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LCON Pharmacology. > Pharm Exam 2 (A) > Flashcards

Pharm Exam 2 (A) Flashcards

1
Q

What foods should one avoid when taking Dopamine Agonists?

A
  • Iron
  • Protein
  • Vitamin B6
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2
Q

High yield concepts of Selegiline?

A
  • Food Interactions - (Avoid foods with Tyramine)
  • Drug interactions - (Dopamine & MAOIs)
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3
Q

Myasthenia Gravis worsens in the______________?

A

Evenings

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4
Q

What should the Nurse assess first before giving a PO Cholinesterase inhibitors to a patient?

A
  • Their Swallowing Ability

(Ask the Pt to take a few sips of water in order to assess the swallowing ability. if they cant swallow notify the provider and request for an IV order)

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5
Q

What does the Extrapyramidal motor system do?

A
  • It helps regulate involuntary movements and muscle tone.
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6
Q

Examples of Dopamine Agonist Medications?

A
  • Carbidopa/Levodopa
  • Pramipexole
  • Ropinirole
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7
Q

Alzheimer’s disease is associated with the build-up of?

A
  • Plaques
  • Tangles
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8
Q

What does Selegiline medications do?

A
  • It treats Parkinson’s disease.
  • The transdermal version is prescribed for Depression.
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9
Q

What is Alzheimer’s disease?

A
  • Its a type of Dementia disease.
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10
Q

What are the two major types of medication for Myasthenia Gravis?

A

1) Cholinesterase Inhibitors
2) Immunosuppressive drugs

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11
Q

What does Carbidopa do?

A
  • It helps prevent Levodopa from converting into Dopamine before it crosses the Blood Brain Barrier, Because Dopamine cannot cross the BBB.
  • It wont cross the BBB, but helps the Levodopa to cross the BBB
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12
Q

What happens when the neurons of an Alzheimer’s patient dies, there is a?

A
  • Deficit of Acetylcholine.
  • Too much Glutamate (Causes toxicity in the brain).
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13
Q

Since Parkinson’s disease causes an imbalance in the brain, What effect will the medications have on a Parkinson’s patient?

A
  • The drug will:-
    * Increase dopamine
    * Decrease acetylcholine
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14
Q

Symptoms of Myasthenia Crisis

A

1) Extrem Skeletal muscle weakness
2) May stop breathing

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15
Q

Signs and symptoms of Sever stage of Alzheimer’s disease?

A
  • Loss of the ability to :-
    * Eat.
    * Speak.
    * Understand language.
    * Ambulate.
    * Control elimination.
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16
Q

How do the Dopamine Agonist medications work?

A
  • They also increase the Dopamine activities in the brain.

(Since the Parkinson’s disease causes low dopamine)

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17
Q

Acetylcholine is responsible for?

A

Muscle Contraction

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18
Q

Myasthenia Gravis patients should be encouraged to wear a_____________?

A

Medic Alert Bracelet
(Since both the disease and the medication can be fatal)

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19
Q

What is Myasthenia Gravis?

A

Its an Autoimmune disease that attacks the Acetylcholine receptors on the Skeletal muscle

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20
Q

What is the Focus?

A
  • Its the locations where seizure starts.
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21
Q

When you hear the word “Parkinson’s disease” what comes to mind?

A
  • Dopamine
  • Tremors
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22
Q

Signs of Under-medication of Cholinesterase inhibitors / Acetylcholin?

A

1) Ptosis (Droopy eyelids)
2) Difficulty swallowing

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23
Q

High yield concepts of Anticholinergic medications?

A
  • Can’t See
  • Can’t Spit
  • Can’t Pee
  • Can’t defecate
  • Drowsiness
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24
Q

Signs of Parkinson’s Disease

A

(TRAP) mnemonic

  • Tremors (shakiness)
  • Rigidity (Stiffness, jerkiness)
  • Akinistia (Can’t sit still)
  • Postural (Instability)
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25
Q

Myasthenia Gravis is better in the______________?

