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Flashcards in CNS review Deck (319):
1

3 1st generation AEDs that are enzyme inducers

Phenytoin, Phenobarbital and Carbamazepine

2

MOA of oxcarbazepine

Stabilizes inactivated Na channels

3

The major inhibitory transmitter in the brain

GABA

4

Treatment options for status epilepticcus `

IV benzodiazepine, phenytoin or phenobarbital

5

The major excitatory neurotransmitter in the brain

Glutamate

6

What is special about the metabolism of phenytoin

saturable metabolism

7

What is special about the metabolism of carbamazepine

autoinduction

8

Type of receptor that GABA-A receptor is

inotropic Cl channel

9

Major toxicities of phenytoin

nystagmus, ataxia, gingival hyperplasia, osteomalacia

10

Amount of oxcarbazepine that can induce OC metabolism

>1200 mg/day

11

Toxicities of oxcarbazepine

dizziness, diplopia, ataxia, hyponatremia

12

toxicity with lacosamide

diplopia, HA, dizziness, nausea

13

The most studied AED in pregnancy

Lamotrigine

14

MOA of carbamazepine

Stabilizes inactivated Na Channels

15

AED that was recently moved to pregnancy category D due to risk of low birth weights

topiramate

16

Amount of topiramate that induces OC metabolism

>200 mg/day

17

Toxicities with lamotrigine

sedation, diplopia, ataxia, nausea, rash

18

Toxicities associated with topiramate

difficulty concentrating, kidney stones, weight loss

19

MOA of zonisamide

Stabilizes inactivated Na channels and acts on Ca channels

20

Toxicities associated with zonisamide

somnolence, dizziness, kidney stones, weight lossq

21

MOA of rufinamide

Stabilizes inactivated Na channels

22

MOA of phenobarbital

GABA-A agonist

23

Toxicities with phenobarbital

sedation, paradoxical hyperactivity, osteomalacia

24

Seizure that involves brief episodes of staring, unable to respond

absence/ patit mal

25

Black box warning for vigabatrin

irreversible visual field loss

26

MOA of vigabatrin

Irreversible inhibitor of GABA transaminase

27

SSRI that has potential for QTc prolongation

Citalipram

28

MOA of ethosuximide

Inhibits T-type Ca channels

29

Drug of choice for absence seizures

ethosuximide

30

MOA of tiagabine

decreases GABA reuptake into neurons and glial cells

31

MOA of valproic acid

Inhibits T-type Ca channels, weak effect of Na channels and increases GABA activity

32

1st generation AED that is an enzyme inhibitor

valproic acid

33

Type of receptor that GABA-B is

metaboltropic

34

Toxicities associated with gabapentin

fatigue, ataxia, dizziness

35

Major toxicities of carbamazepine

diplopia, dizziness, leukopenia, osteomalacia

36

MOA of pregabalin

Binds to alpha2-delta site of Ca channels

37

Toxicities associated with pregabalin

dizziness, ataxia, weight gain

38

MOA of levetiracitam

Binds to synaptic vesicle protein (SV2A)

