8.4 Pharmacological Profile Flashcards
(206 cards)
1
Q
What’s the action of long acting barbiturates?
A
- sedative
- hypnotic
- anti convulsant properties
- depress sensory cortex
- decrease motor activity
- altar cerebellar function
- produce drowsiness
2
Q
What are the subdivisions of anti anxiety drugs?
A
- Benzodiazepines (short term only)
- non- benzodiazepines
3
Q
What are the classes of antidepressants?
A
- Tricyclic (TCAs)
- Monoamine Oxidase Inhibitors (MAOI)
- Selective Serotonin Reuptake (SSRI)
- Serotonin-norepinephrine (SNRI)
4
Q
What are the actions of TCA?
A
Increase levels of norepinephrine and serotonin by inhibiting their reuptake and blocking the action of acetylcholine
5
Q
What is the action of MAOI?
A
inhibits the activity of monoamine oxidase resulting in increased endogenous neuro-hormones
6
Q
What is the action of SSRI?
A
Increase serotonin by inhibiting neuronal uptake to CNS
7
Q
When shouldn’t you give TCA’s
A
- hypersensitivity to formulation
- within 14 days of MAOI’s administration
- acute recovery from MI
8
Q
What receptors do Antipsychotics block?
A
- dopamine receptors in the brain
9
Q
Use of Stimulants
A
Treatment of narcolepsy and as adjunctive treatment in the management of ADHD
10
Q
Examples of Anticonvulsives
A
- Diazepam
- Lorazepam
- Midazolam
- Clonazepam
- Phenytoin
11
Q
What medication acts as an antiemetic mainly by diminishing motion sickness?
A
Meclizine
12
Q
Examples of Antiemetics
A
- Prochlorperazine
- Chlorpromazine
- Metoclopramide
- Ondansetron
- Prochlorperazine
- Promethazine
13
Q
Examples of Antivertigo medications
A
- Meclizine
- Diphenhydramine
- Benzodiazepines
14
Q
What is the action of Local Anesthetics?
A
Inhibits transport of ions across neuronal membranes, thereby preventing initiation and conduction of normal nerve impulses
15
Q
Action of Ketamine
A
Non competitive antagonist of glutamate, causing neuro-inhibition and anesthesia where the patient is dissociated form the surrounding
16
Q
Examples of Local Anesthesia
A
- lidocaine
- bupivacaine
17
Q
Example of general anesthesia
A
ketamine
18
Q
What are the classes of analgesics
A
- salicylate
- non- salicylate
- NSAID
- urinary analgesics
19
Q
Action of salicylates
A
- dilates peripheral blood vessels (cools body)
- prolongs bleeding by inhibiting aggregation of platelets
20
Q
Uses of salicylates
A
- relief of mild to moderate pain
- reduction of body temp
- inflammatory conditions
- decreases risk of MI
- prevention and treatment of blood clots
21
Q
Contraindications of salicylates
A
- pregnancy
- bleeding disorders
22
Q
Examples of salicylates
A
ASA
23
Q
Adverse effects of non salicylates
A
- severe hepatic impairment or severe active liver disease
24
Q
Contraindications of non salicylate
A
- Hepatoxicity: acute liver failure
- do not exceed 4g daily
25
Patient management of non-salicylate
- can be administered w/o food
- safe for pregnancy
- asses alcohol use
26
Examples of non salicylates
- acetaminophen
| - benzocaine- menthol
27
Action of NSAIDs
Inhibit COX-1 and COX-2 (non selective) or Cox-2 (selective) which is responsible for prostaglandin synthesis
- anti-inflammatory
- analgesic
- antipyretic
28
Adverse effects of NSAIDs
- Nausea, vomiting
| - increase risk of heart attack or stroke
29
Contraindication for Celecoxib
Sulfa allergy
30
Contraindication for Ibuprofen
- peptic ulcer
- GI bleed
- HTN
31
When should you stop NSAIDS?
