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Pharmocologic Actio
Ch 12 Pharmocolgic Actions
| Question | Answer |
|---|---|
| Characteristics of an ideal drug | effective for its therapeutic use, safe even if given in large quantities, would not have any adverse efffects |
| toxic effects occur when? | when more than recommended does is given. |
| USAN Council = | United States Adopted Name Council |
| olol is an ending for? | Beta blocker |
| pril is an ending for? | Ace inhibitor |
| ol is an ending for? | Bronchodilators |
| tropium? | Anticholergenic agents |
| What is an anticholergenic agent? | It is an anti-inflammatory inhaler |
| Give and example of an anticholergenic agent? | Ipratropium, Tiotropium |
| What are the three types of Bronchodilators? | Beta 2 agonists, Xanthines, and Anticholingeric drugs. |
| Which drugs should not be used with Beta 2 agonist bronchodilators? | Beta-blockers and glaucoma drugs (latanoprost). |
| Theophylline is a xanthines bronchodilator with a high incidence of side effects that occur at therapeutic doses. What factors influence the dose level adminisitered? | Age, diet, smoking, other medications and illnesses |
| What are some medications that require measurement of levels in blood? or levels can be measure in the blood? | Theophylline, Creatinine used to measure proper kidney function, lithium |
| Anticholingeric inhalers are used for COPD | True |
| What is COPD | It is a chronic Obstructive pulmonary disorder such as chronic bronchitis and emphysema |
| Name a short acting Bronchodilator. | Albuterol |
| Name a long acting Bronchodilator | Salmeterol |
| one ending is for? | Inhaled Corticosteroids |
| lukast is an ending for? | Leukotriene ihhibitors |
| Corticosteroids are used to prevent asthma attacks and are used with bronchodilators, which is used first? | The bronchodilators because they open up the airways, so that the steroid can reach the airway and lungs easier |
| Antihistamines are for? | Allergies |
| A common side effect of corticosteroids is thrush. What is thrush? | Is is a fungus of the throat and mouth |
| How do you prevent thrush? | Use a spacer in the inhaler. |
| Leukotriene meds are given to patients that have this type of asthma attack in common, what is it? | Patients who waken in the middle of the night with an attack are given Leukotriene |
| Antihistamines do what? | Prevent the release of histamine from the body. Histamines cause an allergic reaction. Antihistamine block the bodies response to histamine. |
| Name an oral decongestant? | pseudoephedrine (pseudophed) |
| What do decongestants restrict? | they constrict blood vessels in the nose, which decreases swelling. |
| What types of conditions do not mix well with decongestants? | High blood pressure, heart disease, over active thyroid, diabetes mellitus |
| What are anticholinergec effects? | they are the dry effects, dry mouth, constipation, blurred vision, difficulty urinating etc. |
| Antitussive drugs are used for? | Coughs without chest congestion. |
| Expectorants are used for coughs with chest congestion. What is the best? | Water |
| Name the only expectorant drug approved by the FDA? | Guaifenesin |
| Antitussive drugs that are on Schedule II are | Codeine and hydrocodone |
| Name an over the counter Antitussive drugs | Diphenhydramine (benadryl) |
| Benedryl is an antihistamine and also used as a cough med? true or false? | True |
| Name the antidepressant subclasses | Tricyclic, MAOIS, SSRI |
| triptyline is an ending for? | Tricyclic anti-depressants |
| Name a Tricyclic anti-depressants | Amitriptyline, Nortriptyline, protriptyline |
| How do MAOIs work? | prevent the break down of neurotransmitters |
| Name the neurotransmitters | norepinephrine, epinephrine, dopamine, serotonin, acetylcholine |
| What are some SSRI's | Fluoxetine, Sertraline, Paroxetine, Escitalopram |
| What is a critical side effect of the antidepressant Mirtazapine? | Agranulocytosis and neutropenia. Agranulocytosis is decreased production of all blood cells. Neutropenia is decreased production of white blood cells. |
| Why do people get depressed? | response to stimuli such as greif or for endogenous reasons (a chem. disorder of the brain) |
| MAOIs have a drug-diet interaction with foods containing? | tyramine, such as sausage, aged cheese, and red wine. |
| Antidepressants are started at low doses and may take 3-4 weeks to feel effects. True or false? | True and is a reason why patients may become non-compliant. |
| Antipsychotics are classified as conventional and atypical. Conventional drugs block? Atypical block? | Conventional block dopamine and Atypical block dopamine and serotonine. |
| Fluphenazine and Haloperidol are good for patients who may not be very compliant because? | They are long acting injections that can last more than 4 weeks. |
| Atypical antipsychotics include? | Clozapine, Olanzepine (Zyprexa), Risperidone (Risperdol), Quetiapine (seroquel) ,and Ariprazole (Abilify). |
| Common ending of ine is for what drugs? | Atypical antipsychotics |
