Pharm Final 6 Flashcards
1
Q
serotonin receptor agonist used for migraines
A
sumatriptan
2
Q
phenobarbital
A
barbiturate (sedative/hypnotic/anxiolytic)
3
Q
diazepam
A
benzodiazepines (sedative/hypnotic/anxiolytic)
4
Q
zolpidem
A
benzodiazepines (sedative/hypnotic/anxiolytic)
5
Q
eszopiclone
A
“other anxiolytic and hypnotic drugs” (this one is Lunesta)
6
Q
general CNS depressants that inhibit neuronal impulse conduction
A
barbiturates
7
Q
Although the mechanism of barbiturates is unclear, it might have to do with activating
A
GABA
8
Q
the major inhibitory transmitter of the CNS
A
GABA
9
Q
the 2 major groups of sedative/hypnotic/anxiolytics
A
barbiturates and benzodiazepines
10
Q
facilitate activity of GABA at it’s receptors
A
benzodiazepines (and possibly barbiturates)
11
Q
the suffix “ital” means
A
barbiturate
12
Q
the suffix “pam” means
A
benzodiazepine
13
Q
benzodiazepines are less likely to causes this than barbiturates
A
respiratory depression, coma, death
14
Q
clinical pharmacology: sedation hypnosis anesthesia anticonvulsant muscle relaxant respiratory depression anxiety disorders
A
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
15
Q
used to induce anesthesia
A
barbiturates
16
Q
reduces the amount of anesthesia needed
A
barbiturates
17
Q
used for epilepsy
A
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
18
Q
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic) control epilepsy by
A
reducing the number of neurons firing
19
Q
toxic/undesirable effects: tolerance physical dependence anterograde amnesia drowsiness respiratory depression, coma, death
A
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
20
Q
tolerance develops for anti-seizure effects
A
benzodiazepines
21
Q
tolerance does not develop for anxiolytic effects
A
benzodiazepines
22
Q
tolerance develops to the sedative and hypnotic effects
A
barbiturates
23
Q
withdrawal symptoms include anxiety and insomnia
A
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
24
Q
toxic/undesirable effects: anterograde amnesia
A
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
25
toxic/undesirable effects: respiratory depression, coma, death
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
26
poor memory during the drug use, memory returns after
anterograde amnesia
27
inducers of the P450 system
barbiturates
28
drug interactions occur with other CNS sedatives like alcohol, narcotics, and anticonvulsants
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
29
```
clinical uses:
anxiety
sleep disorders
anesthesia
epilepsy
alcohol withdrawal
```
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
30
nursing implications for barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic) (4)
vitals
assess sleep patterns
day time drowsiness (don't drive etc)
avoid alcohol and other CNS depressants (like benedryl)
31
```
nursing implications:
vitals
assess sleep patterns
day time drowsiness (don't drive etc)
avoid alcohol and other CNS depressants
```
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
32
nursing implications: day time drowsiness (don't drive etc)
barbiturates and benzodiazepines (sedative/hypnotic/anxiolytic)
33
2 drugs we learned that are best for insomnia
zolpidem and eszopiclone
34
haloperidol
antipsychotic
35
clozapine
antipsychotic
36
prochlorperazine
antipsychotic
37
in addition to being an antipsychotic, it's also used for antiemetic
prochlorperazine
38
the glaring/obvious symptoms of schizophrenia are called
positive symptoms
39
are antipsychotics better at controlling positive symptoms or negative symptoms?