- prolonged bleeding
| - dark stools
32
Examples of NSAIDs
- Ibuprofen
- Ketorolac
- Naproxen
- Celecoxib
- Meloxicam
33
Examples of COX2 inhibitor NSAIDS
- celecoxib
| - meloxicam
34
Action of narcotic analgesics
Bind to opiate receptors in the CNS where they act as agonists of endogenously occurring opioid peptides. The result is alteration to perception of and response to pain
35
Use of Narcotic analgesics
short term management of moderate to severe pain
36
Adverse effects of narcotic analgesics
- constipation
| - respiratory depression
37
When shouldn’t you give narcotic analgesics
- head injury
| - ICP
38
Patient management of narcotic analgesics
- avoid use of narcotics and benzodiazepines or other CNS depressants when possible
39
Examples of narcotic analgesics
- codeine
- fentanyl
- morphine
40
Action of Naloxone
- competitive antagonist that bind to the opioid receptors with higher affinity than agonist but does not activate the receptor.
- This effectively blocks the receptor, preventing the body from responding to opiates and endorphins
41
Withdrawal sx of opioids
pain, tachycardia, HTN, fever, sweating, abdominal cramps, diarrhea, nausea, vomiting, agitation and irritability
42
Contraindications for naloxone
- hypersensitivity to naloxone
- CAD
- pregnant women
- opioid dependent patients
43
How do H1 antihistamines work?
binds to histamine H1 receptors in mast cells
44
What is the difference between 1st and 2nd generation antihistamines
- 1st generation has more side effects such as drowsiness
| - 2nd generation has few CNS side effects
45
Use of H1 antihistamines
- treat allergic reactions
- insomnia
- motion sickness
- vertigo
46
Use of H2 antihistamines
- binds to H2 receptors in upper GI tract
- treats gastric acid conditions
- some relief of Parkinson-like reaction
47
Contraindications/warnings of antihistamine
- pregnancy
| - counseled on operating heavy machinery
48
Examples of 1st generation antihistamine
- diphenhydramine
- hydroxyzine
- promethazine
49
Examples of 2nd generation antihistamine
- cetirizine
- fexofenadine
- loratadine
50
How do decongestants work?
Induces vasoconstriction of the blood vessels in the nose, throat and paranasal sinuses
51
Active ingredients in decongestants
- pseudoephedrine
| - phenylephrine
52
What adverse effect can decongestants cause due to vasoconstriction
- HTN
| - paired with antihistamines, may lessen effect but do not cancel each other out
53
Contraindications/ warnings of decongestants
- not recommended for pregnancy
| - over use of topical can cause rebound nasal congestion
54
Examples of decongestants
- oxymetazoline (afrin, don't use for more than 3 days)
- pseudoephedrine
- phenylephrine
55
Action of beta2 agonist (bronco dilators)
Beta2 receptors are in bronchial smooth muscle and when stimulated cause relaxation (dilation) of bronchioles
56
What can beta2 agonists be used for?
Reversible air way obstruction caused by:
- bronchial asthma
- exercise induced bronchospasm
- emphysema
57
Excessive use of beta2 agonists may cause what?
- excessive use may result in paradoxical bronchospasm
| - tachycardia
58
Contraindication/ Caution/ Warnings of beta2 agonists
- cardiac arrhythmias
- beta blockers my inhibit the effect of beta2 agonists
- caution with DM, may cause increase blood glucose
59
Patient management of beta2 agonists
Provide a spacer and face mask
60
muscarinic antagonists relieve sx and manage what?
- Relief of bronchial asthma
| - management of COPD
61
Adverse effects of anticholinergic
- Red as a beet (flushed face/sleepy)
- blind as bat (blurred vision)
- stuffed as a pipe (stuffed as a pipe)
- mad as a hatter (confusion)
- Hot as a hare (increased HR/body temp)
- Dry as bone (dry mouth)
62
Contraindication/warning of muscarinic antagonist/anticholinergics
- arrhythmias
| - use in pregnancy if potential benefit outweighs risk
63
Examples of muscarinic antagonist/anticholinergics
- ipratropium
| - tiotropium
64
What is Leukotriene?
| What does a leukotriene antgonist result in?
- Leukotriene is a broncho constrictive substance released by body during inflammation
- Antagonist results in bronchodilation
65
Mast cell stabilizer stop the release of a substance that causes what in the respiratory tract?
- bronchoconstriction
| - inflammation
66
What conditions do Leukotriene Antagonist and Mast Cell stabilizer treat?
- treatment of asthma
| - treatment of COPD
67
Contraindication/warning/caution of leukotriene antagonist and mast cell stabilizer
- acute asthma/bronchospasms
| - ASA sensitive asthmatics
68
Action of Inhaled Corticosteroids
- suppressing inflammation
| - decrease inflammatory process in the air way through inhibiting multiple different inflammatory cytokines
69
What is a common condition caused from inhaled corticosteroids?
