Pharmacology 4 Flashcards

Terms Definitions
-floxacin
antibiotic
Thiordazine
neuroleptic
Prozac
duloxetine
Macrobid
mupirocin
vecuronium
FENTANYL
(blank)
inderal
propanolol
diazepam
valium
cyclobenzaprine
flexeril
-navir
protease inhibitor
ECG (EKG)
cardiogram
Thrombolytics
p. 329
Alprazolam
Benzodiazepine sedative−hypnotic

widely used in anxiety states, selectivity for panic attacks and phobias; possible antidepressant actions.

Tox:
psychologic and physical dependence, additive effects with other CNS depressants
Decongestantsphenylephrine
Neosynephrine, Nostril
carvedilol
B blocker
Systemic antifungals
-Amphotericin B-Flucytosine-Ketoconazole-Fluconazole-Voriconazole-fungins
propylhexedrine
alpha nonselective agonist
atropine use 4
antispasmodic
antidiarhea
antisecritory
op poisoning
naproxen
NSAID
proprionic acid derivative
analgesic, antiinflammatory, antipyretic
class: echothiophate
indirect cholinomimetic
Phenytoin
Anticonvulsant

used for tonic−clonic and partial seizures; blocks Na+ channels in neuronal membranes. Serum levels variable due to first−pass metabolism and dose−dependent nonlinear elimination kinetics.

Tox-
sedation, diplopia, gingival hyperplasia, hirsutism, respiratory depression in overdose, teratogenic potential. Drug interactions via effects on plasma protein binding or induction of hepatic metabolism
methotrexate
MTX (immune suppresant)
Community acquired pneumonia DOC
-Levofloxacin
-Moxifloxacin
Sodium stibogluconate
Parasites (Leishmaniasis)MOA: inhibition of glycolysis at the phosphofructokinase reactionAdmin: IM or IV (daily)SE: GI Fever, arthralgias T wave changes, QT prolongOTH: First line therapyTX: Cutaneous & visceralleishmaniasis (f/ sandflies)
innovar
neuroleptanalgesic= droperidol + fentanyl
Our pH is at
7.35-7.45
Recombinant Cytokine- oprelvekin (interleukin2) is used for?
Thrombocytopenia
Type of drug?
Chlorothiazide
Thiazide diuretic
Erythromycin
Macrolide antibiotic

inhibitor of protein synthesis (50S); activity includes gram−positive cocci and bacilli, M pneumoniae, Legionella pneumophila, C trachomatis.

Tox-
cholestatic jaundice, inhibits liver drug−metabolizing enzymes, interactions with astemizole, theophylline, terfenadine, warfarin
Halothane
General anesthetic prototype

inhaled halogenated hydrocarbon. Causes cardiovascular and respiratory depression and relaxes skeletal and smooth muscle. Use has decreased due to sensitization of heart to catecholamines, and occurrence (rare) of hepatitis and malignant hyperthermia
Oral antihistamines- nonsedating (NS)
loratadine
desloratadine
fexofenadine
cetirizine (zrytec)
Iproniazid
non-selective MAO i, Depression
pharmacist
Person licensed to dispense medications.
Leuprolide
Endocrine (GnRH long-acting)MOA: Binds GnRH receptor → ↑Ca2+ → PLC → ↑FSH & ↑LHMET: Long-acting agents (leuprolide, histrelin, nafarelin, goserelin) have D-AA's at cleavage siteSE: Hypogonadism, ↓bone mineralization, ↑lipidsPulsatile: ↑LH & FSH release Continuous: ↓LH & FSH releaseTX: GnRH deficiency Delayed/precoc. Puberty Gn-depen. Disease
examples of benzodiazepines
anxiety: alprazolam (Xanax)
 
seizues: lorazepam
 
anesthesia: lorazepam 
Drug Mechanisms
1. directly/indirectly potentiates actions of  norepi/serotonin in brain
 
2. Biogenic Amine Theory
 
3. Mania d/t overproduction of these NT
Factors are:
- readiness to learn- teaching plan- implementation- evaluation
(Gluco)

NI
Careful admin. with diabetics, hypertensive patients, children, patients with PUD, anyone with a systemic fungal or blood infection should not get this because it decreases the immune system.
Prolongs the action of diazepam
cimetidine
Saquinavir, ritonavir, indinavir, nelfinavir, amprenavir are example of this type of anti-HIV drug.
Protease inhibitor.
examples of 2nd generation sulfonylureas
glyburide
glimepiride
glipizide
Type of drug?
Maprotiline
Heterocyclic antidepressant
NE reuptake inhibitor
Mexiletine
Group IB antiarrhythmic drug

like lidocaine but orally active
didrocal
etidronate/calcium 90 day kit bisphosponate
Pirenzepine
Blocks M1 receptors (muscarinic antagonist) and blocks gastric acid secretion via blockade of ganglionic neuron.Binds M1 receptors more than M2 or M3, but selectivity diminishes at higher doses. (Good for minimizing gastric acid secretions (ulcers))
Ketoconazole
-Administration
-Uses
-SEs
-ORAL
-When amphotericin B is not well tolerated (kidney failure)
 
-Inhibits CYP3A4
-Inhibits adrenal and testicular formation
-Gynecomastia
Terbinafine
Anti-Fungal (sys Rx for mucocutaneous) MOA: inhibits squalene epoxidase which syn ergosterol, accum of squalene is toxic to fungi Admin: oral or topical SE: Rash Headache GI, contraindicated in pregnancy TX: first-line Dermatophyte infections, esp onychomycosis
Which opiates are virtually insoluble in waterand so can't be administered IV or parenterally?
diphenoxylate
Agonists
Drugs that bind to post-synaptic receptors and stimulate the receptor to produce autonomic response
nitroprosside
work on arteriolar and venules decrease in TPR (NO)
alpha 1 stimulation
vasoconstriction: increase b/p, HTN
Bactroban ung, nasal ung
neomycin. polymx/ HC
Substance that increases blood glucose level
Glucagon
Edrophonium =
anticholinesterase - Dx myasthenia gravis, very short acting
Name some sulfonamides
Sulfamethoxazole (SMX), sulfisoxazole, triple sulfa and sulfadiazine
MOA fibrates
increases action of lipoprotein lipase, encouraging the breakdown of VLDL --> LDL
also decreases hepatic synthesis and secretion of VLDL
increases HDL by decreasing TG (results from decreased VLDL) --> decresaed exchange of cholestreryl esters from HDL --> lipoproteins
Type of drug?
Streptozocin
Cancer drug- Alkylating agent
Nitrosurea- used on brain tumors
Lithium
Antimanic prototype

drug of choice in mania and bipolar affective disorders; blocks recycling of the phosphatidyl inositol second messenger system.

Tox-
tremor, diabetes insipidus, goiter, seizures (in overdose), teratogenic potential (Ebstein’s malformations)
G/B famotidine
Pepcid
What is flagyl most effective against?
Anaerobes
Curare
Blocks Nm receptors at neuromuscular junctions.
Labetalol
Potent non-selective beta and alpha-1 blocker used to treat hypertensive crisis.
Bendroflumethiazide
Is a thiazide-type diuretic. It blocks the sodium-calcium pump found in the luminal membrane.
Is a bound drug active or inactive?
inactive
What does this abbreviation mean?
 
