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Test 1
Test 1
62
Pharmacology
Undergraduate 3
02/12/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
Name two Rapid Acting Insulins(short duration)
Definition
  1.  
    1. Insulin lispro -Humalog
    2. Insulin aspart - NovoLog
Term

What is the onset, peak and duration of insulin lispro (Humalog)? When should this insulin be given?

Definition
  • Onset 15-30 (min)
  • Peak 0.5-2.5 (hr)
  • Duration 3-6.5 (hr)

Administered right before or after eating.

Term

What is the onset, peak, and duration of Insulin aspart(Novolog)? &

When should this insulin be given?

Definition
  • Onset 10-20 (min)
  • Peak 1-3 (hr)
  • Duration 3-5 (hr)
  •  

    5 to 10 minutes before meals

    Term
    Name two regular insulin's?
    Definition
    1. Humulin R
    2. Novolin R
    Term
    What is the onset, peak, and duration of Humulin R & Novolin R? & When should it be administered?
    Definition
    • Onset: 30-60 min
    • Peak: 1-5 hr
    • Duration: 6-10 hr

    Administered:  Injected before meals to control hyperglycemia, infused sub Q to provide basal glycemic control

     ONLY INSULIN THAT CAN BE GIVEN THROUGH AN IV.....

    Term
    What are two intermediate duration insulins?
    Definition
    1. NPH (Neutral Protamine Hagedorn) Insulin
    2. Insulin Determir (Levemir)
    Term
    What is the onset, peak, and duration of NPH?  When should it be administered?
    Definition
    • Onset 60-120 min
    • Peak 6-14 hr
    • Duration 16-24 hr

    Injected twice daily to provide glycemic control between meals and during the night.

     

    Term
    What is the onset, peak, and duration of insulin determir (Levimir)?
    Definition
    • Onset 6-8 min
    • Peak12-24 hr
    • Duration - Duration is dose dependent

    Slower onset, longer the duration than NPH binds to albumin.

    Term
    What is a long duration insulin?
    Definition

    Insulin glargine (Lantus) also Levemir at higher doses.

    Term
    What are 5 oral hypoglycemic drugs?
    Definition
    1. Sulfonylureas
    2. Meglitinides "Glinides"
    3. Biguanides
    4. Thiazolidinediones "Glitazones"
    5. Alpha-glucosidase inhibitors
    Term

    What are two types of Sulfonylureas?  What does sulfonylureas do?

    What are the adverse effects?

    Definition
    1. Tolbutamide(first generation)
    2. Glipizide (Second generation)

    Promote insulin secretion by the pancreas, may also increase tissue response to insulin. can only be used in type 2 diabetes.

     

    Excessive lowering blood pressure, hypoglycemia

    Term
    What is the duration of Tolbutamide (Orinase)?
    Definition

    Duration 6-12 hrs.

    Term
    Since Glipizide is a second generation agent what is the releases that occurs? and what is the duration?
    Definition

    Immediate release (Glucotrol) Dur: 10-24 hr

     

    Term
    What action does the Meglitinides "Glindes" do?  What are the adverse effects?  What drug is most common?
    Definition

    Action: Promotes insulin secretion by the pancrease

    Adverse Effect: Hypoglycemia

    Drug: Repaglinide(Prandine)

    Only for type 2 diabetes

    Term
    What action does Biguanides have?
    What are the adverse effects?
    What is the drug associated with it?
    Definition
    Action: Decrease glucose production by the liver, increases tissue response to insulin.
    Adverse Effect: GI symptoms: decreased appetite, nausea, diarrhea(rarly)
    Drug: Metiformin (Glucophage)
    Term

    What action does Thiazolidinediones "Glitazones" do?

    What are the adverse effects?

    What is the drug associated with it?

    Definition

    Action: Decrease insulin resistance, and therby increase glucose uptake by muscle and decrease glucose production by the liver.

    Adverse Effects:  Hypoglycemia, but only in the presence of excessive insulin.

    Drug: Rosiglitazone (Avandia)

    Term

    What is the action of Alpha-glucosidase inhibitors?

    What are the adverse effects?

    What is the drug name?

    Definition

    Action: Inhibit carbohydrate digestion and absorption thereby decreasing the postprandial rise in blood glucose.

