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Pharm Exam 3 > Pharm Exam 3 > Flashcards

Pharm Exam 3 Flashcards

1
Q

What are anticonvulsants

A

Anti seizure medication

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2
Q

How soon do anticonvulsants work

A

May take up to one week to work

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3
Q

What do you need to monitor with AEDs

A

Blood level (narrow therapeutic range)

Suicidal behaviors

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4
Q

What 3 ways do AEDs work

A

Suppressing sodium influx

Suppressing calcium influx

Increase action of GABA

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5
Q

What do hydantoins do (AED)

A

Inhibit sodium influx

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6
Q

Therapeutic range for phenytoin

A

10-20 mcg/ml

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7
Q

What do barbiturates do (AED)

A

Enhances GABA

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8
Q

What do succinimides do

A

Inhibit calcium influx

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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

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10
Q

How do AEDs affect pregnant women

A

Increase seizures by 25%

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11
Q

Classic symptoms with Parkinson’s disease

A

Tremor
Rigidity
Bradykinesia

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12
Q

What is Parkinson’s disease an imbalance of?

A

Dopamine and acetylcholine

Too much acetylcholine and not enough dopamine

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13
Q

Medications used to treat Parkinson’s disease

A 
Anticholinergics
Dopaminergics
Dopamine agonists
MAO-B inhibitor
COMT inhibitor
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14
Q

How do antocholinergics work for Parkinson’s disease

A

Inhibit release of acetylcholine

Reduce rigidity and tremors

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15
Q

Anticholergics used for Parkinson’s

A

Benztropine
Biperiden
Trihexyphenidyl HCl
Diphenhydramine (benedryl)

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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

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17
Q

What does l-dopa do

A

Increases mobility and Parkinson’s disease

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18
Q

Side effects of l-dopa

A

GI upset, dyskinesias, hypertension, cardiac dysrhythmias, psychosis, agranulocytosis

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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

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20
Q

Other Parkinson’s drugs

A

Dopamine agonist, MAOB inhibitors, COMT inhibitors, limit vitamin B6 to normal doses

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21
Q

What histologic changes take place in Alzheimer’s disease

A

Degeneration of cholinergic neurons in a deficiency in acetylcholine

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22
Q

What drugs are used to treat Alzheimer’s disease

A

Acetylcholinesterase inhibitor’s

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23
Q

What are characteristics of my Myasthenia gravis disease

A

Muscular weakness and fatigue

Respiratory muscle paralysis, ptosis, difficulty chewing and swallowing

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24
Q

Drug agents used for MG

A

Ultra short acting, short acting, intermediate acting, long acting

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25
Q

What are characteristics of MS

A

Weakness or’s spasticity in extremities, diplopia

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26
Q

Treatment strategy for acute attack MS

A

Prednisones, ACTH, Methylprednisolone

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27
Q

Treatment strategies for the remission exasperation MS

A

Biologic response modifiers

Interferons, amino suppressant

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28
Q

Treatment strategy for chronic progressive MS

A

Cyclophosphamide, ACTH

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29
Q

Side effects of skeletal muscle relaxants

A

Drowsiness, dizziness, headaches, occasional abdominal distress

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30
Q

What is the primary function of the hypothalamus

A

To regulate levels of hormone production by producing releasing factors that cause glands to release hormones

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31
Q

What controls the pituitary gland

A

The hypothalamus

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32
Q

What hormones are controlled by the anterior pituitary

A

Thyroid stimulating hormones, adrenocorticotropic hormone, and growth hormone

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33
Q

Drugs for growth hormone deficiency

A

Soma-

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34
Q

What should be monitored with drugs for growth hormone deficiency

A

Diabetes mellitus

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35
Q

Drugs for a growth hormone suppression

A

Bromocriptine
Ocretide

Very expensive

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36
Q

What does hyperthyroidism cause

A

Hypermetabolic state

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37
Q

What does a thyroid stimulating hormone deficit cause

A

Hypometabolic state

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38
Q

What does ACTH do

A

Causes release of corticoids by the adrenal gland. Excess or deficit causes steroid excess or deficiency

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39
Q

Drugs used for the anterior pituitary gland

A

Corticotropin and Cosyntropin

Cause of secretion of corticosteroids

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40
Q

Side effects of corticotropin

A

Adema, osteoporosis, ulcer perforation, pancreatitis

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41
Q

What is the posterior pituitary gland do

A

Xers of storage reservoir for hormones from hypothalamus

ADH and oxytocin

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42
Q

What is the natural ADH hormone

A

Vasopressin

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43
Q

What does vasopressin do

A

Reabsorbs water from kidneys to the systemic circulation

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44
Q

What is a ADH hormone deficit called

A

Diabetes insipidus

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45
Q

What does oxytocin do

A

Stimulates uterine contraction

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46
Q

What drug is used for the posterior pituitary

A

-pressin

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47
Q

What are patients monitored for when they are taking a -pressin drug

A

Adema, weight gain, UOP, electrolytes and glucose

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48
Q

How do you treat excess secretion of ADH

A

Fluid restriction

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49
Q

What hormones does the thyroid gland produce

A

T4 or levothyroxine
T3 or Leothyronine

Are we going produces more T4 than T3

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50
Q

What produces the thyroid stimulating hormone

A

Anterior pituitary

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51
Q

What do thyroid hormones do

A

Control rate of cellular metabolism

Regulate protein synthesis in enzyme activity

Stimulate mitochondrial oxidation

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52
Q

What do thyroid hormones control

A

Heat production, oxygen consumption, blood volume, enzyme system activity, regulate growth and development

