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102 Cards in this Set
- Front
- Back
Naloxone
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Trade name - Narcan
Narcotic Antagonist |
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Naltrexone
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Trade Name - Revex
Narcotic Antagonist |
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Pentazocine
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Trade Name - Talwin
Partial narcotic agonist PO or injectable |
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Buprenophrine
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Trade Name - Buprenex
Partial Narcotic Agonist Injectable only |
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Butorphanol
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Trade Name - Stadol
Partial Narcotic Agonist Nasal Spray Injectable |
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Nalbuphrine
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Trade name - Nubian
Partial Narcotic Agonist Injectable |
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Morphine
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Trade Name - Many
Full Narcotic Agonist Extensive first pass effect (90% loss) rapid tolerance P.O. or injectable (PCA Pump) |
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Codeine
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Trade Name - Many
Full Narcotic Agonist Use - Antitussive, Pain Good Cough Relief |
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Meperidine
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Trade Name - Demerol
Full Narcotic Agonist DO NOT USE WITH MAOIs DO NOT USE WITH SEIZURE DISORDERS |
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Methadone
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Trade Name - Dolophine
Full Narcotic Agonist Use - Detox of narcotic addicted patient, pain |
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Fentanyl
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Trade Name - Duragesic
Full narcotic Agonist Use - Preop med, pain, patch (transdermal patch for chronic pain) |
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Hydrocodone
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Trade Name - Vicodin, Lortab, etc.
Full Narcotic Agonist P.O. use for pain Risk for liver failure due to acetominophen in formula. |
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Oxycodone
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Trade Name - Oxycontin, Percodan, Percocet, etc.
Full Narcotic Agonist P.O. use for pain Risk for liver failure due to acetominophen in formula. |
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Epinephrine
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Trade Name - Many
Direct Acting Sympathomimetic Receptors - ALL alpha and beta agonist. Action - SNS Stimulation Uses - Cardiac Stimulant (Children) Anaphylaxis, Used with local anesthetics to keep them local |
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Norepinephrine
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Trade Name - Levophed
Direct-Acting Sympathomimetic Receptors - alpha 1 agonist. Action - Increased vasoconstriction reflex, decreased heart rate. Use - Septic Shock S.E. - Increased BP |
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Dopamine
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Trade Name - Intropin
Direct-Acting Sympathomimetic Receptor - Dapamine Agonist Action-Low Doses:Good Renal blood flow High Doses:Increased BP Increases Cardiac Contractility Uses - Shock S.E.- Increased BP & HR |
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Dobutamine
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Trade Name - Dobutrex
Direct Acting Sympathomimetics Receptor - Beta 1 Agonist (Heart Only) Action - Increases efficiency of heart beat and cardiac contractility Use - DRUG OF CHOICE for Cardiac Stimulation. S.E.- Increased HR |
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Phenylephrine
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Trade Name - Neo-Synephrine
Direct-Acting Sympathomimetic Receptor - Alpha 1 agonist Actions - Vasoconstriction reflex Uses - Paraxysmal Atrial Tachycardia (PAT), cold meds, Pupil Dilation. S.E.- decreased HR |
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Ritodrine
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Trade Name - Yutopar
Direct-Acting Sympathomimetic Receptor - Beta 2 agonist Action - Uterine relaxation Uses - Prevent premature labor/delivery S.E.- Fluid in respiratory system |
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Phenylpropanolamine
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Trade Name - AYDS, Dymetapp, Dexotrim
Indirect-Acting Sympathomimetic Receptor - Alpha 1 agonist Action - Vasoconstriction Uses - Congestion, Diet Aid S.E.- HTN (10-30mm Hg), Axniety, Agitation |
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Pseudoephedrine
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Trade Name - Sudafed
Indirect-Acting Sympathomimetic Receptor - Alpa 1 Agonist Action - Vasoconstriction Uses - Nasal Congestion S.E.- HTN (5-10mm Hg) |
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Phenoxybenzamine
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Trade Name - Dibenzyline
Sympatholytic Receptors - Blocks Alpha 1&2 Action - Vasodilation Uses - Pheochromocytoma S.E.- decreased BP |
