Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
195 Cards in this Set
- Front
- Back
|
What type of headache is characterized by unilateral throbbing head pain of moderate to severe intensity?
|
Migraine
|
|
|
The exact cause of migraine headache is not completely understood, although _______ and _________ are clearly involved.
|
Vasodilation/inflammation
|
|
|
In migraine headaches, the role of CGRP is to ______ migraine, whereas the role of 5-HT is to _____ migraine
|
Stimulate/suppress
|
|
|
Patients with migraine headaches who have mild to moderate symptoms should take ________ medications
|
Aspirin-like
|
|
|
Patients with migraine headaches who have moderate to severe symptoms should take an ___________ or a _________ medication
|
Ergot alkaloid/ triptan
|
|
|
If other agents fail to relieve the pain of a migraine headache a(n) ______ may be needed
|
Opioid
|
|
|
Antiemetics are an important adjunct to migraine therapy. The two most often used antiemetics are ________ and ________
|
Metochlorpramide/Prochlorperazine
|
|
|
The drug of choice for stopping an ongoing migraine attack is _____-
|
Ergotamine
|
|
|
A prominent effect of use of parenteral dihydroergotamine is ______
|
Diarrhea
|
|
|
The drugs of choice for preventing migraine headaches are the ________
|
Beta Blockers
|
|
|
______ is a general term defined as any drug, natural or synthetic, that has actions similar to those of morphine.
|
Opioid
|
|
|
______ is a term that has been used to mean an analgesic, central nervous system depressant and any drug capable of causing physical dependence.
|
Narcotic
|
|
|
Responses to the activation of __________ receptors include analgesia, respiratory depression, euphoria, sedation, and the development of physical dependence.
|
Mu
|
|
|
___________ is the prototype of the strong opioid analgesic and remains the standard by which newer opioids are measured.
|
Morphine
|
|
|
The most serious adverse effect of the opiods is _________
|
Respiratory Depression
|
|
|
When administered at usual therapeutic doses, opioids _________ cause significant respiratory depression. Often, Usually, Rarely, Never
|
Rarely
|
|
|
The adverse effect on the gastrointestinal system related to opioid use is ________
|
Constipation
|
|
|
How does the use of morphine elevate intracranial pressure?
|
Decreases respiratory CO2. Increases CO2 content of blood dilating cerebral vasculature. Causes intracranial pressure (ICP)to rise
|
|
|
Opioid overdose causes three major symptoms. What are they?
|
Coma, respiratory depression and pinpoint pupils
|
|
|
Use of meperidine is on the decline because of 3 major reasons. What are they?
|
Short 1/2 life, drug interactions, & toxic metabolite accumulation
|
|
|
The most effective dosing schedule for morphine is ______
|
Around the clock - ATC - fixed schedule
|
|
|
To minimize physical dependence and abuse, opioid analgesics should be administered how?
|
The lowest effective dosages for the shortest time period.
|
|
|
The underlying cause of the sypmtoms and signs of asthma is ____________
|
Immune mediated airway inflammation
|
|
|
The two major pharmacologic classes of drugs used to treat asthma are ________ and _________
|
Anti-inflammatories and bronchodilators
|
|
|
Beta2 agonists function by promoting _________
|
Bronchodilation
|
|
|
Glucocorticoids are indicated for the treatment of which type of asthma?
|
Chronic
|
|
|
Potential adverse effects of oral glucocorticoids include?
|
1.adrenal suppression 2.osteoporosis 3.hyperglycemia 4.peptic ulcer disease 5.growth suppression in young pts
|
|
|
How does the drug Cromolyn work?
|
Stabilizes the membrane mast cells so they can't release histamine & other mediators
|
|
|
What drug stabilizes the membrane of mast cells so that they can't release histamine & other mediators?
|
Cromolyn
|
|
|
The newest class of drugs for the treatment of asthma is the ____________
|
Leukotriene modifiers
|
|
|
The drug of choice for the treatment of exercise-induced bronchospasm is ____________
|
Cromolyn sodium
|
|
|
What is the substance that plays an important role in allergic reactions and regulation of gastric acid secretion?
|
Histamine
|
|
|
What does histamine do in the vascular system?
|
Dilates blood vessels and increases capillary permeability
|
|
|
What does histamine do in the bronci?