39

Toxicities associated with ezogabine

dizziness, fatigue, diplopia, ataxia, urinary retention

40

What is notable about gabapentins metabolism

saturable absorption

41

QIDS score that indicates very severe depression

>20

42

MOA of ezogabine

potassium channel stabilizer

43

MOA of phenytoin

Stabilizes inactivated Na channels

44

MOA of perampanel

noncompetitive AMPA receptor antagonist

45

Black box warning with parampanel

suicidality and homocidality

46

MOA of topiramate

Stabilizes inactivated Na channels, GABA agonist and glutamate antagoinist

47

SSRI that is pregnancy category D

Paroxetine

48

Black box warning with ezogabine

bluish discoloration of the skin and ocular toxicity

49

QIDS score that indicates severe depression

16-20

50

Issue with felbamate that limits its use

hepatotoxicity

51

Seizure in 1 hemisphere in which consciousness is not impaired

Simple partial seizure

52

MOA of ketamine

NMDA antagonist

53

QIDS score that indicates mild depression

6-10

54

SSRI that has the highest rate of diarrhea

Sertraline

55

Location where norepinephrine is synthesized

locus ceruleus

56

Presynaptic NE autoreceptor that is important in feedback inhibition

Alpha2

57

The hormonal influence on seizures in women who are menstrating

Catamenial influence

58

Seizure in 1 hemisphere in which consciousness and memory are impaired

Complex partial seizure

58

Precursor for NE

Tyrosine

59

Precursor for serotonin

tryptophan

60

Length of an untreated major depressive episode

>6 months

61

Length of a typical treated major depressive episode

4-5 months

62

toxicities associated with valproic acid

weight gain, hair loss, tremor, thrombocytopenia

63

QIDS16 score that indicates remission

64

A diminished interest in activities

anhedonia

65

2nd line antidepressant pharmacotherapy options

TCAs, trazadone, nefazadone

66

QIDS score that indicates normal

0-5

67

QIDS score that indicates moderate depression

11-15

68

QIDS16 score that indicates a response

6-8

69

Return of symptoms meeting full criteria within 6-12 months of full and sustained remission from the index episode

Relapse

70

1st line options for antidepressant pharmacotherapy

SSRIs, SNRIs, buproprion, mirtazepine

71

Occurrence of a new episode following 6-12 months of full and sustained remission from the index episode

Reoccurance

72

3rd line antidepressant pharmacotherapy options

MAOIs

73

MOA of lacosamide

Stabilized inactivated Na channels

74

MOA of lamotrigine

Stabilizes inactivated Na channels and decreases glutamate release

75

SSRI with highest rate of sexual dysfunction

Paroxetine

76

Toxicities associated with levetiracitam

somnolence, dizziness, behavioral changes

77

5 most common residual symptoms of depression

insomnia, fatigue, pain, difficulty concentrating, lack of interest

78

MOA of Gabapentin

Binds to alpha2-delta site of Ca channels, decreasing neurotransmitter release

79

4 most common triggers of seizures

lack of sleep, stress, acute infections, missed medications

80

MOA of vilazodone

SSRI and partial 5HT1A receptor agonist

81

MOA of trazadone

weak SSRI and 5HT2A and 5HR2C antagonist

82

Black box warning for nefazodone

rare hepatic failure

83

Non-selective serotonin antagonist that is used to treat serotonin syndrome

Cyproheptidine

84

MOA of buproprion

Inhibits DA and NE reuptake

85

MOA of mirtazapine

alpha2-adrenergic antagonist, 5HT2A and 5HT3 antagonist and H1 antagonist

86

5 tertiary amine TCAs

amitriptyline, trimipramine, imipramine, clomipramine, doxepin

87

3 secondary amine TCAs

desipramine, nortriptyline, protriptyline

88

5 patient populations to use caution when using TCAs

1. underlying CV disease (QT prolongation)
2. seizures
3. glaucoma
4. urinary retention
5. elderly

89

3 major groups of SEs with TCAs (tertiary > secondary amines)

1. anticholinergic SEs
2. orthostatic hypotension
3. sedation

90

Antagonist of what receptor leads to orthostatic hypotension

alpha adrenergic receptor

91

3 non-selective MAO-A and MAO-B irreversible inhibitors

phenelzine,, tranylcypromine, isocarboxazid

92

A selective MAO-A irreversible inhibitor

Selegiline

93

Dietary restriction associated with MAO-Is

tyramine containing foods

94

Drug used to treat hypertensive crisis created by food or drug interactions with MAO-Is

phentolamine

95

4 major groups of SEs associated with MAO-Is

1. orthostatic hypotension
2. CNS stimulation (anxiety, insomnia)
3. weight gain
4. sexual dysfunction

96

Wash out period needed when switching from MAO-I to another antidepressant or vice versa

2 weeks

97

Length of time to see effect in GAD

2-4 weeks until effect, 4-6 weeks until max effect

98

Wash out period needed when switching between fluoxitine and another antidepressant

5 weeks

99

A transcription factor, whose levels are increased by antidepressants that leads to an increase in the neuronal growth factor BDNF

CREB

100

Area of the brain that processes threatening or taumatic stimuli

Hippocamous

101

1st line pharmacologic treatments in anxiety disorder

SSRIs and SNRIs

102

MOA of buspirone

5HT1A receptor partial agonist

103

Difference in dose of SRIs between treatment of depression and anxiety

use 1/2 the starting dose in anxiety

104

GABA-A receptor subunits that are required for BZD binding

alpha and beta

105

GABA-A receptor subunits that are required for GABA binding

alpha and gamma

106

3 preferred BZDs in liver disease

Lorazepam, oxazaepam and temazepam

107

Length of time of excessive anxiety/worry to qualify as generalized anxiety disorder

>6 months

108

GAD-7 Score that qualifies as mild GAD

5-9

109

GAD-7 score that qualifies as moderate GAD

10-14

110

Transtheoretical model for change phase that a patient is i when they are ready to quit within the next 30 days