How do you prevent it?
- Candida Albicans (yeast infection)
| - patient should rinse mouth with water after using inhaler
70
Contraindication of inhaled corticosteroids
caution with compromised immune system
71
Action of antitussives
- central acting: depresses cough center
| - peripheral acting: anesthetize stretch receptors
72
What does an antitussive do?
relieves non productive cough
73
Adverse effects of codeine
- respiratory depression
- euphoria
- sedation
74
Contraindication/warnings/caution of antitussives
- persistent cough (greater than 2 weeks)
| - codeine with respiratory disorders
75
Examples of Antitussives
- benzonatate
| - codeine sulfate
76
Action of mucolytic
- loosens and mobilize thick mucus from respiratory system
77
How does an expectorant work?
reduces viscosity of tenacious secretions by increasing respiratory tract fluid
78
Contraindications of mucolytic and expectorants
persist cough
79
Example of expectorant
guaifenesin
80
How do antiarrhythmics work?
Decrease symptomatology, increases hemo-dynamic performance
81
Action of Class 1 Antiarrhythmic
depresses myocardial excitability to electrical stimuli thus decreasing pulse rate
82
Action of Class 2 Antiarrhythmic
Beta blockers block stimulation of beta receptors of the heart
83
```
How does Amiodarine affect the heart?
What class antiarrhythmic is it?
```
- Amiodarone blocks potassium channels in the heart.
- This is used for ventricular dysrhythmias and atrial fibrillation
- Class 3 antiarrhythmic
84
Action of Class 4 Antiarrhythmic
Verapamil blocks calcium channels which are critical in the production of muscle contraction and electrical conduction
85
Use of antiarrhythmics
treats cardiac arrhythmias
86
Examples of antiarrhythmic
- lidocaine
- amiodarone
- metoprolol
87
Action of nitrates
Direct relaxing effect on smooth muscle of blood vessels
88
Contraindications/warning of nitrates
postural hypotension
89
When should you not give nitrates
- BP below 100 systolic, do not give
| - do not use with dick meds
90
Examples of nitrates
Nitroglycerin
91
HTN guidelines
```
Normal: 120/80
Elevated: 120-129/80
Stage 1: 130-139/80-89
Stage 2: 140/90
Higher value between systolic and diastolic determines the stage
```
92
Step care regimen for HTN
- Step 1: Life Style Changes
- Step 2: Use of thiazide diuretic
- Step 3: Increase dose of drugs or combine 2
- Step 4: combine 2-3 of step 3
93
Which medication is used to control 80% of patients with HTN
diuretics
94
How do Ace Inhibitors/ARBs lower blood pressure?
- by dilating or increasing the size of the arterial blood vessels
95
Adverse effects of Ace Inhibitors
- postural or orthostatic hypotension
- Angioedema in african american patients
- dry, hacking cough in 5-20% of patients
96
Examples of ace inhibitors
- lisinopril
- captopril
- enalapril
- ramipril
97
Examples of ARB
- losartan
| - telmisartan
98
Action of calcium channel blocker
act by causing peripheral vasodilation
99
What are the 2 types of calcium channel blockers
- Dihydropyridines
| - Non-dihydropyridines
100
Use of dihydropyridines
- potent vasodilators that have little or no negative effect upon cardiac contractility or conduction
- primarily for HTN
101
Use of non-dihydropyridines
-less potent vasodilators but have a greater depressive effect on cardiac conduction and contractility
102
Patient management of calcium channel blockers
- much more effective in older and in black patients with HTN
103
Use of beta blocker
- HTN
| - angina pectoris
104
Should you stop beta blockers abruptly
Absolutely not
105
Examples of beta blockers
Ends in (-olol)
- metoprolol
- propranolol
- atenolol
106
When should diuretics be administered?
| How often will patient need to void?
- administer early in the day to prevent nocturnal diuresis
| - need to void often the first few weeks
107
Contraindications/warning of diuretics
- sulfa allergy
- kidney disease
- electrolyte imbalance
108
Examples of loop diuretics
- Furosemide
109
Examples of thiazide diuretics
- HCTZ
| - chlorthalidone
110
Most commonly prescribed antihyperlipidemics
Statins
111
How do antihyperlipidemics work?
