deck_771610 Flashcards
(129 cards)
2
Q
Side Effects of Chemotherapy
A
Hair LossGI Tract: nausea and vommittingSusceptibility to infection, hemorrhage, anemia (suppresses bone marrow)liver or kidney damage
3
Q
Chemotherapy: Alkylating Agents
A
Cell cycle non-specific drugs: Transfer alkyl groups to cellular constituents especially DNA, crosslink the paired DNA strands. Alkylated or strand crosslinked DNA cannot undergo replication.
4
Q
Cyclophosphamide
A
Alkylating agent: must be metabolically activated in liver
5
Q
Mechlorethamine
A
Alkylating Agent: Shortest duration- only used by IV injection
6
Q
Chlorambucil
A
Alkylating Agent: Least toxic alkylating agent
7
Q
Carmustine
A
Alkylating Agent: Alkylate RNA (and DNA)- lipid soluble, crosses blood-brain barrier and exerts effects on brain tumors
8
Q
Lomustine
A
Alkylating Agent: Alkylate RNA (and DNA)- lipid soluble, crosses blood-brain barrier and exerts effects on brain tumors
9
Q
Cisplatin
A
Binds to and cross-links DNA (although not alkylating agent); inhibits DNA synthesis, protein synthesis and cell replication.Adverse effect: Renal toxicity- can be prevented by proper hydration
10
Q
Mitomycin
A
Antibiotic; Alkylates DNA and causes DNA strand breakage
11
Q
Uses of alkylating agents
A
Hodgkin’s disease, lymphoma, leukemia; ovarian, breast, testicular CA; head, neck, lung CA; Neuroblastomas, brain tumors
12
Q
Side-effects of Alkylating Agents
A
Inhibition of cell replication in rapidly replicating normal cells (GI, skin, bone marrow)-Nausea, hair loss, bone marrow suppression (tiredness, increase bleed time, increased infection), renal toxicity
13
Q
Chemotherapy: Antimetabolites
A
Cell cycle-specific drug: Synthesis (S) stagesubstitutes normal precursors used by cells to form the A,G, C and T bases; drug binds to and blocks the activity of nucleotide-synthesizing enzymes so that DNA cannot be synthesized
14
Q
Side effects of Antimetabolites
A
Inhibition of cell replication in rapidly replicating normal cells (GI, skin, bone marrow)-Nausea, hair loss, bone marrow suppression (tiredness, increase bleed time, increased infection)
15
Q
6-Mercaptopurine
A
Antimetabolite: Purine Analog (purine antagonist)– substitute for guanine (G) in DNA, produces abnormal DNA, failure of cell replication, failure of normal protein production–> cell death
16
Q
Thioguanine
A
Antimetabolite: Purine Analog (purine antagonist)– substitute for guanine (G) in DNA, produces abnormal DNA, failure of cell replication, failure of normal protein production–> cell death
17
Q
5-Florouracil
A
Antimetabolite: Pyrimidine analog (pyrimidine antagonist); Substitutes for uracil which is precursor for thymidine (T), production of abnormal DNA, failure of cell replication, failure of normal protein production –> Cell Death
18
Q
Cytosine Arabinoside (cytarabine)
A
Antimetabolite: Pyrimidine analog (pyrimidine antagonist); Substitutes for cytosine (C), incorporated into DNA (instead of cytosine), production of abnormal DNA, failure of cell replication, failure of normal protein production –> Cell Death
19
Q
Methotrexate
A
Antimetabolite: Folic Acid analog (Folate antagonist); Inhibitor of dihydrofolate reductase (production of thymidine), inhibits production of thymine from folate, reduced DNA production, failure of cell replication, failure of normal protein production –>cell death
20
Q
uses of antimetabolites
A
brease, colorectal CA, osteosarcoma, leukemias, non-hodgkin’s lymphoma
21
Q
Vinblastin
A
Mitotic Inhibitor; prevent mitosis and cell divisionMech: Binds to tubulin and prevents normal movement of of large molecules and cells within cell (particularly effective in Neurons)- tubulin dysfunction disrupts chromosome separationUses: Hematologic CA (leukemias) and breast CA/other solid tumorsSide Effects: Nausea, hair loss, bone marrow suppression (fatigue, increased bleeding time, infection), NEUROPATHY
22
Q
Vincristine
A
