Pharm Ii Intro

Front 1

CNS: Voluntary or Involuntary?

Back 1

Voluntary

Front 2

ANS: Voluntary or Involuntary?

Back 2

Involuntary

Front 3

Neurotransmitter for CNS

Back 3

Acetylcholine, Epinephrine

Front 4

Neurotransmitter for ANS

Back 4

Noreepinephrine
Sympathetic

Front 5

Inducer: Action

Back 5

Induces enzymes in gut and small bowel

Speeds up metabolism of drug and lowers drug level

Basically speeds up drug

Front 6

Inducer: I.E.

Back 6

St John's Wort lowers level of OCS

Front 7

Inhibitor: Action

Back 7

Blocks enzymes in the gut and small bowel

Lowers metabolism of drug and can cause toxic levels

Front 8

Inhibitor: I.E.

Back 8

Grapefruit juice: Naringin

Front 9

Category A

Back 9

Studies fail to show risk

(Tylenol)

Front 10

Category B

Back 10

Only if clearly indicated

Front 11

Category C

Back 11

Adverse Effects

Front 12

Category D

Back 12

Positive evidence

Front 13

Category X

Back 13

Demonstrated fetal abnormalities

Ace Inhibitors, Tholitimide

Front 14

Pharmacokinetic Interactions

Back 14

Diminished drug delivery to site of action

Increased drug delivery to site of action

Front 15

Pharmacodynamic Interaction

Back 15

Additive/Synergistic effect (anticoag/NSAID)

Antigonistic effect (clonidine and doxepin) One is object drug, other is precipitant drug.

Front 16

Cholingergic Drug: System and neurotransmitter

Back 16

Parasympathomimetic (parasympathetic), acetylcholine

Front 17

Cholingergic Drug: Effect

Back 17

Increased secretions
Decreased blood pressure and heart rate

Front 18

Parasympathomimetic: Actions

Back 18

Mimic effect of PNS
Mimics acetylcholine
Cholinergic Drug
Slow or inhibit pns activity by activating or inhibiting muscarinic receptor that are normally activated by acetylcholine using enzyme acetylcholinesterase

Front 19

Cholinergic Agonists: I.E.

Back 19

bethanechol (Urecholine, Duvoid, Myotonachol
pylocarpine (Pilocar, Isopto Carpine)

Front 20

Cholinergic Agonists: Indications

Back 20

Glaucoma (pilocarpine)
non-obs urinary retention, urogenic bladder, adynamic colon (bethanecol)

Front 21

Cholinergic Agonists: Contraindications

Back 21

Urinary or GI obstruction, prostate enlargement, pregnancy

Front 22

Cholinergic Agonists: Adverse Effects

Back 22

hypotension, headache, flushing, sweating, abdominal cramps, nausea, vomiting, diarrhea, increased salivation

Front 23

Cholinergic Agonists: Interactions

Back 23

If used with atropine-like drugs, parasympathomimetic actions inhibited

Front 24

Cholinergic Agonists: Nursing Actions

Back 24

Assess urinary and Gi status
Observe for s/s of toxicity (bradycardia, excessive secretions, respiratory depression, urinary urgency)

Front 25

Acetylcholinesterase Inhibitors: I.E.

Back 25

neostigmine (Prostigmin)
physostigmine (Antillirium)
pyridostigmine (Mestinon, Regonol)
edrophonium (Tensilon)

(Most r/t anesthesia)

Front 26

Acetylcholinesterase Inhibitors: Indications

Back 26

Post op ileus (neostigmine)
glaucoma and anticholinergic poisonings including tricyclic antidepressant overdosage (physostigmine)
diagnosis of myasthenia gravis (edrophonium)
treatment of m/g (neostigmine and pyridostigmine)

Front 27

Acetylcholinesterase Inhibitors: Contraindications

Back 27

urinary or gi obstruction

Front 28

Acetylcholinesterase Inhibitors: Adverse Effects

Back 28

nausea and vomit, diarrhea, bradycardia, hypotension, diaphoresis, miosis, muscle crams, fatigue, weakness, paralysis, hypertension, respiratory depression (nicotinic)

Front 29

Acetylcholinesterase Inhibitors: Interactions

Back 29

neostigmine and nondepolarizing neuromuscular blocking drugs (eg tubocurarine) decreases actions of latter drugs

Neostigmine potentiates depolarizing muscle relaxants increasing the length of time of muscle paralysis

Front 30

Acetylcholinesterase Inhibitors: Nursing Actions

Back 30

assess pt's neuromuscular status, gait, muscle strength, reflexes

Front 31

Random Facts
Acetylcholinesterase Inhibitors

Back 31

Curare: paralysis
(poison darts)

Front 32

Parasympatholytic: Definition

Back 32

Anticholinergic or cholinergic blocking drugs, block the action of acetylcholine at muscarinic receptors in the parasympathetic nervous system

Front 33

Parasympatholytic: I.E.