Reduction of blood lipids
112
Labs for patients on anti hyperlipidemics
- LFT
- Lipid Panel
- Chemistry
113
Examples of statins
- atorvastatin
| - simvastatin
114
Action of antacids
- neutralize or reduce acidity
115
Adverse reactions of antacids
- laxative effect and produce diarrhea
116
Contraindications/ warning of antacids
- Sodium Containing: Patients with cardiovascular problems such as HTN or CHF
117
Examples of antacids
- aluminum hydroxide gel
- magnesium hydroxide
- calcium carbonate
118
H2 receptors are located where?
| How do H2 antagonists affect the body?
- H2 receptor cells are in stomach
| - reduces secretion of gastric acid
119
H2 antagonist treats what conditions
gastric and duodenal ulcers
120
Examples of H2 antagonists
- Cimetidine
- Famotidine
- Ranitidine
121
Action of proton pump inhibitors
- blocks final step in production of gastric acid
122
Uses of proton pump inhibitors
- GERD
- heart
- Ulcers w/ H pylori
123
How are proton pump inhibitors administered?
30-60 minutes before a meal
| before breakfast and before dinner
124
proton pump inhibitors has a risk of causing what condition
- risk of osteoporosis resulting from high dose
125
Examples of proton pump inhibitors
- esomeprazole
- omeprazole
- pantoprazole
126
Action of anti diarrheal
decrease intestinal peristalsis which is usually increased with diarrhea
127
Examples of antidiarrheal
- loperamide
128
Action of anti-flatulents
defoaming action disperses and prevents formation of mucus surrounded gas pockets in intestine
129
What do anti-flatulents help relieve?
- excess gas
130
examples of anti-flatulents
Simethicone
131
Adverse reactions of laxatives
obstruction of esophagus, stomach, small intestine and colon may occur
132
Examples of bulk forming laxatives
- psyllium
| - methylcellulose
133
Examples of emollient laxatives
- mineral oil (enema)
134
Examples of fecal softener
Docusate calcium
135
Examples of hyperosmolar
- glycerin
| - polyethylene glycol
136
Example of Irritant or stimulant laxative
- Bisacodyl
| - senna
137
examples of saline laxative
magnesium citrate
138
Adverse effect of hemorrhoid agents
- may lead to atrophy of affected tissues
139
Examples of hemorrhoid agents
- hydrocortisone
| - proctocream
140
Use of insulin
- controlling type 1 DM
| - can be used for type 2 DM
141
Adverse reactions of insulin
Hypoglycemia- too much insulin with not enough glucose
142
How can a patient become hypoglycemic
- Pt eats too little food
- Insulin dose is incorrectly measured
- increase in physical activity
- Infection may change dose requirement
143
Sulfonylureas (antidiabetic) stimulate what organ to do what?
Stimulating beta cells of pancreas to make more insulin, lowering blood glucose
144
Adverse reactions of antidiabetics
- GI upset
| - Hypoglycemia
145
What hormone influences every organ and tissue in the body?
Thyroid
146
What should you consider when giving thyroid medicine
- overdose
| - hyperthyroidism
147
How long will efforts of thyroid hormone replacement take?
- may not be apparent for 6 weeks, early effects may be apparent as soon as 48 hours
148
Examples of thyroid medication
levothyroxine
149
Use of male hormones
Replacement therapy for testosterone deficiency (hypogonadism)
150
Actions of contraception's
inhibits ovulation
151
Difference between progestin and progesterone
```
Progestin= synthetic
Progesterone= natural
```
152
Examples of oral contraceptives
- Progestin only pills (POP)
- norethindrone
- Drospirenone
- Combined estrogen-progestin (COC)
- Monophasic (COC): fixed dose of estrogen and progestin through cycle
- Biphasic and Triphasic (COC) delivers hormones similar levels of naturally produced
153
Uses of oral contraceptives
- prevents pregnancy
- regulation of menstrual cycle
- dysmenorrhea
- reduce acne
154
Adverse reaction of oral contraceptives
-Venous thromboembolism (COC)
155
Define Bactericidal
Drugs that kill bacteria
156
Define Bacteriostatic
Drugs that slow or retard the multiplication of bacteria
157
Define broad spectrum antibiotic
effective against both gram negative and gram positive bacteria
158
Define super infection
bacteria or fungal microorganism not affected by antibiotic being used for treatment
159
Use of sulfonamides
- UTIs caused by e coli
- staphylococcus aureus
- MRSA
160
What condition and allergy should you consider with sulfonamides
- caution with G6PD
| - Sulfa allergy
161
Examples of drugs containing sulfonamide
- celecoxib
| - furosemide
162
Contraindications for sulfonamide
- not used near end of pregnancy
- caution with bronchial asthma
- contraindicated for patients with allergy and G6PD
163
What medication is similar to PCN but will work if its PCN resistant?
