Final (Exam 3) Flashcards
(111 cards)
1
Q
Alprazolam (Xanax)
A
[Benzodiazepine]
- Onset: 60 min
- 1/2 life: 11 hrs
- Active metabolites
2
Q
Clonazepam (Klonipin)
A
[Benzodiazepine]
- Onset: 20-40 min
- 1/2 life: 22-23 hrs
3
Q
Diazepam (Valium)
A
[Benzodiazepine]
- Onset: 10-20 min
- 1/2 life: Up to 48 hrs
- Active metabolites
4
Q
Lorazepam (Ativan)
A
[Benzodiazepine]
- Onset: 30-60 min
- 1/2 life: ~15 hrs
5
Q
Citalopram (Celexa)
A
[SSRI]
- 1/2 life: 35 hrs
6
Q
Escitalopram (Lexapro)*
A
[SSRI]
- 1/2 life: 3- hrs
- Approved >12 yo*
7
Q
FLUoxetine (Prozac)*
A
[SSRI]
- 1/2 life: 4-6 days
- Active metabolites 7-9 days
- Approved >8 yo*
8
Q
FluvoxaMINE*
A
[SSRI]
- 1/2 life: 16 hrs
- Approved for pediatric OCD*
9
Q
PARoxetine (Paxil)
A
[SSRI]
- 1/2 life: 24 hrs
10
Q
Sertraline (Zoloft)*
A
[SSRI]
- 1/2 life: 26 hrs
- 70-80 hrs
- Approved >6 yo*
11
Q
Duloxetine (Cymbalta)
A
[SSRI/SNRI]
- 1/2 life: 12 hrs
12
Q
Venlafaxine (Effexor)
A
[SSRI/SNRI]
Approved for pediatric use
13
Q
Desvenlafaxine (Pristiq)
A
[SSRI/SNRI]
14
Q
Benzodiazepines - MOA
A
Binds to GABA receptors halting neuronal stimulation
15
Q
SSRI’s - MOA
A
Binds to SRR preventing serotonin from being taken back into the pre-synaptic cell
16
Q
Tricyclic Antidepressants (TCAs) - MOA
A
Inhibits the reuptake of 5-HT & NE increasing synaptic concentrations
17
Q
Amitryptiline
A
[Tricyclic Antidepressant]
18
Q
Doxepin
A
[Tricyclic Antidepressant]
19
Q
Imipramine
A
[Tricyclic Antidepressant]
20
Q
Nortriptyline
A
[Tricyclic Antidepressant]
21
Q
Dopamine Reuptake Blockers - MOA
A
- Structurally different than all other antidepressants
- MOA not fully understood
- Dopaminergic & Noradrenergic activity
- Weak inhibitor of dopamine and norepinephrine (no inhibition of serotonin)
22
Q
Buproprion (Wellbutrin)
A
[Dopamine Reuptake Blocker]
23
Q
Nonadrenergic Antagonists - MOA
A
- Tetracyclic antidepressant
- Increases release of norepinephrine & serotonin
(does NOT inhibit reuptake)
24
Q
Mirtazipine (Remeron)
A
[Noradrenergic Antagonist]
For Major Depressive Disorder
25
Lithium (Lithobid) - MOA
[Mood Stabilizers]
- Alters transport across cell membrane
- Prevents reuptake of serotonin & norepinephrine
- Inhibits postsynaptic D2 receptor
26
Valproic Acid (Depakote) - MOA
[Mood Stabilizers]
- Increases availability of GABA
- Enhances effect and mimics effect of GABA at postsynaptic receptor sites
27
Antipsychotics - MOA
- Prevents binding of serotonin, dopamine, and histamine to receptors
- Stabilizes mood
28
Haloperidol (Haldol)
[Typical Antipsychotics]
29
Chlorpromazine (Thorazine)
[Typical Antipsychotics]
30
Aripiprazole (Abilify)
[Atypical Antipsychotics]
31
Olanzapine (Zyprexa)
[Atypical Antipsychotics]
32
Quetiapine (Seroquel)
[Atypical Antipsychotics]
33
Risperidone (Risperidol)
[Atypical Antipsychotics]
34
Stimulants - MOA
Blocks the reuptake of dopamine & norepinephrine
35
Dexmethylphenidate (Focalin)
[Stimulants]
| for ADD/ADHD
36
Mixed Amphetamines (Adderall)
[Stimulants]
| for ADD/ADHD
37
Methylphenidate (Concerta, Ritalin)
[Stimulants]
| for ADD/ADHD
38
Selective Norepinephrine Reuptake Inhibitor - MOA
Selectively inhibits reuptake of norepinephrine
| for ADD/ADHD
39
Atomoxetine (Strattera)
[Selective Norepinephrine Reuptake Inhibitor]
| for ADD/ADHD
40
Antihypertensives - MOA
- Alpha2 receptor AGONISTS
| - Exact mechanism for ADD/ADHD unknown (Regulates prefrontal cortex of brain)
41
Clonidine (Catapres)
[Antihypertensives]