| Clozapine for antipsychosis and Mirtazapine for depression have what adverse effect in common? | can cause fatal agranulocytosis |
| Common drug for Bipolar disorders and seizures? | Lithium |
| Benzodiazapines is a subclass that is used as | sedatives, anxiety disorders, and hypnotics |
| common ending for BZDs? | pam. Diazapam, Lorazapam, |
| name an antidote for BZDs? to reverse effects for sedation or respiratory depression? | flumazenil |
| What is like an antidote to relieve side effects of Lithium? | propanolol (a beta blocker) |
| What is EPS? | Extra pyramidal symptoms. abnormal muscle contractions |
| EPS is common for what subclass? | High potency anti-psychotics |
| What are the common bipolar disorder drugs? | valproic acid, lithium, carbamazepine |
| what are the most common side effects of BZD's? | sedation, drowsiness and slowed reaction |
| What is tolerance? | a loss of effectiveness over time. |
| What is a seizure? | brief episode of brain dysfunction that result from abnormal firing of nerves in the brain. |
| What is the hangover effect? | Common effect from sedatives and hypnotics. it is the carryover of drowsiness and decreased concentration. |
| BZDs are used as sedatives, hypnotics and anticonvulsants? | true. |
| what are the major seizure drugs? | phenytoin, carbamazepine and valproic acid. |
| why are blood levels of convulsants including phenytoin measured on a regular basis? | ensure the correct therapeutic dose is administered. |
| Name some atypical antipsychotic drugs? | Clozapine, Olanzepine, Risperdone, Quetiapine, Ariprazole |
| Levadopa and Carbidopa are used in combo for Parkinson's disease. true or false? | True. The combination prevents levadopa from being converted to active form in the rest of the body. Concentration of effect is in the brain. |
| What is adjuct therapy? | combination of drugs to work more effectively |
| pill rolling is an abnormality of what disease? | Parkinson's |
| parkinson's is the imbalance of what two brain chemicals? | Dopamine and acetylcholine. |
| the name of the drug that is the combination of levodopa and carbidopa is | Sinemet |
| what are the two drugs that can be used as adjunct therapy with levodopa for parkinson's disease? | Carbidopa and COMT inhibitors (catechol-O-nethyltransferace inhibitor) |
| What is hangover? | common side effect of sedatives and hypnotics. The sedation effect, drowsiness carries over to the next day. person is sluggish. Be careful with sedatives and hypnotics with elderly because they already metabolize drugs slower. |
| it is important to measure drug levels in blood of anticonvulsants (including phenytoin) to make sure the therapeutic does is administered. true or false | true |
| phenytoin is what type of drug? | anti-convulsant |
| Generic name for lunesta? | eszopicolone |
| What is the reversal for Heparin? | protamine |
| What is the reversal for Coumadin? | Vitamin K |
| What is a drug that is a non-BZD, but has similar effects as a BZD? | Zolpidem (Ambien) |
| What is hyperlipidemia? | increased levels of cholesterol in blood. |
| What are the Cholesterol lowering classes? | Bile Acid Sequestrants, HMG-CoA reductase Inhibitors (statins) and Fibrates |
| What do bile acid sequestrants do? | bind bile in the intestines and prevent the bile from being reabsorbed in the blood. |
| Where is cholesterol made? | Liver? |
| Where is it stored? | In gall bladder as bile salts |
| How do the bile acid sequestrants work? | the sequestrants bind to the bile in the intestines, and then it is excreted. the loss of bile stimulates production of more bile, which requires cholesterol. the bile is bound and excreted, which leads to a lower LDL. |
| How do the HMG-CoA reductace Inhibitors (statins) work? | Prevent the formation of cholesterol from fat. |
| What is the HMG-CoA reductase inhibitor ending? | statin |
| How do fibrates effect the total cholesterol? | They lower tricglycerides |
| What are some fibrate drugs? | Gemfirozil (lopid) and Fenofibrate (tricor) |
| What does Nicotinc acid do? | reduces cholesterol and triglycerides |
| What is the most bothersome side effect of nicotinic acid? | flushing sensation, headace, itching and tingling. |
| What is suggested to do to alleviate side effects of nicotinic acid? | Take an aspirin 30 minutes before. |
| Why is it important to take plenty of fluids with Bile Acid sequestrants? | because they can form a solid mass in the the esophagus or intesting and cause blockage, or they can bind with other medications and cause problems. |
| Name the 3 types of diuretics | Thiazide diuretics, loop diuretics, potassium sparing diuretics. |
| What are other HB meds? | beta blockers,ace-inhibitors, calcium channel blockers, angiotnesin receptor blockers |
| common ending for beta blocker? | olol |
| common ending for ace-inhibitor? | pril |
| common ending for ARB's? | sartan |
| Beta blockers should not be taken with people that have these conditions. what are they? | Asthma, COPD, and slow heart rate |
| patients allergic to sulfonamides may also be allergic to? | diuretics. |
| Which of the diuretics is most potent? | Loop |