positive
40
In schizophrenia, speech pattern and lack of emotion are __ symptoms
negative
41
although the pathogenesis of schizophrenia is uncertain, the best theory is the ___ hypothesis
dopamine hypothesis
42
hyperdopaminergic means
too much DA
43
the dopamine hypothesis of schizophrenia is that there's an imbalance of DA. hyperdopaminergia causes __ symptoms and hypodopaminergic causes __ symptoms
positive
negative
44
2 examples of a conventional antipsychotic
haloperidol
| prochlorperazine
45
example of atypical antipsychotic
clozapine
46
Both conventional and atypical drugs are good at treating positive symptoms, but ___ can also treat negative symptoms
atypical
47
has side effects r/t muscle activity
```
conventional antipsychotic (haloperidol
prochlorperazine)
```
48
class of drug that works by blocking receptors for DA, ACH, histamine, and NE
antipsychotics
49
class of drug has emotional quieting and reduced physical movement
antipsychotics
50
class of drug, antiemetic
antipsychotics
51
class of drug, increases prolactin
antipsychotics
52
antipsychotics side effects (4)
dry mouth, urinary retention, constipation, sedation, orthostatic hypotension
53
class of drug, has antihistamine effect (causes sedation)
antipsychotics
54
which group of antipsychotic causes less extrapyramidal side effects
atypical
55
which group of antipsychotic can relieve positive and negative symptoms
atypical
56
__ is used to treat some of the extrapyramidal side effects of antipsychotics
benedryl
57
name of side effect: spasms of face, neck, mouth, back
acute dystonia
58
name of side effect: tremor, bradykinesia, mask-like face, altered posture
Parkinson's
59
name of side effect: catatonia, rigidity, fever
malignant syndrome
60
name of side effect: involuntary movements of mouth, face, trunk and extremities; sucking and smacking lips
tardive dyskinesia
61
treatment of acute dystonia
anti-cholinergic (parkinson's drug?)
62
treatment of Parkinsons
anti-cholinergic (parkinson's drug?)
63
treatment of malignant syndrome
stop meds immediately
64
treatment of tardive dyskinesia
minimize doses initially
65
side effect that's irreversible and therefore the causative drug should be started at low dose
tardive dyskinesia
66
time of onset, tardive dyskinesia
months to years
67
time of onset, malignant syndrome
weeks
68
time of onset, Parkinson's
5-30 days
69
time of onset, acute dystonia
1-5 days
70
clinical use can include tourettes syndrome
antipsychotic
71
antipsychotic nursing implications (3)
vitals
monitor extrapyramidal side effects
avoid alcohol
72
which antipsychotic is good for antiemetic
prochlorperazine
73
what's the best side effect to identify malignant syndrome
fever
74
depression in response to an event
reactive
75
depression not in response to an event
no reason
76
no reason depression is aka
endogenous depression
77
no reason depression includes __ disorder
bipolar disorder
78
symptoms: increase or decrease weight, can't sleep or sleep too much
depression
79
depression involves an imbalance between __ and __ neurotransmitters
inhibitory and excitatory
80
most significant neurotransmitters in depression
serotonin and NE
81
Major classes of antidepressants (4)
MAO inhibitors
TCA
SSRI
Other
82
Not an antidepressant, a mood stimulator
lithium
83
TCA prototype
amitryptyline
84
SSRI prototype
sertraline
85
MAO prototype
phenelzine
86
prototype of "other" antidepressants
bupropion
87
antidepressant that works by blocking of NE and/or serotonin reuptake
amitryptyline
88
antidepressant takes 2-3 weeks to work
amitryptyline
89
antidepressant,
anti-cholinergic effects (dry mouth, constipation, urinary retention)
anti-histamine effects (sedation)
orthostatic hypotension
amitryptyline
90
TCA has SEVERE reaction with
MAO inhibitors (coma)
91
TCA (amitryptyline) contraindications
heart conditions
92
side effects,
| drowsy, dizzy, orthostatic hypotension, sedation, constipation
TCA (amitryptyline)
93
toxic effects,
| cardiac conduction defects, coma CV collapse, seizures, delerium
TCA (amitryptyline)
94
used for endogenous depression