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53
Q

Drug used for hypothyroidism

A

Levothyroxine
Drug of choice for long-term hypothyroid treatment, inexpensive and dependable

Increases metabolic rate, oxygen consumption, body growth

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54
Q

What should you monitor with levothyroxine

A

Cardiac, hypertension, angina, DM

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55
Q

Thyroid replacement drugs

A

Cytomegalovirus (T3 only)

Thur Olaf,armor thyroid, euthyroid (T4 & T3)

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56
Q

When should Synthroid be taken

A

First thing in the morning, before eating

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57
Q

Usual maintenance dose for Synthroid

A

50 to 200 mcg

58
Q

When does Synthroid usually kick in

A

1 to 3 weeks

59
Q

What do you anti-thyroid drugs do

A

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
Q

What does parathyroid hormone deficiency cause

A

Hypocalcemia, muscular irritability

61
Q

What do biphosphonates do

A

Prevent calcium release from bone, prevent osteoporosis and fractures

62
Q

How does the body acquire excess PTH

A

Releasing calcium from bones, increased absorption of calcium from food, increased renal tubular reabsorption of calcium

63
Q

How does the body decrease serum calcium

A 
Biphosphonates, 
calcitonin, 
furosemide increases calcium excretion by kidney, 
IV saline, 
corticosteroids, or 
Oral phosphate
64
Q

What does the Medulla of the adrenal gland release

A

Catecholamines: epinephrine and norepinephrine

65
Q

What does the cortex of the adrenal gland do

A

Produces corticosteroids

66
Q

What do corticosteroids do

A

Promote sodium retention and potassium excretion

67
Q

What does an excess of corticosteroids cause

A

Cushing’s syndrome

68
Q

What does a deficit of corticosteroids cause

A

Addison’s disease

69
Q

What do glucocorticoids do

A

Affect metabolism, sodium absorption, anti-inflammatory and anti-stress reactions

70
Q

What are corticosteroids

A

Any hormones synthesized by adrenal cortex except androgens

71
Q

Effects of corticosteroid therapy

A

Anti-inflammatory
Immunosuppression
Blood pressure
Carbohydrate and protein metabolism

72
Q

What do you glucocorticoids treat

A

A wide variety of inflammatory, allergic and debilitating conditions, and organ transplantion

73
Q

Side effects of glucocorticoids

A

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
Q

What does mineralocorticoid do (aldosterone)

A

Promote sodium potassium exchange in renal tubules and collection ducts, therefore enhances sodium reabsorption and potassium loss

75
Q

Replacement drug for mineralocorticoid (aldosterone)

A

Fludrocortisone

76
Q

What is digoxin used to treat

A

Atrial tachycardia, atrial flutter, atrial fibrillation, heart failure

77
Q

Mechanism of action Effects

A

Positive inotropic, negative chronotropic, negative dromatropic

78
Q

Side effects of digoxin

A

Anorexia, nausea vomiting vomiting dizziness headache blurred vision

79
Q

Therapeutic range for digoxin

A

0.5 to 2.0 NG/ML

80
Q

What medication is used to treat digoxin toxicity

A

Digibind

81
Q

Teaching points for digoxin

A

Call healthcare provider if heart rate is less than 60 bpm

Eat foods rich in potassium

82
Q

What is PRIMACOR used for

A

Heart failure

83
Q

What is stable angina

A

Triggered by predictable degree of activity, stable pattern of duration

84
Q

What is unstable angina

A

Increased risk of myocardial infarction, and unpredictable trigger, more severe and frequent, last longer

85
Q

What is variant angina

A

Caused by vasospasm and can occur at rest

86
Q

Types of anti-anginal drugs

A

Nitrate, beta blockers, calcium channel blocker’s

They work by increasing blood flow to the hypoxic area and decreasing oxygen demand

