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Pharmacology > Exam #5 > Flashcards

Exam #5 Flashcards

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1
Q

Anxiolytic

A

drug used to depress the CNS, prevents the signs & symptoms of anxiety.

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2
Q

Barbiturate

A

Former drug for anxiety/sedation/sleep induction. Potentially SEVERE side effects & D2D interactions

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3
Q

Benzodiazepine

A

Acts in the Limbic system and RAS to make GABA, causing interference with neuron firing, depresses the CNS. (wet blanket)

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4
Q

Sedative

A

drug that depresses the CNS, produces a loss of awareness of an reaction to the environment

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5
Q

Hypnotic

A

Extreme sedation resulting in CNS depression & sleep

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6
Q

____ prevent anxiety without causing sedation

A

Benzodiazepines

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7
Q

5 common conditions that are treated with Benzodiazepines

A 
Anxiety
Alcohol Withdrawal 
Hyperexcitability
Agitation 
Pre-op relief of anxiety and tension
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8
Q

Benzodiazepines are NOT for pregnancy because risk for:

A

Cleft Lip/palate
inguinal hernia
cardiac defects
microcephaly

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9
Q

2 reasons barbiturates are used less often than Benzos:

A

INCREASED risk of ADDICTION & DEPENDENCY

INCREASED likelihood of SEDATION & ADVERSE EFFECTS

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10
Q

Most common side effects of barbiturates related to CNS depression

A

Drowsiness, anxiety, lethargy, vertigo, paradoxical excitement, hallucinations

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11
Q

Antidote for Benzos:

A

Flumazenil (Romazicin)
works within 30 seconds
Give up to 3 mg

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12
Q

Teaching points for anxiolytics, sedatives, & hypnotics

A 
Fall risk
Take prior to bed
Barrier Contraceptives
NOT to take while pregnant
Importance of side effects
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13
Q

Monoamine oxidase inhibitor (MAOI)

A

prevents the ENZYME monoamine oxidase from breaking down NOREPINEPHRINE

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14
Q

Selective Serotonin Reuptake Inhibitors (SSRI)

A

specifically BLOCKS the reuptake of serotonin

NOT associated with Anticholinergic and sympathomimetic effects

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15
Q

Tricyclic Antidepressant (TCA)

A

BLOCKS the reuptake of NOREPINEPHRINE and SEROTONIN

ASSOCIATED with anticholinergic and sympathomimetic effects

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16
Q

Affect

A

refers to people’s feelings in response to their environment, whether +/- & unpleasant

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17
Q

Affective disorder

A

is when a person’s mood goes far beyond the usual, normal “ups & downs”

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18
Q

Depression

A

an affective disorder involving feelings of sadness that are more SEVERE and LONG-LASTING than expected

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19
Q

3 neurotransmitters whose deficiency may cause depression

A

Norepinephrine (NE)
Dopamine
Serotonin (5HT)

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20
Q

Tricyclic Antidepressants (TCA) are more effective for depression characterized by

A

Anxiety & Sleep disturbance

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21
Q

Patients using MAOIs should AVOID food high in _____.to prevent a fatal hypertensive crisis

A

Tyramine

Hard cheeses, red wine, smoked/pickled meats, lunch meats, etc.

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22
Q

Selective Serotonin Reuptake Inhibitors (SSRIs) are indicated for treatment of:

A

Depression, OCD, Panic attacks, bulimia, PMDD, PTSD, social phobias, and social anxiety disorder

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23
Q

Adverse effects of SSRIs:

A

CNS effects: HA, drowsiness/dizziness, insomnia, anxiety, tremors, seizures
GI effects: N/V/D/C/A/, dry mouth, change in taste.
GU effects: painful menstruation, sexual dysfunction,
Resp. effects: cough, dyspnea, URI, pharyngitis.
Sweat, rash, fever, pruritis

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24
Q

Herbs that cause reactions with SSRIs:

