Pharm 1 Flashcards
(270 cards)
1
Q
Bethanechol indications
A
treatment of post-op and postpartum urinary retention (nonobstructive)
2
Q
Bethanechol MOA
A
a synthetic ester of choline, stimulates parasympathetic nervous system, increases bladder muscle tone, also stimulates gastric motility
3
Q
Bethanechol side effects
A
hypotension, tachycardia, colic, headache, diaphoresis, cramps, diarrhea, salivation, vomiting, urinary urgency, lacrimation, miosis, bronchoconstriction
4
Q
Bethanechol contraindications
A
mechanical obstruction of GI or GU, hyperthyroidism, peptic ulcers, asthma, CAD, hypotension, parkinsonism
5
Q
Bethanechol drug interactions
A
ACE inhibitors may enhance effect, Beta blockers may enhance effect
6
Q
Pilocarpine indications
A
Systematic: xerostomia
Ophthalmic: Glaucoma management
7
Q
Pilocarpine MOA
A
cholinergic agonist, stimulates miosis and lowering of intraocular pressure
8
Q
Pilocarpine side effects
A
lacrimation, diarrhea, nausea, vomiting, decreased visual acuity
9
Q
Pilocarpine contraindications
A
anterior chamber inflammation
10
Q
Pilocarpine drug interactions
A
ACE inhibitors may enhance effect, Beta blockers may enhance effect
11
Q
Atropine indications
A
Sinus bradycardia, inhibition of salivation and secretions, antidote for anticholinesterase poisoning, mydriasis
12
Q
Atropine MOA
A
blocks acetylcholine at parasympathetic, muscarinic receptors
13
Q
Atropine side effects
A
tachycardia, palpitations, ataxia, disorientation, anhidrosis, constipation, xerostomia, urinary retention, angle-closure glaucoma, blurry vision, mydriasis, increased intraocular pressure, fever
14
Q
Atropine contraindications
A
Narrow-angle glaucoma, pyloric stenosis, prostatic hypertrophy
15
Q
Atropine drug interactions
A
Anticholinergics may enhance effect, ACE inhibitors may decrease effect, may enhance constipation and urinary retention with opiates
16
Q
Scopolamine indications
A
treatment of nausea and vomiting, decrease salivary and respiratory secretions, produce amnesia, sedation and tranquilization
17
Q
Scopolamine MOA
A
block acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and CNS
18
Q
Scopolamine side effects
A
orthostatic hypotension, tachycardia, restlessness and sedation (?), urinary retention, tremor, weakness, blurry vision
19
Q
Scopolamine contraindications
A
glaucoma
20
Q
Scopolamine drug interactions
A
Anticholinergics may enhance effect, ACE inhibitors may decrease effect, may enhance constipation and urinary retention with opiates
21
Q
Ipratropium indications
A
bronchodilator
22
Q
Ipratropium MOA
A
anticholinergic atropine derivative
23
Q
Ipratropium side effects
A
bronchitis, sinusitis, xerostomia
24
Q
Ipratropium contraindications
A
hypersensitivity
25
Ipratropium drug interactions
Anticholinergics may enhance effect, ACE inhibitors may decrease effect, may enhance constipation and urinary retention with opiates
26
Tubocurarine indications
skeletal muscle relaxation for operation
27
Tubocurarine MOA
nondepolarizing neuromuscular blocker, competitively block ACh
28
Tubocurarine side effects
hypotension
29
Tubocurarine contraindications
not commonly used, but one big contraindication is myocardial ischemia
30
Tubocurarine drug interactions
tetraethylammonium reverses effects
31
Succinylcholine indications
rapid sequence inductions, skeletal muscle relaxation for surgery
32
Succinylcholine MOA
the only depolarizing muscle relaxant in use today, activating nicotinic receptors to depolarize the neuromuscular junction
33
Succinylcholine side effects
arrhythmias, bradycardia, hyperkalemia, excessive salivation, increased intraocular pressure
34
Succinylcholine contraindications
malignant hyperthermia, acute phase of injury following multiple trauma or major burns, upper motor neuron lesion
35
Succinylcholine drug interactions
ACE inhibitors may increase serum concentration of succinylcholine, succinylcholine may enhance the bradycardic effect of opioids
36
botulinum toxin indications
