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Pharm Charm IV
Exam 2
| Question | Answer |
|---|---|
| drugs that produce unconsciouness, a lack of responsiveness to all painful stimuli. | General Anesthetics |
| what are the 2 types of anesthetics? | Inhalation and Intravenous anesthetics |
| Drugs that are admin by mask or endotracheal tube. Many are mixed with oxygen. They are rapidly absorbed in the patients' lungs. | Inhalation Anesthetics |
| Inhalation Anesthesia: Laughing gas.induction anesthetic,for short procedures. It must be mixed with oxygen. | Nitrous Oxide |
| Inhalational Anesthesia: volatile liquids that provide plesant and rapid induction and recovery. | Fluranes |
| Inhalation Anesthesia: may have myocardial and respiratory depressant effects | Fluranes |
| IV Anesthesia: Barbituate. RAPID onset and SHORT duration. Produces(hangover)which happens because it is a poor analgesic and causes muscle relaxation. | THIOPENTAL [Pentothal] |
| IV Anesthesia: Benzodiazeoine.Conscious sedation,induction,produces marked anterograde amnesia (Amnesia b4 or after a procedure). | [VERSED]Midazolam |
| IV Anesthesia: Opoid.RAPID Induction of anesthesia and good analgesia. | Fentanyl |
| stabilize the nerve cell membranes blocking the conduction of impulses in nerve fibers. | Local Anesthetics |
| amides (Method of inactivation,allergic rxns are rare).[Lidocaine] | Local Anesthetics |
| esters (allergic rxns) [Novocain] | Local Anesthetics |
| Epinephrine or other vasoconstrictors are often mixed with the this to produce a prolong effect | LocalAnesthetics |
| pain relief drug | Analgesic,Analgesia |
| use low doses. Used as sedatives and in higher doses as hypnotics. | Barbituates |
| loerance occurs rapidly,it depressed REM sleep, cause drug hangover and are potent P450 inducers. | Disadvantages of Barbituates |
| When discontinuing the use of these a withdrawal syndrome may occur or it may cause death. | Barbituates |
| sleep induction in high dose anxiety reduction in low dose muscle relaxation seizure control acute alcohol withdrawal phobia preoperative meds | BENZodiazepines uses |
| receptors found only in the CNS next to GABA receptors when stim.Enhances the activity of GABA or glycine which is an inhibitory transmeitters in the CNS. | BENZodiazepine mechanism |
| minmal depression of ventilation or of the cardiovascular system,low changce tolerance,wide therapeutic index | Advantages of BENZodizepine |
| DEA class IV,aneterograde amnesia occurs with midazolam and triazolam. | Disadvantages of BENZodizepine |
| Oxidizable benzodiazepine. Prototype.Metab by phase I metabolism to active metabolites with a long half-life. | [Valium] |
| most addicting oxidizable drug.Metab by phase I metabolism to active metabolites with a long half-life. | [Xanax] |
| susceptible to induction and inhibition of hepatic microsomal enzymes.Most freq prescribed benzodiazepine. | [Xanax] |
| NONOXIDIZED Drugs | [Ativan] |
| bypass phase I metabolism and are metabolized by conjugation to inactive metabolites. Not effected by induction of enzymes.Good for elderly with hepatic problems. | [Ativan] |
| given w/overdose of multiple drugs bc benzadiazepine adds to CNS depression,alcohol adds to effect. | (Romazicon) |
| tapered slowly to minimize rebound or withdrawal symptoms,appear with in hours to weeks.Ataxia and confusion are especially dangerous in the elderly. | discontinue use of(Romazicon) |
| Drowsiness(sedation) ataxia detachment irritability amnesia constipation double vision hypotension | Acute/Common Romazicon |
| tolerance dependency rebound insomnia | Long-term/Common Romazicon |
| short-term treatment of anxiety,takes a week for anxiolytic effect pure anti-anxiety med | Buspirone [BuSpar] |
| bind to benzodiazepines receptors affecting glycine activity,producing a sedative effect,treatment of insomnia,prior to going to bed (fast onset),not effect REM sleep | [Ambien c-iv] |
| side effects: confutation and falling in elderly,amnesia | [Ambien] |
| use:local,cools,low potent anitimicrobial. | Ethyl alcohol |
| causes cross-tolerance,NOT an anesthetic b/c not safe | disadvantage of Ethyl alcohol |
| alcohol is a primary and continuous depressant,parts of the brain are freed from inhibition | Ethyl Alcohol and the CNS |
