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Pharmacology ex.1 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

Damage to the ________ causes Parkinson Disease

A

Substantia nigra

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2
Q

When substantia nigra neurons die ________ decrease and ________ increase

A
  1. dopamine
  2. acetylcholine
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3
Q

Sign and Symptoms of Parkinson’s disease

A

(TRAP)
Tremors (resting)
Rigidity (cogwheel)
Akanesia (slow movement
Postural instability

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4
Q

Meds for parkinson’s disease increase ________ and decrease _______

A
  1. dopamine
  2. acetycholine
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5
Q

Dopamine Agonists

A
  1. levodopa/carbidopa
  2. Pramipexole
  3. Ropinirole

(Prescribed for Parkinson’s disease and RLS)

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6
Q

Levodopa is converted to __________

A

dopamine (once it has crossed the BBB)

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7
Q

Carbidopa help keep __________ low

A

levodopa

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8
Q

Pramipexole and Ropinirole are ___________ agonists

A

dopamine (stimulate dopamine receptors)

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9
Q

Carbidopa prevents the conversion of

A

levodopa to dopamine before it crosses the BBB

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10
Q

Protein, vitamin B6, and iron prevent the absorption of _________

A

levodopa/carbidopa

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11
Q

Orthostatic hypotension is caused by ______

A

dopamine alteration

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12
Q

Dopaminergic medications can cause paranoia and _____________

A

hallucination

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13
Q

Pramipexole and ropinirole can cause __________

A

impulse control issues (gambling, shopping, binge eating)

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14
Q

Selegiline oral form is for

A

Parkinson’s disease

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15
Q

Selegiline transdermal version is for ___________

A

Depression

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16
Q

Selegiline MOA (mechanism of action)

A
  1. MOA-B inhibitor (prevents breakdown of dopamine)
  2. Avoid tyramine rich food (cheese, smoke meat, fig, beer, soy sauce)
  3. Avoid other drugs that increase monoamines
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17
Q

Anticholinergics meds

A
  1. Benztropine
  2. Trihexyphenidyl
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18
Q

Anticholinergic uses and MOA

A
  1. treat parkinson’s disease and extrapyramidal effects
  2. Block acetylcholine receptors
  3. Cause drowiness
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19
Q

Monoamine Oxidase Inhibitors (MAOIs) meds

A
  1. Isocaboxazid
  2. Phenelzine
  3. Selegiline transdermal
  4. Tranylcypromine
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20
Q

Monoamines Oxidase Inhibitors (MAOIs) use and MOA

A
  1. treats major depression
  2. Blocks monoamine oxidase ( oxidase break down dopamine, serotonin, norepinephrine)
  3. Increase serotonin, norepinephrine and dopamine levels
  4. Avoid food containing tyramine (i.e., old and stinky)
  5. Avoid drugs that increase same neurotransmitters ( antidepressants, cold meds, meperidine, triptan)
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21
Q

___________ process produces high levels of tyramine

A

fermenting

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22
Q

Tyramine and _____________ cause a patients blood pressure to become too high

A

norepinephrine
(hypertension can manifest as a headache)

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23
Q

Serotonin syndrome is characterized by an altered _______ status

A

mental
(also high fever, sweating and clonus)
2. Clonus is involuntary rhythmic muscle contraction

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24
Q

Many patients that take MAOI experience __________

A

orthostatic hypotension

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25
Q

Tricyclic Antidepressants (TCAs) meds

A
  1. Amitriptyline
  2. Nortriptyline
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26
Q

TCAs uses and MOAs

A
  1. help treat depression, neuropathic pain, and anxiety disorders
  2. Block serotonin and norepinephrine reuptake pump cause them to increase
  3. TCA are not selective and causes anticholinergic affects
  4. Orthostatic hypotension is common
  5. TCAs can cause heart dysrhythmias when overdosed
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27
Q

