Term
| Pt presents with major depression, tx medication will cause decreased sexual function as a side effect. |
|
Definition
| SSRI (fluoxetine, paroxetine, sertaline, fluvoxamine, excitalopram, citalopram) |
|
|
Term
| What can SSRI's be used to treat aside from major depression |
|
Definition
| obsessive compulsive disorder |
|
|
Term
| why is the simultaneous use of SSRI's and MAOI's contraindicated. |
|
Definition
| serotonin syndrome (changes in mental status, muscle stiffness, hyperthermia). |
|
|
Term
| 14 yo boy with enuresis secondary to depression. You want to start him on a psychotropic medication that potentiates the effects of norepinephrine and serotonin at the synaptic cleft.... |
|
Definition
| Tricyclic Antidepressants (first generaton = desipramine, nortriptyline, amitriptyline, doxepin. Second generation = amoxapine, trazadone, bupropion). |
|
|
Term
| What 3 conditions can TCA's be used to treat? |
|
Definition
| major depression, enuresis, chronic pain syndromes. |
|
|
Term
| what is trazadone used to treat? |
|
Definition
|
|
Term
| what is amitriptyline used to treat? |
|
Definition
|
|
Term
| what is bupropion used to treat? |
|
Definition
| help to aid in smoking cessation |
|
|
Term
| what are the SE fo TCA's? |
|
Definition
| sedation, postural hypotension, anticholinergic effects (urinary retention, dry mouth). |
|
|
Term
| what side effect is associated only with trazadone? |
|
Definition
|
|
Term
| why is simultaneous use of TCAs and MAOIs contraindicated? |
|
Definition
|
|
Term
| how does TCA overdose present? |
|
Definition
| ECG changes, arrhythmias, mental status changes, and seizures |
|
|
Term
| IV medication used in the tx of alcohol withdrawal symptoms |
|
Definition
|
|
Term
| what are the short acting benzos? |
|
Definition
|
|
Term
| what are the intermediate acting benzos? |
|
Definition
| lorazepam, temazepam, oxazepam, alprazolam, chlordiazepoxide |
|
|
Term
| what are the long acting benzodiazepines? |
|
Definition
| diazepam, prazepam, clonazepam, flurazepam |
|
|
Term
| what are the four clinical uses of benzos? |
|
Definition
| anxiety, seizures, status epilepticus, alcohol withdrawal |
|
|
Term
| what is the unique indication for midazolam and diazepam? |
|
Definition
|
|
Term
| what is the main SE of benzos? |
|
Definition
|
|
Term
| what is the main fear with long term use of benzos? |
|
Definition
| Pts will become dependent and experience withdrawal symptoms if stopped abruptly. |
|
|
Term
| how do you treat benzo overdose? |
|
Definition
|
|
Term
| who should not be treated with benzos? |
|
Definition
| Pt with liver disease, or who use alcohol, barbiturates, or other CNS depressants. |
|
|
Term
| medication used to treat the positve and negative symptoms of schizophrenia that may cause agranulocytosis |
|
Definition
| Atypical Antipyschotic Agents (clozapine, risperidone, olanzapine, ziprasidone, aripriprazole, quetiapine. |
|
|
Term
| what is the unique indication of olanzapine, risperidone, and quetiapine? |
|
Definition
|
|
Term
| what is the main SE of atypical antipsychotics? |
|
Definition
|
|
Term
| what are the two important SEs of clozapine? |
|
Definition
| leukopenia, agranulocytosis (need weekly monitoring of WBC count) |
|
|
Term
| what is the big difference between typical and atypical antipsychotics? |
|
Definition
| atypical antipsychotics have fewer extrapyramidal and anticholinergic side effects. |
|
|
Term
| medication that blocks post synaptic dopamine receptors in the limbic system and relieves symptoms of delirium. |
|
Definition
| Typical Antipsychotic Agents (haloperidol, fluphenazine, chlorpromazine, thioridazine) |
|
|
Term
| medication used to treat only the positive symptoms of schizophrenia, delirium, and agitation. |
|
Definition
|
|
Term
| 5 SEs of typical antipsychotics |
|
Definition
| sedation, anticholinergic SE, EPS, galactorrhea, amenorrhea |
|
|
Term
| what is the worst effect associated with typical antipsychotic agents? |
|
Definition
| neuroleptic malignant syndrome, which is treated with dantrolene. |
|
|
Term
| Pt with hx of bipolar presents with HA, palptitations, dehydration, excessive urination, and uncontrollable thirst. You suspect her symptoms are caused by the medication being used to control her bipolar disorder, which is working as an antidiuretic hormone antagonist. |
|
Definition
|
|
Term
|
Definition
| tremor, hypothyroidism, nephrogenic diabetes insipidus. |
|
|
Term
| When is lithium not advised? |
|
Definition
|
|
Term