| immediate effects are minor, causes vasodilation of blood vessels. flushed skin warm skin | Ethyl Alcohol and the Cardiovascular system |
| rise in acidic secretion,normalpepsin,irritant to stomach and with aspirin it can cause gastric damage | Ethyl Alcohol and the GI Tract |
| chronic use can lead to cirrhosis or hardening,metabolized to acetylehyde by zero-order kinetics | Ethyl Alcohol and the Liver |
| fetal alcohol syndrome,CNS dysfunction,slowness of growth | Teratogenic effects of Ethyl Alcohol |
| denaturant and solvent. "wood alcohol" | Methyl Alcohol |
| poisoning due to CNS depression and acidosis,specific toxicity can cause blindness and 80-150 ml is fatal. | Poisoning bc of Methyl Alcohol |
| Ethanol is an antidote for __.Competes for the enzyme that converts methanol to formic acid. | Methyl Alcohol Antidote |
| treats alcoholism | Disulfiram[Antabuse] |
| markedly alters the intermediary metabolism,causing a 5-10 times increase in blood acetylehyde concentration in patients who have ingested alcohol | Mechanism of disulfiram |
| this syndrome occurs 5-10 min after ingestion of alcohol.vasodilation spreads, resp difficulties,nausea,copious vomiting,sweating,thirst,chest pain,hypotension,orthostatic syncope,uneasiness,wakness,vertigo,blurred vision | Acetylehyde syndrome |
| blockade of dopamine (Dsub2) in the nigrostriatal pathway,caudate nucleus or substantia nigra,causes extrapyramidal symptoms. | Antipsychotics(Neuroleptics) |
| Blockade of dopamine receptors in the chemoreceptor trigger zone alleviates nausea. | Antipsychotics (Neuroleptics) |
| Blockade in the hypothalamus causes release of prolactin | Antipsychotics (Neuroleptics) |
| Uses: schizophrenia,the manic phase of manic-depressive illness | Antipsychotics (Neuroleptics) |
| Absorbed in GI, it is lipid soluble and metab in liver | Antipsychotics (Neuroleptics) |
| Dosing: Avail in soluble form (Zyprexa) and IM (Haldol) that lasts for weeks! | Antipsychotic (Neuroleptics) |
| IV admin causes a fall in BP.HALDOL can cause prolongation of the QT interval | Cardiovascular side effects of Antipsychotics |
| Blockade of dopamine (D sub 2) receptors in the caudate nucleus may cause akathasia,acute dystonic rxns and extrapyamidal symptoms | EXTRApyramidal side effects of Antipsychotics |
| involuntary movements smacking of the lips lateral jaw movements sudden thrusts fwd of tongue hard to treat irreversible | Tardive dyskinesia (Antipsychotics) |
| result of compensatory increases in the function of dopamine activity in the basal ganglia | Tardive dyskinesia (Antipyschotics) |
| dopamine is inhibited causing an increase in PROLACTIN. In HYPOTHALUMUS and PITUITARY glands. | Endocrine changes bc of Antipsychotics |
| Galactorrhea (nipple issues), Pseudocyesis (false pregnancy) and gynecomastia (man boobs) are seen! | Endocrine changes bc of Antipsychotics |
| may cause Neuroleptic Malignant Syndrome (NMS) and obstructive jaundice. | Antipsychotics |
| Antiemetic effects, anticholinergic effects like blurred vision,dry mouth, sedation, lower seizure threshold,epilepsy,phtosensitivity | Endocrine changes bc of Antopsychotics |
| other antipsychotic drugs,partic the phenothiazines seem to enhance the effect of other CNS depressants,analgesics (pain relief drugs)and anticholinergic drugs (bronchodilators). | Antipsychotic Drug interactions |
| "CONVENTIONAL" drugs or 1st generation neuroleptics.Relieves positive effects NOT negative symptoms. | [THORAZINES],[HALDOL] |
| Mechanism of ____ drugs: block postsynaptic dopamine (D sub 2) receptors in the mesolimbic dopaminergic system. | Conventional or 1st generation drugs |
| large doses are unlikely to cause life-threatening depression of ventilation. High therapeutic index! | Conventional or 1st generation drugs |
| Relieves both positive and negative symptoms! Have less effect on (D sub 2) recep and more eff on others. Have more eff on Serotonin 5-HT. | Atypical or 2nd generation drugs |
| 2nd generation Neuroleptics | Atypical Drugs |
| has less effect on (D sub 2) recep and more effect on Serotonin 5-HT recep | Risperdal |
| less EPS (Extrapyrimidal) Symptoms | Risperdal |
| effected by enzyme induction and inhibitors | Risperdal (Risperidone) |