Mitotic Inhibitor; prevent mitosis and cell divisionMech: Binds to tubulin and prevents normal movement of of large molecules and cells within cell (particularly effective in Neurons)- tubulin dysfunction disrupts chromosome separationUses: Hematologic CA (leukemias) and breast CA/other solid tumorsSide Effects: Nausea, hair loss, bone marrow suppression (fatigue, increased bleeding time, infection), NEUROPATHY
23
Q
Paclitaxel
A
Mitotic Inhibitor; prevent mitosis and cell divisionMech: Binds to tubulin and prevents normal movement of of large molecules and cells within cell (particularly effective in Neurons)- tubulin dysfunction disrupts chromosome separationUses: Hematologic CA (leukemias) and breast CA/other solid tumorsSide Effects: Nausea, hair loss, bone marrow suppression (fatigue, increased bleeding time, infection), NEUROPATHY
24
Q
DNA Topoisomerase Inhibitors
A
Inhibit topoisomerase which maintains and replicates DNA; Causes DNA strand breakage
25
Q
Etoposide
A
DNA Topoisomerase Inhibitor: inhibit DNA maintenance and replication (causes DNA strand breakage)Uses: Ovarian, colorectal, testicular, and lung CAAdverse effects: Nausea, hair loss, bone marrow suppression (Fatigue, increase bleed time, infection)
26
Teniposide
DNA Topoisomerase Inhibitor: inhibit DNA maintenance and replication (causes DNA strand breakage)Uses: Ovarian, colorectal, testicular, and lung CAAdverse effects: Nausea, hair loss, bone marrow suppression (Fatigue, increase bleed time, infection)
27
Hormone Receptor Agonists and Antagonists
Some tumor cells express receptors for steroid hormones (esrogens, androgens, and glucocorticoids); One of the functions of these receptors may be to control replication rate; Steroid hormones receptor agonists or antagonists may slow rate of proliferation of cells in a tumor (do not generally cause tumor regression)
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Diethylstilbestrol
Estrogen hormone receptor agonistUses: Prostatic carcinoma, advanced breast CA in postmenopausal womenAdverse effects: hypercalcemia, uterine bleeding, thromboembolic problems
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Ethinyl estradiol
Estrogen hormone receptor agonistUses: Prostatic carcinoma, advanced breast CA in postmenopausal womenAdverse effects: hypercalcemia, uterine bleeding, thromboembolic problems
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Testosterone propionate
Androgen hormone receptor agonistUses: carcinoma of the breastAdverse effects: Virilization, edema, hypercalcemia
31
Fluoxymesterone
Androgen hormone receptor agonistUses: carcinoma of the breastAdverse effects: Virilization, edema, hypercalcemia
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Prednisone
Corticosteroid hormone receptor agonistUses: Leukemia in childrenAdverse effects: GI ulcers, osteoporosis, mental confusion
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Medroxyprogesterone
Progestogen hormone receptor agonist
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Hydroxyprogesterone
Progestogen hormone receptor agonist
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Megestrol
Progestogen hormone receptor agonist
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Tamoxifen
Anti-Estrogen; estrogen hormone receptor antagonistAdverse effects: not a steroid-less toxic
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Flutamide
Anti-Androgen; Androgen hormone receptor antagonist
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Tyrosine Kinase Inhibitors
Target tyrosine kinase- enzyme in normal and tumor cells in multiple signal transduction pathways
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Erlotinib
Tyrosine Kinase inhibitor (inhibits enzyme in multiple signal transduction pathways)
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Imatinib
Tyrosine Kinase inhibitor (inhibits enzyme in multiple signal transduction pathways)
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Monoclonal Antibodies
target specific antigens on cell surfaces characteristic of certain types of CA. Kills CA cell or reduces tumor viability. Usefull against very restricted group of CA.