| Pt diagnosed with atypical depression with psychotic features, she is started on a new med. You tell your pt it is important to avoid foods with tyramine because they could lead to a hypertensive crisis in conjucntion with her medication. |
|
Definition
| Monamine Oxidase Inhibitors |
|
|
Term
| what are the three MAOI's |
|
Definition
| tranylcypromine, phenelzine, isocarboxazid |
|
|
Term
| what is the MOA of selegiline? |
|
Definition
| inhibits MAOB and used in the treatment of Parkinson Disease. |
|
|
Term
| Pt has lost a lot of weight due to lack of appetite secondary to anxiety. She is diagnosed with generalized anxiety disorder. You prescribe a med to treat her anxiety, and depression as well as stimulate her appetite. |
|
Definition
| Heterocyclic Antidepressants (nefazodone, mirtazapine, venlafaxine, maprotiline) |
|
|
Term
| What is the MOA for nefazodone, maprotiline, venlafaxine? |
|
Definition
| block the re-uptake of norepinephrine and serotonin. |
|
|
Term
| what is the MOA of mirtazapine? |
|
Definition
| inhibits activation of alpha 2-adrenergic receptors and at 5HT2 receptors, which increases the release of norepinephrine and serotonin. |
|
|
Term
| what is the main SE of heterocyclic antidepressants? |
|
Definition
|
|
Term
| medication used to facilitate endotracheal intubation by potentiating GABA receptor activity and is commonly used for anesthesia induction. |
|
Definition
| barbituates: phenobarbital, thiopental, secobarbital, amobarbital, pentobarbital |
|
|
Term
| what is the MOA of barbituates? |
|
Definition
| decreased activity of CNS neurons |
|
|
Term
| what is the clinical use of barbituates (3)? |
|
Definition
| sedation, induction of anesthesia, and management of seizures. |
|
|
Term
| what is the concern with barbituates? |
|
Definition
| Pts can become dependent and may experience withdrawal symtpoms. |
|
|
Term
| how does barbituate overdose present? what is the treatment? |
|
Definition
overdose = cardiac and respiratory depression.
Treatment = mechanical ventilation, hemodialysis, and alkalinization of the urine. |
|
|
Term
| when should barbituates not be used? |
|
Definition
| pregnancy, liver disease, patients with porphyria or who use alcohol, benzos, or other CNS depressants |
|
|
Term
| 17 yo girl being treated for grand mal seizures, you caution her to use birth control because the medication being used can cause severe birth defects including growth retardation and congenital cardiac and palate malformations. |
|
Definition
|
|
Term
|
Definition
| nystagmus, gingival hyperplasia, drug induced lupus, fetal hydantoin syndrome |
|
|
Term
| clinical use of lamotrigine |
|
Definition
| simple and complex partial seizures and generalized tonic-clonic seizures |
|
|
Term
| medication that treats absence seizures and works by reducing calcium current across neuronal cell membranes |
|
Definition
|
|
Term
| clinical use of valproic acid (4) |
|
Definition
| generalized tonic-clonic seizures, myoclonic seizuers, absence seizures, and treatment of mania |
|
|
Term
|
Definition
| hepatotoxicity, teratogen (neural tube defects) |
|
|
Term
| Ethosuximide is used to treat what? |
|
Definition
|
|
Term
| medication used to treat trigeminal neuralgia often associated with multiple sclerosis, often causes low white blood cell counts. |
|
Definition
| Carbamazepine (oxcarbazepine) |
|
|
Term
|
Definition
| hepatoxicity, agranulocytosis, aplastic anemia |
|
|
Term
| topiramate is used to treat what? |
|
Definition
| adjunct treatment for simple and complex partial seizures. |
|
|
Term
| Pt with hx of complex partial seizures, recent increase in seizures after discontinuation of phenytoin bc of non-tolerance. You start a new medication which inhibits reuptake of GABA in the synaptic cleft. SE = nausea, diarrhea, and drowsiness, but not the serious SE from phenytoin. |
|
Definition
|
|
Term
| Vigabatrin is used in the treatmet of? |
|
Definition
|
|
Term
| Levetiracetam is used in the treatment of? |
|
Definition
| adjunctive treatment for epilepsy and for neuropathic pain. |
|
|
Term
| In need of a paralytic agent with rapid onset to facilitate endotracheal intubation, you adminster a depolarizing neuromuscular blocker and monitor for bradycardia and arrhythmias |
|
Definition
|
|
Term
| what happens with succinylcholine is administered with halothane? |
|
Definition
| malignant hyperthermia, treated with dantrolene |
|
|
Term
| non-depolarizing neuromuscular blocker which is short acting and easily reversible making it appropriate to facilitate bronchoscopy |