| Can thiazides alter blood glucose levels? | yes and therefore is a problem for diabetics. |
| What is a first line drug? | A drug that is most likely to be tried first for a condition. |
| Name a first line HBP drug? | beta blockers, and calcium channel blockers |
| How do beta blockers work? | decrease blood volume pumped by each heart contraction. |
| How do diuretics work? | decrease blood volume |
| How do Ace inhibitors work? | Prevent the production of certain chemicals in the blood that cause constriction of blood vessels and retention of Na and H2O. |
| Propanolol is a beta blocker for HB, what else is it used for? | treating tremors, angina (chest pain), heart rhythm disorders. Treats tremors that are a side effect of lithium(for bipolar disorder) |
| How do the ARB's work? | they work on kidneys to lower blood pressure by inhibitin the angiotension II receptors and blocking blood vessel constriction. |
| What is a unique and annoying side effect of ace inhibitors? | cough |
| Ace inhibitors can slow or prevent developement of kidney disease in diabetic patients. true or false? | true |
| How do the calcium channel blockers work? | inhibit movement of calcium in and out of cells, and the result is a decreased force of contraction of the heart. |
| What are the subclasses for calcium channel blockers? | Dihydropyridines and nondihydropyridines |
| What is a common ending for calcium channel blockers? | dipine |
| Name a common calcium channel blocker. | Amlodipine (norvasc) |
| What is an important concern with nitrates for chest pain? | development of tolerance. after 24 hrs of continued use, they are no longer effective. |
| nitrates come in many forms. what are they? | sublingual tabelts, inhalants, sprays, |
| side effects of nitrates are? | headahe, dizziness, postural tension, flushing |
| what is angina pectoris? | Chest pain caused by lack of oxygen in the cardiac muscle, |
| other than nitrates what is another common drug for angina? | aspririn |
| Heart failure drugs are? | betablockers, ace inhibitors, diuretics, and cardiac glycosides |
| What are some cardiac glycosides? | digoxin, digitoxin and deslanoside, |
| How does digoxin work? | increases rate and force of heart muscle contrastions, which improves blood flow and reduces heart rate |
| What is the downside of digoxin | it has a narrow therapeutic index and is therefor toxis |
| Phenytoin is used for anti-convulsants and also for? | arrhythmias |
| lidocaine is a pain reliever but also used as an Antiarrhythmic drug? | true |
| What are the three anticoagulants? | Coumadin. Heparin,and LMWH |
| Side effects of anticoagulants are? | redorange urine, nausea, bleeding, nose bleeds |
| Vitamin K counteracts Warfarin? | true, K helps form clots so need to reduce amount of vit. K when taking warfarin |
| What are the classes of Antiarrhythmic drugs? | Class IA, IB,and IC |
| Which class of Antiarrhythmic drugs are of most concern or greatest risk? | IC because of increased mortality. this class is only used to treat life threatening arrhythmias. |
| Mast cell stabilizers are used in patients with allergic asthma or exercise induced asthma. true or false? | True |
| How do mast cell stabilizers work? | The hinder the release of histamines and other chemicals from the mast cells, which prevent constriction of the bronchioles. |
| name common gastrointestinal disorders. | GERD, peptic ulcer disease, diarrhea, vomitting, constipation, inflammatory bowel disease |
| Name the commone GI meds | antacids, H2 antagonists, proton pump inhibitors, prostaglandin drug and sucralfate |
| Calcium carbonate is the ingredient in? | Tums |
| Name some antacids | Calcium carbonate, Al hydroxide, Mg hydroxide |
| Side effect of Al hydroxide? | constipation |
| Side effect of Mg hydroxide? | diarrhea |
| What is one of the biggest problems with antacids? | drug interactions. They can react with other drugs or cause changes in acidity in stomach that inhibit absorption of the drug |
| How do H2 receptor antagonists work? | they inhibit the histamine and reduce the output of acid from the stomach cells by blocking the receptors |
| How do proton pump inhibitors work? | They lower the stomach acid's output (more than H2 antagonists) |
| Is H-pylori a bacterium? What does it cause? | Yes, it causes a peptic ulcer |
| How is H-pylori treated? | with an antibiotic, or with a histamine 2 receptor antagonists or proton pump inhibitor |
| Common ending for proton pump inhibitor? | prazole |
| Bismuth subsalicylate is for diarrhea and as an adjunct for h-pylori. What is it's brand name? | pepto-bismal |
| Salicyate is in aspirin and Bismuth subsalicylate, what are some side effects from high levels in system? | ringing in ears, nausea, vomitting. In children, Reyes syndrome |
| name some subclasses of laxatives | bulk-forming laxatives, Emollient, Hyperosmotic, stimulant |
| what laxative produces thorough evacuation of intestines within hours? | Stimulant laxatives. |
| what type of laxative is metamucil (methylcellulose) | Bulk forming |
| Emollient laxatives are also know as | stool softeners. |
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