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Rituximab
Monoclonal Antibody- Non-Hodgkin's lymphoma(target specific antibody of CA cell surface and kills cell)
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Trastuzumab
Monoclonal Antibody- Metastatic Breast CA(target specific antibody of CA cell surface and kills cell)
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Bevacizumab
Monoclonal Antibody- Colon CA(target specific antibody of CA cell surface and kills cell)
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Sulfonamides
Antibacterial: blocks bacterial intermediary metabolismMech: competitive substrate for dihydropteroate synthetase; bacterial PABA metabolism, folic acid production, purine synthesis and DNA synthesis reduced (bacteriostatic except at high concentrations)Spectrum: Broad Spectrum; Gram +Adverse effects: Toxicity- crystalluria (crystals form in kidney tubules and Urinary tract); nausea and vomiting; hemolytic anemia; aplastic anemia; agranulocytosisUses: UTI's, meningococcal and chlamydial infections.
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Sulfisoxazole
Sulfonamide: rapidly absorbed and rapidly excretedShort acting; systemic infections, respiratory tract, CNS, urinary tract
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Sulfamethoxazole
Sulfonamide: slowly absorbedLong acting, GI tract infections
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Sulfacetamide
Sulfonamide: topically absorbed (not systemic)Ophthalmic infection
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Mafenide
Sulfonamide: Topically applied (not systemic)Prevents infections on burned skin
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Trimethoprim
Blocks bacterial intermediary metabolismMech: Suppression of folate reductaseSpectrum: Broad spectrum, Gram +Uses: Primarily in UTI's
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Penicillins
Antibacterial: Target bacterial cell wallMech: bind to penicillin binding proteins (PBP), cause dysfunction of cell wall and rupture of plasma membrane.BactericidalSpectrum: Narrow spectrum, Gram + (streptococci and staphylococci); Gram - relatively resistant (except gonorrhea and syphilis)Absorption: not well absorbed in GI, need suffection oral drug, can be IM or IV injectionRestrictions to usefulness: Anaphylactic shock; dermatitis; GI upsetUses: Pneumonia, Meningitis, Tetanus, Syphilis, Anthrax
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Methicillin
Penicillin Derivative
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Oxacillin
Penicillin Derivative
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Ampicillin
Penicillin Derivative
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Amoxicillin
Penicillin Derivative
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Ticaricillin
Penicillin Derivative
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Clavulanate
Penicillinase inhibitor Amoxicillin + clavulanate
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Sulbactam
Penicillinase inhibitorAmpicillin + sulbactam
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Cephalosporins
Antibacterial: Targets bacterial cell wallsMech: Binds PBP, causes dysfunction of cell wall and ruptures plasma membraneBactericidalSpectrum: Over-used as broad spectrumGram + most sensitive; some effect on gram -Absorption: Poorly absorbed across GI, IV or IM administrationAdverse effects: rashes, anaphylactic shock, bone marrow suppression
60
Cefazolin
1st generation cephalosporingram + activity (minimal gram -)Uses: Anti-bacterial prophylactic prior to surgery
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Cephalexin
1st generation cephalosporingram + activity (minimal gram -)Uses: anti-bacterial prophylactic prior to surgeryNarrow spectrum
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Cefoxitin
2nd generation cephalosporinUses: anti-bacterial prophylactic prior to surgeryNarrow Spectrum
63
Cefotaxamine
3rd generation CephalosporinUses: Meningitis resulting from gram -; gonorrhea; influenza; salmonella; some nosocomial infections
64
Cefepime
4th generation cephalosporinUses: Meningitis resulting from gram -; gonorrhea; influenza; salmonella; some nosocomial infections
65
Vancomycin
