8.4 Pharmacological Profiles

Question 1

Sedatives and Hypnotics

Answer 1

dose-dependent depression of the CNS
barbiturates, benzodiazepine, melatonin agonists
anti convulsive properties, depress the sensory cortex, decrease motor activity
used as a sedative
abuse potential

Question 2

Antianxiety Drugs

Answer 2

benzodiazepines (short term only)
Non-benzodiazepines 
generalized CNS depression 
physical and psychological dependence 
act on brain's dopamine and serotonin receptors 
never discontinue abruptly

Question 3

Examples of Antianxiety

Answer 3

alprazolam : Xanax

diazepam: Valium
lorazepam: Ativan

Question 4

Antidepressants

Answer 4

Tricyclic Antidepressants (TCAs)
Monoamine Oxidase Inhibitors (MAOI)
Selective Serotonin Reuptake Inhibitors (SSRI)
Serotonin-norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin Reuptake Inhibitor/ Antagonist
Dopamine/Norepinephrine-Reuptake Inhibitor

Question 5

Actions of antidepressants

Answer 5

TCAs: increase levels of norepinephrine and serotonin by inhibiting their reuptake
MAOI: inhibits monoamine oxidase resulting in increased endogenous neuro-hormones
SSRI: increase serotonin by inhibiting neuronal uptake to CNS.

Question 6

Adverse effects of antidepressants

Answer 6

TCAs: dry mouth, blurred vision, hypotension
MAOI: food interactions, med interactions, vertigo, nausea, constipation
SSRI: nausea, vomiting, sexual dysfunction, insomnia, weight gain

Question 7

Contraindications of Antidepressants

Answer 7

TCAs: cannot take within 14 days of MAOIs
MAOI: can cause serotonin syndrome, CVA disease, hypertension, CHF, and elderly. many meds interactions
SSRI: fluoxetine is less effective in patients who smoke

Question 8

Examples of antidepressants

Answer 8

MAOI: Nardil 
SRIA: trazodone 
SNRI: venlafaxine, duloxetine
DNRI: Buproprion (Wellbutrin) 
SSRI:
Citalopram : celexa 
fluoxetine : prozac
sertraline : zoloft 
paroxentine : paxil

Question 9

Antipsychotic drugs

Answer 9

block dopamine receptors in the brain
tx of acute and chronic psychoses
chlorpromazine is used for intractable hiccups

Question 10

Examples of Antipsychotics

Answer 10

Haloperidol : Haldol (1st gen)
Prochlorperazine : Compazine (1st gen)
Quetiapine : Seroquel (2nd gen)
Olanzapine : Zyprexa (2nd gen)

Question 11

CNS Stimulants

Answer 11

Amphetamines and Anorexiants

CNS stimulation by increasing levels of neurotransmitter in CNS

Question 12

Examples of CNS Stimulants

Answer 12

amphetamines
methylphenidate : concerta
dextroamphetamine : adderall

anorexiants
phentermine : ionamin

Question 13

Anticonvulsants

Answer 13

reduction of excitability of the neurons of the brain
it is not uncommon for pts to require more than one anticonvulsant
Steven Johnson (emergency) - skin rash, exfoliative and bullous
Pregnancy cat D

Question 14

Examples of anticonvulsants

Answer 14

diazepam : valium 
lorazepam : ativan
midazolam : versed 
clonazepam : klonopin 
phenytoin : dilatin 
ethosuximide : zarontin 
valproic acid : depakote

Question 15

anti-emetics

Answer 15

phenothiazines act on the chemoreceptor trigger zone to inhibit nausea and vomiting
ondansetron blocks serotonin at 5-HT3 receptor sites
depressing sensitivity of the vestibular apparatus in the inner ear

Question 16

Examples of anti-emetics

Answer 16

phenothiazines
-prochlorperazine : compazine
- chlorpromazine : thorazine 
metoclopramide : reglan 
ondansetron : zofran
prochlorperazine : compazine 
promethazine : phenergan

Question 17

examples of antivertigo

Answer 17

meclizine : antivert
diphenhydramine : benadryl
benzodiazepines : ativan, valium

Question 18

action of anesthetic

Answer 18

removes feeling or sensation

analgesic alleviates or relieves the pain from a patient

Question 19

action of local anesthetics

Answer 19

inhibiting transport of ions across neuronal membranes thereby preventing initiation and conduction of normal nerve impulses

Question 20

ketamine actions

Answer 20

general anesthetic

dissociated from the surrounding

Question 21

adverse reaction to ketamine

Answer 21

ischemic heart disease, sympathomimetic effects

Question 22

doses of ketamine

Answer 22

10-20mg IV

20-40mg IM

Question 23

examples of anesthetics

Answer 23

lidocaine
bupivacaine 
ketamine 
propofol
etomidate

Question 24

classes of analgesics

Answer 24

salicylate
non salicylate
nonsteroidal anti-inflammatory drugs
urinary analgesics

Question 25

salicylates

Answer 25

action - inhibition of prostaglandins use - mild to moderate pain/ reduce body temp / prevention of blood clots adverse - gastric upset, GI bleeds, reyes syndrome examples - aspirin

Question 26

non-salicylate

Answer 26

action - analgesic & antipyretic use - mild to moderate px, reduce body temp, arthritis examples - acetaminophen benzocaine-menthol

Question 27

nonsteroidal anti-inflammatory drugs

Answer 27

action - inhibit the action of the enzyme cyclooxygenase (COX 1 - non selective, COX 2 selective) use - arthritis, pain, fever reduction, dysmenorrhea AE - GI bleeds contraindications - COX 2 allergy to sulfonamides / ibuprofen GI bleeds, hypertension, peptic ulcer examples - ketorolac, celecoxib meloxicam

Question 28

narcotic analgesics

Answer 28

action - opioids bind to opiate receptors in the CNS, alterations to perception of and response to pain contraindications - increased ICP, hypoxia, hepatic impairment examples - codeine, fentanyl, methadone, morphine sulfate, oxycodone, hydrocodone

Question 29

narcotic antagonist

Answer 29

action - competitive antagonists that bind to the opioid receptors example - naloxone (Narcan)

Question 30

antihistamine actions

Answer 30

H1 - antihistamines work by binding to histamine H1 receptors in mast cells, smooth muscles and endothelium they suppress the histamine induced wheal response(swelling) and flare response (vasodilation)

Question 31

uses of H1 antihistamines

Answer 31

allergic reactions, motion sickness and vertigo

Question 32

1st generation antihistamines

Answer 32

diphenhydramine hydroxyzine promethazine

Question 33

2nd generation antihistamines

Answer 33

cetirizine HCL fexofenadine loratadine

Question 34

Decongestants do what?

Answer 34

reduce swelling of nasal passages | enhance drainage of sinuses

Question 35

action of decongestants

Answer 35

enhancing norepinephrine and epinephrine

Question 36

examples of decongestants

Answer 36

oxymetazoline HCL pseudoephedrine phenylephrine

Question 37

beta 2 agonists

Answer 37

increase the levels of endogenous catec