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Pharamcology > week 5 > Flashcards

week 5 Flashcards

1
Q

_______ is a new hypnotic used in the treatment of insomnia. this drug appears to bind to the ______ receptors. generic form available and long acting form under patent

A

zolpidem (ambien)

GABA

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2
Q

______ is the new non-benzodiazepine on the market. It is thought to work by activating GABA receptors in the brain.

A

lunesta

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3
Q

_________ is an anti-anxiety drug acting on the ____. Reduces anxiety before medical procedures and also used for nausea and allergies.

A

Hydroxyzine

hypothalamus

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4
Q

_______ is a new anti-anxiety agent that does not have sedative effects. this drug takes several ___ to develop.

A

Buspiron

weeks

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5
Q

___-_____ such as atenolol or propanol may be effective in many anxiety situations where the main need is to reduce adrenergic stimulation and tachycardia.

A

Beta-blockers

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6
Q

what are two illegal street drugs with a sedative action

A

Quaalude, and Doriden

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7
Q

______ has similar activity to barbiturates with a mild euphoria. It was commonly abused during the 60’s and 70. it is no longer legal.

A

Quaalude

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8
Q

______was a sedative prone to abuse and is no longer a legal drug

A

Doriden

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9
Q

there are approx. ___ million patients with seizures.

A

3

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10
Q

seizures are initiated bisynchronous excessive electrical discharge from hyper-excitable neurons in the ___ ____

A

cerebal cortex

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11
Q

what 2 things can be used to monitor seizures and provide additional information

A

EEG

MRI

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12
Q

what are seizures called when they occur with out any known cause

A

termed idiopathic seizures

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13
Q

About 50% of people who had a seizure will have a recurring one. If they are put on meds they are put on for about 2-5 years and eventually the drug dosage is reduced and 75% have no recurrence

A

-

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14
Q

______ seizure is referred to when the electrical discharge is limited to only adjacent area in the ____ cortex

A

partial

cerebral

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15
Q

______ seizure is when the electrical discharge is spread past the cerebral cortex.

A

generalized

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16
Q

Partial
simple-1
complex-2

A
  1. no loss of consciousness, limited to one part of the body.
  2. impairment of continuous, confused or bizarre behavior.
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17
Q

Generalized
_____ (—-)-consists of alternating periods of synchronous muscle jerks (____) and muscle rigidly (____) with impairment of consciousness: followed by a period of CNS depression
____ (—-) is a brief, frequent losses of consciousness with staring and fluttering eyelids that last 10-30 seconds
___ ____ is a persistant general seizure (>30 min) which can be life treating if not stopped

A

Tonic-Clonic (Grand Mal)
clonic
tonic

Absence seizures (Petit mal)

status epilepticus

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18
Q

anti-seizure medications prevent either the _____ charge to the ____ of the electrical discharge.

A

initial

spread

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19
Q

antiseizure meds work 4 different ways

A
  • inhibit Na influx thus inhibiting depolorization
  • enhancing the effect of inhibitory pre-synaptic neurons.
  • inhibit excitatory pre-synaptic neurons
  • inhibit depolarization of T-type Ca channels
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20
Q

_____ acts to inhibit the sodium channels in the ___-___ neuron but only when repeat frequent firing of the neuron has occurred so that the neuron doesn’t have tome to completely repolarize. It works on all types of seizures except _____ seizure. this drug also induces cyt- P-____

A

Phenytoin
post-synaptic
absence
450

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21
Q

Adverse effects of Phenytoin include

A
  • gingival hyperplasia
  • steven johnson syndrome
  • teratogenicity (heart defects, cleft palate)
  • sudden withdraw can produce SE
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22
Q

______ is a newer drug of phenytoin. less alkaline and easier on the veins

A

Fosphenytoin

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23
Q

_____ appears to work to inhibit Na channel and to augment the action of the GABA receptors. Its official FDA approval for prevention of ____ and off label use for ___ pain and drug withdraw. Its recent approval from the FDA is for weight ___.

