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Nurs 306 / Pharm 2 > Pharm test 1 > Flashcards

Pharm test 1 Flashcards

1
Q

What is the involuntary contraction of muscles or muscle groups?

A

Spasms

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2
Q

What are three causes of muscle spasms?

A

Epilepsy
Hypocalcemia
Pain Syndromes

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3
Q

What is a group of movement disorders in the CNS characterized by increased muscle tone, spasms, and a loss of dexterity?

A

Spasticity

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4
Q

What are two disorders that have spasticity?

A

Sclerosis and Cerebral Palsy

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5
Q

What are two drugs that are used to relieve spasms and decrease local pain and increase range of motion?

A

Diazepan and Tizanidine

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6
Q

What medication is a benzodiazepine that works through GABA in the spinal cord and the brain but can cause sedation?

A

Diazepam (Think IZZY)

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7
Q

What drug is used for muscle spasms and it’s moa is that it mimics the actions of GABA on the spinal nerves? but has no effect of skeletal muscles?

A

Baclofen

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8
Q

What are the AE of Baclofen?

A

Nausea
Constipation
Urinary retention

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9
Q

What medication acts on skeletal muscle to lower the release of calcium

A

Dantrolene

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10
Q

What is Dantrolene used for?

A

Spasticity and Malignant Hyperthermia

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11
Q

What are the AE of Dantrolene?
Used for spasticity so it causes the opposite….

A

Hepatotoxicity
Muscle Weakness

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12
Q

What is a disease that is characterized by progressive memory loss and the inability to perform daily tasks?

A

Alzheimer’s disease

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13
Q

What is the cholinesterase inhibitor that causes IRREVERIBLE inhibition of cholinesterase to treat AD?

A

Rivastigmine

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14
Q

What are possible AE of Rivastigmine

A

Abdominal Pain— PUD
Lung disease
Bradycardia
Sick sinus syndrome
Urinary Obstruction
Fainting and falls

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15
Q

What is the cholinesterase inhibitor that causes REVERSIBLE inhibition of cholinesterase in MILD, MODERATE, AND SEVERE AD?

A

Donepezil

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16
Q

What are possible AE with Donezepil?
(this is given for AD)

A

N/V/D
Bradycardia
Fainting, Falls, and Fractures

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17
Q

What is the drug class that blocks the cholinergic receptors and can reduce the individual’s response to cholinesterase used in AD?

A

Cholinesterase Inhibitors

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18
Q

What are cholinesterase inhibitors used in?

A

AD

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19
Q

Cholinesterase Inhibitors prevent the breakdown of _________________

A

Acetylcholine

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20
Q

Overall cholinesterase inhibitors _______ the progression of the disease?

A

SLOW

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21
Q

What are the possible AE of cholinesterase inhibitors?

A

Cholinergic Side Effects
GI
Dizziness
HA
Bronchoconstriction

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22
Q

What is the disorder where there is a rapid degeneration of neurons in the hippocampus and later in the cerebral cortex?

A

Alzheimer’s

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23
Q

What are the primary drug classes used in AD?

A

Cholinesterase Inhibitors

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24
Q

What are the three main cholinesterase inhibitors used in AD?

A

Donepezil
Galantamine
Rivastigmine

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25
Q

What is the cholinesterase inhibitor that causes reversible cholinesterase inhibitor and used in mild to moderate AD?

A

Galantamine

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26
Q

What are possible AE of Galantamine?

A

Bradycardia
Fainting, falls, fractures (this is all AD meds)
Bronchoconstriction

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27
Q

What is the drug that falls in the category of N-methyl-D-asparate receptor antagonist

A

Memantine

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28
Q

What drug is used in moderate to severe AD and is better tolerated that cholinesterase inhibitors

A

Memantine

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29
Q

What are possible AE with Memantine
*** They are all pretty typical.