Preparation

110

Transtheoretical model for change phase that a patient is i when they are ready to quit within the next 30 days

Preparation

111

GAD-7 score that qualifies as severe GAD

>15

112

Minimum length of treatment for GAD

12 months

113

Length of time of persistent worry about another panic attack to qualift as panic disorder

1 month

114

SSRI that is 2nd line for panic disorder

citalipram

115

Treatments that are NOT effective for panic disorder

propanolol, buspirone, antihistamines, antipsychotis

116

Time it takes to see max effect during treatment of manic disorder

6-12 weeks

117

Length of treatment for panic disorder

12-24 months

118

Length of fear of social situation to qualify as social anxiety disorder

>6 months

119

Treatment options for performance only SAD

propranolol, atenolol

120

Treatments that are not effective for general SAD

TCAs, buspirone monotherapy, atenolol

121

Length of medication trial in SAD

8-12 weeks

122

Length of treatment for SAD

usually long-term

123

Therapies that are not effective in PTSD

buspirone, buproprion, desimpramine

124

Time until treatment effect is seen in PTSD

8-12 weeks

125

Length of therapy in PTSD

Minimum 12 months after response

126

1st line options for OCD

SSRIs, clmipramine

127

Length of delay in treatment effect in OCD

10-12 weeks

128

Length of treatment for OCD

1-2 years, usually lifelong

129

3 best options for treating anxiety in pregnancy

citalopram, fluoxetine, sertraline

130

BZD to use if absolutely necessary in pregnancy

clonazepam and lorezapam

131

Timing of bright light therapy for advanced sleep phase sleeping disorder

PM

132

Timing of bright light therapy for advanced sleep phase sleeping disorder

PM

134

Transthoretical model for change that a patient is in when they are thinking about quitting in the next 6 months

Contemplation

135

BZD antagonist that can reverse effects in overdose

flumazenil

136

SSRI that has been shown to be safetly used post-MI

Sertraline

137

GABA receptor subtype that Z-hypnotics preferentially bind to that creates sedative effects but no anxiolytic effects

Alpha-1

138

Area of the hypothalamus that controls circadian rhythm

suprahiasmatic nucleus

139

Where melatonin is synthesized

pineal gland

140

AA precursor of melatonin

tryptophan

141

MOA of ramelteon

M1 and M2 melatonin receptor agonist

142

Timing of melatonin therapy in advanced sleep phase disorder

dawn

143

Transtheoretical model of change stage that a patient is in when they are not yet ready to quit

Pre-contemplation

144

Location of the hypothalamus where histamine is produced

tuberomemmillary nucleus

145

Transthoretical model for change that a patient is in when they are thinking about quitting in the next 6 months

Contemplation

146

Inhibitory dopamine receptors

Type2 (D2, D3 and D4)

147

Hoehn and Yahr Parkinson's stage when motor dysfunction is bilateral with postural abnormalities

Stage IV

148

BZD antagonist that can reverse effects in overdose

flumazenil

149

TCA that is FDA approved for insomnia characterized by sleep maintenance issues

doxepin (silenor)

150

MOA of suvorexant

Orexin receptor (OX1 and OX2) antagonist

151

Transtheoretical model for change that patients are in when they are 6 or more months after their quit date and are now considered a former user

Maintenance

152

Peptide neurotransmitters implicated in wakefulness that are lost in patients with narcolepsy

Orexins A and B

153

FDA approved medications for sleep onset

BZDs
Z-hypnotics
Remelteon

154

Max trial of antidepressants that should be tried with no response

9 weeks

155

FDA approved medications for sleep maintenance

BZDs
Z-hypnotics
Silenor

156

3 sleep medications/classes that should not be taken with high fat meals due to decreased absorption

z-hypnotics
ramelteon
silenor

156

The best established pathway for reinforcement

dopaminergic projection from the ventral tagmental are (VTA) to the nucleus accumbens

157

Preferred class of sleep drugs in the elderly

Z-hypnotics

160

MOA of tolcapone

COMT inhibitor in the periphery and CNS

161

Transtheoretical model of change phase that patients are in when they are actively trying to quit and are still within 6 months of their quit date

Action

162

GABA receptor subtype that Z-hypnotics preferentially bind to that creates sedative effects but no anxiolytic effects

