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172 Cards in this Set
- Front
- Back
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Allergic Rhinitis |
allergic rhinitis and asthma often coexist, and the txs for each often overlap
allergic rhinitis is caused by histamine release nonallergic rhinitis = common cold, infection |
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Antihistamines
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-alpha-adrenergic agents
- compete with histamine and block H1 receptor sites - prevent histamine from reaching exposed tissue - greatest therapeutic effect on nasal allergic reactions - not effective on histamines that are already attached to their receptor sites. Therefore most effective if taken before contact with an allergen. -OTC antihistamines are also used to treat motion sickness and prevent N/V |
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Cautions of Antihistamines
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-tolerance can develop
-also used as sedatives due to a side effect of sedation -drug action time is usually 15-60 minutes |
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Chronic Obstructive Pulmonary Disease (COPD)
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4th leading cause of death in US
COPD comprises two dzs: emphysema chronic bronchitis |
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Goals of Drugs (COPD)
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cause bronchodilation or reduce inflammation
* beta 2- adrenergic agonists primarily achieve this function, but anticholinergics may also be used Moderate to severe COPD requires corticosteroids to reduce inflammation severe COPD may need repeated antibiotics, as well as long-term oxygen therapy |
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Agents that Tx Cough
2 Main Categories |
Antitussives reduce the urge to cough
-generally treat dry coughs Expectorants/Mucolytic Agents loosen mucous in LU for easier expulsion -stimulate respiratory tract secretions, and decrease viscosity of the mucous. |
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Antitussives
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Codeine** (and other opiates)
act on cough centers in CNS, decrease their sensitivity to peripheral stimuli ** codeine also causes sedation ** codeine may or may not require Rx, depending on state Recall that codeine works on the CNS for its effects on the Respiratory (& other) systems |
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Expectorants/ Mucolytic Agents
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Guaifenesin
- generic name for all expectorants listed in integrated pharmacology (Mucinex, Robitussin, Anti-Tuss, Guaifenex) -may cause kidney stones when used in large quantities Dextromethorphan - found in many OTC cold and cough medications (Robitussin, Vicks, Sucrets Cough, Tussidex, Triaminic, Dayquil, Mucinex) |
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Selective Serotonin Reuptake Inhibitors (SSRIs)
prescribed for: |
Depression
generalized anxiety disorder panic disorders OCD Pain |
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SSRIs
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prevent reuptake of serotonin from synaptic cleft
Side effects: n/v and HA can also precipitate suicidal effect with major depression |
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EX of SSRIs
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Fluoxetine (Prozac, Sarafem, Symbyax)
Sertraline (Zoloft) |
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Serotonin syndrome
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concern with MAOIs + SSRIs: muscle fasciculations, akathisia-like restlessness, sweating, erection, tremors, myoclonus, hyperreflexia, shivering, seizures, coma
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Monoamine Oxidase Inhibitors (MAOIs)
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Prescribed for:
Atypical depression |
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MAOIs Side Effects
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drowsiness
orthostatic hypotension blurred vision dry mouth constipation dysuria |
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MAOIs and Tyramine
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Inhibition of MAO may cause adverse reactions to foods containing tyramine:
aged cheeses chicken liver beer and red wine overripe and dried fruit, esp avocados, eggplant, figs, grapes, oranges, plums, prunes, raisins processed foods soy nuts: peanuts, coconuts, brazil nuts chocolate banana peels |
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MAOIs - drug interactions
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Serotonin syndrome can be caused by concurrent administration MAOIs and
SSRIs |
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Dopamine Reuptake Inhibitor
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Bupropion (budeproin, buproban, wellbutrin, zyban)
Tx depression, SAD, and smoking cessation (zyban) mechanism not fully understood reuptake inhibition of 5HT, DA, NE thought to affect NE and/or DA > 5HT * May alter the effects of Warfarin |
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Mania
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DSM-IV: at least one week period of abnormally and persistent elevation in expansive and irritable moods
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Mania Tx
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Lithium (Li) is used to tx mania acutely and prophylactically. Acute tx will often include an anti-psychotic d/t Li's slow onset of action.
