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pharm exam 1 drugs
what they are, what they do, AE's

Additional Pharmacology Flashcards





Antiseizure drug (act as GABA agonists), 

brand name: valium

used for generalized seizures- absence, tonic-clonic, and myoclonic

stimulate influx of chloride ions (effect associated with GABA),

delaying influx of sodium and calcium

excreted faster with a slightly acidic filtrate

Adverse effects: drowsiness, sedation, ataxia, laryngospasm, respiratory depression, cardio collapse, coma

Phenytoin (dilantin)
  • Therapeutic class: Anti-seizure drug; antidysrhythmic

  • Pharmacologic class: hydantoin; sodium influx-suppressing drug

  • Actions: desensitizes sodium channel in CNS that are responsible for neuronal responsivity; this prevents the spread of disruptive electrical charges in the brain that produce seizures

  • Effective against most types of seizures, except absence seizures

Onset is slow and peak is 1.5-3 hrs for IR and 4-12 hrs for XR; duration is 15 days

Adverse effects:

  • Dysrhythmias such as bradycardia or ventricular fibrillation

  • Severe hypotension

  • Hyperglycemia

  • Headache, ataxia, confusion and slurred speech, twitching, insomnia

  • Aplastic anemia

  • Severe skin rashes, including exfoliative dermatitis and Stevens-Johnson syndrome


  • pts with hypersensitivity to hydantoin products

  • Rash, seizures due to hypoglycemia, sinus bradycardia and heart block



  • Oral anticoagulants, glucocorticoids, food supplements (folic acid, calcium & vitamin D)

  • Should not be combined with tricyclic antidepressants

  • Can increase serum levels of glucose and may decrease protein-bound iodine and urinary steroid levels

Lithium (Eskalith)


  • Therapeutic class: bipolar mood stabilizer

  • Pharm class: glutamate inhibitor, serotonin receptor antagonist


  • Used in treatment for bipolar disorder

    • Remains effective in purely manic and purely depressive states

  • Narrow therapeutic/toxic ratio; risk of toxicity is high

  • Onset is 5-7 days

  • Acts like sodium in the body and conditions when sodium are lost (ie. excessive sweating or dehydration) can cause lithium toxicity

  • Overdose may be treated with hemodialysis and supportive care & serum sodium and lithium level need to be monitored together

  • Adverse effects:

    • Headache, lethargy, fatigue, recent memory loss, nausea, vomiting, anorexia, abdominal pain, diarrhea, dry mouth, muscle weakness, hand tremors, reversible leukocytosis, nephrogenic diabetes insipidus

    • Peripheral circulatory collapse

  • This drug is contraindicated for Pts with renal disease, dehydration, cardiovascular disease and cases of severe sodium depletion
Clozapine (clozaril)


  • First atypical antipsychotic (2nd generation)

  • Control positive and negative schizophrenia

  • no ESP effects

  • may block D2 receptors and serotonin (5-HT) and alpha adrenergic receptors

  • Adverse side effects of atypical antipsychotics:

    • tachycardia, transient fever, sedation, dizziness, headache, lightheadedness, somnolence, anxiety, nervousness, hostility, insomnia, nausea, vomiting, constipation, parkinsonism, akathisia

    • Clozapine brings increased risk of agranulocytosis



  • Therapeutic class: conventional antipsychotic; schizophrenia drug

    • First effective drug to treat schizophrenia

  • Action: D2 dopamine receptor antagonist

  • Can be administered PO (max dose: 1,000 mg/day), IV/IM (max dose: 600 mg every 4-6h)

  • Adverse effects include:

    • Common: drowsiness, dizziness, orthostatic hypotension, urinary retention

    • Serious: agranulocytosis, pancytopenia, anaphylactoid reaction, tardive dyskinesia, neuroleptic malignant syndrome, hypothermia, adynamic ileus, sudden unexplained death

  • Contraindicated in Pts with: alcohol withdrawal, comatose state, bone marrow depression, Reye’s syndrome or during lactation

  • Lab tests: false-positives may be seen for urine bilirubin, pregnancy tests, or amylase

  • Drug interactions:

    • Avoid concurrent use with sedatives such as phenobarbital

    • Taking with tricyclic antidepressants can elevate BP

    • Taking it with antiseizure medications can lower the seizure threshold

Haloperidol (Haldol)


  • Therapeutic class: conventional antipsychotic; schizophrenia drug

  • Action: D2 dopamine receptor antagonist, nonphenothiazine

  • Pregnancy class C

  • Used to treat Pts with Tourette’s syndrome and children with severe behavioral problems (unprovoked aggression or hyperexcitability)

  • Long-lasting IM or subcutaneous administration - good for Pts who are uncooperative/unable to take oral meds

  • *Do NOT abruptly discontinue; severe adverse reactions will occur

  • Adverse effects:

    • High incidence of extrapyramidal side effects (EPS) such as acute dystonia (muscle spasms of back, neck, tongue and face), akathisia (inability to rest/relax), parkinsonism (tremor, muscle rigidity, stooped posture, shuffling gait)  and tardive dyskinesia

    • Older adults more likely to experience adverse effects, so they’re perscribed ½ adult dose

  • Interactions:

    • Decreased effect when combined with: lithium, phenobarbital, beta blockers

    • Haloperidol inhibits action of centrally acting antihypertensives  



  • therapeutic class: analgesic; antipyretic

  • pharmacological class: centrally acting COX inhibitor

  • mechanism of action

    • reduces fever by direct action at the level of the hypothalamus and dilation of peripheral blood vessels which enables sweating and dissipation of heat

  • used to treat

    • useful in treatment of fever in children

    • relief of mild to moderate pain when aspirin is contraindicated

  • adverse effects

    • AE are uncommon, generally safe drug

    • less GI issues than aspirin

    • toxicity can lead to renal failure

    • inhibits Warfarin

  • overdose treatment: N-acetylcysteine
Ibuprofen (Advil, Motrin)


  • therapeutic class: analgesic; anti-inflammatory drug, antipyretic

  • pharmacologic class: NASAID

  • Uses:

    • treatment of mild to moderate pain, fever, and inflammation

    • common indications include pain associated with chronic musculoskeletal disorders such as RA, osteoarthritis, headache, dental pain, and dsymenorrhea

  • Action: inhibition of prostaglandin synthesis

  • Adverse effects

    • mild nausea, heartburn, epigastric pain, dizziness

    • GI ulceration with occult or gross bleeding may occur in high doses

    • chronic use can lead to renal failure

  • Interactions/Contradictions

    • should be avoided when taking anticoagulants

    • should be avoided with patients who have peptic ulcers

Methadone (Dolophine)


  • Class: opioid analgesics

  • Action: inhibits ascending pathways, altering perception response to pain

  • Uses

    • sometimes used to treat opioid addiction \

    • methadone maintenance: treats opioid dependence; allows patient to return to productive work and social life without physical, emotional, and criminal risks

  • heroin addicts switched to methadone to prevent unpleasant withdrawal symptoms

    • prolonged withdrawal, less symptoms

  • adverse effects

    • dizziness, nausea, cardiac arrest, convulsions, severe respiratory depression or arrest

    • anticholinergic effects  (dry mouth, palpitation, tachycardia)

Dicyclomine (Bentyl)


  • Anticholinergic drug - induces fight or flight responses by inhibiting parasympathetic response

  • Used to treat irritable bowel syndrome (IBD)

  • Taken orally

  • Adverse effects:

    • Dry mouth

    • Blurred vision

    • Drowsiness

    • Constipation

    • Urinary Hesitancy

    • Tachycardia

Apriprazole (Abilify)


  • Class: Atypical Antipsychotic drug

  • Treats schizophrenia and schizoaffective disorder by controlling both positive and negative schizophrenic symptoms

  • Mechanism of action: dopamine system stabilizers/ domamine partial agonists

  • Adverse effects are virtually non-existant although noticable side effects include:

    • Headache

    • Nausea/vomiting

    • Fever

    • Constiptation

    • Anxiety



  • opioid agonist

  • Schedule I

    • too dangerous for therapeutic use

    • major drug of abuse

  • After injection or inhalation, heroin rapidly crosses the blood brain barrier to enter the brain, where it’s metabolized to morphine.

