Exam 1 medications Flashcards
(140 cards)
1
Q
what is the goal for ALL antiseizure pharmacotherapy?
A
suppress neuronal activity enough to prevent abnormal or repetitive firing
2
Q
what antiseizure drugs mimic the effects of GABA by stimulating an influx of chloride ions
A
- barbiturates
- benzodiazepines
- GABA modulators
3
Q
effective treatment for all seizures except absence seizures - inhibit impulse conduction in RAS to depress the cerebral cortex and motor nerve output, altering cerebellar function via ionic channel influence
A
barbiturates
4
Q
what are the pharmacologic and therapeutic classes of phenobarbital?
A
- pharm: barbiturate; GABA receptor agonist
- therapeutic: antiseizure
5
Q
what are the indications of phenobarbital?
A
treatment of generalized tonic-clonic and cortical focal seizures; can be used as emergency control status of epilepticus
6
Q
what is the mechanism of action for phenobarbital?
A
enhances the actions of GABA neurotransmitter and suppresses abnormal neuronal discharges
7
Q
what drug has the following adverse effects: dependence CNS depression, vitamin deficiencies, laryngospasm (difficult to breath and speak), increased sensitivity to pain?
A
phenobarbital
8
Q
what drug has the following symptoms if it becomes toxic: nystagmus (involuntary eye movements), ataxia, respiratory depression, coma, pinpoint pupils, hypotension, death?
A
phenobarbital
9
Q
cause muscle relaxation and anxiety relief without affecting cortical functions - stabilize nerve membranes throughout the CNS to decrease excitability
A
benzodiazepines
10
Q
what are the pharmacologic and therapeutic classes of diazepam?
A
- pharm: benzodiazepine; GABA receptor agonist
- therapeutic: antiseizure
11
Q
what is the mechanism of action for diazepam?
A
intensifies GABA in the brain suppressing neuronal activity
12
Q
what are the indications for diazepam?
A
treat status epilepticus and severe recurrent convulsive seizures; management of epilepsy in patients who require intermittent use for control
13
Q
what drug is administered if there is an overdose of diazepam?
A
flumazenil
14
Q
which drug has the following adverse effects: CNS depression, constipation, dry mouth, anorexia, cardiac arrhythmias, BP changes, urinary retentions, incontinence, brady- and tachycardia
A
diazepam
15
Q
modulate GABA inhibitor neurotransmitter to treat absence seizures
A
GABA modulators
16
Q
what are the pharmacologic and therapeutic classes of valproic acid?
A
- pharm: valproate; phenytoin-like drug
- therapeutic: antiseizure
17
Q
what is the mechanism of action of valproic acid?
A
increases GABA activity at inhibitory receptors and desensitizes sodium channels
18
Q
which of the following drugs has these adverse effects: limited CNS depression, visual disturbances, ataxia, vertigo, headache, hepatoxicity, hyperammonemia, thrombocytopenia
A
valproic acid
19
Q
what antiseizure drugs suppress sodium influx?
A
hydantoin, carbamazepine, amino acid compounds
20
Q
delays sodium channels, stabilizing nerve membranes throughout the CNS directly influencing ionic channels in the cellular membrane to decrease excitability
A
hydantoins
21
Q
what drug has the following symptoms when it becomes toxic: unusual bleeding, liver and brain disease, heart block, hypoglycemia, connective tissue disturbances
A
hydantoins
22
Q
what are the indications of phenytoin?
A
treating all types of epilepsy except absence seizures
23
Q
what are the pharmacologic and therapeutic classes of phenytoin?
A
- pharm: hydantoin; sodium-influx suppressing drug
- therapeutic: antiseizure, antidysrhythmic
24
Q
what is the mechanism of action of phenytoin?
A
desensitizes sodium channels to prevent spread of abnormal electrical charges in the brain that produce seizures - highly protein bound drug that is to be administered with a filter on the IV and is placed into a larger vein
25
which drug has the following adverse effects: harmless pinkish red or brown urine, gingival hyperplasia double vision, cognitive impairment, fatigue, tremor, headache, dysrhythmias, hypotension, SJS, n/v
phenytoin
26
what is the therapeutic range for phenytoin?
10-20mcg/mL
27
what are the indications for carbamazepine?
treatment of generalized and focal seizures in addition to trigeminal neuralgia
28
what is the mechanism of action for carbamazepine?
extended release for desensitizing sodium channels preventing the spread of abnormal electrical charges in the brain that produce seizures
29
which drug has the following adverse effects: CV complications, hepatitis, drowsiness, ataxia, dizziness, SJS, nystagmus (involuntary eye movement)?
carbamazepine
30
reduce brain excitability by suppressing positive ion influxes - Na+ primarily
amino acid compounds
31
which amino acid compound is used to treat absence seizures?
carbonic anhydrase inhibitors
32
which amino acid compound is used to treat focal seizures?
sodium channel blocker
33
what antiseizure drugs suppress calcium influx?
succinimides and GABA analogues
34
believed to delay calcium influx into the neurons inhibiting neural pathways of the brain to suppress abnormal activity - treat absence seizures
succinimides
35
what are the pharmacologic and therapeutic classes of ethosuximide?
