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N216 > Midterm Drugs > Flashcards

Midterm Drugs Flashcards

1
Q

Adrenergic Medications

A

Stimulate the SNS

Controls the release of neurotransmitters

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2
Q

Adrenergic Medications cause

A

Vasoconstriction & CNS Stimulation
Increase HR
Dilate pupils
Treat shock and hypotension

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3
Q

Types of Adrenergic Medications

A

Decongestant
Bronchodilators
Vasopressors
Cardiac Stimulant

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4
Q

What symptoms would adrenergic cause

A

Fight or flight

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5
Q

2 classes of adrenergics

A

Catecholamines

Non-catecholamines

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6
Q

Catecholamines

A

similar to norepinephrine, short duration of action & administered parentarelly

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7
Q

Non-catecholamines

A

Taken orally, longer duration of action, not rapidly destroyed by monoamine oxidase

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8
Q

Adrenergic meds treat

A

shock, hypotension & acute asthma exacerbations

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9
Q

Side effects of adrenergic

A 
Anxiety
Restlessness/ Wakefulness
Dizziness
Headache
Nausea
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10
Q

Cholinergic medications stimulate

A

PNS

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11
Q

Cholinergic Cardiovascular effects

A

Decrease HR and BP

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12
Q

Cholinergic Pupil effects

A

Constrict pupils and decrease inoculate pressure

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13
Q

Cholinergic GI&GU effects

A

Increases gastric secretions and urinary frequency

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14
Q

Cholinergic respiratory effects

A

Bronchial constriction

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15
Q

Indirect acting cholinergics

A

Contraindicated in pregnancy and breastfeeding avoid use in GI&GU obstruction, COPD, Parkinsons and bradycardia hypotension

Increase muscular tone and contraction

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16
Q

Action of adrenergic antagonists

A

Inhibit the SNS

Block adrenergic receptors

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17
Q

Clinical applications of Adrenergic antagonists

A

Effects relaxation on vascular smooth muscle in small arterioles and decrease BP
BPH:increases urine flow
Beta receptors are blocked thus reducing BP

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18
Q

Side effects of adrenergic antagonists

A

Orthostatic hypotension
Impotence
Reflex Tachycardia
Nasal Congestion

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19
Q

Cholinergic Blocking agents Function

A

Inhibition of the PNS

Block or inhibit the actions of acetylcholine in the PNS

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20
Q

Cholinergic Blocking agents Cardiovascular

A

Increase HR in small doses and decrease HR in large doses

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21
Q

Cholinergic Blocking agents Respiratory

A

Open airways

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22
Q

Cholinergic Blocking agents GI

A

Decrease motility, peristalsis, gastric and mucous production

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23
Q

Cholinergic Blocking agents CNS

A

Decreases muscle rigidity and tremors in small doses and drowsiness and hallucinations in large doses

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24
Q

Cholinergic Blocking agents are used to treat

A

Asthma

Bradycardias and Brady-dysrhymias

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25
Q

Side effects of anticholinergics

A 
Tachycardia
CNS stimulation
Urinary Retention in men with prostate disorders
Dry mouth
Dry eyes
Inhibit sweating
Photophobia
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26
Q

Triptans

A

Antimigraine drug that stimulates 5-HT receptors in cerebral arteries, causing vasoconstriction and reducing headache symptoms

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27
Q

Ergot alkaloids

A

antimigraine
Constrict or narrow blood vessels
obtained from fungus

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28
Q

ANtimigraine drugs

Triptans

A 
Sumatriptan (Imitrex)
Almotriptan (Axert)
Eletriptan (Relpax)
Naratriptan (Amerge)
Rizatriptan (Maxalt)
Zolmitriptan (Zomig)
Frovatriptan (Frova)
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29
Q

Adverse effects of Triptans

A

Vasoconstriction
Irritation at injection site
Tingling, flushing, congestion

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30
Q

Adverse effects of ergot alkaloids

A

Nausea & vomitting
Cold and clammy hands
Muscle pain
Dizziness

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31
Q

Antiepileptic drugs traditionally used to manage seizure disorders

A

Barbiturates
Hydantoins
Iminostilbenes plus valproic acid
Second and third generation antiepileptics

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32
Q

Pharmacological effects of anti epileptic drugs

A

Reduce nerves ability to be stimulated
Suppress transmission of impulses from one nerve to the next,
Decrease speed of nerve impulse conduction within.a neuron