Antibacterial: Targets bacterial cell wallMech: inhibits cell wall synthesis by inhibiting peptidoglycan synthesisBacteriostatic (except in dividing bacteria)Spectrum: Narrow spectrum, Gram +Absorption: Poorly absorbed from GI, does not cross blood brain, infused IVUses: Severe infections resistant to methicillin (or for those allergic to penicillin); Effective against staphylococcal infectionsAdverse effects: Skin rashes, anaphylactic shock, ototoxicity (deafness/hearing problems), nephrotoxicity
66
Erythromycin
Antibacterial: Targets bacterial protein synthesisMech: Binds and inhibits 50S ribosomes and inhibit protein synthesisBacteriostaticSpectrum: Broad spectrumAbsorption: Oral, IV or IM useful; excreted by liver into bileUses: alternative to penicillin, legionnaires disease, whooping cough, diphtheria, chlamydial infections, mycoplasma induced pneumoniaToxic effects: GI disturbances, liver injury (cholestatic hepatitis), back up of bile into liver
67
Clindamycin
Antibacterial: inhibits bacterial protein synthesisMech: Binds to and inhibits 50S ribosomes and protein synthesisBacteriostatic Uses: Abdominal /Pelvic infections from various bacteriaSide effects: Sever colitis (usually from superinfection-- C Diff)
68
Tetracyclines
Antibacterial: inhibits protein synthesisMech: Binds to and inhibits 30S ribosomes and protein synthesisSpectrum: Broad spectrumAbsorption: Usually given orally (75% absorbed); Ca, Mg, Al reduce absorptionUses: Used extensively in past; less used nowSide effects: GI upset, liver damage, suprainfection, teeth discoloration, renal damage, ototoxicity
69
Tetracycline
Tetracyclines with short duration of actionMech: Binds to and inhibits 30S ribosomes and protein synthesisSpectrum: Broad spectrumAbsorption: Usually given orally (75% absorbed); Ca, Mg, Al reduce absorptionUses: Used extensively in past; less used nowSide effects: GI upset, liver damage, suprainfection, teeth discoloration, renal damage, ototoxicity
70
Demechlorcycline
Tetracyclines with medium duration of actionMech: Binds to and inhibits 30S ribosomes and protein synthesisSpectrum: Broad spectrumAbsorption: Usually given orally (75% absorbed); Ca, Mg, Al reduce absorptionUses: Used extensively in past; less used nowSide effects: GI upset, liver damage, suprainfection, teeth discoloration, renal damage, ototoxicity
71
Doxycycline
Tetracyclines with long duration of actionMech: Binds to and inhibits 30S ribosomes and protein synthesisSpectrum: Broad spectrumAbsorption: Usually given orally (75% absorbed); Ca, Mg, Al reduce absorptionUses: Used extensively in past; less used nowSide effects: GI upset, liver damage, suprainfection, teeth discoloration, renal damage, ototoxicity
72
Aminoglycocides
Antibacterial: Inhibits protein synthesisMech: Inhibit 30S ribosome, which inhibits protein synthesisBactericidalSpectrum: Broad spectrum; effective against Gram - Absorption: Not well absorbed in GI, administered IVUses: Many against gram -; E. Coli and other enteric bacteria; pseudomonas; tubercle bacillus; reserved for severe infections due to side effectsAdverse effects: Damage to 8th cranial nerve (hearing loss and vestibular disturbances), placental crossing (hearing loss in fetus), renal toxicity, muscle weakness, bacterial resistance
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Streptomycin
Aminoglycoside
74
Neomycin
Aminoglycoside
75
Kanamycin
Aminoglycoside
76
Gentamicin
Aminoglycoside
77
Tobramycin
Aminoglycoside
78
Linezolid
Antibacterial: Inhibits protein synthesisMech: Inhibits 30S ribosome; inhibits protein sythesisBacteriostatic/bactericidalSpectrum: Narrow spectrum; Gram +Adverse effects: undocumented
79
Quinolones
Antibacterial: Target bacterial DNA synthesis and repairBactericidalSpectrum: Broad spectrumAbsorption: fair to good oral Side effects: In neonates/fetus-lead to improper cartilage/bone development; nephrotoxicity; CNS effect (dizzy, light headed, HA, confusion); N/V, diarrhea, abdominal painUses: UTI's, bacterial diarrhea, infections of bone, joints, and soft tissue, Anthrax
80
Benzodiazepines
Mech: Enhance GABAergic neurotransmission in CNS (dose dependent)Activation of benzodiazepine receptor increases affinity of GABA; Increase effect of GABA.Pharmacokinetics: Lipid soluble, absorbed orally, widely distributed, rapid onset, metabolized by liverSide effects: Daytime sedation; confusion, amnesia, and hallucinations, rebound insomnia and anxiety, irritability on withdrawal.