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Phentolamine
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Trade Name - Regitine
Sympatholytic Receptors - Blocks Alpha 1&2 Action - Vasodilation Uses - Shock, Control of Peripheral Resistance (Fast onset/offset) S.E.- Decreased BP |
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Labetolol
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Trade Name - Trandate
Sympatholytic Receptors - Blocks Alpha 1, Beta 1&2. Action - Decrease BP Uses - HTN, esp. post-MI S.E. Postural Hypotension |
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Propranolol
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Trade Name - Inderal
Sympatholytic Receptors - Blocks Beta 1&2 Actions - Vasodilation Uses - HTN S.E.- decreased HR, use with caution (if at all) in smokers, asthmatics, or diabetics. Decreased Exercise tolerance. Do not d/c abruptly! |
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Metoprolol
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Trade Name - Lopressor, Toprol XL
Sympatholytic Receptor - Beta 1 Specific Uses - HTN, Less bronchospasm S.E. decreased BP |
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Pilocarpine
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Trade Name - Pilocar, OcusertPilo
Cholinergic Receptor - muscarinic agonist Use - Glaucoma |
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Bethanechol
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Trade Name - Urecholine
Cholinergic Receptor - muscarinic agonist Uses - Urinary retention, GI Atony |
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Physostigmine
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Trade Name - Antilirium
Cholinergic Action - AChE inhibitor Use - Glaucoma, anticholinergic toxicity |
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Donepizil
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Trade Name - Aricept
Cholinergic Action - AChE inhibitor Use - Alzeimer's Disease |
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Atropine
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Trade Name - Atropisol
Anticholinergic Action - ACh antagonist Uses - Diarrhea, bronchospasm, anesthesia (Increased HR, Decreased Secretions), Urinary incontinence, ER Codes. S.E.- Anticholinergic |
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Scopolamine
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Trade Name - Transderm Scop
Anticholinergic Action - ACh antagonist Uses - Motion Sickness S.E.-Anticholinergic |
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Propantheline
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Trade Name - Probanthine
Anticholinergic Action - Large, Charged ACh agonist Uses - Diarrhea, ulcers, (Local GI effect) S.E.- Anticholinergic |
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Trihexyphenidyl
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Trade Name - Artane
Anticholinergic Action - ACh antagonist Use - Parkinson's Disease S.E.- Anticholinergic |
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Benztropine
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Trade Name - Cogentin
Anticholinergic Action - ACh antagonist Use - Parkinson's Disease S.E.- Anticholinergic |
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Succinylcholine
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Trade Name - Anectine
Depolarizing Neuromuscular Blocker (Only depolarizing in use) Action - Shortest-acting:Onset 30 sec-1 min, duration: 5 min. Uses - Facilitation of intubation, endoscopy. S.E.- Watch for Malignant Hyperthermia |
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Curare
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Trade Name - Pipecuronium, Mivacurium, Pancuronium, Rocuronium, etc.
Non-depolarizing Neuromuscular Blocker Uses - Longer Surgical Procedures, as adjuncts to anasthesia. S.E.- Malignant Hyperthermia |
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Malignant Hyperthermia
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Presents as muscle rigidity, tremors, and HIGH fever soon after exposure to neuromuscular blockers.
Treatment is to d/c the causative drug, bring temperature down with cooling measures (drugs won't work), and treat muscle spasms with Dantolene (Dantrium) |
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Topiramate
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Trade Name - Topamax
Class- 2nd line anticonvulsant Uses - Seizure, MIGRAINE prophalaxis, alcoholic/cocaine aversion, weight loss |
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Botox
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Blocks ACh release from nerve terminals, relaxes muscles.
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Metaxalone
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Trade Name - Skelaxin
Muscle Relaxant |
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Baclofen
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Trade Name - Lioresal
CNS Drug for muscle spasms |
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Pemoline
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Trade Name - Cylert
CNS Stimulant Uses - Narcolepsy, ADD Less potential for abuse. |
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Methylphenidate
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Trade Name - Ritalin, Concerta, Attendate, etc.