A

Mornings

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26
Q

What is Epilepsy?

A
  • Its two or more seizures that happen a day or more apart.
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27
Q

What is the Antidote of Cholinergic Crisis?

A

Atropine

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28
Q

What are the effects of Myasthenia Gravis?

A

1) Decreases stimulation
2) Damage to the skeletal muscle

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29
Q

Signs of Anticholinergic Effects

A
  • Can’t See
  • Can’t Spit
  • Can’t Pee
  • Can’t Defecate
  • Drowsiness
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30
Q

Which of the Antiepileptic medications are also prescribed for Bipolar disorder?

A
  • Valproic Acid.
  • Carbamazepine.
  • Lamotrigine.
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31
Q

Examples of medications that treat Alzheimer’s disease?

A
  • Cholinesterase inhibitors (Donepezil).
  • Memantine.
  • Atypical antipsychotics (Risperidone, Olanzapine).
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32
Q

What are the High yield concepts of Cholinesterase inhibitors meds?

A

1) Difficulty Swallowing
2) Dose Adjustment
3) Acute Toxicity (Cholinergic Crisis)
4) Antidote (Atropine)

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33
Q

Signs and symptoms of Moderate stage of Alzheimer’s disease?

A
  • Wandering alot.
  • Emotional instability.
  • Confabulation (The brain creates a memory that it can’t find)
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34
Q

High yield concepts of Donepezil?

A
  • Bradycardia & Syncope (fainting).
  • Drug interactions (Avoid TCA, Antihistamines, Oxybutynin).
  • Cholinergic effects (GI issues is the most common issue).
  • Realistic Expectations (the meds dont stop or even slow down the disease so we should not give the Pt false hopes).
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35
Q

Which Dopamine Agonist medications can cross the Blood Brain Barrier?

A

Levodopa

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36
Q

Signs of Cholinergic Crisis

A

(SLUDGE,BBB) mnemonic

  • Salivation
  • Lacrimation (excess tearing)
  • Urination
  • Diaphoresis / Diarrhea
  • GI cramps
  • Emesis (vomiting)
  • Bradycardia
  • Bronchospasm
  • Bronchorrhea (lots of watery sputum)
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37
Q

Which medications do we give to help treat Parkinson’s disease?

A
  • Dopamine Agonists
  • Selegiline
  • Anticholinergics
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38
Q

The Hippocampus is involved with?

A
  • Memory.
  • Learning.
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39
Q

What are the examples of Benzodiazepines medications?

A

(They end with “zolam & zepam” )

  • Diazepam.
  • Lorazepam.
  • Clonazepam.
  • Alprazolam.
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40
Q

Signs of Over-medication of Cholinesterase inhibitors / Acetylcholin?

A
  • Excessive Salivation
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41
Q

What are the examples of Anticholinergic Medications?

A
  • Benztropine.
  • Trihexyphenidyl
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42
Q

Facts about Donepezil?

A
  • Its a Cholinesterase inhibitor.
  • It is treats all stages of Alzheimer’s disease.
  • It primarily works in the brain.
  • It the only Cholinesterase inhibitor that crosses the Blood Brain Barrier, thats why it works in the brain).
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43
Q

How does Memantine work?

A
  • It treats only two stages of Alzheimer’s disease (Moderate & severe Alzheimer’s).
  • It helps regulate the Glutamate levels in the brains.

(Since an Alzheimer’s Pt has too much Glutamate in their brain).

44
Q

What does a Cholinesterase inhibitor medication do?

A

It binds the Cholinesterase enzyme (causing it to not breakdown the Acetylcholine) hence causing the levels of Acetylcholine to increase.

45
Q

High yield concepts of Dopamine Agonists?

