Exam 3 Flashcards

Question

What is orlistat and alli? MOA? Side effects?

Answer 1

anorexiants; binds to gastric and pancreatic enzymes to reduce fat absorptions; oily spotting, flatulence

Answer 2

control or prevent seizures while maintaining a resonable quality of live and minimize adverse effects and drug-induced toxicity; lifelong therapy with tapering, constant serum drug monitoring; not known but may change movement of electrolytes to make cell membranes of nerves less excitable

Answer 3

barbiturate antiepiletpic drug; reduce nerve impulses of brainstem; phenobarbitol (PO or IV) for different types of seizures and primidone (PO) metabolized in liver to phenobarbitol thereby lowering phenobarbitol serum levels and decreasing side effects, long half life; sedation (over time tolerance), GI upset; contraindicated for liver or kidney disease, (medications that induce liver enzymes to increase metabolism such as) beta-blockers - "olol", Ca channel blockers - "dipines", contraceptives; therapeutic serum levels 10-40 mcg/mL

Answer 4

hydantoins antieplieptic; phenytoin (PO or IV) is a common first line that must be diluted fosphenytoin (IV) is converted to phenytoin to overcome serious side effects of phenytoin; increase liver to produce cytochrome p-450 enzymes; highly bound protein, sedation and letahrgy, gingival hyperplasia (good oral care to prevent), dilantin facies (hypertrophy of subcutaneous cells), hirsutism (abnormal hair growth); medications that reduce hydantonin clearance: proton pump inhibitors - "prazoles", azoles, sulfa drugs; therapeutic drug level 10-20 mcg/mL, careful IV administration, albumin level monitoring

Answer 5

medication has a strong affinity for albumin meaning less free drug but if the medication is given with other drugs with high protein bound characteristics they will compete for the site on the protein. This results in an increase in free drug and a toxicity of either of the medications

Answer 6

iminostilbene antiepileptic drug used for partial seizures and generalized tonic-clonic seizures; carbamazepine is a hepatic enzyme inducer that will stimulate enzymes in the liver to metabolize it faster oxcarbazepine is not a hepatic enzyme inducer and is an analog of carbamezepine; headache, dissiness, nausea; no grapefruit juice, can make seizures worse if mixed with other antieplictic drugs that treat a different type of seizure; therapeutic levels are 4-12 mcg/mL

Answer 7

PO, antiepiletic chemical analog of GABA; partial seizures and treatment of neuropathy; will increase syntehsis and coagulation of gaba at the synaptic clef; CNS depression and GI

Answer 8

PO antiepiletic; neuropathic pain, postherapeutic neuroalgia, fibromyalgia, adjunct therapy for partial seizures; thought to bind to Ca channels in CNS to reduce neurotransmitter relsease; suicidal thoughs, drowsiness and dizziness

Answer 9

antiepiletic; generalized seizures, bipolar disorder, partial seizures; drowsiness, GI, weight gain, tremor; therapeutic levels 50-125 mcg/mL, highly protein bound, cannot take with carbonated beverages, should be taken with food or water

Answer 10

chronic, progresive dengerative disorder affecting dopamine-producing neurons causing an imbalance of dopamine (too little) and acetylcholine (too much); TRAP: tremor, rigidity, akinesia (slow in movement), postural instability; PT and medications (which only slow the symptoms), drug therapies that aim in increasing levels of dopamine and antagonizing the effects of acetylcholine

Answer 11

antiepiletic; "giline" selegine and rasagiline; inhibits monoamine oxidase B enzyme to increase levels of dopamine timulation in brain; headache, insomina, dizziness, GI

Answer 12

interaction between non-selective MOAIs and tyrosine containing foods (cheese) leading to severe hypertension; low dosage of MOAI B specific

Answer 13

dopamine replacement; main treatment of parkinsons; precursor of dopamine that will cross the blood brain barrier and be converted into dopamine; GI, low bp, involuntary movements; if used by itself or in large dosages it can lead to an increase of side effects, do not eat too much protein or it will slow down or prevent absorption, take 30 minutes before or 1 hour after eating

Answer 14

used to prevent levodopa breakdown before it reaches the brain, does not cross the blood brain barrier

Answer 15

CNS depressant; "pam" diazepam, midazolam, temazepam; "hangover effect"; grapefurit juice, azoles, and alcohol

Answer 16

non-benzodiazepam CNS depressants; eszopicloze is the first hypnotic approved for long term use and zolpidem: is a short acting depressant also good for long-term use

Answer 17

cyclobenzaprine, tizanidine; doxylamine, diphenhydramine; acetaminophen/diphenhydramine

Answer 18

mild, moderate, severe with increasing BP, HR and agitation

Answer 19

last resort for alcohol withdrawal; alters metabolism of alcohol to induce acetaldehyde syndrome to induce vomiting, hypotension, blurred vision, and headache if they drink alcohol which will last a couple of days