81
GABAergic neurotransmission in CNS
Active sedative, anxiolytic, anti-epileptic, anti-convulsant, hypnotic, general anesthetic, and muscle relaxant
82
Triazolam
Benzodiazepine: Increase action of GABAUses: Relief of insomnia, reduces sleep induction time, decrease # of awakenings, decrease nocturnal awake time
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Temazepam
Benzodiazepine: Increase action of GABAUses: Relief of insomnia, reduces sleep induction time, decrease # of awakenings, decrease nocturnal awake time
84
Diazepam
Benzodiazepine: Increase action of GABAUses: Relief of anxiety (produce some euphoria), epilepsy, muscle spasms, pre-anesthesia, Alcohol detox
85
Chlordiazepoxide
Benzodiazepine: Increase action of GABAUses: Relief of anxiety, Alcohol detox
86
Lorazepam
Benzodiazepine: Increase action of GABAUses: Relief of anxiety, Pre-anesthesia
87
Alprozalam
Benzodiazepine: Increase action of GABAUses: Relief of Anxiety, panic disorders
88
Midazolam
Benzodiazepine: Increase action of GABAUses: Pre-anesthesia, Anesthesia, Alcohol Detox
89
Flumazenil
Benzodiazepine antagonist- reverses toxicity and benzodiazepine-induced anesthesia
90
Barbiturates
GABA receptor modulator: Mech: Enhance effect of GABA, Action: Paradoxical stimulation, sedation, hypnosis, anesthesia, coma, respiratory depression, deathPharmacokinetics: Absorption r/t lipid solubility, liver degrades-kidney excreteSide effects: Tolerance & physical dependence, suppression of REM cycle, liver dysfunction and pathologyUses: Anticonvulsant, antiepileptic (anti-seizure), preanesthetic, anesthetic, insomniaOverdose: sedation-coma-death (treat with artificial respirator and diuretic)
91
Phenobarbital
Barbiturate: GABA receptor modulatorMedium onset, long duration action (12-18 hrs)Uses: antiepileptic
92
Pentobarbital
Barbiturate: GABA receptor modulatorShort onset, short duration action (6-8 hr)Uses: Sedative - hypnotic
93
Thiopental
Barbiturate: GABA receptor modulatorImmediate onset (IV injection), short duration (30 min.)Uses: Anesthetic
94
Zolpidem
GABA receptor modulator: Non Benzodiazepine, non barbiturate hypnotic drug.Mech: Activates benzodiazepine receptor, has all effects of benzodiazepines (sedative, anxiolytic, anti-epileptic, anti-convulsive, hypnotic, anesthetic, muscle relaxant)Short duration of action, less likely [to produce] daytime hangover, tolerance and dependence
95
Zaleplon
GABA receptor modulator: Non Benzodiazepine, non barbiturate hypnotic drug.Mech: Activates benzodiazepine receptor, has all effects of benzodiazepines (sedative, anxiolytic, anti-epileptic, anti-convulsive, hypnotic, anesthetic, muscle relaxant)Short duration of action, less likely [to produce] daytime hangover, tolerance and dependence
96
Eszopicione
GABA receptor modulator: Non Benzodiazepine, non barbiturate hypnotic -Not a benzodiazepine-Mimics benzodiazepine
97
Ramelteon
Hypnotic Agent not affecting GABA receptorsMech: Agonist at melatonin receptors-induces sleep
98
Doxepin
Hypnotic Agent not affecting GABA receptorsMech: Antagonist H1 and H2 histamine receptor-developed and used as antidepressant
99
Buspirone
Anxiolytic Agent not affecting GABA receptorMech: Acts as agonist at specific serotonin receptor-Advantages of cf benzodiazepines-Latency action of 7-10 daysAdverse effects: tachycardia, palpitations, nervousness
100
Inhibitors of NE and 5HT (serotonin) reuptake
Treatment of DepressionMech: Inhibits reuptake of norepinephrine and serotonin-Therapeutic effects delayed (2-4 weeks)- unknown whyTherapeutic Uses: Unipolar Depression (primary); prevent relapse of major depression; depressive phases of bipolar disorder; enuresis (urinary incontinence); chronic pain (aid in control); anxiety; OCD--Therapeutic effects delayed of 1-3 weeks--Used as long term prophylactic for 6mo-1yr before given reduced dose
