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Pharm week 1-5 NRS230
n/a
97
Pharmacology
Undergraduate 2
01/18/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
Describe aspects of the nurses role as an advocate:
Definition

Follows the patient’s status most closely


Detect mistakes made by pharmacists and prescribers


Observe and evaluate drug responses and intervene if required


Must know the response that a medication is likely to elicit


Last line of defense for the patient


Ethically and legally unacceptable to administer a drug that is harmful to the patient even though the medication has been prescribed by a licensed prescriber and dispensed by a licensed pharmacist

Term
What is the main role of the nurse in pharmacology?
Definition
appropriate med for the patient

contraindicated meds for the patient

interaction between drug and patient.
Term
Pharmacokinetics:
Definition

Determining how much of administered dose gets to its sites of action

 

 

Impact of the body on drugs

Term
List the four major pharmacokinetic processes: AD ME
Definition

AD ME

 

 

absorption distribution metabolism excretion

Term
Explain to a patient how drugs are absorbed.
Definition

Channels and pores - Concentration gradient 

 

Polar molecules= Uneven distribution of a charge/No net charge.Ions= Molecules that have a net electrical charge


Transport systems P-glycoprotein Direct penetration of the membrane

Term
Drug distribution:
Definition
Blood flow to tissues Exiting the vascular system Entering cells
Term
Describe the process of absorption and excretion of drugs and  enterohepatic recirculation
Definition

absorbed  along the GI tract—stomach, small intestine, and large intestine (but not the oral mucosa or distal rectum)


must go through the liver, via the portal vein, on their way toward the heart and the general circulation.


For some drugs, passage is uneventful. Others undergo extensive metabolism.


Still others undergo excretion into the bile, after which they re-enter the small intestine (via the bile duct), and then either (1) undergo reabsorption into the portal blood, thereby creating a cycle known as enterohepatic recirculation, or (2) exit the body in the stool.

Term
Whats important to know about Plasma albumin in drug absorption:
Definition

Albumin is the most prevalent protein in plasma and the most important of the proteins to which drugs bind.

 

Only unbound (free) drug molecules can leave the vascular system. Bound molecules are too large to fit through the pores in the capillary wall.

 

this means medications can stay in the system and reach toxic levels if bound to albumin???

Term
Three most important things about drugs:
Definition

Effectiveness

 

Safety

 

Selectivity

Term
An ideal drug would be:
Definition

Reversible action

Predictability

Ease of administration

Freedom from drug interactions

Low cost

Chemical stability

Simple generic name

(Easy to say,take,buy,store,no interactions,consitantly effective)

Term
Describe the therapeutic objective of drugs:
Definition
To provide maximum benefit with minimum harm
Term
Describe Drug metabolism also called:
Definition

biotransformation

 

Defined as the enzymatic alteration of drug structure Most often takes place in the liver through a process of enzymatic transformation CYP450. This can transform the drug into an active, inactive, or less potent compound.

Term
List the ways drugs are excreted:
Definition
Urine, sweat, saliva, breast milk, stool, or expired air
Term
Define Pharmacodynamics:
Definition
Impact of drugs on the body
Drug-receptor interaction
Binding of the drug to its receptor
Patient’s functional state
Influences pharmacodynamic processes
Placebo effects
Also help determine the responses a drug elicits
Impact of the body on drugs – “Idiopathic”
Physiologic variables
Age, gender, weight
Pathologic variables
Diminished function of kidneys and liver
Genetic variables
Can alter metabolism of drugs and predispose patient to unique interactions
Drug interactions
Term
Explain the process of drug development and whats the most important thing to know about it:
Definition

Preclinical testing Clinical testing Phase I Phase II and III Phase IV: postmarketing surveillance

 

Most important: Be neither the first to adopt the new nor the last to abandon the old. Balance potential benefits against inherent risks. New drugs generally present greater risks than old ones.

Term

If you took a preparation of hydrocodone (T1/2 is 4 hours) containing 10 mg, list the amounts left in the blood at 1T1/2, 2T1/2, 3T1/2, 4T1/2:

 

Definition

5 mg left at the end of 4 hours

 

1.5 mg left after 8 hours,

 

0.75 mg left after 12 hours,

 

0.375 mg left after 16 hours, and roughly 0.16mg left after 20 hours.