induce local muscle paralysis, multiple applications
37
botulinum toxin MOA
blocks release of acetylcholine from synaptic vesicles
38
botulinum toxin side effects
pain, infection
39
botulinum toxin contraindications
infection at injection site, hypersensitivity
40
botulinum toxin drug interactions
aminoglycosides, neuromuscular blocking agents, anticholinergics all enhance effect
41
pyridostigmine indications
myasthenia gravis treatment, antagonism of nondepolarizing neuromuscular blockers, pretreatment for soman nerve gas exposure
42
pyridostigmine MOA
inhibition of acetylcholinesterase
43
pyridostigmine side effects
arrhythmias, convulsions, dizziness, diarrhea, nausea, salivation, vomiting, urinary urgency, lacrimation
44
pyridostigmine contraindications
asthma, bronchospasm, cholinergic sensitivity
45
pyridostigmine drug interactions
anticholinergic agents: diminished effect, beta blockers: enhanced, cholinergics: increased effect, succinylcholine: increased serum concentrations, nondepolarizing neuromuscular blockers: diminished effect
46
neostigmine indications
symptomatic control of myasthenia gravis, prevention of perioperative urinary retention, reversal of nondepolarizing neuromuscular blockers
47
neostigmine MOA
inhibition of acetylcholinesterase
48
neostigmine side effects
arrhythmias, convulsions, dizziness, diarrhea, nausea, salivation, vomiting, urinary urgency, lacrimation
49
neostigmine contraindications
peritonitis, urinary obstruction
50
neostigmine drug interactions
anticholinergic agents: diminished effect, beta blockers: enhanced, cholinergics: increased effect, succinylcholine: increased serum concentrations, nondepolarizing neuromuscular blockers: diminished effect
51
edrophonium indications
diagnosis of myasthenia gravis
52
edrophonium MOA
inhibition of acetylcholinesterase
53
edrophonium side effects
arrhythmias, convulsions, dizziness, diarrhea, nausea, salivation, vomiting, urinary urgency, lacrimation
54
edrophonium contraindications
hypersensitivity, GI or GU obstruction
55
edrophonium drug interactions
anticholinergic agents: diminished effect, beta blockers: enhanced, cholinergics: increased effect, succinylcholine: increased serum concentrations, nondepolarizing neuromuscular blockers: diminished effect
56
physostigmine indications
reversal of central nervous system anticholinergic syndrome
57
physostigmine MOA
inhibition of acetylcholinesterase, able to cross blood-brain barrier
58
physostigmine side effects
hallucinations, nervousness, restlessness, seizure, SLUD
59
physostigmine contraindications
GI, GU obstruction, asthma, diabetes, CV disease
60
phystostigmine drug interactions
anticholinergic agents: diminished effect, beta blockers: enhanced, cholinergics: increased effect, succinylcholine: increased serum concentrations, nondepolarizing neuromuscular blockers: diminished effect
61
epinephrine indications
treatment of anaphylactic reactions, treatment of shock hypotension, code drug for arrhythmia
62
epinephrine MOA
stimulates alpha and beta 1,2 adrenergic receptors
63
epinephrine side effects
angina, tachycardia, anxiety, xerostomia, urinary retention, tremor, weakness, exacerbation of glaucoma, diaphoresis
64
epinephrine contraindications
none in life-threatening situation, nose, ears, fingers, and toes for local anesthesia
65
epinephrine drug interactions
multiple, the gist: enhanced effect with sympathomimetics,
66
norepinephrine indications
severe hypotension
67
norepinephrine MOA
stimulates alpha and beta 1 adrenergic receptors, increasing heart contractility and vasoconstricting
68
norepinephrine side effects
arrhythmia, peripheral ischemia, anxiety, dyspnea
69
norepinephrine contraindications
hypersensitivity, non-emergent hypotension from extravasation
70
norepinephrine drug interactions
alpha and beta blockers, many others
71
dopamine indications
treatment of shock which persists after adequate fluid volume replacement
72
dopamine MOA
stimulates dopaminergic receptors and beta 1 adrenergic receptors
73
