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MIDTERMS > PHARMA 1 > Flashcards

PHARMA 1 Flashcards

1
Q

a class of medications designed
specifically to relieve pain.

A

ANALGESICS

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2
Q

Require a different prescription (yellow
prescription) from the usual one because they are
addictive

A

Narcotics

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3
Q

● Enzyme responsible for conversion of arachidonic
acid into prostaglandins.
● Synthesis of prostaglandin

A

CYCLOOXYGENASE (COX)

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3
Q

Not all doctors have this; only doctors, usually psychiatrists and anesthesiologists, who are members and have a license from PDEA; requires an additional payment.

A

Yellow prescription

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4
Q

● Response to tissue injury and infection.
● Protective mechanism.

A

INFLAMMATION

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5
Q

● Protects stomach lining
● Regulates blood
platelets

A

COX-1

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6
Q

Triggers inflammation
and pain.

A

COX-2

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7
Q

● Prostaglandin inhibitors

○ Relieve pain (analgesic)
○ Reduce elevated body temperature (antipyretic)
○ Inhibit platelet aggregation (anticoagulant)

A

ANTI-INFLAMMATORY AGENTS

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8
Q

7 GROUPS OF NSAID

A
  1. Salicylates
  2. Para-Chlorobenzoic Acid Derivatives or Indoles
  3. Phenylacetic Acids
  4. Propionic Acid derivatives
  5. Fenamates
  6. Oxicams
  7. Selective Cox-2 inhibitors
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9
Q

● Aspirin, also known as acetylsalicylic acid (ASA).
● It is taken for hypertensive and high cholesterol
patients
Lowers the risk for heart attack or stroke

Key notes:
GI UPSET: Should be taken with milk, water or food
(full meal)

REYE SYNDROME: Not be taken by children with
flu symptoms.

C/I: pregnancy in their third trimester because it can
cause premature closure of ductus arteriosus.

A

SALICYLATES

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10
Q

● Indomethacin (Indocin)
● Sulindac (Clinoril)
● 1st generation NSAID.
● May cause increased BP and sodium & water
retention

● Indications:
○ Rheumatoid arthritis
○ Gouty arthritis
○ Osteoarthritis

A

PARA-CHLOROBENZOIC ACID

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11
Q

● Diclofenac Na (Voltaren)
● Indications:
○ Rheumatoid Arthritis
○ Osteoarthritis
○ Ankylosing spondylitis

A

PHENYLACETIC ACID DERIVATIVES

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12
Q

● Short term management of pain.
● 1st injectable NSAIDs.
● Greater analgesic effect.

A

KETOROLAC

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13
Q

● Ibuprofens (Alaxan, Advil, and Medicol)

● Drug interactions: increase effects of warfarin,
sulfonamides, certain cephalosporin, phenytoin,
insulin, oral hypoglycemic

● SE: gastric upset (to be taken with food)

A

PROPIONIC ACID DERIVATIVES

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14
Q

● Indications: Acute & chronic arthritic conditions
● SE: Gastric irritation
● C/I: Patient with peptic ulcer
● Mefenamic Acid (Ponstel)(Ponstan)
● Meclofenamate Na Monohydrate (Meclomen)

A

FENAMATES

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15
Q

● Piroxicam (Feldene Flash), Meloxicam

● Indication: Long term arthritic conditions

● S/E: lower incidence of gastric problems;
ulceration; epigastric distress

● Should NOT BE TAKEN with aspirin; other NSAIDs
because it can decrease its effectiveness.

A

OXICAMS

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16
Q

COX-2 INHIBITORS:

A

Celecoxib (Celebrex)
Rofecoxib (Vioxx)
Nabumetone (Relafen)

● NSAIDs in the elderly.
● Assessment of renal function - creatinine.

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17
Q

NURSING CONSIDERATIONS (NSAIDs)

A

N - Not good for the body
● GI Bleed, Bronchospasm, Heart dse., Kidney
clogging, Blood clot

S - Sticky Blood (EXCEPT ASA)
● Increase risk for thrombosis
● MI, Stroke, DVT

A - Asthma Attack
● Bronchospasm

I - Increase Bleeding Risk
● Easy bruising, Tarry stool, Coffee ground emesis
● AVOID PEPTIC ULCER!

D - Dysfunctional Kidneys
● Creatinine - 1.3, UO <30cc
● KETOROLAC - kills kidneys
● NOT given CHF - Na

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18
Q

● Suppressing and preventing many of the
components of the inflammatory process at the
injured site.

● Widely prescribed for patients with arthritis but
not a drug of choice due to its numerous side
effects.