|
Constricts
|
|
|
What does histamine do in the stomach?
|
Stimulates acid secretions
|
|
|
What does histamine do to the central nervous system?
|
Acts as a neurotransmitter
|
|
|
________ and ________ are the two types of cells in which histamine is synthsized and stored
|
Mast cells and basophils
|
|
|
The initial requirement for allergic release of histamine is the production of antibodies of the _______ class
|
IgE
|
|
|
The principal causative agents in anaphylactic shick are ______
|
Leukotrienes
|
|
|
Overdose with antihistamines can produce _______.
|
CNS stimulation
|
|
|
Overdose of antihistamines can produce CNS stimulation which can result in ______
|
Convulsions
|
|
|
Despite their widespread presence in cold remedies, antihistamines are of _______ against the common cold
|
NO VALUE
|
|
|
The second-generation antihistamines exert little or no sedative effect because ___________
|
They don't cross the Blood Brain Barrier
|
|
|
The principal drugs used to treat allergic rhinitis include what 4 classes?
|
Oral antihistamines, intranasal glucocorticoids, intranasal cromolyn & sympathomimetics
|
|
|
What is the role of antihistamines in the treatment of the common cold?
|
Decrease rhinorrhea but not effective in reducing congestion - NO VALUE
|
|
|
What Is the role of antihistamines in the treatment of allergic rhinitis?
|
H1 blocker, decreases rhinorrhea, itching eyes nose and throat. Most helpful prophylactically - not much help after symptoms appear.
|
|
|
What is the only antihistamine available for intranasal use?
|
Azelastine
|
|
|
How does cromolyn work?
|
Decreases symptoms by suppressing histamine release & other mediators from mast cells
|
|
|
What drug is a monoclonal antibody that is directed against immunoglobulin E?
|
Omalizumab
|
|
|
The two most frequently used drugs for cough suppression are _____ & ______
|
Codeine and hydrocodone
|
|
|
_______ is the most effective non-opioid cough suppressant available
|
Dextromethorphan
|
|
|
What actions do Beta2 agonists have on the lungs?
|
Bronchodilators
|
|
|
How do Beta2 agonists work?
|
Selective activation of Beta2 receptors on smooth muscle in lungs promotes bronchodilation
|
|
|
Name 2 long acting Beta2 agonists
|
Salmeterol (Serevent) & Formoterol(Foradil)
|
|
|
Name 1 short acting Beta2 agonist
|
Albuterol (Proventil)
|
|
|
Which type of beta2 agonist do you use for quick relief?
|
Short acting
|
|
|
Which type of Beta2 agonist do you use on a fixed schedule?
|
Long acting
|
|
|
Can you "pre-treat" yourself for exercise induced asthma?
|
Yes - take SABA prophylactically immediately before exercise or Cromolyn 15 min before
|
|
|
Should spacers be used for any type of inhaler?
|
YES
|
|
|
What do leukotrienes do?
|
Promote bronchoconstriciton and eosinophil filtration causing mucus production and edema
|
|
|
What type of drug is Singulair?
|
Leukotriene blocker
|
|
|
Name a leukotriene blocker
|
Singulair
|
|
|
What is the purpose of inhaled glucocorticoids?
|
Anti-inflammatory
|
|
|
Why are inhaled glucocorticoids so great?
|
They are the most effective medication for the treatment of asthma
|
|
|
How do inhaled glucocorticoids work?
|
They suppress inflammation in the bronchi
|
|
|
Are inhaled glucocorticoids given PRN or on a fixed schedule?
|
Fixed schedule
|
|
|
Name 2 glucocorticoids
|
Budesomide (Pulmicort), Ciclesomide (Azmacort)
|
|
|
Which do you give first Albuterol or Pulmicort? Why?
|
Albuterol - to open bronchioles & allow more surface area for pulmicort to work on
|
|
|
Why is Cromylin so safe and effective?
|
Only 8% is absorbed in the lungs & it is excreted in the urine unchanged. Suppresses inflammation
|
|
|
Name an anticholinergic drug
|
Ipratropium (Atrovent)
|
|
|
What does Ipratroprium (Atrovent) do?