    Adverse Effect: GI Symptoms- flatulence, cramps, abdominal distention, borborygmus

    Drug:  Acarbose(Precose)

    Term

    What are three local anesthetics?

    What are they used for?

    Definition
    • Cocaine
    • Bupivicaine(Marcaine)
    • LIdocaine

    Topical: Applied to the skin to relieve pain, itching and soreness of various causes, including infection, thermal burns, sunburn, diaper rash, wounds, bruises, abrasions, plant poisoning,and insect bites,

    Injectable: High risk and must be administered by a anesthesiologist.

    Term

    Lidocain

    Topical or Injectable?

    What is the peak, onset and duration?

    Amide or Ester?

    What does it do?

     

    Definition
    • Both Topical and Injectable
    • Topical Peak: 2-5 min
    • Topical Duration: 15-45
    • Injectable Onset: Less than 2 min
    • Injectable Duration: 0.5-1 hr
    • Amide, it is a Local Anesthetic
    Term

    Cocaine

    1. How is it administered (Topical/Injectable)
    2. What is the peak and duration?
    3. Ester/Amide?
    4. Where is it usually used?
    5. Adverse Effects?
    Definition
    1. Topical
    2. Peak 1-5 min,  Duration 30-60 min
    3. Ester
    4. Ear, nose, and throat
    5. Vasoconstrictor, HTN, Dysrhythmia, Angina, Hypertension
    Term

    Bupivicaine (Marcaine)

    1. Topical/Injectable
    2. Onset/Duration
    3. Amide/Ester
    4. What are the adverse effects?
    Definition
    1. Injectable
    2. Onset: 5 min Duration: 2-4 hr
    3. Amide
    4. __________________________
    Term
    What are general anesthetics?
    Definition
    they produce unconsciousness and a lack of responisveness toall painfull stimuli.
    Term

    Whare are preanesthetic drugs (3)?

    What is the purpose of these drugs?

    Definition
    1. Benzodiazepines
    2. Opiods
    3. Parasympathetic Blocker(Atropine sulfate)

    Reducing anxiety, producing prerioperative amnesia, Relieving properative and postop  pain.

    Term

    Benzodiazepines (Preanesthetic)

    1. What drug is used and how is it given?
    2. Adverse Effects
    3. ?
    Definition
    1. Midazolam(Versed) IV,
    2. _______________________
    Term

    Opioid (Pre-anesthetic)

    1. What is it used for?
    2. Adverse Effect?
    3. What are the drugs used?
    Definition
    1. Post & Pre op, help suppress cough,
    2. Bowel and Urinary tract retention, Risk of post op respiratory distress, may promote vomiting
    3. Morphine, Fentanyl

     

    Term
    1. What drug is used as a parasympathetic blocker?
    2. It is given during surgery to decrease the risk of?

     

    Definition
    1. Atropine Sulfate
    2. Bradycardia
    Term

    What are 3 inhalation anesthetics drugs?

     

    Definition
    1. Halothane (Fluothane)
    2. Isolfurane (Forance)
    3. Nitrous Oxide
    Term

    Halothane(Fluothane) Inhalation Anesthetic

    1. Adverse Reactions
    2. How is it used today?
    Definition

    Adverse Reaction: Halothane causes a dose-dependent reduction in blood pressure, Hypertension, respiratory depression, promotion of dysrhythmia, Malignant hypothermia, Hepatotoxicity

     

    NO LONGER IS USE!!!!

    Term

    Isofluance (Forane)

    1. Adverse Effects
    2. How is it used to day?
    3. What is the MAC index?
    4. What type of liquid?
    Definition
    1. Hypotension, supresses uterine contraction, No renel or hepatic toxicity becase elimination it mostly be breath
    2. It is the most widely used drug
    3. 1.15%
    4. Volatile Liquid
    Term

    Nitrous Oxide Inhalation anesthetic

    1. What is it known as?
    2. Adverse Effects
    3. When is it mostly used?
    4. What is the MAC and potency?
    Definition
    1. Laughing gas NO2
    2. No major adverse effect but may cause nausea  and vomitting?
    3. Dentistry and during delivery
    4. MAC- 105,  very low anesthetic potency, very high analgesic potency.
    Term
    What are 3 anesthetics that are administered through an IV?
    Definition
    1. Short Acting barbiturates (Thiopental)
    2. Benzodiazepines
    3. Ketamine(Ketalar)
    Term