101
Imipramine
Tricyclic Antidepressant (inhibitor of NE and Serotonin reputake)- Drug of choice for endogenous unipolar depression, chronic neurogenic painSide effects: Major- Weight Gain; minor- sexual dysfunction, dry mouth, blurred vision, constipation, sedation, orthostatic hypotension, cardiac arrhythmias
102
Desimipramine
Tricyclic Antidepressant (inhibitor of NE and Serotonin reputake)-Drug of choice for endogenous unipolar depressionSide effects: Major- Weight Gain; minor- sexual dysfunction, dry mouth, blurred vision, constipation, sedation, orthostatic hypotension, cardiac arrhythmias
103
Amytriptyline
Tricyclic Antidepressant (inhibitor of NE and Serotonin reputake)- Drug of choice for endogenous unipolar depressionSide effects: Major- Weight Gain; minor- sexual dysfunction, dry mouth, blurred vision, constipation, sedation, orthostatic hypotension, cardiac arrhythmias
104
Nortriptyline
Tricyclic Antidepressant (inhibitor of NE and Serotonin reputake)- Drug of choice for endogenous unipolar depressionSide effects: Major- Weight Gain; minor- sexual dysfunction, dry mouth, blurred vision, constipation, sedation, orthostatic hypotension, cardiac arrhythmias
105
Clomipramine
Tricyclic Antidepressant (inhibitor of NE and Serotonin reputake)- Drug of choice for endogenous unipolar depressionSide effects: Major- Weight Gain; minor- sexual dysfunction, dry mouth, blurred vision, constipation, sedation, orthostatic hypotension, cardiac arrhythmias
106
Duloxetine
Non-tricyclic Mixed NE and Serotonine reuptake inhibitor- work the same as Tricyclic antidepressents (TCA)Uses: Unipolar depression, chronic neurogenic pain-Side effects: similar to TCAs
107
Venlafaxine
Non-tricyclic Mixed NE and Serotonine reuptake inhibitor- work the same as Tricyclic antidepressents (TCA)-Side effects: similar to TCAs
108
Isocarboxazide
Monoamine oxidase inhibitor (MAOI): Treats depressionMech: Inhibits MAO- enzyme that metabolizes norepinephrine and serotonin (increase NE and serotonin transmission)Uses: Solely as antidepressentSide effects: Hypertensive crisis- food/drug interactions (interacts with dietary tyramine to produce fatal effects)
109
Phenelzine
Monoamine oxidase inhibitor (MAOI): Treats depressionMech: Inhibits MAO- enzyme that metabolizes norepinephrine and serotonin (increase NE and serotonin transmission)Uses: Solely as antidepressentSide effects: Hypertensive crisis- food/drug interactions (interacts with dietary tyramine to produce fatal effects)
110
Tranylcypromine
Monoamine oxidase inhibitor (MAOI): Treats depressionMech: Inhibits MAO- enzyme that metabolizes norepinephrine and serotonin (increase NE and serotonin transmission)Uses: Solely as antidepressentSide effects: Hypertensive crisis- food/drug interactions (interacts with dietary tyramine to produce fatal effects)
111
Fluoxetine
Serotonin selective reuptake inhibitors (SSRIs)Mech: Does not act through NE,selective inhibition of serotonin reuptake mechanism.Uses: Unipolar depression, chronic neurogenic pain depression phases in bipolar, eating disorders, anxiety, OCDSide effects: Sexual dysfunction (major), serotonin syndrome- confusion, hallucinations, hyperreflexia, tachycardia, palpitations
112
Sertraline
Serotonin selective reuptake inhibitors (SSRIs)Mech: Does not act through NE,selective inhibition of serotonin reuptake mechanism.Uses: Unipolar depression, depression phases in bipolar, eating disorders, anxiety, OCDSide effects: Sexual dysfunction (major), serotonin syndrome- confusion, hallucinations, hyperreflexia, tachycardia,
113
Paroxetine
Serotonin selective reuptake inhibitors (SSRIs)Mech: Does not act through NE,selective inhibition of serotonin reuptake mechanism.Uses: Unipolar depression, depression phases in bipolar, eating disorders, anxiety, OCDSide effects: Sexual dysfunction (major), serotonin syndrome- confusion, hallucinations, hyperreflexia, tachycardia,