Alpha-1

163

5 A's for clinicians when dealing with substance abuse

Ask
Advise
Assess
Assist
Arrange

164

1st line therapy for alcohol withdraw

BZDs

165

4 vitamins given to patients with alcohol withdraw

Thiamine (B1)
Folic Acid
Phosphate
Magnesium

166

The only 2 treatments that were found to be effective for alcohol dependance

Acamprosate
Naltrexone

167

MOA of disulfiram in treatment of alcohol dependance

increases acetyl aldehyde, creating a terrible rxn when patients drink

168

Hoehn and Yahr Parkinson's stage when motor dysfunction is bilateral but there are no postural abnormalities

Stage II

169

Initial symptoms that anticholinergics help to treat in Parkinson's disease

tremor and rigidity

170

Hoehn and Yahr Parkinson's stage when the disease is fully developed and the patient is bed or chair bound

Stage V

171

Treatment for the physical symptoms of cocaine intoxicatoin

phentoamine

172

Ferritin level that worents ferrous sulfate supplementation in RLS

173

1st line sleep therapy in children

Non-drug therapy

174

MAO of pramiprexole

D2 and D3 agonist

175

Area of the brain in which DA is too high, creating the positive symptoms in schizophrenia

mesolimbic pathway

176

MOA of naltrexone

opioid receptor antagonist

177

Timing of bright light therapy in delayed sleep phase type sleep disorder

30-60 min in the AM

178

MOA of phentolamine

alpha-1 blocker

179

1st line treatment for Parkinson's disease for a patient

Amantadine and MAO-B-Is

180

MOA of naloxone

mu-receptor antagonist

181

Hoehn and Yahr Parkinson's stage when motor dysfunction is unilateral

Stage I

182

MOA of carbidopa

peripheral dopa decarboxylase inhibitor

183

Location in the brain where dopamine is synthesized

substantia nigra

184

MOA of entacapone

COMT inhibitor in the periphery

185

High potency FGAs

Trifluoperazine, Fluphenazine, Haloperidol

186

2 anticholinergic medications that can be used to treat Parkinson's disease

trihexyphenidyl
benztropine

187

2 MAO-B inhibitors used to treat Parkinson's disease

Selegilline
Rasagiline

188

MAO of bromocriptine

D2 agonist and mild D3 antagonist

189

MAO of Ropinerole

D2 and D3 agonist

190

2 DA agonist used to treat Parkinson's Disease that may cause peripheral edema

amantadine
pramiprexole

191

MOA of apomorphine

D2 and D3 agonist and D4 antagonist

192

1st line treatment for Parkinson's disease for a patient

Dopamine agonist

193

MOA of all SGAs and FGAs

D2 receptor antagonists

194

1st line treatment for Parkinson's disease in a patient that has some cognitive impairment

Carbidopa/levodopa

195

Inability to sit still

choreiform

196

1st line treatment for Parkinson's disease for a patient

Anticholinergics or MAO-B-I

197

2 antipsychotics that have been studied in Parkinson's disease

Clozapine and quetiapine

198

MOA of caffeine

Adenosine A1 and A2 receptor antagonist

199

Low potency FGAs

Chlorpromazine, Thioridazine

200

MOA of guanfacine and clonidine

alpha-2 adrenergic agonists

201

Area of the hypothalamus that controls circadian rhythm

suprahiasmatic nucleus

202

Area of the brain in which DA is too low, creating the negative symptoms in schizophrenia

Mesocortical pathway

203

Schizophrenia + bipolar disorder

Schizoaffective disorder

204

2 TCAs that are preferred in the treatment of ADHD with depression

Imipramine and desipramine

205

Medium potency FGAs

Loxapine, Perphenazine, Thiothixene

206

Low potency SGAs

Clozapine, Quetiapine

207

High potency SGAs

Risperidone, Paliperidone

208

Receptor that SGAs block that gives them additional efficacy on negative symptoms

5HT2A

209

SGA that has the highest risk of akathisia (inner restlessness)

Aripiprazole

210

Antagonism of what receptor by antipsychotics causes anticholinergic SEs

M1

211

Antagonism of this receptor leads to sedation created by antipsychotics

H1

212

Antagonism of this receptor leads to hypotension created by antipsychotics

alpha-1

213

Antipsychotics that have the highest risk of DIMD

high potency, slow dissociation (FGAs)

214

Antipsychotics that have the highest risk of anticholinergic SEs and sedation

low potency

215

Antipsychotics that have the highest risk of hypotension

low potency and Iloperidone

216

Antipsychotics with the highest risk of hyperprolactinemia

FGAs, risperidone and paliperidone

217

Antagonism of this receptor leads to weight gain associated with antipsychotics

H1

218

Antagonism of these 3 receptors is associated with lipid and glucose changes associated with antipsychotics