A

Dizziness
HA
Confusion
Constipation`

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30
Q

What are possible AE with Memantine

A

Dizziness
HA
Confusion
Constipation`

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31
Q

What are the antidepressants discussed?
Used in patients with ADHD
hintIf you use antidepressants you may be in a BIND

A

Bupropion
Imipramine
Nortriptyline
Desipramine

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32
Q

Antidepressants are paired with patient’s who already have what conditions?

A

PSYCH

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33
Q

What are possible AE of antidepressants

A

Arrythmias
Anticholinergic effects
AND THESE DRUGS LOWER THE SEIZURE THRESHOLD

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34
Q

What drugs are used in ADHD and are LESS effective that stimulants?

A

ALPHA 2 ADRENERGIC

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35
Q

What are possible AE of Alpha 2 Adrenergics
(Everything opposite of Fight or Flight)

A

Sedation
Fatigue
HA
low HR and BP
Depression

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36
Q

What general anesthetic is used primarily in kiddos?

A

Ketamine

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37
Q

What anesthetic is associated with hallucinations, bad dreams and delirum

A

Ketamine

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38
Q

What are the drugs that can be used as an epidural?

A

Lidocaine and Bupivacaine

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39
Q

What is a key point when giving an epidural?

A

HAVEA GOOD IV LINE!

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40
Q

What is is called when the patient is unconscious and there is a lack of responsiveness to all painful stimuli including loss of all sensations?

A

General Anesthetics

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41
Q

What is is called when there is a combo of drugs to achieve what we cannot achieve with inhalation anesthetics alone?

A

Balanced anesthesia

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42
Q

What are the components of Balanced anesthesia?

A

Short acting barbiturate for INDUCTION
Neuromuscular blocking agent for muscle relaxation
Opioids and NO for analgesia

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43
Q

What is the minimum alveolar concentration?

A

The lower the MAC value the higher the potency

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44
Q

What are the possible AE of General Anesthetics

A

Resp. and cardiac depression
Sensitization of the heart to catecholamines
Malignant hyperthermia
Aspiration of gastric contents
Hepatic toxicity

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45
Q

What meds are given before anesthesia to decrease anxiety, promote perioperative amnesia and relieve pre-op pain?

A

Benzo
Opiods
Clonidine
Anticholinergic drugs

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46
Q

What drug class decreases the amount of anesthesia needed to prevent contraction of all skeletal muscle including the diaphragm?

A

Neuromuscular blocking agents.

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47
Q

What are the three meds given post-anesthetically?

A

Analgesia- pain control depending on severity
Antiemetics- General anesthesia makes you nauseous
Muscarinic agents- enable PNS

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48
Q

What is the inhaled anesthetic that has a quick action and a weak analgesic?

A

Halothane

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49
Q

What inhaled anesthetic has weak muscle relaxation so you give it with NMBA?

A

Halothane

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50
Q

What are the AE of Halothane?
HALLMARK AE IS H_____________

A

Hypotension
RR depression
Sensation of the heart to catecholamines
Malignant hypertethermia
Hepatic toxicity

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51
Q

What is the potent anesthetic that has a low MAC value but is an effective muscle relaxant?

A

Isoflurone

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52
Q

What is the anesthetic that does not have any effect on renal or hepatic toxicity?

A

Isoflurone

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53
Q

What are the AE of Isoflurone?

A

Resp. depression
Hypotension

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54
Q

What anesthetic is AKA laughing gas?

A

Nitrous Oxide

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55
Q

Nitrous Oxide is a _____ anesthetic and a ______ analgesic but will never be used as a primary anesthetic?

A

WEAK anesthetic
STRONG analgesic

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56
Q

20% NO= the pain relief of ________

A

Morphine

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57
Q

Are there serious side effects of NO?

A

NO ;)

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58
Q

What is the IV sedative used for induction and maintentnce of anesthesia?