OS
OS= Left eye
insulin secretagogues - short acting
 
thiazolidinediones 
(often called glitazones) 
rosiglitazone (Avandia)
pioglitazone (Actos)
 
newest antidiabetic drug 
Pharmacology
the study of drugs and their interactions with living organisms
This route of drug administration is the application of drugs to various mucous membranes and skin.
Topical
Name three M-phase oncogenic drugs?
Vincristine, Vinblastine, Paclitaxel
– Similar to asprin, but shorter half-life
Ketorolac
Pharmacokinetics
How drug is absorbed, distributed and eliminated
Differential diagnosis for Seratonin Syndrome?
Malignant Hyperthermia
Neuroleptic Malignant Syndrome
Withdrawal: EtOH/Sedative Hypnotics
Heatstroke
Thryotoxicosis
Meningitis/encephalitis
ethylene glycol -->
oxalic acid: acidosis and nephrotoxicity (crystals)
Which drug inhibits DNA polymerase and is used to treat AML?
cytarabine
uses for 2nd generation cephalosporins
HEN PEcKS
H. flu
Enterobacter
Neisseria

Proteus
E. coli
Klebsiella
Serratia
which glaucoma drugs decrease the synth of aqueous humor?
beta-blockers
brimonidine
acetazolamide
pharmaceutical prep
the form in which it comes
Which of the following antianziety drugs is not a benzodiazepine?
buspirone (Buspar)
Barbituates
Sedative Hypnotic drug used in past times, only a few used today (all end in barbitol)
Habit forming; low therapeutic index
Css is reached after how many halflives?
4-5
Chlorothiazide
1/10th potency of hydrochoro. and with shorter half life.
prescription
Order given by a doctor for medication dosage, route, and timing of administration.
tranylcypromie is what kind of drug?
MAOI non selective
adverse effects of sulfonamides
crystalluria, resulting in renal damage-older agents have low solubility adequate hydration & alkalinization of urine prevent the problem by reducing the conc of drug & promoting its ionization
hypersensitivity
photosensitivity

Kernicterus: very high levels of bilirubin in CNSsulfa displaces bilirubin from binding sites on serum albumin; bilirubin is free to pass into the CNS
sulfas should be avoided in newborns & infants less than 3 mo old a s well as pregnant women (can cause permanent brain damage)
nifedipine adverse effects and interactions
adverse effects:
flushing, headache, perpheral adema, gingival hyperplasia and reflex tachy
 
ineractions:
beta-adrenergic blockers
What do barbituates, benzodiazepines, arylcyclohexylamines and narcotic analgesics have in common?
they are IV anesthetics
clinical uses of benzodiazepines
pre-anesthetic med (often w/ opioids)tx of seizures (midazolam: neonatal seizures in foals)tx anorexia in catstx fears & phobias
Define pharmacology
The study of drugs and their interactions with the body.
Potentiation effect
2 drugs given together, one drug increases the effect of the other drug.
Define drug
Chemical used to diagnose, treat, or prevent disease.
this kind of sleep is undesirable to an anesthetist because it increases cerebral oxygen demand
REM
physiological effects of dissociatives
analgesia (mostly somatic, less visceral)
sympathetic activation
hypertonicity (use w/ benzos, alpha-2s, or guaifenesin)
inc. ICP, IOP
convulsions (use w/ benzos)
apneustic breathing
retention of near normal pharyngeal & laryngeal reflexes
What is the antidote for salicylates toxicity/overdose
Alkanize urine/dialysis
what effect does amiloride have on the following serum levels:
K
HCO3
Ca
Mg
urate
increased
decreased
increased
none
none
What do retinoids target to control acne?
-comedogenesis
-sebum production
-bacterial control
-inflammation
Muscle spasm is often from?
injury to musculoskeletal system
Benzocaine
very low water sol
can be applied to open wounds
Lignocaine
Aka lidocaine. A local sometimes used with EPI for dental procedures or minor surgeries.
Tramadol
is an opiate analgesic – one of the weaker opiate analgesics, it is used to treat moderate to moderate-severe pain.
What does this abbreviation mean?
 
tid
tid= three times a day
Pharmacokinetics of CAH inhibitors
PO, IM, IV, ophthalmic drops
 
well distributed int he tissue, crosses the placenta &  passes into breast milk
 
excreted in urine (PCT) 
Uses of Anticholinergic Agents (8):
(1) Decreases glandular secretions, (2) “common cold” (to prevent rhinorrhea), (3) “drooling” (in clients with cerebral palsy or other disabilities), (4) To dilate pupils for optical examinations, (5) Treatment of Parkinsonism, (6) To stimulate the heart for bradyarrhythmias, (7) To cause a bronchodilation effect in asthma and COPD, (8) To decrease gastrointestinal and genitourinary tract actions: (Diarrhea, Enuresis - involuntary urination, "Nervous Stomach" and "Spastic Colon", Overactive Bladder (OAB) and urinary incontinence)
The therapeutic uses of these drugs are:Used as surgical adjuvants to anesthesia. For promoting skeletal muscle relaxation For facilitating endotracheal intubation
Tubocurarine and succinylcholine
Difference between Cyclosporine and Tacrolimus in their mechanism?
1. Cyclosporine inhibits the synthesis of IL-2 2. Tacrolimus inhibits the release of IL-2.
Enteral route
Uses the GI tract for ingestion and absorption of drugs.
Is there any such thing as a safe drug?
no
What does the abbreviation stand for: q4h, q4*
every 4 hours
name three antimuscarinics that act on eye
atropine, homatropine, tropicamide
A Ligand with a higher affinity for Ri
Ra<<<<<<Ri
Inverse Agonist
(Antagonist)
Indication of Lioresal
alleviation of signs and symptoms of spasticity, may be used in spinal cord injuries or spinal cord diseases
What is the usual method of prophylaxis for adults?
2 g amox
Metabolism of amide anesthetics
Hydrolyzed by liver microsomal enzymes (P450), so toxicity is bad with patients with liver disease. Metab. is slow so redistribution dictates duration of action.
what is a Trough?
where the graph of half-lives dips slightly before it plateaus
Pathophysiology of Hyperlipidemia
two main lipids found in the blood (lipoproteins)
cholesterol & triglycerides
 
both are lipids that come from exogenous sources (diet) and endogenous sources (hepatic synthesis)
b/c they are lipids, they are not soluble in blood & require protein carries for transport to other sites
these protein carriers are LIPOPROTEINS (carry lipids from the GI system -> liver -> tissues) 
Side Effects of Cholinergic Agents (2):
Abdominal cramping and diarrhea (contraindicated in ulcers), & secretions (perspiration, saliva, etc.)
Which nerves are associated with the parasympathetic system?
Cranial and Sacral nerves
What are some components of Tylenol?
Most common; Analgesic and antipyretic properties; no anti-inflammatory properties; can cause serious liver or kidney damage if abused
Therapeutic uses of cholinergic agonists
--stimulate the intestines and bladder (post-op)
--decrease IOP (intraocular pressure)
--to promote salivation and sweating
--to terminate neuromuscular blockade (increase neuro trans)
--to treat Myastenia Gravis (a neuromuscular disease caused by lack of Ach)
List the chain of infection
1. Pathogens in sufficient quantity
2. Reservoir
3. Port of exit where the pathogen leaves the host
4. Mode of transportation
5. Port of entry where pathogen enters another host
6. A susceptible host
What are its side-effects
GI distress, skin rash, seizures at high conc.
3rd generation cephalosporins
"If you are THIRsty, try a FOTO TAZER"

