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Flashcards in Exam 4 Blueprint Deck (80):
1

Barbiturates

-stronger than benzos
-phenobarbital (luminal)

2

Benzodiazepines

-most frequently used
-African Americans have a higher risk of toxicity
-diazepam (Valium)

3

Antidote for diazepam (Valium)

Flumazenil (romazicon)

4

Acute withdrawal syndrome

-abrupt cessation
-causes nausea, headache, malaise, vertigo, nightmares

5

TCAs

-bad side effects
-interacts with many drug classes
-doses should be delivered at bedtime
-imipramine (tofranil)

6

MAOIs

-bad drug..many interactions
-can cause htn crisis of taken with TCA
-no tyramine foods allowed
-phenelzine (Nardil)

7

Tyramine containing foods

-aged cheese
-avocados
-chocolate
-wine
-aged meats

8

Drug used to treat HTN crisis

Pentolamine (regitine)

9

SSRIs

-better drug because less adverse effects than TCAs and MAOIs
-suicide risk especially in adolescents
-fluoxetine (Prozac)

10

Neuroleptics

-not called tranquilizers anymore
-block dopamine
-can cause neuro malignant syndrome
-typical: chlorpromazine (Thorazine)
-atypical: clozapine (clozaril)

11

Neuro malignant syndrome

-caused by General anesthetics and drugs that have direct CNS effects
-includes high fever
-EPS, rigidity, htn, tachycardia

12

Lithium (lithobid)

-anti manic drug
-contraindicated in hyponatremia
-drug should be held if lithium levels are high or Na levels are low
-therapeutic: (0.6-1-2)
-risk of death: 2 mEq/L

13

CNS stimulants

-tricks the brain and allows the ADD person to be more calm
-controlled substance
-methylphenidate (Ritalin)

14

Generalized antiseizure agent

-effect the entire brain and reduce the chance of sudden electrical outbursts
-patients should wear a medical alert tag
-phenytoin (Dilantin)

15

Phenytoin (Dilantin) levels

10-20 mcg/ml

16

Dopaminergic drugs

-act like or increase dopamine at the receptor sites
-more effective than anticholinergics at treating Parkinson's
-levodopa (dopar)

17

Levodopa (dopar)

-helps to create balance between stimulating and inhibitory neurons
-cause bone marrow depression
-interacts with MAOIs and phenytoin (Dilantin)
-avoid tyramine containing foods

18

Skeletal muscle relaxant: central acting

-spasmolytics
-baclophen (lioresol)

19

Baclophen (lioresol)

-works in the CNS to interfere with the reflexes that are causing spasms
-causes depression, drowsiness, fatigue, dry mouth, constipation
-discontinue the drug slowly so that hallucinations and psychosis won't occur

20

Anxiolytics

-high risk of cleft lip and palate in African American pregnant women
-prevent fear or tension
-sedatives/hypnotics

21

Morphine (Roxanol)

-narcotic
-major CNS depressant
-will hold if respiratory rate is 12
-controlled substance

22

Antidote for morphine overdose

Naloxone (narcan)

23

Ergots

-used in relief of migraine or vascular headaches
-don't take with beta blockers
-causes severe thirst, hypoperfusion, chest pain, BP changes, confusion
-ergotism

24

Antidote to NMJ blocking agents

Cholinesterase inhibitor

25

Pancuronium (pavulon)

-nondepolarizing NMJs
-act as antagonist to Ach in the NMJ to prevent depolarization of muscle cells
-can cause malignant hyperthermia and paralysis of muscles

26

Succinylcholine (anectine)

-depolarizing agent
-depolarization causes stimulation of muscle and the muscle contracts then causes flaccid paralysis
-can cause malignant hyperthermia

27

Alpha 1

-generally about excitation/stimulation
-located in eye, salivary glands, GI/GU sphincters, arterioles

28

phenylephrine (Sudafed PE)

-Alpha 1 agonist
-decongestant drug

29

doxazosin (Cardura)

-Alpha 1 antagonist
-causes relaxation
-used for BPH

30

Stimulation of alpha 1 causes..

-mydriasis (pupil dilation)
-arterial constriction which allows for fight or flight

31

Alpha 2

-generally about relaxation
-located in smooth muscle NMJ synapse

32

clonidine (Catapres)

-Alpha 2 agonist
-causes more relaxation
-good BP medication

33

Stimulation of alpha 2 causes..

more relaxation

34

Blocking of alpha 2 causes..

less relaxation

35

Blocking of alpha 1 causes..

-miosis (pupil constriction)
-vasodilation of arterioles

36

Beta 1

-generally about stimulation
-located in the heart, brain and kidney

37

Stimulation of beta 1 causes..

-more stimulation
-increase conductivity
-increase renin production
-sympathetic

38

Blocking of beta 1 causes..

