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peripheral vasodilators2 > tricyclic antibiotics 2 > Flashcards

tricyclic antibiotics 2 Flashcards

1
Q

how long for therapeutic effect tricyclics? ssri?

A

2-3 weeks

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2
Q

mech action tca

A

unknown, inhibits norepi neuronal uptake mild 5-h serotonin receptor

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3
Q

metabolism tca

A

liver, 1/2 life is 8-84hr, large vol distribution

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4
Q

s/e TCA

A

orthostatic hypotension, tachycardia, tachy, blurred vision, dry mouth, sedation, delirium, tremors, weight gain, neurolepitc malignant

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5
Q

cns toxicity tca s/s

A

cognitive, motion, psych changes

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6
Q

overdose tCA-

A

fatal arrhythmias

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7
Q

SSRIs mech action

A

modulate serotonin neurons in the brain

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8
Q

s/e ssris

A

no anticholinergic/cardiac s/e, nausea, vomiting, anxiety, insomnia, weight loss

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9
Q

1/2 life ssri

A

2-3 days

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10
Q

MAOIs

A

ihibit MAO-A and MAO-B but action at MAO-a, which inhibits metabolism of norepi

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11
Q

s/e maois

A

hepatotoxic,cardiac toxic with tyrosine, tremors, orthostatic htn, hyperpyrexia with certain meds

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12
Q

trazodone

A

mech unknown

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13
Q

s/e trazodone

A

no muscarinic effects, CNS stim with insomnia, tremors

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14
Q

contraindications trazodone

A

seizures and head trauma

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15
Q

lithium

A

replaces sodium at certain synapses mood stabilizer, narrow therapeutic window

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16
Q

s/s lithium toxicity

A

n,v,diarrhea, abd pain, polyuria, sedation

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17
Q

what may occur with chronic lithum use?

A

hypothyroidism

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18
Q

antipsych meds do what

A

block dopamine in the brain which is therapeutic at the mesolimbic-mesocortical system but the nigostraital system causes extrapyrimidial side effects

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19
Q

s/e antipsychotics

A

sedation secondary to histamine release, extrapyradamidal side effects (acute dystonia, akathisa, parkinsonism, tardive dyskinesia

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20
Q

what is a late, occuring s/e of antipsychotics

A

tardive dyskinesia- usually irreversible

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21
Q

how do you treat acute dystonia

A

treat with congentin

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22
Q

how do you treat akathisia

A

benzo/beta block

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23
Q

s/s neuroleptic malignant syndrome

A

fever, diffuse muscle pain, severe eps, autonomic dysfunction

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24
Q

tx neuroleptic malignant syndrome

A

tx with parlodel, cooling, hydration, dantrium

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25
Q

s/e antipsychotics

A

postural hypotension, hyperprolactinemia, jaundice, corneal opacities, photosensitivity, agranulocytosis

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26
Q

contraindications antipsych

A

parkinsons, hepatic failure, bone marrow dep

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27
Q

whoch meds do pt on antipsychotics respond to better?

A

norepi vs. epi with hypotension

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28
Q

levodopa/carbidopa is for

A

tx parkinsons, considered replacement therpy, precuror of dopamine

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29
Q

levodopa is

A

an amino acid, transported across bbb and converted to dopamine by the enzyme L-aromatic amino acid decorboxylase

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30
Q

why is carbidoba given with levodopa?

A

carbidopa blocks conversion of levodopa to dopamine in the periphery b/c carbidopa is there, but cannot cross bbb. if not pt would have hypertensive crisis secondary to carbidopa which increases blood pressure

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31
Q

prob with pt with parkinsons

A

not enough dopamine, which is necessary for movement. insufficient amount makes them not able to move

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32
Q

where is carbiopa activated and what is it

A

decarboxylase inhibitor, ative liver, kidney, gi

33
Q

which symptoms improve first with levo/carbo

A

rigidit and bradykinesia before tremor

34
Q

s/e levo/carbo

A

nausea, vomiting, anorexia, secondary to ctz activation in the area postrema in the medulla by dopamine, orthostatic hypotension adn cardiac arrhythmias by beta dopamine stim