A

topomax
migraines
neuropathic
loss

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24
Q

_____ is used primarily in the treatment of grand mall and complex seizures. this drug should not be combined with dilantin because it has the sam eeffects and doesn’t stop ___ seizures. this drug stimulates the liver to produce increased levels of enzyme.

A

Tegretol

absence

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25
Q

Tegretol XL works by having half the pill ____ to water water the other half _____. This creates pressure to build the drug released slowly through a tiny drilled hole

A

permeable

impermeable

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26
Q

Adverse effects of tegretol include ….

A 
agranulocytes (absence of granulocytes)
aplastic anemia (absence of both red and white blood cells)
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27
Q

_____ works as an anti-seizure medication by increasing GABA receptors. Dedication may be a problem. It is effective against all forms expect ____. its use is decreasing

A

phenobarbital

absence

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28
Q

valproic acid’s enteric coated form is known as

A

Divalproex

29
Q

Valproic acid is believed to stimulate _____ receptors; it may also inhibit sodium channel depolarization and __-type Ca channel. this is the only drug _____ of all seizures. On considerable side effect is nausea but this can be helped by taking divalproex but it is expensive

A

GABA
T
effective

30
Q

______ used primarily in treatment of partial and tonic clonic seizures. it is also being used for the depressive stages of bipolar disorder

A

lamotrigine

31
Q

Lamotrigine adverse effects include

A

rash- stevens johnson syndrome

nausea

32
Q

____ is seeing increased use as an adjunct drug un the treatment of partial and tonic-clonic seizures

A

levetiracetam

33
Q

_____ and _____ are both commonly used for stopping status epileptics.

A

lorazepam and diazepam

34
Q

______ is commonly used in treatment of absence seizures

A

Clonazepam

35
Q

______ acts to inhibit calcium channels in the brain neurons thus reducing activity. it is approved for use as adjunct therapy in partial and secondarily generalized seizures. also approved for posttherpetic pain (shingles.)

A

gabapentin

36
Q

______ is a newer version of gabapentin which is FDA approved for partial seizures as as well as treating neurological pain associated with diabetes and shingles. IT has also been approved for _____

A

Pregabalin

fibromyalgia

37
Q

this type of diet known as ____ diets help reduce seizures. This very high fat diet can cause substantial elevation in blood cholesterol with potential acceleration of atherosclerosis

A

ketogenic

38
Q

______ nerve stimulation reduces frequency and severity if complex seizures. a small magnet placed over the device can manually activate the device when a seizure starts.

A

Vagus

39
Q

antipsychotics are also known as x2

A

neuroleptics

major tranquilizers

40
Q

how is schizophrenia shown?

A

usually divided into positive and negative characteristics

41
Q

What are the positive symptoms of schizophrenia x3

A
  • religious, grandiose or persecutory delusion
  • hallucinations
  • paranoia, though disorder, withdraw- violence to objects, other people and to themselves
42
Q

what are the negative symptoms of schizophrenia x5

A
  • apathy
  • lack of motivation
  • inability to think and communicate clearly
  • lack of energy
  • withdraw from society
43
Q

before the advent of antipsychotic dugs what did people have to endure during the 50’s

A
  • electroconvulsive therapy
  • insulin shock therapy
  • institutionalization
  • physical restraint
44
Q

a simple molecular model of schizophrenia suggests that it is due to ___ of ______ or _____ of _____ r_____ in the part of the brain known as ______ and _______ areas of the brain

A

overproduction of dopamine or oversensitivity of dopamine receptors
mesolimbic and mesocortical

45
Q

the treatment of this is opposite of ______ disease because the dopamine is trying to be decreased. By decreasing dopamine this can lead to symptoms like

A

Parkinson

Parkinson disease

46
Q

Older antipsychotic drugs have been effective in decreasing the _____ symptoms but have increased the ____ symptoms. They appear to work by blocking ________ receptors in the ____ and ____ areas of the brain

A

positive
negative
dopamine 2
mesolimbic and mesocortical

47
Q

the newer atypical antipsychotics appear to block _____ receptors and _____ receptors. These newer drugs are claimed to be more effective in treating the negative symptoms of schizophrenia. They also show some efficacy in treating patients with _____ _____ or a combination of this and schizophrenia. most atypicals have been approved for used with the manic phase of bipolar disorder and some forms of autism.