dopamine side effects
angina, anxiety, piloerection, elevated glucose, vomiting, increased intraocular pressure, polyuria, dyspnea
74
dopamine contraindications
hypersensitivity to sulfites, V fib
75
dopamine drug interactions
multiple, similar to norepi and epi
76
isoproterenol indications
mild or transient episodes of heart block
77
isoproterenol MOA
beta 1, 2 agonist
78
isoproterenol side effects
angina, dizziness, nausea, vomiting, tremor, blurry vision, diaphoresis
79
isoproterenol contraindications
angina, arrhythmia, cardiac glycoside intoxication
80
isoproterenol drug interactions
enhances sympathomimetics
81
albuterol indications
treatment or prevention of bronchospasm
82
albuterol MOA
beta 2 agonist in respiratory system
83
albuterol side effects
tachycardia, excitement, xerostomia, URI
84
albuterol contraindications
hypersensitivity, pregnancy (injected)
85
albuterol drug interactions
beta blockers diminish, sympathomimetics enhance
86
phenylephrine indications
nasal congestion
87
phenylephrine MOA
selective alpha agonist
88
phenylephrine side effects
burning, nasal discharge, sneezing
89
phenylephrine contraindications
hypersensitivity, V tach
90
phenylephrine drug interactions
alpha blockers diminish, sympathomimetics enhance
91
amphetamine indications
a drug of abuse, but some amphetamines are used to treat ADHD, obesity, and narcolepsy
92
amphetamine MOA
stimulates release of norepinephrine, serotonin, dopamine, inhibits monoamine oxidase
93
amphetamine side effects
arrhythmias, palpitations, agitation, anxiety, hallucinations, paranoia, restlessness, seizures, cool/blue fingers, bruxism, diaphoresis, liver failure, xerostomia
94
amphetamine contraindications
history of drug abuse, glaucoma, cardiovascular disease, hypertension, hyperthyroidism, agitation
95
amphetamine drug interactions
oodles, MAO inhibitors enhance, opioids enhanced, cns depressants less effective
96
levodopa indications (other name in combo)
treatment of parkinson's (sinemet as levodopa/carbidopa)
97
levodopa MOA
blood-brain barrier crossing dopamine precursor
98
levodopa side effects
anorexia, nausea, tachycardia, hypotension, psychiatric problems
99
levodopa contraindications
hypersensitivity, narrow-angle glaucoma
100
levodopa drug interactions
oodles, MAOi's enhanced, antipsychotics diminished, hypotensives enhanced
101
carbidopa indications
administered with levodopa to diminish side effects
102
carbidopa MOA
inhibits dopamine decarboxylase, does not cross blood brain barrier
103
carbidopa side effects
similar to levodopa, though less intense/frequent
104
carbidopa contraindications
hypersensitivity
105
carbidopa drug interactions
increases serum concentration of droxidopa, MAOi's enhanced
106
entacapone indications
adjunct to levodopa/carbidopa for those with wearing off symptoms
107
entacapone MOA
inhibits catechol-0-methyltransferase, which converts levodopa into methyldopa. Methyldopa competes with levodopa
108
entacapone side effects
nausea, dyskinesa, dizziness, drowsiness
109
entacapone contraindications
hypersensitivity
110
entacapone drug interactions
oodles, CNS depressants enhance CNS depression
111
pramipexole indications
treatment of signs and symptoms of idiopathic parkinsonism
112
pramipexole MOA
dopamine receptor agonist
113
pramipexole side effects
sedation, hallucinations, confusion, nausea, hypotension
114
pramipexole contraindications
none listed
115
pramipexole drug interactions
alcohol may enhance sedative effect, MAOi's enhance orthostatic hypotension effects, other CNS depressants enhance CNS depression
116
ropinirole indications
treatment of parkinson disease
117
ropinirole MOA
dopamine receptor agonist
118
ropinirole side effects
sedation, hallucinations, confusion, nausea, hypotension
119
ropinirole contraindications
hypersensitivity
120
ropinirole drug interactions
alcohol may enhance sedative effect, MAOi's enhance orthostatic hypotension effects, other CNS depressants enhance CNS depression
121
selegiline indications
