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N216 > Midterm Drugs > Flashcards

Midterm Drugs Flashcards

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1
Q

Adrenergic Medications

A

Stimulate the SNS

Controls the release of neurotransmitters

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2
Q

Adrenergic Medications cause

A

Vasoconstriction & CNS Stimulation
Increase HR
Dilate pupils
Treat shock and hypotension

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3
Q

Types of Adrenergic Medications

A

Decongestant
Bronchodilators
Vasopressors
Cardiac Stimulant

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4
Q

What symptoms would adrenergic cause

A

Fight or flight

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5
Q

2 classes of adrenergics

A

Catecholamines

Non-catecholamines

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6
Q

Catecholamines

A

similar to norepinephrine, short duration of action & administered parentarelly

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7
Q

Non-catecholamines

A

Taken orally, longer duration of action, not rapidly destroyed by monoamine oxidase

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8
Q

Adrenergic meds treat

A

shock, hypotension & acute asthma exacerbations

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9
Q

Side effects of adrenergic

A 
Anxiety
Restlessness/ Wakefulness
Dizziness
Headache
Nausea
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10
Q

Cholinergic medications stimulate

A

PNS

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11
Q

Cholinergic Cardiovascular effects

A

Decrease HR and BP

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12
Q

Cholinergic Pupil effects

A

Constrict pupils and decrease inoculate pressure

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13
Q

Cholinergic GI&GU effects

A

Increases gastric secretions and urinary frequency

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14
Q

Cholinergic respiratory effects

A

Bronchial constriction

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15
Q

Indirect acting cholinergics

A

Contraindicated in pregnancy and breastfeeding avoid use in GI&GU obstruction, COPD, Parkinsons and bradycardia hypotension

Increase muscular tone and contraction

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16
Q

Action of adrenergic antagonists

A

Inhibit the SNS

Block adrenergic receptors

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17
Q

Clinical applications of Adrenergic antagonists

A

Effects relaxation on vascular smooth muscle in small arterioles and decrease BP
BPH:increases urine flow
Beta receptors are blocked thus reducing BP

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18
Q

Side effects of adrenergic antagonists

A

Orthostatic hypotension
Impotence
Reflex Tachycardia
Nasal Congestion

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19
Q

Cholinergic Blocking agents Function

A

Inhibition of the PNS

Block or inhibit the actions of acetylcholine in the PNS

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20
Q

Cholinergic Blocking agents Cardiovascular

A

Increase HR in small doses and decrease HR in large doses

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21
Q

Cholinergic Blocking agents Respiratory

A

Open airways

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22
Q

Cholinergic Blocking agents GI

A

Decrease motility, peristalsis, gastric and mucous production

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23
Q

Cholinergic Blocking agents CNS

A

Decreases muscle rigidity and tremors in small doses and drowsiness and hallucinations in large doses

