Neuro malignant syndrome

A
  • caused by General anesthetics and drugs that have direct CNS effects
  • includes high fever
  • EPS, rigidity, htn, tachycardia
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12
Q

Lithium (lithobid)

A
  • anti manic drug
  • contraindicated in hyponatremia
  • drug should be held if lithium levels are high or Na levels are low
  • therapeutic: (0.6-1-2)
  • risk of death: 2 mEq/L
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13
Q

CNS stimulants

A
  • tricks the brain and allows the ADD person to be more calm
  • controlled substance
  • methylphenidate (Ritalin)
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14
Q

Generalized antiseizure agent

A
  • effect the entire brain and reduce the chance of sudden electrical outbursts
  • patients should wear a medical alert tag
  • phenytoin (Dilantin)
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15
Q

Phenytoin (Dilantin) levels

A

10-20 mcg/ml

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16
Q

Dopaminergic drugs

A
  • act like or increase dopamine at the receptor sites
  • more effective than anticholinergics at treating Parkinson’s
  • levodopa (dopar)
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17
Q

Levodopa (dopar)

A
  • helps to create balance between stimulating and inhibitory neurons
  • cause bone marrow depression
  • interacts with MAOIs and phenytoin (Dilantin)
  • avoid tyramine containing foods
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18
Q

Skeletal muscle relaxant: central acting

A
  • spasmolytics

- baclophen (lioresol)

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19
Q

Baclophen (lioresol)

A
  • works in the CNS to interfere with the reflexes that are causing spasms
  • causes depression, drowsiness, fatigue, dry mouth, constipation
  • discontinue the drug slowly so that hallucinations and psychosis won’t occur
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20
Q

Anxiolytics

A
  • high risk of cleft lip and palate in African American pregnant women
  • prevent fear or tension
  • sedatives/hypnotics
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21
Q

Morphine (Roxanol)

A
  • narcotic
  • major CNS depressant
  • will hold if respiratory rate is 12
  • controlled substance
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22
Q

Antidote for morphine overdose

A

Naloxone (narcan)

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23
Q

Ergots

A
  • used in relief of migraine or vascular headaches
  • don’t take with beta blockers
  • causes severe thirst, hypoperfusion, chest pain, BP changes, confusion
  • ergotism
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24
Q

Antidote to NMJ blocking agents

A

Cholinesterase inhibitor

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25
Q

Pancuronium (pavulon)

A
  • nondepolarizing NMJs
  • act as antagonist to Ach in the NMJ to prevent depolarization of muscle cells
  • can cause malignant hyperthermia and paralysis of muscles
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26
Q

Succinylcholine (anectine)

A
  • depolarizing agent
  • depolarization causes stimulation of muscle and the muscle contracts then causes flaccid paralysis
  • can cause malignant hyperthermia
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27
Q

Alpha 1

A
  • generally about excitation/stimulation

- located in eye, salivary glands, GI/GU sphincters, arterioles

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28
Q

phenylephrine (Sudafed PE)

A
  • Alpha 1 agonist

- decongestant drug

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29
Q

doxazosin (Cardura)

A
  • Alpha 1 antagonist
  • causes relaxation
  • used for BPH
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30
Q

Stimulation of alpha 1 causes..

A
  • mydriasis (pupil dilation)

- arterial constriction which allows for fight or flight

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31
Q

Alpha 2

A
  • generally about relaxation

- located in smooth muscle NMJ synapse

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32
Q

clonidine (Catapres)

A
  • Alpha 2 agonist
  • causes more relaxation
  • good BP medication
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33
Q

Stimulation of alpha 2 causes..

A

more relaxation

34
Q

Blocking of alpha 2 causes..

A

less relaxation

35
Q

Blocking of alpha 1 causes..

A
  • miosis (pupil constriction)

- vasodilation of arterioles

36
Q

Beta 1

A
  • generally about stimulation

- located in the heart, brain and kidney

37
Q

Stimulation of beta 1 causes..

A
  • more stimulation
  • increase conductivity
  • increase renin production
  • sympathetic
38
Q

Blocking of beta 1 causes..

A
  • less stimulation
  • decrease conductivity
  • decrease renin production
  • anti sympathetic
39
Q

Atenolol (tenormin)

A
  • beta 1 blocker (selective antagonist)
  • lowers BP
  • less stimulation, decrease conductivity
40
Q

dobutamine (dobutrex)

A
  • beta 1 selective agonist

- use in shock to improve conductivity stimulation of the heart

41
Q

Beta 2

A
  • generally about stimulation

- located in smooth muscle, bronchioles, liver, uterus

42
Q

Stimulation of beta 2 causes..

A
  • more stimulation
  • dilation
  • increase lipolysis
  • improves insulin
43
Q

Blocking of beta 2 causes..

