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Medication Flashcards

1
Q

What type of medication is Haloperidol?

A

First generation antipsychotic
Typical

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2
Q

What is the indication for haloperidol?

A

Schizophrenia
Acute delirium
Moderate to severe manic episodes associated with bipolar disorder

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3
Q

What’s the dosage for haloperidol in schizophrenia?

A

2-10mg daily in 1-2 divided doses
But usual is 2-4mg daily
In first episode up to 10mg

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4
Q

What’s the maximum dosage for haloperidol in schizophrenia

A

Maximum dosage is 20 mg per day

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5
Q

What is the dosage and frequency of haloperidol for moderate to severe manic episodes associated with bipolar disorder

A

2 to 10 mg daily in 1 to 2 divided doses.

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6
Q

What is the maximum dosage of haloperidol for moderate to severe manic episodes associated with bipolar disorder

A

Maximum 15 mg per day

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7
Q

What are the contra indications of haloperidol

A

CNS central nervous system depression, QT interval prolongation, recent acute myocardial infarction, and compensated heart failure, Parkinson’s disease

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8
Q

What are the side effects for haloperidol 

A

Depression, eye disorders, headache, nausea, neuromuscular dysfunction, psychotic disorder, vision disorders, weight decreased

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9
Q

What are all the side effects for antipsychotic drugs

A

Agitation, arrhythmia, constipation, dizziness, drowsiness, dry mouth, erectile dysfunction, fatigue, hypoglycaemia, hypersalivation, hypertension, insomnia, movement disorders, muscle rigidity, Neutropenia, parkinsonism, postural hypertension but that dose related, QT interval prolongation, severe rash, seizure, tremors, urinate retention, vomiting, and weight increased

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10
Q

What is the mechanism of action for haloperidol

A

Haloperidol is an antipsychotic that works by blocking dopamine receptors particularly D2 receptors in the brain. Reduces dopamine activity in the central nervous system which helps alleviate symptoms of positing symptoms of psychosis, agitation and mania

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11
Q

What is the pharmacodynamics of haloperidol

A

It works by having an antigen antagonising effect on dopamine D2 receptors. Reducing dopamine activity alleviate symptoms of psychosis agitation and delusions

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12
Q

How does haloperidol work in relation to neurotransmitters

A

It works by reducing dopamine in the brain because psychotic symptoms are related to an overproduction of dopamine

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13
Q

What are the pharmacokinetics of haloperidol

A

Haloperidol is well absorbed after oral administration with pink plasma concentration is occurring within 2 to 6 hours
Haloperidol is metabolised in the liver


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14
Q

What are the monitoring requirements for haloperidol

A

A baseline ECG is recommended before treatment initiation
Physical health monitoring including cardiovascular disease risk assessments at least once per year

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15
Q

What are the indications for Lorazepam

A

Short-term use in anxiety


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16
Q

What type of medication is lorazepam

A

Short acting benzodiazepine

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17
Q

What are the contra indications of Lorazepam

A

Central nervous system depression, compromised airway, respiratory depression

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18
Q

What are the cautions of benzodiazepines

A

Avoid prolonged use and abrupt withdrawal, debilitated patience, history of alcohol dependence or abuse, history of drug dependence, paradoxical effects which may increase hostility and aggression

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19
Q

What are the side effects of Lorazepam

A

Apnoea, coma, disinhibition, extra pyramidal symptoms, memory loss, speech slurred, alertness decreased, anxiety, confusion, drowsiness, headache, muscle weakness, nausea, withdrawal syndrome

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20
Q

What are the pharmacodynamics of Lorazepam

A

It enhances the activity of gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain.

