deck_771610 Flashcards
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)
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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)
28
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
32
Prednisone
Corticosteroid hormone receptor agonistUses: Leukemia in childrenAdverse effects: GI ulcers, osteoporosis, mental confusion
33
Medroxyprogesterone
Progestogen hormone receptor agonist
34
Hydroxyprogesterone
Progestogen hormone receptor agonist
35
Megestrol
Progestogen hormone receptor agonist
36
Tamoxifen
Anti-Estrogen; estrogen hormone receptor antagonistAdverse effects: not a steroid-less toxic
37
Flutamide
Anti-Androgen; Androgen hormone receptor antagonist
38
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)
40
Imatinib
Tyrosine Kinase inhibitor (inhibits enzyme in multiple signal transduction pathways)
41
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)
44
Bevacizumab
Monoclonal Antibody- Colon CA(target specific antibody of CA cell surface and kills cell)
45
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.
46
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
49
Mafenide
Sulfonamide: Topically applied (not systemic)Prevents infections on burned skin
50
Trimethoprim
Blocks bacterial intermediary metabolismMech: Suppression of folate reductaseSpectrum: Broad spectrum, Gram +Uses: Primarily in UTI's
51
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
53
Oxacillin
Penicillin Derivative
54
Ampicillin
Penicillin Derivative
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Amoxicillin
Penicillin Derivative
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Ticaricillin
Penicillin Derivative
57
Clavulanate
Penicillinase inhibitor Amoxicillin + clavulanate
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Sulbactam
Penicillinase inhibitorAmpicillin + sulbactam
59
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
61
Cephalexin
1st generation cephalosporingram + activity (minimal gram -)Uses: anti-bacterial prophylactic prior to surgeryNarrow spectrum
62
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
73
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
83
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
