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Pharm 1 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

How to administer eye drops (glaucoma drugs)

A

Pull down the bottom eyelid
Place eyedrop in “well”
Have the patient apply pressure to inner canthus for 60 seconds

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2
Q

Why don’t we want eye meds (especially beta blockers) to get into the inner canthus?

A

So there is no system circulation

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3
Q

If a person doesn’t like getting eye drops or its a child what is another way of administering the meds?

A

Have the patient squeeze their eyes closed
Put the drop in the the inner corner and then have them open their eyes
The med will flow into the eye

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4
Q

Anxiolytic drugs are indicated for

A

Anxiety disorders

ANXIolytic = ANXIety

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5
Q

Anxiolytic drugs: Benzodiazepines prototypes

A

Alprazolam (Xanax)
Diazepam (Valium)

LAM and PAM!

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6
Q

Alprazolam and Diazepam risks

A

Can be habit forming

Risk of overdose

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7
Q

Alprazolam and Diazepam overdose

A

Flumazenil (Romazicon) is the antidote for all benzos

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8
Q

Alprazolam and Diazepam AE/SEs

A 
Confusion*
Ataxia
Headache
CNS depression*
- Drowsiness* 
- Dizziness*
Postural hypotension
Disinhibited (truthful)*
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9
Q

Alprazolam and Diazepam interactions

A

Other CNS depressants

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10
Q

Alprazolam and Diazepam are often ordered how?

A

PRN

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11
Q

Anxiolytic drugs: Non-benzodiazepines prototype

A

Buspirone (Buspar)

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12
Q

Buspirone half life

A

Short - dosed 2-3 times daily

NOT HABIT FORMING

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13
Q

Buspirone interactions

A

Many, including grapefruit

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14
Q

Buspirone is often ordered how?

A

Scheduled, not PRN

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15
Q

Mood stabilizers are indicated for

A

Bipolar disorder

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16
Q

Mood stabilizers prototypes

A 
Lithium (Eskalith or Lithobid)
Valproic acid (Depakote)
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17
Q

Lithium therapeutic range

A

Very narrow: 0.6-1.2 mEq/L

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18
Q

Lithium patient education

A

Required regular monitoring - blood draws on a regular basis

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19
Q

Lithium interactions

A

Sodium - kidney treats both similarly

  • Low sodium can lead to high lithium
  • Drink lots of water but not too much
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20
Q

Lithium toxicity

A

Dialysis (no antidote)

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21
Q

Lithium AEs

A 
GI discomfort
Tremor
Confusion
Somnolence
Seizures and cardiac dysrhythmia (toxicity)
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22
Q

Valproic acid therapeutic range

A

50-125 mcg/mL

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23
Q

Valproic acid contraindications

A

Liver impairment (hepatotoxicity)

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24
Q

Valproic acid interactions

A

MANY

Highly protein bound

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25
Q

Tricyclic antidepressants (TCA) prototype

A

Amitriptyline (Elavil)

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26
Q

Amitriptyline overdose

A

Very lethal

ALMOST ALWAYS FATAL

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27
Q

Amitriptyline toxicity s/s

A

Seizures and cardiac dysrhythmias

28
Q

Amitriptyline indications

A

Depression
More often used for
- Neuropathic pain
- Insomnia

29
Q

Amitriptyline patient

education

A

High risk for increased depression/SI at the start (plus overdose)

Patient will only receive a small dose (a few days or a week) at the start

30
Q

Antidepressants: Monoamine Oxidase Inhibitors (MAOIs) prototype

A

Phenelzine (Nardil)

31
Q

Phenelzine controindication

A

Tyramine (foods)

32
Q

Phenelzine interactions

A

Everything :)

Alcohol!

33
Q

Phenelzine AEs

A 
Hypertensive crisis (tyramine)
Postural hypotension
34
Q

Phenelzine patient education

A

OTC cold meds are likely to interact

NO ALCOHOL

35
Q

In general, how long does it take for antidepressants to reach full therapeutic affect?