|
Promotes bronchodilation
|
|
|
What is Ipratroprium (Atrovent) mainly used to treat?
|
COPD
|
|
|
What type of drug is Ipratroprium (Atrovent)?
|
Anticholinergic
|
|
|
Atrovent is a drug used for COPD. Can it be prescribed for asthma as well?
|
YES
|
|
|
What does Theophylline (TheoDur) do to help with COPD?
|
CNS excitation and bronchodilation
|
|
|
What is a COPD medication that is occasionally used as an IV drip in critical care?
|
Amminophylline
|
|
|
Why is it important for people with COPD do get their flu and pneumonia vaccines?
|
Do decrease the incidence of illness and death
|
|
|
How often should a person with COPD get a flu shot?
|
EVERY YEAR
|
|
|
How often should a person with COPD get a pneumococcal vaccine?
|
Every 5-10 years
|
|
|
Is COPD a reversible disease?
|
Not Fully NO!
|
|
|
Why does morphine help dyspnea?
|
Mu receptors located in the lung
|
|
|
Where is histamine synthesized and stored?
|
In Mast cells
|
|
|
What are the S/S of H1 receptor stimulation?
|
1.Vasodilation 2.Increased capillary permeability 3.bronchoconstriction 4.mucus secretion 5.sensory nerves - itching & Pain
|
|
|
What receptors do antihistamines block?
|
H1 receptors
|
|
|
What type of drug is the first line therapy for allergic rhinitis?
|
Anti histamines
|
|
|
Give an example of a 1st generation antihistamine
|
Diphenhydramine (Benadryl)
|
|
|
What is a side effect of diphenhydramine?
|
It is highly sedating
|
|
|
Give 4 examples of 2nd generation antihistamines
|
Loratadine (Claritin), Astelin, Astepro, Pantanase
|
|
|
What are some side effects of 2nd generation antihistamines?
|
Drowsiness and headache
|
|
|
What are 2 benefits of 2nd generation antihistamines?
|
Less sedating and they don't cross the BBB
|
|
|
What are the side effects of anticholinergic drugs?
|
Blurred vision, drying effects in the mucosa, constipation (can't see, can't pee, can't spit, can't poop)
|
|
|
Name 2 glococorticoids
|
Flonase, Nasonex
|
|
|
What type of allergy medication is given orally?
|
Leukotriene antagonist
|
|
|
Why does Singulair (a leukotriene antagonist) have little impact in itching/sneezing?
|
They don't block histamine receptors
|
|
|
What is the term for a complex reflex involving the CNS, peripheral nervous system and the muscles of respiration?
|
COUGH
|
|
|
Why is a cough often beneficial?
|
It brings the mucus up out of the lungs (mucus can trap bacteria)
|
|
|
When should a cough be suppressed?
|
When it is non-productive, associated with a cold or caused by an upper respiratory infection
|
|
|
How do opioid anti-tussives work?
|
They act in the CNS to elevate the cough threshold
|
|
|
What is the most commonly used opioid anti-tussive?
|
Codeine
|
|
|
What is the most commonly used non-opioid anti-tussive?
|
Dextromethorphan
|
|
|
Name one side effect of dextromethorphan?
|
Can cause hallucinations in high doses
|
|
|
Can dextromethorphan reduce pain?
|
YES
|
|
|
Is Benadryl an anti-tussive?
|
YES - in larger doses
|
|
|
What medication makes a cold go away?
|
NONE
|
|
|
What type of medication may be helpful during a cold to dry up mucus membranes?
|
Antihistamines
|
|
|
What type of medication may be helpful during a cold to relieve nasal congestion?
|
Decongestants
|
|
|
Name 1 decongestant that is and oral tablet or a liquid
|
Pseudoephedrine (Sudafed)
|
|
|
Name 1 decongestant that is a nasal spray
|
Phenylephrine (Neo-Synephrine)
|
|
|
What is a side effect of using decongestant nasal sprays?
|
Rebound nasal congestion
|
|
|
How can rebound nasal congestion be limited when using decongestant nasal sprays?
|
Don't use more than 3 days
|
|
|
What are the 3 properties of an "ideal" drug?
|
Effectiveness, safety and selectivity
|
|
|
What does the term agonist mean?