A

Propofol

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59
Q

Propofol’s onset is ____ seconds
Duration is ______ minutes

A

60 seconds
3-5 minutes

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60
Q

What are the AE of Propofol?
Requires close monitoring in the RESP. system

A

Resp. depression
Low BP
Bacterial infection
Monitor triglycerides (if on this long term)

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61
Q

Propofol needs to be discarded after ______ hours

A

6

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62
Q

What are the two benzodiazepines that can be used in balanced analgesia?
(END IN AM)

A

Diazepam
Midazolam

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63
Q

People taking Diazepam are unconscious within __ minute

A

1

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64
Q

Pancurionium is used for what?

A

General anesthesia, intubation, and mechanical ventilation

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65
Q

What is the antidote for Pancurionium?

A

Neostigamine

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66
Q

Use caution giving pancurionium to patient’s with _______

A

Liver disease

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67
Q

What is the drug that competes with ACH at the nicotinic receptors?

A

Succinylcholine

68
Q

Succinylcholine peaks at ____ minute

A

1

69
Q

What is Succinylcholine’s use?

A

Muscle relaxation during Intubation

70
Q

What are AE of Succinylcholine?

A

Apnea
Malignant hyperthermia
Post-op muscle spasms

71
Q

What are drugs that suppress pain by blocking the impulse?

A

Local anesthetics

72
Q

Give local anesthetics with __________________ like Ephedrine?

A

Vasoconstrictors.

73
Q

Amides (Lidocaine) can be given ____________ or ____________

A

Topical or Injection

74
Q

The onset of amides is rapid and intense and have more __________________ effects

A

Prolonged

75
Q

Esthers (Procaine) there is an increased risk of __________ rxn.

A

Allergic

76
Q

Procaine can give _______ only!

A

Injection

77
Q

What is the first line therapy for ADHD?

A

Stimulants

78
Q

Atomoxetine has a black box warning for _______!

A

Suicide

79
Q

What are adverse effects for stimulants in the treatment of ADHD?

A

Decreased appetite
Poor growth
Dizziness
Insomnia
Mood lability
Rebound
Tics
Psychosis
MISUSE??

80
Q

What is the most effective drug for Parkinson’s?

A

Levodopa

81
Q

What is the MOA of levodopa?

A

Decrease s/sx of PD by increasing the synthesis of Dopamine

82
Q

T/x for a wearing off effect?

A

Give the dose more frequently
Add COMT inhibitor
Add dopamine agonist
Controlled release form

83
Q

T/x for the on off effect in PD?

A

Add COMT inhibitor
Redistribute dietary proteins

84
Q

AE of levodopa?

A

Dyskinesias- with all PD drugs
CV- orthostatics
Psychosis- Hallucinations
Darkens sweat

85
Q

What is the most notable AE for Levodopa?

A

MALIGNANT MELANOMA

86
Q

Carbidopa is given with levodopa to ________ the effects?

A

ENHANCE

87
Q

Carbidopa has ____ effect on it’s own?

A

NO

88
Q

What is the MOA of Pramipexole?

A

Dopamine receptor agonist

89
Q

Pramipexole is typically used with _______

A

Levodopa

90
Q

What are the AE for Levodopa

A

Daytime somnelence
insomnia
Hallucinations

91
Q

What is the MOA of Bromocriptine?

A

Direct acting dopamine agonist

92
Q

AE of Bromocriptine?
USED FOR PD

A

Nightmares
Agitation
Hallucinations
Paranoid Delusions

93
Q

Bromocriptine is used with ________

A

Levodopa

94
Q

What is the COMT inhibitor that inhibits the metabolism of levodopa in the periphery.

A

Tolcapone and Entacapone

95
Q

The use of Tolcapone is with levodopa and allows for ____ dosage and ____ function of levodopa

A

Decrease dosage
Increase function

96
Q

What is the primary AE for Tolcapone?

A

Liver failure

97
Q

What are the AE for Entacapone?

