CNS depressants and Stimulants
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| When a drug is partially metabolized before it enter the blood stream | First pass effect
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| The dose range where the drug is giving the desired response and is not causing toxicity | Therapeutic index
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| Most drug metabolism takes place here | Liver
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| Most drug excretion takes place here | Kidneys
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| The amount of time it takes for 50% of a drug to be excreted from the body | Half-life
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| The number of half-life's it takes for a drug to be completely excreted from the body | 5
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| The trimester during pregnancy that is potentially the most harmful to be taking drugs | First trimester
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| The trimester during pregnancy when the fetus is getting the highest doses of the maternal drugs | Third trimester
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| In these patients drug doses may need to be adjusted because their vital organs are still developing and may be more sensitive to certain drugs | Pediatrics
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| In these patients drug doses may need to be adjusted due to organ impairments, polypharmacy effects, and higher risk for adverse effects | Geriatrics
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| These patients have immature liver and kidneys which leads to slow metabolism and excretion, also lower gastric ph and higher body water content | Pediatrics
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| These patients have slowed metabolism and excretion due to organ impairments, and lower-body water content | Geriatrics
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| These patients have a weak blood-brain barrier and are more prone to adverse effects from drugs such as opioids, analgesics, NSAIDs, cholinergic, CNS depressants, sedatives, hypnotics, ect. | Geriatrics
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| How many controlled substance classes are there | 5
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| This controlled substance class includes drugs that are highly addictive and have no medical purpose | C1
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| This controlled substance class includes drugs that are highly addictive and have some recognized medical uses | C2
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| This controlled substance class has drugs that are moderately addictive, but have recognized medical uses | C3
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| This controlled substance class includes drugs that are mildly addictive, and have well-known medical uses | C4
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| This controlled substance class includes drugs that are very mildly addictive and have a wide-variety of medical uses | C5
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| Control class for heroin, mescaline, marijuana | C1
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| control class for oxycodone, morphine, codeine | C2
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| Control class for hydrocodone | C3
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| Control class for benzodiazepines | C4
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| Control class for cough medications | C5
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| The phase of the drug trial where small groups of healthy individuals are tested using various dosing amounts | Phase 1
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| The phase of the drug trial where small groups of ill patients are tested and therapeutic indexes are refines | Phase 2
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| The phase of a drug trial where large groups of ill patients are tested and drug effectiveness and safety are determined | Phase 3
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| The optional phase of the drug trial where large groups of patients are taking the drug and more adverse effects can be reported | Phase 4
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| If a person understands all possible benefits and risks of a drug trial and chooses to participate of their own free choice, they have | Informed consent
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| This cultural group may have symptoms of psychosis managed at lower doses | Hispanic
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| Legend drugs are also known as | Prescription drugs
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| This drug group has no proof of efficiency and no standards for quality control | Herbal supplements
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| This herbal supplement is known to help shrink the prostate to ease urination and has antiplatelet factors to "thin the blood" | Saw Palmetto
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| This herbal supplement can be used to help prevent heart attacks | Garlic
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| This herbal supplement has anti-inflammatory properties, as well as antimicrobial and digestion aids | Goldenseal
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| This herbal supplement is used for memory disorders like AZ as well as for poor blood flow | Ginkgo
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| This herbal supplement is used as an anti-depressant | St. John's Wart
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| This herbal supplement is used as a sleep aid | Valerian
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| Common adverse effects of this drug class include, constipation, nausea and vomiting, and sedation | CNS depressants
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| This drug class will decrease HR, R, and pain | CNS depressants
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| Dramatic decrease in respiratory status r/t CNS depressant use | Respiratory depression
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| A progressive decline over hours-days in mood and respiratory status due to CNS depressants | Subacute overdose
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| Morphine; class, control, considerations | Opioids agonist, c2, itching
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| Codeine, class, control, considerations | Opioids agonist, c2,
Ceiling effect, antitussive
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| Fentanyl, class, control, considerations | Opioids agonist, c2
Very potent, transdermal patch use
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| meperidine, class, control, considerations | Opioids agonist, c2
Toxic in elderly
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| Oxycodone, class, control | Opioids agonist, c2
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| Analgesic class that directly effects pain centers to decrease pain | Opioids agonist
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| Analgesic class that uses competitive reception to block pain, and is usually a C4 drug control | Opioids agonist-antagonists
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| This drug class competes with opioids for CNS receptor sites and works against analgesic drugs | Opioids antagonist
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| Naloxone (Narcan), class, considerations | Opioids antagonist
Reverses opioid overdose and respiratory depression (Narcan)
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| Analgesic class including OTC analgesics and is not viewed as addictive or having side effects like respiratory depression | Non-opioids analgesics
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| Acetaminophen, class, considerations | non-opioid analgesic, toxic over 3 grams
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| Tramadol, class, considerations | Non-opioid analgesic,
Unique workings in CNS, associated with serotonin syndrome when taken with SSRIs
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| Transdermal reservoir system | 4 layers, worn 3-4 days, older system, contains alcohol, more irritating to skin
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| Transdermal matrix system | 2 layers, worn 7 days, new system, does not contain alcohol
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| Drugs that produce pain-killer effects without altering consciousness | Analgesics
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| Drugs that control pain while producing decreased or loss of consciousness and muscle relaxation | Anesthesia