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24
Q

Cholinergic Blocking agents are used to treat

A

Asthma

Bradycardias and Brady-dysrhymias

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25
Side effects of anticholinergics
``` Tachycardia CNS stimulation Urinary Retention in men with prostate disorders Dry mouth Dry eyes Inhibit sweating Photophobia ```
26
Triptans
Antimigraine drug that stimulates 5-HT receptors in cerebral arteries, causing vasoconstriction and reducing headache symptoms
27
Ergot alkaloids
antimigraine Constrict or narrow blood vessels obtained from fungus
28
ANtimigraine drugs | Triptans
``` Sumatriptan (Imitrex) Almotriptan (Axert) Eletriptan (Relpax) Naratriptan (Amerge) Rizatriptan (Maxalt) Zolmitriptan (Zomig) Frovatriptan (Frova) ```
29
Adverse effects of Triptans
Vasoconstriction Irritation at injection site Tingling, flushing, congestion
30
Adverse effects of ergot alkaloids
Nausea & vomitting Cold and clammy hands Muscle pain Dizziness
31
Antiepileptic drugs traditionally used to manage seizure disorders
Barbiturates Hydantoins Iminostilbenes plus valproic acid Second and third generation antiepileptics
32
Pharmacological effects of anti epileptic drugs
Reduce nerves ability to be stimulated Suppress transmission of impulses from one nerve to the next, Decrease speed of nerve impulse conduction within.a neuron
33
Long term therapy of Phenytoin (Dilantin) may cause
Gingival hyperplasia, acne, hirsutism, and dilantin facies
34
Antiepileptic drugs
``` Carbamazepine (Mazepine) Ethosuximide (Zarontin) Fosphenytoin (Cerebyx) Gabapentin (Neurontin) Lamotrigine (Lamictal) Levetiracetam (Keppra) Oxcarbazepine (Trileptal) Phenobarbital Phenytoin (Dilantin) Perampanel (Fycompa) Pregabalin (Lyrica) Primidone Topiramate (Topamax) Valproic acid (Depakene) ```
35
Barbiturates serum drug level
15-40 mag/ML
36
Contraindications of Barbiturates
allergy, porphyria, liver or kidney impairment, respiratory illness
37
Adverse effects of barbiturates
Cardiovascular, CNS, GI, and dermatological reactions
38
Barbiturate drugs
Phenobarbital & Primidone
39
Primidone is metabolized in the liver to
phenobarbital
40
Therapeutic drug levels of phenytoin (Dilantin)
10-20mcg/mL
41
Phenytoin (Dilantin) administration
Iv, however very irritating to veins | Filter must be used, diluted in normal saline for IV infusion
42
What is the injectable version of phenytoin (Dilantin)
Fosphenytoin (Cerebyx)
43
Ethosuximide (Zarontin)
Used in treatment of uncomplicated absence seizures | Not effective for secondary tonic-clonic seizures
44
Ethosuximide (Zarontin) Contraindication
Allergy
45
Ethosuximide (Zarontin) Adverse effects
GI & CNS effects
46
Ethosuximide (Zarontin) Drug interactions
Hepatic enzyme-inducing drugs
47
Gabapentin (Neurontin)
HAs the chemical analogue of a neurotransmitter that inhibits brain activity
48
Gabapentin (Neurontin) Contraindication
Allergy
49
Gabapentin (Neurontin) Adverse Effects
CNS & GI Symptoms
50
Gabapentin (Neurontin) administration
Oral use only
51
Lamotrigine (Lamictal)
anti seizure and also used for bipolar disorder
52
Lamotrigine (Lamictal) Contraindications
Allergy
53
Lamotrigine (Lamictal) Adverse effects
minor CNS and GI symptoms possible Stevens Johnson Syndrome
54
Lamotrigine (Lamictal) Administration
Oral use only
55
Levetiracetam (Keppra)
Adjunct therapy for partial seizures with and without secondary generalization
56
Levetiracetam (Keppra) contraindication
allergy
57
Levetiracetam (Keppra) Adverse effects
generally well tolerated, CNS effects
58
Levetiracetam (Keppra) Administration
Oral and Injectable forms
59
Pregabalin (Lyrica)
Structually related to GABA, mostly used for adjunct therapy for neuropathic pain, postherpetic neuralgia
60
Pregabalin (Lyrica) Indication
Partial seizures
61