Answer 20

first nicoteine-free medication to treat nicotine dependence that may be prescribed to aid in smoking cessation, considered an antidepressent

Answer 21

typically a 12 week course of medication to treat nicotine withdrawal symptoms; stimulating nicotine receptor; GI and insomnia

Answer 22

chemoreceptors in the cerebral cortex stimulate the medulla, the vomiting center

Answer 23

blocks the vomiting pathway in the brain, inner ear, or GI

Answer 24

used for motion sickness, effects the vestibular area of the brain and blocks acetylcholine from binding to receptors in inner ear thereby blocking signals sent to chemoreceptor trigger zone to indicate nausea, will also dry out GI secretions and slow down smooth muscle spasms; scopolamine (patch); drowsiness; narrow angle glaucoma and caution with older adults

Answer 25

inhibits acetylcholine by binding to H1 receptors; stop vestibular and reticular signaling to chemoreceptor trigger zone; dimenhydrinate, meclizine; dizziness, dry mouth

Answer 26

block dopamine receptors in chemoreceptor trigger zone of the brain with a slight affect to acetylcholine; IV, PR; prochlorperazine, promethazine; dry mouth, constipation; promethazine needs to be diluted if given IV

Answer 27

for motion issues and assisting in peristalsis; blocks dopamine receptors in the chemoreceptor trigger zone; metoclopramide; fatigue, sedation, dry mouth, if used long term: tardive dyskinesia (involuntary movement of face or body

Answer 28

given for chemotherapy and post-operative induced N&V; block serotonin receptors in chemoreceptive trigger zone, and works in GI and medualla; IV or PO (oral disintegrating tablets); ondansetron; headache, diarrhea, rare arrhythmia; give 30 to 60 minutes prior to chemo

Answer 29

synthetic THC, second line medication for antinausea and antiemetics; inhibits cerebral cortex and thalamus effecting the chemoreceptive trigger zone; dronabinol (PO); appetite stimulant; considered control 2 substance and can have withdrawal if used long term

Answer 30

parietal cells: produce and secrete HCL (many antiacid medications work here) chief cells: secrete pepsinogen which will be activated into pepsin when exposed to acid to aid in protein breakdown muscous cells: provide a coating to protect from self-digestion

Answer 31

gastric or duodenal ulcers that involve digestion of the GI mucosa by pepsin; helicobacter pylori; 10-14 days of proton pump inhibitors, clarithromycin and amoxicillin or metronizadole, or bismuth and tetracycline and metronidazole

Answer 32

Al, Ca, Mg, and/or Na salts; neutralize stomach acid and reduces pain but will not prevent acid production, stimulates mucus, prostablands, and bicarbonate; Mg can cause diarrhear and cannot be used if pt is in renal failure. Ca can cause kidney stones; antibiotics, cannot be taken together usually 2 hours before or after

Answer 33

"tidine"; blocks H2 receptors in acid parietal cells to reduce acid secretion; GERD and peptic ulcer disease; confusion, disorientation, affects drug absorption, cimetidine can lead to impotence and gynecomastia (blocks enzyme in liver that breaks down medication); smoking can reduce effectiveness, can be taken with antacids if taken about an our before the antacid

Answer 34

"prazole"; binds to hydrogen-potassium ATPase pump and blocks all acid secretion; GERD and erosive esophagitis and ulcers (in combination with antibiotics); long term use can increase risk of osteoporosis and fractures; takes a bit to work and should be taken on an empty stomach 30-60 minutes before food to be most effective; produce toxicity levels of diazepam, phenytoin, and warfarin

Answer 35

used for ulcers; binds to base of ulcers and forms a protective barrier; should be given an hour before meals and cannot be taken at the same exact time as PPI

Answer 36

prostaglandin analogue; prostaglandin can inhibit gastric acid secretion and protects mucosa; can induce labor and therefore should never be given to a pregnant person

Answer 37

reduces gas pain by making the gas bubbles smaller and increase expulsion through the mouth or rectum (does not reduce amount of gas)

Answer 38

unpleasant state of mind characterized by sense of dread and fear, could be based on anticipatory experiences or past experiences, or an exaggerated response to imaginary negative situations

Answer 39

changes in mood that range from mania to depression or the experience of both (bipolar)

Answer 40

severe emotional disorder that impairs of mental function to the point that they cannot participate in daily life due to a loss of contact with reality

Answer 41

herbal therapy for depression, anxiety, and sleep disorders that should not be taken with any other psychotherapy drugs

Answer 42

Anxiolytic drugs Mood-stabilizing drugs Antidepressant drugs Antipsychotic drugs

Answer 43

benzodiazepines, "pam"; reduce anxiety by reducing CNS over acitvity; largest and most most commonly prescribed for anxiety, alcohol withdrawal, insomnia, muscle spasms, and adjunct treatment for depression; sedation, drowsiness, loss of coordination, dizziness, headaches