| for ADD/ADHD
42
Guanfacine (Intuniv)
[Antihypertensives]
| for ADD/ADHD
43
Triptans - MOA
- Bind to 5-HT 1B & 1D to cause vasoconstriction with reduced inflammation
- For headaches
44
Sumitriptan (Imitrex)
| Rizatriptan
[Triptans]
| For headaches
45
Rapid-Acting Insulin - PK parameters
```
Onset = 15 mins
Peak = 1-2 hrs
Duration = 3-4 hrs
```
46
```
Insulin Aspart (Novolog)
Insulin Lispro (Humalog)
Insuline Glulisine (Apidra)
```
[Rapid-Acting Insulin]
47
Short-acting Insulin - PK parameters
```
Onset = 30-60 mins
Peak = 2-4 hrs
Duration = 4-8 hrs
```
48
Insulin Regular (Novolin R, Humalin R)
[Short-acting Insulin]
49
Intermediate-acting Insulin - PK parameters
```
Onset = 1-2 hrs
Peak = 4-10 hrs
Duration = 10-18 hrs
```
50
Insulin NPH (Novolin N)
[Intermediate-acting Insulin]
51
Insulin Detemir (Levemir) - PK parameters
```
[Long-acting Insulin]
Onset = 6 hrs
Peak = 12-16 hrs
Duration = 2 hrs
Dose freq = q12-24 hrs
```
52
Insulin Glargine (Lantus) - PK parameters
```
[Long-acting Insulin]
Onset = 4-5 hrs
Peak = NO PEAK
Duration = 22-24 hrs
Dose freq = q24 hrs (q12)
```
53
Sulfonylureas - MOA
- Enhancement of insulin secretion
- Bind to sulfonylurea receptor (SUR) on pancreatic Beta cells
- Closes ATP-dependent K channels, influx of Ca
- Suppresses hepatic glucose production
* Trying to push whatever insulin you're making out of Beta cells
54
Glipizide
| Glyburide
[2nd gen Sulfonylureas]
| *only ones approved for pediatric use
55
Metformin (Glucophage) - MOA
- Increases insulin sensitivity
- Decrease hepatic glucose production
- Decreases intestinal glucose absorption
56
Glucagon (Glucogen) - MOA
- Stimulates adenylate cyclase increasing cAMP & gluconeogenesis
57
Somatotropin (Serostim), aka rGH
- biosynthetic (recombinant) Growth Hormone
| - Goal: normalization of height during childhood and attainment of normal adult height
58
Oral Levothyroxine
- Tx of congenital hypothyroidism (CH)
- Also Acquired Hypothyroidism
- Dose: 10-15 mcg/kg/day
- Take on empty stomach
59
Methimazole and Propylthiouracil (PTU) - MOA
[Antithyroid Medications]
- Inhibit synthesis of thyroid hormones by blocking oxidization of iodine in the thyroid gland
- Dosed every 8-12 hours
60
Antacids - MOA
- Neutralize stomach acid
| - Deactivate pepsin & acidity of reflux
61
Calcium Carbonate (Tums, Maalox)
[Antacids]
| For GERD
62
Aluminum Hydroxide/Magnesium Hydroxide (Mylanta)
[Antacids]
| For GERD
63
Ranitidine (Zantac)
[H2 Receptor Blockers]
- TID dosing
- Large dosing range recommendation
64
Famotidine (Pepcid)
[H2 Receptor Blockers]
- Twice daily dosing
- Standard dosing 1 mg/kg twice daily
65
Proton Pump Inhibitors - MOA
- Blocks acid secretion by inhibiting ATPase enzyme system in parietal cells
- Causes prolonged decrease in gastric acid secretion
- Decreases acidity of reflux
66
Esomeprazole (Nexium)
[Proton Pump Inhibitors]
| For GERD
67
Omeprazole (Prilosec)
[Proton Pump Inhibitors]
| For GERD
68
Lansoprazole (Prevacid)
[Proton Pump Inhibitors]
For GERD
- Only one with liquid formulation, best for enteral tube administration
69
Pantoprazole (Protonix)
[Proton Pump Inhibitors]
| For GERD
70
Prokinetic Agents - MOA
- Increase gastric emptying
| - Increase LES pressure
71
Metoclopramide (Reglan)
[Prokinetic Agents]
| For GERD
72
Erythromycin
[Prokinetic Agents]
| For GERD
73
Sucralfate (Carafate) - MOA
Forms a paste in the presence of gastric pH to coat the lining of the esophagus & stomach.
