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Pharm > Pharm Exam 2 > Flashcards

Pharm Exam 2 Flashcards

1
Q

Narcan

A

MOA: Structural analog of morphine that is a competing antagonist at the opioid receptors.

Indications: Opioid overdose, reversal of post-op opioid actions, reversal of neonatal respiratory depression.

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2
Q

Hypertension: Categories

A

Pre-hypertension: 120-139 / 80-89
Stage 1 Hype: 140-159 / 90-99
Stage 2 Hype: 160 / >100

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3
Q

Beta Adrenergic Blockers

A

eg Metoprolol
MOA: impede action of catecholamines (epi, norepi, dopamine) at heart receptors
- reduces HR
- reduces cardiac contractility
- reduces cardiac impulses through AV node
- Reduces renin production in kidney

Non selective - block Beta1 & Beta2 - Propranolol - can cause bronchospasm, impaired glucose metab, treat for hyperthyroidism, tremors, migraines

Selective - more effective on Beta1 - Metoprolol - less bronchospasm

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4
Q

Hypertension: Nonpharmoc. Interventions

A 
Stress mngmt
Restrict Salt
Excercise
Reduce weight
DC smoking/tobacco
Limit Alcohol
Lower fats/triglycerides
Breath as stress reducer
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5
Q

Alpha1 Adrenergic Agonists

A

Decongestants
MOA: activate Alpha1 Adren. Receptors in nasal blood vessels
Shrink nasal membranes that are inflamed

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6
Q

Angiotensin II Receptor Blockers (ARBS): MOA

A

Angio II constricts systemic and renal blood vessels
Receptor blockers prevent constriction, lowering BP
Action: Blocks Angio II after it is formed. Receptors in smooth muscle and adrenal gland, drop BP by affecting renin-angio cycle. Block vasoconstriction and secretion of aldosterone. Similar to ACE inhibitors, minus cough.

ARBs more effective after MI, do not treat BP as effectively in CHF

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7
Q

Diltiazem (Cardizem) - Calcium Channel Blockers

A 
Less vasodilation
Used in atrial arrythmias.
- Blocks calcium influx into cells
- Reduces cardiac contractility
- Smooth muscle cells in vasculature effected by vasodilation
- Decrease HR

SE: Hypotension, arrythmias, chest pain, peripheral edema, GI sx

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8
Q

Antihypertensives for Severe Hypertension

A

First-line: Thiazide-type diuretics, calcium channel blockers, ACEIs, ARBs
Second/Third-line: Higher doses and combinations

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9
Q

Clonidine (Catapress)

A

Centrally-acting Alpha2 Agonists
MOA: Act centrally on brain
- Reduces vasoconstriction
- Reduces renin (precursor of Angio1->Angio2->potent VC

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10
Q

Potassium & Diuretics

A

Thiazide causes loss of K+, as do loop diuretics such as furosemide (Lasix).

K+ sparing= Spironolactone (Aldactone). Block aldosterone, which allows Na+ to be released. Sod/Pot pumps inhibited, causing Na+ secretion and K+ retention

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11
Q

Tetracycline: SE/AE

A

GI issues, discoloration of teeth, suprainfection, hepatoxicity, renal toxicity. High doses can correlate to liver damage

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12
Q

Melatonin Agonists

A

Ambien, Ramelteon (Rozerem)
Newer hypnotic used for chronic insomnia.
MOA: melatonin receptor activation. Short onset and short duration. Induces sleep well but does not maintain

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13
Q

Agonist/Antagonist Opioids

A

4 groups: Pentazocine, nalbuphine, butorphanol, buprenorphine

Low potential for abuse, less powerful analgesic. Produces less respiratory depression than more powerful opioids.

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14
Q

MRSA medication

A

Vancomycin
Most widely used ABX in hospitals
MOA: bacterial cell wall lysis. Only gram +
SE/AE: renal failure, admin. low doses

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15
Q

Muscle Spasm Meds

A

Two groups: Analgesic Anti-inflamms (e.g. Aspirin) and muscle relaxers–>
Baclofen (Lioresal), Carisoprodol (Soma), Diazepam (Valium), Cyclobenzaprine (Flexeril)
Baclofen & Diazepam relieve spasticity by acting on CNS
Dantrolene acts directly on skeletal muscle

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16
Q

Antihistamines

A

First gen: Diphnhydramine (benedryl), chlorpheniramine (Chlor-trimeton allergy)

Second gen: Fexofenadine (Allegra), loratadine (Claritin)
MOA: block histamine receptors
Indications: Relieve rhinitis except for nasal congestion, reduce inflammation and reactions
A/E: Mild sedation

Intranasal: Aselastine (Astelin) & olopatadine (Patanase)
Indications: Allergic rhinitis children over 12
S/A: olopatadine=epistaxis, Azelastine= unpleasant taste

17
Q

Antitussives

A

Suppression of cough
Opioids: ability to suppress cough, most common being codeine and hydrocodone (<- slightly more potent/prone to abuse

Non-opioids: Dextromethophan (Robitussin DM) most widely used and effective
MOA: block NMDA receptors (minimal analgesic)
S/E: mild inebriation, mind-body dissociation

18
Q

Xanthines & Anticholinergic Agents

A

Methylxanthine (Theophylline): bronchodilator used for asthma

Antichol. (ipreatropium (Atrovent)): block muscarinic receptors in bronchi, cause bronchodilation. Muscarinic antagonist used in COPD and asthma

19
Q

Asthma

A

Chronic inflammatory disease of the airways, characterized by bronchoconstriction, airway inflammation, bronchial hypersensitivity.