| Prototype of atypical neuroleptics. | Clozaril (Clozapine) |
| May cause agranulocytosis,failure of bone marrow to produce enough wbc's. | Clozaril (Clozapine) |
| Weekly CBC's (Complete Blood Count) are rec in patients taking? | Clozaril (Clozapine) |
| does not supress bone marrow | Zyprexa (Olanzapine) |
| less effect on (D sub 2) recep more eff on serotonin 5-HT less Extrapyrimidal symptoms | Zyprexa(Olanzapine) |
| can cause neuromalignant syndrome and tardive dyskinesia | Zyprexa (Olanzaoine) |
| contraindications: diabetes patients elderly with dementia | Zyprexa |
| partial agonist at 5-HT recep and D sub 2 recep.Antipsychotic drug. | Abilify |
| Relieves both positive and negative symptoms.little or no risk of causing extra pyrimidal symptoms or tardive dyskinesia | Abilify |
| can be taken once a day and has a longer half-life | Abilify |
| diabetic patients or elderly suffering from dementia should not take?? | Abilify |
| useful in alleviating nausea and vomiting. Also allevisted pruritus. Used in anesthetics | certain Phenothiazines |
| Uses: mania depression manic-depressive (bipolar) disorders | Antidepressants |
| inhibitin reuptake of norepinephrine and/or serotonin into neurons,hence increasing concen of these chemicals at postsynaptic juxns in the brain | Mechanism of Antidepressants |
| use cautiosly in patients with bipolar disorder,may cause hypomania. | Contraindications of Antidepressants |
| antideppressant benefit may not be apparent for several weeks.It takes weeks to take effect. | Antidepressants |
| Prototype Cyclic (or tricyclic)antidepressant | Amitriptyline and Tofranil |
| Use: depression chronic pain childhood enuresis OCD panic disorders premenstrual depression | Cyclic antidepressants |
| Mechanism: inhibiting reuptake of norepinephrine and/or serotonin 5-HT Incr concen of these chem at postsynapticjunctions in the brain block alpha andrenergic,histamine and muscuranic recep | cyclic antidepressant mechanisms |
| dry mouth blurred vision tachycardia urinary retention | Cyclic antidepressants side effects |
| arrythmias orthostatic hypotension tachycardia EKG changes and death overdose is life threatening | Cardiovascular side effects of Cyclic antidepressants |
| sedation given at bed time | Central Nervous System side effects of Cyclic antidepressants |
| upset and nausea | GI tract side effects of Cyclic antidepressants |
| prostatic hypertrophy,narrow-angle glaucoma,cardiac arrthymias | Contraindications of cyclic antidepressants |
| Enzyme inhibition (warfarin,clonidine,MAO inhibitors) | Cyclic antidepressants drug interactions |
| sympathomimetics: By blocking reuptake of NE,increase response | Cyclic antidepressants drug interactions |
| Anticholinergic: Additive effect | Cyclic antidepressants of drug interactions |
| Antihypertensives: may block the effect | Cyclic antidepressants of drug interactions |
| MAOI: Concomitant administration of MAO inhibitors and TCA,additive effect | Cyclic antidepressants of drug interactions |
| inhibit reuptake of both NE and Serotonin 5-HT labeled SNRI's but have actions and side effects most similar to SSRI's | Second Generation "Heterocyclic" Antidepressants |
| does not block cholinergic,histaminergic or alpha-1 recep like TCA's | Venlafaxine [Effector XR] |
| stimulant action,does not cause weight gain or sexual dysfunction it may cause seizures | Buproprion [Wellbutrin] |
| Selective Serotonin Reuptake Inhibitor | SSRI |
| SSRI: Prototype.Also called Prozac. selectively inhibit the reuptake of serotonin | Fluoxetine |
| Use: depression bulemia disorder OCD pain | Use of Prozac |
| selectively inhibit reuptake of serotonin 5-HT, long half-life | Prozac mechanism |
| absence of sedation weight gain antichloinergic effects cardiovascular compromise given in the AM | Advantages of Prozac |
| nausea insomnia sedation headache dizziness agitation fatigue diarrhea dry mouth loss of libido (sex drive) | Side effects of Prozac |
| discontinuation syndrome,increased risk of suicide (high in children) | what happens when you discontinue use of Prozac |
| Category D because it can cause fetal anamolies | Teratogenic effects of Prozac |
| inhibits cytochrome P450 2D6 and hence may raise the blood levels of other drugs served by this pathway,including TCAs and benzodiazepines | PROZAC drug interactions |
