Study Cards Flashcards
(37 cards)
Beta-2 Adrenergic Receptors
- G protein coupled receptor that is coupled to the Gs protein
- Activated by Epinephrine & Norepinephrine
When Stimulated:
- Increase Heart Rate
- Increase Contractility (inotropic effect)
- Increased Lipolysis
- Increased Insulin Secretion
- Increased Aqueous Humor Production
- Ciliary Muscle Relaxation (smooth muscle in eye)
- Vasodilation
- Bronchodilation
- Decreased Uterine Tone
Beta-1 Adrenergic Receptors
*G-Protein-coupled receptor associated with the Gs subunit
Stimulation causes:
- Increased Heart Rate
- Increased Contractility
- Increased Renin Release
- Increased Lipolysis
Alpha-1 Adrenergic Receptor
- G protein coupled receptor associated with the Gq subunit
- Activated by Epinephrine & Norepinephrine
Stimulation causes:
- Increased Vascular Smooth Muscle Contraction
- Increased Pupillary Dilator Muscle Contraction
- Increased Intestinal & Bladder Sphincter Muscle Contraction
Alpha-2 Adrenergic Receptors
- G protein-coupled receptor associated with the Gi subunit
- Epinephrine and Norepinephrine signal through this receptor where it inhibits the release of norepinephrine in a form of negative feedback
Stimulation causes:
- Decreased Sympathetic Outflow
- Decreased Insulin Release
- Decreased Lipolysis
- Increased Platelet Aggregation
- Decreased Aqueous Humor Production
P450 Inhibitors
Decrease the activity of the P450 enzyme, impairing the metabolism of drugs that are metabolized by the P450 system
Quinidine Ciprofloxacin Isoniazid Grapefruit Juice Acute Alcohol Use Erythromycin (Macrolide) Indinavir Cimetidine Sulfonamides Ketoconazole Amiodarone
P450 Inducers
Increase the activity of the P450 enzymes causing drugs that are metabolized by P450 to be metabolized at an increased rate.
Higher doses of medications may be needed to maintain therapeutic levels
Griseofulvin Phenytoin Carbamazepine Rifampin Barbiturates Chronic Alcohol Use St. John's Wart
Benzodiazepine Antidote
Flumazenil
-Reverses the effects of benzodiazepines by competitive inhibition at the benzodiazepine binding site on the GABA receptor
Warfarin Antidotes
Vitamin K
-helps reverse the anticoagulation effects but does not have immediate onset of action
Fresh Frozen Plasma
-replaces coagulation factors and helps to reverse warfarin effects more quickly than vitamin K
Beta Blocker Antidote
Glucagon
-Increases intracellular cAMP and cardiac contractility
Opioid Antidote
Naloxone
- U-opioid receptor antagonist
- Used in acute life-threatening opioid toxicity
Naltrexone
- Opioid receptor antagonist
- Used for dependence treatment rather than in emergent treatment of overdose
Dinoprostone & Misoprostol
Prostaglandins that act to ripen the cervix Indications: -Promote cervical ripening -Prevent GI ulcers -Medical abortion
Side Effects:
- Fetal Distress
- Hyperstimulation of Uterus
Vaginal insertion before induction of labor (oxytocin) to soften the cervix
Clomiphene
Used for ovulatory dysfunction. Selective estrogen receptor modulator (SERM), acts as an antagonist in the hypothalamus. Indications: -Infertility -PCOS Mechanism of Action -Estrogen Antagonist -Increases GnRH, LH, and FSH Secretion -Induction of Ovulation Side Effects -Multiple Gestations -Visual Disturbances -Hot Flashes
Opioid Indications
- Pain
- Weaning (Methadone)
- Cough (Codeine)
- Diarrhea (Loperamide & Diphenoxylate)
Opioid Mechanism of Action
- Interacts at the mu (u), kappa (K), and delta receptors.
- Decrease synaptic transmission- open K+ channels & close CA2+ channels
- Inhibit release of acetylcholine, norepinephrine, 5-HT, glumate, & substance P
Opioid Side Effects
- Respiratory Depression
- Addiction
- Miosis (pinpoint pupils)
- Constipation
Codeine
Opioid Receptor Agonist Mild to Moderate Pain Cough Suppressant Side Effects: Sedation, Constipation, Miosis Considerations: -Close monitoring when breast feeding -Often combined with non-opioids
Morphine
Opioid Receptor Agonist
Indications:
Pain, Myocardial Infarction
Side Effects: Nausea/Vomiting CNS depression Biliary colic Constipation Increased ICP Pupillary constriction Hypotension
Oxycodone
Opioid Receptor Agonist
Indicated for refractory moderate-to-severe pain
Side Effects
Respiratory Depression
Constipation
CNS Depression
Considerations
Addiction
Antidote
Naloxone
Lidocaine
Mechanism of Action:
Blocks Na+ channels
Indications:
Ventricular arrhythmia
Anesthetic
Side Effects: Paresthesias Seizures Respiratory Depression Drowsiness
Considerations:
Anesthetic effects are extended with epinephrine
Methotrexate
Antimetabolite & disease-modifying antirheumatic drug (DMARD) that acts by inhibiting dihydrofolate reductase. Folic acid analog, prevents folic acid metabolism
This results in stopping production of dTMP (thymidine), which is necessary for DNA, RNA, and protein synthesis. Results in cell death. S-Phase specific
Indications for use:
Rheumatoid arthritis
Cancer
Medical abortion
Side Effects: Pulmonary fibrosis Myelosuppression- can be treated with Leucovorin Rescue (Folinic Acid) Macroytic Anemia Hepatitis Teratogenic Mucositis
Substance Use Disorder
Signs & Indicators
Changes in mood Poor Hygiene Odd Sleep Patterns Frequent Injuries Relationship or Job Difficulties Poor performance Anorexia or weight loss Social isolation Financial problems
Diagnosis of Substance Use Disorder
2 or more symptoms for 1 year
Tolerance Withdrawal Symptoms Cravings Using more than intended Inability to cut down Time-Consuming substance acquisition Impaired functioning at work Reduced recreational activities Dangerous activities Continued use of substance despite awareness of harm
Amphetamines Intoxication Assessment Findings
Euphoria Insomnia Mydriasis -pupillary dilation Diaphoresis Hypertension Tachycardia Paranoia Anxiety Anorexia Seizures
Benzodiazepine Intoxication Assessment Findings
Drowsiness Confusion Respiratory Depression Hypotension Coma
Treatment: Flumazenil