A 
St. John's Wart
evening primrose oil
ginkgo
Ginseng
Valerian
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25
Other than depression, what other conditions might duloxetine (Cymbalta) be prescribed for
Neuropathic Pain Fibromyalgia Generalized Anxiety
26
Antipsychotic
drug used to Tx disorders involving thought processes, dopamine-receptor blocker that helps affected people to organize their thoughts & respond appropriately to stimuli
27
Neuroleptic
a drug associated with many neurological adverse effects that is used to Tx disorders that involve thought processes (ie: schizophrenia)
28
Narcolepsy
mental disorder characterized by daytime sleepiness and periods of sudden loss of wakefulness.
29
Which agents target the thought process?
Psychotherapeutic agents
30
Antipsychotic drugs aka Neuroleptic drugs block ______ receptors and treat disorders involving the ________ process.
block DOPAMINE receptors and used to treat disorders involving the THOUGHT process
31
5 disorders treated with antipsychotic medications
Schizophrenia, hyperactivity, bipolar disorder, combative behavior, irritability/aggression
32
why are antipsychotic medications contraindicated in the elderly?
INREASED risk for CARDIOVASCULAR events & death
33
what is the effective range for lithium
0.6-1.2 mEq/L
34
What diuretic is given with lithium that INCREASES the risk for toxicity
Carbamazepine (CNS toxicity)
35
What are 2 newer drugs proven effective in treating bipolar disorder?
Aripiprazole (Abilify) Quetiapine (Seroquel) Olanzapine (Zyprexa)
36
What classification of drug is used to treat ADD & Narcolepsy
CNS stimulants- RAS (reticular activating system) (awake & sleep cycle) RIDALINE (methylphenidate) Lock up in hospital
37
Why is cardiac disease and hypertension contraindicated for CNS stimulants?
they EXACERBATE the stimulatory effects of the drugs
38
T or F: Physical and psychological dependence is a concern with CNS stimulant drugs.
TRUE
39
List the 4 neurotransmitters we use:
Norepinephrine Dopamine Serotonin GABA
40
Benzodiazepines
are most commonly used to treat anxiety without sedation effects alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan)
41
Benzodiazepine prototype: Diazepam (Valium)
used for anxiety, alcohol withdrawal, muscle relaxant, antiepileptic for status epilepticus, antitetanus, and preoperative anxiolytic
42
Benzodiazepine: Diazepam (valium) | ACTION
Acts on limbic system and Reticular Activating System (RAS) to potentiate GABA
43
Benzodiazepine: Diazepam (Valium) | ADVERSE EFFECTS
Mild drowsiness, lethargy, fatigue, restlessness, Bradycardia/tachycardia, decreased libido, drug dependency with withdrawal syndrome, urinary retention
44
Abrupt cessation of Benzos causes
withdrawal syndrome | nausea, HA, vertigo, malaise, nightmares
45
Barbiturates: phenobarbital (Luminal) | FORMERLY USED
used for sedation, short-term insomnia, long-term use for tonic-clonic seizures, control of seizures, preanesthetic
46
Barbiturates: phenobarbital (Luminal) | ACTION
CNS DEPRESSION: Inhibits conduction of the reticular activating system (RAS), depresses the cerebral cortex, sedation/hypnosis, deep coma
47
Barbiturates: phenobarbital (luminal) | ADEVERSE EFFECTS
Somnolence, agitation, confusion, hyperkinesia, ataxia, vertigo, CNS depression, N/V/D/C hypoventilation, withdrawal syndrome
48
Antihistamines: | promethazine (Phenergan) & diphenhydramine (Benadryl)
used for sedation especially in elderly and pediatrics
49
Buspirone
antianxiety agent without sedation- given to mothers to increase energy levels
50
Anxiety- sympathetic stress reaction
INCREASED heart rate, RAPID breathing, and ELEVATED blood pressure
51
Benzos safe for pediatric patients
diazepam, clonazepam, clorazepate, chlordiazepoxide | PREFER antihistamine use first
52
Dexamedetomidine (PRECEDEX)
patients requiring mechanical ventilation
53
Eszopiclone (LUNESTA) & zolpidem (AMBIEN)
used as sleep aid, treat insomnia
54
Biogenic amines
norepinephrine dopamine serotonin
55
``` Tricyclic Antidepressants (TCAs) prototype: imipramine (Tofranil) ```
inhibit reuptake of Serotonin & Norepinephrine; | relief of depression with anxiety & sleep disturbance & bedwetting in children >6yrs
56
Benzos: Antidote