A

Hallucination
Yellow and orange urine

98
Q

What is the drug that increases dopamine levels and us used with levodopa….. CAN CHANGE INTO AN AMPHETAMINE

A

Selegiline

99
Q

What is the medication that inhibits MAO-B and increased dopamine and is used with levodopa? DOES NOT CHANGE INTO AN AMPHETAMINE

A

Rasagiline

100
Q

What are the AE of Rasagiline (used in PD)?

A

Arthralgia
Flu like s/sx

101
Q

What is the med that promotes Dopamine release and is used in early PD?

A

Amantadine

102
Q

What are the AE of Amantadine?

A

Urinary retention
Livedo reticularis- skin discoloration that occurs when the patient has been on this for 1 mo.

103
Q

_________ are given for PD and can be used alone or with levodopa?

A

Anticholinergic drugs

104
Q

What are the AE of anticholinergic drugs?
These dry everything out

A

Dry mouth
Blurred vision
Photophobia
Urinary retention
Constipation and increased HR

105
Q

Dopaminergic drugs in PD address?

A

Tremor
Bradykinesia
Rigidty

106
Q

Anticholinergic drugs only address

A

Tremor

107
Q

What are the three steps for the initial treatment for PD?

A
  1. Dopamine agonsit less effective than levodopa
  2. Levodopa
  3. COMT inhibitor added ot levodopa
108
Q

What is the neurodegenerative disease that is associated with an imbalance of ACH and Dopamine

A

Parkinson’s Disease

109
Q

What is the drug that addresses PARTIAL seizures and lessens Ca++ currents?

A

Zonisamine

110
Q

What is the drug that is good for partial seizures and decreases NA+ Currents

A

Topiramate

111
Q

What drug could be useful in Absence seizures?

A

Zonisamide

112
Q

What are the AE of Topiaramate?

A

Somnolence
Nervousness
Ataxia

113
Q

What is the schedule 5 drug that can be used for neuropathic pain

A

Pregabalin

114
Q

What are the AE of Pregabalin?

A

Drowsiness
Weight Gain
Angioedema

115
Q

What is the drug that prevents hypersychronization and is not metabolized extensively?

A

Levetiracetam (KEPPA)

116
Q

What are the AE of Levetiracetam?
**this is the drug that the man had to stop taking because it changed his behavior so much

A

Drowsiness
Behavioral Changes

117
Q

What drug can be used for status epillepticus?

A

Levetiracetam

118
Q

What is the drug that moa is noncompetitive antagonist of AMPA glucamate receptor?

A

Perampanel

119
Q

What are the AE of PErampanel?

A

Neuropsychiatric effects
dizziness
gait disturbances
Weight gain

120
Q

What is the barbiturate that is effective against clonic/tonic seizures but may WORSEN absent seizures?

A

Phenobarbital

121
Q

What are the AE of phenobarbital

A

Neuropsychiatic
Rickets
Pophyria
Nystagmus and ataxia

122
Q

Phenobarbital is really effected (levels skyrocket) when used with ________ ____

A

Valproic Acid

123
Q

Avoid food with tyramine in people taking

A

Rasagiline

124
Q

Drug interactions with Rasagiline

A

Meperidine
SSRIs
Phenylephrine

125
Q

What is the moa for Valproic Acid?

A

Decrease Ca, decrease neuron firing

126
Q

Valproic acid is used in _______, _________ disorders, and _______

A

Seizures
Bipolar disorders
Migrianes (not the best med for this)

127
Q

What are the AE of Valproc Acid?

A

Liver failure
Pancreatitis
Hyperamonemia
Hypersalivation

128
Q

What are Drug drug interactions with Valproic Acid

A

Phenobarbital- levels rise by 40%
Phenytoin
Topiramate
Menopenem and Imipenem

129
Q

What is the MOA for carbamazepine?