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Lithium
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common side effects
nausea diarrhea drowsiness polyuria polydipsia weight gain fine hand tremor skin reactions (i.e. acne) |
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Lithium drug interactions
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anticholinergic agents and other substances that affect GI motility: may alter blood concentrations of Li
*the narrow TI indicates extreme caution be taken when Rx CHM with Li. This drug should not be used with CHM w/o direct medical supervision/permission |
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Neuroleptics/Antipsychotics
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antischizophrenics
tx schizophrenia Block dopamine and serotonin receptors-preventing activation (opposite of Parkinson's drugs) |
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Ex of typical/traditional Neuroleptics
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Haloperidol - Haldol
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Endogenous Opioid Peptides
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Acupuncture does this too:
by releasing endogenous opioid peptides 1. Endorphins relieves pain 2. Enkephalins increase pain threshold 3. Dynorphins can inhibit dopamine release |
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Opioid Analgesics and Antagonists treatment for:
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pain, mb w/ associated anxiety
Oxycodone/Oxycontin manage opioid addictions Methadone antitussives Codeine |
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Mechanisms of Opioids
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3 major opioid receptors
k (mostly kappa receptors), u (mu), delta |
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Opioids side effects
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codeine not to be used by breast feeding women
addiction constipation sedation |
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Common Adverse Effects of Opioids
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remember, this is suppression of the CNS - NOT the same as stimulation of the parasympathetic
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Inflammation
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inflammation is a normal and healthy process
the normal response to tissue injury caused by infection, physical trauma, noxious chemicals the body's effort to inactivate/destroy invaders, remove irritants, and set the stage for tissue repair when the healing process is complete, the inflammation process generally subsides |
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general manifestations of inflammation
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redness
heat swelling pain dysfunction |
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Pathways of Inflammation
Arachidonic Acid/COX/LOX |
arachidonic acid = AA
arachidonic acid is mobilized into the interior of mast cells by phospholipases, phospholipase A2 in particular. AA is then transformed into other inflammatory mediators by a COX (Cyclo-oxygenase) enzyme |
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Cyclo-oxygenase Enzymes
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Cox 1:
-found normally in most cells, generally associated with normal physiological functioning -required for protection of GI mucosa, maintenance of renal function, control of hemostasis - on a normal basis Cox 2: induced by the inflammatory process -upregulated by cytokines and other cellular signals |
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NF-KB
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nuclear factor KB
creates inflammation *remember that this involves complex pathways and cascades *NF-KB will generally have a role in inducing other inflammatory pathways - i.e. increasing production of COX-2 *abnormal regulation of NF-KB can lead to pathology |
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Pathological Inflammation
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Inflammation becomes a pathological process when it is:
Extreme (sepsis, anaphylaxis) Progressively destructive (reperfusion injury after certain types of chemical injury or frostbite) Persistent or recurrent (chronic inflammatory diseases/conditions) |
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Chronic Inflammatory Processes
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levels elevated but not as high as acute inflammation
think "slow smoldering fire" vs. "inferno" (acute inflammation) ex: (autoimmune) asthma osteoarthritis rheumatoid arthritis systemic Lupus erythematosus thyroiditis diabetes mellitus neurodegenerative disorders |
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common triggers of inflammation
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farm raised beef and pork
wheat corn potatoes eggplant tomatoes anger hostility depression shame stress |
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NSAIDs
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Non-Steroidal Anti-Inflammatory Drugs
inhibit prostaglandin (PG), etc. synthesis by blocking COX enzymes Some are selective for COX-2 |
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Common NSAIDs
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Celecoxib is a COX-2 selective inhibitor
*Aspirin *Naproxen ( Aleve, Naprosyn) these are both COX-1 and COX-2 *Celecoxib (Celebrex) - only one that is COX-2 specific |
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NSAIDs Adverse Effects
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all except aspirin may increase risk of CV events (MI, CVA, increase HTN)
all increase risk of GI irritation, ulceration, hemorrhage, and perforation. may cause Kidney toxicity Celecoxib inhibits CYP2D6 and can cause increase levels of some beta blockers, anti-depressants, and anti-psychotic drugs. *Do not take aspirin 1 week before surgery * Aspirin is contraindicated in children with viral infections or any fever-causing illness. |
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COX Enzymes - Inhibitors
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inhibited by NSAIDs (including aspirin and ibuprofen), COX-2 Inhibitors (specific to COX-2)
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Inhibitors of Phospholipase A2
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The enzyme that converts phospholipids from the membrane into AA
inhibited by: corticosteroids Vitamin E |
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Inhibitors of NF-KB
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bringing down inflammation
Antioxidants omega 3 fatty acids: EPA, DHA Clove Ginger |
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Other ways to reduce inflammation
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adequate sleep
exercise whole foods diet/ eating close to nature |
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Functions of the Digestive System
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food digestion
secretion of hormones - insulin fluid and electrolyte imbalance - too much Vit C = watery diarrhea |
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gastro-colic reflex
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food in ST increases colonic motility
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Orthocolic Reflex
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getting out of bed
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Stimulation of HCl
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Cephalic phase
- stim of Vagus Nerve = Stim parietal cells Gastric Phase - Distention of ST = stim Vagus Nerve and parietal cells |
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Functions of HCl
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digestion of food
-activates pepsin (protease that initiates protein digestion) barrier against micro-organisms |
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GERD
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gastro-esophageal reflux disease
reflux of acid from ST to esophagus - Irritation of the LES = less effectiveness in closure = ST acid in lower esophagus |
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Hyperchlorhydria
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RARELY a factor in GERD. The vast majority of pts with GERD have normal or insufficient amounts of acid secretion
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Peptic Ulcers
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1) Gastric: Erosion of the mucosal lining of ST
2) Duodenal: erosion of 1st part of SI. Can be life-threatening if hemorrhage/perforation. - epigastric pain 1-3 hrs after meal |
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Common causes of peptic ulcers
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1. the presence of Helicobacter pylori bacteria. This bacteria can be difficult to eradicate.