87
Q

How are anti-anginal medication selected

A

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
Q

Antidysrhythmic’s action

A

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
Q

What are class One antidysrhythmic drugs

A

Sodium channel blocker’s

90
Q

What do medications in class 1A antidysrhythmic drugs do

A

Slows conduction and prolongs repolarization

91
Q

What does class 1B antidysrhythmic drugs do

A

Slows conduction and shortens repolarization

92
Q

What does class 1C antidysrhythmic drug do

A

Prolongs conduction with a little or no effect on repolarization

93
Q

What are class 2 antidysrhythmic drugs

A

Beta blockers

94
Q

What do you class III antidysrhythmic drugs do

A

Prolongs repolarization

95
Q

What are class 4 antidysrhythmic drugs

A

Calcium channel blocker’s

96
Q

“Some”. 1
“Block” 2
“Potassium” 3
“Channels”. 4

A

Xxxxx

97
Q

Example of class 1A agent

A

Procainamide

98
Q

Example of class 1B agent

A

Lidocaine

99
Q

Signs of lidocaine toxicity

A

S. Slurred or difficult speech
A. Altered central nervous system
M. Muscle twitching
S. Seizures

100
Q

Example of class 1C agent

A

Flecanide

101
Q

Example of class II agent

A

Acebutolol

102
Q

Example of class III agents

A

Adenosine, amiodarone

103
Q

Example of class IV agents

A

Diltiazem

104
Q

What are the five categories of diuretics

A

Thiazide and thiazide like

Loop or high ceiling

Osmotic

Carbonic anhydrase inhibitor

Potassium sparing

105
Q

What function must be normal for thiazide medications

A

Kidney function

106
Q

What are the three groups of thiazides

A

Short acting (>12 hours) long acting (>24 hours) an intermediate acting (12-24 hours)

107
Q

Side effects of thiazides

A

Loss of sodium potassium and magnesium, calcium absorption, glucose tolerance, headache, nausea, vomiting, constipation, hives

108
Q

What do you loop diuretics do

A

Inhibit sodium and chloride transport

109
Q

Example of a loop diuretic

A

Furosemide

110
Q

Loop diuretic side effects

A

Hypokalemia, hypomagnesemia, Hyponatremia, hypocalcemia, Hyperglycemia, Hypotension

111
Q

What do K sparing diuretics do

A

Inhibit sodium channels

112
Q

Examples of potassium sparing diuretics

A

Spironolactone

113
Q

Potassium sparing side effects

A

Hyperkalemia nausea vomiting diarrhea

114
Q

What are osmotic diuretics

A

They pull water into the blood vessels are nephrons from the surrounding tissues

115
Q

What are the uses of osmotic diuretics

A

They prevent kidney failure, decrease intracranial pressure, decrease intraocular pressure found inglaucoma

116
Q

Side effects of osmotic diuretic

A

Electrolyte in balance, nausea, vomiting, tachycardia from rapid fluid loss

117
Q

What do you carbonic acid inhibitors do

A

Block the action of carbonic anhydrase, thus preventing the exchange of hydrogen ions with sodium and water

118
Q

What are CAIs used for

A

Treatment of open angle glaucoma

119
Q

Examples of direct acting vasoconstrictors

A

Nipride

Hydralazine

120
Q

What do alpha-1 blocker’s end with

A

-Zosin

121
Q

How do Alpha blockers work

A

Dilation of peripheral blood vessels via blocking the Alpha adrenergic receptors

122
Q

When do patients take the first dose of alpha-1 blocker

A

At bedtime and to move slowly from a sitting to a standing position

123
Q

What do centrally acting alpha-2 agonist do

A

Decrease sympathetic response, decreased sympathetic activity, decreased serum level of epinephrine & norepinephrine

124
Q

Example of centrally acting alpha-2 agonist

A

Clonidine HCl

125
Q

What do adrenergic neuron blockers do

A

Hibbetts release of norepinephrine

126
Q

Example of adrenergic neuron blocker

A

Resperine

127
Q

What do ACE inhibitors do

A

Blocks action of aldosterone, lowers preload

128
Q

Side effects of ace inhibitors

A

Cough, headache, dizziness, fatigue, insomnia, hyperkalemia, tachycardia, nausea, vomiting, dizziness, first dose hypotension

129
Q

Example of ACE inhibitor

A

Lisinopril

Enalipril

130
Q

Angiotensin II receptor blocker action

A

Selective and competitive antagonist of angiotensin II receptor is resulting in vasodilation

131
Q

Examples of angiotensin II receptor blocker’s

A

Anything that ends with -sartan

132
Q

What do you calcium channel blocker’s do

A

Blood calcium channel in the vascular smooth muscle promoting vasodilation

133
Q

Examples of calcium channel blocker’s

A

Anything that ends with -pine

134
Q

Side effects of calcium channel blocker’s

A

Hypertension, palpitations, Bradycardia, constipation, nausea

135
Q

What should patients taking calcium channel blocker’s avoid

A

Grapefruit juice

136
Q

Side effects of beta blockers

A

Bradycardia, decreased blood pressure, insomnia, depression, nightmares, sexual dysfunction

137
Q

What patient should avoid the use of beta blockers oh my goodness

A

Patients with COPD or asthma

138
Q

Why should patients not suddenly stop beta blockers

A

Because of the risk of rebound tachycardia and hypertension

139
Q

What do direct renin inhibitors do

A

Inhibition of renin results in decreased formation of angiotensin II

140
Q

Example of direct renin inhibitor

A

Aliskiren

Pharm Exam 3 (1 decks)

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