Pharm Exam 3 Flashcards
1
Q
What are anticonvulsants
A
Anti seizure medication
2
Q
How soon do anticonvulsants work
A
May take up to one week to work
3
Q
What do you need to monitor with AEDs
A
Blood level (narrow therapeutic range)
Suicidal behaviors
4
Q
What 3 ways do AEDs work
A
Suppressing sodium influx
Suppressing calcium influx
Increase action of GABA
5
Q
What do hydantoins do (AED)
A
Inhibit sodium influx
6
Q
Therapeutic range for phenytoin
A
10-20 mcg/ml
7
Q
What do barbiturates do (AED)
A
Enhances GABA
8
Q
What do succinimides do
A
Inhibit calcium influx
9
Q
What to watch for with AEDs
A
G- gingival hyperplasia
U- use alternative birth control
M- mouth care
S- don’t stop abruptly
10
Q
How do AEDs affect pregnant women
A
Increase seizures by 25%
11
Q
Classic symptoms with Parkinson’s disease
A
Tremor
Rigidity
Bradykinesia
12
Q
What is Parkinson’s disease an imbalance of?
A
Dopamine and acetylcholine
Too much acetylcholine and not enough dopamine
13
Q
Medications used to treat Parkinson’s disease
A
Anticholinergics Dopaminergics Dopamine agonists MAO-B inhibitor COMT inhibitor
14
Q
How do antocholinergics work for Parkinson’s disease
A
Inhibit release of acetylcholine
Reduce rigidity and tremors
15
Q
Anticholergics used for Parkinson’s
A
Benztropine
Biperiden
Trihexyphenidyl HCl
Diphenhydramine (benedryl)
16
Q
Side effects of anti-cholinergics
A
Red as a beat, dry as a bone, mad as a Hatter, hot as a hare, can’t see can’t pee, can’t spit can’t shit
17
Q
What does l-dopa do
A
Increases mobility and Parkinson’s disease
18
Q
Side effects of l-dopa
A
GI upset, dyskinesias, hypertension, cardiac dysrhythmias, psychosis, agranulocytosis
19
Q
Benefits of carbidopa and levodopa
A
Allows more dog mean to reach the brain
Allows for once a day dosing
Smaller doses of little but are required to achieve desired effect
20
Q
Other Parkinson’s drugs
A
Dopamine agonist, MAOB inhibitors, COMT inhibitors, limit vitamin B6 to normal doses
21
Q
What histologic changes take place in Alzheimer’s disease
A
Degeneration of cholinergic neurons in a deficiency in acetylcholine
22
Q
What drugs are used to treat Alzheimer’s disease
A
Acetylcholinesterase inhibitor’s
23
Q
What are characteristics of my Myasthenia gravis disease
A
Muscular weakness and fatigue
Respiratory muscle paralysis, ptosis, difficulty chewing and swallowing
24
Q
Drug agents used for MG
A
Ultra short acting, short acting, intermediate acting, long acting
25
What are characteristics of MS
Weakness or's spasticity in extremities, diplopia
26
Treatment strategy for acute attack MS
Prednisones, ACTH, Methylprednisolone
27
Treatment strategies for the remission exasperation MS
Biologic response modifiers
| Interferons, amino suppressant
28
Treatment strategy for chronic progressive MS
Cyclophosphamide, ACTH
29
Side effects of skeletal muscle relaxants
Drowsiness, dizziness, headaches, occasional abdominal distress
30
What is the primary function of the hypothalamus
To regulate levels of hormone production by producing releasing factors that cause glands to release hormones
31
What controls the pituitary gland
The hypothalamus
32
What hormones are controlled by the anterior pituitary
Thyroid stimulating hormones, adrenocorticotropic hormone, and growth hormone
33
Drugs for growth hormone deficiency
Soma-
34
What should be monitored with drugs for growth hormone deficiency
Diabetes mellitus
35
Drugs for a growth hormone suppression
Bromocriptine
Ocretide
Very expensive
36
What does hyperthyroidism cause
Hypermetabolic state
37
What does a thyroid stimulating hormone deficit cause
Hypometabolic state
38
What does ACTH do
Causes release of corticoids by the adrenal gland. Excess or deficit causes steroid excess or deficiency
39
Drugs used for the anterior pituitary gland
Corticotropin and Cosyntropin
Cause of secretion of corticosteroids
40
Side effects of corticotropin
Adema, osteoporosis, ulcer perforation, pancreatitis
41
What is the posterior pituitary gland do
Xers of storage reservoir for hormones from hypothalamus
| ADH and oxytocin
42
What is the natural ADH hormone
Vasopressin
43
What does vasopressin do
Reabsorbs water from kidneys to the systemic circulation
44
What is a ADH hormone deficit called
Diabetes insipidus
45
What does oxytocin do
Stimulates uterine contraction
46
What drug is used for the posterior pituitary
-pressin
47
What are patients monitored for when they are taking a -pressin drug
Adema, weight gain, UOP, electrolytes and glucose
48
How do you treat excess secretion of ADH
Fluid restriction
49
What hormones does the thyroid gland produce
T4 or levothyroxine