For GERD
74
Aminosalicylates - MOA
For IBD
- unknown MOA
- Works typically to inhibit pro-inflammatory cytokines
- Inhibits inflammatory transcription of NF-kB to block prostaglandin and leukotriene production
75
Mesalamine
[Aminosalicylates] For IBD
- Ascacol
- Pentasa
- Rowasa
76
Sulfasalazine
[Aminosalicylates]
| For IBD
77
Balsalazine
[Aminosalicylates]
| For IBD
78
Corticosteroids - MOA
For IBD
- Unknown MOA
- Decreases transcription of proinflammatory cytokines
- Prevents nuclear translocation of NF-kB
- Inhibits inflammatory response
79
Hydrocortisone
[Corticosteroids]
| For IBD
80
Prednisone/Prednisolone
[Corticosteroids]
| For IBD
81
Budesonide (Enterocort)
[Corticosteroids]
| For IBD
82
Metronidazole
[Antibiotics]
For IBD
- Active CD
- UC maintenance
83
Ciprofloxacin
[Antibiotics]
For IBD
- CD (perineum)
- UC
84
Azathioprine (Imuran) & Mercaptopruine (6MP)
[Immunomodulators] For IBD
| - inhibit inflammatory response (protein synthesis, nucleic acid metabolism, clonal expansion of lymphocytes)
85
Methotrexate
[Immunomodulators] For IBD
- MOA unknown
- Inhibits proinflammatory cytokines and down-regulates activate T cells and neutrophils
86
Calcineurin Inhibitors
[Immunosuppressants] For IBD
- Tacrolimus & Cyclosporine
- MOA: Inhibit production of Interleukin 2 (IL 2) and cytokines
87
Antimetabolites
[Immunosuppressants] For IBD
- Mycophenolate mofetil (Cellcept)
- Suppresses T and B cell proliferation
- Used in conjunction w/ other agents
88
Biologics - MOA
For IBD
- Neutralizes proinflammatory cytokine TNF
- Activates complement-mediated cytolysis of TNF-producting monocytes
* Monoclonal antibodies targeting a specific immune response, using a more targeted therapy compared to methotrexate or calcineurin inhibitors whcih ahve a larger ADE profile)
89
Humira (Adalimumab)
[Biologics] For IBD
| - Only subcutaneous injection
90
Remicade (Infliximab)
[Biologics] For IBD
| - Only intravenous infusion
91
5-HT3 Receptor Antagonists - MOA
For N/V
- Effects occur at CTZ (potentiality at peripheral sites as well)
- Block binding of Serotonin
92
Ondansetron (Zofran)
Granisetron (Kyrtril)
Palenosetron
Dolasetron
[5-HT3 Receptor Antagonists]
| For N/V
93
Antihistamine & Anticholinergic Agents - MOA
- For N/V
| - Weak antiemetic properties but work by competing with histamine on H1-receptors or M1 (scopolamine)
94
```
Diphenhydramine (Benadryl)
Hydoxyzine (Vistril)
Medizine (Dramamine)
Dimenhyrinate (Gravasol)
Scopolamine
```
[Antihistamine & Anticholinergic Agents]
| For N/V
95
Dopamine Receptor Antagonists - MOA
For N/V
| Work primarily affecting DA receptors but also bind to M1 and H1
96
Prochlorperazine
Promethazine
Metoclopramide
[Dopamine Receptor Antagonists]
| For N/V
97
Dronabinol (Marinol)
For N/V
- Synthetic delta-9-tetrahydrocannabinol (delta-THC)
- CIII medication (controlled)
- No DDI except w/ highly protein-bound drugs (Warfarin)
98
Dexamethasone
```
[Corticosteroid]
For BPD
- 0.25 mg/kg/dose IV BID x 3 days
- Gradually taper by 10% every 3 days
- Taper over 12-21 days, total of 42 days is possible