    IV Anesthetic - Short Acting Barbiturates (Thiobarbiturates)

    1. What is the drug?
    2. What is the onset and duration?
    3. Adverse Reaction
    Definition
    1. Thiopental
    2. Has a rapid onset but a short druation.  Onset will usually happen 10-20 seconds but if not followed by a inhalation anesthetic the patient will wake up in about 10 min.
    3. Cardiovascular and Respiratory Depression.  Also if given too fast may cause apnea.
    Term

    IV Anesthetic- Benzodiazepines

    1. What are the names of the drugs?
    2. Adverse effect
    3. What drug is used for consious sedation?
    Definition
    1. Diazepam(Valium), Midazolam(Versed), lorazepam
    2. Valium-causes little muscle relatztion and no analgesia, Cardiovascular and respiratory depression are usually only moderate. Versed- dangerous cardiovasular effects, respiratory depression and respiratory and cardiac errest.
    3. Valium
    Term

    IV Anesthetics - Ketamine

    1. What is the drug name?
    2. What are the adverse effects?
    3. What type of anesthetic?
    4. How long does it take to recover?
    5. What age group is it used in?
    Definition
    1. Ketalar
    2. Hellucinations, disturbing dreams, and delirium (may occur days or even weeks after being used)
    3. Dissociative anethetic
    4. full recovery may take hours
    5. used in young children for minor surgeries 
    Term

    What is a  neuroleptic- opoid  combinations?

    What is it known as?

    What are the adverse reactions?

    Definition
    1. Droperidol plus Fentanyl
    2. neurolept analgesia
    3. Cardiac, B/P, Respiratory drespression, Neurolept anesthesia-major surgery, Neurolept Analgesia- quiescence indiferrent to pain.
    Term
    1. What is a neuromuscular blocking agents?
    2. Mixing this will cause?
    3. What does this drug do?
    Definition
    1. Succinylcholine
    2. Malignant hyperthermia
    3. skeletal muscle relaxation.

     

    Term
    What are analgesics?
    Definition
    They are drugs that relieve pain without causing loss of consciouness.
    Term
    What is a opioid?
    Definition
    This is a general term used to define any drug, natural or synthetic, that has actions similar to those of morphine.
    Term
    1. What is a opioid prototype analgesics?
    2. What are the adverse effects?
    3. What does it do?

     

    Definition
    1. Morphine
    2. Respiraroty Depression, consitipation, orthostatic hypertension, urinary retention, cough suppression, bilary colic, emesis, elevation of intracranial pressurem, euphoria/dysphoria, sedation, miosis, neurotoxicity, hormonal functions and immune function with prolonged use.
    3. relief of moderate to sever pain .  The drug can relieve poroperative pain of myocardial infarction and dyspnea associated with left ventircualr failure and pulmonary edema, no longer the drug of choice.
    Term

    Analgesia Fentanyl

    1. How can it be admisitered?
    2. What are the onset, peak, and duration?
    Definition
    1. IM, IV, transdermal

    IM-Onset: 7-8 min, Duration: 1-2 hr

    IV: Duration: 0.5-1 hr

    Trans: Onset:delayed, Peak: 24-72 min, Duration: 72

     

    Term

    Meperidine (Demerol)

    1. How is it administed?
    2. Adverse effects
    Definition
    1. Parenteral and oral
    2. can interact with MAO inhibitors to cause excitation, delirium, hyperexia, and convulsions.  Coma and death can follow.
    3. INFO: first line drug for relief of moderate to severe pain. and has a short half life.
    Term

    Methadone

    1. How is it administered?
    2. What are the peaks, onsets and duration?

     

    Definition
    1. PO, IM, IV
    2. ..