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| Anesthesia that results in complete loss of consciousness, paralysis, and loss of respiratory function | General Anesthesia
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| A post-anesthesia complication including fever, tachycardia, tachypnea, and muscle rigidity | Malignant Hyperthermia
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| Daltrolene, use | treatment of malignant hyperthermia
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| Balanced anesthesia contains | Pain control, sedative/hypnotic effect, and paralysis effect
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| Anesthesia adverse effects | Myocardial depression, respiratory depression, confusion, and toxicity
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| Ketamine | Anesthetic sedative
Used commonly for setting broken bones
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| Propofol | Used for induction and maintenance of general anesthesia, and moderate sedation
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| Moderate sedation | Used more for out-patient surgeries, PT is able to maintain airway and consciousness, but is completely relaxed. Benzodiazepine w/ an opioid is common
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| Anesthesia that results in regional loss of sensation and maintains consciousness and respiratory function | Local Anesthesia
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| Lidocaine, class, considerations | Local anesthetic, may cause itching and allergic reaction
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| Neuromuscular blocking drugs (NMBD) | paralyze the body but leaves the mind alert, used in adjunct with general anesthesis
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| Succinylcholine, class, uses, considerations | depolarizing neuromuscular blocking drug
Used to facilitate endotracheal ventilation,
used over short periods
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| Pancuronium, class, uses, considerations | nondepolarizing NMBD
Used for starting vents and skeletal relaxing
Used over long period surgeries
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| A CNS depressant that reduces irritability and anxiety without causing sleep | Sedative
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| A CNS depressant that causes sleep and relaxation | Hypnotic
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| Three classes of sedative-hypnotics | Barbiturates, benzodiazepines, misc. drugs
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| Sleep hangers occur in which class of drugs | Sedative-hypnotics
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| Rebound insomnia | Insomnia effect after a sedative hypnotic is discontinuated
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| Flumazenil, use | Antidote for benzodiazepine overdose
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| Symptoms for benzodiazepine overdose | Diminished reflexes, solemnness, confusion, and coma
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| Benzodiazepine uses | Sedative, anxiety, depression, sleep, muscle relaxants, seizures
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| clonazepam, diazepam, alprazolam, lorazepam Class of drugs | Benzodiazepine
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| eszopiclone, zolpidem Class of drugs, generic names | Non-benzodiazepine hypnotic
Ambien and Lunesta
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| Barbiturates uses | Insomnia, sedation, seizures
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| Why are barbiturates rarely used | Narrow therapeutic index, unfavorable side effects, psychologically addictive. Benzodiazepines are safer
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| Pentobarbital, Phenobarbital class | Barbiturates
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| Sleep considerations for Barbiturates | Suppresses REM sleep, increased irritability
After discontinuation, increased REM sleep, nightmares
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| Muscle Relaxant uses | Skeletal muscle pain, muscle spasms, MS, Parkinsons
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| Dantrium, class, considerations | Muscle relaxant
Only muscle relaxant that is not centrally acting, works directly on the skeletal muscles
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| Baclofen, class, considerations | Muscle relaxant
Works with an implanted pump
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| Cyclobenzaprine, class, considerations | Muscle relaxant
Commonly used after muscle injury, causes marked sedation
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| Major classes of CNS stimulants | Amphetamines, serotonin agonists, sympathomimetics, xanthines
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| Increased HR, increased R, increased BP, increased mental excitability are effects of which drug group | CNS stimulants
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| Migraines, narcolepsy, ADHD, apnea, and obesity are all conditions that can be treated with | CNS stimulants
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| These drugs increase alertness, decrease appetite, improve performance hindered by fatigue/boredom, and elevate mood | CNS stimulants
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| Methylphenidate (Ritalin), class, uses, control | CNS stimulant, ADHD and narcolepsy
C2
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| Atomoxetine, class, use | CNS stimulant, ADHD
May cause suicidal thoughts in adolescents
Not controlled substance
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| Modafinil (Provigal, class, use, control | CNS stimulant, narcolepsy and shift-work disorder, C4
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| This drug class is used to treat obesity, is a CNS stimulant and suppresses appetite | Anorexiant
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| Adverse effects of anorexiants | headache, agitation, increased BP, increased HR, dizziness, and anxiety
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| Orlistat, class, use, considerations | Weight loss supplement, binds to fat in the GI tract, causes oily stools and fecal incontinence
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| Serotonin receptor agonists (Triptans), uses, considerations | CNS stimulant,
Treatment of migraines
Causes vasoconstriction
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| Sumatriptan, class, use, considerations | Serotonin receptor agonists
Migraines
vasoconstriction
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| analeptics, use, considerations | Treatment of respiratory depression and apnea in neonates, post-op, COPD, drug overdose, ect.
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| Caffeine, class, uses | Analeptics, apnea in neonates, respiratory depression in adults
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| Antiepileptic drugs, class, uses | CNS depressant, treat epileptic disorders
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| Anticonvulsant drugs, class, uses | CNS depressant, treat consultant seizures associated with epileptic disorders
Never stop abruptly
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| Three ways antiepileptic drugs work | increase threshold in brain for stimulation, limit the spread of seizure discharge, and decrease the speed of nerve impulses
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| Dilantin, class, considerations | antiepileptic
Lethargy, cognitive changes, abnormal movements, and confusion
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| Carbamazepine, class, considerations | Antiepileptic, associated with AUTOINDUCTION
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| autoinduction, define, drug association | Stimulates the liver to produce enzymes that metabolize the drug faster and results in lower than expected drug concentrations, (occurs within 2 months of treatment) **Carbamazepine
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| oxcarbazepine, class | antiepileptic
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| Neurontin (gabapentin), class, use | Antiepileptic,
Treat neuropathic pain
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| pregabalin, lamotrigine, topirimate, valproic acid (also used in bipolar disorder) | Antiepileptic drugs
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| Adverse effects of antiepileptics | Cold clammy hands, tremors, sweating, agitation
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| The purpose of anti-Parkinson drugs is to | increase dopamine production, provide synthetic dopamine, treat symptoms of Parkinson's disease
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