Lecom Pharm One Liners 2015 Part 5

Front 1

Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation

Back 1

Neuromuscular blocking drugs

Front 2

These drugs strongly potentiate and prolong effect of

Back 2

Inhaled anesthetics, especially isoflurane,

Front 3

neuromuscular blockade (NMB)

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aminoglycosides, and antiarrhythmic

Front 4

These prevent the action of Ach at the skeletal muscle endplate to produce a "surmountable blockade," effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)

Back 4

Nondepolarizing type antagonists

Front 5

Agent with long duration of action and is most likely to cause histamine release

Back 5

Tubocurarine

Front 6

Non-depolarizing skeletal muscle antagonist that has short duration

Back 6

Mivacurium

Front 7

Skeletal muscle agent that can block muscarinic receptors

Back 7

Pancuronium

Front 8

Skeletal muscle agent that undergoes Hofmann elimination (breaks down spontaneously)

Back 8

Atracurium

Front 9

One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis, causes muscle pain postoperatively and myoglobinuria may occur

Back 9

Succinylcholine

Front 10

During Phase I these agents worsen muscle paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine

Back 10

Cholinesterase inhibitors

Front 11

Spasmolytic drugs

Front 12

Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease

Back 12

Spasmolytic drugs

Front 13

Facilitates GABA presynaptic inhibition

Back 13

Diazepam

Front 14

GABA agonist in the spinal cord

Back 14

Baclofen

Front 15

Similar to clonidine and may cause hypotension

Back 15

Tizanidine

Front 16

DOC for malignant hyperthermia by acting on the sacroplasmic reticulum or skeletal muscle

Back 16

Dantrolene

Front 17

Agent used for acute muscle spasm

Back 17

Cyclobenzaprine

Front 18

Drugs Used in Parkinsonism & Other Movement Disorders

Front 19

Irreversible condition resulting from the use of antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog)

Back 19

Drug induced Parkinsonism

Front 20

Agent used in drug therapy of Parkinson's instead of Dopamine which has low bioavailability and does not cross the BBB

Back 20

L-dopa

Front 21

This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE's (GI distress, postural hypotension, and dyskinesias)

Back 21

Carbidopa

Front 22

Clinical response that may fluctuate in tx of Parkinson's dx

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"On-off-phenomenon"

Front 23

Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma

Back 23

Levodopa

Front 24

Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia

Back 24

Bromocriptine

Front 25

Non ergot agents used as first-line therapy in the initial management of Parkinson's

Back 25

Pramipexole and ropinirole

Front 26

Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis

Back 26

Amantadine

Front 27

Inhibitor of MAO type B which slows down metabolism of dopamine, used adjunct to levodopa or as sole agent in newly diagnosed patients

Back 27

Selegiline

Front 28

Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson's dx and cause acute hepatic failure (monitor LFT's)

Back 28

Tolcapone

Front 29

Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects

Back 29

Benztropine

Front 30

Agent effective in physiologic and essential tremor

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Propranolol

Front 31

Agents used in Huntington's Disease

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Tetrabenazine (amine depleting drug), reserpine

Front 32

Agents used in Tourette's dx

Back 32

Haloperidol, pimozide , clonidine

Front 33

Chelating agent used in Wilson's disease

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Penicillamine

Front 34

Antipsychotics

Front 35

Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor

Back 35

Older antipsychotic agents, D2 receptors

Front 36

MOA of neuroleptics

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Dopamine blockade

Front 37

Side effects occuring in antipsychotics that block dopamine

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Hyperprolactinemia, menorrhea, galactorrhea, confusion, mood changes, decreased sexual interest, and weight gain

Front 38

Antipsychotics that reduce positive symptoms only

Back 38

Older antipsychotics

Front 39

Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation

Back 39

Olanzapine, aripiprazole, and sertindole

Front 40

Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia

Back 40

Risperidone

Front 41

Atypical antipsychotic causing high prolactin levels

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Risperidone

Front 42

Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes

Back 42

Olanzapine

Front 43

Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker

Back 43

Haloperidol

Front 44

Drug used in neuroleptic malignant syndrome

Back 44

Dantrolene

Front 45

Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)

Back 45

Muscarinic blockers

Front 46

Antipsychotic having the strongest autonomic effects

Back 46

Thioridazine

Front 47

Antipsychotic having the weakest autonomic effects

Back 47

Haloperidol

Front 48

Only phenothiazine not exerting antiemetic effects, can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias

