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48 Cards in this Set
- Front
- Back
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What is latanoprost and what are its side effects?
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Prostaglandin (PG-F-2-alpha)
- Increases outflow of aqueous humor in pts w/ glaucoma - Darkens color of iris (browning) |
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What is butorphanol and what is it used for?
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- Partial agonist at opioid mu receptors, full agonist at kappa receptors
- Used for pain (causes less respiratory depression than full agonists) - Causes withdrawal if on full opioid agonist |
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How do you treat benzodiazepine toxicity?
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Flumazenil (competitive antagonist at GABA benzodiazepine receptor)
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How do you treat barbiturate toxicity?
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Symptom management (assist respiration, increase BP)
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How would you treat malignant hyperthermia?
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Dantrolene
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What is dantrolene used for, and what is its mechanism of action?
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Used to treat malignant hyperthermia
- Prevents the release of Ca from the sarcoplasmic reticulum of skeletal muscle |
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What drug classes can you use to treat glaucoma?
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- alpha-2 agonists (brimonidine)
- beta blockers (timolol, betaxolol, carteolol; decrease aqueous humor secretion) - carbonic anhydrase inhibitors (acetazolamide; decrease aqueous humor secretion) - cholinomimetics (pilocarpine, carbachol, physostigmine, echothiophate; increase outflow) - prostaglandins (latanoprost; increase outflow) |
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What is tramadol, what is its mechanism of action, and what is its major toxicity?
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Very weak opioid agonist; also inhibits 5-HT and NE reuptake (works on multiple NT- "tram it all in")
Toxicity: similar to opioids, but also decreases seizure threshold |
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How do you treat status epilepticus?
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1. IV diazepam
2. IV phenytoin |
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What drugs can cause a lupus-like syndrome?
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It's HIPP to have lupus:
Hydralazine Isoniazid Procainamide - Others less frequently: phenytoin, quinidine, propafenone |
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How do cholinergic agonists work to improve glaucoma?
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Increase outflow of aqueous humor, contract ciliary muscle and open trabecular meshwork
- Side effects: miosis, cyclospasm |
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What drug should you use in emergent glaucoma?
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Pilocarpine--v effective at opening meshwork into canal of Schlemm
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How should you monitor a pt on valproic acid?
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Measure LFTS (can cause rare but fatal hepatotoxicity)
- Other toxicities: GI distress, neural tube defects in fetus, tremor, weight gain |
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How should you monitor a pt on lamotrigine?
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Watch for signs of rash (can cause Stevens-Johnson syndrome)
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What are some short-acting benzodiazepines? and long-acting?
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Short-acting: alprazolam, triazolam, midazolam
- Highest addictive potential Long-acting: chlordiazepoxide, diazepam ("CHLORine makes you DIe slowly") |
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What is midazolam and what is it used for?
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Short-acting benzodiazepine
Used as IV anesthetic- most common drug used for endoscopy |
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What is thiopental and what is it used for?
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Barbiturate used as IV anesthetic, for induction of anesthesia and for short surgical procedures
- High potency, high lipid solubility, rapid entry into brain; effect terminated by redistribution into tissue and fat - Decreases cerebral blood flow |
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What is propofol and what is it used for?
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IV anesthetic used for rapid anesthesia induction and short procedures
- Works by potentiating GABA-A Cl channels - Less post-op nausea than thiopental |
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What electrolyte abnormalities can succinylcholine cause?
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Hypercalcemia, hyperkalemia
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Pt on anti-psychotic therapy with rigidity, myoglobinuria, autonomic instability, hyperpyrexia... what is it and how would you treat it?
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Neuroleptic malignant syndrome
- Treat with dantrolene or dopamine agonists (bromocriptine) |
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What drug would you use to treat an essential tremor?
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Beta blocker (propranolol)
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What is galantamine and what is it used for?
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Anti-cholinesterase used for Alzheimer's
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What is rivastigmine and what is used for?