Cefotaxime
Ceftazidime
ceftriaxone
Which of the drugs listed below is a monoclonal antibody that binds to tumor necrosis factor (TNF) and is indicated for the treatment of Crohn's disease?
infliximab (Remicade)
2 Eicosanoids for vasoconstriction
PGE2 and PGF2-alpha (mediated by Ca2+ or IP3/DAG). PGF2-alpha doesnt cause much change in BP though.
Triple response to intradermal injection of histamine
Wheal, flare and itch. (mostly H1...some H2)
Explain the pharmacodynamics of two drug-herb interactions?
A) Ginkgo biloba inhibits platelet aggregation, it has the same effect as NSAIDsB) SSRIs and St. John's wort together cause mild seratonergic syndrome (a neurological condition that results in fever, seizures & heart rhythm disturbances)
Potassium Supplements are notoriously...?
irritating to the GI tract and also have a “bad” taste
what is the mechanism of benzodiazepines
increase frequency of Cl channel opening --> facilitate GABA-A action (Frenzodiazepines increase frequency)
Comprehensive Drug Abuse Prevention and Control Act
*established DEA as part of Justice Dept*Drugs with potential for abuse needed control*5 drug schedules established*Security measures for those handling controlled substances*Set limitations on use of controlled substances*prescribers must register and obtain a DEA number*enforment by DEA
What are the four potential mechanisms that lead to seratonin syndrome?
No breakdown: MAOIs
Increased Release: MDMA
Percursor/Agonist: Li, LSD, Tryptophan, Buspirone
Block Reuptake: SRIs, TCAs, Opiates, Cocaine
what are the side effects of ethosuximide
GI distress, lethargy, headache, urticaria, Stevens-Johnson syndrome
What is the most inportant action of alpha-adrenergic receptors?
vasoconstriction, raising blood pressure
5 clinical indicatinos for furosemide
Acute pulmonary edema, edecma with CHF chronic renal failure and cirrhosis, acute hyper calcemia, hyperkalemia, and acute renal failure.
What are the two desired effects of acetaminophen?
Analgesic (painkiller) & Antipyretic (reduce fever)
what are the side effects of beta blocker treatment in glauzoma
no pupillary or vision changes
Misc approaches to treating Alzheimers: NSAID
NSAIDS are not of value in persons who already have Alzheimer’s disease. NSAIDSare probably protective against AD but, considering the danger of GI hemorrhage associated withmost NSAIDS, they can’t be recommended as standard preventative therapy at the presenttime.
What does reserpine do at the noradrenergic presynaptic nerve terminal?
blocks transport of dopamine into vesicle to be made into NE (for HTN, causes sedation/depression/nasal stuffiness/diarrhea)
What are the short acting Insulin agent?
Lispro, Aspart, and Regular Insulin. Short acting preparations are typically injected before meals to mimic physiologic bolus of insulin.
What is the clinical use of class 1A antiarrhythmics?
Atrial and ventricular arrhythmias
3 things that can cause high output cardiac failure
Hyperthyroidism, severe anemia, or arterio-venous shunts.
What kinds of activity might one avoid while taking Warfin?
contact sports, anything that might cause bleeding injuries such as shaving w/ a straight razor.
What is phase 1 of acetamenophen toxicity?
Phase 1: 0.5-24hours - Anorexia, N/V, frequent (early), malaise. Transaminases may be elevated but essentially a normal or asymptomatic appearance.
What happens during an oxidative metabolic reaction?
The drug loses an electron and gains an oxygen atom.
What are the two parameters that the intensity of withdrawal sx depend on?
the higher the dosage the more severethe longer the T1/2 the less severe
What is the Tx for strychnine toxicity?
Restore inhibition - pt. in dark room, minimal stimuli, benzos, barbiturates, paralysis and intubation. Use a non-depolarizing agent to intubate.
Why can't non-BDZs be use to produce surgical anesthesia?
there is too small a gap between anesthetic doses and those that cause cardiovascular collapse
What should you know about making PRN decisions?
know the reason for the drug and be able to assess the patients medication needs
-caine
anesthetics
Chlorprothixene
neuroleptic
Pamelor
fluoxetine
EscitalopramFluoxetineParoxetineSertraline
Bupropion
TRAZODONE
(blank)
xatrol
afluzosin
gabapentin
neurontin
tiotropium
spiriva
-lol
beta blocker
ginsing
immune stimulant
Cardiac Glycosides
p.320
Thorazine
Chlorpromazine HCL
Parasympatholyticsipratropium bromide
Atrovent
Phenobarbitone
barbituiate, anti-convulsant
Anticholinergics
Oppose parasympathetic responses
 
Nonphenothiazine Prototype
Haloperidol (Haldol)
ACARBOSE?
ORAL hypoglycemic drug
Long acting BZD
lorazepam
MOA benzos
increases GABA
Colchicine
Microtubule assembly inhibitor

reduces mobility and phagocytosis by WBCs in gout− inflamed joints; useful in acute, not chronic gout.

Tox-
GI, hepatic, renal damage
Is Echinaceae effective?
No!
ditropan(xl), oxytral patch
oxybutinin
Co-trimoxazole
-Sulfonamide
-Active against both methicillin susceptible and methicillin resistant strains
 
Acetaminophen
Class: Nonopioid analgesic, antipyreticAction: Relieves pain and reduces feverSide Effects: Leukopenia, neutropenia, pancytopenia, thrmbocytopenia, liver damage, hypoglycemia.Contraindications: AllergicNursing considerations: Do not use for more than 10 for pain (5 for children) and 3 for fever unless prescribed, monitor, toxicity to liver,
Sevoflurane
Nervous SystemInhalantFaster than Isoflurane, unconsciousness
An osmotic diuretic drug
Mannital
Damages the nervous system
Lead
COX 2 Inhibitors
pg 314
Type of drug?
Finasteride
Anti-androgen
5alpha-reductase inhibitor →↓conversion of testosterone to DHT
Tx of BPH
Guanethidine
Postganglionic sympathetic neuron blocker

enters nerve ending by means of uptake−1 and is stored in the ending (effect reversed by TCAs, cocaine).

