PHCT Flashcards

(55 cards)

1
Q
  • Found in many over-the-counter cough and cold
    preparations
  • Often found in combination products containing
    antihistamines, decongestants, or acetaminophen.
A

Dextromethorphan

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2
Q

Examples of Dextromethorphan

A

Nyquil, Robitussin DM, Triaminic DM, and Vick
Pediatric Formula 44

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3
Q

a synthetic analogue of codeine

A

d-isomer of 3-methoxy-N-methylmorphinan

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4
Q

– Has no apparent analgesic or addictive properties and produces relatively mild opioid effects in overdose.
– Also has anticholinergic properties

A

Dextromethorphan

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5
Q

Dextromethorphan | Well-absorbed orally, and effects are apparent within ______

A

15-30 minutes

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6
Q

Dextromethorphan | duration of effect is normally ____

A

3-6 hours

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7
Q

Both dextromethorphan and its o-demethylated
metabolite appear to antagonize

A

N-methyl-D-aspartate (NMDA) glutamate receptors.

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8
Q

inhibits reuptake of serotonin,
and may lead to the serotonin syndrome in patients
taking monoamine oxidase inhibitors

A

Dextromethorphan

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9
Q

Dextromethorphan | Toxic Dose

A

10mg/kg

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10
Q

Dextromethorphan | Usual recommended adult daily dose of dextromethorphan is
; in children age 2-5 years, up to 30 mg/d.

A

60-120 mg/d

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11
Q

Dextromethorphan | Usual recommended
in children age 2-5 years

A

up to 30 mg/d

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12
Q

Dextromethorphan | Clinical Presentation
* Clumsiness
* Ataxia
* Nystagmus
* Restlessness
* Visual and auditory hallucinations

A

Mild intoxication

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13
Q

Dextromethorphan | Clinical Presentation
- Stupor
– Coma
– Respiratory depression (coingestion with alcohol)
– Pupils may be dilated or constricted.
– Seizures are reported after ingestions of 20-30 mg/kg

A

Severe Poision

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14
Q

Dextromethorphan | Clinical Presentation
– Severe hyperthermia
– Muscle rigidity
– Hypertension
– Related to serotonin syndrome.

A

Therapeutic doses taking MAOI

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15
Q

Dextromethorphan | Treatment
Drug , mg

A

Naloxone ; 0.06 - 0.4mg

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16
Q

Dextromethorphan | Treatment
Opioid Intoxication

A

0.4-2 mg naloxone IV

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17
Q

Dextromethorphan | Treatment

Decontamination:

A

Activated Charcoal

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18
Q

PPA means

A

Phenylpropanolamine

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19
Q
  • Also widely used as an appetite
    suppressant
  • Widely available in nonprescription nasal decongestants and
    cold preparations
  • Usually also contain antihistamines and cough suppressants
A

Phenylpropanolamine (PPA)

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20
Q

PPA example (3)

A
  • Phenylephrine
  • Ephedrine
  • Pseudoephedrine
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21
Q

PPA
Mechanism of PPA + Phenylephrine

A
  1. Direct alpha-adrenergic agonists
  2. PPA produces mild β1-adrenergic stimulation and acts in part indirectly by enhancing norepinephrine release
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22
Q

PPA
Ephedrine and pseudoephedrine

A
  1. Have both direct and indirect alpha- and beta-adrenergic activity
  2. They clinically produce more beta-adrenergic
    stimulation than PPA or phenylephrine
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23
Q

PPA, phenylephrine, and ephedrine have _____ (low, high) toxic:therapeutic ratios

24
Q

PPA | Toxicity often occur after ingestion of just _____ times the therapeutic
dose

25
PPA | _____ is slightly less toxic, with symptoms occurring after 4- 5 times the usual therapeutic dose
Pseudoephedrine
26
PPA HTN is treated if diastolic pressure is higher than
100-105mmHg
27
PPA | TX for HTN ; Non-pharmacological
phentolamine or nitroprusside; upright position
28
PPA | Caution in TX of HTN Do not use beta blockers alone w/o first giving a ______.
vasodilator
29
PPA | Tx for Arrhythmias
Give propanolol or esmolol
30
PPA | Caution:
Do not treat AV block or sinus bradycardia associated with hypertension
31
PPA | Treatments
1.) Ipecac-induced emesis may be useful for initial treatment. 2.) Administer activated charcoal and cathartic.
32
PPA | widely used for the treatment of asthma
Methylxanthine
33
IV infusions of ______ are used to treat bronchospasm, congestive heart failure and neonatal apnea.
aminophylline
34
Commonly used orally in sustained-release preparations
Theophylline
35
Theophylline | Toxic Dose: Acute single dose of _____
8-10 mg/kg
36
Theophylline | Acute oral overdose of more than _____ may potentially result in a level above 100 mg/L and significant toxicity.
50 mg/kg
37
Theophylline | Status epilepticus, , seizures (serum levels)
> 100 mg/L
38
Theophylline | When excessive doses are administered repeatedly over 24hours or longer
Chronic Intoxication
39
Theophylline | Drugs Examples Use low-dose ______ 0.01-0.03 mg/kg IV
propanolol
40
Theophylline | Drugs Examples _______ 25-50 µg/kg/min
Esmolol
41
Bronchodilators-_____ agonists
B2
42
Bronchodilators: first line in the tx of acute exacerbation of BA primary reliever medication
Short acting rapid onset
43
Bronchodilators: prophylactic agent (acute attacks) for controlling nocturnal attacks controller medication
Long acting slow onset
44
Bronchodilators: controller usually given through inhalation
Long acting with rapid onset
45
Selective B2 agonists Oral, MDI
Albuterol, Metaproterenol
46
Selective B2 agonists For severe asthma; SC inj.(0.25 mg)
Terbutaline
47
Selective B2 agonists long-acting DOA: 12 hours
Salmeterol & Formoterol
48
Type of Bronchodilators reserved for special situations (cardiac stimulation)
Bronchodilators – Non-selective
49
Non-Selective | Bronchodilator Epinephrine Dose: Onset: Duration:
Epinephrine SC (0.4 mL of 1:1000 solution) inhaled - 320 g per puff Onset: 15 minutes Duration: 60–90 mins
50
Non-Selective | Bronchodilator Ephedrine
Lower Potency
51
Non-Selective | Bronchodilator Inhaled: 80–120 g Onset: 5 minutes Duration: 60–90 mins
Isoproterenol
52
IPRATROPIUM TIOTROPIUM Classification:
Anticholinergic/Antimuscarinic
53
Bronchodilators | quaternary ammonium derivative of atropine
ipratropium bromide
54
Bronchodilators | longer-acting selective antimuscarinic agent
tiotropium
55
Bronchodilators | Also used in allergic rhinoconjunctivitis
Mast cell stabilizers