35
Q

2nd set side effects levo/dop after long term therapy

A

abn movement of limbs, hands, trunk, tongue, serious mental disturbances (drug holiday x 1 week)

36
Q

contraindications levo/carbi

A

MAO inhibitors, narrow angle glaucoma, heart arrhythmias, recent MI

37
Q

what that is given with levo/carbi can cause EPS

A

phenothiazines, reserpine, butyrophenones

38
Q

selegine

A

first choice drug parkinsons, enhances endogenous dopamine it is an MAO-B inhibitor

39
Q

precautions slegiline

A

same as MAOs

40
Q

seleginline and tcas

A

fever, agitation, delirium, coma

41
Q

belladonna alkaloids

A

mild parkinsons, helps in drug induced dysonia

42
Q

dopamine agonists

A

parlodel, permax

43
Q

s/e dopamine agonists

A

anorexia, nausea

44
Q

parkinsons and anesthesia

A

have pt take meds pre op, avoid phenothiazines, butyrophenones and reglan, increased risk aspiration, intravascularly vol depleted, increased risk laryngospasm

45
Q

pt on deprenyl what drug cant give

A

ephedrine

46
Q

ketamine can cause what with parkinsons

A

exagg symp response

47
Q

succ and parkinsons

A

potential hyperkalemic response

48
Q

anticonvulsants goal

A

to raise seizure threshold

49
Q

% pt who become seizure free on anticonvulsants

A

40%

50
Q

anticonvulsants mech of action

A

sodium channel blockers, block the sustained high frequency repetitive firing of action potentials

51
Q

type I anticonvuls

A

enhance sodium channel inactivation

52
Q

type I anticonvulsant meds

A

phenytoin, carbamezepine, oxcarbazepine, lamotrigine, felamate

53
Q

type II anticonvulsants

A

enhance gaba inhibition, reduce t calcium currents, block ssustained high freq repetitive firins

54
Q

type II anticonvulsant drugs

A

valproic acid, benzos, phenobarb, primidone,

55
Q

type III anticonvulsants

A

block T calcium channels only

56
Q

type of type II anticonvulsants

A

ethosuximide, trimethadione

57
Q

type IV anticonvulsants

A

only enhances GABA inhibtition

58
Q

type of type IV anticonfulsants

A

vigabatrin

59
Q

noncategorized anticonvulsents

A

no effect on any known causes

60
Q

drugs asso with noncat.

A

gabapentin

61
Q

dilantin treats

A

tonic-clonic seizures and partial

62
Q

dilantin is metabolized by

A

zero order kinetics which leads to induction of hepatic micorsomal enzymes

63
Q

dilantin and protein binding

A

highly

64
Q

s/e dilantin

A

gingival hyperplasia, enlargement lips and nose, fetal hydantoin syndrome, folate def

65
Q

acute overdose diantin signs

A

nystagmus, ataxia, vertigo, diplopia, cognitive changes

66
Q

drug interactions dilantin

A

cimetidine, chloramphenicol, disulfram, isoniazid

67
Q

tegretol type of seizures treated

A

tonic-clonic and abcesnse

68
Q

common side effect tegretol

A

drowsiness

69
Q

what will tegretol do with metaboism

A

increase rate of metabolism of other anticoags

70
Q

barbiturates mech action

A

facilitation of GABA inhibition

71
Q

main side effect barbs

A

sedation

72
Q

all anticonvulsants bascially cause

A

hepatic microsomal enzyme

73
Q

depakene mech action

A

blockage sodium channels that are voltage dependent, cause increase brain GABA

74
Q

s/e Depakene

A

hepatotoxicity, fetal neural tube defects, alopecia

75
Q

benzos mech action

A

interaction with GABA- not first line therapy

76
Q

administer phenytoin rate

A

25-50mg/min to avoid hypotension

77
Q

phenytoin causes

A

resistance to NBMR

78
Q

what can phenytoin cause

A

stevens johnson syndrome

79
Q

people on anticonvulsants show

A

a toleratnce to opiods secondary to enzyme activation caused by anticonvulsant

peripheral vasodilators2 (10 decks)

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