 

1 T1/2 = 50% left 2 T1/2 = 25% left 3 T1/2 = 12.5% left 4 T1/2 = 6.25% left 5 T1/2 = 3.125% left

Term
How long does it generally take for a drug to be inactive in your system?
Definition
it takes 3-5 half lives for the drug to be inactive in the body.
Term
Describe therapeutic range:
Definition

 

The range bewteen a drug being effective for theraputic application and when the drug is unable to ellicite more of an effective response but instead becomes toxic. 

Term
Describe a dose response curve and differentiate between potency and efficacy.
Definition

maximal efficacy: maximal response a drug can produce. The efficacy of a drug is indicated by the height of its dose-response curve.

 

Potency is how much drug needed to get desired response.

 

Potency is usually not an important quality in a drug unless you have to take ten pills instead of 1.

Term
Explain First pass effect:
Definition
is a phenomenon of drug metabolism in the liver via CYP450 whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation: (morphinepropranololbuprenorphinediazepammidazolamdemerolcimetidine, and lidocaine.)
Term
List some reasons for individual variation (ideopathic) in response to drugs:
Definition
Age, gender, weight Diminished function of kidneys and liver Genetic variables Drug interactions
Term
Explain the problems with drug names:
Definition
Generic-difficult to remember/different names nationaly. trade names - change often
Term
List 7 applications of pharmacology in patient care
Definition
  1. Preadministration assessment 
  2. Dosage and administration 
  3. Evaluating and promoting therapeutic effects
  4. Minimizing adverse effects 
  5. Minimizing adverse interactions 
  6. Making PRN decisions 
  7. Managing toxicity

why,admin,effect,adverse, interact,prn, toxic

Term
What should we educate our patients on about their medications:
Definition

Drug name

therapeutic category

Dosage size

Dosing schedule

Route and technique of administration

Expected therapeutic response and when it should develop

Nondrug measures to enhance therapeutic responses

Duration of treatment

Method of drug storage

Symptoms of major adverse effects and measures to minimize discomfort and harm

Major adverse drug-drug and drug-food interactions

Whom to contact in the event of therapeutic failure, severe adverse reactions, or severe adverse interactions


type,dose,route,schedule,treats,outcome,adverse, contraindications,when to call

Term
List 3 objectives when making our nursing diagnosis
Definition

Judge the appropriateness of the prescribed regimen.

 

Identify potential health problems that the drug might cause.

 

Determine patient’s capacity for self-care.

 

(right drug, adverse, patient adherence)

Term
List common routes of administration:
Definition
Oral
Sublingual
Rectal
Intravascular Subcutaneous Intramuscular
Inhalation Intranasal
Intrathecal
Topical Transdermal
Vaginal
Opthalmo
Oto
Term
Explain why some drugs can cross the Blood-Brain barrier:
Definition

Tight junctions between cells that compose the walls of capillaries in the CNS.

 

Drug must pass direct lipid soluble or must be able to use an existing transport system.

Term
What is the Hepatic Drug Metabolizing Enzyme and how does it work?
Definition
Cytochrome P450 system converts drugs from hydrophyllic to lypophyllic to be excreted. Changes to drug to be active, inactive, or less active.
Term
Describe the substrate inhibitor/inducer relationship to some medications:
Definition

a molecule metabolized by the isoenzyme

Drugs and other substances can be Inhibitors or Inducers of the isoenzyme action

 

Ex. Caffeine is a CYP1A2 substrate and Ciprofloxacin (antibiotic) is a CYP1A2 inhibitor – so if your patient drinks 4 cups of coffee and starts on Cipro, may experience insomnia,

 

other caffeine effects Nicotine is a CYP1A2 inducer and Theophylline (respiratory med) is a CYP1A2 substrate – so if your patient cuts back on nicotine the isoenzyme will decrease in action and there may be increased therapeutic effect and adverse effects of the theophylline

Term
Describe receptor binding
Definition
drug binds to a receptor, mimic, block action, but not indice a new action
Term

Define an agonist, name the medication and it's receptor:

 

Definition

Molecules that activate receptors.Endogenous regulators - make process go faster or slower based on receptors potential.