Pregabalin (Lyrica) Contraindication
Allergy
62
Pregabalin (Lyrica) Adverse drug reaction
primarily CNS related
63
Pregabalin (Lyrica) Administration
Oral use only
64
What are anti platelet drugs for
Used for the treatment of further strokes and in clients who have had TIA Also manages BP
65
Most frequently used anti platelet drug
Aspirin
66
Psychotherapeutic Drugs
Used in treatment of emotional and mental disorders
67
Types of Psychotherapeutic Drugs
Anxiolytic drugs Mood stabilizing drugs Antidepressants Antipsychotics
68
Anxiolytics Action
Reduce anxiety by reducing overactivity in the CNS; Binds to GABA receptors
69
Anxiolytics Indication
Ethanol withdrawal, insomnia, muscle spasms, seizure disorders, anesthesia, depression anxiety
70
Anxiolytics Contraindication
Allergy, Narrow angle glaucoma, Pregnancy
71
Anxiolytics Adverse effects
CNS depression, hypotension, drowsiness, dixzziness, lethargy, headache, ataxia, slurred speech, depression, bradycardia, hypotension, constipation, diarrhea, nausea, vomiting
72
Anxiolytics Prototype Class
benzodiazepines
73
Anxiolytics Prototype drug
Lorazepam
74
Examples of Benzodiazepines
alprazolam (Xanax) diazepam (Valium) lorazepam (Ativan)
75
Alprazolam (Xanax)
Most commonly used anxiolytic
76
Alprazolam (Xanax) Indications
GAD, Short term relief of anxiety symptoms, panic disorder, anxiety with depression
77
Alprazolam (Xanax) adverse effects
Confusion ataxia headache
78
Alprazolam (Xanax) Interactions
Alcohol, antacids, oral contraceptives
79
Diazepam (Valium) Indications
Relief of anxiety, Management of alcohol withdrawal, reversal of status epileptics, preoperative sedation, adjunct for relief of skeletal muscles
80
Diazepam (Valium) Adverse affects
headache, confusion, slurred speech
81
Diazepam (Valium) avoid with
patients with hepatic dysfunction
82
Diazepam (Valium) Interactions
Alcohol, oral contraceptives
83
Lorazepam (Ativan) acting
Immediate acting benzodiazepine
84
Lorazepam (Ativan) administration
can be given intravenously or intramuscularly
85
Lorazepam (Ativan) indications
used to treat agitated pt and pt with alcohol withdrawal
86
Buspirone Hydrochloride (Buspar) Action
Unknown
87
Buspirone Hydrochloride (Buspar) adverse effects
``` Paradoxical anxiety Blurred vision dizziness headache nausea ```
88
Buspirone Hydrochloride (Buspar)
miscellaneous anxiolytic
89
Buspirone Hydrochloride (Buspar) administration
On a scheduled basis
90
mechanism of action for antidepressants
Enhance the action of certain neurotransmitters Block breakdown of norepinephrine Slow reuptake of serotonin
91
Lithium drug of choice for treating
Mania
92
Lithium action
potentiate serotonergic neurotransmission
93
Litium acute therapeutic range
serum level 1-1.5mmol/L | maintenance levels should stay around 0.6-1.2
94
Lithium levels above what produce toxicity
1.5-2
95
Symptoms of lithium toxicity
GI discomfort, tremor, confusion, somnolence, seizures and death
96
What helps maintain therapeutic lithium levels
Maintaining a sodium level of 135-145mmol/L
97
Adverse effects of lithium
Cardiac dysrhythmias, drowsiness, slurred speech, epilepsy, ataxia, choreoathetic movements, hypotension Long term treatment can cause hypothyroidism
98
First gen antidepressants
Tricyclics Tetracyclines MAOIs
99
Second gen antidepressants
SSRIs | SNRIs
100
example of tricyclic antidepressants
amitriptyline (Elavil)
101
tricyclic antidepressants mechanism
Block reuptake of neurotransmitters causing accumulation at nerve endings
102
tricyclic antidepressants idications
``` Neuropathic pain insomnia OCD anorexia Childhood enuresis ```
103
tricyclic antidepressants adverse effects
Sedation impotence orthostatic hypotension
104
tricyclic antidepressants Overdose
CNS and cardio systems affected | Death results from dysrhymias or seizure
105
tricyclic antidepressants therapeutic effects