- pharm: succinimides
- therapeutic: antiseizure
36
what is the mechanism of action for ethosuximide?
suppresses calcium
37
which drug has the following adverse effects: mood swings, depression, dizziness, drowsiness, lethargy, fatigue, ataxia, sleep disturbances, epigastric pain, myelosuppression
ethosuximide
38
believed to bind to calcium channels - structured similar to GABA
GABA analogues
39
what are the indictions for gabapentin?
treatment of focal onset seizures with and without secondary generalization; also for neuralgia and restless leg syndrome
40
what are the pharmacologic and therapeutic classes of gabapentin?
- pharm: GABA analogue
- therapeutic: antiseizure
41
what is the mechanism of action for gabapentin?
binds to voltage-activated calcium channels
42
which drug has the following adverse effects: eosinophili, drowsiness, ataxia, dizziness, peripheral edema, fatigue, nystagmus (involuntary eye movement), hypersensitivity with angioedema
gabapentin
43
extracted from willow bark, popular trees, and other plants to be used for mild to moderate pain - available OTC and prescription
NSAIDS/salicylates
44
what are the indications for aspirin?
pain, fever, anti-platelet aggregation
45
what are the pharmacologic and therapeutic classes of aspirin?
- pharm: salicylate
- therapeutic: anti-inflammatory, antipyretic, analgesic, anti-platelet
46
which drug has the following adverse effects: n/v, heartburn, epigastric discomfort, blood loss, tinnitus, acidosis, salicylism toxicity
aspirin
47
which drug has the following symptoms if it becomes toxic: buzzing or ringing in ears, balance issues, gait issue, vertigo, dark urine
aspirin
48
what are the indications for acetaminophen?
mild to moderate pain and fever
49
what are the pharmacologic and therapeutic classes for acetaminophen?
- pharm: non-opioid
- therapeutic: antipyretic; analgesic
50
what is the mechanism of action for acetaminophen?
acts directly on the hypothalamus to cause vasodilation and sweating to reduce a fever
51
which drug has the following adverse effects: rash, fever, chest pain, liver toxicity and failure, myelosuppression
acetaminophen
52
natural and/or synthetic narcotics to suppress pain impulses by activating mu and kappa receptors
opioid agonists
53
natural and/or synthetic narcotics to suppress pain impulses by blocking mu and kappa receptors
opioid antagonists
54
pain-blocking receptors
mu receptors
55
associated with some analgesia, pupillary constriction, sedation, and dysphoria (feeling of discomfort)
kappa receptors
56
which drug has the following adverse effects: respiratory depression, cough suppression, orthostatic hypotension, circulatory depression, shock/coma, tachycardia
opioids
57
what are the indications for opioids?
moderate to acute severe pain
58
what are the 3 opioids?
- morphine
- hydromorphone
- fentanyl
59
what are the pharmacologic and therapeutic classes of the 3 opioids?
- pharm: opioid receptor agonist
- therapeutic: analgesic
60
what is the mechanism of action for the 3 opioids?
binds with mu and kappa opioid receptors in CNS
61
what drug can be administered if a patient ODs on an opioid?
naloxone
62
which drug has the following adverse effects: sedation, respiratory depression, constipation, anxiety, fear, hallucinations, impaired mental processes
opioid agonist-antagonist/buprenorphine
63
what are the indications for buprenorphine?
relief of moderate to severe pain and treatment of moderate to severe opioid use disorder
64
what are the pharmacologic and therapeutic classes of buprenorphine?
- pharm: opioid receptor agonist-antagonist
- therapeutic: analgesic
65
what is the mechanism of action for burprenorphine?
partial agonist at mu receptor and weak kappa and delta antagonist
66
drugs that bind strongly to opioid receptors but does not activate them
opioid receptor antagonist
67
what are the indications for naloxone?
complete or partial reversal effects of opioids
68
what is the pharmacologic class for naloxone?
opioid receptor antagonist
69
what is the mechanism of action for naloxone?
reverses effects of opioids
70
serotonin agonists constricting blood vessels
triptans
71
interact with adrenergic, dopaminergic, and serotonin receptors to constrict cranial blood vessels and decrease pulsation of cranial arteries to terminate active migraines
ergot derivatives
72
block CGRP receptors to prevent and/or treat headaches
CGRP inhibitors
73
what are the pharmacologic and therapeutic classes of sumatriptan?
