Flashcards in Pharm 2 - Exam 1 Deck (88):
Which opioid receptor site is for pain?
These receptor sites are found throughout the body and can lead to many systemic effects.
This opioid analgesic has a high affinity for mu receptors and is known to blunt perception.
Morphine/ MS Contin
This drug might be used in the case of pain, anxiety and acute MI due to its vasodilatory effect.
Respiratory depression is the most common cause of death related to this drug.
These three s/sx are an indicator of opiate analgesic use.
How do opiates cause constipation or even paralytic ileus?
Mu receptors in the GI are stimulated and reduce GI motility.
Which are the routes of administration for morphine?
IV, PO, rectal
This drugs has 80x the analgesic strength of morphine.
What are the routes of administration for Fentanyl/Duragesic?
IV, transdermal patch, buccal lozenge, sublingual spray, LOLLIPOP
Patients using concomitant CYP450 inhibitors are at risk for fatal blood level of this drug.
Fentanyl/Duragesic patches can be rendered less effective/not work as intended by doing what two things?
cutting the patch in half
placing heat over the patch
This opiate analgesic is also an effective antitussive.
Which opiate analgesic prescription can be called in?
This centrally-acting analgesic also affect neurotransmitters and so may improve mood.
Spell the common name of Diacetylmorphine.
H-E-R-O-I-N (there is no E)
Name the synthetic opioid that is used to control withdrawal from heroin and morphine.
This drug is known for the rapid reversal of opiate effects in addicted patients.
This drug is the dextro-isomer of codeine.
What compounds do NSAIDs prevent the synthesis of?
prostaglandins (via COX-1 and COX-2)
Name the COX-2 inhibitor
Does aspirin reversibly/irreversibly inhibit COX-1?
What medications can be used for migraine prophylaxis?
Beta-blockers, Ca Channel Blockers, Methysergide, Tricyclic antidepressants, ergotamine, anti-seizure medications
Which medication is used during the prodromal phase of migraine management?
Triptans (mc Sumatriptan/Imitrex)
Which medications are used for the actual headache phase of the migraine?
Name the drug and class of beta blocker (selective/non-selective) that is used for migraine prophylaxis.
Non-selective, e.g. Propranolol/Inderal
This tricyclic antidepressant is used in the treatment of migraine/tension HA.
This anticonvulsant is used for the treatment of migraines and may also be used for weight loss and for drug withdrawal.
Methysergide/Sansert is an ergot derivative - serotonin 2 receptor ____________ (agonist/antagonist), therefore causing ____________ (vasodilation/vasoconstriction.)
What are the three most concerning side effects of Methysergide/Sansert?
2. pulmonary fibrosis and retroperitoneal fibrosis
3. heart valve thickening >>> murmurs
This migraine med is Category X
Sumatriptan/Imitrex is a serotonin-1 _________ (agonist/antagonist) used during the prodromal phase of migraine HAs. It results in stronger ______________ (vasoconstriction/vasodilation).
What is the recommended maximum # of doses of 100mg Sumatriptan/Imitrex in a day?
2 (Max: 200mg daily)
This migraine drug is Category C.
What are the potential symptoms of serotonin syndrome?
diarrhea (most common)
What class of drugs has the potential of causing serotonin syndrome?
Name the most common NSAIDS
Ibuprofen (motrin, advil)
Unlike Aspirin, this NSAID is known for its reversible inhibition of COX-1 and COX-2 enzymes
This migraine drug is a mixed agonist-antagonist of opioid receptors and is generally given as a nasal spray.
This drug is a typical neuroleptic anti-emetic used when vomiting is associated with migraine HAs.
What are the side effects of Prochlorperazine/Compazine ?
drowsiness, dry mouth constipation, urinary retention and lowered seizure threshold.
What is the indication and MOA of Ondansetron/Zofran?
Blockage of 5HT3 serotonin receptor.
What 3 drugs could you use for an acute gout attack?
What 3 drugs could you use for prophylactic treatment of gout?
What is the first-line treatment for gout?
What do COX-1 and COX-2 target in particular?
COX-1: stomach mucosa
COX-2: fevers and inflammation
What is Sampter's Triad?
Aspirin allergy, asthma, nasal polyps
What is the most common SE of Colchicine?
Neuropathy: hands, feet, GI problems
What is the MOA of Colchicine?
inhibits neutrophil motility and activity = anti-inflammatory
Name a purine analog (decreases uric acid production) used in the treatment of gout and hyperuricemia.
What enzyme does Allopurinol/Zyloprim inhibit?
Substances that decrease the excretion of uric acid in the urine.
Name a uricosuric that is used in the treatment of hyperuricemia and gout.
What is the most notable SE of Probenecid/Probalan?
uric acid renal stones (esp. with renal insufficiency)
T/F. Probenecid/Probalan may cause an acute gout attack at the onset of use?
Which two drugs are know for interfering with Folate metabolism?
When prescribing Methorexate/MTX, which patients would you want to supplement folate with and which would you would not?
Yes: Auto-immune patients
No: Cancer patients
T/F. Oral methotrexate is dosed daily.
How is methotrexate delivered?
All the ways.
PO, IM, IV, SQ, IT (intra-thecal)
What lung pathology might Methotrexate cause?
Name the purine anti-metabolite immunosuppressant used in the treatment of transplant rejection, IBD, SLE, RA.
What is the desired outcome when cyclosporines are used in the eyes?
to stimulate tear production
What is the most potent immunosupressive drug?
What is a notable side effect of DMARDS?
ITP (platelet drop)
Name the class and MOA of Etanercept/Enbrel.
Anti-TNFalpha = anti-inflammatory
How is Infliximab delivered?
IV (often every 2 months)
Of Infliximad/Remicade and Etanercept/Enbrel, which has show efficacy in the treatment of Crohn's and UC?
This drug is an anti-malarial drug that is also used for autoimmune disease treamtment.
This drug can cause the corneas to become opaque when used long-term and in higher doses, as in the treatment of AI conditions. Frequent eye exams are mandated.
Patients with G6PD who take Hydroxychloroquine can develop what?
a rapid decrease in response to a drug over a short time
Name the MC short acting glucocorticoid (8-12hrs).
Name the MC intermediate acting glucocorticoid (18-36hrs)
Name the 2 MC long acting glucocorticoid (24-72hrs)
Rank Hydrocortisone, Dexamethason, Betamethasone, and Prednisone in terms of anti-inflammatory potency.
What may happen if glucocorticoids are abruptly ceased?
acute adrenal insufficiency syndrome aka Addisonian crisis
(may be lethal)
The greater the glucocorticoid action, the _________ (weaker/greater) the mineralcorticoid action.
What are the symptoms are Addisonian crisis?
severe lethargy, vomiting, diarrhea, low bp, confusion, LOC, convulsions, mb death
Name the fluorinated corticosteroid
This corticosteroid is used for Asthma and COPD and is not indicated for treating an acute asthma attack.
What is the indicator that a patient's asthma is no longer well controlled?
When they are needing to use their steroid inhaler more than 4 times per day.
Name a mineralocorticoid used in the treatment of Addison't disease or other cases of hyponatremia and does not have any anti-inflammatory affect.
MAOIs are known for what serious side effects?
Hypertensive emergencies and fatal accelerated HTN
What side effects do Tricyclic antidepressants cause?
anti-cholinergic signs: dry mouth, constipation, urinary hesitancy, orthostatic hypotension and sedation
What other type of antidepressant should Tricyclic antidepressant not be mixed with?
Who would most benefit from TCAs?
Those suffering from insomnia and depression
Name the TCA