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Pharm Me > Final exam review (slides 105-208) > Flashcards

Final exam review (slides 105-208) Flashcards

1
Q

Name (4) effects of serotonin on the Nervous system

A
  1. Melatonin precursor (5-HT)
  2. Vomiting reflex
  3. Pain and itch (similar to histamine)
  4. Chemoreceptor reflex
    -Bradycardia
    -Hypotension
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2
Q

Name (2) effects of serotonin on the Respiratory system

A
  1. Facilitate ACh release - constriction
  2. Hyperventilation
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3
Q

Name (1) effect of serotonin on the GI system

A
  1. overproduction/diarrhea
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4
Q

Name (2) effects of serotonin on the CV system

A
  1. Contraction of vascular smooth muscle
    exception: skelectal muscle, heart
  2. Platelet aggregation (transient vasoconstriction)
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5
Q

Name an agonist of the 5-HT1A serotonin receptor. What does it treat?

A
  1. Buspirone
  2. Anxiolytic: GAD, OCD
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6
Q

Name an agonist of the 5-HT1D/1B serotonin receptor. What does it treat? Major toxicity/drug interaction?

A
  1. Triptans (Sumatriptan)
  2. Migraine HA
  3. Toxicity: Serotonin syndrome (triptans+SSRIs, MAOIs)
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7
Q

Name (2) antagonist of the 5-HT2 serotonin receptor. What do they treat?

A
  1. Phenoxybenzamine: carcinoid tumors
  2. Cyproheptadine: cold induced urticaria
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8
Q

Name (1) antagonist of the 5-HT3 serotonin receptor. What does it treat?

A
  1. Ondansetron (Zofran)
  2. anti-emetic
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9
Q

What are some signs and symptoms of serotonin syndrome? Onset?

A
  1. HTN, hyperreflexia, tremor, clonus, hyperthermia, hyperactive bowel sounds, diarrhea, mydriasis, agitation, coma
  2. Onset within hours
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10
Q

What is the treatment for serotonin syndrome?

A
  1. Sedation (benzos), paralysis, intubation, and ventilation
  2. Consider HT2 block with cyproheptadine or chlorpromazine
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11
Q

What is the primary cause of Neuroleptic malignant syndrome?

A

D2-blocking antipsychotics

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12
Q

What are the signs and symptoms of neuroleptic malignant syndrome? Onset?

A
  1. Acute severe parkinsonism, hypertension, hyperthermia, normal or reduced bowel sounds
  2. Onset over 1-3 days
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13
Q

What is the treatment for neuroleptic malignant syndrome?

A

Diphenhydramine (parenteral), cooling, sedation (benzos)

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14
Q

The primary cause(s) of Malignant hyperthermia is _____ and/or _____?

A

Volatile anesthetics, succinylcholine

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15
Q

What are the signs and symptoms of malignant hyperthermia? Onset?

A
  1. Hyperthermia, muscle rigidity, hypertension, tachycardia
  2. Onset within minutes
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16
Q

What is the treatment for malignant hyperthermia?

A

Dantrolene, cooling

17
Q

What are the (3) major classes of antidepressants? What channels does each inhibit?

A
  1. Monamine oxidase inhibitors: blocks all monoamines
  2. Tricyclic antidepressants (Elavil): SERT, NET, and anticholinergic effects
  3. SSRIs:
    a. SERT (Prozac, Zoloft)
    b. SNRIs - SERT & NET (Pristique, Cymbalta)

**All carry BB warning for suicidal tendencies

18
Q

Which (4) seizure types do Phenytoin, Phenobarb, and Carbamazine ALL treat?

A
  1. Simple partial
  2. Complex partial
  3. Partial seizures secondarily generalized
  4. Generalized tonic-clonic (grand mal)
19
Q

What is the drug of choice for focal seizures?

A

Lamotrigine

20
Q

What is the drug of choice for absence seizures?

A

Ethosuxamide

21
Q

Name a GABA analogue used to treat infantile spasms

A

Vigabatrin

22
Q

Which (4) seizure types can be treated with Valproid acid?

A
  1. Absence
  2. Tonic
  3. Atonic
  4. Clonic and myoclonic
23
Q

Which drug class can be used to treat all seizures but is particularly effective in continuous seizure activity (status epilepticus)?

A

Benzodiazapines

24
Q

Valproic acid has a tendency to displace ___________, causing toxicity due to increased free-form levels of this drug.

A

Phenytoin (Dilantin)

25
Q

Describe the toxicity profile for Carbamazepine (Tegretol)

A
  1. diplopia
  2. ataxia
  3. GI effects
  4. drowsiness
26
Q

Describe the toxicity profile for Phenobarbitol

A
  1. SEDATION
  2. Hepatic enzyme inducer!
27
Q

Describe the toxicity profile for ethosuximide. What is the only oral form for this drug?

A
  1. GI, lethargy, hiccup, euphoria
  2. Syrup
28
Q

Describe the toxicity profile for Valproic acid

A
  1. Hepato/inhibitor of many drugs
  2. GI
  3. Sedation
  4. fine tremor
29
Q

What are the therapeutic, free, toxic, and lethal levels for phenytoin?

A
  1. Therapeutic: 10-20 mcg/ml
  2. Free phenytoin: 1-2.5 mcg/ml
  3. Toxic: 30-50 mcg/ml
  4. Lethal: >100 mcg/ml
30
Q

A status epilepticus patient is having continuous seizures in the ER. Vital signs have been stabilized, but the patient is not responding to Phenytoin or phenobarbital. What should be the next option for this patient? (two interventions)

A

Benzodiazepines, consider intubation

31
Q

Second-generation antihistamines are preferred to first generation in the relief of allergy symptoms because…

A

They do not cause sedation

32
Q

T/F Sertraline is a SSRI (inhibits SERT)?

A

True

33
Q

Vasoconstriction, formation of platelet plugs, and regulation of coagulation and fibrinolysis are all components of…

A

Thrombogenesis

34
Q

What are the (4) phases of platelet plug formation?

A
  1. Adhesion
  2. Aggregation
  3. Secretion
  4. Cross-linking of adjacent platelets
35
Q

Briefly describe the thrombogenesis pathway

A
  1. collagen and VWF are exposed and bind to GP1a and GP 2b
  2. The first platelet releases ADP, TXA2, and serotonin
  3. ADP, TXA2, and serotonin bind to receptors on the next platelet (cascade effect)
  4. The clotting cascade results in fibrin binding to GP2B/GP3B, which crosslinks the platelets together

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