Cephalosporines
164
What age should tetracyclines not be given?
9 years and younger, could cause permanent teeth discoloration
165
Examples of tetracyclines
Doxycycline
166
What medication class is an alternate to PCN for strep and treats chlamydia?
Macrolides
167
Examples of macrolides
- azithromycin
| - erythromycin
168
fluoroquinolone should only be used to treat what conditions if no other treatment is available?
- UTI
- bacterial bronchitis
- bacterial sinusitis
169
What tendon might rupture while taking fluoroquinolones?
Achilles
170
Examples of fluoroquinolones
ciproflaxin
171
What are aminoglycosides used for?
primarily gram negative bacteria
172
Adverse reactions to taking aminoglycosides
ototoxicity
173
Examples of aminoglycosides
gentamycin
174
Uses of carbapenems
- hospital acquired pneumonia
- meningitis
- pyelonephritis
175
Contraindications/warnings of carbapenems
- seizure disorder
- steven johnson syndrome
- renal impairment
176
Examples of carbapenems
ertapenem
177
Uses of amebicides, antiprotozoal and nitroimidazole
gynecologic infections: bacterial vaginosis, trichomoniasis including treatment of asymptomatic partners
178
What should not be used with Amebicide, Antiprotozoal, and Nitroimidazole?
- use of alcohol or propylene glycol containing products during or within 3 days of therapy discontinuation
179
Example of Amebicide, Antiprotozoal, and Nitroimidazole
- metronidazole
180
Lincosamide Is considered bacteriostatic but is bactericidal against what?
- some strains of staphylococci
- streptococci
- anaerobes such as Bacteroides fragilis
181
Examples of lincosamide
clindamycin
182
How do antivirals work?
| How many infections do they work against?
- inhibit viral replication
| - have limited use because they are effective against small number of specific vital infections
183
What viruses do antivirals treat?
- herpes
- HIV
- influenza
- Hep C
184
Examples of antivirals
- acyclovir
- valacyclovir
- oseltamivir
185
Antifungals may be what 2 things?
- may be fungicidal or fungistatic
186
What tests must you perform while using antivirals?
periodic liver function tests
187
Absorption of ketoconazole is impaired when drug is taken with what?
- histamine antagonist
| - antacids
188
Examples of antifungals
- clotrimazole
- tolnaftate
- ketoconazole
- terbinafine
189
What do muscle relaxers do?
- relieve acute painful MSK conditions attributed to sedative effect
190
How does cyclobenzaprine reduce muscle spasms?
effects on muscle tone
191
What is the exact mode of diazepam in terms of MSK conditions?
- unknown but does have sedative effects
192
Examples of muscle relaxers
- cyclobenzaprine
- methocarbamol
- diazepam
- baclofen
193
Action of corticosteroids
- anti-inflammatory action
194
What disorders can corticosteroids help with?
- auto immune disorders
195
What happens if you stop corticosteroids abruptly
- could be potentially life threatening as administration shuts off pituitary release of hormones
196
Examples of corticosteroids
- hydrocortisone
- prednisone
- dexamethasone
197
Action of antimigraine
acts on intracranial blood vessels and trigeminal system; causes vasoconstriction and reduces neurogenic inflammation
198
What conditions should be considered when giving anti migraines?
- arrhythmias
| - Wolff-Parkinson-White disease
199
examples of antimigraine
sumatriptan
200
Action of scabicide
- paralysis and death of pests
201
Examples of scabicide
permethrin
202
Where should you not use topical steroids?
face, groin or axilla
203
What growths are keratolytics used for?
- epidermis growths such as warts
204
Contraindications keratolytic
- warts with hair
- genital or facial warts
- mucous membrane
- infected skin
205
examples of keratolytic
- podofilox
| - salicylic acid
206
Types of Nicotine replacement therapy
- patch
- gum
- inhaler
- nasal spray
- lozenge