CNS Stimulant Uses - Narcolepsy, ADD DO NOT USE with MAOIs DO NOT USE with seizure disorders |
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d-amphetamine
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Trade Name - Dexedrine (Adderall, Strattera)
CNS Stimulant Use - Narcolepsy, ADD DO NOT USE with MAOIs DO NOT USE with Seizure Disorders |
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Phenobarbital
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Trade Name - Luminal
Barbiturate Long acting: 10-12 hours Use - Epileptic Seizures, component of anesthesia, sedation. MOA - Interacts with GABA receptor so that chloride flux into CNS cells is increased, resulting in CNS Depression.(decreased nerve firing) |
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Diazepam
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Trade Name - Valium
Benzodiazepine (BZD) Uses - Anticonvulsant, muscle relaxant. RED-FLAGGISH |
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Lorazepam
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Trade Name - Ativan
Benzodiazepine (BZD) Use - Preanesthetic (amnesia), alcohol withdrawl. |
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Midazolam
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Trade Name - Versed
Benzodiazepine (BZD) Uses - Sedation, Amnesia, Induction of anesthesia |
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Alprazolam
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Trade Name - Xanax
Benzodiazepine (BZD) Use - Antianxiety |
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Olanzepine
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Trade Name - Zyprexa
Atypical Antipsychotic Use - Psychosis ADRs - Headache, agitation, nervousness Use - "Negative" symptoms of psychosis, mania. DRUG OF CHOICE (DOC) for psychosis with negative symptoms (withdrawn,etc.) Used to reorient a patient to society. |
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Risperidone
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Trade Name - Risperdal
Atypical Antipsychotic Use - Psychosis ADRs - CNS Stimulation, EPS, headache Used for "negative" symptoms of psychosis |
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Clozapine
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Trade Name - Clozaril
Atypical Antipsychotic Use - Schizophrenia in patients who cannot tolerate other antipsychotics. ADRs - Very few EPS, but agranulocytosis may be seen. Used for some of the "negative" symptoms of psychosis (because of 5-HT blockade). |
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Haloperidol
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Trade Name - Haldol
Antipsychotic Uses - Psychosis, Tourettes's Syndrome ADRs - DRAMATIC EPS (worst of all drugs), withdraw slowly |
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Prochlorperazine
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Trade Name - Compazine
Antipsychotic Uses - Nausea and Vomiting ADRs - Fewer EPS than chlorpromazine Blocks DA Receptors in the Chemoreceptor Trigger Zone (CTZ), blocks vomiting. Main drug used for vomiting |
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Thioridazine
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Trade Name - Mellaril
Antipsychotic Uses - Psychosis, hiccoughs ADRs - Fewer EPS than chlorpromazine. P.O. ONLY |
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Chlorpomazine
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Trade Name - Thorazine
Antipsychotic Uses - Psychoses, Schizophrenia, hiccoughs ADRs - Extrapyramidal Symptoms, Sedation, Anticholinergic This class of drugs called neuroleptics (blocked, dull, blunted emotions)Older drug, but still used. |
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Lithium
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Trade Name - Lithobid, Eskalith
Treats Manic-Depressive Disorders. Considerations - Increased Na levels cause decreased Li levels and vice-versa. Pt. on Na restriction, or in hot weather at risk for Li toxicity. S.E.- Gi upset, polyuria, FINE TREMOR at theraputic doses. Chronic use may cause diabetes incipidius/dehydration with resulting Li toxicity. 0.5-1.5 mEq = Theraputic Dose 1.2 mEq = risk for toxicity 1.5-3.0 mEq = Coma, death |
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Phenelzine
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Trade Name - Nardil
MAOI Use - Depression when TCAs/SSRIs fail ADRs - Interaction with foods that contain tyramine. Interaction with meperidine (demerol) and sympathomimetics (decongestants, etc) couse a huge release of NE, resulting in Hypertensive Crisis, seizures, Arrhythemia, strokes. |
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Paroxetine
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Trade Name - Paxil
SSRI Use - Depression, OCD, pain, PMDD (PMS), migraine. ADRs - Nausia, nervousness (take in AM) headache, anorexia. May increase risk of suicide (esp in teens). Decreased Sex Drive is main reason for d/c. DO NOT STOP ABRUPTLY, due to mood swings, suicide ideation, psychosis, seizures. |
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Citalopram
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Trade Name - Celexa
SSRI Uses - Depression, OCD, pain, PMDD (PMS), migraine ADRs - Nausia, nervousness (take in AM) headache, anorexia, may increase risk of suicide (esp in teens) Decreased Sex Drive is main reason for d/c |
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Bupropion
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Trade Name - Wellbutrin
Antidepressant MOA - Blocks reuptake of NE & DA Uses - Depression,OCD,pain,PMDD (PMS)Migraine ADRs- Agitation, Headache, Dry mouth, constipation, weight loss, GI Upset, dizziness, tremor, insomnia, blurred vision, tachycardia, seizures |
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Fluoxetime
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Trade Name - Prozac
SSRI Use - Depression,OCD,PMDD (PMS), migraine ADRs- Nausia, Nervousness (take in AM) headache,anorexia,may increase risk of suicide(esp in teens),decreased sex drive is main reason for d/c. Is the only antidepressant approved for teens. Safafem is "Girly Prozac" |