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33
Q

Long term therapy of Phenytoin (Dilantin) may cause

A

Gingival hyperplasia, acne, hirsutism, and dilantin facies

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34
Q

Antiepileptic drugs

A 
Carbamazepine (Mazepine)
Ethosuximide (Zarontin)
Fosphenytoin (Cerebyx)
Gabapentin (Neurontin)
Lamotrigine (Lamictal)
Levetiracetam (Keppra)
Oxcarbazepine (Trileptal)
Phenobarbital
Phenytoin (Dilantin)
Perampanel (Fycompa)
Pregabalin (Lyrica)
Primidone
Topiramate (Topamax)
Valproic acid (Depakene)
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35
Q

Barbiturates serum drug level

A

15-40 mag/ML

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36
Q

Contraindications of Barbiturates

A

allergy, porphyria, liver or kidney impairment, respiratory illness

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37
Q

Adverse effects of barbiturates

A

Cardiovascular, CNS, GI, and dermatological reactions

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38
Q

Barbiturate drugs

A

Phenobarbital & Primidone

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39
Q

Primidone is metabolized in the liver to

A

phenobarbital

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40
Q

Therapeutic drug levels of phenytoin (Dilantin)

A

10-20mcg/mL

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41
Q

Phenytoin (Dilantin) administration

A

Iv, however very irritating to veins

Filter must be used, diluted in normal saline for IV infusion

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42
Q

What is the injectable version of phenytoin (Dilantin)

A

Fosphenytoin (Cerebyx)

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43
Q

Ethosuximide (Zarontin)

A

Used in treatment of uncomplicated absence seizures

Not effective for secondary tonic-clonic seizures

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44
Q

Ethosuximide (Zarontin) Contraindication

A

Allergy

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45
Q

Ethosuximide (Zarontin) Adverse effects

A

GI & CNS effects

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46
Q

Ethosuximide (Zarontin) Drug interactions

A

Hepatic enzyme-inducing drugs

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47
Q

Gabapentin (Neurontin)

A

HAs the chemical analogue of a neurotransmitter that inhibits brain activity

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48
Q

Gabapentin (Neurontin) Contraindication

A

Allergy

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49
Q

Gabapentin (Neurontin) Adverse Effects

A

CNS & GI Symptoms

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50
Q

Gabapentin (Neurontin) administration

A

Oral use only

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51
Q

Lamotrigine (Lamictal)

A

anti seizure and also used for bipolar disorder

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52
Q

Lamotrigine (Lamictal) Contraindications

A

Allergy

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53
Q

Lamotrigine (Lamictal) Adverse effects

A

minor CNS and GI symptoms possible Stevens Johnson Syndrome

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54
Q

Lamotrigine (Lamictal) Administration

A

Oral use only

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55
Q

Levetiracetam (Keppra)

A

Adjunct therapy for partial seizures with and without secondary generalization

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56
Q

Levetiracetam (Keppra) contraindication

A

allergy

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57
Q

Levetiracetam (Keppra) Adverse effects

A

generally well tolerated, CNS effects

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58
Q

Levetiracetam (Keppra) Administration

A

Oral and Injectable forms

59
Q

Pregabalin (Lyrica)

A

Structually related to GABA, mostly used for adjunct therapy for neuropathic pain, postherpetic neuralgia

60
Q

Pregabalin (Lyrica) Indication

A

Partial seizures

61
Q

Pregabalin (Lyrica) Contraindication

A

Allergy

62
Q

Pregabalin (Lyrica) Adverse drug reaction

A

primarily CNS related

63
Q

Pregabalin (Lyrica) Administration

A

Oral use only

64
Q

What are anti platelet drugs for

A

Used for the treatment of further strokes and in clients who have had TIA
Also manages BP

65
Q

Most frequently used anti platelet drug

A

Aspirin

66
Q

Psychotherapeutic Drugs

A

Used in treatment of emotional and mental disorders

67
Q

Types of Psychotherapeutic Drugs

A

Anxiolytic drugs
Mood stabilizing drugs
Antidepressants
Antipsychotics

68
Q

Anxiolytics Action

A

Reduce anxiety by reducing overactivity in the CNS; Binds to GABA receptors

69
Q

Anxiolytics Indication

A

Ethanol withdrawal, insomnia, muscle spasms, seizure disorders, anesthesia, depression anxiety