```
99
Furosemide (Lasix)
[Diuretics]
For BPD
- IV (0.5-1 mg/kg/dose), max 2 mg/kg/dose q24 (or q12)
- PO (1-2 mg/kg/dose)
100
Chlorothiazide (Diuril)
[Diuretics]
For BPD
- <6 months: 20-40 mg/kg/day, divided q12
- >6 months: 20 mg/kg/day po divided q12 (max 1g)
101
Spironolactone (Aldactone)
[Diuretics]
For BPD
- Potassium sparing diuretic
- 1-3mg/kg/day po q24 hours - 2mg/kg/day typical
102
Albuterol
[Bronchodilators]
For BPD
- Nebulizer 2.5 mg every 2-6 hours PRN
103
Indomethacin (Indocin)
[Prostaglandin Inhibitor]
For PDA
- Prophylactic dose (0.1 mg/kg/dose) IV over 20 min Q24 hours for the first 6 days of life
- All <1250 grams BW who have received surfactant for RDS
- Early symptomatic dose (0.2 mg/kg/dose) IV over 20 min, 2nd and 3rd doses (0.1 mg/kg/dose if <1250 grams and <7 days old) given 12 and 36 hours after first dose
- If >1250 grams and >7 days old 0.2 mg/kg/dose
- TYPICALLY THIS IS DAYS 2-4 of life when symptoms appear!
104
Ibuprofen
[Nonselective cyclooxygenase inhibitor]
- Studies show as effective as Indocin for PDA
- Advantage: does not reduce the mesenteric and renal artery blood flow..so fewer renal side effects
- DOSE (10mg/kg/dose followed by 2 doses of 5 mg/kg) each after 24 and 48 hours within 1st week of life
- Due to change in PK, higher doses (18 mg/kg and 9 mg/kg) after the 2nd week of life
105
Caffeine Citrate (CAFCIT)
[Methylxanthine]
For Apnea of Prematurity
- Loading dose: 20-25 mg/kg IV or PO
- Maintenance dose: 5-10 mg/kg/day IV or PO Q24 hours
- Therapeutic levels: 5-25 mcg/ml trough, draw on day 5 of life if needed
106
Ampicillin
[Antibiotic]
For Neonatal Sepsis
- <2kg = 100 mg/kg/day IV divided every 12 hours
- May see 50 mg/kg/day IV divided every 12 hours
- >2kg = divided every 8 hours (75-150mg/kg/day)
- GBS meningitis: 200-300 mg/kg/day divided every 8 hours IV
107
Gentamicin
[Antibiotic]
For Neonatal Sepsis
- = 29 weeks PMA: 4.5mg/kg/dose ever 36-48 hours (5mg and 48 hours if in first 7 days of life)
- 30-40 weeks PMA: 4-4.5mg/kg/dose every 24-36 hours (4.5 and 36 hours if in first 7 days of life)
- >/= 35 weeks PMA: 4mg/kg/dose IV every 24 hours
- OTOTOXICITY WITH HIGH LEVELS
- Trough: 0.5-2mcg/ml; if trough high adjust the interval
108
Vancomycin
[Antibiotic]
For Neonatal Sepsis
- Gram positive activity
- Streptococci, Staph, MRSA, Listeria
- 15 mg/kg/day IV every 8 (>2kg and >7 days)
- MRSA DOSING: 15 mg/kg/dose every 6 hours for 2-6 wks
109
Cefotaxime
[Antibiotic]
For Neonatal Sepsis
- Gram negative
- Pseudomonas, E-coli, Klebsiella, Serratia, H. influenzae
- 100 mg/kg/day divided every 12 hours (up to 1 mo of age) IV
- 1/2 life 1-4 hours
- Excreted in the urine
110
Clindamycin
[Antibiotic]
For Neonatal Sepsis
- NEC anaerobic coverage for suspected perforation
- 10-15 mg/kg/day IV divided every 8-12 hours
- Does not cross BBB so not used to treat meningitis
111
Ranitidine (Zantac) - Neonatal GERD
- DOSE Neonatal: 2-4 mg/kg/day divided every 8-12 hours PO (max is 6 mg/kg/day)
- DOSE Infants >1 month: 5-10 mg/kg/day divided 2-3x daily