A
  • less stimulation
  • constriction
  • decrease lipolysis
  • impairs insulin
44
Q

albuterol (Proventil)

A
  • beta 2 agonist
  • used to open airways
  • dilation of the bronchioles
  • will also hit beta 1 and caused increase in heart rate
45
Q

terbutaline (Brethine)

A
  • beta 2 agonist

- used for premature labor which causes the uterus to relax

46
Q

If we over stimulate the sympathetic nervous system…

A

-have a decrease in CO because of too fast of HR, too slow of contraction

47
Q

Beta 1 selective adrenergic blockers are..

A
  • preferred in patients with respiratory problems
  • used to treat HTN, angina, and HF
  • must be tapered
  • causes hypersensitivity to catecholamine
48
Q

M1 receptors are located..

A

CNS and enteric nervous system

49
Q

M2 receptors are located..

A

Heart

50
Q

Me receptors cause

A
  • increase exocrine gland secretion
  • increase gut motility
  • miosis
  • accommodation
  • broncho constriction
  • bladder constriction “M3 makes you pee”
51
Q

What is primarily the neurotransmitter for the parasympathetic nervous system?

A

Ach

52
Q

bethanechol (Urecholine)

A

Used for urinary retention

-direct cholinergic drug

53
Q

carbechol (Carbastat)

A

Used for glaucoma, urinary retention

-direct cholinergic drug

54
Q

methacholine (Provocholine)

A

asthma challenge test

  • If the pt wheezes faster than they should, we know we have disease in the bronchioles
  • direct cholinergic drug
55
Q

pilocarpine (Salagen)

A
  • used to test for cystic fibrosis
  • stimulation causes increased exocrine function
  • direct cholinergic drug
56
Q

Anti-acetylcholine esterases

A
  • you become more cholineric
  • prevent enzymes from breaking down Ach
  • indirect cholinergic drug
57
Q

neostigmine (Prostigmin)

pyridostigmine (Mestinon)

A
  • used for urinary retention
  • used as an antidote to NMJ blocker
  • used in myasthenia gravis
  • indirect cholinergic drug
58
Q

physostigmine (Antilirium)

A
  • FIXostigmine
  • used to counteract atropine overdose
  • indirect cholinergic drug
59
Q

The rescue drug for an anticholinergic is..

A

a cholinergic drug

60
Q

donepezil (Aricept)

A
  • used to treat Alzheimer’s/dementia
  • works on the M1 receptors in the brain
  • indirect cholinergic drug
61
Q

Antagonizing M3 receptor

A
  • decrease exocrine secretions
  • decrease gut motility
  • mydriasis
  • no accommodation
  • broncho relaxation
  • bladder distention
62
Q

atropine (Atreza)

A
  • used to create mydriasis in the eye to see retina better
  • used as an antidote to cholinergic poisoning
  • used to prevent or slow down drooling
  • used as a rescue drug for bradycardia
63
Q

ipratropium (Atropent)

A

-used to treat asthma

64
Q

oxybutinin (Ditropan)

A

used to help with bladder spasms and urinary retention issues

65
Q

scopolamine (Maldemar)

A
  • used for motion sickness

- Hits M1 and causes CNS depression

66
Q

Cholinergic/Myasthenia crisis

A

Patient presents with progressive muscle weakness and respiratory difficulty

67
Q

Drug to treat a cholinergic crisis

A

atropine

68
Q

edrophonium (Tensilon)

A

used to discern between cholinergic and myasthenia crisis

  • pt will get better if it’s a myasthenia crisis
  • pt will not get better if it’s a cholinergic crisis
69
Q

fluoroquinolones

A
  • Antibiotic

- broad spectrum: treat gram negative and positive infections

70
Q

ciprofloxacin (Cipro)

A
  • interferes with DNA replication
  • fluoroquinolones
  • BBW for achilles tendon pain
  • if given with theophylline, both drugs become toxic
71
Q

rifampin (Rifadin)

A
  • treat Tb
  • treat meningococcal meningitis or for prophylaxis
  • narrow spectrum
72
Q

What is the main goal for Tb treatment?

A

Protection of the population

73
Q

Antiviral agents

A
  • Viruses are really hard to kill because they become a part of us
  • Must kill the virus and the cell the virus has invaded
74
Q

rimantadine (Flumadine)

A
  • treats influenza A
  • prevents the shedding of the viral protein coat…means it cannot replicate
  • has anticholinergic effects
75
Q

acyclovir (Zovirax)

A
  • treats herpes and CMV

- causes neuropathy, paresthesia, confusion, renal toxicity, bone marrow suppression

76
Q

HIV treatment

A
  • takes a lot of drugs to treat HIV
  • HIV is no longer a death sentence
  • all have terrible side effects
77
Q

terbinafine (Lamisil)

A
  • antifungal
  • causes major bone marrow suppression
  • GI problems
  • liver toxicity
  • have good results with this drug except on the scalp, nails
78
Q

Most common protozoal infection

A

Giardia

79
Q

metronidazole (Flagyl)

A
  • antiprotozoal agent
  • considered cancer causing, causes Steven Johnsons
  • can cause cinchonism
80
Q

cinchonism

A

poisoning

-causes vertigo, tinnitus, bone marrow suppresion

Pharm (20 decks)

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