Back 48

Thioridazine

Front 49

Agent having no effect on D2 receptors, blocks D4, reserved for resistant schizophrenia, and can cause fatal agranulocytosis

Back 49

Clozapine

Front 50

Anti-psychotic not shown to cause tardive dyskinesia

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Clozapine

Front 51

Anti-psychotics available in depot preparation

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Fluphenazine and haloperidol

Front 52

Reduced seizure threshold

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Low-potency typical antipsychotics and clozapine

Front 53

Orthostatic hypotension and QT prolongation

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Low potency phenothiazines and ziprasidone

Front 54

Increased risk of developing cataracts

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Quetiapine

Front 55

Lithium

Front 56

Major route of elimination for Lithium

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Kidneys

Front 57

Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop

Back 57

Lithium toxicity

Front 58

Drug increases the renal clearance hence decreases levels of lithium

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Theophylline

Front 59

Lithium is associated with this congenital defect

Back 59

Cardiac anomalies and is contraindicated in pregnancy or lactation

Front 60

DOC for bipolar affective disorder

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Lithium

Front 61

Concern using lithium

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Low therapeutic index

Front 62

SE of lithium

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Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus

Front 63

Antidepressants

Front 64

Example of three antidepressants that are indicated for obsessive compulsive disorder

Back 64

Clomipramine, fluoxetine and fluvoxamine

Front 65

Neurotransmitters affected by the action of antidepressants

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Norepinephrine and serotonin

Front 66

Usual time needed for full effect of antidepressant therapy

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2 to 6 weeks

Front 67

Population group especially sensitive to side effects of antidepressants

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Elderly patients

Front 68

All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion

Back 68

Side-effect profile, drug interaction potential and prior pt response

Front 69

Well-tolerated and are first-line antidepressants Monoamine oxidase inhibitors (MAOI)

Back 69

SSRI's, bupropion, and venlafaxine

Front 70

Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression

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Monamine oxidase inhibitors

Front 71

Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)

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Hypertensive crisis

Front 72

MAOI should not be administered with SSRI's or potent TCA's due to development of this condition Tricyclic antidepressants (TCA)

Back 72

Serotonin syndrome

Front 73

Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly

Back 73

Tricyclic antidepressants (TCA)

Front 74

Three C's associated with TCA toxicity

Back 74

Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)

Front 75

Agents having higher sedation and antimuscarinic effects than other TCA's

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Tertiary amines

Front 76

TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects

Back 76

Amitriptyline

Front 77

TCA used in chronic pain, enuresis, and ADD

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Imipramine

Front 78

TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep

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Doxepin

Front 79

TCA used in obsessive compulsive disorder (OCD), most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms

Back 79

Clomipramine

Front 80

Secondary amines that have less sedation and more excitation effect

Back 80

Nortriptyline, Desipramine

Front 81

Side effects seen with tricyclic antidepressants

Back 81

Muscarinic blockade (dry mouth, constipation); weak alpha-1 block (orthostatic hypotension); weak hisamine block (sedation)

Front 82

Heterocyclics

Front 83

Antidepressant associated with neuroleptic malignant syndrome

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Amoxapine

Front 84

Antidepressant associated with seizures and cardiotoxicity

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Maprotiline

Front 85

Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure

Back 85

Venlafaxine

Front 86

Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake

Back 86

Venlafaxine, duloxetine

Front 87

Antidepressant also used for sleep that causes priapism

Back 87

Trazodone

Front 88

Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure

Back 88

Nefazodone

Front 89

Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures

Back 89

Bupropion

Front 90

Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating

Back 90

Mirtazapine

Front 91

SE of mirtazapine

Back 91

Liver toxicity, increased serum cholesterol

Front 92

Selective serotonin reuptake inhibitors (SSRI)

Front 93

Except for these agents all SSRI have significant inhibition of CytP450 enzymes

Back 93

Citalopram and its metabolite escitalopram

Front 94

Side effects frequently seen with SSRIs

Back 94

CNS stimulation; GI upset

Front 95

Antidepressants with no effect on BP, no sedation

Back 95

SSRIs

Front 96

SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx

Back 96

Fluoxetine

Front 97

SSRI indicated for premenstrual dysphoric disorder

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Fluoxetine (Sarafem)

Front 98

Some of SSRIs' therapeutic effects beside depression

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Panic attacks, social phobias, bulimia nervosa, and PMDD (premenstrual dysphoric disorder), OCD