These GABA receptors Has an inhibitory response that reduces the activity of nerve cells which helps reduce anxiety by making you feel more relaxed and promoting a calming and sedating effect

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21
Q

What are the pharmacokinetics of lorazepam

A

It is rapidly absorbed after oral administration with peak plasma concentrations reached in two hours your liver process is the medication and it stays in your system for about 12 to 18 hours before being removed by your body through urine

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22
Q

What is the dosage of Lorazepam for short-term use in anxiety

A

1-4mg daily in divide a doses

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23
Q

what type of medication is Clozapine

A

Atypical or second generation antipsychotic

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24
Q

what is the indication for Clozapine

A

treatment resistant schizophrenia,
last resort when trying at least 2 other medications

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25
Q

what is the dosage for clozapine initiation

A

Day 1 - 12.5mg 1-2 times per day
Day 2 - 25-50mg for day 2
Increase in steps of 25-50g daily (gradually increased over 14-21 days)
Increased up to 300mg daily in divided doses

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26
Q

what is the maximum dosage and when should the larger dose be taken?

A

900mg per day and night time should the larger dose be taken

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27
Q

what is the usual dose for clozapine?

A

200-450mg daily

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28
Q

what happens if a Clozapine dose is missed

A

If missed after 48 hours then restart titration

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29
Q

what are the contra indications for clozapine

A

cardiac disorders, uncontrolled epilepsy, drug intoxication, bone marrow disorders, severe respiratory disease, severe CNS depression, history of agranulocytosis (severely low netrphils –> increase risk to infection

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30
Q

What are the cautions of clozapine

A

neutropenia and potentially fatal agranulocytosis reported
myocarditis- inflammation of heart muscle, intestinal obstruction - constipation, severe respiratory disease, diabetes- may raise blood glucose, history of jaundice, cardiovascular disease, conditions predisposing to seizures

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31
Q

what are the side effects of clozapine

A

hypertension, anxiety, agitation, fatigue, constipation, QT interval prolongation, muscle rigidity, parkinsonism, hypertension, urinary disorder, arrhymias, nausea, speech impairment, blurred vision, abnormal sweating, temperature regulation disorders, hypersalivation, insomnia, seizure, tremoir, weight retention, dry mouth

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32
Q

what are the monitoring requirements for Clozapine in terms of bloods

A

blood tests every week for 18 weeks to monitor for white blood cell count
then every 2 weeks for up to one year
then monthly

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33
Q

what other monitoring requirements are there other than blood tests

A

Cardiac monitoring- ECG to monitor for myocarditis - heart muscle becomes inflames making it harder to the heart to pump
particularly important as the risk of myocarditis is higher within the first month of treatment

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34
Q

what symptom should prompt observation for indicators of myocarditis

A

persistent tachycardia in first 2 months

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35
Q

what happens if myocarditis is suspected when taking clozapine

A

it should be stopped gradually reduce dosage over 1-2 weeks to avoid risk of rebound psychosis

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36
Q

what factors can affect the dosage of clozapine given to a patient

A

smoking- reduces clozapine levels in the blood due to an enzyme in the liver metabolising clozapine therefore smokers need a higher dose

if a patient stops smoking while on clozapine, blood levels may increase rapidly

Patients with liver impairment may process clozapine more slowly, requiring lower doses and careful monitoring for toxicity

Reduced kidney function may slow the excretion of clozapine’s active metabolites, leading to higher blood levels.

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37
Q

what are the pharmacodynamics rof clozapine

A

antagonising effect on dopamine and serotonin receptors

dopamine is associated with positive symptoms of schizophrenia

reduces excessive serotonin activity that can suppress dopamine function in areas like the prefrontal cortex, thus improving symptoms such as emotional withdrawal, lack of motivation, and impaired thinking.

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38
Q

what are the pharmacokinetics of clozapine

A

undergoes almost complete absorption with time to maximum plasma concentration of 1.5-2 hours in which maximum effect works 4 hours after administration

metabolised via hepatic pathway in the liver with a half life of 12-16 hours

route of elimination - excreted in the urine and faeces

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39
Q

what medication is olanzapine

A

atypical antipsychotic
second generation

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40
Q

what are the indications for olanzapine

A

schizophrenia and bipolar disorder

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41
Q

what is the usual dosage for olanzapine

A

5-20mg daily

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42
Q

what is the maximum dosage for olanzapine

A

20mg

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43
Q

when might you consider a lower initial dosage of olanzapine

A

females, elderly and non-smoker

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44
Q

what are the cautions of olanzapine

A

cardiovascular disease, respiratory disease, history of jaundice, low leucocyte count, CNS depression