- pharm: triptan
- therapeutic: antimigraine
74
what are the indications for sumatriptan?
abort migraines with or without auras
75
which drug has the following adverse effects: dizziness, vertigo, weakness, myalgia (muscle pain), BP alterations, tightness/pressure in chest
sumatriptan
76
what are the pharmacologic and therapeutic classes of ergotamine?
- pharm: ergot derivative
- therapeutic: antimigraine
77
what are the indications for ergotamine?
prevention or abortion of vascular headaches
78
which drug has the following adverse effects: numbness/tingling in toes and fingers, muscle pain in extremities, precordial distress (pinched nerve feeling)
ergotamine
79
what are the pharmacologic and therapeutic classes of galcanezumab?
- pharm: CGRP inhibitor
- therapeutic: antimigraine
80
what are the indications for galcanezumab?
prevention and treatment of migraines and treatment of episodic cluster headache
81
which drug has the following adverse effects: hypersensitivity and injection site reactions
galcanezumab
82
what are the goals of muscle relaxants
minimize pain and discomfort, increase range of motion, improve ability to function independently
83
origin of drug action is in the CNS to treat local spasms resulting from muscular injury - inhibit motor neurons within the brain/spinal cord
centrally acting skeletal muscle relaxants
84
what are the pharmacologic and therapeutic classes of baclofen?
- pharm: GABA analogue
- therapeutic: centrally acting muscle relaxant
85
what are the indications for baclofen?
alleviation of spasticity for spinal cord injuries or diseases
86
what is the mechanism of action for baclofen?
exact mechanisms is unknown but believed to inhibit monosynaptic and polysynaptic spinal reflexes - CNS depressant
87
which drug has the following adverse effects: CNS depression, transient drowsiness, weakness, fatigue, constipation, hypotension, insomnia
baclofen
88
work at neuromuscular junction and skeletal muscles producing antispasmodic effect at muscle tissue level to suppress hyperactive reflexes and release of calcium ions
direct-acting antispasmodics
89
what are the pharmacologic and therapeutic classes of dantrolene sodium?
- pharm: direct-acting antispasmodic and calcium release blocker
- therapeutic: skeletal muscle relaxant
90
what are the indications for dantrolene sodium?
control of clinical spasticity resulting from upper motor neuron disorders
91
what is the mechanism of action for dantrolene sodium?
interferes with release of calcium ions in the skeletal muscle
92
which drug has the following adverse effects: drowsiness, dizziness, weakness, fatigue, diarrhea, hepatitis, myalgia (muscle pain), tachycardia, transient BP changes, rash
dantrolene sodium
93
alpha 1 is responsible for...
BP, contracted piloerection muscles, pupil dilation, thickened salivary secretions, male sexual emission, closure of urinary bladder sphincter
94
alpha 2 is responsible for...
moderation of insulin release and norepinephrine release
95
beta 1 is responsible for...
increase HR, increased conduction through AV node, increased myocardial contraction, lipolysis in peripheral tissues
96
beta 2 is responsible for...
vasodilation, bronchodilation, increased breakdown of muscle and liver glycogen, release glucagon, relaxation of uterine smooth muscle, decrease GI
97
beta 3 is responsible for...
increased metabolism and lipolysis, increased bladder capacity
98
how do muscarinic receptors affect smooth muscle?
pupil constriction, accommodation of the lens, decreased HR, increased GI, increased urinary bladder contraction, male erection, sweating
99
how do nicotinic receptors affect skeletal muscle?
muscle contractions, release norepinephrine, autonomic ganglia stimulation
100
what are indications for nonselective adrenergic agonists?
heart failure, shock, hypotension, anaphylaxis, bronchospasm,
101
what are indications of dopamine?
correction of hemodynamic imbalances present in shock
102
what are the pharmacologic and therapeutic classes of dopamine?
- pharm: nonselective adrenergic agonist, vasoconstrictor
- therapeutic: drug for hemodynamic imbalances, antihypotensive
103
what is the mechanism of action for dopamine?
acts directly and by the release of norepinephrine from sympathetic nerve terminals - mediates dilation of vessels in renal and splanchnic beds
104
which drug has the following adverse effects: tachycardia, ectopic beats, anginal pain (chest pain), dyspnea, n/v
dopamine
105
what are the indications for phenylephrine?
vascular failure in shock or drug-induced hypotension and prolonged spinal anesthesia
106
what are the pharmacologic and therapeutic classes of phenylephrine?
- pharm: alpha 1 selective agonist
- therapeutic: antihypotensive, nasal/eye/ear decongestant, mydriatic drug
107
what is the mechanism of action for phenylephrine?
vasoconstriction and raises systolic and diastolic BP
108
which drug has the following adverse effects: fear, anxiety, restlessness, nausea, decreased urine formation, pallor, hypertension
phenylephrine
109
what is the use of alpha blockers
treat hypertension and decrease symptoms of BPH/enlarged prostate
110
what is the pharmacologic and therapeutic classes of doxazosin?