Tox-
severe orthostatic hypotension, sexual dysfunction
Risperidone
olanzapine
sertindole
Newer atypical antipsychotics

Higher potency, more blocking of 5−HT2 receptors than older antipsychotic agents. Low extrapyramidal toxicity.
valproic acid
depakene (capsule, liquid)
clozapine
dibenzazepine derivatives, atypical neuroleptic
Adrenergic Receptors
Alpha1 (α1)- Vasoconstriction
Alpha2 (α2) - Presynapsic terminal inhibition
Beta1 (β1) - Increased HR, contractility, conductivity and automaticity
Beta2 (β2) - Bronchodilation + arteriole dilation
Beta3 (β3) -Lypolysis of adipose tissues
Dopaminergic - vasodilation in the kidneys
Ketoconazole
Endocrine (steroid syn inhibitor)MOA: inhibits several of the cytochrome P-450 enzymes involved in steroid synthesisTX: Cushing's syndrome
contraindications of prostoglandins (misoprostol)
hypersensitivity
renal dysfunction
contraindicated in pregnancy b/c partial or complete abortion & uterine bleeding may result
contraindicated in lactation & kids
antacids may reduce the action of misoprostol
Parkinsons Disease meds
Dopamine agonistsCOMT inhibitors
Equipment needed for venipuncture
- gloves- alcohol/betadine- rubber tourniquet- sterile 2x2 gaze- band-aid or adhesive tape- appropriate blood collection tubes- sharps container
Drug barriers
1. Blood/brain barrier
2. Placenta
Drug reaction causing Acute Cholestatic Hepatitis???
macrolides!!!
Bacitracin, vancomycin and cycloserine block the synthesis of this molecule, preventing cell wall synthesis
peptidoglycans
Type of drug?
Nitroprusside
Vasodilator
Metabolized into CN
MIC
lowest concentration that inhibits growth
Penicillin G
Penicillin prototype

active against common streptococci, gram−positive bacilli, gram− negative cocci, spirochetes, and enterococci (if used with an aminoglycoside); penicillinase−susceptible.

Tox-
penicillin allergy
Heparin
activates anti-thomrombin III inhibits thormbin formation IV/subcu
Zileuton
Inhibitor of 5-lipoxygenase marketed for the treatment of asthma. (has been withdrawn)
Cyclophosphamide
-Mech
-Uses
-SEs
-T and B cell suppression
-Alkylates DNA
-Can inhibit established immune response
-non-Hodgkins and lymphomas
 
-Hemorrhagic cystitis (MESNA= resolve)
-Bone marrow suppression
-TERATOGENIC
Gonadorelin HCL
Endocrine (GnRH)MOA: Binds GnRH receptor → ↑Ca2+ → PLC → ↑FSH & ↑LHMET: Long-acting agents (leuprolide, histrelin, nafarelin, goserelin) have D-AA's at cleavage siteSE: Hypogonadism, ↓bone mineralization, ↑lipidsPulsatile: ↑LH & FSH release Continuous: ↓LH & FSH releaseTX: GnRH deficiency Delayed/precoc. Puberty Gn-depen. Disease
Most powerful Calcium Channel Blocker?
Nifedipine (procardia)
Diethylstilbestrol (DES)
Renal AND EndocrineGonadotropin - EstrogenInduces abortion/controls incontinence in dogs, SE: Anemia
name class 1b drug antiarrhythemia given orally ?
mexiletine
tocainide
Antihypertensives
Decrease preload and afterload. May decrease heart rate and decrease contractility.
– Intravenous, little post-op nausea and vomiting 
	- Rapid on and off, can be used as a continuous drip
	- Lipid emulsion (mixed with lipids) – increase in lipids
	- Lowers blood pressure in high doses, patient needs to b
Non-depolarizing blockers
Beta adrenergic anatagonists are referred to as
Beta Blockers
Drug reaction causing Gray Baby syndrome?
chloramphenicol
uses?
glaucoma, urinary alk, met alk, altitude sickeness
MOA INH
decreased synth of mycolic acid
Type of drug?
Ipratropium
Muscarinic antagonist- asthma drug
Amiodarone
Group IA and III antiarrhythmic

broad spectrum, blocks sodium, potassium, calcium channels, beta receptors. High efficacy and very long half−life (weeks−months).

Tox:
deposits in tissues; hypo− or hyperthyroidism; pulmonary fibrosis
Digoxin action
inotropic: strengthen cardiac muscle; slow contractility of heart; increase action or parasympathtic effects (slow heart rate)
What are the contraindications for Etodolac?
fd
Aspirin
An irreversible COX-1 and COX-2 inhibitor.
One M-phase specific anticancer drug
Vinca alkaloids
Flurazepam
is a benzodiazepine, used to treat insomnia. It enhances the effect of GABA on neurons, leading to hyperpolarisation and thus stabilisation of neurons.
Where does most drug metabolism take place in the body?
liver
What BDZ is useful for absence seizures?
clonazepam
pharmacological treatment of depression:
 
mood stabilizing drugs/animanic agents 
lithium carbonate (Eskalith, Lithane)
lithium cytrate syrup (Cibalith-S)
 
mania: elevated mood w/ grandiose ideas, expansiveness, pressred speech, flight of ideas, decreased sleep, increased activity
lithium = drug of choice for long-term tx of bipolar disorder (manic-depression); the drug of choice for tx of the manic phase, anthough both episodes respond
also used as an adjunct w/ antidepressants to treat major depression and with antipsychotics to tx schizophrenia
specific mechanism of action is unknown
give PO & ion is excreted by the kidney
 pts w/ impaired kidney functions can develop toxic levels of lithium salts
there is a direct relationship between Na intake & lithium excretion; low Na intake slows lithium excretion & leads to toxicity; excessive Na intake lowers lithium levels
lithium salts: very toxic; TI = very low; therapeutic levels are 1-1.5 in the acute manic pahse; for maintenance, the levels should be 0.6-1.2; 2.0 = max serum level
PO preps are rapidly absorbed, peak serum levels are reached in 1-2hrs; clinical response is noted in 1 week or longer; complete response usually takes 3 weeks; the lithium therapy is continued for yers in bipolar disorder

until therapeutic levels are achieved,symptoms of mania may be controlled by antipsychotics: chlorpromazine
Lithium causes no noticeable effect on normal individuals, it is not sedative, a euphoriant, or depressant
The rate of absorption is __________ to the drug concentration gradient across the barrier and the surface area available for absorption.
proportional
This route of drug administration is lipid soluble and is the application of drugs directly to the surface of the skin for absorption through the dermal layers.
Transdermal
Drug-Drug Interactions
reaction that may potentiate or antagonize drug action
Na channel blocker, used for partial and generalized seizures (not absence)
- SEs: Diplopia < 1 hr after dosing, ataxia at higher levels, decreased WBCs, water retention, Oxcarbazepine has less hypersensitivity reactions
Ethosuxmide
Delivering drugs to the mucousa, has expanding role in delivering systemically acting drugs
Nasal
What are the big five CYP 450's
1A2
2D6
2E1
3A4
2C19
Albuterol =
b2 > b1 agonist - asthma
Clinical uses of Suramin.
African trypanosomiasis (sleeping sickness).
toxicity of imipenem, meropenem
gi distress
rash
seizures
(all occcur at high plasma levels)
what drug is used to close PDA
indomethacin
Captopril
ACE inhibitor prototype

used in HTN, diabetic renal disease, and CHF.

