Pharm Flashcards
Ibuprofen
Drug Classification?
MOA?
Classification: NSAIDs, analgesic, antinflammatory, antipyretic
MOA: non-selective COX inhibitor; decreases production of protglandins (inflammatory mediators) and thromboxane
Acetaminophen
MOA
analgesic -
pregnancy- B
neurotoxicity /headaches
Amoxicillin
MOA
500 mg TID
inhibit cell wall syntheisis
broad spec
Pen V K 500mg x qid
Clindamycin
MOA
Midazolam Classification
paradoxical reaction-
Classification: Benzodiazepine/CNS depressant
(Versed)
Midazolam Pharmacological effects
Effects: -sedative-hypnotic -anxiolytic -anterorgrade amnesic properties ( no retrograde) -Muscle relaxant -Anticonvulsant
Midazolam: Duration of action Dosage T ½ life
Duration of Action: Rapid onset (0.5 - 2 mins) short duration of action Doseage 0.01 -0.1mg/kg T ½ life: 2 hours
Midazolam Mechanism of Action?
MOA: increase activity of inhibitory NT GABA
Midazolam: Metabolism? Elimination?
Metabolism: hepatic CYP Elimination: Kidney
Midazolam: Contraindications Pregnancy category
Contraindications: narrow angle glaucoma, severe respiratory disease (COPD), heart failure, impaired hepatic/renal function Pregnancy: D
Midazolam: reversal agent
Reversal drug: Flumazenil- competitive antagonist; 0.2mg q 60secs- lasts 20 mins - caution: resedation can occur
Propofol MOA
MOA: poorly understood- modulates function of NT GABA and its receptors to produce anaesthesia (NO ANALGESIA)
Fentanyl Indications:
Indications: IV induction, maintenance and recovery of general anaesthesia
Fentanyl Drug Classification:
Analgesic: opioid agonist 100x potency of morphine
Fentanyl Dose
Dose: 0.5 mcg/kg load; 0.01-0.04 mcg/kg/min maintenance
Fentanyl MOA
- activation mu receptors and subsequent decrease of Ca influx and hyperpolarization of cell and inhibition of nerve activity
MME morphine mg equivalents- morphine is 1
Fentanyl Pharmokinetics Onset Duration Metabolism Elimination T ½ life
Onset: 1-3 mins
Duration: 30-60 mins
Metabolism: hepatic cytochrome P450
T1/2: 7 hours
Propofol Classification? Indication?
side effects
buring at site
Classification: IV anaesthetic, sedative/hypnotic Antiemetic properties
Indication: an induction and maintenance agent for general anaesthesia; may also be used as a sedative
Propofol Pharmakinetics Onset/duration Metabolism Elimination T ½ like Dose
- rapid induction (was 15-30 secs); short duration (5-10 mins); rapid recovery 2. Metabolism: hepatic - glucouronidation and CYP enzymes; 3. elimination: inactive metabolites excreted by kidneys T ½ life: 2-10 minutes Dose: 0.5 mg/kg over 3-5 mins???
Propofol Pregnancy Classification negative effects/contraindications
Pregnancy category: B Disadvantages: Myocardial depression and vasodilation and hypotension, respiratory depression
Pseudoephedrine
Brand name:
Drug Class
Schedule
Uses:
Preganancy Category
Pseudoephedrine hydrochloride/sulphate
Sudafed
Drug Class: α->>and β-adrenergic receptor agonist
Schedule: OTC
Uses: decongestant
Preganancy Category: C
Pseudoephedrine
MOA
Pseudoephedrine
MOA: sympathomimetic that directly stimulates α-adrenergic>> and β-adrenergic receptors in the mucosa of respiratory tract producing vasoconstriction (α-adrenergic), and relaxing bronchial smooth muscle (β-adrenergic)
-produces vasoconstriction of respiratory tract mucosa; shrinks nasal mucous membranes; reduces edema and nasla cogestion
Pseudoephedrine
Route
Absorption
Metabolism
Elimination
Pseuodoephedrine Parmacokinetics
Route: PO
Absorption: GI track (no 1st pass metabolism)
Distribution:
Metabolism: primarily liver
Elimination: kidneys (urine)
Protein binding: doesn’t biind to plasma proteins in concentration range between 50-2000 ng/ml
Pseudoephedrine
Dosage: adult/pediatric Max dose:
Onset:
duration:
t1/2 life:
Dose
- adult: 60 mg q4-6h; max: 240 mg/day
- extended dose 120mg q 12h
- child: 30 mgq 6h; max: 120mg/day
Onset: 15-30 mins
Duration: 4-6 hrs; 8-12 hrs
t1/2: 9-16 hr (child: 3h)
Pseudoephedrine
Contrindications
Cautions
Dental Concerns
Contraindications:
pregnancy and breast-feeding
CAD
severe HT
MAO inhibitors (MAO breaksdown NE, Epi- inhibiting this)
Caution:
-cardiac (tachycardia/palpations); hyperthyroidism, DM
Dental Concerns:
- dysrythmia (hydrocarbon inhalation anaesthetics)
- Increased CNS, cardiovascular effects (sympathomimetic)
Oxymetazoline (Oxymetazoline hydrochloride )
Brand name:
Drug Class
Schedule
Uses:
Preganancy Category
Brand name: Afrin
Drug Class: α-adrenergic receptor agonist, sympathomimetic amine
Schedule: OTC
Uses: decongestant; vasoconstriction resulting in decreased blood flow and decreased nasal congestion
Preganancy Category: C
Oxymetazoline hydrochloride (Afrin)
MOA
MOA- α-adrenergic receptors agonist
-acts directly on the arterioles of the nasal mucosa by binding to α-adrenergic receptors n arterioles producing vasoconstriction
(diated nasal vessels cause nasal congestion)
Oxymetazoline
Route
Absorption
Metabolism
Elimination
Route: intranasal spray (topical)
Absorption: nasal mucosa
Metabolism: kidney 30%; feca; 10%
Elimination: unchanged 30% kidneys/ 10% feces
Oxymetazoline
Dosage: adult/pediatric Max dose:
Onset:
duration:
t1/2 life:
Dosage:
- adult: 2-3 drops/sprays (0.05% nasal solution) ea nostril q 12 hrs
- pediatric: 2-4 drops/sprays (0.025% nasal solution) ea nostril q 12 hrs up to 3d
- max dose- do not exceed 2 doses in 24hours
Onset: 10 min
duration: 7+ hrs
t1/2 life: 5-8 hrs
Oxymetazoline and conjunctivitis
Dose
1-2 drops (0.025% opthalmic solution) ea eye q 6 hrs up to 3-4 d
Oxymetazoline
Contrindications
Cautions
Dental Concerns
Contrindications: narrow-angle glaucoma; hypersensitivity to oxymetazoline
Cautions: Child <6; DM; HT; CVD; HyprThy; glaucoma
rebound congestion; long term ischemia
Dental Concerns: increased risk HT: tricyclic antidepressants (TCAs)