|
It makes something work better - activates receptors
|
|
|
Name a drug that is an agonist
|
Morphine
|
|
|
What does the term antagonist mean?
|
It prevents receptor activation
|
|
|
Name a drug that is an antagonist
|
Naloxone
|
|
|
What is the term that refers to the dose that is effective in 50% of people?
|
ED50
|
|
|
What is the term that refers to the dose that is lethal to 50% of people?
|
LD50
|
|
|
What is the drug metabolizing enzyme system that inactivates drugs and can also accelerate them?
|
Cytochrome P-450
|
|
|
Name 2 prodrugs
|
Codeine and morphine
|
|
|
What is a prodrug?
|
|
|
|
What is the term that means the ability of a drug to reach systemic circulation from the site of administration?
|
Bioavailability
|
|
|
What is the term that means the ability to change a drug into a water soluble form?
|
Biotransformation
|
|
|
Where in the body does biotransformation primarily occur?
|
LIVER
|
|
|
Where in the body other than the liver can biotransformation occur?
|
Plasma, kidneys, and membranes of intestines
|
|
|
What are 2 diseases that can slow metabolism?
|
Cirrhosis and CHF
|
|
|
What is the term that refers to the amount of drug given to ellicit an effect?
|
Potency
|
|
|
What is the term that refers to the minimum amount of drug necessary to get a response?
|
Plasma drug level
|
|
|
What is the term that refers to how a drug moves across a membrane into the blood?
|
Absorption
|
|
|
What are 5 things that can affect absorption?
|
1.Surface area 2.how fast drug dissolves 3.blood flow 4.lipid solubility 5.pHpartitioning
|
|
|
What is the term that refers to how a drug is delivered to the site of action?
|
Distribution
|
|
|
What is the term that means the process to remove drugs from the body?
|
Excretion
|
|
|
The ______ rate (a process to remove drugs from the body) determines drug concentration in tissues and affects the duration of a drugs action
|
Excretion
|
|
|
What does a bolus or a loading dose do?
|
It brings concentration of drug in the blood up to a certain level where a normal dose can then be administered
|
|
|
What is the term that refers to rapid hepatic inactivation of certain oral medications?
|
First pass effect
|
|
|
What does the first pass effect refer to?
|
Rapid inactivation of certain oral medications in the liver
|
|
|
What does a narrow therapeutic index mean in reference to the safety of a drug?
|
It means the drug is relatively UNSAFE
|
|
|
What does a large therapeutic index mean in reference to the safety of a drug?
|
It is relatively SAFE
|
|
|
What must you watch for in a patient taking a drug with a narrow therapeutic index
|
Toxic Side effects
|
|
|
Name a drug with a narrow therapeutic index
|
Digoxin
|
|
|
How might age effect drug metabolism, absorption etc…
|
1.Organ degeneration 2.increased severity of illnesses 3.multiple diseases 4.tx w/multiple drugs
|
|
|
What type of medication is on the first step of the WHO step ladder?
|
Non-opioids
|
|
|
What type of medication is on the second step of the WHO step ladder?
|
Opioid for mild to moderate pain as well as non-opioid and adjuvant medication
|
|
|
What type of medication is on the third step of the WHO step ladder?
|
Opioid for Moderate to Severe pain as well as nonopioid and adjuvant medication
|
|
|
What is the most important VS to watch when a patient has been given opioids?
|
Respirations
|
|
|
What drug is 100 times stronger than Morphine Sulfate?
|
Fentanyl
|
|
|
What is the name of the PO form of Fentanyl?
|
Actiq
|
|
|
What is the name of the IV form of Fentanyl?
|
Sublimaze
|
|
|
What is the name of the transdermal form of Fentanyl?
|
Durageisic
|
|
|
What are the receptors that are activated by opioids to induce euphoria?
|
MU
|
|
|
What type of headache produces a non-throbbing, band-like pain?
|
Tension Headaches
|
|
|
What type of headache is more common in men?
|
Cluster Headaches
|
|
|
Name 3 drugs used to treat cluster headaches
|
Verapamil, prednisone, lithium
|
|
|
What type of medications are used to treat tension headaches?
|
OTC
|
|
|
What type of headache is described as a punding, throbbing, unilateral headache with severe pain?