Muscarinic agonist: Bethanechol


Adrenergic Agonists:

Epinephrine (a1,2 Beta1,2) not dopamine

Norepinephrine (a1,2 beta1) no beta 2 and no dop

Dopamine - (a1,Beta1, dop)

Albuterol - (beta 2)

Term
Define Antagonist, name medications and their receptors:
Definition

prevents receptor activation by endogenous regulatory molecules

 

Anticholenergenic/muscarinic blockers/antimuscarinic:

Atropine (Muscarinic)

Tolterodine (nonselective muscarinc)

Ipratropium Bromide (muscarninc)

 

Antiadrenergenic:

Phenoxybenzamine (nonselective alpha blocker)

Alfuzosin (apha1 blocker)

Propranolol ( nonselective beta blocker

Labetalol (nonselective Beta and Alpha1)

Atenolol (beta 1 blocker)

Metoprolol (beta 1 blocker)

Term
define noncompetitive antagonists and give an example
Definition

Bind irreversibly Reduce maximal response(fewer available receptors) not permanent (cells breaking down “old” receptors synthesizing new)

 

 chantix ??

Term
Competitive antagonists
Definition

Compete with agonists for receptor binding Bind reversibly to receptors

 

Equal affinity: receptor occupied by whichever agent is present in the highest concentration

Term
Define a Partial Agonist
Definition

These are agonists that have only moderate intrinsic activity.

 

The maximal effect that a partial agonist can produce is less than that of a full agonist.

 

Can act as antagonists as well as agonists 

Term
Examples of receptorless drugs
Definition
Antacids, antiseptics, saline laxatives, chelating agents
Term
Describe receptor regulation
Definition

Continuous exposure to agonist

 

Desensitized or refractory=Down-regulation

 

Continuous exposure to an antagonist= Hypersensitive and upregulation

Term
Ibuprofen
Definition

Treats:rheumatoid arthritis osteoarthritis, bursitis, fever,dysmenorrhea

 

1st gen NSAID - Anti-inflamatory COX 1&2 inhibitor

 

Adverse: Ulcers, bleeding, renal impairment. Increase risk of Stroke and MI

Term
Salicylates – asprin (ASA) acetylsalicylic acid
Definition

Treats:pain, fever, inflamation

CAT: 1st gen NSAID

Action: Nonselective inhibitor of COX1,2 irreversible inhibitor TXA2 

Adverse:Bleeding platelet agg lasts(8days). GI,Ulcers,Renal impairment-prostaglandin deprived.


Contraindication: Glucocorticoids,Warfarin, Heprin, alcohol. Reye’s syndrome- kids chicken pox, influenza. Pregnancy Anemia, postpartum hemorrhage, may prolong labor, close fetus ductusateriosus. Acute poisonings

Term
Acetominophen
Definition

Treats:fever, headache but not inflammation in body

Category: NSAID,

Action:Inhibits Cox in CNS only.

Adverse: hepatotoxin via P450

 

Contraindications:alcohol,warfarin,

 

Other:May blunt immune response to vaccine

Term
H1 Antagonists (Promethazine,Fexofenadine)
Definition

Treats:Anti-Inflammatory allergy, Motion sickness, insomnia, cold.

Action: Blocks h1 receptors (vasodilatation, increased capillary permeability, bronchoconstriction, CNS sleep/wake cycle-memory)  

Adverse: anticholenergenic -(dry mouth, dry mucous membranes, urinary hesitancy, constipation, palpitations) Depresses CNS – lipid soluble, crosses BBB,Respiratory depression,Cardiac dysrythmia: prolongs QT interval Contraindicated: alcohol,3rd trimester, nursing mothers, newborns asthmatics- thickens mucous, anaphylaxis

Other: Severe tissue injury-avoid IV gangrene and amputation. IM is ok and oral is preferred

Term
Glucocorticoids: Dexamethasone,Prednisolone 
Definition

Treats: Rheum arthritis, lupus, IBS, Allergic conditions, Asthma, Dermatologic disorders, Neoplasms, Suppression of allograft rejection. Prevention of RDS in premature infants


Action:Immunosuppressant, Anti-inflammatory, Increase RBC, decrease WBC,increase blood glucose, decrease protein metabolism, promote glycogen storage, fat breakdown.