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Anti-cholinesterase used for Alzheimer's
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What is tacrine and what is it used for?
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Anti-cholinesterase used for Alzheimer's
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What drugs can you use to treat Huntington's disease?
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Reserpine + tetrabenazine (both inhibit VMAT --> depletion of amines)
Haloperidol (dopamine receptor antagonist) |
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If an inhalation anesthetic has high blood solubility, what does that imply about its pharmacologic properties?
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High blood solubility --> slow onset of action
This is because more gas is required to saturate the blood |
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If an inhalation anesthetic shows a high AV concentration gradient, what does that imply about its pharmacologic properties?
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High AV conc gradient --> slow onset of action
This is because a high AV conc gradient indicates that lots of the drug is being taken up by the tissues, so more gas is required to saturate the tissue |
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What's the major toxicity of halothane?
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Hepatotoxicity
- Other side effects: vagomimetic (bradycardia), cardiac arrhythmias |
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When is enflurane contraindicated?
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Pts with kidney failure (renal excretion) or seizure disorders (proconvulsant effects)
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How would you treat a patient with amphetamine intoxication?
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Chlorpromazine or haloperidol
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How would you treat a patient with cocaine intoxication? and withdrawal?
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Benzodiazepines (for both)
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Pt with drug intoxication who is belligerent, with psychomotor agitation and ataxia... what drug?
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PCP
- Can also see impulsiveness, fever, vertical and horizontal nystagmus, tachycardia, homicidality, psychosis, delirium |
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Pt with drug intoxication with pupillary dilation, delusions, visual hallucinations, and flashbacks... what drug?
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LSD
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What drugs are used to treat anorexia/bulimia?
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SSRIs
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What drugs are used to treat atypical depression?
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MAOIs, SSRIs
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What drugs are used to treat bipolar disorder?
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Lithium, valproic acid, carbamazepine, atypical antipsychotics
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What drug would you use to treat depression with insomnia?
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Mirtazapine (also increases appetite)
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What drugs are used to treat obsessive-compulsive disorder?
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SSRIs, clomipramine
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What drugs are used to treat PTSD?
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SSRIs
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What drugs are used to treat social phobias?
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SSRIs
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How would you monitor a pt on clozapine?
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Weekly WBC counts (can cause agranulocytosis)
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What are the major side effects of lithium?
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LMNOP:
Lithium: Movement (tremor), Nephrogenic diabetes insipidus (ADH antagonist), hypOthyroidism, Pregnancy probs (can cause Ebstein's anomaly- heart defect) |
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What is mirtazapine and what is its mechanism of action?
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Atypical antidepressant
- Alpha-2 antagonist (causes increased NE and 5-HT release) and 5-HT2 and 5-HT3 receptor antagonist |
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Which TCA would you use if you wanted to avoid anticholinergic effects? (i.e. in older pts)
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Nortriptyline
- Amitriptyline and imipramine have the most anticholinergic side effects |
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What are the major toxicities of TCAs?
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Tri-C's: Convulsions, Coma, Cardiotoxicity (arrhythmias)
- Also respiratory depression, hyperpyrexia, anticholinergic effects - Give NaHCO3 for CV toxicity |
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Pt on antidepressant tx who develops hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures... what is it and how would you treat it?
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"Serotonin syndrome"--seen with combos of any drugs that increase serotonin (SSRIs, MAOIs, meperidine)
- Treat with cyproheptadine (5-HT2 receptor antagonist) |
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What is maprotiline and what is its mechanism of action?
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Atypical antidepressant
- Blocks NE reuptake |
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What is trazodone, what is it used for, and what is its mechanism of action?
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Atypical antidepressant used to treat insomnia (high doses needed for antidepressant effect)
- Main effect is inhibition of 5-HT reuptake - Toxicity: sedation, nausea, priapism (trazoBONE), postural hypotension |