-less stimulation
-decrease conductivity
-decrease renin production
-anti sympathetic

39

Atenolol (tenormin)

-beta 1 blocker (selective antagonist)
-lowers BP
-less stimulation, decrease conductivity

40

dobutamine (dobutrex)

-beta 1 selective agonist
-use in shock to improve conductivity stimulation of the heart

41

Beta 2

-generally about stimulation
-located in smooth muscle, bronchioles, liver, uterus

42

Stimulation of beta 2 causes..

-more stimulation
-dilation
-increase lipolysis
-improves insulin

43

Blocking of beta 2 causes..

-less stimulation
-constriction
-decrease lipolysis
-impairs insulin

44

albuterol (Proventil)

-beta 2 agonist
-used to open airways
-dilation of the bronchioles
-will also hit beta 1 and caused increase in heart rate

45

terbutaline (Brethine)

-beta 2 agonist
-used for premature labor which causes the uterus to relax

46

If we over stimulate the sympathetic nervous system...

-have a decrease in CO because of too fast of HR, too slow of contraction

47

Beta 1 selective adrenergic blockers are..

-preferred in patients with respiratory problems
-used to treat HTN, angina, and HF
-must be tapered
-causes hypersensitivity to catecholamine

48

M1 receptors are located..

CNS and enteric nervous system

49

M2 receptors are located..

Heart

50

Me receptors cause

-increase exocrine gland secretion
-increase gut motility
-miosis
-accommodation
-broncho constriction
-bladder constriction "M3 makes you pee"

51

What is primarily the neurotransmitter for the parasympathetic nervous system?

Ach

52

bethanechol (Urecholine)

Used for urinary retention
-direct cholinergic drug

53

carbechol (Carbastat)

Used for glaucoma, urinary retention
-direct cholinergic drug

54

methacholine (Provocholine)

asthma challenge test
-If the pt wheezes faster than they should, we know we have disease in the bronchioles
-direct cholinergic drug

55

pilocarpine (Salagen)

-used to test for cystic fibrosis
-stimulation causes increased exocrine function
-direct cholinergic drug

56

Anti-acetylcholine esterases

-you become more cholineric
-prevent enzymes from breaking down Ach
-indirect cholinergic drug

57

neostigmine (Prostigmin)
pyridostigmine (Mestinon)

-used for urinary retention
-used as an antidote to NMJ blocker
-used in myasthenia gravis
-indirect cholinergic drug

58

physostigmine (Antilirium)

-FIXostigmine
-used to counteract atropine overdose
-indirect cholinergic drug

59

The rescue drug for an anticholinergic is..

a cholinergic drug

60

donepezil (Aricept)

-used to treat Alzheimer's/dementia
-works on the M1 receptors in the brain
-indirect cholinergic drug

61

Antagonizing M3 receptor

-decrease exocrine secretions
-decrease gut motility
-mydriasis
-no accommodation
-broncho relaxation
-bladder distention

62

atropine (Atreza)

-used to create mydriasis in the eye to see retina better
-used as an antidote to cholinergic poisoning
-used to prevent or slow down drooling
-used as a rescue drug for bradycardia

63

ipratropium (Atropent)

-used to treat asthma

64

oxybutinin (Ditropan)

used to help with bladder spasms and urinary retention issues

65

scopolamine (Maldemar)

-used for motion sickness
-Hits M1 and causes CNS depression

66

Cholinergic/Myasthenia crisis

Patient presents with progressive muscle weakness and respiratory difficulty

67

Drug to treat a cholinergic crisis

atropine

68

edrophonium (Tensilon)

used to discern between cholinergic and myasthenia crisis
-pt will get better if it's a myasthenia crisis
-pt will not get better if it's a cholinergic crisis

69

fluoroquinolones

-Antibiotic
-broad spectrum: treat gram negative and positive infections

70

ciprofloxacin (Cipro)

-interferes with DNA replication
-fluoroquinolones
-BBW for achilles tendon pain
-if given with theophylline, both drugs become toxic

71

rifampin (Rifadin)

-treat Tb
-treat meningococcal meningitis or for prophylaxis
-narrow spectrum

72

What is the main goal for Tb treatment?

Protection of the population

73

Antiviral agents

-Viruses are really hard to kill because they become a part of us
-Must kill the virus and the cell the virus has invaded

74

rimantadine (Flumadine)

-treats influenza A
-prevents the shedding of the viral protein coat...means it cannot replicate
-has anticholinergic effects

75

acyclovir (Zovirax)

-treats herpes and CMV
-causes neuropathy, paresthesia, confusion, renal toxicity, bone marrow suppression

76

HIV treatment

-takes a lot of drugs to treat HIV
-HIV is no longer a death sentence
-all have terrible side effects

77

terbinafine (Lamisil)

-antifungal
-causes major bone marrow suppression
-GI problems
-liver toxicity
-have good results with this drug except on the scalp, nails

78

Most common protozoal infection

Giardia

79

metronidazole (Flagyl)

-antiprotozoal agent
-considered cancer causing, causes Steven Johnsons
-can cause cinchonism

80

cinchonism

poisoning
-causes vertigo, tinnitus, bone marrow suppresion