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45
Q

what are the contra indications of olanzapine

A

central nervous system depression, severe hepatic impairment, acute myocardial infacrtion, bradycardia and severe hypotension, unstable angina

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46
Q

what are the side effects of olanzapine

A

hypersomnia weight gain, appetite increased, fever, oedema, sexual dysfunction, agitation, fatigue, anticholinergic syndrome- ACS toxic syndome leading to agitation and delirium and confusion and restlessness

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47
Q

what are the pharmacodynamics of olanzapine

A

involves blocking dopamine D2 receptors and serotonin receptors to help balance neurotransmitter levels
this improves symptoms of hallucinations and delusions

effect on serotonin receptors prevents the onset of anhedonia, flat affect, alogia and avolition and poor attention

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48
Q

what are the pharmacokinetics of olanzapine

A

Absorption- well aborbed reaching peak plasma concentration 6 hours after oral administration
large distribution throughout the body
metabolised in the liver which represents around 40% of the administered dose
route of elimination- mainly through metabolism hence only 7% is found as the unchanged form
mainly excreted in urine 53% and 30% faeces

half life- 30 hours average

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49
Q

what type of medication is Venlafaxine

A

a serotonin and noradrenaline re uptake inhibitor

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50
Q

what is the usual dosage for venlafaxine for depression

A

75mg in 2 divided doses then inreased if necessary up to 375mg daily in 2 divided doses

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51
Q

what are the indications for venlafaxine

A

major depression, generalised anxiety disorder

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52
Q

what is the usual dosage for venlafaxine for depression

A

75mg once daily then increased up t 225mg once daily

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53
Q

what are the associated risks with SNRIs

A

increase the risk of bleeding due to their effect on platelet function

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54
Q

what are the contra indications for venlafaxine

A

uncontrolled hypertension

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55
Q

what are the cautions for venlafaxine

A

conditions associated with high risk of cardiac arrhythmias, diabetes heart disease (monitor blood pressure), history of bleeding disorders, history of epilepsy, history of mania, susceptibility to angle closure glaucoma

56
Q

what are the side effects of venlafaxine

A

anxiety, appetite decreased, arrhythmias, confusion, constipation, diarrhoea, dizziness, dry mouth, headache, hypertension, movement disorder, nausea, palpitations, sedation, sexual dysfunction, skin reactions, sleep disorders, weight changes, vomiting, tremor, urinary disorders

57
Q

what is the pharmacodynamics of venlafaxine

A

works by increasing the levels of serotonin and norepinephrine. This is done by inhibiting the reuptake of both serotonin and norepinephrine at the presynaptic terminal = more neurotransmitters in the synapse for it to be absorbed

58
Q

what are the pharmacokinetics of venlafaxine

A

Absorption- well absorbed after with bioavailability of 45%
volume of distribution- steady state
undergoes liver metabolism
half life- of about 5 hours
elimination - urine and faeces

59
Q

what type of medication is sertraline

A

an antidepressant- selective serotonin reuptake inhibitor

60
Q

what is the indication for sertraline

A

depression, ocd, ptsd , social anxiety disorder

61
Q

what is the dose for sertraline

A

initially its 50mg once daily then increased in 50mg intervals at least 1 week if required and maintenance is 50mg once daily

62
Q

what is the maximum dosage for sertraline

A

200mg per day

63
Q

contra indications for SSRI sertraline

A

poorly controlled epilepsy and should not be used if patient enters manic phase

64
Q

what aer the cautions for SSRI

A

cardiac disease, concurrent electroconvulsive therapy, diabetes, epilepsy, history of bleeding disorders, history of mania,

65
Q

what are the side effects of sertraline

A

Chest pain, gastrointestinal disorders,
impaired concentration, diarrhoea, dry mouth, constipation, fever, vasodilation where the vessels widen- lower blood pressure, emotional blunting, dry mouth, headache, dizziness, weight gain/loss

Also monitor for first 2 weeks as it can increase suicidal ideation

66
Q

what to do if you want to come off sertraline

A

dose should be reduced gradually over 4 weeks or longer if withdrawal symptoms emerge