Back 33

Atropine, benztropine (Cogentin)
glycopyrrolate (Robinul)
propantheline (Promabthine)
thrihexylphenidyl (Artane)

Front 34

Parasympatholytic: Indications

Back 34

bradyarrhythmias (atropine and glycopyrrlate)
dyskinesis and parkinsonism (benzotropine and trihexphenidyl)
peptic ulcer and bowel spasm ( propantheline and glycopyrrlate)
mydriasis, acetylcholine antidote (atropine)
decrease saliva and bronchial secretions (atropine, scopolamine and glycoprrlate)

Front 35

Parasympatholytic: Contraindications

Back 35

narrow angle glaucoma, severe hemorrhage, uncontrolled tachycardia urinary or GI Obstruction

Front 36

Parasympatholytic: Adverse Effects

Back 36

tachycardia, constipation, urinary retention, dry mouth, blurred vision, photophobia

Front 37

Parasympatholytic: Interactions

Back 37

Antacids decrease absorption

tricyclic antidepressants may cause additive toxicity (anticholenergic effect)

Front 38

Parasympatholytic: Nursing Actions

Back 38

Monitor I/O
Admin ac and hs when used to decrease GI motility
Monitor OTC meds to prevent inx

Front 39

Random
Anticholinergic

Back 39

Belladonna (Constricts pupils)

Front 40

Chantix

Back 40

Used for smoking cessation.
more effective than Zyban

Front 41

Chantix Dosages and Forms

Back 41

Oral capsule One week titration
0.5mg once daily on days 1-3
0.5mg twice daily days 4-7
1mg twice a day for 12 weeks

Front 42

Chantix Adverse Effects

Back 42

N & V headache, insomania, dysgeusia (change in taste)

Front 43

Adrenergics: Actions

Back 43

Mimic or inhibit sympathetic act by activation or blocking alpha and beta receptors which are activated by the neurotransmitter norepinephrine or dopamine receptor activated by dopmine

Front 44

Adrenergics: Actions cont

Back 44

norepinephrine (focus)
dopamine (joy, attn, pleasure, too much, paranoia, cocaine acts pleasure circuit and prevents reabs of dopamine/ build up = euphoria)

Front 45

Adrenergics: Prototype

Back 45

epinephrine (Adrenalin)

sympathominmetic

Front 46

Adrenergic agonist (sympathomimetics) alpha adrenergic agonist: Actions

Back 46

Tx hypotension, increase blood pressure, eg norepinephrine (levophed)

Front 47

Beta I adrenergic agonist: Action

Back 47

Treat heart failure
increase cardiac output
heart rate
myocardial contractility and accelerate atrioventricular conduction eg dobutamine (Dobutex)

Front 48

Beta II adrenergic agonist: Action

Back 48

Treat asthma and allergies
cause bronchodilitation and peripheral vasodilation, eg albuterol (Proventil, Ventolin) and epinephrine (Adrenalin)

Front 49

Dopamine agonist: Action

Back 49

Treat mild renal failure caused by decreased cardiac output and dilate renal arteries in low doses eg dopamine (Intropin)

Front 50

Alpha Adrenergic blocking drugs: Action

Back 50

Treat peripheral vascular disorders, Raynaud's disease, vascular headaches by acting as smooth muscle relaxants and vasodilators
eg phentolamine (Regitine) and ergotamine tartrate with caffeine (Cafergot)

Front 51

Beta Adrenergic blocking drugs: Action

Back 51

Treat hypertension
prevent migraine headaches
MI
glaucoma
acute anxiety reaction (stage fright) by blocking myocardial stimulation and causing vasodilation reduced glycogenolysis and bronchodilation eg atenolol (Tenormin) and metaprolol (Lopressor)

Front 52

CNS Stimulants: Action

Back 52

Increase neurotransmitter levels in the CNS causing CNS and respiratory stimulation, pupil dilation, increased motor activity, mental alertness, decreased fatigue

Front 53

CNS Stimulants: I.E.

Back 53

dextroamphetamine (Dexedrine)
methylphendiate hydrochkirude (Ritalin, Concerta ER) Potential for abuse

Front 54

Strattera

Back 54

atomoxetine

increases norepinephrine for ADHD
in rare cases causes liver damage, not habit forming

Front 55

CNS Stimulants: Indications

Back 55

narcolepsy (dextroamphetamine)
ADHD (methylphendiate HCL)
respiratory stimulation after anesthesia (doxapram, Dopram)

Front 56

Botulinum Toxin

Back 56

inhibits release of acetylcholinesterase from motor neurons.
lasts 2-6 months
reduces involuntary muscle contraction