Answer 44

used to treat bipolar illness and mania; lithium carbonate and lithium citrate; increases serotonin neurotransmission and alter how sodium is released; cardiac dysrhythmias, drowsiness, slurred speech, epilepsy-type seizures, problem with movement and coordination; narrow therapeutic range 0.6-1.2 mEq/L, monitor sodium levels, no drastic change to intake of sodium and water, avoid thaizides, ACE inhibitors, and NSAIDs

Answer 45

major depressive disorders, chronic depression, adjunct with schizophrenia, eating disorders, and personality disorder, treatment of migraines, chronic pain, and sleep disorders; Increase neurotransmitters (serotonin, dopamine, norepinephrine) levels in CNS; high risk of suicide; requires at least 6 weeks of therapy to see results, used in conjunction with psychotherapy; tricyclic antidepressants, monoamine oxidase inhibitors, second generation antidepressants (SSRIs and SNRIs)

Answer 46

tricyclic antidepressant; second line antidepressants or used in adjunct with SSRIs for neuropathic pain and insomnia; blocks reuptake of neurotransmitter: serotonin and norepinephrine; sedation, orthostatic hypotension, impotence, dry mouth, constipation; any overdose is lethal, no antidote

Answer 47

citalopram: most commonly used for depression and OCD, short half life and therefore commonly assoicated with discontinuation syndrome (antidepressant withdrawal syndrome) duloxetine: selective serotonin norepinephinrine reuptake inhibitor for depression, generalized anxiety, diabetic neuropathy, fibromyalgia Fluoxetine: depression, bulimia, OCD, panic disorder SSRI and SSNI; insomnia, weight gain, sexual dysfunction; highly protein bound, washout period of 2-5 weeks if changing from MAOIs

Answer 48

behaviors or ways of thinking that they didn’t have before they became ill ex/ Hallucinations, delusions, and conceptual disorganization; All antipsychotics show efficacy in improving the positive symptoms of schizophrenia

Answer 49

Thoughts or behaviors person used to have before ill but do not have them any more iel. Apathy, social withdrawal, blunted affect, poverty of speech, and catatonia; Conventional drugs are less effective in managing negative symptoms. Atypical antipsychotics have improved efficacy in treating both positive and negative symptoms

Answer 50

for serious mental illness, blocks dopamine receptors in the brain (imbic system and basal ganglia, areas assoicated with emotion, cognitive function, motor function;

Answer 51

antipsychotic drug; PO, IM, IV; pts with schizophrenia who are nonadherent with drug regimen due to long half life; tremors, muscle twitching, extrapyramidal symptoms of tremors and muscle twitching;

Answer 52

clozapine, risperidone (more of an affinity for serotonin receptors than clorzapine), aripiprazole (quinolone for schizophrenia, bipolar, agitation in those with autism; block dopamine-2 receptors and serotonin receptors; overall much lower than haldol, weight gain, sedative, tardive dyskinesia

Answer 53

nonopioids after pain has been assessed and identified opioids with or without nonopioids and with or without adjuvants opioids indicated for moderate to severe pain

Answer 54

synthetic drugs that bind to opiate receptors to receive pain; Agonists: bind to opioid pain receptor in brain Reduce sensation of pain Mild: codeine & hydrocodone Strong: morphine, hydromorphone, oxycodone, fentanyl, methadone

Answer 55

Fentanyl (IV, patch, po) IV and PO very strong and works fast 1 mg: 10 mg of morphine Patch: for chronic pain and will take a bit longer to reach steady pain control Work for about 72 hours Hydromorphone (Dilaudid) Stronger than morphine 1mg:7mg Methadone (Dolophine) PO Longer half life Morphine sulfate PO, IV, ER Oxycodone oxycodone/acetaminophen (Percocet) hydrocodone with acetaminophen (Vicodin) Cough suppression and diarrhea; CNS depression, constipation, sweating, flushing, itching; alcohol, sntihistamines, barbiturates, and benzodiazepines will promote CNS depression

Answer 56

Tolerance: where a larger dose is required to maintain same level of analgesia, Not addiction Physical dependence: the body has adapted to the opioid, Not addiction Psychologic dependence: compulsive drug use where the person has a continued need and craving for the drug for other reasons than pain relief

Answer 57

pure opioid antagonist and drug of choice for complete or partial reversal of opioid-induced respiratory depression

Answer 58

acetaminophen; block pain impulses peripherally by blocking synthesis of prostaglandins; maximum daily dosaeg for healthy adults is 3000 mg/day and for older adults and those with liver disease 2000 mg/day

Answer 59

analgesic for moderate to moderately severe pain; weak bond to opioid receptors and inhibit norepinephrine and serotonin reuptake; Drowsiness, dizziness, headache Nausea and constipation Respiratory depression Seizures Increase risk with those on anti-depressants

Answer 60

topical anesthetic; postherapeutic neuralgia; skin irritation may occur; have patch in place no longer than 12 hours