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Flashcards in Exam 2 Deck (95)
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1

Alzheimers meds

1st- donepezil (Aricept)
-for low agitation clonazepam (Klonopin)
-for mod/severe memantine (Namenda)

2

CNS analgesia, fever reducer
-toxic intermediate metabolite

acetaminophen
-no anti-inflammatory or antiplatelet effects

3

aerosolized corticosteriods

budesonide (Pulmicort) and fluticasone (Flovent)

4

SABA

albuterol sulfate
rescue (<2x/week)
-s/e tachy, tremors

5

LABA

Advair (fluticasone and salmeterol)
-twice daily use
-maintenance

6

Parkinson's meds

-benztropine (cogentin)
-carbidopa (Levodopa)
-haloperidol (haldol)

7

benztropine (cogentin)

treats parkinsonian symptoms (extrapyramidal) seen with psych drugs
-watch for abnormal involuntary movements

8

what and how does benztropine (Cogentin) work

mood stabilizer, anticonvulsant, seizures
-potentiates GABA

9

side effects and caution with benztropine (Cogentin)

s/e CNS, ataxia
-caution with bone marrow depression, induce drug metabolism

10

what and how does carbidopa (Levodopa work)

-PD med
-crosses BBB and is decarboxylated into dopamine

11

side effects and caution with carbidopa (Levodopa)

monitor renal/liver/cardiac fxn
-s/e hallucinations, dizziness, dyskinesia, depression

12

chlorpromazine (thorazine)

-typical antipsychotic
-blocks central dopaminergic receptors
-treats positive symptoms (tardive dyskinesia)

13

s/e of chlorpromazine (thorazine)

HA, tremors, bradycardia, bronchospasm, SIADH, heat intolerance, eye rolling, twisted neck

14

what and how does clonazepam (klonopin) work

-long acting benzo
-acts at GABA
-often used for seizures
-can treat alc withdrawal

15

caution and side effect with clonazepam (klonopin)

s/e drowsiness, CNS depression, hepatotoxicity
-need to taper

16

antidote to clonazepam (klonopin)

flumazenil

17

clonidine (catapres)

*central a-agonist, dec sympathetic outflow
-treats HTN, ADHD, drug withdrawal
-stimulates frontal lobe to control limbic system

18

what and how does clozapine (clozaril) work

-atypical antipsychotic
-antagonize serotonergic activity
-pos and neg symptoms

19

s/e and caution with cloapine (clozaril)

-s/e strong sedative, anticholinergic effects, postural hypotension, seizures
-WATCH FOR METABOLIC SYNDROME (AGRANULOCYTOSIS)- WEEKLY CBC

20

dantrolene

-treats malignant hyperthermia (fever and muscle rigidity), neuroleptic malignant syndrome, serotonin syndrome
-muscle relaxant

21

what is and how does diazepam (valium) work

-benzo, acts at GABA, multiple bioactive metabolites
-antiepileptic, muscle relaxant, ETOH withdrawal

22

s/e and caution with diazepam (valium)

s/e drowsiness, CNS depression, hepatotoxicity
-need to taper

23

antidote for diazepam (valium)

flumazenil

24

what is and how does donepezil (aricept) work

-acetylcholinesterase inhibitor
-1st line for Alz
-metabolized in liver

25

s/e and caution with donepezil (aricept)

s/e N/V/D, weight loss, muscle cramping, rhabdomyolysis
-caution with preg, peptic ulcers, seizures, asthma
-avoid other cholinergics/anticholinergs

26

what is and how does epi work

-b adrenergic agonist (b1 inc HR and FOC, b2 bronchodilation, uterine relax)
-g protein complex, 2nd messenger system

27

fentanyl

ultra short acting synthetic opioid analgesic, powerful

28

fluoxetine (Prozac)

SSRI- depression, OCD, bulimia
-s/e HA, drowsiness, sexual dysfunction, GI upset
-drug/drug interactions

29

halothane (halogenated gas)

inhaled anesthesia
-monitor for hepatotoxicity
-risk of malignant hyperthermia if given with succinylcholine

30

type and what does haloperidol (haldol) treat

-typical antipsychotic
-dopamine antagonist
-avoid long term
-treats pos symptoms
-watch for abnormal movements

31

how to treat EPS and parkinsons symptoms

cogentin

32

how to treat neuroleptic malignant syndrome

dantrolene

33

lidocaine

-can be used in spinals, epidurals (give with epi if you want a longer effect)
-Na channel blocker
-caution in areas of bod with low blood supply

34

first line tx for bipolar

lithium (lithobid)

35

how and what is lithium (lithobid) used for

-manic phase or maintenance of BD
-interfere with NaK atpase

36

risks with lithium (lithobid)

-risk for drug induced nephrogenic diabetes
-frequent blood tests, renal fxn, thyroid, CBC, EKG, electrolytes

37

lopressor (metoprolol)

b1 antagonist
-decreases HR and FOC
-treats angina

38

what is memantine (namenda) used for

moderate to severe AD
-acts as NMDA receptor

39

s/e and cautionn with memantine (namenda)

s/e GI, drowsiness, HA, hallucinations, aggression
-dont use with amantadine, ketamine, robitussin DM!!!!!!