T3 or Leothyronine
Are we going produces more T4 than T3
50
What produces the thyroid stimulating hormone
Anterior pituitary
51
What do thyroid hormones do
Control rate of cellular metabolism
Regulate protein synthesis in enzyme activity
Stimulate mitochondrial oxidation
52
What do thyroid hormones control
Heat production, oxygen consumption, blood volume, enzyme system activity, regulate growth and development
53
Drug used for hypothyroidism
Levothyroxine
Drug of choice for long-term hypothyroid treatment, inexpensive and dependable
Increases metabolic rate, oxygen consumption, body growth
54
What should you monitor with levothyroxine
Cardiac, hypertension, angina, DM
55
Thyroid replacement drugs
Cytomegalovirus (T3 only)
Thur Olaf,armor thyroid, euthyroid (T4 & T3)
56
When should Synthroid be taken
First thing in the morning, before eating
57
Usual maintenance dose for Synthroid
50 to 200 mcg
58
When does Synthroid usually kick in
1 to 3 weeks
59
What do you anti-thyroid drugs do
Bought production of T3 and T4
Patient will need to be on thyroid replacement therapy every day for the rest of his or her life
Drug interactions: Oral anticoagulants, insulin, oral anti-diabetics, digoxin, lithium, Dilantin
60
What does parathyroid hormone deficiency cause
Hypocalcemia, muscular irritability
61
What do biphosphonates do
Prevent calcium release from bone, prevent osteoporosis and fractures
62
How does the body acquire excess PTH
Releasing calcium from bones, increased absorption of calcium from food, increased renal tubular reabsorption of calcium
63
How does the body decrease serum calcium
```
Biphosphonates,
calcitonin,
furosemide increases calcium excretion by kidney,
IV saline,
corticosteroids, or
Oral phosphate
```
64
What does the Medulla of the adrenal gland release
Catecholamines: epinephrine and norepinephrine
65
What does the cortex of the adrenal gland do
Produces corticosteroids
66
What do corticosteroids do
Promote sodium retention and potassium excretion
67
What does an excess of corticosteroids cause
Cushing's syndrome
68
What does a deficit of corticosteroids cause
Addison's disease
69
What do glucocorticoids do
Affect metabolism, sodium absorption, anti-inflammatory and anti-stress reactions
70
What are corticosteroids
Any hormones synthesized by adrenal cortex except androgens
71
Effects of corticosteroid therapy
Anti-inflammatory
Immunosuppression
Blood pressure
Carbohydrate and protein metabolism
72
What do you glucocorticoids treat
A wide variety of inflammatory, allergic and debilitating conditions, and organ transplantion
73
Side effects of glucocorticoids
Weight gain, peptic ulcer's, decreased/impaired wound healing, capillary fragility
When stopping, doses tapered so adrenal cortex can begin to produce cortisol again
74
What does mineralocorticoid do (aldosterone)
Promote sodium potassium exchange in renal tubules and collection ducts, therefore enhances sodium reabsorption and potassium loss
75
Replacement drug for mineralocorticoid (aldosterone)
Fludrocortisone
76
What is digoxin used to treat
Atrial tachycardia, atrial flutter, atrial fibrillation, heart failure
77
Mechanism of action Effects
Positive inotropic, negative chronotropic, negative dromatropic
78
Side effects of digoxin
Anorexia, nausea vomiting vomiting dizziness headache blurred vision
79
Therapeutic range for digoxin
0.5 to 2.0 NG/ML
80
What medication is used to treat digoxin toxicity
Digibind
81
Teaching points for digoxin
Call healthcare provider if heart rate is less than 60 bpm
Eat foods rich in potassium
82
What is PRIMACOR used for
Heart failure
83
What is stable angina
Triggered by predictable degree of activity, stable pattern of duration
84
What is unstable angina
Increased risk of myocardial infarction, and unpredictable trigger, more severe and frequent, last longer
85
What is variant angina
Caused by vasospasm and can occur at rest
86
Types of anti-anginal drugs
Nitrate, beta blockers, calcium channel blocker's
They work by increasing blood flow to the hypoxic area and decreasing oxygen demand
87
How are anti-anginal medication selected
Nitrates or beta blockers are usually recommended first for people with stable angina
Calcium channel blocker's are an alternative if there are side effects or other conditions that limit the use of beta blockers and nitrates
88
Antidysrhythmic's action
Block adrenergic stimulation of the heart, depressed myocardial excitability and contractility, decrease conduction velocity and cardiac tissue, increase recovery time of the myocardium, suppress atomaticity
89