  1. Anti-inflammatories: glucocorticoids, routine schedule via inhalation for chronic use (Advair)
  2. Bronchodilators: Beta2 agonists. Fixed schedule or PRN usually inhaled (albuterol)

For severe exacerbations: systemic glucocorticoid, nebulized SABA, nebulized ipratropium. O2 as well

20
Q

Insulin

A

Short Duration/Rapid Acting: Logs. Onset 10-30 min

Short Duration/Slower (Humulin R): Onset 1/2 to 1 hr.

Intermediate Dur (Novolin N): Onset 1-2 hr.

Long Dur (Lantus): onset 70 min.

21
Q

Hypothyroidism

A

Low T3/T4 & high TSH.

SE: incr. weight gain, low temp, tired, hair loss, incr. sleep, lower heart rate

22
Q

Hyperthyroidism

A

High T3/T4 & low TSH.

SE: increased energy, nervous, insomnia, weight loss, Graves disease, incr heart rate

23
Q

Diabetes: Oral Agents

A

Biguanides (Metformin). MOA lowers BG and improves glucose tolerance

Sulfonylurea: MOA: stimulates release of insulin

Thisazolidinediones (Glitazones) MOA: reduces BG by decreasing insulin resistance

Meglitinides (Glinides) MOA: stimulate release of insulin

Alpha-Glucosidase Inhibitors. MOA: delays absorption of carbs and reduces BG after meals

24
Q

Rhinitis: Meds

A

Rhinitis= inflamm of upper/lower airways and eyes

Glucocorticoids: anti-inflamm that suppress SX of allergic reactions

Antihistamines: Block histamine receptors

Sympathomimetics (decongestants): Activation of Alpha1 adrenergic receptors, VC of inflamed vessels.

25
Q

Advair Diskus: COPD

A

Glucocorticoid (anti-inflamm) & LABA (bronchodilator) combo

26
Q

Morphine Sulfate: Problems

A

Acts on mu receptors to mimic actions of opioid peptides

Euphoria, sedation, mental clouding, resp. depression, urinary retention, constipation, cough suppression, emesis, phys dependence, miosis (impaired vision), biliary colic (bileduct spasm)

27
Q

Oxycodone (Oxycontin)

A

Similar to codeine, 10% potency of morphine. Percodan (oxy + aspirin), Percocet (oxy + aceta)

Relieves mild/mod pain, coughing, antidiarrhea, antihypertensive, antianxiety, sedative.

S/E: Euphoria, itching, drowsy, miosis, urnary retent, constipation, dry mouth, N/V, ortho hypo

28
Q

MDI Meds

A

Glucocorticoids: beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, triamicinolene and QVAR

Cromolyn: act on mast cells to stop secreting histamine and eosinophils to dec. inflamm

Bronchodilators (SABA/LABA):

  • SABA- albuterol, levalbuterol, pirbuterol, terbutaline and ipratropium
  • LABA- Salmeterol and formoterol

Mixed- symbicort: gluco & broncho

29
Q

Expectorants: MOA

A

Guafenesin (mucinex) Stimulates flow of resp tract secretions

30
Q

ACE Inhibitors

A

Prototypes: captopril (Capotem)- short half-life, bid or tid dosing. Enalapril (Vasotec)- QD, caution with diuretics

MOA: block angiotension II, decrease BP by lowering peripheral resistance and decreasing blood volume

Indications: BP, heart failure, MI

SE: Minor, cough, postural hypotension, laryngeal swelling (fatal), hypersensitivity, hypokalemia (suppresses aldosterone release)

31
Q

Hypotension Measures

A

Stop hypertension meds

Give: Alpha-adrenoreceptor agonist - stimulates alpha receptors- VC & CNS stimulation
Steroids: salt retention
Vasopressors: VC to increase BP
Antidiuretic hormone

Raise feet
Decompression Staking
Fluids

32
Q

Sedative-Hypnotics

A

Indication: anxiety & insomnia
MOA: CNS depressents
Hypnotics: Sleep
Low doses for anxiety, high for sleep

33
Q

Benzodiazepines

A

alprazolam (Xanax), diazepam (Valium)

Indication: Anxiety, seizures, muscle spasms, alcohol withdrawal, pre-op, insomnia

MOA: cross BBB easily. Bind to GABA, hep receptors stay open longer. More Cl- enter synaptic neuron, hyperpolarize it making it less exciteable. Depresses CNS

A/E: increase CNS depression, amnesia, sleep disturbance, Toxicity from OD

34
Q

Benzodiazepine-Like Agents

A

Zolpidem (Ambien)

Indication: Insomnia (not anxiety)

MOA: similar to to benzo, binds to specific GABA-BZ receptor compleex

Pharm (3 decks)

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