● Dexamethasone
● Prednisone
● Prednisolone

A

CORTICOSTEROIDS

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19
Q
  • common in males due to their lifestyle and diet (drinking alcohol and eating organ meats)

● Inflammation of the joints.
● Uric Acid

A

Gout

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20
Q

Inhibit leukocytes on the inflamed site; effective
against acute symptoms of gout but is not effective
in decreasing inflammation of other inflammatory
disorders

A

COLCHICINE

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21
Q

● Inhibit final steps of uric acid synthesis.
● No caffeine and alcohol.
● Indicated gout patients with renal impairment.
● Prevents the increase of uric acid.

A

ALLOPURINOL

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22
Q

● Increase level of uric acid.

A

THIAZIDE DIURETICS

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23
Q

● Alleviating chronic gout

Increase rate of uric acid excretions in the kidneys. - Probenecid

A

URICOSURICS

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23
Q

Safe, effective analgesic and antipyretic drug used
for muscular aches, pains and fever caused by viral
infections

ANTIDOTE: Acetylcysteine (Mucomyst or Fluimucil)

A

ACETAMINOPHEN

24
Q

● NON-OPIOID – acts on PNS
● OPIOID – acts on CNS

A

ANALGESICS

25
Q

● Unpleasant sensory and emotional experience
related to tissue injury.
● Analgesic - relief of pain
● Acute - less than 3 months
● Chronic - more than 3 months

A

PAIN

26
Q

● Opioid agonists
● Can cause addiction
● Analgesia, respiratory depression, euphoria, and
sedation
● Cough suppression
● Antidiarrheal effect

A

OPIOID ANALGESICS

27
Q

Pain medicine similar to an opioid. It acts in the
central nervous system (CNS) to relieve pain

Seizures have been reported in patients taking

Maximum dose: 400 mg per day

A

TRAMADOL

28
Q

DOLCET

A

Tramadol HCL 37.5 mg
Paracetamol 325 mg

29
Q

Given for post op clients and with Myocardial
infarction

As pre op medication- relieve anxiety

ANTIDOTE: NALOXONE (NARCAN)

DO NOT give the medicine to patients with
○ Asthma
○ COPD
○ Pediatric clients (lungs are still not mature)

A

MORPHINE

30
Q

● Shorter duration of action than Morphine.
● No antitussive property
● Neurotoxic
● Can decrease BP
● The drug of choice for patients with Acute
Pancreatitis.

A

MEPERIDINE (DEMEROL)

31
Q

● More potent than morphine (6 times)
● Faster onset, shorter duration of action than Morphine

Withdrawal syndrome – irritability, diaphoresis,
muscle twitching, increase in PR and BP.

A

HYDROMORPHONE

32
Q
  • long acting opioid analgesic medications for round the clock for acute and chronic pain.
  • immediate acting opioid analgesic medications for breakthrough pain.
A

Oxycontin

Oxynorm

33
Q

This is for the management of moderate to severe chronic pain unresponsive to non-narcotic analgesia.

A

TARGIN

33
Q

HEADACHES: MIGRAINE AND CLUSTER PREVENTIVE TREATMENT

A

● Beta-adrenergic blockers (Propranolol & Atenolol)
● Anticonvulsant (Valproic Acid & Gabapentin)
● TCA (amitriptyline & imipramine)

● Treatment/ cessation of attack
○ Opioid analgesics
○ Ergot alkaloids
○ Selective serotonin (Triptans)

34
Q

● Powerful opioid used as a pain medication and
together with other medications for anesthesia.

● 50 to 100 times more potent than Morphine.

● Available in Transdermal patch and Ampule

● Given for patients with Buerger’s disease

● For example of transdermal: Durogesic D- Trans
● For example of ampule: Hospira Fentanyl Citrate

A

FENTANYL

35
Q

● Major involuntary unconscious, automatic portion of the nervous system.

● Major divisions:
○ Parasympathetic ANS
○ Sympathetic ANS
○ Enteric nervous system

A

AUTONOMIC NERVOUS SYSTEM

36
Q

~ Thoracic (T1-T12) and Lumbar (L1-L5) segments of the spinal cord

~Paravertebral chains that lie along the spinal column, some along the anterior aspect of the abdominal aorta

~ Preganglionic Fibers Short

~ Postganglionic Fibers Long

A

SYMPATHETIC

37
Q

~ CN III, VII, IX, X, and sacral segments of the spinal cord

~ Most are located in the organs innervated, more distant from the spinal cord

~ Preganglionic Fibers long

~ Postganglionic Fibers Short

A

PARASYMPATHETIC

38
Q

ADRENERGIC SYSTEM:
- Primary transmitter at the sympathetic postganglionic neuron-effector cell synapses in most tissues.