Adverse:Increase blood glucose, decrease protein metabolism,pot belly, moonface, neck hump/cushings


Contraindications:Adrenal hypoplasia- times of stress fatal Osteoporosis, lowered immune, and glycosuria. Myopathy,electrolyte disturbances,Growth retardation,insomnia, irritability, delirium, hallucinations Cataracts, glaucoma: Peptic ulcer disease,pregnancy and lactation Drug interactions NSAIDs- ulcers Insulin-may need to increase. Vaccines /live 

Term
DMARDs (Disease modifying antirheumatic drugs) Methotrexate (Reumatrex, Trexall)
Definition

Treats: RA

 

Action: Suppress B and T lymphocytes, Slow progression of joint deformity

Adverse: GI disturbances,Dermatologic,Hepatic fibrosis, bone marrow suppression, GI ulceration, pneumonitis. 

Contraindications: teratogenic, Sulfa allergy

Term
Vaccine MMR2
Definition

Treats: Stimulates immunity for Measles, Mumps, Rubella.

Action:3 live virus stimulate adaptive active immunity Adverse:Sore, red, glandular swelling in cheek, neck, jaw. Transient rash

Contraindications:allergy to egg or gelatin, pregnancy, children with thrombocytopenia, neomycin allergy, moderate febrile illness,immunocompromised, Glucocorticoids, anticancer drugs, HIV

Term
Flu vaccine: Nasal LAIV FluMist
Definition

Action:Weakened virus introduced for active adaptive immune sytem

 

Adverse:May get flu, Runny nose, cough, fever, vomit, muscle aches, headache, sore throat. Contraindications:Anaphylaxix, Rare-Guillian Barre Syndrome  Bells palsey, Under 2 over 49, pregnant, immunocompromised

Term
Flu vaccine Fluzone
Definition

Action:Attenuated virus (weakened)

Adverse: Malaise, fever, myalgia, Rare-Guillian Barre Syndrome.

Contraindications: febril Fever illness, egg allergy, under 6 months, immunocompromised

Term
Penicillins
Definition

Treats:Antimicrobials Menningitis Pneumonia Streptococcus infections throat and pericarditis syphilis

Action:Beta-Lactam antibiotic weaken cell wall, bact. takes up water and bursts. Not effective against gram neg cell walls. -+bacteria have beta-lactamase producing bacteria. MRSA resistant mutated low PBP’s produced. - nonteratogenic


Adverse:Sore red at site


Contraindications:Neurotoxic if injected into nerve(seizures), or intra atrial –(necrosis) Allergy (Immediate, Accelerated, late), Probenecid/ procaine = hyperkalemia,death Other:Never mix penicillin with Aminoglycoside in IV, inactivates Aminoglycoside

Term

Cephalosporins

Cefazolin

Cefaclor

Cefoperazone *

Cefepime

Definition

Treats: Cefazolin-  g+Staphlococci, Streptococcus, Cefaclor G-, Cefoperazone G- MRSA, Cefepime menningitis


Action:Beta-Lactam binds to penicillin binding proteins (PBP), autolysin bacterioside, low toxicicity, . 1st 2nd generation not used often. 3rd and 4th penetrate cerebral spinal fluid used meningitis, nonteratogenic


Adverse:Low toxicity, well tolerated. Oral take with food, IM very sore, IV slow, 2nd gen Use may contribute to C-Diff.


Contraindications:allergy, bleeding, thrombophlebitis Probenecid Alcohol Drugs that promote bleeding Calcium and ceftriaxone

Term
Like cephlosporins - Vancomycin
Definition

Treats:MRSA, c-diff

 

Action:Inhibits cell wall synthesis. Binds to cell wall not PBP. Used for severe infections only. Works on MRSA. Oral dose for c-diff after metronidazole

 

Adverse:Nephrotcicity,red, burn, itch- slowly infuse. thrombophlebitis at site of iv. Thrombocytopenia, allergy

 