|
Definition
|
|
Term
|
Definition
|
|
Term
| how can you reverse the effects of pancuronium? |
|
Definition
| administration of cholinesterase inhibitor (neostigmine) |
|
|
Term
| medication that will dull sensation to a particular area by blocking neuronal sodium channels |
|
Definition
| Local Anesthetic (esters and amides) |
|
|
Term
| what are the ester medications? |
|
Definition
| procaine, cocaine, tetracaine, benzocaine |
|
|
Term
| what are the amide medications? |
|
Definition
|
|
Term
| major SE of local anesthetics |
|
Definition
|
|
Term
| what is often administered with local anesthetics? |
|
Definition
| a vasoconstrictor (epinpehrine) to minimize systemic absorption |
|
|
Term
| what differentiates ester from amides? |
|
Definition
| esters have a shorter duration of action |
|
|
Term
| generalized anesthetic that can cause massive centrilobular liver cell necrosis (fulminant hepatic necrosis) |
|
Definition
|
|
Term
| what are the general inhaled anesthetic agents |
|
Definition
| halothane, isoflurane, desflurane, sevoflurane, enflurane, methoxyflurane |
|
|
Term
| SE of generalized anesthetics (2) |
|
Definition
| myocardial and respiratory depression |
|
|
Term
|
Definition
| fulminant hepatic necrosis, cardaic arrhythmias |
|
|
Term
| SE fo methoxyflurane and enflurane |
|
Definition
|
|
Term
| what happens when halothane and succinylcholine are administered together? |
|
Definition
| malignant hyperthermia which is treated with dantrolene |
|
|
Term
| in preparation for cardioversion you administer short acting intravenous anesthetic agent that acts to prolong activity at the GABAa receptor, but that also causes only minimal hypotension. |
|
Definition
|
|
Term
| which general anesthetic IV agent acts as an NMDA receptor antagonist |
|
Definition
|
|
Term
| medication used for the induction and maintenance of anesthesia and conscious sedation |
|
Definition
|
|
Term
| medication for the induction of anesthesia and conscious sedation |
|
Definition
|
|
Term
| SE of propofol, etomidate, and ketamine (seperately) |
|
Definition
propofol: hypotension, chemical pancratitis.
etomidate: vomiting, myoclonus, adrenal suprression.
Ketamine:hallucinations, cardaic and respiratory depressant. |
|
|
Term
| medication administered through a self-controlling pump containing an analgesic that binds to specific receptors in the brain and spinal cord involved in pain transmission. |
|
Definition
|
|
Term
| specific indication for codeine and dextromethorphan |
|
Definition
|
|
Term
| unique indication of diphenoxylate |
|
Definition
|
|
Term
| unique indication for morphine |
|
Definition
|
|
Term
|
Definition
| cardiac and respiratory depression, constipation |
|
|
Term
| how do you treat opioid overdose? |
|
Definition
|
|
Term
| what medication is used in maintenance programs for opioid addicts? |
|
Definition
|
|
Term
| Pt with sypmtoms of Parkinson disease, you start treatment with a medication to increase the levels of dopamine in his brain? |
|
Definition
|
|
Term
|
Definition
| dyskinesia, cardiac arrhythmias |
|
|
Term
| what is levodopa often administered with? |
|
Definition
| carbidopa which is unable to cross the BBB. |
|
|
Term
| unique indication for bromocriptine |
|
Definition
|
|
Term
| treatment of acute migraine that will stimulate 5-HT1D receptors in the dura |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when is sumatriptan contraindicated? |
|
Definition
| pts with coronary artery disease |
|
|
Term
| this medication aids smoking cessation by acting as a partial agonist at nicotinic receptors |
|
Definition
|
|
Term
|
Definition
| nausea, insomnia, suicidal ideation |
|
|
Term
|
Definition
| inhibit reuptake of norepinephrine and dopamine (nicotinic antagonist) |
|
|
Term
|
Definition
| psychosis, seizures, dry mouth |
|
|
Term
| medication used to treat generalized anxiety that allows social drinking and isn't as addictive but may take 1-3 weeks to show efficacy |
|
Definition
|
|
Term
|
Definition
| dizziness, insomnia, nausea |
|
|
Term
| Pt has hx of recent shingles, presents with pins and needles over the previous shingles, you believe his pain is related to the prior episode and prescribe a medication to treat his pain |
|
Definition
|
|
Term
| indication for gabapentin |
|
Definition
| postherpetic neuralgia, partial seizures |
|
|
Term
|
Definition
|
|
Term
| indication for pregabalin (2) |
|
Definition
| neuropathic pain, fibromyalgia |
|
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