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Flashcards in Pharm 2 - Exam 1 Deck (88):
1

Which opioid receptor site is for pain?

Mu

2

These receptor sites are found throughout the body and can lead to many systemic effects.

Opioid

3

This opioid analgesic has a high affinity for mu receptors and is known to blunt perception.

Morphine/ MS Contin

4

This drug might be used in the case of pain, anxiety and acute MI due to its vasodilatory effect.

Morphine/MS Contin

5

Respiratory depression is the most common cause of death related to this drug.

Morphine/MS Contin

6

These three s/sx are an indicator of opiate analgesic use.

pinpoint pupils
itching
respiratory depression

7

How do opiates cause constipation or even paralytic ileus?

Mu receptors in the GI are stimulated and reduce GI motility.

8

Which are the routes of administration for morphine?

IV, PO, rectal

9

This drugs has 80x the analgesic strength of morphine.

Fentanyl/Duragesic

10

What are the routes of administration for Fentanyl/Duragesic?

IV, transdermal patch, buccal lozenge, sublingual spray, LOLLIPOP

11

Patients using concomitant CYP450 inhibitors are at risk for fatal blood level of this drug.

Fentanyl/Duragesic

12

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

13

This opiate analgesic is also an effective antitussive.

Codeine

14

Which opiate analgesic prescription can be called in?

Codeine

15

This centrally-acting analgesic also affect neurotransmitters and so may improve mood.

Tramadol/Ultram

16

Spell the common name of Diacetylmorphine.

H-E-R-O-I-N (there is no E)

17

Name the synthetic opioid that is used to control withdrawal from heroin and morphine.

Methadone

18

This drug is known for the rapid reversal of opiate effects in addicted patients.

Nalaxone/Narcan

19

This drug is the dextro-isomer of codeine.

Dextromethorphan (DM)

20

What compounds do NSAIDs prevent the synthesis of?

prostaglandins (via COX-1 and COX-2)

21

Name the COX-2 inhibitor

Celecoxib/Celebrex

22

Does aspirin reversibly/irreversibly inhibit COX-1?

Irreversibly

23

What medications can be used for migraine prophylaxis?

Beta-blockers, Ca Channel Blockers, Methysergide, Tricyclic antidepressants, ergotamine, anti-seizure medications

24

Which medication is used during the prodromal phase of migraine management?

Triptans (mc Sumatriptan/Imitrex)

25

Which medications are used for the actual headache phase of the migraine?

Analgesics
Anti-emetics

26

Name the drug and class of beta blocker (selective/non-selective) that is used for migraine prophylaxis.

Non-selective, e.g. Propranolol/Inderal

27

This tricyclic antidepressant is used in the treatment of migraine/tension HA.

Amitriptyline/Elavil

28

This anticonvulsant is used for the treatment of migraines and may also be used for weight loss and for drug withdrawal.

Topiramate/Topamax

29

Methysergide/Sansert is an ergot derivative - serotonin 2 receptor ____________ (agonist/antagonist), therefore causing ____________ (vasodilation/vasoconstriction.)

Antagonist
Vasoconstriction

30

What are the three most concerning side effects of Methysergide/Sansert?

1. vasoconstriction
2. pulmonary fibrosis and retroperitoneal fibrosis
3. heart valve thickening >>> murmurs

31

This migraine med is Category X

Methysergide/Sansert

32

Sumatriptan/Imitrex is a serotonin-1 _________ (agonist/antagonist) used during the prodromal phase of migraine HAs. It results in stronger ______________ (vasoconstriction/vasodilation).

agonist
vasoconstriction

33

What is the recommended maximum # of doses of 100mg Sumatriptan/Imitrex in a day?

2 (Max: 200mg daily)

34

This migraine drug is Category C.

Sumatriptan/Imitrex

35

What are the potential symptoms of serotonin syndrome?

diarrhea (most common)
agitation
tremor
ataxia
fever
chills

36

What class of drugs has the potential of causing serotonin syndrome?

Triptans

37

Name the most common NSAIDS

Ibuprofen (motrin, advil)
Indomethacin
Aspirin
Naproxen
Acetaminophen

38

Unlike Aspirin, this NSAID is known for its reversible inhibition of COX-1 and COX-2 enzymes

Ibuprofen

39

This migraine drug is a mixed agonist-antagonist of opioid receptors and is generally given as a nasal spray.

Butorphanol/Stadol

40

This drug is a typical neuroleptic anti-emetic used when vomiting is associated with migraine HAs.

Prochlorperazine/Compazine

41

What are the side effects of Prochlorperazine/Compazine ?

drowsiness, dry mouth constipation, urinary retention and lowered seizure threshold.