Nonteratogenic 

Term
Tetracyclines, Doxycycline
Definition

Treats: Rickettsial disease, Chlamydia, Brucellosis, Cholera, acne, mycoplasma pnemoniare, lyme disease


Action: Suppress bact. Growth, inhibit protein synthesis


Adverse: GI upset avoid hs dose


Contraindications:Absorption inhibited by chilation(calcium), milk, iron, antacids, GI irritation Diarrhea, super infection(another bact not affected by Tet), high doseIV=hepatotoxic, renal toxic, photosensitivity, Pregnancy (affects fetus adult teeth)children under 8, kidney disease, c-diff

Term
Macrolides: Erythromycin Clarithromycin (Biaxin) Azithromycin (Zithromax) 
Definition

Treats:Whooping cough, ditheria, clamydia, Group A strep

 

Action:Broad spectrum – inhibits protein synthesis, used for penicillin allergic, bacteriostat

 

Adverse:GI pain, nausea, vomit, GI, Super infection, QT interval prolongation and sudden cardiac death

 

Contraindications: Increases with Warfarin, carbamazepine, opylline, Promotes C.diff

Term
Other bactstat inhibit: Clindamycin
Definition

Treats:G+or-, Group Astrep, gas gangrene, abdominal infections, B.Fragilis

 

Action:Binds to 50s subunit to inhibit protein synthesis. Does not cross BBB Adverse:Diarrhea


Contraindications:fatal c-diff

Term
Aminoglycoside: Gentamicin
Definition

Treats:aerobic gram-negative bacilli. Pseudomonas aeruginosa, e.coli, serratia.

 

Action:Narrow-spectrum antibiotics Bactericidal. Don’t readily cross membranes “polycations” positively charged.

 

Adverse:serious injury to inner ear and kidney Not absorbed from the GI tract Microbial resistance, Nephrotoxicity Ototoxicity Other:Must be given IM or IV. Binds to kidney and ear


Contrainidcation: teratogenic 

Term
Sulfonamides - Sulfadiazine
Definition

Treats:UTI, MRSA

Action:Broad-spectrum antibiotics Suppress bacterial growth by inhibiting bacteria from folic acid synthesis


Contraindications:Stevens-Johnson syndrome Hematologic effects Kernicterus- newborn Renal damage from crystalluria Inhibits hepatic metabolisim of other drugs,infants under 2m, preg. breastfeed

Term

Trimethoprim - Trimethoprim-sulfamethoxazole (TMP-SMZ) combo

 

Definition

Treats:Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter, coagulase-negative Staphylococcus Urinary tract

 Action:Inhibits dihydrofolate reductase Broad-spectrum antibiotics Suppress bacterial growth by inhibiting bacteria from folic acid synthesis.


Contraindications:Hematologic effects, hyperkalemia, Folate deficient Gastrointestinal Nausea and vomiting Rash Hypersensitivity reactions (Stevens-Johnson syndrome) Blood dyscrasias Kernicterus - preg. breastfeed Renal damage: crystalluria

Term
Quinolones - Ciprofloxin
Definition

Treats:MRSA Anthrax respiratory,(UTI), GI, bones, joints, skin, soft tissue

Action:Disrupt DNA replication and cell division Contraindications:Tendon rupture, teratogenic,Promotes cdiff, > 60 years, glucocorticoids, kidney, heart, or lung transplantation. Absorption reduced by: Aluminum Mag antacids Iron Zinc salts, Sucralfate, dairy products.

Term
Nitrofurantoin: Furadantin, macrodantin, Macrobid
Definition

Treats:UTI, e.coli, staph, strep, neserria, bacteriodes Action:Broad spectrum, enzymatically activated then damages DNA

 

Adverse:2-4 days Dyenpnea, pain,fever, chills, hypersensitivity months, hematologic;agrannulocytosis, leucopenia, thrombocytopenia, megaloblastic anemia,

 

Contraindications: Pregnant, infants, hepatotoxic – test liver funct, tertatogenic,

Term
Cholinesterase Inhibitors: Galantamine 
Definition

Treats: Alzheimer

Action:Increase cognition, behavior, and function and may slow disease progression slightly. Prevent ACh break down and increases its availability. Adverse:Dizzy, GI symptoms  and bronchoconstriction

Contraindications:first-generation antihistamines, tricyclic antidepressants, conventional antipsychotics) reduce responses to cholinesterase inhibitors.

