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pharm objectives Flashcards

1
Q

Cholineric agonist increases what

A

SLUDGE

Salivation
Lacrimation
Urination
Diarrhea
GI motility/secretions 
Emesis
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2
Q

Cholinergic agonist decreases/constricts what

A

CONSTRICTS pupils

DECREASES HR

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3
Q

Cholinergic Antagonist side effects

A

CANT SEE, CANT PEE, CANT SPIT, CANT SHIT

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4
Q

Cholinergic crisis

A

when a patient recieves too much of a cholinergic agonist

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5
Q

Symptoms of a Cholinergic Crisis

A 
abdominal cramping
bloody diarrhea
cardiac arrest
hypOtension
salivation 
shock
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6
Q

Treatment of a Cholinergic Crisis

A

anticholinergic

ATROPINE!

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7
Q

Somatic pain is located where

A

bones, muscles, and soft tissue

includes joints and ligaments

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8
Q

What does somatic pain feel like

A

well-localized
aching
throbbing
gnawing

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9
Q

Examples of somatic pain

A

arthritis

incisional pain

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10
Q

Treatment of somatic pain

A

responds well to NSAIDs

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11
Q

Visceral pain is located where

A

deep tissues and organs

poorly localized

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12
Q

What does visceral pain feel like

A

deep aching, cramping, pressure

visceral pain commonly has “referred” component

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13
Q

Examples of visceral pain

A

bowel obstruction

liver disease

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14
Q

Treatment of visceral pain

A

often requires opioids

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15
Q

Neuropathic pain is located where

A

moves from location to location

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16
Q

What does neuropathic pain feel like

A

shooting
burning
stabbing

“radiates”

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17
Q

Examples of neuropathic pain

A

diabetic neuropathy

sciatica

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18
Q

Treatment of neuropathic pain

A

may use antiepileptic meds and antidepressents

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19
Q

MOA of opioid agonist

A

binds to mu / kappa receptors and causes a response

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20
Q

MOA of opioid antagonist

A

binds strongly to mu/kappa receptors, but reverses the effects of the opioid

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21
Q

MOA of opioid agonist antagonist

A

when administered alone, analgesia is produced

when administered with a pure opioid agonist, it can antagonize the analgesia caused by the pure agonist

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22
Q

Teaching for client on antiepileptic med

A 
take regularly, same time each day
take with meals to reduce GI upset
do not crush,chew,open extended release forms
if patients NPO talk to physician
med alert tag or ID should be worn
driving may be impaired
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23
Q

Parkinsons drugs: Indiret-acting dopamine receptor agonist

A

used in early stages of disease
helpful with symptoms fluctuations

~rasagiline (Azilect) PO
~selegiline (Eldepryl, Zelapar) PO

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24
Q

Parkinsons drugs: Dopamine modulator

A

reduces tremor or muscle rigidity

~amantadine (Symmetrel) PO

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25
Q

Parkinsons drugs: COMT inhibitors

A
  • Usually added to carbidopa-levodopa to treat -symptoms fluctuations;
  • delays “off” periods;

~entacapone (Comtan) [PO]
~talcapone (Tasmar) [PO]

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26
Q

Parkinsons drugs: Direct-Acting Dopamine Receptor Agonist

A
  • choice for young patients
  • for “off periods”
  • can be used to reduce dyskinesia associated with later stages

~bromocriptine (Palodel) [PO],
~pramipexole (Mirapex) [PO]
~ropinirole (Requip) [PO]
~rotigotine (Neupro) [transdermal]

27
Q

Parkinsons drugs: Dopamine Replacement Drugs

A
  • started as soon as patient becomes functionally impaired
  • drug of choice for most older adults

~carbidopa-levodopa (Simemet, Rytary) [PO]

28
Q

Parkinsons drugs: Anticholinergic Drugs

A

Used as secondary drugs for tremor/muscle rigidity

~benztropine (Cogentin) [PO, IV]
~trihexyphenidyl (generic only) [PO]

29
Q

Parkinsons drugs: Antihistamines

A

Used as secondary for tremor/muscle rigidity

~diphenhydramine (Benadryl) [PO, IV]

30
Q

Management of barbiturate overdose

A

Tx focuses of maintaining an airway, and providing respiratory support via oxygen therapy and ventilation if necessary

31
Q

Triad symptoms of barbiturate overdose

A

respiratory depression
coma
pinpoint pupils

32
Q

use of “-triptans”