Tox:
hyperkalemia, fetal renal damage, cough ("sore throat")
Which local anesthetic drug does not relax vascular smooth muscle?
cocaine
Cranberries
Used as an antiseptic, bladder and kidney health
Sotalol
The only beta blocker that delays ventricular repolarization and is effective for maintenance of sinus rhythm in cases of chronic atrial fibrillation.
Tolcapone and toxicity
COMT inhibitor and fatal hepatotoxicity.
Neuromuscular Blocking Agents
produces state of paralysis without affecting consciousness.
 
___ oz= 30 mL
1 oz. = 30 mL
direct toxicity
high serum levels of certain abx and/or prolonged use may cause toxicity by affecting cellular processes in the host directly
e.g. aminoglycosides can cause ototoxicity by interfering w/ membrane function in the hair cells of the organ of Corti
Stroke volume is influenced by:
Myocardial contractility
 
Cardiac afterload
 
Cardiac preload
how does flumazenil work
competitive antagonist at GABA receptor
Errors
Piercing thru to the other side of veinForget to release tourniquetSample diluted because of IV fluids
Uses of B12
metabolism of carbohydrates, fats, & protein
(Gluco S/E)

Growth retardation
Related to catabolism. Seen primarily in children. Monitor height and weight.
Define potentiation
One drug enhances the effect of another.
Affect of BZD when 20% of receptors are occupied
anxiolysis
Various stimuli activate a blood proactivator to a blood activator that promotes conversion of _________ to blank thereby increasing fibrinolysis
plasminogen to plasmin
Highly active antiretroviral therapy (HAART) generally entails combination therapy with ---------- and -----------.
Protease inhibitors, reverse transcriptase inhibitors.
what effect does thiazide have on the following serum levels:
K
HCO3
Ca
Mg
urate
decrease
increase
increased
decreased
increased
Describe mercury's life cycle:
anthopogenic + natural mercury (volcanoes)
Hg in water sediment acted on by bacteria to form methyl mercury
Bioaccumulates in the food chain
alpha-glucosidase inhibitor administration
TID with first bite of meal
what types of drugs enhance cholinergic transmission?
nicotinic agonist
muscarinic agonist
cholinesterase inhibitor
5 Irreversible ChE inhibitors
Organophosphates, and include drugs such as echothiophate and diisopropyl fluorophosphate (DFP), some insecticides (eg., malathion, parathion), and nerve gases (soman). These agents serve as hemi-substrates for ChE, but the resulting phosphorylated enzym
Gold compounds
are a DMARD and are injected directly into the affected joint.
1 in. = ____ cm.
1 in = 2.54 cm.
pharmacokinetics of loop diuretics
admin. PO, IM, IV
 
duration of action 1-4 hrs (IV = 2 hrs) 
The mainstay of hypertension therapy is:
lifestyle interventions initiated prior to or in conjunction with pharmacologic therapy: smoking cessation, weight reduction, dietary sodium restriction to
This is when a receptor can only be activated with drugs with similar chemical structure.
Selectivity
Food, Drug and Cosmetic Act
(1938)*provided safety testing for all durgs, with the FDA responsible for enforcement
What does the Pneumococcal polysaccharide vaccine (PPV) protect against?
23 types of pneumococcal bacteria
4 disadvantages to using oral route
Variability of absorption, inactivation, complience of patient, local irritation of GI tract
What does the abbreviation stand for: kg
kilogram, 2.2 lb
1st line of Treatment for Lead Poisoning include
Dimercaprol and EDTA
what is the mechanism of alpha-methyldopa
centrally acting alpha-adrenergic agonist, decreases central adrenergic outflow
A single polypeptide that spans the membrane 1 time. Intracellular domain has phosphorylate proteins
Receptor Tyrosine Kinase
Action of Prostaglandins
inhibit the secretion of gastrin and increase the secretions of the mucous lining of the stomach, providing a buffer
propranolol
B clocker can cross BBB + class II anti-arrythmic
Protein in blood that carries B12
Plasma glycoprotein transcobalamin II
Mefloquine
MalariaMOA: Schizonticide Used as prophylaxisMET: Long half-life (~20 days)SE: GI Neuropsychiatric Cardiac & blood dyscrasiasOTH: Does not eliminate liver forms (P. vivax & P. ovale) No P. falciparum gametocyte killTX: PF malaria (chloroquine resistant)
side effects of decongestants:
excitation of the central NS (leading to insomia, restlessness, agitation), tachycardia, urinary retention & increase in BP; rebound congestion
 
 
should be avoided in HTN, DM, hyperthyroidism, CAD, or urinary obstructive disease 
what are the two main pharmacological classes of asthma drugs?
anti-inflammatory drugs and bronchodilators
Echothiophate: Class of drug, use.
Muscarinic, Indirect Stimulants - to treat glaucoma
1. Folic analog used to treat leukemias, lymphomas, choricarcinoma, also a abortifacient? 2. Name other conditions this drug is in their treatment? 3. Side effects?
1. Methotrexate 2.Sacromas, rheumatoid arthritis, psoriasis 3. It may lead to myelosuppression
2 types of influenza vaccine
1. An inactivated (killed) vaccine, given as a shot.

2. A live, weakened vaccine was licensed in 2003. It's sprayed into the nostrils.
What does the abbreviation stand for: U
unit, a dosage measure
how do beta blockers treat hypertension
decrease cardiac output, decrease renin secretion
MOA latanoprost in tx of glaucoma
PGF-alpha, increases outflow of aqueous humor
If abdominal pain is caused by the release of an allergy or inflammation mediator, what mast cell stabilizer may be prescribed?
cromolyn sodium (Gastrocrom)
PGEs do what to ADH?
Inhibit fluid resorption done by it.
3 drugs contraindicated with WPW
B-blockers, Ca channel blockers, and digoxin.
what kind of drug is methadone?
opiate agonist that has identical pharmacology as morphine
Mechanism of action of Spironolactone [Aldactone]
Blocks aldosterone in the distal nephron 
 
 Retention of potassium Increased excretion of sodium
This type of drug impairs the release of calcium from the sarcoplasmic reticulum
Dantrolene Sodium (Dantrim, prototype)
Drug microsomal metabolizing system (DMMS)
group of enzymes located primarily in th eliver that function to metabolize (biotransform) drugs
Salicylates cross the blood brain barrier slowly unless?
there is a condition of acidosis
What are the 3 indications for misoprosol?
prevention of NSAID-induced peptic ulcers, maintains a PDA and used to induce labor
What conditions are vasopressin contraindicated in?
CHF, asthma, epilepsy; Used in central DI; NOT nephrogenic!!!!
Anticholinergic drugs block ______ in _____
block action of ACh in CNS
What is benzocaine used for?
Topic local for wounds, ulcers, and burns (is hydrophobic)
How would you treat hypoxia in an overdose morphinated patient?
ventilation only (administering oxygen will decrease respiratory drive)
What is the clinical uses of TCAs?
Endogenous depresion. Bed wetting - imipramine. OCD- clomipramine.
What is the permeability of steroid and thyroid hormones? Why? Where do they interact with receptors?
*Steroid and thyroid hormones can easily pass through plasma membrans because they are HYDROPHOBIC.