40

midazolam (versed)

-sedative with amnestic
-blocks substance p (slow severe pain)

41

antidote for midazolam (versed)

flumazenil- benzo antagonist, short half life

42

flumazenil reverses what 3 meds

-clonazepam (klonopin)
-diazepam (valium)
-midazolam (versed)

43

how and what is phenobarb used for

-increase Cl influx at GABA
-tx seizures and in OR
-often used for kiddos

44

s/e and caution with phenobarbital

-s/e drowsiness, withdrawal, fatigue
-caution with CNS depression, need to taper
-watch for growth spurts (monitor levels Q3 months)

45

propanolol (inderal)

-a and b blocker
-crosses BBB
-pts at risk of depression and fatigue
-caution in pts with asthma or HTN

46

sertraline (zoloft)

SSRI
-for depression and bulimia
-monitor for serotonin syndrome
-caution with driving

47

what is and s/e of trancyclpromine (parnate)

MAOI, tricyclic antidepressant
-s/e ortho hypo, wt gain, sexual dys, insomnia

48

all the cautions with tranylcypromine (parnate)

-avoid tyramine (risk of HTN and seizures)
-risk of serotonin syndrome if given with SSRI
-exacerbate hypoglycemia
--exacerbate sympathomimetics

49

how do tricyclic antidepressants work

inhibit reuptake of serotonin and norepi

50

5 classes of tricyclics

MAOI, SSRI, SNRI, NDRI, SNDI

51

SSRIs

-imipramine
-elavil (amitriptyline)- chronic pain
-dont give to seizure patients

52

wellbutrin (buproprion)

NDRI
-smoking cessaion, not cardiotoxic
-used when SSRI caused sexual dysfunction

53

use and how does valproic acid (depakote) work

-increases available GABA
-tx seizures, bipolar (2nd line)

54

caution and s/e with valproic acid (depakote)

s/e GI, pancreatitis, tremor, sedation
-caution with liver toxicity, preg women, dec drug metabolism
-monitor LFTs, CBC

55

adrenergic agonists

clonidine, dopamine, epinephrine, norepi, phenylephrine

56

adrenergic antagonists

propanolol (inderal)

57

cholinergic antagonists

atropine, scopalamine

58

what is phenylephrine and what does it treat

A1 receptor agonist
-vasoconstriction, inc BP, def HR and FOC
-decongestant, shock

59

side effect of phenlephrine

arrhythmia, HF, HTN crisis, blurred vision
-caution with MAOI (increased sympathomimetic effect)

60

what can't you give with fluoxetine (prozac)

MAOIs- risk for serotonin syndrome
**need to taper

61

a- agonist in the CNS

reduces the responses of the sympathetic nervous system.

62

MAOI meds

deprenyl and tranylcypromine/parnate ( use if tricyclics fail), watch for liver toxicity

63

theophylline

phosphodiesterase inhibitor
-promotes bronchodilation
-increases cyclic AMP

64

what does ach stimulate

both nicotinic and muscarinic receptor

65

atropine

cholinergic antagonist, antimuscarinic (blocks parasympathetic effect)
-use with severe bradycardia

66

scopalamine

cholinergic antagonist
-antimuscarinic, sedating, blocks short term memory

67

succinylcholine

neuromuscular blocker (paralytic)
-depolarizes nicotinic receptor at neuromusc junction
-***malignant hyperthermia

68

alpha adrenergic response

vasoconstriction, intestinal relaxation, pupil dilation

69

beta 1 adrenergic response

inc HR, inc force of contraction

70

beta 2 adrenergic response

vasodilation, bronchodilation, intestinal/uterine/bladder relax

71

sympathetic receptor

adrenergic

72

parasympathetic receptor

muscarinic

73

ach acts first on what type of receptor

nicotinic

74

warfarin (Coumadin)

anticoagulant
-monitor ptt
-reverse with vit K

75

don't mix coumadin with

asa, hepatic dx, hyperthyroid, antifungals

76

aldactone (spironolactone)

K sparing diuretic use in HF, edema, endometriosis
-caution in renal dx, B blockers, NSAIDS, ACE inhibitors

77

Baclofen

GABA receptor agonist
-muscle relaxant
-treat withdrawal

78

cimetidine (tagamet)

-antihistamine and antacid
-potentiates effects of anticoagulants and sedation, lots of med interactions!!!

79

codeine

-mild/moderate pain
-cough suppressant
-sometimes given with tylenol

80

too much dopaminergic tx of Parkinson's can cause

psychosis

81

carbamazepine (Tegretol)

-typical antiepileptic, treats Bipolar
-potentiates GABA
-caution with bone marrow depression

82

concerta (methylphenidate)

stimulant med for ADHD
-child needs to have drug holidays in order to grow
-sympathomimetic (want for hyperthermia)

83

dextromethorphan

-OTC cough meds
=robitussin
-interacts at NMDA receptor in brain
-can't give with Namenda or elderly

84

digoxin

-treats afib and CHF
-indirectly supports vagus nerve
-inhibits NaK atpase
-need good K levels

85

droperidol

-neuroleptic
-increases sensitivity to opioids
-used in anesthesia

86

flumazenil (Romazicon)

-reverses Versed

87

guaifenesin

-mucinex
-watch for multi-symptom OTC meds

88

ketoconazol

azol antifungal
-many drug/drug interactions

89

Lasix

-loop diuretic
-monitor electrolytes

90

leukotriene antagonists

-block leukotriene response in allergic asthma

91

narcan

blocks opioids

92

rivastigmine (Exelon)

for Alzheimers

93

tranylcypromine (parnate)

-MAOI

94

tricyclic antidepressants

-antimuscarinic effects
-low BP effects
-antihistamine, sedation

95

kindling effect

-a trigger which sets off seizure or bipolar episode