67
Q

what are the pharmacodynamics of sertraline

A

improves or relieves the symptoms of depression, OCD, PTSD by inhibiting the serotonin reuptake
Blocks the serotonin transporter which reduces serotonin reuptake in the presynaptic neuron –> increase availability in the synampse enhancing serotonergic neurotransmission

68
Q

what is salbutamol

A

short-acting beta 2 adrenergic agonist

bronchodilator

69
Q

what are the indications for salbutamol

A

chronic asthma, acute asthma, prophylaxis of allergen,

70
Q

what is the dosage for chronic asthma via aerosol and nebuliser

A

aerosol- 100-200 micrograms taken for symptomatic relief

2.5-5mg initiated by specialist via nebuliser

71
Q

what are the different routes for salbutamol

A

inhaled by aerosol, powder or nebuliser but must be indicated by a specialist or slow intravenous injection in acute asthma

72
Q

what is the dosage for acute asthma for aerosol and powder salbutamol

A

aerosol or inhaler - 100 micrograms every 30seconds to 1 minute for up to 10 doses

each dose must be inhaled separately via a spacer

Repeat every 10-20 minutes or when required

Or alternatively 200 micrograms every 30 seconds- 1 minute for up to 5 doses

73
Q

what is the dosage for acute asthma for slow intravenous injection salbutamol

A

250 micrograms to be administered over 5-10 minutes dose can be repeated if necessary

74
Q

what is the dosage for acute asthma for continuous intravenous injection salbutamol

A

initially 5 micrograms per minute but adjusted to response and tolerance,
usual dose is 3-20 micrograms per minute

75
Q

what is the dosage for acute asthma for nebuliser of salbutamol

A

2.5-5mg repeat every 15-30 minutes or when required
give via oxygen-driver nebiliser

76
Q

what is the dosage for prophylaxis of allergen via aerosol and nebuliser

A

200 micrograms taken every 10-15 minutes

77
Q

what are the contra indications of salbutamol

A

severe cardiovascular conditions because it can raise heart rate

uncomplicated premature labour, allergies to any of the salbutamol ingredients, pregnant and breast feeding unless agreed by doctor

78
Q

what are the cautions of salbutamol - beta 2 adrenoceptor agonists

A

arrhythmias, cardiovascular disease, diabetes (risk of hyperglycaemia and ketaacidosis, hypertension, hyperthryroidism, hypokalaemia (low blood potassium), susceptibility to QT interval prolongation

79
Q

what are the side effects of salbutamol

A

tachycardiam muscle tremors, hypotension due to peripheral vasodilation, hypokalemia , hyperglycemia

80
Q

what are the monitoring requirements when on salbutamol

A

heart rate, muscle tremors, blood pressure due to it causing hypotension, serum potassium levels due to hypokalemia as a side effect and blood glucose levels

81
Q

what are the pharmacodynamics of salbutamol

A

short acting beta 2 agonist

binds to beta 3 adreno receptors stimulating a protein in the smooth muscle of the airways causing it to relax and therefore allowing fo bronchodilation. This results in making it easier to breathe due to less airway resistance, more gas exchange can occur

82
Q

pharmacokinetics of salbutamol

A

adsorption- absorbed in the lungs and gastrointestinal tract
lasts for 3-4 hours
quick acting

weakly bound to plasma proteins

metabolised in the liver and excreted via urine
2-5 hours half life

83
Q

what type of medication Ipratropium bromide

A

anticholinergic - bronchodilatr

84
Q

what are the indications of Ipratropium bromide

A

reversible airway obstruction in asthma and COPD, acute bronchospasm and severe acute asthma

85
Q

what is the dosage for Ipratropium bromide via aerosol

A

20-40micrograms 2-4 times a day

86
Q

what is the dosage required for Ipratropium bromide via nebulised solution

A

250-500 micrograms 3-4 times a day

87
Q

what is the dosage of Ipratropium bromide for severe or life threatening acute asthma