|
Migraine
|
|
|
What type of headache can cause an aura?
|
Migraine
|
|
|
IS migraine headache more common in women or men?
|
WOMEN
|
|
|
What type of headache can be generated by neural events that trigger vasodilation?
|
Migraine headache
|
|
|
What type of headache can be caused by overuse of abortive headache medications?
|
MOH - medication overuse headache
|
|
|
How do you treat an MOH headache?
|
d/c use of medications causing the HA, limit medication use and alternate types of medication used for HA
|
|
|
What is the difference between nociceptive and neuropathic pain?
|
Nociceptive - injury to tissues; Neuropathic- injury to peripheral nerves
|
|
|
What type of drug would be appropriate for chronic pain?
|
Ibuprofen
|
|
|
What type of drug would be appropriate for severe acute pain?
|
Morphine
|
|
|
What class of drug is an analgesic and a CNS depressant?
|
Opioids
|
|
|
Name the three opioid receptors
|
Mu, Kappa, Delta
|
|
|
Name a drug that is a mu receptor agonist
|
Morphine
|
|
|
Name a drug that is mu receptor antagonist
|
Naloxone
|
|
|
Name one drug that is an agonist-antagonist
|
Pentazocine
|
|
|
What are 4 adverse effects of opioids?
|
Respiratory depression, sedation, constipation and nausea
|
|
|
What is the cheapest and most non-invasive form of medication administration?
|
PO
|
|
|
What form of medication administration can be painful and sometimes unreliable?
|
IM
|
|
|
What form of medication administration is most likely to have severe adverse effects?
|
IV
|
|
|
What does the acronym ATC mean?
|
Around the Clock
|
|
|
Why is the drug meperidine not used much anymore?
|
It has a short half life and can accumulate toxic metabolites
|
|
|
What kind of dosing schedule is best for people who have cancer?
|
Around the Clock dosing
|
|
|
Should one worry about dependence/addiction to narcotics in clients with cancer?
|
NO
|
|
|
Is there an upper limit to opioid dosage for a client with cancer?
|
NO
|
|
|
What type of medication administration has a rapid, prolonged action?
|
Epidural, intrathecal
|
|
|
How can respiratory depression be managed in a patient on opioid medication?
|
Don’t use with CNS depression and hold if respirations are less than 12/min
|
|
|
Can a tolerance be developed to respiratory depression in a patient taking opioids?
|
YES
|
|
|
How can sedation be managed in a patient taking opioids?
|
Smaller doses more often, choose opioids with a shorter 1/2 life
|
|
|
How can constipation be managed in a patient taking opioids?
|
Increased fiber intake, increased fluids, laxatives or stool softeners
|
|
|
How can nausea be managed in a patient in a patient taking opioids?
|
Remain still, pre-treat with antiemetic
|
|
|
Can tolerance to constipation be developed in a patient taking opioids?
|
NO
|
|
|
Can tolerance to nausea be developed in a patient taking opioids?
|
YES
|
|
|
Name one headache medication that will not cause MOH
|
Dihydroergotamine
|
|
|
Name one NSAID medication used for headache
|
Ibuprofen
|
|
|
Name one opioid analgesic medication used for the treatment of migraine headache
|
Stadol
|
|
|
Name one Ergot Alkaloid medication used in the treatment of migraines
|
Ergotamine or Dihydroergotamine (DHE)
|
|
|
Name one triptan medication used in the treatment of migraine headaches
|
Imitrex
|
|
|
Name 4 types of abortive headache medications used for migraines
|
NSAIDs, Opioid Analgesics,Triptans, Ergot Alkaloids
|
|
|
Name 4 types of medications used for the PREVENTION of migraine headaches
|
Beta blockers, Calcium Channel Blockers, Anti-epiliptic Drugs, Tri-Cyclic Anti-Depressants
|
|
|
Name one beta blocker used for the prevention of migraine headaches
|
Propranolol
|
|
|
Name one calcium channel blocker used in the prevention of migraine headaches
|
Verapamil
|
|
|
Name one Anti-epileptic drug (AED) used in the prevention of migraine headaches
|
Depakote
|
|
|
Name one Tri-Cyclic Antidepressant (TCA) used in the prevention of migraine headaches
|
Amitriptyline
|