A

abortive therapy for headaches

33
Q

side effects common to most Antidysrhythmics: Sodium Channel Blockers

A
  • bradycardia

* hypotension

34
Q

Quinidine common side effects and BBW

A
  • diarrhea
  • cinchonism (tinnitus, blurred vision, headache, nausea)

BBW: increased mortility caused by ventricular dysrhythmias

35
Q

Procainamide (Short-term only) is associated with

A

similar to quinidine but fewer anticholinergic effects

  • associated with Lupus-like syndrome
  • bloody dyscrasias including decreased WBCs and platelets
36
Q

lidocaine (Xylocaine) toxicity signs

A

involve CNS (confusions, anxiety, tremors, paresthesias)

37
Q

flecainide (Tambocor) BBW

A

FIRST LINE FOR AF

BBW: increased mortility and prodysrhythmis effects

38
Q

Amiodarone (Cordarone) side effects and BBW

A
  • corneal microdeposits
  • hypo/hyperthyroidism
  • pulmonary toxicity
  • prodysrhytmis

BBW: hepatotoxicity, pulmonary toxicity

39
Q

statins common side effects

A

myopathy –> can lead to rhabdomyolysis which can lead to acute renal failure and death

40
Q

fibrates common side effects

A

GI upset, increased risk of gallstones, increased liver enzymes

INCREASED RISK OF RHABDOMYOLYSIS IF COMBINED WITH STATIN

41
Q

Niacin (vit B3) common side effect

A

Flushing

42
Q

Action of thrombolytics

A

lyse (breakdown existing clots)

43
Q

first line drug therapy for type 2 diabetic

A

metformin (Glucophage)

44
Q

Folate antagonist (Methotraxate)

A

folic acid deficiency
bone marrow suppression
Leucovorin = rescue drug and given within 24 hours of methotrexate

45
Q

mitotic inhibitors (paclitaxel; Taxol)

A

high risk sensitivity reaction

premedicate w/ dexamethasone, diphenhydramine, rantidine

46
Q

mitotic inhibitors (vincristine)

A

give IV only

NOT intrathecally

47
Q

Alkylating drugs (cisplatin; Planitol) (cyclophoshamide; Cytoxan)

A

risk of nephrotoxicity

48
Q

hematopoietic drugs

A

epoetin alpha (Epogen, Procrit)
filgrastim (Neupogen)
oprelvekin (Neumega)

49
Q

epoetin alpha (Epogen, Procrit) stimulates

A

erythropoiesis (RBCs)

50
Q

filgrastim (Neupogen) increases what

A

granulocytes (WBCs)

51
Q

oprelvekin (Neumega) stimulates production of

A

thrombocytes (platelets)

52
Q

immunosuppressants are commonly given with

A

corticosteroids

53
Q

immunosuppressants include

A

cyclosporine (Sandimmune) & cyclosporine-modified (Gengraf, Neoral)

azathioprine (Imuran)

glatiramer acetate (Copaxone)

54
Q

cyclosporine (Sandimmune) & cyclosporine-modified (Gengraf, Neoral)

toxicity/monitor
BBW

A

nephrotoxicity
monitor BUN and creatinine

BBW: renal impairment, risk of infection, liver injury, seizures, encephalopathy, skin cancer

55
Q

azathioprine (Imuran) BBW

A

BBW: bone marrow suppression, development of lymphoma

  • leukopenia/neutropenia
  • thrombocytopenia
56
Q

glatiramer acetate (Copaxone)

used in…
administered..

A

used in MS

SubQ

57
Q

beta-lactamase inhibitors

A
  • Clavulanic acid
  • Tazobactam
  • Sulbactam
  • Avibactam
58
Q

Clavulanic acid with

A

amoxicillin/clavulanic acid (Augmentin)

ticarcillin/ clavulanic acid (Timentin)

59
Q

Tazobactam with

A

piperacillin/ tazobactam (Zosyn)

60
Q

Sulbactam with

A

ampicillin/ sulbactam (Unasyn)

61
Q

Avibactam

A

see cephalosporins

62
Q

beta lactamase that specifically inactivate penicillin molecules are called

A

penicillinases

63
Q

metabolism (Biotransformation)

A

primary results are INACTIVATION OF THE DRUG and acceleration of excretion

Pharm (6 decks)

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