  • Exceptions: Eccrine sweat glands and Vasodilator in the sympathetic fibers of skeletal muscles
A

Norepinephrine

39
Q
  • For severe anaphylactic reactions
  • Bronchodilator effects
A

Epinephrine

40
Q

Mode of Action
● Direct activation of adrenoceptors

● Indirect activation by increasing concentration of available catecholamines in the synapse

A

SYMPATHOMIMETICS

41
Q

Means the drug acts on both alpha-1 and alpha receptors; it is non-specific

A

Non - Selective Alpha Agonist

42
Q

~Most vascular smooth muscle - Contracts

~Arterioles - Increased TPR, DBP and Afterload

~Veins - Preload

~Bladder - Urinary Retention

~Kidneys - Decreased Release

A

ALPHA - 1 ADRENERGIC EFFECTS

43
Q

~ Adrenergic and cholinergic nerve terminals = Inhibits transmitter release

~ Platelets = Stimulates aggregation

~ Some vascular smooth muscle = Contracts

~ Fat Cells = Inhibits lipolysis

~ Pancreatic B cells = Inhibits insulin release

A

ALPHA - 2 ADRENERGIC EFFECTS

44
Q

Heart =

Stimulates rate and force
● ↑ heart rate (positive chronotropy)
● ↑ conduction velocity (positive dromotropy)
● ↑ contractility (positive inotropy

~ Juxtaglomerular cells of kidney = Stimulates renin release

A

BETA - 1 ADRENERGIC EFFECTS

45
Q

~ Airway, uterine, and vascular smooth muscle = Relaxes

~ Liver = Stimulates glycogenolysis

~ Pancreatic B cells = Stimulates insulin release

~ Somatic motor neuron terminals (voluntary muscle) = Causes tremor

~ Heart = Stimulates rate and force

A

BETA - 2 ADRENERGIC EFFECTS

46
Q

CLASS:
Sympathomimetic (alpha 2 - selective)

MOA:
Activates alpha-2 adrenergic receptor

INDICATION
● Preeclampsia
● Gestational Hypertension

SE:
● Sedation
● Hemolytic anemia

A

METHYLDOPA

47
Q

CLASS: Sympathomimetic (alpha 2 - selective)

MOA: Activates alpha-2 adrenergic receptors

INDICATION:
● Hypertension
● Cancer Pain
● Opioid withdrawal
● Decreases the blood
pressure of the px

SE:
● Sedation
● Dry mouth
● Rebound
hypertension

A

CLONIDINE

48
Q

CLASS: Sympathomimetic (non - selective, direct-acting)

MOA: Activates alpha and beta adrenergic receptors

INDICATION:
● Cardiac arrest
Anaphylaxis
Asthma
COPD
Hemostasis

SE:
● Hypertension
● Tachycardia
● Ischemia

A

EPINEPHRINE

49
Q

CLASS: Somatic motor neuron terminals

MOA: Activates a,b, and D1 adrenergic receptors

INDICATION:
● Cardiogenic shock
● Heart failure

SE:
● Cardiovascular
disturbance
● Arrhythmias

A

DOPAMINE

49
Q

CLASS: Sympathomimetic (beta 2 - selective)

MOA: Activates beta 2 - receptors in bronchial smooth muscle causing bronchodilation

INDICATION:
● Acute asthmatic attacks
● Tocolysis for preterm
labor

SE:
● Tachycardia
● Tremors
● Nervousness
● Restlessness

A

ALBUTEROL

50
Q

Postsynaptic effector cells, especially smooth muscle

A

(A1) Alpha1

51
Q

Presynaptic adrenergic nerve terminals, platelets, lipocytes, smooth muscle

A

(A2) Alpha2

51
Q

Postsynaptic effector cells, especially heart, lipocytes, brain; presynaptic adrenergic and
cholinergic nerve terminals, juxtaglomerular apparatus or renal tubules, ciliary body epithelium

A

(B1) Beta1

52
Q

Postsynaptic effector cells, especially smooth muscle and cardiac muscle

A

(B2)Beta2

52
Q

Postsynaptic effector cells, especially lipocytes; heart

A

(B3) Beta3

52
Q

CLASS:
Adrenergic antagonist (alpha non - selective)
MOA:
Irreversibly blocks alpha adrenergic receptors (a1>a2)

INDICATION:
Pheochromocytoma
● Unable to urinate

SE:
● Orthostatic hypotension
● Reflex tachycardia
● Gastrointestinal irritation
● Myocardial ischemia

A

PHENOXYBENZAMINE

53
Q

CLASS: Adrenergic antagonist (alpha non - selective)

MOA: Reversibly blocks alpha adrenergic receptors (a1>a2)

INDICATIONS: Pheochromocytoma

SE:
● Orthostatic hypotension
● Reflex tachycardia
● Gastrointestinal irritation

A

PHENTOLAMINE
TOLAZOLINE

MIDTERMS (7 decks)

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