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NUR 406 exam 2 > meds > Flashcards

meds Flashcards

1
Q

ALS
Riluzole
Class:

A

glutamate inhibitor

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2
Q

Alteplase (tPA)

treats

A
  • acute MI
  • PE
  • ischemic stroke
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3
Q

Rotigotine

treats:

A

PD

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4
Q

PD drugs (4)
class: dopamine receptor agonist (increases dopamine)

Levodopa/carbidopa
Duopa - (Carbidopa/levodopa infusion)
Pramipexole
Ropinirole
Rotigotine
Apomorphine

A

Pramipexole
Ropinirole
Rotigotine
Apomorphine

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5
Q

neostigmine treats

A

myathesnia gravis

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6
Q

PD drug

MOA
_________ = converts dopamine in the brain and activates dopamine receptors (increase dopamine)

___________ = blocks destruction of levodopa (allows dopamine to be in system longer)

A

Levodopa
Carbidopa

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7
Q

mitoxantrone

treats

A

MS

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8
Q

Alteplase (tPA)

s/e
increased risk of ___________
- don’t give if pt had a hx of __________

Antidote: _____________ (antithrombolytic) stops bleeding

Often given with meds:
___________ and __________
- which prevent FUTURE clots from forming

Route
IV

Monitor
vitals = _____ and ______

A

s/e
increased risk of intracranial bleeding
- don’t give if pt had a hx of bleeding (hemorrhagic stoke, GI bleed, etc.)

Antidote: Aminocaproic acid – antithrombolytic – stops bleeding

Often given with Heparin and antiplatelets
- prevent clots from forming

Route
IV

Monitor
BP and HR

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9
Q

MOA
Inhibits immune cells, which decreases inflammation
and may have anti-oxidant properties

MS drug ?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

A

dimethyl fumarate

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10
Q

1a – avonex
1b – betaseron
Interferon beta 1a, 1b

treats

A

Multiple sclerosis

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11
Q

class: (acetyl)cholinesterase inhibitor AKA (anticholinesterase)

drug:

treats:

A

neostigmine

myathesnia gravis

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12
Q

migraines:

drug ___________
class: Selective serotonin receptor agonists

drug _____________
class: Calcitonin gene-related peptide (CGRP) antagonist

A

Sumatriptan
class: Selective serotonin receptor agonists

Rimegepant
class: Calcitonin gene-related peptide (CGRP) antagonist

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13
Q

Ropinirole

treats:

A

PD

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14
Q

Glutamate antagonist
Reduces damage to motor neurons

drug:
treats:

A

Riluzole

ALS

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15
Q

1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)
fingolimod
dimethyl fumarate
natalizumab
alemtuzumab
mitoxantrone

oral (2)
injectable (2)
infusion (3)

A

injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

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16
Q

migraines:

Sumatriptan
class:

Rimegepant
class:

Calcitonin gene-related peptide (CGRP) antagonist
Selective serotonin receptor agonists

A

Selective serotonin receptor agonists

Calcitonin gene-related peptide (CGRP) antagonist

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17
Q

Levodopa/carbidopa

treats

A

PD

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18
Q

migraine indications:

drug/class:
mild to moderate migraines
and
moderate to severe migraines, w/out severe n/v

drug/class:
moderate to severe migraines, w/out severe n/v

Treats acute migraines

When triptan is ineffective or contraindicated

A

Sumatriptan
Selective serotonin receptor agonists

Rimegepant
Calcitonin gene-related peptide (CGRP) antagonist

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19
Q

duopa: PD drug

Route -

Can do continuous infusion for continuous blood levels

  • DO NOT TAKE within 2 weeks of ______ (for depression) – levodopa toxicity
  • know all of pts current medications

Interactions
- anti HTN
- MAOI
- antipsychotic
- metoclopramide
- isoniazid
- iron
- vitamins
- high ________ – decreases levodopa effects

A

Route
feeding tube

Can do continuous infusion for continuous blood levels

  • DO NOT TAKE within 2 weeks of MAOI (for depression) – levodopa toxicity
  • know all of pts current medications

Interactions
- anti HTN
- MAOI
- antipsychotic
- metoclopramide
- isoniazid
- iron
- vitamins
- high protein – decreases levodopa effects

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20
Q

migraines - drug and class?