A
  • Purpose of Carbidopa.
  • Orthostatic Hypotension
  • Psychiatric issues (Paranoia, hallucinations & Impulse issues)
  • Food interactions (Iron, Proteins & Vitamin B6)
46
Q

What are the Signs and Symptoms of Myasthenia Gravis?

A

1) Double Vision
2) Droopy Eyelids (Ptosis)
3) Skeletal muscle weakness

47
Q

How do the Anticholinergics work?

A
  • They also treat extrapyramidal effects.
  • They decrease the levels of Acetylcholine in the brain, by blocking the Acetylcholine receptors.

(Since Parkinson’s disease causes too much Acetylcholine)

48
Q

What are the causes of Dementia?

A
  • Alzheimer’s disease
  • Trauma.
  • Genetics.
  • Toxicity.
  • Parkinson’s disease.
  • Frontal Temperal Dementia.
  • Infection.
49
Q

How do the Cholinesterase Inhibitors affect the acetylcholine levels?

A
  • They cause the Acetylcholine levels to increase.

(This causes a production of stronger muscle contractions.)

50
Q

How does Donepezil work?

A
  • It is a Cholinesterase inhibitor, which means it blocks the Cholinesterase that breaks down the Acetylcholine hence increasing the Acetylcholine levels in the brains. (This temporarily improves the clients memory).
51
Q

What enzyme is responsible for breaks down Acetylcholine?

A
  • Cholinesterase
52
Q

What are the examples of Antiepileptic medications?

A
  • Valproic Acid.
  • Carbamazepine.
  • Lamotrigine.
  • Levetiracetam.
  • Phenytoin (most mentioned).
  • Topiramate.
53
Q

Why can’t we give a Parkinson’s disease patient Dopamine?

A
  • Because Dopamine cannot cross the Blood Brain Barriers, so the Pt has to take Levodopa to help cross the Blood Brain Barrier before it is converted to Dopamine after it crosses.
54
Q

Selegiline is part of the?

A

MAO-B inhibitors

(They only prevent the breakdown of Dopamine)

55
Q

Facts about Seizures?

A
  • Happens when the brain becomes Hyperexcitable.
56
Q

How do the Antiepiletic medications work?

A
  • They slow down the CNS
    (They are CNS Depressants)
57
Q

What happens to the patient when a neuron dies (Parkinson’s Disease)?

A
  • Parkinson’s disease causes and imbalance of the two neurotransmitters (Dopamine & Acetylcholine)
    * Too little Dopamine
    * Too much Acetylcholine
58
Q

What are the two types of Cholinesterase drugs that treat Myasthenia Gravis?

A

1) Neostigmine
2) Pyridostigmine

59
Q

What is Substantia nigra

A
  • This the Extrapyrmidal system that releases Dopamine
  • Means Black substance
60
Q

High yield concepts of Memantine?

A
  • Its is well tolerated.
61
Q

Complications of Parkinson’s disease?

A
  • Motor problems
  • Dementia
  • sleep disturbance
  • Difficulty smelling
  • Depression
62
Q

Signs and Symptoms of CNS Depression?

A
  • Sedation.
  • Ataxia (Clumpsiness).
  • Double vision.
  • Cognative impairment.
63
Q

Signs and symptoms of Mild stage of Alzheimer’s disease?

A
  • Short-term memory loss.
  • Confusion.
  • Loss of self management skills (they can clean like they used to).
64
Q

What do the Dopamine Agonists do?

A
  • They help treat Parkinson’s disease
  • They are prescribed for Restless leg syndrome (RLS).

(if its used for RLS its only given at night)

65
Q

What are the causes of Seizures?

A
  • Hypoxia.
  • Head trauma.
  • Infection.
  • Strokes.
  • Tumors.
  • Genetic factors.
  • Some medications.
66
Q

High yield concepts of Antiepileptic Medications?