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Amitryptiline
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Trade Name - Elavil
Tricyclic Antidepressant (TCA) MOA- blocks reuptake of NE, 5-HT Uses - Depression,Panic,Agoraphobia, OCD,pain,preventing migraines, Depression+Panic,Peripheral Neuropathies. ADRs- Anticholinergic effects, sedating, 2-3 weeks before antidepressant effect is seen. |
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Isoflurane
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Trade Name - Forane
General Anesthetic - Inhalation Less arrhythmias than Halothane Better skeletal muscle relaxation (with neuromuscular blocker on board) Less potent than Halothane |
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Halothane
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Trade Name - Flouthane
General Anesthitic - Inhalation Most widely used. Doesn't give good skeletal muscle relaxation. May cause arrhythemias. |
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Nitrous Oxide
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General Anesthetic - Inhalation
Used alone in Dental procedures Used in conjunction with halothane for rapid induction and for analgesia/amnesia. |
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Lidocaine
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Trade Name - Xylocaine
Local anesthetic - Amide class Fast onset: <1 minute Longer Duration: ~2 hours All injection and topical forms of anesthesia may cause heart block or arrhythemias because ...caines block Na channels into excitable cells (e.g. heart muscle) When giving by injection, ASPIRATE! |
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Bupivacaine
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Trade Name - Marcaine
Local Anesthetic Slow onset: >10minutes Long Duration: 3+ hours Used for spinal,epidural,infiltration, and nerve block anesthesia May cause arrhythemias When giving by injection, ASPIRATE! |
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Levodopa
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Trade Name - L-Dopa
1st drug to treat Parkinson's Disease Crosses BBB and is converted to DA. 98% of L-Dopa is metabolized in first pass effect. |
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Carbidopa
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Trade Name - Lodosyn
Parkinson's Disease Drug Inhibits dopa decarboxylase in the periphery. Used togetherwith L-Dopa, eliminates much of the first pass effect. |
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Amantadine
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Trade Name - Symmetrel
Antiviral Drug used to treat Parkinson's Disease. Increases Dopamine release from nerve terminals. |
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Trihexyphenidyl
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Trade Name - Artane
Parkinson's Disease Drug Anticholinergic Causes tachycardia Causes mydriasis (excessive dilation of the pupil) |
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Benztropine
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Trade Name - Cogentin
Parkinson's Disease Drug Anticholinergic Causes Tachycardia Causes Mydriasis (excessive dilation of the pupil) |
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Ketamine
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Trade Name - Ketalar
Street Name - Special K General Anesthetic - IM/IV Produces dissociative anesthesia/analgesia Poor muscle relaxation Hallucinations common even after procedure. |
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Thiopental
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Trade Name - Pentothal (truth serum)
General Anesthetic - IM/IV Ultra-Short acting barbiturate Rapid onset, brief duration: <15 min. Used with nitrous oxide |
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Curare
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Trade Name - Mivacurium,Pancurium, etc.
Neuromuscular Blocker (paralytic) Always use shortest acting, most reversible drugs. |
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Lorazepam
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Trade Name - Ativan
Preanesthesia Med Benzodiazepine (BZD) Produces sedation and amnesia |
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Secobarbital
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Trade Name - Seconal
Preanesthesia Med Barbiturate Ordered the night before surgery to induce sleep (3-6 Hours) |
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Hydroxyzine
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Trade Name - Vistaril
Preanesthetic Med Antihistamine that causes mild sedation Ordered the night before the procedure to induce sleep. |
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Diphenhydramine
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Trade Name - Benadryl
Preanesthetic Med Antihistamine that causes mild sedation ordered the night before the procedure. |
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Promethazine
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Trade Name - Phenergan
Preanesthetic Med Antipsychotic that is sedative, anticholinergic, antihistamine, antienetic, and enhances analgesia. |
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Droperidol
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Trade Name - Inapsine
Preanesthetic Med Antipsychotic that is sedative, anticholinergic, antihistamine, antiemetic, enhances analgesia |
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Fentanyl
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Trade Name - Oralet
Preanesthetic Med Lollipop given 20-40 min prior to desired effect. Also used for conscious sedation. Also used transdermal (Duragesic Patch) Risk of Hypoventillation |
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Atropine
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Preanesthetic Med.
Anticholinergic - decreases secretions. |
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Glycopryrrolate
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Anticholinergic, decreases secretions.