*They interact with receptors inside the cell.
Vesamicol is an anticholinergic that inhibits transport of:
Acetyl-CoA + choline into a packaging vesicle
What are the indications to use oxytocin?
Controls hemorrhage after labor, used in incomplete abortion, and milk let-down.
What type of effects do beta blockers cause on the heart?
Negative chronotropic, inotropic, and dronotropic
What receptor does histamine act on to cause edema?
H1 receptor in microcirculation vessels (hives). You get leakage through vessels.
3.) IND (investigational new drug)
FDA must approve an application for an investigational new drug before the drug can be distributed for the purpose of conducting studies in human subjects. The IND application includes a complete description of the drug, the results of all experimental studies completed to date, and a description of the design and methods of the proposed clinical studies and the qualifications of the investigators.
What does the abbreviation stand for: tid
ter in die, three times a day
risperidone (Risperdal) therapeutic dose, route, and onset
1-6 mg/day; PO onset 1-2 wks; IM 3 wks - last 2 wks
How does this drug tx opiate abuse: methadone; acetyl-methadol
breaks habit of injecting drugs, no withdrawal fear, no buying of illegal drugs, long T1/2 (so less serious withdrawal)
How to pee out drugs like phenobarbital, MTX, aspirin:
these are weak acids - want to alkalinize urine with bicarb to increase their clearance
How does this drug tx opiate abuse: naltrexone
long last antagonist which can be good during early detoxification phase
What steps do you use when preparing medication for injection by z-track?
Use 2 20 gauge needles  (at least 2 inches)
draw up medication with 0.2- 0.5 mL of air
remove first neelde and replace with unused second needle  (prevents irritation to sc tissue as needle is inserted.
choose a large muscle mass - gluteal
displace the skin laterally by pulling it 1 in. away from injection site.
Inject deeply at a 90 degree angle
ASPIRATE
Inject slowly
wait 10 seconds before withdrawing needle
Withdraw (slowly???)
Release displaced skin and sc tissue
do not massage
encourage ROM or walk to facilitate absorption
Alternate sites
 
zolipidem
Ambien
HEROIN
(blank)
propanolol
inderal
timolol
timoptic
spiriva
tiotropium
CXR
chest x-ray
echinacea
common cold
Cyclophosphamide
Antineoplastic, immunosuppressive

cell cycle−nonspecific alkylating agent.

Tox-
alopecia, gastrointestinal distress, hemorrhagic cystitis, myelosuppression
Sympathomimeticsepinephrine
Volmax
Primatene, Adrenalin
beclomethasone
steroid, asthma
Mycoplasma pneumoniae DOC
-Tetracycline
-Erythromycin
naphazoline
alpha1 selective agonist
somatropine
human recombanant GH
salicylic acid
aka aspirin
uses for pyridostigmine
MG
Clindamycin
Lincosamide antibiotic

bacteriostatic inhibitor of protein synthesis (50S); active against gram−positive cocci, B fragilis.

Tox:
GI distress, pseudomembranous colitis
Streptokinase
Thrombolytic

protein from streptococci that accelerates plasminogen−to−plasmin conversion.

Tox-
bleeding, allergy
methylprednisolone
Solu-Meduol, Depo-Meduol (steroid)
Flucytosine
-Mechanism
-Uses
-SEs
-Fungal DNA antagonist: 5-fluorouracil--> anticancer
-Combined with Amphotericin B for cryptococcus infections
-Bone marrow depression, GI distrubances, alopecia
Pyrantel Pamoate
Parasite (Nematode)MOA: Tetrahydropyrimidine derivative NMJ blocking agent → paralyzes & expels Admin: oral Poorly absorbed from GI (good!) SE: GI InsomniaOTH: ACh release & AChE inhibition Cure rates >90%TX: Ascariasis (roundworm) Pinworm (Enterobius vermicularis) Hookworm (Necator americanus)
Zolazepam
Nervous SystemTranquilizer - Benzodiazepine"Telazole w/ Tiletamine"IM, anesthetic, combined drug, SE: pu/pd, ataxia, lethargy
theophylline
methylxanthine (weak analpetic)used in tx of asthma, adjunct to digoxin to tx CHF (dilates coronary aa.)
Oral (PO), orogastric/nasogastric (OG?NG), sublingual (SL), buccal, and rectal (PR) are ______________ routes of medication administration.
enteral
when are barbiturates contra-indicated
porphyria
Type of drug?
Minoxidil
Vasodilator
Inhibits phosphodieseterase
Levodopa
Dopamine precursor

used in parkinsonism, usually combined with carbidopa (a peripheral inhibitor of dopamine metabolism).

Tox-
dyskinesias, hypotension, on−off phenomena, behavioral changes
ophthalmic alternatives - NSAIDS
KetorolAC
DiclofenAC
BromfenAC
NepafenAC
SuproFEN
FlurbiproFEN
Phen-fen
anti-obesity withdrawn bad s/e
Morphine
Opioid receptor agonist, strong painkiller
NPH Insulin
EndocrineMOA: Insulin(-) complexed w/protamine(+) & zincMET: Intermediate-actingSE: Hypoglycemia (Counter-reg. often impaired) Mild: juice/glucose Severe: glucagon ~ Allergy (insulin or protamine) ~ Insulin resistance (IgG) ~ LipohypertrophyOTH: Insulin requirements ↑ during 2nd half of pregnancy ~ If impaired renal fx: ↓insulin clearanceTX: Type 1 diabetes
epilepsy
chronic brain disorder characterized by recurrent seizures, ranging from brief unconsciousness to violent, life threatening convulsions

seizure: an abnormal discharge of electrical impulses within the brain, resulting in changes in awareness, sensory alterations & involuntary muscle movements; in most pts, intelligence is not affected

3 or more seizures = epilepsyepilepsy affects about 2.3 million Americans (1% population), with circa 181,000 new cases/year
Angiotensin Converting Enzyme Inhibitor prototype
Catopril (Capoten)
What are special barriers?
Placenta, brain
(Gluco)

Uses
Patient with inflammatory disease: rheum. arthritis, lung disease, COPD, inflamm. bowel, bursitis, tendinitis.
Induction drug that displaces coumadin
Brevital
name 4 barbiturates
phenobarbital, pentobarbital, thiopental, secobarbital
toxicity associated with 2nd generation sulfonylureas
hypoglycemia
Type of drug?
Venlafaxine
Heterocyclic antidepressant
Inhibits serotonin, NE & dopamine reuptake
Also for generalized anxiety
Misoprostol
NSAIDs for arthritis.

