Week 3 Pharmacology Flashcards

1
Q

whats mannitol

A
  • sugar-alcohol that is not effectively metabolized
  • excreted largely unchanged in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

whys mannitol used in emergency settings

A

lowers ICP when due to cerebral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when should you not use mannitol

A

crystals are present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the MOA of mannitol

A

pulls excess fluid from CNS into the vascular space Via osmotic gradietn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are adverse rxns of mannitol

A

fluid overload (worsening HF, pulmonary edema, etc.)
renal failure
confusion
coma
sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

whats the function of antiplatelet drugs

A

prevent platelet adhesion (needed to form thrombus)

ex. ASA (Aspirin), Clopidogrel (Plavix), Ticagrelor (Brilinta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ASA

A
  • contraindicated in children due to Reyes syndrome
  • pain relief properties not worthwhile in era of NSAIDS/acetaminophen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what modification was made to ASA due to its irritating effects

A

often enteric coated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the main indications for antiplatelet drugs?

A

treatment and prevention of MI/CVA
prevent in-stent re-thrombosis following angioplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why are antiplatelets often more beneficial than anticoagulant drugs?

A

lower bleeding rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

thrombolytic drugs

A

drugs that break down, or lyse, already formed clots

ex. Alteplase/TPA (Activase, Cathflo), Tenecteplase/TNK (TNKase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

whats the MOA of thrombolytic drugs

A

activate plasminogen and convert it to plasmin, which lyses the thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the indications of thrombolytic drugs?

A

acute MI (STEMI)
arterial thrombolysis (DVT, PE)
acute ischemic stroke
blocked central line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are adverse effects of thrombolytic drugs?

A

bleeding (internal, intracranial, and superficial)
N/V, HTN
hypersensitivity/anaphylactoid reactions
reperfusion cardiac dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some nurisng implications for thrombolytic drugs

A
  • follow institutional guidelines for preparation and administration
  • monitor IV sites for bleeding, redness, pain
  • monitor bleeding from gums, mucous membranes, nose, and injection sites
  • watch for signs of internal bleeding (decreased BP, restlessness, increased pulse, worsening neurological status)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

antiepileptic drugs

A
  • aka anticonvulsants
  • single-drug therapy started before multiple-drug therapy tried to minimize adverse effects
  • serum drug concentrations can be measured for some agents but do not correlate completely with efficacy or toxicity
17
Q

what are the prominent goals of anticonvulsant therapy?

A

control/prevent seizures while maintaining a reasonable quality of life
minimize ADR and drug-induced toxicity

18
Q

whats the MOA of anticonvulsants

A

unknown;
- `CNS depressants,
- reduce nerve’s ability to be stimulated,
- suppress transmission or speed of impulses from one nerve to the next

19
Q

AEDs for analgesia (chronic neuropathic pain)

A
  • carbamazepine (Tegretol)
  • Gabapentin (Neurontin)
  • Pregabalin (Lyrica)
20
Q

AEDs used to treat psychiatric illness (used for bipolar depression)

A
  • Carbamazepine (Tegretol)
  • Lamotrigine (Lamictal)
  • Valproic Acid, divalproex (Depakene)
21
Q

gabaminergic vs glutaminergic

A

gaba- CNS depressants, ethanol, AEDs, others
gluta- stimulants, withdrawal of CNS depressants

22
Q

whats the aim of balance for AEDs

A

slightly tip in a neuro-depressive manner by being gabaminergic

23
Q

what can occur with virtually all AEDs

A

fatigue, cognitive impairment, dizziness, ataxia (cerebellar toxicity)

24
Q

status epilepticus

A

a seizure >/ 30 min or 2 successive seizures without ful recovery in the same period

result:
hypotension, hypoxia, brain damage, possibly death

25
Q

hydantoins; phenytoin

A
  • non linear relationship between dose and drug levels for this agent (sim. to ethanol consumption)
  • small dose titrations can produce larger than expected results
26
Q

IV infusion of phenytoin

A
  • irritating to veins
  • slow directly into large vein through 20+-gauge venous catheter
  • diluted in normal saline for IV infusion
  • filter must be used
  • max. rate must be used to avoid cardiac arrhythmias
  • saline flush
27
Q

what are considerations when taking phenytoin

A

same time each day w meals reducing GI upset