70
Q

Anxiolytics Contraindication

A

Allergy, Narrow angle glaucoma, Pregnancy

71
Q

Anxiolytics Adverse effects

A

CNS depression, hypotension, drowsiness, dixzziness, lethargy, headache, ataxia, slurred speech, depression, bradycardia, hypotension, constipation, diarrhea, nausea, vomiting

72
Q

Anxiolytics Prototype Class

A

benzodiazepines

73
Q

Anxiolytics Prototype drug

A

Lorazepam

74
Q

Examples of Benzodiazepines

A

alprazolam (Xanax)
diazepam (Valium)
lorazepam (Ativan)

75
Q

Alprazolam (Xanax)

A

Most commonly used anxiolytic

76
Q

Alprazolam (Xanax) Indications

A

GAD, Short term relief of anxiety symptoms, panic disorder, anxiety with depression

77
Q

Alprazolam (Xanax) adverse effects

A

Confusion ataxia headache

78
Q

Alprazolam (Xanax) Interactions

A

Alcohol, antacids, oral contraceptives

79
Q

Diazepam (Valium) Indications

A

Relief of anxiety, Management of alcohol withdrawal, reversal of status epileptics, preoperative sedation, adjunct for relief of skeletal muscles

80
Q

Diazepam (Valium) Adverse affects

A

headache, confusion, slurred speech

81
Q

Diazepam (Valium) avoid with

A

patients with hepatic dysfunction

82
Q

Diazepam (Valium) Interactions

A

Alcohol, oral contraceptives

83
Q

Lorazepam (Ativan) acting

A

Immediate acting benzodiazepine

84
Q

Lorazepam (Ativan) administration

A

can be given intravenously or intramuscularly

85
Q

Lorazepam (Ativan) indications

A

used to treat agitated pt and pt with alcohol withdrawal

86
Q

Buspirone Hydrochloride (Buspar) Action

A

Unknown

87
Q

Buspirone Hydrochloride (Buspar) adverse effects

A 
Paradoxical anxiety
Blurred vision
dizziness
headache 
nausea
88
Q

Buspirone Hydrochloride (Buspar)

A

miscellaneous anxiolytic

89
Q

Buspirone Hydrochloride (Buspar) administration

A

On a scheduled basis

90
Q

mechanism of action for antidepressants

A

Enhance the action of certain neurotransmitters
Block breakdown of norepinephrine
Slow reuptake of serotonin

91
Q

Lithium drug of choice for treating

A

Mania

92
Q

Lithium action

A

potentiate serotonergic neurotransmission

93
Q

Litium acute therapeutic range

A

serum level 1-1.5mmol/L

maintenance levels should stay around 0.6-1.2

94
Q

Lithium levels above what produce toxicity

A

1.5-2

95
Q

Symptoms of lithium toxicity

A

GI discomfort, tremor, confusion, somnolence, seizures and death

96
Q

What helps maintain therapeutic lithium levels

A

Maintaining a sodium level of 135-145mmol/L

97
Q

Adverse effects of lithium

A

Cardiac dysrhythmias, drowsiness, slurred speech, epilepsy, ataxia, choreoathetic movements, hypotension
Long term treatment can cause hypothyroidism

98
Q

First gen antidepressants

A

Tricyclics
Tetracyclines
MAOIs

99
Q

Second gen antidepressants

A

SSRIs

SNRIs

100
Q

example of tricyclic antidepressants

A

amitriptyline (Elavil)

101
Q

tricyclic antidepressants mechanism

A

Block reuptake of neurotransmitters causing accumulation at nerve endings

102
Q

tricyclic antidepressants idications

A 
Neuropathic pain
insomnia
OCD 
anorexia
Childhood enuresis
103
Q

tricyclic antidepressants adverse effects

A

Sedation
impotence
orthostatic hypotension

104
Q

tricyclic antidepressants Overdose

A

CNS and cardio systems affected

Death results from dysrhymias or seizure

105
Q

tricyclic antidepressants therapeutic effects

A

take 2-6 weeks

106
Q

tricyclic antidepressants contraindications

A

acute recovery phase of MI and history with heart block

107
Q

tricyclic antidepressants drug interactions

A

Oral contraceptives, alcohol, CNS depressants, clonidine

108
Q

Amitriptyline (Elavil)