A

4 weeks

36
Q

What do doctors suggest along with medications to treat depression?

A

Therapy/counseling

37
Q

Antidepressants: Selective Serotonin Reuptake Inhibitors (SSRIs) prototype

A

Fluoxetine (Prozac)

38
Q

Fluoxetine AEs

A

Serotonin syndrome

39
Q

Fluoxetine interactions

A

St John’s wort
MAOI
Other SSRIs
Sumatriptan

(all of these increase serotonine)

40
Q

Antidepressants: Serotonin/Norepinephrine Reuptake Inhibitors (SNRI) prototype

A

Venlafaxine (Effexor)

41
Q

Venlafaxine AEs

A

Serotonin syndrome

42
Q

Venlafaxine patient education

A

Capsules can be opened and sprinkled on applesauce/food

Best to take with food

Can lead to weight loss in children

43
Q

Venlafaxine interactions

A

Things that increase serotonin

44
Q

Antidepressants: Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) are also known as

A

Atypical Antidepressants

45
Q

Antidepressants: Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) prototype

A

Bupropion (Wellbutrin)

46
Q

Bupropion contraindications

A

Hx of seizures - lowers seizure threshold

47
Q

Bupropion indications

A

Depression

Used mainly for

  • Smoking cessation
  • Weight loss
48
Q

What is the black box warning for all antidepressants?

A

Higher risk for suicide

- Especially for children and those up to age 24

49
Q

AE for all antidepressants

A

Antidepressant discontinuation syndrome - don’t stop abruptly

S/S

  • dizziness
  • headache
  • N/V

Severe cases can cause aggression, mood disturbances, SI

50
Q

All meds cause sexual side effects except

A

Bupropion

51
Q

All meds cause weight gain except

A

Bupropion

52
Q

Conventional antipsychotics indications

A

Effective for positive symptoms (added effects)

  • Hallucinations
  • Delusions
  • Disorganized thinking

Less effective for negative symptoms (things that are missing)

  • Withdrawal
  • apathy
  • flat effect, lack of desire to do things
53
Q

Conventional antipsychotics AEs

A

Extra Pyramidal Symptoms (EPS)

Neuroleptic Malignant Syndrome (NMS)

54
Q

What is EPS?

A

Extra pyramidal symptoms

  • Muscle movements
  • Akathisia
  • Acute dystonia
  • Tardive dyskinesia (can be permanent even if med is discontinued)
55
Q

What is NMS?

A

Neuroleptic Malignant Syndrome

  • Potentially life threatening and rare
  • Like malignant hyperthermia (high BP, fever)

Can occur after the first dose or after 20 years, so keep monitoring patient

56
Q

Conventional antipsychotic forms of administration

A

PO

IM - for deep injection to the ventrogluteal site

57
Q

Conventional antipsychotics prototypes

A

Chlorpromazine (Thorazine)

Haloperidol (Haldol)

58
Q

Chlorpromazine AE

A

IV and IM can cause hypotension - keep in recumbent position for 30 minutes after administration

59
Q

Chlorpromazine administration

A

Push 1 mL/min VERY SLOW

60
Q

Haloperidol IM versus IV administration

A

IM injection given every 4 weeks - long acting

IV used for acute situations - bad episode of psychosis

61
Q

Atypical Antipsychotics prototype

A

Risperidone (Risperdal)

62
Q

Risperidone indications

A

Treats positive AND negative symptoms of psychosis

63
Q

Risperidone AE

A

Metabolic syndrome - gain weight, become type 2 diabetic, high cholesterol

can cause stoke or MI

64
Q

Why is Risperidone preferred over older class of antipsychotics?

A

Causes minimal EPS

65
Q

Risperidone administration

A

IM onset is 3 weeks

Must take PO until IM is effective

Pharm 1 (6 decks)

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