med review Flashcards by Brittany Blackston

Bethanechol
Cevimeline
pilocarpine

muscarinic agonists

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muscarinic agonist used in xerostomia (dry mouth) and Sjorgren syndrome

Cevimeline

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Pilocarpine

Muscarinic agonist used in glaucoma

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Atropine

treatment of muscarinic poisoning / muscarinic antagonist

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Pyridostigmine

which is a reversible cholinesterase inhibitor

drug of choice for Myasthenia gravis

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muscarinic antagonist that is used for motion sickness

Scoplamine

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Muscarinic antagonist used in the treatment of asthma, COPD, rhinitis caused by allergies or the common cold

Atrovent

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muscarinic antagonist used for IBS and functional bowel disorders such as hypermotility and diarrhea

Dicyclomine (Bentyl)

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Benztropine (Congentin

Trihexyphenidyl

centrally actin anticholinergic used to treat Parkinson disease and drug induced parkinsonism

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oxybutynin (Oxytrol)
Darifenacin (Enablex) 
tolterodine (Detrol)
Solifenacin (Vesicare)
Fesoterodine (Toviaz)
Trospium (Sanctura XR)

anticholinergics agents used in Overactive bladder if behavioral therapy has not worked

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in the case of severe liver impairment, which anticholinergic would you avoid when treating for Overactive bladder

Darfenacin (Enablex)

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which of the anticholinergics used in overactive bladder can prolong QT

Solifenacin (Vesicare)
Tolterodine (Detrol)
Fesoterodine (Toviaz)

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which of the anticholinergics used in overactive bladder can cause angioedema in the face, lips, tongue and larynx

Solifenacin (Vesicare)

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antimuscarinic tox mnemonic

Hot as a hare (hyperthermia)
Dry as a bone (dry eyes, dry mouth, dry skin)
Red as a beet (flushed face)
Blind as a bat (mydriasis)
Mad as a hatter (delirium)

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antidote for antimuscarinic poisoning

physostigmine (acetylcholinesterase inhibitor)

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drug of choice for HTN with no other comorbidities

Thiazide diuretic

Hydrochlorathiazide

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what antihypertensives are not good for a renal pt

Aces (-pril) and ARBS (-sartan)

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HTN and CAD

B Blocker ( -lol)

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Diabetic with HTN

Ace inhibitor (-pril)

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Pregnant with HTN

methyldopa

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a hyperkalemic pt needs a diuretic

Bumex, HCTZ and lasix are potassium wasting diuretics

ACE or ARB - which is less likely to cause hyperkalemia

ARB (-sartan)

Ace inhibitors should not be combined with what diuretic?

spironolactone - spares potassium

Ace has a risk of hyper K as well

Drugs given for Verapamil tox

Atropine and glucagon for bradycardia

norepinephrine for hypotension

what should be combined with nifedipine to prevent reflex tachycardia

B blocker

what type of CCB can be given if they have a history of bradycardia

dihydropyridine | Nifedipine

nondihydropyridine CCB

These affect HR and slow conduction of SA node Verapamil Diltiazem (Cardizem)

antihypertensives most likely to cause orthostatic hypotension

Prazosin (Minipress) captopril Losartan

fluid retention is a serious side effect and can lead to cardiac decompensation

Minoxidil

what antihypertensive is safe for a 1 month old, a child and an older adult

Hydralazine

hydralazine is usually combined with a ____ to prevent ___

B blocker | reflex tachycardia

drug of choice in severe pre-eclampsia

Hydralazine

can a hf pt have NSAIDS

no, can increase fluid retention

HF pt - what meds?

diuretic - Loop - lasix Ace inhibitors if they cant tolerate use ARB ACE -causes dilation in periphery, decrease in systemic vascular resistance. blockade of aldosterone (aldosterone hangs onto sodium which makes you retain water). reduced cardiac modeling due to elevated levels of kinin. ARB - we don't see elevated levels of kinin so not as cardiac protection as the ACE. other benefits are the same. B Blocker (has to be pretty dry when initiate or adjust) If they are having an exacerbation or fluid overload, do not mess with B Blocker. long term survival benefits -Metoprolol XR -Carvedilol -Bisoprolol 2nd line adjunct Spironolactone as a short term adjunct burst therapy. balance potassium loss, blocks aldosterone Digoxin -requires frequent lab monitoring and teaching signs and symptoms of dig tox

lab monitoring for pt on an ACE or ARB

CBC CMP follow BUN and creatinine bc elevated would be contraindication for ACE also avoid in pt with severe renal artery stenosis

lab monitoring for pt on Diuretic

CMP | monitor electrolytes

lab monitoring for Digoxin

serum dig levels

pt on digoxin has n/v | anorexia

most common adverse effect not dig tox

pt on dig altered HR or rhythm visual disturbances gastro disturbances

dig tox

renal difference in thiazide vs loop diuretics

loop diuretics can be given even with a low GFR | thiazide diuretics do not work in poor renal function

why are potassium sparing diuretics used in HF

to offset loss of potassium in the loop diuretics | also blocks aldosterone in RAAS

1st line breastfeeding mom for antidepressant

zoloft

Demerol Elavil Benadryl okay for older adults?

what anti-seizure has the genetic variant (asian) | HLA-B1502

Carbamazepine (Tegretol)

Zoloft and azythromycin, why can they not be given together?

they both have the chance of prolong QT

chlordiazepoxide clorazepate (Tranxene) oxazepam Lorazepam (Ativan)

Benzodiazepines used to facilitate alcohol withdrawal you can add on a B blocker for elevated HR if needed

Naltrexone

opioid antagonist blocks pleasurable effects with alcohol used to maintain abstinence

Acamprosate

maintaining abstinence in pt with alcohol dependence | Benefits derive from reducing unpleasant feelings

lopid and coumadin together

lopid displaces coumadin (elevated coagulation) hyperlipidemia

first line for GAD

SSRI and SNRI Effexor Cymbalt Paxil lexapro