A

Oldest and most widely used antidepressant

109
Q

Amitriptyline (Elavil) Indication

A

depression
Insomnia
Neuropathic pain

110
Q

Amitriptyline (Elavil) Contraindications

A

Allergy
pregnancy
myocardial infarction

111
Q

Amitriptyline (Elavil) adverse effects

A

Dry mouth, constipation, blurred vision, urinary retention, dysrhythmias

112
Q

MAOI

A

Monoamine Oxidase Inhibitor

113
Q

MAOI disadvantage

A

Potentail to cause hypertensive crisis when taken with tyramine

114
Q

MAOI use

A

Parkinsons disease

115
Q

When on MAOI patients must avoid

A 
food with tyramine
aged cheese
smoked, pickled, aged meats
yeast extracts
red wine
Italian broad beans
116
Q

Second gen antidepressants

A 
Trazodone (Oleptro)
Bupropin (Wellbutrin)
SSRIS 
-Fluoxetine (Prozac)
-Sertraline (Zoloft)
-Paroxetine (Paxil)
-Fluvoxamine maleate (Luvox)
- Citalopram (Celexa)
- escitalopram oxalate (Cipralex)
117
Q

Second gen antidepressants Indication

A

Depression, BPD, Obesity, eating disorder, OCD, Panic attacks, social anxiety, PTSD, Prementrual dysphoric disorder, neurologic disorder myoclonus, substance abuse and alcoholism

118
Q

Bupropion Hydrochloride indication

A

depression and smoking cessation

119
Q

Duloxetine Hydrochloride (Cymbalta) Indications

A

depression, GAD, pain from diabetic peripheral neuropathy fibromyalgia, chronic back pain, osteoarthritis

120
Q

Duloxetine Hydrochloride (Cymbalta) adverse effects

A

Dizziness, drowsiness, headache, GI upset anorexia, hepatotoxicity

121
Q

Duloxetine Hydrochloride (Cymbalta) drug interactions

A

SSRI triptans, alcohol

122
Q

Duloxetine Hydrochloride (Cymbalta) can worsen

A

Uncontrolled angle closure glaucoma

123
Q

Fluoxetine (Prozac) is

A

Prototypical SSRI

124
Q

Fluoxetine (Prozac) indications

A

Depression bulimia, OCD panic disorder, premenstrual dysphoric disorder

125
Q

Fluoxetine (Prozac) contraindications

A

allergy, concurrent MAOI therapy

126
Q

Fluoxetine (Prozac) adverse effects

A

anxiety dizziness, drowsiness, insomnia

127
Q

Mirtazapine (Remeron) Action

A

Promotes pre synaptic release of serotonin and norepinephrine in the brain

128
Q

Mirtazapine (Remeron) indications

A

depression, sexual adverse effects in male pt with SSRI therapy, appetite stimulant

129
Q

Mirtazapine (Remeron) Contraindications

A

allergy MAOI

130
Q

Mirtazapine (Remeron) adverse effects

A

Drowsiness, abnormal dreams, dry mouth, constipation, increased appetite, asthenia

131
Q

Mirtazapine (Remeron) drug interactions

A

CNS depressant effets with alcohol and cytochrome P-450 inhibitors

132
Q

Antipsycotics Mechanism

A

block dopamine receptors in the brain areas associated with emotion, cognitive function and motor function
dopamine levels in CNS are decreased

133
Q

Antipsycotics indications

A

psychotic illness
schizophrenia
anxiety and mood disorders

134
Q

Haloperidol (Haldol) indications

A

long term treatment of psychosis

135
Q

Haloperidol (Haldol) Contraindications

A

hypersensitivity, Parkinson’s disease

136
Q

Clozapine (Clozaril)

A

Selectively blocks the dopaminergic receptors in the meolimbic region of the brain

137
Q

Clozapine (Clozaril) Adverse effects

A

Blood dyscarias

138
Q

Risperidone (Risperdal) Indication

A

Schizophrenia

139
Q

Risperidone (Risperdal) adverse effects

A

Minimal EPS at therapeutic dosages of 1-6 mg/day

140
Q

Risperidone (Risperdal) administration

A

Oral and long acting injectable forms

141
Q

St Johns Wort

A

Herbal product used for depression, anxiety, sleep disorders, nervousness

142
Q

St Johns Wort adverse effects

A

GI upset, fatigue, dizziness, confusion, dry mouth, photosensitivity

143
Q

St Johns Wort Interactions

A

MAOI SSRI Tyramine foods

N216 (5 decks)

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