adjunct to levodopa/carbidopa in parkinson's with diminishing effect of l/c, transdermal for major depressive disorder
122
selegiline MOA
selectively inhibits MAO type a (metabolizes dopamine), will inhibit MAO type b at high doses
123
selegiline side effects
headache, insomnia, dizziness, nausea
124
selegiline contraindications
hypersensitivity
125
selegiline drug interactions
oodles, MAOi's enhanced, tramadol lowers seizure threshold and enhances neuroexcitatory
126
isoflurane indications
maintenance of general anesthesia
127
isoflurane MOA
variety of molecular mechanisms, increase sensitivity of GABAa
128
isoflurane side effects
arrhythmia, hypotension, mood changes, nausea, vomiting, BUN decreased, creatinine increased, respiratory depression, malignant hyperthermia
129
isoflurane contraindications
hypersensitivity, predisposition to malignant hyperthermia
130
isoflurane drug interactions
oodles, CNS depressants enhance
131
nitrous oxide indications
sedation, analgesia, amnesia
132
nitrous oxide MOA
may inhibit action potentials, may act on opiate receptors,
133
nitrous oxide side effects
headache, dizziness, confusion
134
nitrous oxide contraindications
hypersensitivity, presence of intraocular gas bubble, do not administer without oxygen
135
nitrous oxide drug interactions
CNS depressants enhance effect
136
thiopental indications
induction of anesthesia, very short acting
137
thiopental MOA
blocking of excitatory glutamate receptors, enhancing GABAa receptors: decreased neuronal activity
138
thiopental side effects
addictiveness, drowsiness, nausea, vertigo, tremors, enzyme induction
139
thiopental contraindications
hypersensitivity, hepatic impairment, dyspnea, sedative addiction
140
thiopental drug interactions
oodles and oodles, CNS depressants enhance, enzyme inducers
141
midazolam indications
preoperative sedation
142
midazolam MOA
GABAa enhancement
143
midazolam side effects
drowsiness, confusion, ataxia
144
midazolam contraindications
hypersensitivity, glaucoma
145
midazolam drug interactions
CNS depressants enhance
146
ketamine indications
induction and maintenance of general anesthesia
147
ketamine MOA
blocks glutamate at NMDA receptors
148
ketamine side effects
increased ICP, salivation, increased intraocular pressure, respiratory depression
149
ketamine contraindications
hypersensitivity, conditions in which increased blood pressure would be hazardous
150
ketamine drug interactions
oodles, CNS depressants enhance, watch for metabolism
151
fentanyl indications
pain management, adjunct to anesthesia
152
fentanyl MOA
binds with many receptors in CNS, increases pain threshold, alters pain perception, inhibits pain pathways
153
fentanyl side effects
hypotension, dysphoria, sedation, constipation, urinary retention, nausea, potential for addiction, respiratory depression
154
fentanyl contraindications
opioid naive, hypersensitivity
155
fentanyl drug interactions
oodles, CNS depressants enhance, watch for metabolism
156
propofol indications
induction of anesthesia
157
propofol MOA
GABAa agonist, possibly NDMA glutaminergic antagonist
158
propofol side effects
hypotension, movement, apnea
159
propofol contraindications
hypersensitivity, including to eggs or soy
160
propofol drug interactions
oodles, CNS depressants enhance
161
procaine indications (duration)
local anesthesia, short acting
162
procaine MOA
blocks sodium channels, inhibiting action potential
163
procaine side effects
local irritation, arrhythmia if IV
164
procaine contraindications
hypersensitivity
165
procaine drug interactions
watch for Cyp3a4 and cyp1a2 metabolism
166
lidocaine indications (duration)
local anesthesia, intermediate acting
167
lidocaine MOA
blocks sodium channels, inhibiting action potential
168
lidocaine side effects
local irritation, arrhythmia if IV
169
lidocaine contraindications
hypersensitivity
170
lidocaine drug interactions
watch for Cyp3a4 and cyp1a2 metabolism
171
bupivicaine indications (duration)
local anesthesia, long acting