Flumazenil | works within 30 seconds; give up to 3mg
57
TCA half life
LONG: 8-46 hours
58
BLACK BOX WARNING for Antidepressants
Risk for Suicide especially in peds & teens
59
Tricyclic antidepressant: | Imipramine (Tofranil) ADVERSE EFFECTS
CNS, sedation, anticholinergic effects, confusion, anxiety, orthostatic hypertension, dry mouth, urine retention, rash, bone marrow depression
60
Monamine Oxidase Inhibitors (MAOIs) | prototype: phenelzine (Nardil)
inhibits the enzyme monoamine oxidase from breaking down NE, 5HT, & dopamine REQUIRES DIETARY REGIMEN: tyramine
61
Sources of TYRAMINE
hard cheeses, red wine, chocolate, lunch meat/pickled meat, yogart, avacados, fava beans, sour cream
62
MAOIs: | phenelzine (Nardil) INDICATIONS
treats depression when unresponsive to other antidepressants
63
MAOIs: | phenelzine (Nardil) ACTIONS
Irreversibly inhibits Monoamine Oxidase allowing the accumulation of NE, 5HT, dopamine
64
MAOIs: | phenelzine (Nardil) ADVERSE EFFECTS
Dizziness, vertigo, HA, overactivity, liver toxicity, dry mouth, othrostatic hypotension, potential HYPERTENSIVE crisis, edma
65
Selective Serotonin Reuptake Inhibitors (SSRIs) | prototype: fluoxetine (Prozac) ACTION
newest group of antidepressants; specifically block reuptake of serotonin Less effects than MAOIs and TCAs
66
SSRIs: | Fluoxetine (Prozac) INDICATIONS
treat depression, OCD, panic attacks, PMDD< PTSD, social anxiety
67
SSRIs: | Fluoxetine (Prozac) ADVERSE REACTIONS
CNS: HA, drowsiness, insomnia, anxiety, tremors, dizziness, nervousness Dry mouth, sexual dysfunction, UPPER RESPIRATORY INFECTIONS, weight loss, fever
68
Other SSRIs:
Citalopram (Celexa) escitalopram (Lexapro) paroxetine (Paxil) sertraline (Zoloft)
69
Herbals to avoid while taking SSRIs
St. John's wart, evening primrose oil, gingko, ginseng, Valerian
70
Other antidepressants: | bupropion (Wellbutrin, Zyban)
Smoking cessation | Blocks NE, dopamine, & 5HT
71
Other antidepressants: | Desvenlafaxine (Pristiq)
Treat major depressive disorder in adult | blocks NE & 5HT
72
Other antidepressants: | Duloxetine (Cymbalta)
Treat major depressive disorder, neuropathic pain, fibromyalgia blocks reuptake of NE & 5HT
73
Other antidepressants: | venlafaxine (Effexor)
generalized anxiety, social anxiety, and to decrease addictive behavior blocks reuptake of NE & 5HT
74
Antipsychotics for children > 12 yrs.
Aripiprazole (Abilify) | atypical antipsychotic
75
Antipsychotics focus on treatment of
the thought process; they are Dopamine-receptor blockers; meant for change in neuron stimulation
76
Antipsychotics: Typical prototype: Chlorpromazine (Thorazine) INDICATION
Manage psychotic disorders, preop restlessness, tetanus, behavioral problems in children, HICCUPS
77
Antipsychotics: Typical | Chlorpromazine (Thorazine) ACTIONS
Blocks dopamine receptors
78
Antipsychotics: typical | Chlorpromazine (Thorazine) ADVERSE EFFECTS
Drowsiness, insomnia, vertigo, extrapyramidal symptoms, orthostatic hypotension, urine retention and photosensitivity
79
Antipyschotics: Atypical prototype: Clozapine (Clozaril) INDICATIONS
Tx Schizophrenia
80
Antipsychotics: Atypical | Clozapine (Clozaril) ACTIONS
Block Dopamine and 5HT, depressing the RAS
81
Antipsychotics: Atypical | Clozapine (Clozaril) ADVERSE REACTIONS
Drowsiness, sedation, seizures, dizziness, syncope, HA, tachycardia, neuroleptic malignant syndrome
82
Antipsychotics cause what change to the urine
Pink to reddish-brown
83
Antimanics: Aripiprazole (Abilify) & olanzapine (Zyprexa) Prototype: Lithium Salts ACTIONS
Treat Acute manic episodes & bipolar disorder
84
Normal Range for lithium
0.6-1.2
85
Antimanics: | Lithium
Inhibits NE & dopamine but NOT serotonin
86
Antimanic | Lithium ADVERSE EFFECTS
CNS disturbances, fine tremor, cardiovascular collapse
87
CNS Stimulants | prototype: methylphenidate (Ritalin) INDICATIONS
treat ADD and narcolepsy
88
CNS Stimulants: | methylphenidate (Ritalin) ACTIONS
Mild cortical stimulant | "Fight or Flight" response
89
CNS Stimulants: | methylphenidate (Ritalin) ADVERSE EFFECTS
CNS stimulation: Nervousness, insomnia, increased pulse and BP, tachycardia, loss of appetite, abdominal pain

Pharmacology (6 decks)

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