Medication Flashcards
What is the dosing of dexamethasone or prednisone used in acute asthma treatment ?
Dexamethasone 0.3 mg/kg per dose to max dose of 10 mg Prednisone 2mg/kg per dose to max dose of 60mg
Compare and contrast the dosages and time to onset of the benzodiazepines.
What are common muscarinic agonists? Side effects?
- Muscarine
- Pilocarpine
- Methacholine
SE- headache, nervousness, polyuria, decreased blood pressure and heart rates
What are muscarinic antagonists? What is their function? Common side effects?
Atropine - 0.4 to 0.8 mg sq q4-6
Benztropine
Ipratroprium
oxybutinin
scopolamine
function of a muscarinic antagonist (vagolytics, antimuscarinic) is to lower the parasympathetic drive
SE- confusion, agitation, hallucination, restlessness
What is a pure alpha 1 agonist, dosages, side effects?
Phenylephrine
100-300 ug/min
SE= constriction of smooth muscle- increased BP, increased sphincter tone, uterus and prostate tone, dilatation of radial muscle= pupillary dilatation
Beta 1 agonist, examples, side effects, so on?
dobutamine
2-20 ug/kg/min
Increased cardiac performance–> increased heart rate, contractility, conduction speed,
increased fat release for energy
increased release of renin–>
what is the distrobution of alpha 1 agonists and the general function in the body?
constriction of smooth muscle
Distrobution
- blood vessels
- sphincters
- uterus and prostate
- eye (radial muscle)
What is the distrobution of alpha 2 receptors and their general function?
Inhibition of sympathetic autonomic ganglia (decrease the sympathetic nervous system)
distrobution
- presynaptic ganglionic neurons
- GI tract
what is the distrobution and general function of beta 1 receptors in the body?
Increased cardiac performance and liberation of energy
distrobution
- heart (increased rate, contractility, conduction speed)
- fat cells ( release fat for energy during lypolysis)
- kidney (release renin to conserve water)
What is the distrobution and funciton of beta 2 receptors?
Relaxation of smooth muscle
Distrobution
Lungs (bronchodilation)
Blood vessels
Uterus
GI
Bladder
Liver (liberates glucose via glycogenolysis)
What are the 3 categories of beta blockers? What are the common kinds of each 3 categories?
1) Cardio-selective
- atenolol
- bisoprolol
- metoprolol
2) Non-selective
- Nadolol
- propranolol
3) Non-selective beta and alpha 1 blockade
- carvedilol
- labetolol
What are the alpha 1 antagonists? Side effects?
Prazosin
Phentolamine
SE- vasodilatation of smooth muscle-> decreased constriction of blood vessels, decreased sphincter tone, uterus and prostate relaxation, relaxation of radial muscles of eye
What is the major problem with nitroprusside?
cyanide toxicity
What is the desired wedge pressure in left heart failure?
the highest pressure that will augment cardiac output without producing pulmonary edema
What is the medical treatment for graves disease?
Methimazole and propylthiouracil counteract the formation of thyroid hormone
Radioactive iodine destroys the gland itself
(contraindicated in prenancy, and those wanting to get pregnant)
What is digoxin, and what are its important side effects?
digoxin is a cardiac glycoside that is used to
1) increase SV and CO
2) decrease sympathetic tone
3) compensatorily increase parasympathetic tone
Its main mechanism of action is to increase the intracellular calcium levels which increases SV and CO, and reduces the need for high sympathetic tone
Its two major indications are
1) CHF (third line)
2) atrial fibbrilation
THe theraputic index of digoxin is very low with working doses being between 0.5-2.5 nmol/L and toxicity occuring between 2.6-3.0 nmol/L
Certain drugs can increase the amount of digoxin in the blood
- potasium sparing diuretics
- antiarrhythmics (quinidine and amiodarone)
- calcium antagonists (verapamil only)
- HMG-CoA reductase inhibitors
Hypokalemia and hypercalcemia can increase digoxin sensitivity
Digoxin toxicity
gynecomastia
GI distress (N/V, abdo pain, diarrhea)
CNS disturbances- confusion, dizziness, agitation
Cardiovascular: arrhythmias, heart block
visual: orange tinted vision, visual disturbances
H2 receptor antagonists
Ranitidine (Zantac)
150mg po BID usual dose
AE: diarrhea, constipation, headache, fatigue, confusion
Dosage: should decrease dosage in elderly, decreased renal function….
PPI
Pantoprazole (Pantoloc)
40mg po daily