172
bupivicaine MOA
blocks sodium channels, inhibiting action potential
173
bupivicaine side effects
local irritation, arrhythmia if IV
174
bupivicaine contraindications
hypersensitivity
175
bupivicaine drug interactions
watch for Cyp3a4 and cyp1a2 metabolism
176
acamprosate indications
maintenance of alcohol abstinence
177
acamprosate MOA
mechanism not fully defined, structurally similar to GABA
178
acamprosate side effects
chest pain, anxiety, depression, decreased libido, xerostomia, suicide attempt
179
acamprosate contraindications
hypersensitivity, severe renal impairment
180
acamprosate drug interactions
no known significant interactions
181
ethanol indications
drug of abuse, ethylene glycol overdose antidote, methanol overdose antidote, topical anti-infective
182
ethanol MOA
competitively inhibits alcohol dehydrogenase (which metabolizes ethylene glycol and methanol into toxic metabolites)
183
ethanol side effects
hypotension, agitation, disorientation, vertigo, nausea, vomiting, intoxication
184
ethanol contraindications
hypersensitivity, seizure disorder, diabetic coma
185
ethanol drug interactions
oodles, enhances CNS depressants, watch for liver metabolized stuff
186
methanol indications
drug of abuse
187
methanol MOA
metabolized by alcohol dehydrogenase to formaldehyde, then metabolized by aldehyde dehydrogenase into formic acid: metabolic acidosis, toxic to optic disk and putamen
188
methanol side effects
increased MCV, cardiovascular failure, blindness (snowstorm), acidosis, diarrhea, dyspnea, death
189
methanol contraindications
uh. . . being human?
190
methanol drug interactions
N/A, I guess?
191
ethylene glycol indications
drug of abuse
192
ethylene glycol MOA
metabolized by alcohol dehydrogenase to glycoaldehyde, then by aldehyde dehydrogenase into glycolic acid and others: metabolic acidosis, encephalopathy
193
ethylene glycol side effects
heart failure, acidosis, nausea, vomiting, diplopia, respiratory distress, ataxia, CNS depression, disorientation, coma
194
ethylene glycol contraindications
uh. . . being human?
195
ethylene glycol drug interactions
N/A, I guess?
196
naltrexone indications
treatment of alcohol dependance
197
naltrexone MOA
competitive antagonist to opioid receptors
198
naltrexone contraindications
opioid dependance, opioid withdrawal, opioid use
199
naltrexone side effects
syncope, headache, nausea
200
naltrexone drug interactions
diminish opioids, enhance opioid antagonists, go figure
201
disulfiram indications
management of chronic alcoholism
202
disulfiram MOA
interferes with aldehyde dehydrogenase
203
disulfiram side effects
with alcohol: flushing, nausea, thirst, palpitations, chest pain, vertigo
without alcohol: drowsiness
204
disulfiram contraindications
psychosis, myocardial disease
205
disulfiram drug interactions
ethanol, may increase serum concentration of diazepam
206
thiamine indications
treat deficiency, as in Wernicke's encephalopathy and Korsakoff's syndrome
207
thiamine MOA
an essential coenzyme in carbohydrate metabolism
208
thiamine side effects
hypersensitivity, restlessness, hemorrhage into GI tract
209
thiamine contraindications
hypersensitivity
210
thiamine drug interactions
none known
211
chloral hydrate indications
not used in US, short term sedative and hypnotic
212
chloral hydrate MOA
mechanism unknown, CNS depressant
213
chloral hydrate side effects
arrhythmia, diarrhea, CNS depression, hallucinations, nightmares
214
chloral hydrate contraindications
hepatic or renal impairment
215
chloral hydrate drug interactions
CNS depressants enhance
216
nicotine indications
drug of abuse, given to wean for addiction
217
nicotine MOA
autonomic ganglia and CNS stimulant, acts on nicotinic receptors
218
nicotine side effects
risk of addiction, headache, cough, irritation
219
nicotine contraindications
arrhythmias, pregnancy, angina pectoris
220
nicotine drug interactions
adenosine: tachycardic effect enhanced, cimetidine may increase serum concentration of nicotine
221