Term
NMDA receptor antagonists: Memantine
Definition

Treats:Moderate - Severe Alzheimer

 

Action:Receptor antagonist blocks calcium influx when extra cellular glutamate is low.

 

Adverse:Dizziness, headache, constipation Contraindications:Combined with Amantadine and ketamine undesireable addictive effect.

Term
Antiepileptic: Phenytoin
Definition

Treats: Epilepsy

 

Action:selective inhibition of sodium channels Varied oral absorption, Nystagmus Sedation Ataxia Diplopia Cognitive impairment Gingival hyperplasia Skin rash 

 

Contraindications:pregnancy Cardiovascular effects Other:Half-life: 8 to 60 hours large variable monitor

Term
Antiepileptic: Carbamazepine (tegratol)
Definition

Treats:Epilepsy Bipolar disorder Trigeminal and glossopharyngeal neuralgias

Action:Suppression of sodium influx Suppression of calcium influx Antagonism of glutamate Potentiation of GABA

Adverse:nystagmus, ataxia leukopenia, anemia, thrombocytopenia, Hypo-osmolarity,rash, photosensitivity

Contraindications: teratogenic, increases rate that drugs are inactivated, Suicide risk, avoid grapefruit juice: increases drug plasma levels by 40%

Term
Phenobarbital
Definition

Treats: Bipolar, epilepsy


Action:binds to GABA receptors causing them to respond more to GABA.


Adverse:Lethargy, depression, learning impairment


Contraindications: teratogenic, dependency

Term
Gabapentin
Definition

Treats:Epilepsy

 

Action:may enhance GABA release

 

Adverse: somnolence, dizzy, ataxia, nystagmus Contraindications: unknown pregnancy

Term

SSRIs Selective Serotonin Reuptake Inhibitors - Fluxotine Sertraline (Zoloft)

Paroxetine (Paxil, Paxil CR, Pexeva)

Definition

Treats: Depression, bipolar, OCD,panic, bulimia, PTSD

 

Action:blocks serotonin uptake increases amount of transmitters to eventually increase amount of serotonin uptake into neurons->decreasing depression.


Adverse:70%sexual dysfunction,weight gain, serotonin syndrome(agitation,hallucinations, altered mental status, tremor, fever) W/D dizzy, headache, termor. Can cause neonatal abstinence syndrome (baby w/d) infant Pulmonary hypertension, possible heart defects

Other:Suicide risk, bruxism (teeth grinding)GI bleeding.


Contraindications: MAOIS, TCI, Anticoagulants

Term

SNRIs- Serotonin/Nor-epinephrine Reuptake Inhibitors

 

Venlafaxine (Effexor)

Definition

Treats: Depresion,anxiety

 

Action:blocks serotonin, NE and weakly blocks dopamine Adverse: hypertensio, sexual dysfunction, pupil dilation, hyponatremia,suicide

 

Contraindications: MAOI's 

Term
SNRIs- Duloxetine (Cymbalta)
Definition

Treats:depression,diabetic neuropathy

 

Action:Inhibits serotonin and NE reuptake Weakly inhibits dopamine reuptake

 

Adverse:Nausea, Somnolence Dry mouth Sweating Insomnia Blurred vision Effects in pregnancy and lactation Drug interactions

Contraindications:Alcohol MAOIs Drugs that inhibit CYP1A2 or CYP2D6 Other:

Term
TCAs (tricyclic antidepresants) - Amitriptyline
Definition

Treats:Depression, bipolar, fibromyalgia

Action:blocks uptake of NE and 5-HT, increases transmitters and sensitivity

Adverse:Orthostatic hypotension,anticholenergenic effects (blocks muscarinic dry mouth, urinary hesitancy, tachycardia),Diaphoresis, sedation, cardiac toxicity, seizures, hypomania, suicide, yawngasm :-) Contraindications:MAOI's, direct acting sympathomimetic drugs (prolonged in system-increased sensitivity)Blocks indirect acting sympathomimetic, intensify anticholinergenic -antihistamines and sleep aids. Overdose

Term
MAOIs - Phenelzine
Definition

Treats:depression, panic, OCD

Action:Blocks liver enzyme MAO A and B from converting NE,dopamine, and serotonin.