A

Effects Na+ channels and inhibits voltage sensitive channels

130
Q

Carbamazepines work on all seizures BUT ________

A

Absent seizures

131
Q

What are the theraputic index for Carbamazepines

A

4-12

132
Q

What are the AE for Carbamazepine

A

Visual disturbances
Ataxia
Vertigo
Leukopenia
Pregnancy category D
Promotes ADH
Rash and SJS

133
Q

What lab needs to be monitored on patient’s with Carbamazepine

A

CBC bc it can cause anemia

134
Q

What drug has the moa that inhibits the influx of Na

A

Phenytoin

135
Q

What is the DOC for tonic-clonic seizures and partial seizures but ineffective in absent seizures?

A

Phenytoin

136
Q

What are the normal TI for Phenytoin?

A

10-20

137
Q

Phenytoin is _______ protein bound?

A

Hightly

138
Q

What levels need to be monitored on a patient with phenytoin?

A

Albumin

139
Q

What are the AE for phenytoin
** associated with TI levels

A

Nystagmus
Ataxia and seizing (levels above 30)
Stupor and coma (levels above 40)

140
Q

If a patient on Phenytoin has gingiva hyperplasmia what should you give them to help?

A

Folic Acid

141
Q

What are inducers of metabolism?

A

Phenytoin
Carbamazepine
Phenobarbital

142
Q

What is the inhibitor of metabolism?

A

Valproic ACid

143
Q

What is a med that is used broad spectrum for seizures activity and bipolar disorders

A

Lamotrigine

144
Q

What are AE of lamotrigine?

A

Severe skin rxn
Aseptic meningitis
SUICIDE risk

145
Q

Gabapenttin is used for what?

A

Neuropathic pain

146
Q

What is used for monotherapy for partial seizures?

A

Oxacarbazepine

147
Q

What is the hallmark AE for oxacarbazepine?

A

Clinically significant hyponatremia

148
Q

What drug decreases the threshold for Ca++ currents and is used in ABSENT seizures?

A

Ethosuximide

149
Q

What are the normal serum levels for valproic acid?

A

50-100

150
Q

When giving Phenytoin IV it can cause _________

A

Cardiac dysrhythmias and hypotension

151
Q

When giving Phenytoin IV give it _______ and _______

A

slowly and DILUTED

152
Q

What is the pro-drug of phenytoin?

A

Fosphenytoin

153
Q

Phenytoin is an _______ of metabolism

A

Inducer

154
Q

What can increase the CNS effects of Phenytoin?

A

CNS depressants

155
Q

What is the DOC for partial seizures?

A

Carbamazepine

156
Q

Carbamazepine is an ________ of metabolism and it is so strong it ________ itself!

A

Inducer; Induces itself!

157
Q

Never allow a patient to drink what with Carbamazepine?

A

Grapefruit juice

158
Q

What med is used for absent seizures but is not effective for T/C?

A

Ethosuximide

159
Q

What is another medication that can be used in patients with AHDH

A

Methylphenidate

160
Q

What is a non-stimulant used in patients with AHDH

A

Amoxetine

161
Q

Can Neuromusclular Blocking Agents cross the BBB?

A

No

162
Q

Do neuromuscular blocking agents have analgesic properties?

A

No; Patients who have this are fully awake, but paralyzed

163
Q

Generally speaking, neuromuscular blocking agents end in what?

A

“IUM”

164
Q

Patients who are on neuromuscular blockers need what because of the severe resp. depression?

A

Mechanical Ventilation

165
Q

What to do if a patient has malignant hyperthermia?

A

Chilled Saline and Dantrolene

166
Q

Use caution when giving patients with Alzheimer’s what other class of drugs?

A

Depolarizing Neuromuscular Blocker

167
Q

Using a vasoconstrictor with local anesthetics serve what purpose?

A

prolong anesthesia and decrease the risk of toxicity

Nurs 306 / Pharm 2 (4 decks)

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