cocaine indications
drug of abuse, topical anesthesia for mucous membranes
222
cocaine MOA
for anesthesia: blocks ion channels in sensory nerves, inhibiting action potential
for abuse: blocks reuptake of monoamines (norepi, serotonin, dopamine)
223
cocaine side effects
CNS stimulation, loss of smell, chronic use depletes dopamine
224
cocaine contraindications
hypersensitivity, ophthalmologic anesthesia (causes sloughing of corneal epithelium)
225
cocaine drug interactions
cyp3a4 substrates enhanced
226
methamphetamine indications
drug of abuse, ADHD, obesity
227
methamphetamine MOA
sympathomimetic, CNS stimulant
228
methamphetamine side effects
vertigo, hypertension, insomnia, confusion, addictive potential, nausea, diarrhea
229
methamphetamine contraindications
glaucoma, cardiovascular disease, hypertension, agitation, predilection for addiction
230
methamphetamine drug interactions
MAO inhibitors enhance hypertensive effect, diminishes effect of sedatives, enhances stimulants
231
MDMA indications
drug of abuse, AKA molly, Ecstasy
232
MDMA MOA
amphetamine, sympathomimetic, CNS stimulant
233
MDMA side effects
vertigo, hypertension, insomnia, confusion, addictive potential, hyperthermia, serotonin syndrome
234
MDMA contraindications
no indication for use, drug of abuse
235
MDMA drug interactions
MAO inhibitors enhance hypertensive effect, diminishes effect of sedatives, enhances stimulants
236
cannabis indications
drug of abuse, appetite induction, antiemetic, minor pain control
237
cannabis MOA
acts on cannabinoid receptors in CNS
238
cannabis side effects
tachycardia, impaired memory, hallucinations, conjunctivitis, increased appetite, impaired coordination
239
cannabis drug interactions
enhance CNS depressants, enhance tachycardia with sympathomimetics
240
cannabis contraindications
Hx schizophrenia, hypersensitivity
241
bupropion indications
depression, smoking cessation
242
bupropion MOA
not fully understood, norepinephrine and dopamine reuptake inhibitor
243
bupropion side effects
tachycardia, headache, xerostomia, weight loss, blurry vision
244
bupropion contraindications
seizure disorder, anorexia
245
bupropion drug interactions
MAO inhibitors, linezolid, methylene blue, oodles
246
varenicline indications
smoking cessation aid
247
varenicline MOA
partial nicotinic receptor agonist
248
varenicline side effects
suicidal thoughts, vivid nightmares, mood changes, headache
249
varenicline contraindications
hypersensitivity
250
varenicline drug interactions
enhance toxic effect of alcohol, trimethoprim, quinolones increase serum concentration
251
dantrolene indications
malignant hyperthermia, spacticity
252
dantrolene MOA
interferes with release of calcium from sarcoplasmic reticulum in skeletal muscle
253
dantrolene side effects
drowsiness, limb pain, nocturia, dysuria
254
dantrolene contraindications
active hepatic disease for oral formulation
255
dantrolene drug interactions
CNS depressants enhance, oodles
256
phencyclidine indications (AKA)
PCP, drug of abuse
257
phencyclidine MOA
reduced glutamate activity due to NDMA receptor antagonism
258
phencyclidine side effects
behavioral abnormalities, hypertension, tachycardia
259
phencyclidine contraindications
no indication for use
260
phencyclidine drug interactions
treat with benzodiazepines
261
memantine indications
treatment of Alzheimer dementia
262
memantine MOA
blocks NMDA receptors, preventing toxic levels of Ca in cell
263
memantine side effects
hypertension, dizziness, incontinence, diarrhea
264
memantine contraindications
hypersensitivity
265
memantine drug interactions
bupropion, trimethoprim may increase serum concentration
266
donepezil indications
treatment of Alzheimer dementia
267
donepezil MOA
inhibits centrally-active acetylcholinesterase
268
donepezil side effects
insomnia, nausea, diarrhea
269
donepezil contraindications
hypersensitivity
270
donepezil drug interactions
anticholinergics diminished by ACE inhibitors, may enhance bradycardic effect of bradycardics