Adverse:orthostatic hypotension,


Contraindications:hypertensive crisis:dietary tyramine (cheese, sausage, aged fish) All drugs

Term
Benzodiazepines (Xanex,Ativan,Valium)
Definition

Treats:Anxiety, insomnia, seizure

Actions: intesnify GABA effects(not agonist) Adverse:Acute toxicicty, CNS depress, amnesia, paradoxical effects(opposite), respiratory depress,


Contraindications:teratogenic, dependance,

Other:IV induces severe hypotension and cardiac arrest

Term
atypical antidepressants -Bupropion (Wellbutrin) 
Definition

Treats:Depression, seasonal affective disorder, smoking cessation.

 

Action:blocks NE and dopamine not SSRI or MAOI

 

Adverse:headache, nausia, dry mouth, seizure Contraindications:SSRI's or MAOI's Other:

Term
St Johns Wort (Hypericum perforatum)
Definition

Treats:mild depression

 

Action:may equal TCA's Adverse: induces p-450 liver enzyme drug metabolizing, induces P-Glycoprotien (transport drugs through intestinal lumen and urine)


Contraindications: serotonin syndrome if combined with other SSRI's 

Term
Mood-stabilizing drugs -Lithium
Definition

Treats:acute manic depression, depression, Action:unknown exactly, ion critical to neuronal function may block SSR, NE, Dop Adverse:small therapurtic index-monitor plasma, weakness, tremor, GI, polyuria, goiter, leukocytosis

 

Contraindications:teratogenic nephrotoxic,diuretics, don't change to low sodium diet-restricts excretion of lith -> toxicity, NSAIDS,Anticholenergenic (antihistamines, TCA's)

Term
Benzodiazepines like drugs: Zolpidem (Ambien)
Definition

Treats:insomnia Category:hypnotic

 

Action:binds where benodiazepines do on GABA receptors

 

Adverse: CNS depressants, alcohol, unknown safe in pregnancy

Term
Barbiturates (Phenobarbital)
Definition

Treats:Seizure disorders Induction of anesthesia Insomnia


Action:Binds to the GABA receptor–chloride channel complex


Adverse:CNS depression,Respiratory depression, Suicide, Abuse, Use in pregnancy, Exacerbation of intermittent porphyria Hangover, Paradoxical excitement, Hyperalgesia Cardiovascular effects


Contraindications:CNS depressants drug-metabolizing enzymes Chloral hydrate Meprobamate

Term
Atypical anstidepressant -Trazadone
Definition

Treats:insomnia from antidepresents, depression

 

Category:hypnotic Action:Blocks 5HT uptake

 

Adverse:prolongs QT, prolonged painful erection

 

Contraindications:drugs that inhibit metabolisim Other:

Term

Muscarinic agonists (Parasympathetic/ cholenergenic)

Bethanechol 

Definition

Treats:urge incontinence


Action:Sweat glands, decrease heart rate, smooth muscle,Contraction in lung (constriction) GI tract (increased tone/motility) Bladder (contraction of detrusor) Vascular (relaxation, vasodilation, hypotension) Eye (pupillary constriction and ciliary contraction)


Adverse:Cardiovascular system Alimentary system Urinary tract Exacerbation of asthma Dysrhythmias in hyperthyroid patients

Term

Muscarinic Antagonists (Anticholenergenic)

 

Atropine, Tolterodine

Definition

Treats:Preanesthetic medication, Disorders of the eye Bradycardia, Intestinal hypertonicity, and hypermotility, Muscarinic agonist poisoning, Peptic ulcer disease Asthma Biliary colic


Action: block acetylcholine at muscarinic receptors.


Adverse:Xerostomia (dry mouth) Blurred vision and photophobia Elevation of intraocular pressure, Urinary retention, Constipation, Anhidrosis, Tachycardia, Asthma Contraindications:Other muscarinc blockers.