114
Aripiprazole
Partial agonist at dopamine receptorMech: Functional antagonist (by being only partial agonist) at DA2 receptorsUses: unipolar depression, bipolar, mania, psychosis (used as "add-on" drug)
115
Bupropion
NE and DA (dopamine) reuptake inhibitorMech: Acts by inhibiting DA uptake by NE transporter; Bupropion metabolized, one metabolite more potent as NE reuptake inhibitor than as DA reuptake inhibitor
116
Lithium carbonate
Treatment of Mania"Mech: UnknownUses: Treatment of mania and bipolar, may cause depression (used in combo with antidepressant)Pharmacokinetics: Oral, not metabolized, excreted in urineSide effects: Lithium intoxication (apathy, muscle rigidity, tremor, coma/death; [chronic use] renal impairment
117
Valproate
Non-sedating antiepileptic- treatment of maniaNonbarbiturate, non benzodiazepine
118
Cabamazepine
Non-sedating antiepileptic- treatment of maniaNonbarbiturate, non benzodiazepine
119
Opiates
-Act as analgesic by inhibiting transfer of information between sensory neurons and ascending neuron (to the brain) and also in parts of brain-Have other actions inside and outside of brain
120
Uses of Opiates
-CNS- Analgesia, sedation/drowsiness, euphoria/dysphoria, pupillary constriction (miosis), nausea/vomitting, increase intracranial pressure-Respiratory depression (decrease rate, compensatory increase depth)-Induction of vasodilation (continual hypotension, postural hypotension)-GI system- decrease motility, decrease absorption, decrease bile secretion; feces retention/constipation-Urinary System- urine retention-Uterus- decrease contractility
121
Morphine
Opiate receptor agonist: Analgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic, tolerance/dependence, highly addictiveUses: Relief of pain dyspneaMajor side effects: Tolerance, physical/psychological dependence
122
Fentanyl
Opiate receptor agonist: Analgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic, tolerance/dependence, highly addictiveUses: Relief of PainMajor side effects: Tolerance, physical/psychological dependence
123
Meperidine
Opiate receptor agonist: Analgesic, sedative, respiratory depressant, weak antitussive and antidiarrheal, weak effect on uterus (used for pain w/out prolonging labor), slower development of tolerance and dependence, withdrawal symptoms shorter and less severeUses: Relief of pain, DyspneaMajor side effects: Tolerance, physical/psychological dependence
124
Oxycodone
Opiate receptor agonist: Similar to morphineAnalgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic, tolerance/dependence, highly addictiveUses: Relief of painMajor side effects: Tolerance, physical/psychological dependence
125
Hydrocodone
Opiate receptor agonist: Similar to morphineAnalgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic, tolerance/dependence, highly addictive
126
Hydromorphone
Opiate receptor agonist: Similar to morphineAnalgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic, tolerance/dependence, highly addictive
127
Methadone
Opiate receptor agonist: Analgesic, sedative, sedation, respiratory depression, antitussive effects, development of tolerance/dependence;Less constipation and emesis (than morphine)Longer duration of actionUses: relief of pain and treatment of heroin addictionWithdrawal less severe but longer action
128
Codeine
Opiate receptor agonist: Analgesic (less effective than morphine but more effective than aspirin); well absorbed orally; antitussive actions at doses that do not produce analgesia; addiction potentialUses: Antitussive (cough suppressor)
129
Loperamide
Opiate receptor agonist in GI: Treats diarrheaLow abuse potential
130
Diphenyoxylate
Opiate receptor agonist in GI: Treats diarrheaLow abuse potential