H1, M3, 5HT2C

219

SGAs that have the highest risk of metabolic issues

clozapine and olanzapine

220

SGAs that have the lowest risk of metabolic issues

ziprasidone, lurasidone, aripiprazole

221

Antipsychotics that have the highest risk of neuroleptic malignant syndrome

high potency

222

3 antipsychotics that are the most important not to abruptly discontinue

clozapine, quetiapine, iloperidone

223

Antipsychotic that has the highest risk of QT prolongation

Thioridizone

224

Antipsychotic that has the highest risk of seizures

clozapine

225

Antipsychotic that has the lowest seizure risk

quetiapine

226

Special dietary restriction with asenapine

no food or drink within 10-15 min

227

Dietary restriction with ziprasidone

must take with > 500 cal

228

Dietary restriction with lurasidone

must take with >300 cal

229

Antipsychotic medications that are both anti-manic and anti-depressive

quetiapine
lorasidone
olanzepine + fluoxitine

230

Order of increasing risk of mood switching for antidepressants used in bipolar disorder

bupropriod

231

AEDs used to treat bipolar disorder that are mainly anti-manic with slight anti-depressive effects

valproic acid
carbamazepine
oxcarbazepine

232

AED that is used in bipolar disorder that has mainly antidepressive effects

Lamotrigine

233

Treatment that tends to be the most effective for classic euphoric mania

Lithium

234

Treatment that tends to be the most effective for dysphoric mania

AEDs

235

What qualifies a HA as chronic

Occurs more days in a month than not

236

Best acute treatment for a cluster HA

100% O2 inhalation

237

Best treatment for an ice-pick HA (stabbing pain for a short period of time)

Indomethacin

238

Drug of choice for prophylactic treatment of tension type HAs

amitriptylline

239

MOA of triptans

5HT1B/1D receptor agonists

240

5 medications that are FDA approved for prophylaxis of migraines

valproic acid
topiramate
propranolol
timolol
anabotulinum toxin A

241

SGA that is a D2 receptor partial agonist

Aripiprazole

242

Classification when schizophrenia symptoms have lasted less than 6 months

Schizophreniform disorder

243

Antipsychotic that has superior efficacy in treating positive symptoms

Clozapine

244

Issue with tolcapone that limits its use

Increases risk of hepatic failure

245

Where melatonin is synthesized

pineal gland

246

AA precursor of melatonin

tryptophan

247

Excitatory dopamine receptors

Type 1 (D1 and D5)

248

Hoehn and Yahr Parkinson's stage when movement dysfunction is bilateral and there are mild postural abnormalities

Stage III

249

MOA of ramelteon

M1 and M2 melatonin receptor agonist

250

Timing of melatonin therapy in delayed sleep phase sleep disorder

At dusk, about 5 hours before bedtime

251

Timing of melatonin therapy in advanced sleep phase disorder

dawn

252

Transtheoretical model of change stage that a patient is in when they are not yet ready to quit

Pre-contemplation

253

Location of the hypothalamus where histamine is produced

tuberomemmillary nucleus

256

TCA that is FDA approved for insomnia characterized by sleep maintenance issues

doxepin (silenor)

257

MOA of rotigotine transdermal patch

D1, D2 and D3 agonist

258

MOA of suvorexant

Orexin receptor (OX1 and OX2) antagonist

259

Transtheoretical model for change that patients are in when they are 6 or more months after their quit date and are now considered a former user

Maintenance

260

FDA approved medications for sleep maintenance

BZDs
Z-hypnotics
Silenor

261

Preferred class of sleep drugs in the elderly

Z-hypnotics

262

Peptide neurotransmitters implicated in wakefulness that are lost in patients with narcolepsy

Orexins A and B

263

3 sleep medications/classes that should not be taken with high fat meals due to decreased absorption

z-hypnotics
ramelteon
silenor

264

Transtheoretical model of change phase that patients are in when they are actively trying to quit and are still within 6 months of their quit date

Action

265

5 A's for clinicians when dealing with substance abuse

Ask
Advise
Assess
Assist
Arrange

266

1st line sleep therapy in children

Non-drug therapy

267

The best established pathway for reinforcement

dopaminergic projection from the ventral tagmental are (VTA) to the nucleus accumbens

