Pharmacology Flashcards
Schedule I drugs
Highly addictive,not accepted in medical use in United States. Examples of drugs heroin peyote LSD
Schedule II drugs
High risk for potential abuse.
Morphine, oxycodone, amphetamine, cocaine, methadone
Schedule III drugs
Less potential for abuse than schedule two drugs. Examples codeine hydrocodone or anabolic steroids
Schedule IV drugs
Low potential abuse relative to schedule three drugs. Darvon,
Benzodiazepines
First pass effect
Absorption of drugs in intestinal tract and the drug’s entry into portal circulation. First pass through liver detoxifies substances.
Why do mg of medications sometimes differ when given iv or IM as opposed to PO?
Because PO meds go through first pass effect and med gets biotransformed.
Prodrugs
Drugs that, upon biotransformation in liver, produce active metabolites.
iatrogenic effect
Illness induced by medication given for tx.
Common symptoms of bone marrow suppression:
- anemia characterized by weakness, dyspnea, fatigue, syncope
- neutropenia (low neutrophils) characterized by fever chills, sore throat, malaise and opportunistic infection
- thrombocytopenia (low platelets) characterized by eccymosis, petechiae, unusual bleeding
Symptoms of neurotoxic reactions of meds
CNS
-confusion, excitation, sedation, delusions, depression
Autonomic Nervous system-
-constipation, diarrhea
Peripheral NS
- paresthesias, peripheral neuritis, cranial nerve deficits( diplopia)
Symptoms of nephrotoxicity
Oliguria Anuria Edema Weight gain Hematuria Crystakluria Azotemia (azo=nitrogen, so it means nitrogen blood condition)
Symptoms of hepatotoxicity
Anorexia Malaise, fatigue Nausea Fever Hepatic tenderness Jaundice Hepatomegaly Elevated LFT Dark urine Light colored stools
Ototoxicity
Tinnitus
Sensitive to noise
Vestibular toxicity- nystagmus,vertigo, n/v
Cardiotoxicity
Tachyarrhythmias Bradyarrhythmias Cardiomyopathy Chf Severe hypo or hypertension
Symptoms of resp depression
Decreased resp rate and shallow resps
Stevens-Johnson Syndrome
Caused by pcn, sulfa drugs, cotrimoxazole, carbamazepine, hydantoins, allopurinol…
S/sx- erythema multiforme, erosive involvement of mucous membranes of mouth, nose, bronchial tree and genitalia
Toxic epidermal necrolysis
Caused by pcn, sulfa drugs, cotrimoxazole, carbamazepine, hydantoins, allopurinol…
Initially resembles Stevens -Johnson, but progresses to greater than 30% loss of epidermis due to necrosis.
Hypersensitivity syndrome
Caused by carbamazepine, phenytoin, phenobarb, sulfa drugs, allopurinol.
S/sx- skin rash and fever
Hepatitis, arthralgia, lymphadenopathy, blood abnormalities
Drug induced vasculitis
Caused by allopurinol, pcn, sulfa drugs, thiazides, pyrazolones…
-s/sx- Palpable purpuric papular rash usually on lower extremities but can be present in kidneys, gi tract, CNS
Anticoagulant induced skin necrosis
Caused by warfarin and heparin
S/sx: occlusive thrombi of vessels supplying skin and subcutaneous tissue of areas with large amounts of adipose tissue (breast, butt)
Type 1 allergic reaction
Result from IgE
Mast cells release large quantities of histamines.
Rapid onset- 30 min.
S-sx difficulty swallowing or breathing as bronchi become edematous.
rhinitis, sneezing
Treatment is epinephrine and resp support
Type 2 drug reaction
IgG or IgM
-hemolysis (destruction of RBCs)
-Hemolytic reaction to blood transfusion
-immediate reaction is fever
- flank pain, wheezing, n/v, chest pain
Treatment- D/C blood transfusion, maintain BP,
Control bleeding and prevent renal damage, possibly IV diuretics
Type 3 drug reaction
Caused by formation of immune complexes when antigens interact with antibodies, resulting in Serum sickness
Serum sickness occurs with a few days of injection of a protein.
Usually resolve spontaneously within 7-14 days. Antihistamines may help or if severe can use corticosteroids
Type 4 drug reaction
Rash secondary to topical agents.
Mediated by T cell.
Treatment is d/c use of product and use calamine for itch