  • Activates mu and kappa receptors

  • Initial effect -> intense euphoria (“rush”) followed by several hours of deep relaxation.


  • Therapeutic class: centrally acting skeletal muscle relaxant

  • Pharmaceutical class: catecholamine reuptake inhibitor

  • Action: depresses motor activity in brainstem by increasing norepinephrine and blocking presynaptic uptake

  • No used in pediatrics

  • Pregnancy class B

  • onset: 1 hour Peak: 3-8 hours Duration: 12-14 hours

  • Adverse: drowsiness, blurred vision, dizziness, dry mouth, rash, tachycardia  

  • OD: physostigmine
Zolpidem (Ambien)


  • Therapeutic class: Sedative-hypnotic

  • Pharmacologic class: non-benzodiazepine GABA receptor agonist; non-barbiturate CNS depressant

  • Actions: facilitates GABA-mediated CNS depression in limbic, thalamic, and hypothalamic regions

    • Preserves stages III and IV of sleep

  • Used for short-term insomnia management (7-10 days)

  • Onset: rapid (7-27 minutes), should be given immediately before bedtime

  • Pregnancy category B ** lactating women should not take this drug

  • Adverse effects:

    • Daytime sedation

    • Confusion

    • Amnesia

    • Dizziness

    • Depression

    • Nausea/vomiting

  • Interactions

    • When taken with food, onset is delayed

    • Increased sedation when used concurrently with other CNS depressants (including alcohol)

    • Use flumazenil for overdose treatment

Benztropine (cogentin)


  • Therapeutic class: antiparkinson

  • Pharmacologic class: centrally acting cholinergic receptor blocker

  • Action: blocking excess cholinergic receptor blocker

  • can be taken in divided doses

  • Onset: 15m IM/IV 1 hour PO Peak: 1-2 hours duration: 6-10 hours

  • Pregnancy class C

  • adverse: dry mouth, constipation, tachycardia, sedation, restlessness, irritability, nervousness, insomnia

  • Contradicting: glaucoma, myasthenia gravis, GI obstruction

  • OD: physostigmine
Levodopa, carbidopa, entacopone


  • Therapeutic: antiparkinson

  • Pharmacological: dopamine precursor, dopaminergic

  • restores dopamine in the extra pyramidal symptoms of the brain

  • carbidopa and entacapone: prevent enzymatic breakdown of dopamine


  • onset: 30min Peak: 1-2 hours Duration: Variable

  • adverse effects: uncontrolled and purposeless movement, muscle twitching, shrugging, orthostatic hypotension

  • contraindicated in patients with lesions on their skin or melanoma

  • OD: general support measures
Oxybutynin (Ditropan, Oxytrol)
  • Primary use: Incontinence

  • Pharmacologic Class: Anticholinergic/ muscarinic antagonist

-Act by competing with Ach for binding muscarinic receptors. Suppressing the effects of Ach causes symptoms of sympathetic nervous system activation to predominate.


  • Adverse effects for anticholinergics:

    • tachycardia

    • CNS stimulation

    • urinary retention in men with prostate disorders


  • Therapeutic class: Opioid analgesic

  • Pharacologic class: opioid receptor agonist

  • Actions: binds with mu and kappa receptor sites to produce profound analgesia

    • Causes euphoria, constriction of pupils & stimulation of cardiac muscle

  • Use:

    • Symptomatic relief of serious acute and chronic pain (after non-narcotic analgesics have failed)

    • Pre-anesthetic medication

    • Relieves shortness of breath associated with heart failure and pulmonary edema

    • Acute chest pain connected with MI

  • Oral capsules should be taken whole; not broken, chewed, dissolved or crushed

  • It is a Schedule II controlled substance & should be taken properly according to dispensing instructions ***

  • Pregnancy category B (it is category D if used in high doses or for long periods of time)

  • Onset: less than 60 minutes and can last up to 7 hours

  • Adverse effects:

    • Orthostatic hypertension (b/c it causes peripheral vasodilation)