    PO: Onset: 30-60 min, Peak: 90-120, Duration: 4-6d

    IM:  Onest: 10-20min, Peak: 60-120, Duration: 4-5d

    IV: Onset: None, Peak: 15-30 min, Duration: 3-4d

    Term
    What are strong to moderate opiods?
    Definition
    1. Codeine
    2. Oxycodone(Oxycontin
    Term

    Codiene

    1. What does it do?
    2. How is it usually administered?

     

    Definition
    1. Indicated for relief of mild to moderate pain
    2. The drug is usually administed by mouth
    Term

    Butorphanol(Stadol)

    1. Agonist or antagonist
    2. Adverse effects:
    3. How is it administered?
    Definition
    1. agonist at kappa receptors, antagonist at mu receptors
    2. increase cardiac work
    3. IM or IV and Nasal Spray(to treat migraines)
    Term

    What is a opiod antagonist?

     

    Definition
    Narcan it is a drug reverse the effects of morphine
    Term
    What are two drugs with nonopioid central analgesics?
    Definition
    1. Tramadol(Ultram)
    2. Clonidine(Duraclom)
    Term

    Tramadol (Ultram)

    1. What is the mechanism of action
    2. Pharmocokinetics?
    3. Adverse Effects?
    4. Durg Interactions?
    Definition
    1. analog of codiene that relieves pain in part through weak agonist activity at mu opioid receptros.  Works primarily by blocking  uprake of norepinephrine and serotionin activating monaminergic spinal inhibtion of pain.  NAlozone partially blooks  effects.
    2. Administered by mouth and reaches peak plasma levels in 2 hrs.  ELiminate is by heaptic metablism and renal exretion.  The HALF LIFE is 5 to 6 hours.
    3. Sedation, dizziness, headache, dry mouth, and consitpation. Respritory Depression  is minimal.
    4. intensifies  response to CNS depresants and cannot be combined  with these drugs. 
    Term

    Clonidine (Duraclon)

    1. What are the approved applications (2)?
    2. Mechanism of action?
    3. Analgesic Use?
    4. Adverse Effects?
    Definition
    1. Treatment of hypertension and relief of sever pain. 
    2. Clonidine is an alpha adrenergic agonist.  The drug appears to relieve pain by binding to presynaptic alpha receptors in the spinal cord.  The result is blockade of nerve  traffic in pathways that transmit pain signals from the brain.  Pain is not blocked.
    3. Combined with an opiod analgesic, is approved to treat sever cancer pain.
    4. Hypotension, bradycardia, Rebound hyertension, catheter-related  infection.
    Term
    What are anti-depressents?
    Definition
    used to relieve symptoms of depression and to help patients with anxiety.
    Term
    1. What is the antidepresent of first choice for many patients?
    2. What is the thereaputic uses?
    3. What is the half life?
    4. What are the adverse effects?
    Definition
    1. Tricyclic
    2. Depression,  Bipolar Disorder
    3. Half lifes are long and variable  and are administered in a daily dose. 
    4. Orthostatic hypotension, anticholinergic effect, diaphoresis, sedation, cardiac toxicity, seizures, hypomania, sucide risk.
    Term
    What drug is as effective as TCA but does cause hypotension, sedation, or anticholinergic effects?
    Definition

    SSRI's

    Selective Serotonin Reupake Inhibitors

    Term

    SSRI

    1. What is one SSRI?
    2. What is is the action?
    3. What is the therapeutic use?
    4. What is the half life?
    5. ADR
    6. Interactions
    Definition
    1.  Fluoxetine (Prozac)
    2. Produces CNS excitation rather than sedation, inhibition of S-HT reuptake, and thereby intensifies transmission at serotonergic synapse.
    3. Major Depression 1-3 weeks, OCD, Bulimia, PMDD, panic disorder, PTSD, socail phobia, alcoholism, adhd, bipolar disorder, migraine, obesity
    4. 2 days
    5. Sexual dysfunction(70% of men), nausea, headache, insomnia, anxiety, weight gain, hyponitremia
    6. Should not combine w/MAOI, TCA + lithium - elevates plasma levels.
    Term

    S/NRI

    1. What is one drug used?
    2. What is the action?
    3. Therapeutic Use?
    4. Half-Life?
    5. ADR?
    6. Dose
    Definition
    1. Venlafaxine (Effexor)
    2. Neuronal reuptake of sertonin + norepinephrine
    3.  Major depression, genererlized anxiety, sexual phobia
    4. 5 hours
    5. Nausea, headache, anorexia, nervousness, sweating, somnolence, insomnia, Dose related diastolic hypertensin, sexual dysfunction hyponutremia
    6. 75 m/day
    Term