A

500 micrograms every 4-6 hours as required via nebuliser

88
Q

what are the cautions of Ipratropium bromide

A

avoid spraying near eyes, Glaucoma - chronic eye disease,
cystic fibrosis

via intranasal use
bladder outflow obstruction, susceptibility to angle closure glaucoma

89
Q

what are the contra indications of Ipratropium bromide

A

hypersensitivity, glaucoma- eye condition, urinary retention, gastrointestinal obstruction

–> cautiously in urinary retention because of its anticholinergic effects it can relax bladder muscles and impair ability to contract

90
Q

what are the pharmacodynamics of Ipratropium bromide

A

blocks aceytylcholine at the muscarinic receptors which
inhibits the parasympathetic nervous system to undergo bronchoconstriction therefore this inhibition leads to bronchodilation and decreases mucus secretion = airflow improved

it stops acetylcholine actioning on the muscles causing them to contract and producing a narrow airway therefore ipatropium stop this and prevents smooth muscle from contracting and therefore produces them to relax

91
Q

what are the pharmacokinetics of Ipratropium bromide

A

absorption- poorly absorbed agent
serum levels of ipatropium is low after administration

lasts around 4-6 hours

low bioavailability of 2%

metabolised in the gastrointestinal tract and excreted unchanged

excreted mainly via urine

short half life of 1.6 hours

92
Q

what are the side effects of Ipratropium bromide

A

constipation, diarrhoea, nausea, vomiting, difficulty passing urine, , gastrointestinal motility disorder, throat complaints, headaches

93
Q

what type of medication is Carbocisteine

A

mucolytic- cause mucus to be less sticky and easy to cough up

94
Q

what is the indication of Carbocisteine

A

reduction of sputum viscosity

95
Q

what are the contra indications of Carbocisteine

A

active peptic ulceration

96
Q

what are the cautions of Carbocisteine

A

history of peptic ulceration

97
Q

what are the side effects of Carbocisteine

A

gastrointestinal haemorrhage, skin reactions , vomiting

98
Q

what are the pharmacodynamics of Carbocisteine

A

it reduces sputum viscosity by breaking down the bonds in mucus glycoproteins which makes it less sticky

it helps alleviate symptoms such as coughing and breathlessness caused by mucus buildup

99
Q

what are the pharmacokinetics of Carbocisteine

A

rapidly absorbed in the gastrointestinal tract when taken orally

peak serum concentrations achieved within 1-7 hours

volume of distributes well into the lung and bronchial secretions

excreted via urine with 30-60% being unchanged

short half life

100
Q

what is amoxicillin

A

penicilin antibiotic

101
Q

what are the indications for Amoxicillin

A

susceptible infectons, acute exacerbation of COPD, acute cough,

102
Q

what is the dosage of Amoxicillin for susceptible infections

A

500mg every 8 hours
increased to 1g every 8 hours if necessary

103
Q

what is the dose for Amoxicillin in acute exacerbations of COPD

A

500mg 3 times a day for 5 days
increased if necessary to 1g 3 times a day

104
Q

what are the cautions of Amoxicillin

A

glandular fever, increased risk of rashes, maintain adequate hydration with high doses, hepatic impairment renal impairment

105
Q

what are the contra indications of Amoxicillin

A

prior anaphylactic reactions or severe skin reactions

106
Q

what are the side effects of Amoxicillin

A

hypersensitivity, nausea, skin reactions, vomiting, diarrhoea, extreme tiredness,

107
Q

what are the pharmacodynamics of amoxicillin

A

antibiotic that inhibits bacterial cell wall synthesis. This leads to cell wall weakening and therefore stops the growth of bacteria

108
Q

what are the pharmacokinetics of amoxicillin

A

absorption: rapidly absorbed
approximately 60% bioavailability

half life 1 hour

minimal metabolism occurs

excreted through the kidneys

109
Q

what type of medication is Prednisolone

A

corticosteroid that mimics the action of cortisol

has anti inflammatory effects

110
Q

what are the indications of Prednisolone

A

acute exacerbation of COPD
acute asthma
surpression of inflammatory and allergic disorders