A
  • CNS Depression - (They should avoid Alcohol).
  • Drug interaction - (Cytochrome P450 meds).
  • Teratogenic - (causes birth defects).
  • Carbamazepine - (causes blood marrow suppression).
  • Phenytoin - (narrow therapeutic index, check blood levels before giving this meds).
  • Valproic Acid - (causes weight gain, alopecia, Hepatoxicity).
  • Lamotrigine - (causes Steven-Johnson syndrom)
    -Levetiracetam - (Well tolarated, wide therapeutic index, nor drug interaction).
67
Q

How do the Cholinesterase inhibitors work?

A
  • The motor neuron release acetylcholine, causing the skeletal muscles contraction. After acetylcholine is released, an enzyme called Cholinesterase quickly breaks down the Neurotransmitter.
  • Cholinesterase inhibitors temporarily bind to Cholinesterase, slowing it down.causing the levels of acetylcholine to increase, hence producing strong muscle contraction.
68
Q

What are the two major types of seizure medications?

A
  • Antiepileptics.
  • Benzodiazepines (they also treat Anxiety & Muscle spasms).
69
Q

How long should a Patient sit before a nurse checks their Blood Pressure?

A

5 minutes.

70
Q

Hypertension is defined as?

A
  • A systolic pressure >130 mmHg,
    or
    diastolic pressure >80 mmHg.
71
Q

What are the secondary causes of Hypertension?

A
  • Obstructive sleep apnea.
  • Kidney disease.
  • Hyperthyroidism.
  • Some Medications
72
Q

What happened if Hypertension is left untreated. it causes?

A
  • Heart disease.
  • Kidney disease.
  • Stroke.
73
Q

what is the most common symptom of Hypertension?

A

Headache

74
Q

How can we reduce the Blood pressure in our body?

A
  • By decreasing the amount of fluids in the bloodstream.

(By taking Diuretics)

75
Q

How do Diuretics work?

A
  • They relieve the pressure of Hypertension by increasing the urine production.
76
Q

Which is the First-line therapy of Hypertension?

A

Thiazide-type diuretics.

77
Q

What are the different examples of Diuretics?

A
  • Furosemide.
  • Chlorthalidone.
  • Hydrochlorothiazide.
  • Mannitol.
  • Spironolactone.
78
Q

Diuretics are used to treat?

A
  • Hypertension.
  • Heart failure.
  • Edema (Peripheral & Pulmonary)
  • Cerebral edema due to head trauma (Mannitol)
79
Q

Furosemide works in which part of the kidney?

A
  • Ascending loop of Henle.
80
Q

Furosemide is often refered as?

A

Loop Diuretic.

81
Q

High yielding concepts of Diuretics?

A
  • Hypotension
  • Hypokalemia (Muscle cramps, Dysrhythmias, fatigue)
  • Electrolytes imbalance.
  • Nocturia
  • Dehydration.
  • Can cause hearing loss (Furosemide).
82
Q

which foods are rich in Potassium.

A
  • Bananas.
  • Winter squash.
  • Sweet potatoes.
  • Baked potatoes.
  • White beans.
  • Yogurt.
  • Orange juice.
  • Broccoli.
  • Cantaloupe.
  • Spinach.
  • Tomatoes.
83
Q

Facts about Spironolactone?

A
  • Its a weak diuretic.
  • Its a Potassium sparing diuretic (prevents the loss of potassium).
  • They Pt should go easy on potassium and avoid salt substitutes.
  • Monitor the Pt for signs of Hyperkalemia.
84
Q

Facts about Mannitol?

A
  • Its used to treat head trauma.
  • Its not used for hypertension - (just for Cerebral edema & stroke).
  • Keep in a warm temperature room - (To prevent crystal formation).
85
Q

Facts about Hydrochlorothiazide (HCTZ) & Chlorthalidone?

A
  • Its cheap.
  • Its safe.
  • Its effective.
  • Monitor for signs for hypokalemia
  • Its the first-line treatment for hypertension.
86
Q

Examples of Beta-Blockers?