MOA
Mediates pain transmission

MOA
- Constricts intracranial blood vessels
- Suppresses release of inflammatory neuropeptides
- Blocks brain pathways for pain

A

Rimegepant
class: Calcitonin gene-related peptide (CGRP) antagonist

Sumatriptan
class: Selective serotonin receptor agonists

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21
Q

natalizumab

treats

A

MS

22
Q

alemtuzumab

treats

A

MS

23
Q

MS drug ?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

s/e
- flu like
- liver toxicity
- bone marrow suppression
- depression
- drug interactions

A

1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)

24
Q

neostigmine

s/e cholinergic receptors: muscarinic
- __creased secretions
- GI ______
- urinary urgency or retention?
- _____cardia
- bronchial ________tion
- miosis, _______ sightedness

s/e cholinergic receptors: nicotinic
- increased muscle contraction (______ doses)
- reduced muscle contraction (_____ doses)
- toxicity leads to ________

A

s/e cholinergic receptors: Muscarinic
- increased secretions
- GI motility
- urinary urgency
- bradycardia
- bronchial constriction
- miosis, near sightedness

s/e cholinergic receptors: nicotinic
- increased muscle contraction (therapeutic doses)
- reduced muscle contraction (toxic doses)
- toxicity leads to cholinergic crisis

25
Q

Pramipexole

treats:

A

PD

26
Q

Drug Name

Classification
thrombolytics/fibrinolytics

A

Alteplase (tPA)

27
Q

PD drug: Levodopa/carbidopa

s/e – d/t levodopa or carbidopa?

_______ – can give low doses with food but this reduces drug absorption

___________ – abnormal movements ranging from annoying to disabling

  • ___ issues – postural hypotension, dysrhythmias
  • _________ – hallucinations, nightmares, paranoia
  • darkens ________
  • activates _________
A

s/e – d/t levodopa

  • n/v – can give low doses with food but this reduces drug absorption
  • dyskinesias – abnormal movements ranging from annoying to disabling
  • CV issues – postural hypotension, dysrhythmias
  • psychosis – hallucinations, nightmares, paranoia
  • darkens sweat/urine
  • activates malignant melanoma
28
Q

Apomorphine

treats:

A

PD

29
Q

ALS
drug:
class: glutamate inhibitor

A

Riluzole

30
Q

Riluzole
class: glutamate inhibitor

treats:

A

ALS (only drug for ALS)

31
Q

PD drug: Levodopa/carbidopa

Interactions:
____creases effects of levodopa:
- vitamin B
- antipsychotics
- protein
____creases effects of levodopa:
- carbidopa
- anticholinergics
- MOA inhibitors

DisAdv:
- Takes several ______ to see improvement
- s/e
- Doesn’t work long term

gradual loss of drug effect:
-Dose _______ , may need _______ dose intervals

abrupt loss of drug effect –
- “on-off” phenomenon
- Can occur _______ during dosing interval
- “off” periods will ____crease overtime
- Can be reduced with drugs and avoiding high _________ foods

A

Interactions
Decreases effects of levodopa:
- vitamin B
- antipsychotics
- protein
Increases effects of levodopa:
- carbidopa
- anticholinergics
- MOA inhibitors – can cause toxicity

DisAdv:
- Takes several months to see improvement
- s/e
- Doesn’t work long term

  • gradual loss of drug effect
    -Does wears off, may need shorter dose intervals
  • abrupt loss of drug effect – “on-off” phenomenon
  • Can occur at anytime during dosing interval
  • “off” periods will increase overtime
  • Can be reduced with drugs and avoiding high protein foods
32
Q

ALS drug
Riluzole
class: glutamate inhibitor

s/e
- dizzy
- GI upset
- ______toxicity

T/F
slow deterioration?
prolong survival?
cure?

A

s/e
- dizzy
- GI upset
- Hepatoxicity (liver)

T
T - but not long (~6 months)
F

33
Q

fingolimod

treats

A

MS

34
Q

Sumatriptan
class: Selective serotonin receptor agonists

Rimegepant
class: Calcitonin gene-related peptide (CGRP) antagonist

treats

A

migraines

35
Q

MOA
retains lymphocytes in the lymph nodes, preventing them from crossing BBB, which decreases inflammation

MS drug ?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

A

fingolimod

36
Q

migraines - drug and class?

s/e
GI upset

s/e
- injection site reaction (SQ)
- chest pressure
- flushing
- weakness
- h/a
- bad taste (nasal)