Tox-
diarrhea
bismuth salicylate
Pepto-bismol (anti-diahreal) turns tongue and stool black
Pralidoxime
A nucleophilic drug pralidoxime (2-PAM) is used to reverse (reverse AchEI effects) nicotinic effects associated with organophosphate exposure. (Similar to atropine effects)
Fluconazole
-Administration
-Uses
-Adverse effects
 
-ORAL or IV
-CNS penetration--> used for fungal meningitis
-LESS toxic than amphotericin B and flucytosine
-Better tolerated than ketoconazole--> NO CYP3A inhibition
   >No testicular or adrenal problems
Desmopressin
Endocrine (ADH) MOA: Binds V1a receptors → GI/vasoCX Binds V1b receptors → ↑ACTH Binds V2 receptors → ↑aquaporins; V2 >> V1 ADMIN: Nasal spray, subQ SE: VasoCX ↑GI muscle, ↑uterine muscle Desmopressin challenge: urine Osm should ↑50% w/central DI SIADH: Rx w/loop/demeclocycline Central diabetes insipidus TX: Dx central/nephro DI Post-op ileus...eso varices
Uses for D amphetamine and methylphenidate
HypersomniaADHD
Antagonist
Drugs that bind to post-synaptic receptors to prevent the neurotransmitter from binding to its receptor to inihibit the autonomic response
prazosine(azosin)
DOC in Rx HPT with BPH
Define metabolism.
The process of chemically inactivating a drug by converting it into a more water-soluble compound or metabolite that can then be excreted from the body
K-Dur 10 mEq controlled-release tabs
Klor-Con 8
What medication is considered a serotonin antagonist for vominting
Zofran
antidote for antimuscarinic/anticholinergic agents (too little ACh) =
physostigmine (anticholinesterase, for atropine overdose & glaucoma)
What are its uses?
Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas and SMX for simple UTIs
Effects B-blockers have on:
EDV
BP
Contractility
HR
Ejection time
MV O2
up
down
down
down
up
down
Type of drug?
Busulfan
Cancer drug- alkylating agent
Dexfenfluramine
5−HT reuptake inhibitor and receptor agonist previously used as anorexic.

Tox-
produced cardiac valve damage when used in combination with phentermine
G/B nizatidine
Axid
Which penicillin is given PO?
Penicillin V
Treprostinil
eCan be administered using a continuous sub-Q delivery (the endothelium antagonist, Bosentan, is also used for PAH). S ynthetic analogue of prostacyclin, used to treat pulmonary hypertension.
Carcinoid
A yellow circumscribed tumor occurring in the small intestine, appendix, stomach, colon and in the bronchial tree.
Infliximab
is a monoclonal antibody drug which binds to TNF-alpha and downregulates inflammatory processes. Used to treat rheumatoid arthritis, Crohn’s, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis.
Is a prodrug active, inactive, highly active, or subclinically active?
inactive
1/6 grain = ___mg
1/6 grain= 10 mg
 
thyroid gland
facilitates normal growth & maturation by maintaining the level of metabolism in the tissues that is optinal for their normal function
composed of multiple follicles, each of which has a lumen filled w/ thyroglobulin (colloid), the storage form of the thyroid hormone.  The follicles are surrounded by parafollicular cells that produce calcitonin
thyroid hormone has important effects on virtually every tissue of the body; these effects result from the interaction of thyroid hormone w/ its receptor
thyroid hormone takes its part in the regulation of metabolic rate, gasterintenstinal motility, cardiac contractility, HR, body temp, mood, body weight & skin texture
Bupropion
a heterocyclic, blocks DA uptake for anti-depression
These drugs are AKA muscarinic receptor antagonists. They include atropine, scopolamine, methscopolamine and propantheline.
Anticholinergic Drugs
This drug is a G2-phase specific inhibitor of Topisiomerase II, leaving double strand breaks in DNA following DNA replication?
Etoposide
Characteristic of Amides
Rapid onset, medium duration, topical
Drug that binds to receptors and initiates part of response and blocks others
Agonist-antagonist
SRI treatment
ABC's
D = Decontamination - Activated Charcoal
Agitation - Benzodiazepine
Rhabdomyolysis - IVF
Hyperthermia
antidote for lead =
dimercaprol, EDTA, succimer, penicillamine
questions from diagram at bottom of page
uses for penicillin
gram + cocci and rods
GNR
spirochetes
which drugs --> atropine like side effects
tricyclics
liver
lower rate of oxidative reactions in neonates and elderly disease will decrease rate of metabolism
What is a potential problem associated with low-fiber diets?
constipation
Pregnancy Categories
A- OK
B- Use with caution
C- Outweigh risk vs. benefits
D or X- Never, will harm fetus
Mannitol
Is freely filtered and not reabsorbed and acts as a diuretic. Max effect in loop of Henle. Given IV.
over-the-counter, (OTC)
Available for sale without a doctor's prescription.
phenelzine is what kind of drug?
MAOI non selective
general clinical use of first generation cephalosporins
uncomplicated, community-acquired infections of the skin & soft tissue & urinary tract (E.coli)
 
useful for respiratory infections caused by PCN-sensitive streptococcus pneumoniae
 
parenteral 1st generation agents (Ancef) are used  for surgical would prophylaxis
 