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Gabapentin
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Trade Name - Neurontin
Class- 2nd Level anticonvulsant Uses - Adjunct for seizures, migraine, chronic pain, peripheral neuropathies. ADRs- Fatigue, dizziness, aches and pains, edema. |
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Felbamate
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Trade Name - Felbatol
Class- 2nd Line anticonvulsant Use - severe epilepsy |
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Diazepam
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Trade Name - Valium
Anticonvulsant MOA- Interacts with GABA receptor on nerve. This interaction increases chloride flux across nerve, causing decreased nerve firing. Used IV for status epilepticus (as are other BZDs), PO, IM for other seizure disorders. |
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Carbamazepine
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Trade Name - Tegretol
Anticonvulsant MOA- Stabilizes neuronal membrane by decreasing Na & K flux across membrane during an action potential. Start with low dose, increase weekly. Autoinduction RED FLAG DRUG Toxicity includes: bone marrow supression, sedation, vertigo, nausia,rashes (Stevens-Johnson Syndrome),hepatitis,fluid retention (increased ADH secretion) Drug Interactions - MANY |
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Fosphenytoin
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Trade Name - Cerebyx
Anticonvulsant MOA- Stabilizes neuronal membrane by decreasing Na & K flux across membrane during Action Potential May saturate enzymes responsible for its metabolism. RED FLAG DRUG Toxicity: nystagmus(Involuntary oscillation of the eyeball),ataxia,sedation, gingival hyperplasia, rashes(Stevens-Johnson Syndrome), Cardiovascular collapse with rapid infusion. Drug Interactions - MANY |
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Phenobarbital
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Trade Name - Luminal
Anticonvulsant MOA- Interacts with GABA receptor on nerve. This interaction increases chloride flux across nerve, causing decreased nerve firing. |
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Phentoin
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Trade Name - Dilantin
Anticonvulsant MOA- Stabilizes neuronal membrane by decreasing Na & K flux across membrane during an action potiental. May saturate enzymes responsible for its metabolism. RED FLAG DRUG Toxicity: Nystagmus (Involuntary oscillation of the eyeball), ataxia, sedation, gingival hyperplasia, rashes (Stevens-Johnson Syndrome), cardiovascular collapse with rapid infusion. Drug Interactions - MANY |
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Narcotic Antagonists
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Naloxone (Narcan)
Naltrexone (Revex) Both treat narcotic overdose and reduce respiratory depression post-operatively. Both WILL induce withdrawl syndrome - this may be life-threatening! |
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Considerations Using Benzodiazepines
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BZDs have a high theraputic index, OD with alcohol may be fatal.
Dependence may occur (withdraw slowly) Drug interactions with other CNS depressants (alcohol) |
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Considerations using Barbiturates
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Barbiturates are inducers of microsomal enzymes (lots of drug interactions) RED FLAG DRUG.
These drugs can cause respiratory depression. Physical/psychological dependence and tolerance (not to respiratory depression) with prolonged use. |
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Neuroleptic Malignant Syndrome
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High Fever
Like an Allergic Reaction to Drug Fever doesn't respond to antipyretics Muscle rigidity Is an emergency - take to ER Need skeletal muscle relaxant, cooling blanket. |
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Anticholinergic Effects
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Blurred Vision (Can't See)
Dry Mouth (Can't Spit) Urinary Retention (Can't Pee) Constipation (Can't Sh..) Confusion Agents that cause the greatest EPS cause the least anticholinergic effects ALL antipsychotics are anticolinergic. |
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Tardive Dyskinesias
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Involuntary movement of face, trunk, hands, extremities, affecting self-care
Late-developing, irreversible (after 2 years) due to supersensitivity of DA receptors. Use drug holidays to avoid this, to reevaluate the CNS disorder, and maintain effectiveness of the drug. |
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Drug Interactions of Antipsychotics
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Antipsychotics have an additive or synergistic effect with:
Alcohol, tell patient not to drink with antipsychotics. CNS Depressants Anticholinergics(decongestants, weight loss drugs) Drugs with anticholinergic side effects |
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Side Effects Of Antipsychotics
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Blockade of central DA Receptors causes
1)Extrapyramidal Symptoms (EPS) 2)Tardive Dyskinesias 3)Anticolinergic Effects 4)Sedation 5)Other:Orthostatic Hypotension, Photosensitivity,thermoregulatory effects. 6)Neuroleptic Malignant Syndrome. |
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Extrapyramidal Symptoms
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Distonias(painful neck contractions)
Akathisias(restlessness) Pseudo-Parkinsonism(tremor,rigidity, motor dysfunction) *30% incidence Haloperidol (Haldol)has worst EPS |