    • Dysphoria (restlessness, depression & anxiety)

    • Hallucinations

    • Nausea

    • Constipation

    • Dizziness

    • Itching sensation

  • Interactions

    • Should be avoided with CNS depressants (alcohol, other opioids, general anesthetics and MAO inhibitor anti-depressants)

    • Should be avoided in cases of acute or severe asthma, GI obstruction and severe hepatic or renal impairment

    • IV administration of naloxone for over dose
Aspirin (acetylsalicylic acid)


  • Therapeutic class: NSAID, non opioid, antipyretic

  • Pharmacological Class: salicylate, cyclooxygenase inhibitor

  • Inhibits prostaglandin synthesis causing vasodilation and anticoagulants

  • Works by inhibiting both COX 1 and COX 2

  • Excreted in urine causing skewed glucose tests

  • Pregnancy class D

  • Onset: 1 hour Peak: 2-4 hours Duration: 24 hours

  • Adverse Effects: GI bleeding, enteric coated tablets available to lessen the amount released in stomach

  • Do not combine with other anticoagulants  
Clonazepam (Klonopin)


  • Pharmacologic class: benzodiazepine

    • Intensify the effect of GABA in the brain.

    • bind directly to the GABA receptor, suppressing abnormal neuronal foci

  • Therapeutic class: antiseizure

  • Indications: absence seizures and myclonic seizures

    • absence seizure: generalized class

      • lasting a few seconds

      • seen most often in children (child stares into space, does not respond to verbal stimulation. may have fluttering eyelids or jerking)

    • myclonic seizures: special syndromes class

      • large jerking movements of a major muscle group, such as an arm

      • falling from a sitting position or dropping what is held

  • Route and Adult Dose

    • PO; 1.5mg/day in three divided  doses, increased by 0.5-1mg every three days until seizures are controlled

  • Adverse effects:

    • drowsiness, sedation, ataxia

    • laryngospasm, respiratory depression, cardiovascular collapse, coma
Lorazepam (Ativan)


  • Therapeutic class: Sedative-hypnotic; anxiolytic, anesthetic adjunct

  • pharmacologic class: benzodiazepine; GABA-receptor agonist

  • potentiating effects of GABA (inhibitory neurotransmitter) in thalamic, hypothalamic, limbic levels of CNS.

    • this means that it stimulates influx of chloride ions; it also delays influx of sodium and calcium into neuron

  • potent benzodiazepine

  • half-life of 10-20 hours (once or twice a day oral dosing)

  • anxiolytic, also used as preanesthetic medication to provide sedation and management of status epilepticus and tonic-clonic seizures

  • also used for chemotherapy induced nausea and vomiting

  • IV (4 mg injected slowly at 2 mg/min) for orally;

  • AE: drowsiness, sedation, amnesia, weakness, disorientation, ataxia (lack of voluntary muscle control), sleep disturbance, blood pressure changes, blurred vision, nausea, vomiting.



  • Antidote for overdose of Benzodiazepines (sedative-hypnotic)

  • Pregnancy class C

  • Adverse effects: nausea, dizziness, blurred vision, agitation, dyspnea, xerostomia,
Phenobarbital (Luminal)


  • Therapeutic class: antiseizure drug; sedative

  • Pharmacologic class: Barbiturate; GABA receptor agonist

  • Actions: long-acting barbiturate that enhances the action of GABA neurotransmitter

  • Use: management of variety of seizures, promotes sleep


  • Pregnancy category D

  • Schedule IV (high possibility of becoming dependent)

  • Should NOT be given via IM injections - it can cause irritation to the soft-tissue

  • Onset: 20-60 minutes

  • Adverse effects:

    • May cause dependence

    • Drowsiness

    • Vitamin deficiencies (vit. B; D; folate)

    • Larygnospasms

  • Contraindications: not to be used with severe uncontrolled pain, pre-existing CNS depression, severe respiratory disease with dyspnea or obstruction, glaucoma or prostatic hypertrophy

  • Interactions:

    • Not to be taken with alcohol or CNS depressants

    • Phenobarbital increases the metabolism of many other drugs, reducing their effectiveness
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