    S/NRI

    1. Name of the second drug?
    2. Action?
    3. Pharmacokinetics?
    4. Therapeutic Use?
    5. ADR
    6. Dose
    Definition
    1. Duloxitine
    2. Inhibitor of serotinen +NE reuptake, reduces depression sypmtoms +reduce physical pain associated w/depression(backache),
    3. Food reduces absorption, bound to albumin
    4. Used for pain of diabetic neuropathy
    5. Nausea, dry mouth, insomnia, somnolence, constipation, reduced appetite fatigue, increased sweating blurred vision.
    6. 40 mg/day
    Term

    MAOI

    1. Drug name?
    2. Action?
    3. Thereputic Use?
    4. ADR?
    5. Drug Interactions?
    6. Dose?

     

    Definition
    1. Tramylcipramine(Parnate)
    2. Inhibit intraneural MAO-A, increasing amount of NE, irreversible, inhibtion
    3. Depression-MAOI's only for prs w/atypical depression
    4. CNS stimullation,orthostatic hypotension, hypotension crisis from dietary tyramine.
    5. sympathomimetic agents- hypotensive crisis, TCA's + MAOI can cause hypotension, anti-hypertensive-combined w/MAOI can cause hypertencion
    6. 10mg
    Term

    Atypical Antidepressants

    1. Drug?
    2. Action?
    3. ADR?
    4. Drug Interactions?

     

     

    Definition
    1. Buproprion(Wellbutrin)
    2. Stimulant action &  appiete supression, action begins 1-3 weeks.  It may be related to blockade of dopamine uptake.
    3. Seizures, agitiation, headache, dry mouth, constipation, tremor, insomina, blurred vission, tachycardia, GI upset
    4. MAOI's incrase the risk of bupropion toxicity.  Should end MAOI's 2 weeks prior.
    Term

    Sedatives/Hypnotics

    1. What are 3 benzodiazepines?
    2. Action
    3. Pharmacokinetics?
    4. Thereputic Use?
    5. ADR?
    6. Drug Interactions?
    7. Acute Toxicity?
    Definition
    1. Diazepan(Valium), Lorazepam(Ativan), Midazolam(Versed)
    2. Mimick GABA action by binding to chloride channel complex
    3. Highly lipid soluble, cross BBB readily
    4. Anxeity, isnomina, seizures, muscle spasms, alcohol withdrawlal, panic disorder
    5. CNS depression, anterograde amnesia, sleep related behaviors, respiratory depression, abuse,
    6. Do not accelerate metabolism of other drugs.
    7. Oral Overdose- notlikely, IV toxicity- hypotension, respiratory arrest, cardiac arrest
    Term

    Benzodiazephines-like drug

    1. Drug name?
    2. Therapeutic Use?
    3. Half Life?
    4. ADR?
    5. Action?
    Definition
    1. Eszoplicone(Lunesta)
    2. Insomnia-increasing sleep time + equality
    3. 6 hours, peak 1-2 hours
    4. Bitter aftertaste, headache, sominolence, dissiness, dry mouth
    5. BInds to benzodiazepine receptors on GABA receptro chloride channel complex.  Enhances depression actions of endogenous GABA
    Term

    Melatonin Agonists

    1. Drug?
    2. Action?
    3. Therapeutic Use?
    4. Pharmakokinetics?
    5. ADR?
    6. Drug Interactions?
    Definition
    1. Ramelteon(Rozaparam)
    2. Sleep promotion derives from MT + MT2 receptors, selectivity for MT & MT2 receptors explain why remelteon is superior to melitonin itself for treating insomnia
    3. Rapid onset 30 min & short duration, good for induction sleep
    4. Absorption is rapid: food can reduce rate & extent of absorption
    5. Somnolence, dizziness, fatigue, decreased libido, amconorrhea
    6. Fluoxamine, alcohol intensifies sedation  & increase more than 50 should be avoided .  Avoid w/moderate heptic impairment.
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