cefazolin (Ancef) remains the more popular parenteral "1st generation" agent due to its superior blood & tissue conc., low cost, low toxicity 
Asprin
Dosage:160 to 325 mg PO ChewableDef : Inhibits agents that cause the production of inflammations,pain fever relieves mild to moderate pain by acting on the peripheral nervouse system lower body temp in fever and powerfully inhibits platlet aggressionInd:Chest pain sug MICon:hypersensitivity to salicyates active ulcer disease,asthmaPre:allergies to other NSAIDS bledding disorder, children teenagers w varicilla or flu like sypmtoms can cause Reyes syndrome
Give 2 examples of MAO
pg 312 phenelzine. Tranylcypromine
physiological effects of dissociatives
analgesia (mostly somatic, less visceral)sympathetic activationhypertonicity (use w/ benzos, alpha-2s, or guaifenesin)inc. ICP, IOPconvulsions (use w/ benzos)apneustic breathingretention of near normal pharyngeal & laryngeal reflexes
Define assay
Test that determines the amount and purity of a given chemical in a preparation in the laboratory.
Affinity
The ability for drugs to locate a receptor.
Define active transport
Transportation that requires the use of energy to move a substance.
Used to derease cAMP production and to decrease post-op shivering
Precedex
cons of propofol
-some pain w/ IV administration
-can damage tissue if given extravascularly
-apnea common after administration
-dose dependent vasodilation --> dec. MAP (do NOT use in hypotensive patients)
-cats: chronic admin can cause oxidative injury to RBCs
What is the antidote Physostigmine salicylate used to treat?
Antimuscarinic/anticholinergic agents toxicity/overdose
side effects of nitroprusside
hypotension
reflex tachy
CN release
What is another name for Vitamin C?
ascorbic acid
Adverse reactions for anticholinergic drugs
disorientation, confusion, agitation, delirium, NV, paralytic ileus
consists of two hollow prongs through which the oxygen passages
nasal cannula
Arbutamine
It is a beta-1, beta-2 and alpha-1 agonist that increases heart rate (positive chronotropy), force of contraction (positive inotropy) and systolic blood pressure. It has a rapid onset of action and relatively short plasma half-life (about 8 min). It is
Drugs commonly co-administered with to reduce chance of resistance
-Enterococci: penicillin and aminoglycoside
-Pseudomonas: piperacillin and aminoglycoside; 3rd/4th gen ceph and aminoglycoside
5 mL= ___ fl. dram
5 mL= 1 fl. dram
Pharmacotherapeutics of expectorants:
relief of dry, unproductive cough that accompanies resp conditions such as colds, influenza, bronchitis, asthma
facilitation  of secretion removal in resp conditions associated w/ increased mucus prod
most effective at managing symptoms associated w/ URIs; generally not as effective for tx of persistent cough associated w/ smoking, asthma, emphysema
Stimulation of Dopaminergic receptors causes:
Vasoconstriction (these receptors are predominantly located in the renal and coronary vessels)
What are the two anatomical divisions of the Autonomic system?
Sympathetic and Parasympathetic
Which glucocorticoid may trigger apoptosis and may even work on nondividing cells
Prednisone(the killer of non-divding cells):--> just an exagerated mneumonic
Beta adrenergic blocking agents
Non-selective, blocks beta1 and beta2. Cardio selective, blocks beta1.
What are the three essential parameters of measurement that are associated with the prescription and administration of drugs within each system of measurement?
Weight, Volume, and Length
The AHA states that there is an increase in survival rate if the patient receives CPR within ___ min plus receive meds through advance cardiac life support within ___ min.
4, 8
what phase of succinylcholine neuomuscular bloackade is reversible?
phase II (repolarized but blocked)
what are the cardiovascular toxic effects of beta blockers
bradychardia, AV block, CHF
Effector proteins activate ______ which cause an effect in the cell
Second messengers
cAMP, IP3, DAG, Ca++
Muscle spasm caused by?
flood sensory impulses coming to spinal cord from injured area
What are the most absued prescription analgesics?
Vicodin and Oxycontin
Mg2+ is a cofactor in what membrane enzyme?
Na+/K+ ATPase
What is potentiation?
A drug which has no effect that enhances the effect of a second drug.....0+1=2
drug interactions with resins:
may decrease the absorption of other meds given concomitantly; especially fat soluble (b/c product will become bound w/ resin and excreted)
 
i.e. birth control pills
 
so, don't take the other meds for 2-4 hrs either way 
Name some clinical uses ß-agonists?
Bronchodilation for asthma and COPD (ß2); Cardiac stimulant (ß1); Tocolytic (uterine relaxant) – classic off-label use (torbutaline)
Which nerves are associated with the sympathetic system?
Thoracic & Lumbar nerves
What are some properties of cough medications?
Treats non-productive, dry, irritating, and prolonged coughs. Secondary to treating the underlying disorder
Dosage - Gluco

Step dosing
Must be weaned off drug before discontinuing. Gradually dcrease dose. Stopping dosage abruptly can cause adrenal insuff., decreased b/p, decreased glucose, hypotension, muscle ache, joint pain (myalgia, athralgia)
List the shapes of bacteria
spherical, rod shaped, spiral, or comma shaped and can grow together to form S shapes
Does sotalol increase or decrease the effective refractory period?
Increase (K+ channel blocker)
what is the active metabolite of azathioprine
how is it metabolized
implication
mercaptopurine
xanthine oxidase
toxic effects may be increased by allopurinol
What system can be adversely affected by lithium and how?
gastrointestinal-nausea, vomiting, and anorexia; neuromuscular-tremors; weight- weight gain; renal- increased thirst and urination
2 eicosanoids that can be used as abortifacients in the 1st and 2nd trimesters.
PGE2 and PGF2-alpha.
What 2 sensory components does histamine stimulate?
Pain and itching (H1 receptor)
How are adverse drug reactions classified?
Type A - augmented pharmacologic effects (dose dependent and predictable)Type B - idiosyncratic effects (dose independent and unpredictable)Type C - chronic effectsType D - delayed effectsType E - end of Tx effectsType F - failure of therapy
Anticholinergics cause both mydriasis and cycloplegia, what does this mean?
Mydriasis is dilation of the pupil, Cycloplegia is paralysis of the ability for “accommodation” or focusing mechanism in the eye (also blurring of eye)
Which one used in GAD?
Venlafaxine - inhibits 5HT and DA reuptake. Toxicity - stimulant effects
What are signs of impairment of Health Care Worker
Change in behaviorChange in appearanceAbsenteeismSpend alot of time going to their locker or CarTrouble completing assignmentsChange in FriendsSmell like AlcoholDrowiness, Sleepiness
List some variables that affect drug absorption
-Nature of the absorbing surface
-Blood flow to the site of administration
-Solubility of the drug
-pH
-Drug concentration
-Dosage form
-Route of drug administration
-Bioavailability
T/F: Is used during pregnancy
true: it is used during pregnancy because it does not cross the placenta.
Which pair of anticonvulsants is most likely to interact with other drugs a patient may be taking?
phenobarbital (Luminal) and phenytoin (Dilantin)
3 mechanisms of resistance to penicillin
mutations of genes encoding penicillin binding proteins or transpeptidases (several in each cell), mutations of beta-lactamases, and altered uptake.
How can food and social habits affect drug metabolism?
Polycyclic aromatic hydrocarbons in cigarette smoke cause AhR-mediated P450 enzyme induction.Charcoal-broiled foods and cruciferous vegetables induce CYP1A enzymes.
what is the mechanism of action of L-dopa/carbidopa
increase dopamine level in brain
What does the abbreviation stand for: ng
nanogram, one billionth of a gram
Torsades de pointes (two subclasses of antiarrhythmics)
Class III (sotalol), class IA (quinidine) antiarrhythmics
What is the MOA of thiazide diuretics?
Block Na/Cl transporter in distal convoluted tubule
How can antihistamines cause urine retention and blurred vision?
They have atropine like effects in peripheral muscarinic receptors.
for asthma, when would you use a methylxanthine (theophylline)?
 
therapeutic index?
 
use in diffcult to control asthma
 
very narrow th. index
What are the toxic doses of acetamenophen in children and adults?
Acute ingestions of 150-200 mg/kg in children, or 7.5g in adults. Chronic toxicity has been seen with ingestion of high therapeutic doses 4-6g/day in high risk patients. Toxicity has been seen with children taking 60-150 mg/kg/d for 6-8 days
Why is it more difficult to develop antiviral drugs than it is to develop antibiotics?
Because viruses utilize the host (patient) cell processes, killing them is often toxic to the patient.
Why should insulin not be given orally?
If insulin is given orally, it would be destroyed by proteolytic enzymes.
E = Exposure

What should be done to reduce exposure?
Take off the patient's clothes, look in the pockets for drug bottles and needles. Look for other injuries.
Medication to be given SQ should not exceed ____mL.
Medication to be given SQ should not exceed 2 mL.
What 5 things should you teach to the patient about dosage and administration?
- Name of the drug- Dosage and schedule of administration- technique of administration- Duration of drug use- storage of drug
/ 436
Term:
Definition:
Definition:

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