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46 Cards in this Set

  • Front
  • Back
Opioids MOA
1. Bind to and activate opioid receptors
2. Block transmission of pain signal
3. Raise pain threshold
If the Opioid Receptor is MU, the effect is...
analgesia, respiratory depression, euphoria, ++sedation, decreased motility, nausea, confusion, urinary retention
If the Opioid Receptor is KAPPA, the effect is...
analgesia, ++++sedation, miosis
If the Opioid Receptor is SIGMA, the effect is...
dysphoria, psychomotor stimulation, tachycardia
If the Opioid Receptor is DELTA, the effect is...
endogenous analgesia
Pure Agonists
Bind to and activate MU and KAPPA receptors
Partial Agonists
Bind to parts of MU receptors causing less pronounced effects than the pure agaonists + ceiling effect
Mixed Agonist/Antagonist
Act as pure agonist at KAPPA receptors and antagonists at MU receptors + ceiling effect
Pure Antagonists
Bind to and block effects at KAPPA and MU receptors
Opioids are metabolized in the...
LIVER, so watch for patients with renal failure
Opioids are excreted by the...
~Less potent than morphine
~Don't give with MAOIs = severe HTN/HypoTN, coma, seizures, cardiac collapse
Caution! Opioids may interfere with...
CNS evaluation and cause increased ICP!
If sedation occurs with Opioids...
Decrease the Dose and Increase the Frequency
Common causes of Analgesic Failure
1. Practitioner failure to correctly assess pain
2. Inadequate dose
3. Practitioners too worried about dependence
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Binds to viral DNA reverse transcriptase to inhibit viral replication
AZT (NRTI) Caution
Bone Marrow Supression
Hypersensitivity - may be fatal
NRTI adverse effects
N/V/D, pacreatitis, Lactic Acidosis, Peripheral Neuropathy
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Binds to reverse transcriptase preventing the conversion of RNA to DNA
NNRTI Caution
Many drug interactions
Protease Inhibitors (PIs)
Inhibits HIV Protease necessary for cleaving HIV proteins to form infectious new virions
PI Caution
Extensive food and drug interactions, Ritnavir most potent reactions
PI adverse effects
Many pills, N/V/D, Hyperglycemia, lipid abnormalities and lipodystrophy
Ritnavir special considerations
1. Rarely used alone
2. COmbined with other agents to be a pharmacokinetic booster
3. May help remove food restrictions or decrease dose of other meds
Amphotericin B (antifungal)
Binds to sterols in fungal cell membranes and increases permeability of membrane causing leakage
Amphotericin B adverse effects
shaking chills, N/V, fever, headache, myalgia, nephrotoxicity, hypokalemia, hypomagnesemia, phlebitis, anemia, anaphylaxis
Amphotericin B special precaution
Use only with Dextrose in IV and not more than .1mg/ml
"Nazole" Antifungals
Inhibits ergosterol synthesis, increase membrane permeability causing leakage
Special considerations with Fluconazole and Ketoconazole antifungals
FLUC: serious candidal infections like UTI, peritonitis, pneumonia
KETO: extensive drug interactions
Inhibit DNA synthesis or replication
Foscarnet (antiviral) MOA
inhibits viral replication by binding to DNA polymerases and reverse transcriptase
Protese Inhibitor drugs end in...
Antiviral drugs end in...
Antifungal drugs end in...
Antacid (Mylanta Maalox)
Neutralize gastric acid
Histamine Receptor Antagonist (H2As)
Blocks histamine Release, Ach, and gastrin
Histamine Receptor Antagonist (H2A) Caution
Not for children under 16
coats ulcers and absorbs bile salts and pepsins
SUCRALFATE special notes
Has metallic taste
Antacids prevent drug from binding (seperate)
Decreases effects of vitamins
increases gastric mucous and bicarbonate secretion; inhibits acid secretion
Omeprazole (Prilosec)
Irreversibly inhibits HKATPAse enzyme system in parietal cells
Lansoprazole (Prevacid)
Irreversibly inhibits HKATPAse enzyme system in parietal cells
Alginic Acid
Provides mechanical barrier to reflux, coats esophagus
Increases lower esophageal sphincter pressure and esophageal clearance
Increases gastric emptying and LES pressure