42

What is the indication and MOA of Ondansetron/Zofran?

Severe nausea
Blockage of 5HT3 serotonin receptor.

43

What 3 drugs could you use for an acute gout attack?

NSAIDs
Steroids
Colchicine

44

What 3 drugs could you use for prophylactic treatment of gout?

colchincine
allopurinol
probenecid

45

What is the first-line treatment for gout?

NSAIDs

46

What do COX-1 and COX-2 target in particular?

COX-1: stomach mucosa
COX-2: fevers and inflammation

47

What is Sampter's Triad?

Aspirin allergy, asthma, nasal polyps

48

What is the most common SE of Colchicine?

Neuropathy: hands, feet, GI problems

49

What is the MOA of Colchicine?

inhibits neutrophil motility and activity = anti-inflammatory

50

Name a purine analog (decreases uric acid production) used in the treatment of gout and hyperuricemia.

Allopurinol/Zyloprim

51

What enzyme does Allopurinol/Zyloprim inhibit?

Xanthine oxidase

52

Define anti-uricosuric

Substances that decrease the excretion of uric acid in the urine.

53

Name a uricosuric that is used in the treatment of hyperuricemia and gout.

Probenecid/Probalan

54

What is the most notable SE of Probenecid/Probalan?

uric acid renal stones (esp. with renal insufficiency)

55

T/F. Probenecid/Probalan may cause an acute gout attack at the onset of use?

true

56

Which two drugs are know for interfering with Folate metabolism?

Methotrexate
Sulfa

57

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

58

T/F. Oral methotrexate is dosed daily.

False. Weekly

59

How is methotrexate delivered?

All the ways.
PO, IM, IV, SQ, IT (intra-thecal)

60

What lung pathology might Methotrexate cause?

pulmonary fibrosis

61

Name the purine anti-metabolite immunosuppressant used in the treatment of transplant rejection, IBD, SLE, RA.

Azathioprine/Imuran

62

What is the desired outcome when cyclosporines are used in the eyes?

to stimulate tear production

63

What is the most potent immunosupressive drug?

Tacrolimus/Prograf

64

What is a notable side effect of DMARDS?

ITP (platelet drop)

65

Name the class and MOA of Etanercept/Enbrel.

DMARD
Anti-TNFalpha = anti-inflammatory

66

How is Infliximab delivered?

IV (often every 2 months)

67

Of Infliximad/Remicade and Etanercept/Enbrel, which has show efficacy in the treatment of Crohn's and UC?

Infliximab/Remicade

68

This drug is an anti-malarial drug that is also used for autoimmune disease treamtment.

Hydroxychloroquine/Plaquenil

69

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.

Hydroxychloroquine/Plaquenil

70

Patients with G6PD who take Hydroxychloroquine can develop what?

severe anemia

71

Define tachyphylaxis

a rapid decrease in response to a drug over a short time

72

Name the MC short acting glucocorticoid (8-12hrs).

Hydrocortisone

73

Name the MC intermediate acting glucocorticoid (18-36hrs)

Prednisone

74

Name the 2 MC long acting glucocorticoid (24-72hrs)

Dexamethasone
Betamethasone

75

Rank Hydrocortisone, Dexamethason, Betamethasone, and Prednisone in terms of anti-inflammatory potency.

Hydrocortisone
Prednisone
Dexamethasone
Betamethasone

76

What may happen if glucocorticoids are abruptly ceased?

acute adrenal insufficiency syndrome aka Addisonian crisis
(may be lethal)

77

The greater the glucocorticoid action, the _________ (weaker/greater) the mineralcorticoid action.

weaker

78

What are the symptoms are Addisonian crisis?

severe lethargy, vomiting, diarrhea, low bp, confusion, LOC, convulsions, mb death

79

Name the fluorinated corticosteroid

Dexamethasone/Decadron

80

This corticosteroid is used for Asthma and COPD and is not indicated for treating an acute asthma attack.

Triamcinolone inhaler/Azmacort

81

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.

82

Name a mineralocorticoid used in the treatment of Addison't disease or other cases of hyponatremia and does not have any anti-inflammatory affect.

Fludrocortisone/Florinef

83

MAOIs are known for what serious side effects?

Hypertensive emergencies and fatal accelerated HTN

84

What side effects do Tricyclic antidepressants cause?

anti-cholinergic signs: dry mouth, constipation, urinary hesitancy, orthostatic hypotension and sedation

85

What other type of antidepressant should Tricyclic antidepressant not be mixed with?

MOAIs

86

Who would most benefit from TCAs?

Those suffering from insomnia and depression

87

Name the TCA

Amitriptyline/Elavil

88

Name the SSRI

Fluoxetine/Prozac