Selective Serotonin Reuptake Inhibitors (SSRIs) meds

A
  1. escitalopram
  2. Fluoxetine
  3. Paroxetine
  4. Sertraline
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28
Q

SSRI use and MOA

A
  1. used for depression
  2. Block serotonin reuptake pumps
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29
Q

SSRI side affects

A

stomach troubles
slowed metabolism
sexual dysfunction
suicidal ideation
sodium levels decreased
SSRIs are sedating but Fluoxetine is activating (take fluoxetine in the morning)

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30
Q

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) meds

A
  1. desvenlafaxine
  2. duloxetine
  3. Venlafaxine
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31
Q

SNRIs uses, MOA, HYC

A
  1. used for major depression, neuropathic pain and anxiety
  2. MOA: Venlafaxine and duloxetine block the reuptake of serotonin and norepinephrine
  3. Same as TCAs but cleaner
  4. cause hypertension, stomach trouble, slowed metabolism, sexual dysfunction, suicidal ideation, decreased sodium
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32
Q

Miscellaneous Antidepressants

A
  1. Bupropion (used for depression, ADHD and smoking cessation)
  2. Trazodone (used for depression and insomnia
33
Q

Bupropion

A
  1. Inhibits reuptake of dopamine and norepinephrine
  2. does not effect serotonin
  3. Increase libido, no weight gain
  4. Adverse affects include anxiety and insomnia
  5. Contraindicated if a client has risk of seizures
34
Q

Trazadone

A
  1. Weak serotonin reuptake inhibitor
  2. Strong sedative and anticholinergic effects and priapism
35
Q

Antidepressant take ______ to _____ weeks to start working

36
Q

Suicidal ideation is more common with _______ patients

37
Q

Manics characteristics include

A

poor impulse control, racing thoughts, grandiose beliefs, and can be dangerous to others

38
Q

_________ is a milder version of mania

39
Q

Hypomania characteristics include

A

energetic, have a reduced need for sleep, creative, may get alot of work done.

40
Q

Dysthymia

A

A persistant mild form of depression

41
Q

Bipolar disorder treatment difficulties

A
  1. Requires a combination of meds
  2. Medication adherence due to unpleasant side effects
  3. Many clients enjoy feeling hypomanic
42
Q

Lithium is used to treat __________

A

Bipolar disorder

43
Q

Lithium common uses

A
  1. prescribed for acute manic episodes
  2. used for long term maintenance therapy for bipolar disorder
44
Q

Lithium HYCs

A
  1. has a narrow therapeutic index
  2. Level no greater than 1.5
45
Q

Lithium Side effects

A
  1. mild GI problems, mild thirst, polyuria and fine hand tremors
  2. Signs of Toxicity: Sedation and slurred speech, coarse hand tremors, ataxia, nausea, diarrhea
46
Q

Kidney cannot tell the difference between _________ and _______

A

lithium and sodium (both are salts) (kidney will remove both or retain both)

47
Q

How to avoid lithium toxicity

A
  1. maintain consistent amounts of sodium
  2. avoid excessive sweating
  3. stay well hydrated.
48
Q

Longterm effects of Lithium

A
  1. Damage to thyroid and kidney
49
Q

Benzodiazepine meds

A
  1. Alprazolam
  2. Diazepam
  3. Lorazepam
  4. Chlordiazepoxide
  5. Clonazepam
50
Q

Benzodiazepine common uses

A
  1. treat anxiety
  2. insomnia
  3. muscle spasms
  4. seizure disorders
  5. reducing the severity of alchohol
51
Q

Chloride is a _________ charged ion

A

negatively (decrease anxiety and alertness)

52
Q

Benzodiazepine help ___________ work better

53
Q

Benzodiazepine HYC

A
  1. Cause CNS depression (sedation, slurred speech, dizziness, etc)
    2 Don’t mix with opioids
  2. Avoid alcohol
  3. Increase risk of falls and injury
  4. Highly addictive
  5. Short term use; longterm users should avoid abrupt discontinuation
54
Q