A

Rimegepant
Calcitonin gene-related peptide (CGRP) antagonist

Sumatriptan
Selective serotonin receptor agonists

37
Q

migraines: Sumatriptan vs Rimegepant

  1. Route
    SQ
    PO
    Intranasal
  2. CYP substrate – use with caution with CYP inducers or inhibitors
  3. AVOID with ischemic stroke/heart disease and angina
  4. Route
    PO
A
  1. S
  2. R
  3. S
  4. R
38
Q

duopa indications:

  • response to Carbidopa/levodopa PO _______
  • response to Carbidopa/levodopa PO isnt _________
  • pt doesn’t _________ to Carbidopa/levodopa PO at all
A

flucuates
working long enough
respond

39
Q

Duopa

treats:

A
  • (Carbidopa/levodopa infusion)
    PD
40
Q

(Carbidopa/levodopa infusion) is called

A

Duopa

41
Q

PD drugs:
duopa
ropinirole
pramipexole

s/e
- falling asleep with out warning
- orthostatic hypotension
- hallucinations
- unusual urges
- depression
- dyskinesia
- feeding tube s/e in general

s/e
__________ alone
- nausea
- sleep attacks
- pathological gambling or other compulsive behaviors
___________ + Levodopa/carbidopa
- orthostatic hypotension
- dyskinesias
- hallucination

s/e
- long term use increases risk of DM and acromegaly (excessive production of growth hormone, leads to enlargement of certain body parts)
- (similar to other PD drugs)

A

Duopa
(Carbidopa/levodopa infusion)

Pramipexole

Ropinirole

42
Q

MOA
clot buster
conversion of plasminogen to plasmin
restores blood flow

A

Drug Name
Alteplase (tPA)

Classification thrombolytics/fibrinolytics
43
Q

dimethyl fumarate

treats

A

MS

44
Q

MOA
Prevents circulating T cells from leaving the vasculature and crossing BBB, which decreases inflammation

MS drug ?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

A

natalizumab

45
Q

neostigmine toxicity leads to __________ crisis

A

cholinergic

46
Q

PD drugs:
Levodopa/carbidopa
Duopa - (Carbidopa/levodopa infusion)
Pramipexole
Ropinirole
Rotigotine
Apomorphine

  1. Route
    Once daily patch
  2. Route
    Short acting SQ injection
  3. Indications
    - Fast relief of s/s
    - used in “off” phase of PD
A

Rotigotine

Apomorphine

Apomorphine

47
Q

copaxone
class: Glatiramer acetate

treats

A

MS

48
Q

drug:
class:

MOA:
- stops the enzyme acetylcholinesterase, (which breaks down acetylcholine)
- This allows acetylcholine to remain active for longer at cholinergic receptor sites, increasing its effects.
- Enhances cholinergic action by facilitating transmission of impulses across neuromuscular junctions

Affects muscarinic and nicotinic receptors

A

neostigmine

class: (acetyl)cholinesterase inhibitor AKA (anticholinesterase)

49
Q

MOA
Inhibit pro-inflammatory WBCs from crossing BBB
Decreases relapse rate

MS drug ?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

A

1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)

50
Q

MOA
Increased production of anti-inflammatory T cells which cross the BBB and suppress inflammation

Decreases relapse rate

MS drug ?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

oral (2)
fingolimod
dimethyl fumarate

infusion (3)
natalizumab
alemtuzumab
mitoxantrone

A

copaxone (class: Glatiramer acetate)

51
Q

which MS drug?
injectable (2)
1a – avonex
1b – betaseron
(class: Interferon beta 1a, 1b)
copaxone (class: Glatiramer acetate)

s/e
- injection site reaction
- post injection reactions – transient, lasting 15-20 mins, no treatment required
- flushing
- palpitations
- chest pain
- rash
- laryngeal constriction

A

copaxone (class: Glatiramer acetate)

52
Q

which MS drug?
infusion (3)
natalizumab
alemtuzumab
mitoxantrone

s/e
- h/a
- fatigue
- hepatoxicity
- hypersensitivity
- progressive multifocal leuko
encephalopathy
- risk increases when combined with another immunosuppressant
- requires certain training to be able to prescribe, distribute, and infuse this drug

Monotherapy only – not used with any other drugs

A

natalizumab

NUR 406 exam 2 (3 decks)

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