What are class One antidysrhythmic drugs
Sodium channel blocker's
90
What do medications in class 1A antidysrhythmic drugs do
Slows conduction and prolongs repolarization
91
What does class 1B antidysrhythmic drugs do
Slows conduction and shortens repolarization
92
What does class 1C antidysrhythmic drug do
Prolongs conduction with a little or no effect on repolarization
93
What are class 2 antidysrhythmic drugs
Beta blockers
94
What do you class III antidysrhythmic drugs do
Prolongs repolarization
95
What are class 4 antidysrhythmic drugs
Calcium channel blocker's
96
"Some". 1
"Block" 2
"Potassium" 3
"Channels". 4
Xxxxx
97
Example of class 1A agent
Procainamide
98
Example of class 1B agent
Lidocaine
99
Signs of lidocaine toxicity
S. Slurred or difficult speech
A. Altered central nervous system
M. Muscle twitching
S. Seizures
100
Example of class 1C agent
Flecanide
101
Example of class II agent
Acebutolol
102
Example of class III agents
Adenosine, amiodarone
103
Example of class IV agents
Diltiazem
104
What are the five categories of diuretics
Thiazide and thiazide like
Loop or high ceiling
Osmotic
Carbonic anhydrase inhibitor
Potassium sparing
105
What function must be normal for thiazide medications
Kidney function
106
What are the three groups of thiazides
Short acting (>12 hours) long acting (>24 hours) an intermediate acting (12-24 hours)
107
Side effects of thiazides
Loss of sodium potassium and magnesium, calcium absorption, glucose tolerance, headache, nausea, vomiting, constipation, hives
108
What do you loop diuretics do
Inhibit sodium and chloride transport
109
Example of a loop diuretic
Furosemide
110
Loop diuretic side effects
Hypokalemia, hypomagnesemia, Hyponatremia, hypocalcemia, Hyperglycemia, Hypotension
111
What do K sparing diuretics do
Inhibit sodium channels
112
Examples of potassium sparing diuretics
Spironolactone
113
Potassium sparing side effects
Hyperkalemia nausea vomiting diarrhea
114
What are osmotic diuretics
They pull water into the blood vessels are nephrons from the surrounding tissues
115
What are the uses of osmotic diuretics
They prevent kidney failure, decrease intracranial pressure, decrease intraocular pressure found inglaucoma
116
Side effects of osmotic diuretic
Electrolyte in balance, nausea, vomiting, tachycardia from rapid fluid loss
117
What do you carbonic acid inhibitors do
Block the action of carbonic anhydrase, thus preventing the exchange of hydrogen ions with sodium and water
118
What are CAIs used for
Treatment of open angle glaucoma
119
Examples of direct acting vasoconstrictors
Nipride
Hydralazine
120
What do alpha-1 blocker's end with
-Zosin
121
How do Alpha blockers work
Dilation of peripheral blood vessels via blocking the Alpha adrenergic receptors
122
When do patients take the first dose of alpha-1 blocker
At bedtime and to move slowly from a sitting to a standing position
123
What do centrally acting alpha-2 agonist do
Decrease sympathetic response, decreased sympathetic activity, decreased serum level of epinephrine & norepinephrine
124
Example of centrally acting alpha-2 agonist
Clonidine HCl
125
What do adrenergic neuron blockers do
Hibbetts release of norepinephrine
126
Example of adrenergic neuron blocker
Resperine
127
What do ACE inhibitors do
Blocks action of aldosterone, lowers preload
128
Side effects of ace inhibitors
Cough, headache, dizziness, fatigue, insomnia, hyperkalemia, tachycardia, nausea, vomiting, dizziness, first dose hypotension
129
Example of ACE inhibitor
Lisinopril
Enalipril
130
Angiotensin II receptor blocker action
Selective and competitive antagonist of angiotensin II receptor is resulting in vasodilation
131
Examples of angiotensin II receptor blocker's
Anything that ends with -sartan
132
What do you calcium channel blocker's do
Blood calcium channel in the vascular smooth muscle promoting vasodilation
133
Examples of calcium channel blocker's
Anything that ends with -pine
134
Side effects of calcium channel blocker's
Hypertension, palpitations, Bradycardia, constipation, nausea
135
What should patients taking calcium channel blocker's avoid
Grapefruit juice
136
Side effects of beta blockers
Bradycardia, decreased blood pressure, insomnia, depression, nightmares, sexual dysfunction
137
What patient should avoid the use of beta blockers oh my goodness
Patients with COPD or asthma
138
Why should patients not suddenly stop beta blockers
Because of the risk of rebound tachycardia and hypertension
139
What do direct renin inhibitors do
Inhibition of renin results in decreased formation of angiotensin II
140
Example of direct renin inhibitor
Aliskiren