Front 99

SSRI less likely to cause a withdrawal syndrome

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Fluoxetine

Front 100

Opioid Analgesics & Antagonists

Front 101

Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons

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Ascending pathways

Front 102

Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release

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Presynaptic mu, delta, and kappa receptors

Front 103

Activation of these receptors open K+ ion channels to cause membrane hyperpolarization

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Postsynaptic Mu receptors

Front 104

Tolerance to all effects of opioid agonists can develop except

Back 104

Miosis and constipation

Front 105

All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction

Back 105

Meperidine

Front 106

SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone

Back 106

Opioid Analgesics

Front 107

Strong opioid agonists

Back 107

Morphine, methadone, meperidine, and fentanyl

Front 108

Opioids used in anesthesia

Back 108

Morphine and fentanyl

Front 109

Opioid used in the management of withdrawal states

Back 109

Methadone

Front 110

Opioid available trans-dermally

Back 110

Fentanyl

Front 111

Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema

Back 111

Morphine

Front 112

Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome

Back 112

Meperidine

Front 113

Moderate opioid agonists

Back 113

Codeine, hydrocodone, and oxycodone

Front 114

Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

Back 114

Propoxyphene

Front 115

Partial agonist or mixed antagonists

Front 116

Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal

Back 116

Buprenorphine

Front 117

Opioid antagonist that is given IV and had short DOA

Back 117

Naloxone

Front 118

Opioid antagonist that is given orally in alcohol dependency programs

Back 118

Naltrexone

Front 119

These agents are used as antitussive

Back 119

Dextromethorphan, Codeine

Front 120

These agents are used as antidiarrheal

Back 120

Diphenoxylate, Loperamide

Front 121

Drugs of Abuse

Front 122

Inhalant anesthetics

Back 122

NO, chloroform, and diethyl ether

Front 123

Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation

Back 123

Fluorocarbons and Industrial solvents

Front 124

Cause dizziness, tachycardia, hypotension, and flushing

Back 124

Organic nitrites

Front 125

Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression

Back 125

Steroids

Front 126

Readily detected markers that may assist in diagnosis of the cause of a drug overdose include

Back 126

Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses

Front 127

Opioid Analgesics

Front 128

Most commonly abused in health care professionals

Back 128

Heroin, morphine, oxycodone, meperidine and fentanyl

Front 129

This route is associated with rapid tolerance and psychologic dependence

Back 129

IV administration

Front 130

Leads to respiratory depression progressing to coma and death

Back 130

Overdose of opioids

Front 131

Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome

Back 131

Abstinence syndrome

Front 132

Treatment for opioid addiction

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Methadone, followed by slow dose reduction

Front 133

This agent may cause more severe, rapid and intense symptoms to a recovering addict

Back 133

Naloxone

Front 134

Sedative-Hypnotics

Front 135

Sedative-Hypnotics action

Back 135

Reduce inhibition, suppress anxiety, and produce relaxation

Front 136

Additive effects when Sedative-Hypnotics used in combination with these agents

Back 136

CNS depressants

Front 137

Common mechanism by which overdose result in death

Back 137

Depression of medullary and cardiovascular centers

Front 138

"Date rape drug"

Back 138

Flunitrazepam (rohypnol)

Front 139

The most important sign of withdrawal syndrome

Back 139

Excessive CNS stimulation (seizures)

Front 140

Treatment of withdrawal syndrome involves

Back 140

Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol

Front 141

These agents are CNS depressants

Back 141

Ethanol, Barbiturates, and Benzodiazepines

Front 142

Stimulants

Front 143

Withdrawal from this drug causes lethargy, irritability, and headache

Back 143

Caffeine

Front 144

W/D from this drug causes anxiety and mental discomfort

Back 144

Nicotine

Front 145

Treatments available for nicotine addiction

Back 145

Patches, gum, nasal spray, psychotherapy, and bupropion

Front 146

Chronic high dose abuse of nicotine leads to

Back 146

Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures

Front 147

Tolerance is marked and abstinence syndrome occurs

Back 147

Amphetamines

Front 148

Amphetamine agents

Back 148

Dextroamphetamines and methamphetamine

Front 149

These agents are congeners of Amphetamine

Back 149

DOM, STP, MDA, and MDMA "ecstasy"

Front 150

Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)

Back 150

Cocaine "super-speed"

Front 151

Hallucinogens

Front 152

Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic

Back 152

PCP

Front 153

Removal of PCP may be aided

Back 153

Urinary acidification and activated charcoal or continual nasogastric suction

Front 154

THC is active ingredient, SE's include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur

Back 154

Marijuana