Term
Anticholinergic drugs are also called?
Definition

Parasympatholytic drugs


Antimuscarinic Antinicotinic drugs

 

muscarinic/nicotinic blockers

Term
Actions and receptors of the parasympathetic system:
Definition

Muscarinic: agonist                           antagonist

salvia          salivation                      Dry mouth

CNS    enhanced cognition            confusion, hall

Heart    brady cardia                       tachycardia  

detrusor     contract                         relax

GI               increase                        relax

eye iris        contract                        relax

Term
Muscarinic Antagonists: Ipratropium Bromide
Definition

Treats:Asthma,COPD

Action:causes broncodialtion


Adverse:increase intraocular pressure w/glaucoma Contraindications: not many anticholenergenic dry mouth,constipation, urinary hesitancy)

Term
Nicotinic AntiCholenergenic/ Antagonist Neromuscular blocking agent: Succinylcholine
Definition

Treats:Muscle relaxation during surgery Facilitation of mechanical ventilation Adjunct to electroconvulsive therapy Endotracheal intubation Diagnosis of myasthenia gravis

 

Action:Paralysis Adverse:Respiratory arrest Cardiovascular effects,Prolonged apnea in patients with low pseudocholinesterase activity Malignant hyperthermia, Postoperative muscle pain, Hyperkalemia Contraindications:other Cholinesterase inhibitors, Antibiotics Other:Cannot cross Blood-brain barrier No impact on CNS (paralysis, not sedation) Placenta Minimal effects on fetus Drugs: Antibiotics, Aminoglycosides,

Term

Adrenergic Agonists  and receptor actions:

Epinephrine

Norepinephrine

Dopamine

Albuterol

Phenoxybenzamine

Alfuzosin 

(Sympathomimetic)

Definition

                 Agonist         

Alpha 1   dilate pupil                       

 constrict arterioles,veins

bladder,ejeculate

Alpha 2 (inhibits transmitter release) *extra

Beta 1 increase heart

rate, force, renin,

Beta 2- bronich dilation

utuerus relax,contr.skelatal muscle

Dopamine: Kidney dilation

 

Term

Adrenergenic agonist: Epinephrine

Action Treatment and Receptors?

Definition

Treats:Delays absorption of local anesthetic Controls superficial bleeding Elevates blood pressure Mydriasis during ophthalmologic procedures Overcomes AV block Restores cardiac function in arrest Bronchial dilation in asthma Treatment of choice for anaphylactic shock receptors: A1,A2,B1,B2

 

Term

Adrenergenic Agonist: Norepinephrine

 

receptors and actions

Definition

A1,A2,B1 receptors

Increased heart rate and force

dilation lung

uterus relax

Skelatal muscle contraction

 

Term
Dopamine - receptor and action
Definition
dopamine: dilates renal blood vessels
Term
Adrenergenic agonist: Albuterol
Definition

Treats: Asthma, treat preterm labor,

Action: Activates beta 2 receptor, dilates bronchiols, relaxes uterine smooth muscle


Adverse: tremor

Contrainidications: hyperglycimia in diabetic patients, 

Term
Adrenergic Antagonists
Definition
Treats: Category: Action: Adverse: Contraindications: Other:
Term
Phenoxybenzamine
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Alfuzosin
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Propranolol
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Labetalol
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Atenolol
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Metoprolol
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Clonidine
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Methyldopa
Definition
Treats:
Category:
Action:
Adverse:
Contraindications:
Other:
Term
Explain the blood brain barrier to a colleague:
To a patient:
Definition
colleague: The blood brain barrier protects the brain by keeping chemicals and blood products like WBC out of the brain. This can also work to keep drugs out and can make treatment difficult unless the drub is lipid soluble.

patient:The brain forms a protective covering that only allows certain things to cross into it. Infact the brain doesnt even allow our own whiteblood cells of our immune system. It actually has it's own helper cells called glial cells that work like our WBC. The BBB also keeps out medications unless they are whats called lipid or fat soluble because our brain cells are made with a lipid covering.
Term
List the drug treatments for Alzheimer's and the goal of treatment:
Definition
1. Cholinesterase Inhibitors
2. Atypical antipsychotics-agitation, aggression, delusions, hallucinations
3. SSRIs for depression (not AD symptoms)

Goal: Slow disease progression and manage symptoms
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