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MIDTERMS > PHCT > Flashcards

PHCT Flashcards

1
Q
  • Found in many over-the-counter cough and cold
    preparations
  • Often found in combination products containing
    antihistamines, decongestants, or acetaminophen.
A

Dextromethorphan

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2
Q

Examples of Dextromethorphan

A

Nyquil, Robitussin DM, Triaminic DM, and Vick
Pediatric Formula 44

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3
Q

a synthetic analogue of codeine

A

d-isomer of 3-methoxy-N-methylmorphinan

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4
Q

– Has no apparent analgesic or addictive properties and produces relatively mild opioid effects in overdose.
– Also has anticholinergic properties

A

Dextromethorphan

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5
Q

Dextromethorphan | Well-absorbed orally, and effects are apparent within ______

A

15-30 minutes

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6
Q

Dextromethorphan | duration of effect is normally ____

A

3-6 hours

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7
Q

Both dextromethorphan and its o-demethylated
metabolite appear to antagonize

A

N-methyl-D-aspartate (NMDA) glutamate receptors.

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8
Q

inhibits reuptake of serotonin,
and may lead to the serotonin syndrome in patients
taking monoamine oxidase inhibitors

A

Dextromethorphan

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9
Q

Dextromethorphan | Toxic Dose

A

10mg/kg

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10
Q

Dextromethorphan | Usual recommended adult daily dose of dextromethorphan is
; in children age 2-5 years, up to 30 mg/d.

A

60-120 mg/d

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11
Q

Dextromethorphan | Usual recommended
in children age 2-5 years

A

up to 30 mg/d

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12
Q

Dextromethorphan | Clinical Presentation
* Clumsiness
* Ataxia
* Nystagmus
* Restlessness
* Visual and auditory hallucinations

A

Mild intoxication

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13
Q

Dextromethorphan | Clinical Presentation
- Stupor
– Coma
– Respiratory depression (coingestion with alcohol)
– Pupils may be dilated or constricted.
– Seizures are reported after ingestions of 20-30 mg/kg

A

Severe Poision

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14
Q

Dextromethorphan | Clinical Presentation
– Severe hyperthermia
– Muscle rigidity
– Hypertension
– Related to serotonin syndrome.

A

Therapeutic doses taking MAOI

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15
Q

Dextromethorphan | Treatment
Drug , mg

A

Naloxone ; 0.06 - 0.4mg

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16
Q

Dextromethorphan | Treatment
Opioid Intoxication

A

0.4-2 mg naloxone IV

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17
Q

Dextromethorphan | Treatment

Decontamination:

A

Activated Charcoal

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18
Q

PPA means

A

Phenylpropanolamine

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19
Q
  • Also widely used as an appetite
    suppressant
  • Widely available in nonprescription nasal decongestants and
    cold preparations
  • Usually also contain antihistamines and cough suppressants
A

Phenylpropanolamine (PPA)

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20
Q

PPA example (3)

A
  • Phenylephrine
  • Ephedrine
  • Pseudoephedrine
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21
Q

PPA
Mechanism of PPA + Phenylephrine

A
  1. Direct alpha-adrenergic agonists
  2. PPA produces mild β1-adrenergic stimulation and acts in part indirectly by enhancing norepinephrine release
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22
Q

PPA
Ephedrine and pseudoephedrine

A
  1. Have both direct and indirect alpha- and beta-adrenergic activity
  2. They clinically produce more beta-adrenergic
    stimulation than PPA or phenylephrine
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23
Q

PPA, phenylephrine, and ephedrine have _____ (low, high) toxic:therapeutic ratios

A

LOW

24
Q

PPA | Toxicity often occur after ingestion of just _____ times the therapeutic
dose

A

2-3x

25
Q

PPA |

_____ is slightly less toxic, with symptoms occurring after 4- 5 times the usual therapeutic dose

A

Pseudoephedrine

26
Q

PPA
HTN is treated if diastolic pressure is higher than

A

100-105mmHg

27
Q

PPA |
TX for HTN ; Non-pharmacological

A

phentolamine or nitroprusside;
upright position

28
Q

PPA |
Caution in TX of HTN
Do not use beta blockers alone w/o first giving a
______.

A

vasodilator

29
Q

PPA |
Tx for Arrhythmias

A

Give propanolol or esmolol

30
Q

PPA |
Caution:

A

Do not treat AV block or sinus bradycardia
associated with hypertension

31
Q

PPA |
Treatments

A

1.) Ipecac-induced emesis may be useful for initial treatment.
2.) Administer activated charcoal and cathartic.

32
Q

PPA |
widely used for the treatment of asthma

A

Methylxanthine

33
Q

IV infusions of ______ are used to treat
bronchospasm, congestive heart failure and neonatal
apnea.

A

aminophylline

34
Q

Commonly used orally in sustained-release preparations

A

Theophylline

35
Q

Theophylline |

Toxic Dose:
Acute single dose of _____

A

8-10 mg/kg

36
Q

Theophylline |

Acute oral overdose of more than _____ may
potentially result in a level above 100 mg/L and
significant toxicity.

A

50 mg/kg

37
Q

Theophylline |

Status epilepticus, , seizures (serum levels)

A

> 100 mg/L

38
Q

Theophylline | When excessive doses are administered repeatedly
over 24hours or longer

A

Chronic Intoxication

39
Q

Theophylline |
Drugs Examples
Use low-dose ______ 0.01-0.03 mg/kg IV

A

propanolol

40
Q

Theophylline |
Drugs Examples
_______ 25-50 µg/kg/min

A

Esmolol

41
Q

Bronchodilators-_____ agonists

A

B2

42
Q

Bronchodilators:
first line in the tx of acute
exacerbation of BA
primary reliever medication

A

Short acting rapid onset

43
Q

Bronchodilators:
prophylactic agent (acute attacks)
for controlling nocturnal attacks
controller medication

A

Long acting slow onset

44
Q

Bronchodilators:
controller usually given through inhalation

A

Long acting with rapid onset

45
Q

Selective B2 agonists
Oral, MDI

A

Albuterol, Metaproterenol

46
Q

Selective B2 agonists
For severe asthma;
SC inj.(0.25 mg)

A

Terbutaline

47
Q

Selective B2 agonists
long-acting
DOA: 12 hours

A

Salmeterol &
Formoterol

48
Q

Type of Bronchodilators reserved for special situations (cardiac stimulation)

A

Bronchodilators – Non-selective

49
Q

Non-Selective | Bronchodilator
Epinephrine
Dose:
Onset:
Duration:

A

Epinephrine
SC (0.4 mL of 1:1000 solution) inhaled - 320 g per puff
Onset: 15 minutes
Duration: 60–90 mins

50
Q

Non-Selective | Bronchodilator
Ephedrine

A

Lower Potency

51
Q

Non-Selective | Bronchodilator
Inhaled: 80–120 g
Onset: 5 minutes
Duration: 60–90 mins

A

Isoproterenol

52
Q

IPRATROPIUM
TIOTROPIUM

Classification:

A

Anticholinergic/Antimuscarinic

53
Q

Bronchodilators |
quaternary ammonium derivative of atropine

A

ipratropium bromide

54
Q

Bronchodilators |
longer-acting selective antimuscarinic agent

A

tiotropium

55
Q

Bronchodilators |
Also used in allergic
rhinoconjunctivitis

A

Mast cell stabilizers

MIDTERMS (8 decks)

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