- pharm: selective alpha 1 adrenergic-blocking
- therapeutic: antihypertensive, BPH agent
111
what are the indications for doxazosin?
treat mild to moderation hypertension and BPH
112
what is the mechanism of action for doxazosin?
reduces total peripheral resistance through alpha blockage
113
which drug has the following adverse effects: hypotension, fatigue, dizziness, vertigo, tachycardia, edema, nausea, dyspepsia (discomfort in abdomen), diarrhea, retrograde ejaculation
doxazosin
114
what are the indications for nonselective beta blockers?
glaucome, ocular hypertension, angina, arrhythmia, syncope (passing out), migraines
115
what are the effects of blocking beta 1?
decrease BP and pulse, reduces cardiac contractility, mask symptoms of hypoglycemia in diabetes
116
what are the effects of blocking beta 2?
bronchoconstriction, inhibit glycogenolysis
117
what are the effects of cholinergic agonists?
decrease HR and BP, vasodilation, relax sphincter muscles, increase peristalsis, constrict pupils, bronchial constriction, increase secretions, increase salivation, maintain muscle strength and tone
118
what are the indications for direct acting cholinergic-muscarinic agonist?
increase bladder tone, urinary excretion, and GI secretions as well as relieve increased glaucoma
119
what is the mechanism of action for direct acting cholinergic-muscarinic agonist?
similar to ACh and react directly with receptor sites
120
what are the indications for bethanechol?
acute postoperative or postpartum nonobstructive urinary retention, neurogenic atony of bladder with retention
121
what are the pharmacologic and therapeutic classes for bethanechol?
- pharm: direct-acting muscarinic cholinergic agonist
- therapeutic: nonobstructive urinary retention
122
what is the mechanism of action for bethanechol?
acts directly on cholinergic receptors to mimic effects of ACh, increasing tone of detrusor muscles causing emptying of bladder
123
which drug has the following adverse effects: abdominal discomfort, salivation, n/v, sweating, flushing
bethanechol
124
what are the indications for direct acting cholinergic agonist nicotinic?
smoking cessation, nicotine withdrawal/abstinence
125
what are the indications for varenicline?
smoking cessation
126
what is the mechanism of action for varenicline?
binds to nicotinic acetylcholine receptor and acts as an agonist while preventing nicotine from binding
127
what are the pharmacologic and therapeutic classes of varenicline?
- pharm: direct acting cholinergic agonist nicotinic
- therapeutic: smoking cessation
128
which drug has the following adverse effects: n/v, vivid dreams, constipation, flatulence, seizures, neuropsychiatric adverse effects, depression, mania, psychosis, hallucination, skin reactions, angioedema
varenicline
129
what are the indications of pyridostigmine?
increased survival after exposure to nerve gas, antidote for nondepolarizing neuromuscular junction blockers, myasthenia gravis
130
what are the pharmacologic and therapeutic classes of pyridostigmine?
- pharm: indirect acting cholinergic agonist
- therapeutic: drug used for MG
131
what is the mechanism of action for pyridostigmine?
reversible cholinesterase inhibitor the increases the levels of ACh, facilitating transmission at neuromuscular junction
132
react chemically with acetylcholinesterase in synaptic cleft to prevent ACh breakdown
indirect-acting cholinergic agonists
133
what is the mechanism of action for anticholinergic agent?
inhibit parasympathetic nervous system by blocking acetylcholine receptors at muscarinic cholinergic receptor sites
134
what are indications for anticholinergic agents?
COPD, bradycardia, decreasing secretions, overactive bladder, urinary incontinence, hyperactive bowel
135
what are the effects of anticholinergics?
increase HR(large doses), decrease HR(smaller doses), bronchodilation, decrease secretion, relax smooth muscle tone, increase sphincter constriction, dilate pupils, decrease salivation, decrease tremors
136
what are side effects of anticholinergics?
dry mouth, constipation, urinary retention, dilation of pupils, decreased muscle rigidity, tachycardia, drowsiness
137
what are the indications for atropine?
decrease secretions pre-op, parkinsonism, bradycardia, antidote for cholinergic OD
138
what are the pharmacologic and therapeutic classes for atropine?
- pharm: anticholinergic
- therapeutic: anticholinesterase poisoning
139
what is the mechanism of action for atropine?
competitively blocks acetylcholine muscarinic receptor sites - blocking effects of parasympathetic nervous system
140
which drug has the following adverse effects: blurred vision, photophobia, palpitations, tachycardia, dry mouth, altered taste perceptions, urinary retention, decreased sweating, dilated pupils, cycloplegia (paralysis of ciliary muscles in the eyes)
atropine