A

serotonin
dopamine 2
bipolar disorder

48
Q

the older typical antipsychotic agents cause blockade of other brain receptors such asx2

A
  • dopamine blockade in striatum results in adverse extrapyramidal effects to Parkinson’s disease.
  • blockade of cholinergic a1 and histamine receptors.
49
Q

what are some early onset and reversible side effects of older antipsychotics x3

A
  • acute dystonia
  • akathisia
  • neuroleptic malignant syndrome
50
Q

adverse effects which appear years down the road of older antipsychotics

A

-tardive dyskinesia develops (fly catching)

51
Q

____ is used for treatment of _____ and it is used in short term to ______ severe behavior problems

A

haloperidol (haldol)
schizophrenia
sedative

52
Q

this from of Haldol is released at a slow rate because this drug _______ _____ is more fat soluble due to the addition of a lipophilic _______ group. Thus this drug is slowly released as the ____ group is removed

A
  • haloperidol decanoate
  • decanoate
  • decanoate
53
Q

what is an adverse effect of haldol and what drug is this treated with

A

frequent extrapyramidal reaction

cogentin

54
Q

_______ drug has a low potency but is no longer used and a adverse effect includes strong anticholinergic effects (dry mouth, urinary hestinacy and etc)

A

Thorazine

55
Q

what are newer antipsychotics called

A

atypicals

56
Q

atypical are only FDA approved for the use in ____ and these drugs have ranked up ____ billion dollars

A

adults

14.6

57
Q

_____ was the first of the typical on the market (1990) however the major problem with this drug is the increased risk of agranulocytosis in 1-2%. rarely prescribed and weekly testing.

A

Clozapine

58
Q

An a typical no available generic

A

Risperidone

1995

59
Q

_____ is the active metabolite of risperidone. it is available as a long acting (28 day) depot injection known as _____-sustena in which a long lipophilic ____ acid chain has been added to the polar OH group of the paliperidone

A

Invega
Invega
palmitic

60
Q

_______ (1996) weight gain is a common problem and diabetes. the company is paying ___ billion for the illegal marketing of off label uses

A

olanzapine

1.2

61
Q

off label uses of olanzapine included

A

treat elderly patients with dementia, alzheimers, agitation

prometed 5 mg of zyprexa to help old people sleep

62
Q

seroquel (1997) weight gain and sedation
abilify (2002) less weight gain than other atypical
Geodon (2000) nausea and somnolence

A
63
Q

______ reduce nausea and vomiting

A

Antiemetics

64
Q

antiemetics work by blocking the dopamine receptors in the ____ ___ ____ (CTZ)

A

chemoreceptor trigger zone

65
Q

prochloperazine and promethazone are older antiemetics and are structurally related to ______

A

Thorazine

66
Q

_____ is effective for most forms of nausea but is less effective for treating nausea associated with cancer chemotherapy

A

Prochlorperazine

67
Q

_______ is a antiemetic and used for antihistamine and anticholinergic effects. and it is not very effective for nausea when dealing with chemo

A

promethazine

68
Q

_____ is the form of THC and is delta9 tetrahydrocannabinol and helps with anorexia associated with aids and nausea related to chemo

A

marinol

69
Q

_____ and _____work by reducing nausea by blocking serotonin (5-hydroxytryptamine) receptors in CTZ and vagal nerve terminals reducing vagal nerve stimulation of the CTZ. Effective in reducing nausea immediately after Chemo and taken before and after chemo. Adverse effects include headache and diarrhea. They are now averrable in generic forms. They have seen off label use for morning sickness , Hopoate and alcohol withdraw, schizophrenia and irritable bowel syndrome

A

Zofran and Kytril

Pharamcology (12 decks)

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