take 2-6 weeks
106
tricyclic antidepressants contraindications
acute recovery phase of MI and history with heart block
107
tricyclic antidepressants drug interactions
Oral contraceptives, alcohol, CNS depressants, clonidine
108
Amitriptyline (Elavil)
Oldest and most widely used antidepressant
109
Amitriptyline (Elavil) Indication
depression Insomnia Neuropathic pain
110
Amitriptyline (Elavil) Contraindications
Allergy pregnancy myocardial infarction
111
Amitriptyline (Elavil) adverse effects
Dry mouth, constipation, blurred vision, urinary retention, dysrhythmias
112
MAOI
Monoamine Oxidase Inhibitor
113
MAOI disadvantage
Potentail to cause hypertensive crisis when taken with tyramine
114
MAOI use
Parkinsons disease
115
When on MAOI patients must avoid
``` food with tyramine aged cheese smoked, pickled, aged meats yeast extracts red wine Italian broad beans ```
116
Second gen antidepressants
``` Trazodone (Oleptro) Bupropin (Wellbutrin) SSRIS -Fluoxetine (Prozac) -Sertraline (Zoloft) -Paroxetine (Paxil) -Fluvoxamine maleate (Luvox) - Citalopram (Celexa) - escitalopram oxalate (Cipralex) ```
117
Second gen antidepressants Indication
Depression, BPD, Obesity, eating disorder, OCD, Panic attacks, social anxiety, PTSD, Prementrual dysphoric disorder, neurologic disorder myoclonus, substance abuse and alcoholism
118
Bupropion Hydrochloride indication
depression and smoking cessation
119
Duloxetine Hydrochloride (Cymbalta) Indications
depression, GAD, pain from diabetic peripheral neuropathy fibromyalgia, chronic back pain, osteoarthritis
120
Duloxetine Hydrochloride (Cymbalta) adverse effects
Dizziness, drowsiness, headache, GI upset anorexia, hepatotoxicity
121
Duloxetine Hydrochloride (Cymbalta) drug interactions
SSRI triptans, alcohol
122
Duloxetine Hydrochloride (Cymbalta) can worsen
Uncontrolled angle closure glaucoma
123
Fluoxetine (Prozac) is
Prototypical SSRI
124
Fluoxetine (Prozac) indications
Depression bulimia, OCD panic disorder, premenstrual dysphoric disorder
125
Fluoxetine (Prozac) contraindications
allergy, concurrent MAOI therapy
126
Fluoxetine (Prozac) adverse effects
anxiety dizziness, drowsiness, insomnia
127
Mirtazapine (Remeron) Action
Promotes pre synaptic release of serotonin and norepinephrine in the brain
128
Mirtazapine (Remeron) indications
depression, sexual adverse effects in male pt with SSRI therapy, appetite stimulant
129
Mirtazapine (Remeron) Contraindications
allergy MAOI
130
Mirtazapine (Remeron) adverse effects
Drowsiness, abnormal dreams, dry mouth, constipation, increased appetite, asthenia
131
Mirtazapine (Remeron) drug interactions
CNS depressant effets with alcohol and cytochrome P-450 inhibitors
132
Antipsycotics Mechanism
block dopamine receptors in the brain areas associated with emotion, cognitive function and motor function dopamine levels in CNS are decreased
133
Antipsycotics indications
psychotic illness schizophrenia anxiety and mood disorders
134
Haloperidol (Haldol) indications
long term treatment of psychosis
135
Haloperidol (Haldol) Contraindications
hypersensitivity, Parkinson's disease
136
Clozapine (Clozaril)
Selectively blocks the dopaminergic receptors in the meolimbic region of the brain
137
Clozapine (Clozaril) Adverse effects
Blood dyscarias
138
Risperidone (Risperdal) Indication
Schizophrenia
139
Risperidone (Risperdal) adverse effects
Minimal EPS at therapeutic dosages of 1-6 mg/day
140
Risperidone (Risperdal) administration
Oral and long acting injectable forms
141
St Johns Wort
Herbal product used for depression, anxiety, sleep disorders, nervousness
142
St Johns Wort adverse effects
GI upset, fatigue, dizziness, confusion, dry mouth, photosensitivity
143
St Johns Wort Interactions
MAOI SSRI Tyramine foods

N216 (5 decks)

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