| Deaths may have been reported when fluoxetine or sertraline were used with MAOIs serotonin syndrome additive effect | Prozac drug interactions |
| atypical or resistant cases of depression | USE of MAOIs |
| inhibit monoamine oxidase,the enzyme that's responsible for the destruction of norepinephrine,serotonin,and toher monoamines | Mechanism of MAOIs |
| GI Tract allows certain amines in foods (tyramine) to be absorbed | Types of MAOIs [MAO-A] |
| predominant enzyme in the brain,increases concentrations of NE,Dopamine and/or Serotonin | Types of MAOIs [MAO-B] |
| dizziness headache overactivity constipation dry mouth | Side effects of MAOIs |
| fatal hyperpyrexia | Teratogenic effects of MAOIs |
| when given with symphathomimeticss and foods rich in tyramine what occurs when you are currently taking MAOIs? | Hypertensive Crisis |
| caused by coadministration (taken with MAOIs) of that increase serotonin levels in the brain. | Serotonin Syndrome |
| depessive episodes may be treated with a modd stabilizer or with a mood stabilizer plus an antidepressant but not an antidepressant alone | Mood stabilizers (Antimanic Drugs) |
| used for mania in manic depressive patients | Lithium [Lithane] |
| very small therapeutic index, absorbed rapidly,it takes 1-2 weeks for therapeutic effect to be seen | Lithium [Lithane] |
| Renal excretion is inversely related to sodium availability,hence decreased sodium (like:diuretics and low salt diets) increases reabsorption of lithium and risk toxicity. | Lithium and Renal excretion |
| Edema fine hand tremor polydipsia ployuria | Lithium side effects |
| these patients may become confused even at therapeutic levels | The ELDERLY |
| may cause renal damage, encephalopathy, and coma | toxic levels of Lithium |
| may cause weight gain, hypothyroidism,and an unpleasant metallic taste | Lithium[Lithane] |
| Diuretics and indomethacin,possibly other NSAIDs increase lithium blood levels and cause toxcitity. | Lithium drug interactions |
| slow in onset,neuroleptics (for example:olanzapine) are often given concurrently to patients with acute mania. | Lithium |
| Used in conjunction with lithium | benzodiazepine |
| Anticonvulsants used to treat bipolar disorder | Carbamazepine and Valporic Acid |
| Faster in onset than Lithium | Carbamazepine and Valporic acid |
| GI upset, pancreatitis and liver failure | Carbamazepine and Valporic acid |
| stmiulates the CNS causing increases promote release of NE and Dopamine and inhibit their uptake into neurons | CNS mechanisms |
| nervousness and insomnia | side effects of CNS stimulants |
| treatment of infant apnea | Methylxanthines |
| D-amphetamine direct and indirect-acting sympathomimetic stimulates the CNS and decreases appetite Major responses are increased wakefulness alertness motor activity | Methylphenidate [Ritalin,Concerta] |
| use to treat ADHD and narcolepsy | Methylphenidate [Ritalin,Concerta] |
| psychic and physical dependence,tolerance,restlessness,insomnia,anorexia, tachycardia,and psychosis,DEA category C-II | side effects of Methylphenidate [Ritalin,Concerta] |
| A patient has received an overdose of the benzodiazepine, midazolam [Versed]. The appropriate antidote is: | Flumazenil[Romazicon] |
| Mike,an 8 year old w/undifferentiated ADHD,is to receive methylphenidate [Ritalin]daily.He must be assessed for adversed effects of methylphenidate which include: | altered growth & development |
| Which of the following possible side effects of neuroleptic medication (Haloperidol[Haldol])may become irreversible? | Tardive Dyskinesia |
| The antipsychotic drugs (phenothiazines,thioxanthines,butyrophenones) may cause Parkinson-like symptoms (extrapyrimidal symptoms) by blockade of dopamine receptors in the? | Basal Ganglia (striatum) |
| Which statement about antidepressants is false? | Controlled studies show the selective serotonin reuptake inhibitors (SSRIs) produce markedly superior resluts over the older tricyclic antidepressants |
| The drug of choice to treat the manic-depressive(bipolar) disorder patient is: | Lithium [LithoBid] |
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boomer_bevo
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