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70 Cards in this Set
- Front
- Back
Common side effect of hypnotic agents
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Sedation
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Occurs when sedative hypnotics are used chronically or at high doses
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Tolerance
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The most common type of drug interaction of sedative hypnotics with other depressant medications
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Additive CNS depression
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Benzodiazepines used to promote sleep
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Triazolam, Tem-aza-pam, Flu-raz-e-pam
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Benzodiazepine used for anxiety
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Alprazolam
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Non-benzodiazepine used as an anxiolytic
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Buspirone
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Non-benzodiazepine used for sleep
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Zolpidem
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Major effect of benzodiazepines on sleep at high doses
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Decreased REM
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Neurologic SE of benzodiazepines
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ANTEROgrade Amnesia
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Reason benzos are used cautiously in pregnancy
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Ability to cross the placenta
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Main route of metabolism for benzodiazepines
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Hepatic
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Benzodiazepine that undergo extrahepatic conjugation (useful in older or hepatically impaired patients)
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(LOTs) Lorazepam, Oxazepam, Temazepam
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MOA for Benzos
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Increase FREQUENCY of GABA-mediated Chloride Ion channel opening
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Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects)
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Flumazenil
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Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin
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Diazepam
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Benzodiazepine that has efficacy against absence seizures, and in anxiety states, such as agoraphobia
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Clonazepam
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Benzodiazepines that are the most effective in the treatment of panic disorder
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Alprazolam, Clonazepam (Panic = Hot, Turn on the AC)
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Benzo used for anesthesia
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Midazolam
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DOC for status epilepticus
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Diazepam
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Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs
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(Alcoholics listen to CD's) Chlor-diaz-epoxide, Diazepam
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Agents having active metabolites, long half lives, and a high incidence of adverse effects
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(D [the] FCC) Diazepam, Flurazepam, Chlordiazepoxide, Clorazepate
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Barbiturates may precipitate this hematologic condition
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Acute Intermittent Porphyria
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Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property
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Liver enzyme INDUCTION
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Barbiturates MOA
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Increase the DURATION of GABA-mediated chloride ion channels
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Barbiturate used for the induction of anesthesia
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Thiopental
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Site of action for zaleplon and zolpidem
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Benzodiazepine receptor BZ1 (although are not considered benzodiazepines)
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Good hypnotic activity with less CNS SE than most benzodiazepines
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(get your ZZ's) Zolpidem (Ambien), Zaleplon (Sonata)
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Partial agonist for the 5-HT1A receptor
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Buspirone
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DOC for Generalized Anxiety Disorder, NOT effective in acute anxiety
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Buspirone
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Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS)
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Ethanol
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Agent with zero-order kinetics
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Ethanol
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Rate limiting step of alcohol metabolism
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Aldehyde dehydrogenase
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System that increases in activity with chronic exposure and may contribute to tolerance
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MEOS
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Agent that metabolize acetaldehyde to acetate
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Aldehyde dehydrogenase
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Agents that inhibit alcohol dehydrogenase
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Disulfiram, metronidazole, certain sulfonylureas and cephalosporins
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Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension
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Disulfiram
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The most common neurologic abnormality in chronic alcoholics
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Peripheral neuropathy (also excessive alcohol use is associated with HTN, anemia, and MI)
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Agent that is teratogen and causes a fetal syndrome
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Ethanol
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Agent that is the antidote for methanol overdose
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Ethanol
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Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure
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Fomepizole
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MOA of general anesthetics
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Most are thought to act at GABA-A receptor - chloride channel
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Inhaled anesthetic with a low blood/gas partition coefficient
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Nitrous oxide
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Inversely related to potency of anesthetics
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Minimum alveolar anesthetic concentration (MAC)
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Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents
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Halothane and methoxyflurane
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Most inhaled anesthetics SE
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Decrease arterial blood pressure
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Inhaled anesthetics that are myocardial depressants
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Enflurane and halothane
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Inhaled anesthetic causes peripheral vasodilation
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Isoflurane
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Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis
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Halothane
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Inhaled anesthetic, less likely to lower blood pressure than other agents, and has the smallest effect on respiration
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Nitrous oxide
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Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency
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Methoxyflurane
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Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia
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Nitrous oxide
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Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm
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Desflurane
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DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics
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Dantrolene
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IV barbiturate used as a pre-op anesthetic
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Thiopental
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Benzodiazepine used adjunctively in anesthesia
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Midazolam
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Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose
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Flumazenil
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This produces "dissociative anesthesia", is a cardiovascular stimulant which may increase intracranial pressure, and hallucinations occur during recovery
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Ketamine
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Opioid associated with respiratory depression, but is used in high risk patients who may not survive full general anesthetia
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Fentanyl
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State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide
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Neuroleptanesthesia
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Produces both rapid anesthesia and recovery, has antiemetic activity and commonly used for outpatient surgery, may cause marked hypotension
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Propofol
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Slightly increased risk of breast cancer, endometrial cancer, heart disease (questionable), has beneficial effects on bone loss
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Estrogen
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Antiestrogen drugs used for fertility and breast cancer respectively
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Clomiphene and tamoxifen
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Common SE of tamoxifen and raloxifene
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Hot flashes
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Estrogen mostly used in oral contraceptives (OC)
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Ethinyl estradiol and mestranol
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Anti-progesterone used as abortifacient
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Mifepristone (RU-486)
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Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)
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Combination oral contraceptives (OC)
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Oral contraceptive available in a transdermal patch
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Ortho-Evra
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5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness
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Finasteride (Proscar and Propecia respectively)
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Anabolic steroid that has potential for abuse
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Nandrolone and stanozolol
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Anti-androgen used for hirsutism in females
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Cyproterone acetate
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