TCA (amitryptyline)
95
used for OCD
TCA (amitryptyline)
96
antidepressant, blocks reuptake of 5HT by presynaptic terminal
(SSRI) sertraline
97
increases level of 5HT
(SSRI) sertraline
98
antidepressant with no anticholinergic action
(SSRI) sertraline
99
side effects,
| insomnia, nervousness, akathesia, tinnitus, headache, sexual problems, weight loss followed by weight gain
(SSRI) sertraline
100
drug that irreversibly inactivates MAO
phenelzine
101
increases levels of amines such as norepinephrine, epinephrine, DA, serotonin, and tyramine
phenelzine
102
suppress REM and causes orthostatic hypotension
phenelzine
103
has interactions with foods high in tyramine (such as beer, cheese, chicken liver)
MAO inhibitors (phenelzine)
104
phenelzine interaction with tyramine
hypertension
105
antidepressant that enhances the action of general anesthetics, sedatives, narcotics, and TCAs
phenelzine
106
antidepressant contraindicated with st johns wort
phenelzine (both are MAO inhibitors)
107
toxic effects,
liver toxicity
2-3 drug-free period before taking a tri/hetero-cyclic antidepressant
phenelzine
108
overdose can result in agitation, headache, convulsions, hypo/hypertension
phenelzine
109
weakly blocks reuptake of NE, serotonin, and DA
bupropion ("other")
110
at lower doses, can be used for smoking cessation
bupropion ("other")
111
antidepressant with side effects: CNS stimulation, weight change, dry mouth, headaches, GI effects
bupropion ("other")
112
used in treatment of mania and manic parts of bipolar disorder
lithium
113
lithium route of administration
oral
114
drug with very narrow TI
lithium
115
side effects:
| polyuria, excessive thirst, epileptic seizures, thyroid enlargement
lithium
116
contraindicated in pregnancy
lithium
117
the main receptor for opioid is
Mu
118
extrapyramidal side effects refer to ___ issues
muscle
119
extrapyramidal side effects are treated with ___ or ___
benedryl or benztropine
120
insulin increases uptake or
glucose
121
insulin increases storage of glucose as __ in the ___
glycogen in the liver
122
insulin inhibits (3)
gluconeogenesis, glycogenolysis, lipolysis (which makes sense because the point of insulin is to decrease the excess energy in the blood)
123
insulin promotes uptake of AAs and __ synthesis in muscle
protein
124
insulin decreases free __ acids and promotes triglyceride storage in
free fatty acids
| adipocytes
125
increases uptake of potassium
insulin
126
diabetes is characterized by either having no __ or the body not responding to insulin
insulin
127
kind of diabetes thats an autoimmune disorder
type 1
128
type of diabetes where there's no circulating insulin in the plasma
type 1
129
type of diabetes where patient is prone to hyperglycemia and ketoacidosis
type 1
130
kind of diabetes "absolute deficiency"
type 1
131
kind of diabetes "relative deficiency"
type 2
132
kind of diabetes where the body isn't responding to insuln
type 2
133
kind of diabetes that happens with obesity
type 2
134
kind of diabetes occurs due to a defect in the receptor on the pancreatic B cell
type 2
135
in type 1 diabetes, what causes glycosuria, osmotic diuresis, thirst, dehydration
kidneys overloaded with glucose
136
without insulin, a child with IDDM wastes away and dies from DKA which is
diabetic ketoacidosis
137
kind of diabetes, hyperglycemia
type 1
138
kind of diabetes, glycosuria
type 1
139
kind of diabetes, polydipsia
type 1
140
kind of diabetes, weight loss
type 1
141
kind of diabetes, malaise
type 1
142
kind of diabetes, ketoacidosis
type 1
143
increased level or circulating fatty acids, leads to renal failure and circulatory collapse
ketoacidosis
144
kind of diabetes, decreased glucose transport in muscle, elevated hepatic glucose production, and increased breakdown of fat
type 2
145
kind of diabetes, impaired insulin secretion; may lead to beta cell "burn out"
type 2
146
kind of diabetes, increased glucose secretion by the liver (in response to increase insulin)
type 2
147
```
disease includes:
nephropathy
neuropathy
retinopathy
atherosclerosis
```
diabetes