111
Q

what is the dosage of Prednisolone for COPD

A

30mg once daily for 5 days

112
Q

what is the dosage of Prednisolone for acute asthma

A

40-50mg once daily for at least 5 days

113
Q

what are the contra indications of Prednisolone

A

hypersensitivity, live vaccines (avoid if immunosuppressed), untreated systematic infections as it can worsen infections because it suppresses the immune system

114
Q

what are the cautions of Prednisolone

A

diabetes melltus ( can raise blood sugar), hypertension or heart disease (fluid retention and increase BP), peptic ulcers, severe affective disorders (can be steroid induced),

115
Q

what are the side effects of Prednisolone

A

diarrhoea, dizziness, weight gain, mood changes such as irritability, insomnia, increased blood sugar, indigestion, prolonged use can increase susceptibility to infections

116
Q

what are the pharmacodynamics of Prednisolone

A

binding to intracellular gluococorticoid receptors
which surpress inflammatory and immune responses

117
Q

what are the pharmacokinetics of prednisolone

A

absorption - well absorbed has a bioavailability of 70%

widely distributed and highly bound to proteins

metabolised in the liver
excreted in the urine and

half life is around 2-4 hours

118
Q

what type of medication is Mannitol

A

osmotic diuretic

119
Q

what are the indications of Mannitol

A

rcerebral oedema, reduce intracranial pressure (inside the head), intraocular pressure (pressure of fluid in the eyes) or promoting diuresis in acute kidney injury

120
Q

what is the route of administration of intracranial pressure

A

intravenous infusion

121
Q

what is the dosage of Mannitol

A

0.25-2g per kg
can be administered over 30-60 minutes

dose may be repeated 1-2 times after 4-8 hours

122
Q

what are the contra indications of Mannitol

A

anuria (lack or urine output), intracranial bleeding (head bleeding), severe cardiac failure, severe dehydration, severe pulmonary oedema

123
Q

what are the cautions of Mannitol

A

extravasation causes inflammation, heart failure, renal impairment, dehydration risk, hypersensitivity reactions, can cause sodium and potassium disturbances

124
Q

what are the side effects of Mannitol

A

cough, headache, vomiting, dehydration, electrolyte imbalance,

125
Q

what are the monitoring requirements for Mannitol

A

monitor fluid and electrolyte balance, serum osmolality, cardiac, pulmonary and renal function

126
Q

what are the pharmacodynamics of Mannitol

A

increases the osmolarity of plasma= water moves out of cells into the blood stream
= this reduces intracranial pressure by creating an osmatic gradient

127
Q

what are the pharmacokinetics of Mannitol

A

absorption- via intravenously so not absorbed via gastrointestinal tract

only slightly metabolised

primarily excreted unchanged in the urine

half life of 4.5 hours

128
Q

what type of medication is paracetamol

A

analgesic (painkiller) and antipyretic (reduces fever)

129
Q

what is the indication of paracetamol

A

mild to moderate pain
pyrexia- fever

130
Q

what is the dosage of paracetamol

A

500mg - 1 gram every 4-6 hours

maximum 4g per day

131
Q

what are the cautions for paracetamol

A

check when paracetamol was last administered and cumulative paracetamol doe over previous 24 hours, body weight under 50kg, chronic alcohol consumption, chronic dehydration, chronic malnutrition, long term use

some people under 50kg are at increased risk of toxicity

132
Q

what are the contra indications for paracetamol

A

liver disease, hypersensitivity, severe renal impairment, alcohol abuse

133
Q

what are the side effects of paracetamol

A

gastrointestinal issues eg nausea, stomach pain, kidney problems, allergic reaction, liver damage, rash,

134
Q

what are the pharmacodynamics of paracetamol

A

inhibits an enzyme in the brain which results in decreased production of prostaglandins involved in pain but instead stops chemical messengers by reduce the intensity of pain signals to the brain

paracetamol has minimal effect in relieving inflammation.

135
Q

what is the pharmacokinetics of paracetamol

A

absorption- 88% bioavailability

excreted via urine- 90%

half life- 2.5 hours after

if overdose- can range from 4-8 hours

Medications (5 decks)

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