A

(they end with “lol”)

(Cardioselective Agents) - they work in the heart
- Atenolol
- Metoprolol

(Nonselective Agents) - they block alot of receptors
- Carvedilol
- Labetalol
- Propranolol

87
Q

Facts about the Carvedilol & Labetalol?

A
  • They block the:-
    * alpha1
    * beta 1
    * beta2 receptors
88
Q

The Beta-blockers are commonly prescribed for?

A
  • Hypertension.
  • Angina pectoris.
  • Atrial Fibrillation.
  • Cardioprotection following a heart attack (they prevent scarrying formation).
89
Q

Alpha1 receptors are located in the_____________?

A

Arteries

90
Q

Beta1 receptors are located in the_____________?

A

Heart

91
Q

Beta2 receptors are located in the_____________?

A

Lungs

92
Q

High yield concepts of Beta-blockers?

A
  • Hypotension
  • Bradycardia
  • Blood sugar regulation - (check the blood sugar often)
  • Bronchoconstriction
  • Depression (propranolol)
  • Erectile dysfunction (in men)
93
Q

What should the nurse assess first before giving a Beta-blocker?

A
  • Heart rate - (hold if less that 50)
  • Blood pressure - (hold if less than 100)
94
Q

Examples of ACE inhibitors (Angiotensin-Converting Enzyme)?

A

(They end with the “pril”)

  • Benazepril
  • Lisinopril
  • Ramipril
95
Q

The ACE inhibitors are commonly prescribed for?

A
  • Hypertension.
  • Heart failure
  • Cardioprotection following a heart attack - (they prevent scarrying formation).
96
Q

Angiotensin-II causes?

A
  • Vascular smooth muscle to contract.
  • High levels of Aldosterone that causes harmful changes in the heart muscles.
  • the release of the Aldosterone hormone by triggering the receptors in the adrenal gland.
97
Q

High yield concepts of ACE inhibitors?

A
  • Hypotension
  • Hyperkalemia
  • Persistent dry cough
  • Angioedema - (swollen face, eyes,troat, lips & tongue)
98
Q

Examples of ARBs (Angiotensin II Receptor Blockers)

A

(They end with “Sartan”)

  • Losartan
  • Olmesartan
  • Valsartan
99
Q

The ARBs (Angiotensin II Receptor Blockers) are commonly prescribed for?

A
  • Hypertension.
  • Heart failure
  • Slow progression of CKD (chronic kidney disease)
  • Cardioprotection following a heart attack - (they prevent scarrying formation).
100
Q

High yield concepts of ARBs (Angiotensin II Receptor Blockers)

A
  • Hypotension
  • Angioedema
  • They are cheaper
101
Q

Examples of CCBs (Calcium Channel Blockers)

A

(Dihydropyridines) - they end with “dipine”
- Amlodipine
- Nifedipine

(Nondihydropyridines) - they cause Bradycardia
- Diltiazem
- Verapamil

102
Q

Facts about the Nondihydropyridines (Calcium Channel Blockers)?

A
  • They cause Bradycardia
  • Pt taking these should avoid grape-fruit juice
103
Q

The CCBs (Calcium Channel Blockers) are commonly prescribed for?

A
  • Hypertension.
  • Angina pectoris (chest pain)
  • Atrial Fibrillation.
104
Q

High yield concepts of CCBs (Calcium Channel Blockers)

A
  • Hypotension
  • Vasodilation
  • Peripheral Edema
  • Bradycardia
  • Constipation (Verapamil)
105
Q

Facts about Hydralazine?

A
  • Its a Blood pressure medication
  • Its prescribed for hypertension
  • Can be combined with other antihypertensive meds
  • It has a short half life and requires frequent doses
106
Q

High yield concepts of Hydralazine?

A
  • Hypotension
  • Lightheadedness or dizziness
  • They work too well.

LCON Pharmacology. (21 decks)

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