268

Timing of bright light therapy in delayed sleep phase type sleep disorder

30-60 min in the AM

269

Timing of melatonin therapy in delayed sleep phase sleep disorder

At dusk, about 5 hours before bedtime

270

FDA approved medications for sleep onset

BZDs
Z-hypnotics
Remelteon

272

Effect mediated by the mu opioid receptor

analgesia, sedation, inhibition of respiration and slowed GI transit

273

Effects mediated by the kappa opioid receptor

analgesia, dysphoria, slowed GI transit

273

G alpha receptor type for opioid receptors

Gi

274

MOA of morphine

mu-opioid receptor agonist

275

Inactive metabolite of morphine that has neuroexcitatory properties

morphine-3-glucuronide

276

Active metabolite of morphine that is more potent than the parent

Morphine-6-glucuronide

277

MOA of methadone

Mu and delta opioid receptor agonist, NMDA receptor antagonist, SNRI

277

MOA of fentanyl

mu-opioid receptor agonist

278

MOA of oxycodone

mu-opioid receptor agonist and kappa agonist

279

MOA of hydrocodone

mu-opioid receptor agonist

280

MOA of codeine

mu-opioid receptor agonist

281

MOA of tramadol

5HT/NE reuptake inhibitor and metabolite is a weak mu-opioid agonist

282

MOA of pentazocaine

partial mu-agonist and k-agonist

283

MOA of butorphanol

partial mu-agonist and kappa-agonist

284

MOA of nalbuphine

mu antagonist and kappa agonist

285

MOA of buphenorphine

partial mu agonist and possible k antagonist

286

The primary agent use for opioid overdose

naloxone

287

Effects mediated by the delta opioid receptor

analgesia

296

MOA of methylnaltrexone

peripherally acting mu-opioid receptor antagonist

297

FDA approved indication for methylnaltrexone

refractory opioid-induced constipation in patients with advanced illness receiving palliative care

298

2 effects of opioids that patients do not gain tolerance to

GI effects and pupillary constriction

299

MOA of aspirin

irreversible inhibition of COX via acetylation

300

Intrathercal spinal infusion of cone snail venom that is reserved for severe neuropathic pain and blocks presynaptic N-type Ca channels

Zoconitide

301

MOA of epinephrine that makes it useful when combined with local anesthetics

vasoconstrictor

302

Main MOA of local anesthetics

Block Na channel function

303

Alkaloid derived from plants of Solanaceae that activates TRPVI receptor of C fiber sensory neurons and then desensitizes it, depleting Substance P

Capsaicin

304

Normal processing of a stimulus

nociceptive

305

nociceptive pain due to damage to bone, muscle, ligament or skin

somatic

306

nociceptive pain due to damage to solid or hollow organs (liver, heart, spleen, kidney, GI tract)

Visceral

307

Abnormal processing on pain stimuli

neuropathic

308

Only FDA indication of lidocaine patches

Post herpetic neuralgia

309

The drug of choice for trigeminal neuralgia

Carbamazepine

310

MOA of ketamine, used for neuropathic pain

NMDA receptor antagonist

311

Opioid that is the most effective in neuropathic pain

methadone

312

4 1st line agents for neuropathic pain

TCAs
Gabapentin/pregabalin
lidocaine patch
SNRIs

313

NSAID that has the lowest CV risk

naproxen

314

Most common therapy given to patients experiencing opioid-inducted constipation

Senna + docusate

315

Opioid with the worst nausea SE

Codeine

316

2 Opioids that it is most common to have a true allergy to

codeine + morphine

317

2 drugs that are the most common options to switch to if a patient has a true allergy to morphine

fentanyl or methadone

318

Dose of naloxone that should be given to a patient with a respiratory rate of

0.04 mg (diluted) IVP over 15 sec q1-3min

319

Dose of naloxone that should be given to a patient in respiratory arrest

0.4-2 mg

320

Opioid that should specifically be avoided in renal disease

Morphine

321

4 pain medications that can contribute to serotonin toxicity

fentanyl, methadone, meperidine, tramadol

322

MOA of tapntadol

weak mu agonist and NE reuptake inhibitor

323

Active metabolite of hydrocodone

hydromorphone

324

MOA of meperidone

strong mu agonist and NMDA agonist

325

Neurotoxic metabolite of hydromorphone

H3G

326

Non-active, non--toxic CYP3A4 metabolite of oxycodone

noroxycodone

327

Active CYP2D6 metabolite of oxycodone

oxymorphone

328

Cut off for non-opioid naive patients

>60mg/day MEQ for past 7 days