Anxiety Meds

A

Antidepressants
Benzodiazepine
Buspirone
Beta blockers
Certain antihistamines

55
Q

Schizophrenia is caused by ___________

A

excessive dopamine

56
Q

Positive symptoms of schizophrenia include

A

Treated with antipsychotics

  1. hallucinations
  2. delusion
  3. paranoia
  4. agitation
  5. disorganized thinking and speech
57
Q

Negative symptoms of schizophrenia

A

Decrease in normal functions
1. social withdrawal
2. lack of motivation
3. decreased emotional expression
4. inability to recognize one’s illness
5. poor judgement
6. poor self care

58
Q

First Gen Antipsychotic meds

A
  1. Chlorpromazine
  2. Haloperidol
59
Q

Chlorpromazine treats ______

60
Q

Haloperidol help manage _________

A

tourette’s syndrome

61
Q

Chlorpromazine and Haloperidol block __________

A

dopamine (D2) receptors

62
Q

Extrapyramidal symptoms

A

Akathsia
Acute dystonia
parkinsonism
Tardive dyskinesia

63
Q

Neuroleptic Malignant Syndrome signs

A

caused by 1st gen antipsychotic
1. fever
2. elevated WBC and CPK levels
3 Vital signs instability
4. Encephalopathy
5. Rigidity

64
Q

Chlorpromazine and Haloperidol cause

A
  1. photosensitivity (wear sunscreen)
  2. dirty drugs (cause anticholinergic effects, sedation and orthostatic hypotension)
65
Q

2nd Gen antipsychotic meds

A

Treat schizophrenia and prevent bipolar mania

  1. Aripiprazole
  2. Clozapine
  3. Olanzapine
  4. Risperidone
66
Q

2nd gen antipsychotics block ________ and __________

A
  1. dopamine and serotonin
  2. help reduce positive symptoms of schizophrenia
67
Q

2nd Gen antipsychotics HYC

A
  1. Cause extrapyramidal symptoms
  2. Neuroleptic Malignant syndroms
  3. metabolic effects (weight gain, unhealthy cholesterol levels, diabetes)
  4. Agranulocytosis
68
Q

Clozapine is a _________ med

A
  1. 2nd gen antipsychotic med
  2. most effective antipsychotic
  3. destroy white blood cells
69
Q

__________ neurons cause seizures

A

hyperexcitable

70
Q

Area of brain that initiates seizures is called the _______

71
Q

Seizure Medications include

A
  1. Antiepileptics
  2. Benziazepines
72
Q

Antiepileptics Meds:

A
  1. phenytoin
  2. Carbamazepine
  3. Vampiric acid
  4. Lamotrigine
  5. Levetiracetam
73
Q

Anti-epileptics med are used for

A
  1. different kinds of seizures

Valproic acid, Lamotrigine, and carbamazepine are prescribed for:
Bipolar disorder

74
Q

Antiepileptics MOA and HYCs

A
  1. slow down central nervous system (sedation, ataxia, double vision, etc)
  2. Drug interactions
  3. Teratogenic (can cause birth defects)
  4. Phenytoin (narrow therapeutic index, between 10 and 20), cause enlargement of gum, facial hair growth, interfere with vitamin D and K.
75
Q

Carbamazepine and Clouzapine cause destruction of __________ and decreased __________ levels

A
  1. white blood cells
  2. sodium
76
Q

Valproic Acid cause

A
  1. weight gain
  2. hair loss
  3. toxic to liver
    (THINK HOMER SIMPSON)
77
Q

Lamotrigine causes

A
  1. Sevens- Johnson syndrome
  2. Start low and go slow
  3. Teach client to report any new rashes
78
Q

Levetiracetam is an antiepileptics that is

A
  1. much better tolerated
  2. Little CNS depression
  3. Wider therapeutic index
  4. Does not interact with many meds thus its commonly prescribed

Pharmacology ex.1 (6 decks)

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