2. Increased HCl secretion in the ST ( uncommon) 3. Inadequate mucosal protection against ST acid (this can be caused by longterm over us of NSAIDs). |
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Common contributing factors with peptic ulcers
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emotional stress
manual labor lower socioeconomic status |
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Antacids
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used to tx both peptic ulcers and GERD
overuse can interfere with proper digestion. Normal gastric pH is 2.5... highly acidic -usual dosage is 7 times per day Families of antacids are classified by their formulations: Aluminum (Al) compounds = constipation Magnesium (Mg) compounds = diarrhea Calcium (Ca) compounds = constipation |
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Cautions for Antacids
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commom side effects
constipation electrolyte imbalances Chronic use caused acid rebound |
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Prescription Drugs for GERD and PUD
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Goals of treatment:
Decrease amount of acid secreted into the ST - Proton Pump Inhibitors (PPIs) - don't make so much acid Protect mucosal layer |
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Proton - Pump inhibitors
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Stronger and more commonly prescribed than other agents
Nexium Prevacid Prilosec reduces acidity of gastric secretion by affecting the proton pump that pumps H+ ions into the stomach lumen. This is the final step in gastric acid secretion from the parietal cell. |
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H2 - Histamine Antagonists
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Tagamet (Cimetidine)
Reversibly act on histamine receptors (H2) that activate adenylate cyclase, the enzyme that produces cAMP, which activates the proton pump. Side effects: HA Diarrhea |
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Prostaglandins
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reduces the acidity of gastric secretions by affecting the proton pump that pumps H+ ions into the stomach lumen. Milder acting than proton pump inhibitors.
* CI in pregnancy - possible uterine contractions |
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Antimuscarinic Agents
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decrease GI motility
decrease gastric secretions Recall that they block the normal functioning of cholinergic receptors, which activate the proton pump. |
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H. pylori
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strongly associated with duodenal ulcer and antral gastritis. Less so with gastric ulcer.
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Antimicrobial Agents to Eradicate H. pylori
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used in patients with peptic ulcer in conjunction with other treatments.
Bismuth: antimicrobial and helps to form protective mucosal lining |
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LES
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lower esophageal sphincter
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Antidiarrheals
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3 main types of drugs:
1. Antimotility 2. Adsorbents 3. Agents that modify fluid and electrolyte transport |
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Antimotility agents
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decrease peristalsis and slow the action of the intestines by activating presynaptic opiod receptors in the enteric nervous system, inhibiting acetylcholine release.
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Adsorbents
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- absorb intestinal toxins or microorganisms by protecting or coating the mucosa
- as a laxative, this agent provides bulk * CAUTIONS adsorbents can interfere with the absorption of other drugs. Should be administered at least 2 hours before or after other drugs. |
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Laxatives
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used to induce defecation. Therapeutically used to treat constipation.
3 categories: 1. Irritants and stimulants 2. bulking agents 3. stool softeners |
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Irritants and stimulants
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irritate the GI tract and increase peristalsis
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Bulking Agents
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Fiber and other undigestible foods that form a gel in the intestines by absorbing water and causing intestinal distension. This stimulates peristalsis. Polyethylene glycol and lactulose are osmotic agents. They cause water to stay in the intestines, and have a very similar effect as bulking agents.
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Stool softeners
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soften the stool by being dispersed into the stool, allowing for easier passage of stool.
common side effects: electrolyte imbalances habituation |
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Respiratory System
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functions optimally when the airway is open (patent) and normal secretions are maintained. The mucous of the respiratory tract protects the upper respiratory tract from toxins.
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Respiratory Control
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the ANS innervates the tracheobronchial tree and the medulla controls breathing - involuntary process
- Chemoreceptors and baroreceptors in the carotid arteries stimulate respiratory responses - respiratory responses are controlled by fear pain stress exercise blood pressure body temp blood oxygen levels |
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Asthma
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- growing in prevalence in US
- disease of inflammation in airways - many things may trigger inflammation including: allergies/ inflammatory reactions cold air exercise emotions viral infections |
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Temporary bronchoconstriction in asthma is due to 3 main mechanisms
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- smooth muscle contraction causing narrowing of airways
- increased mucus secretion - inflammation causing swelling of the airway |
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Agents used to treat Asthma
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adrenergic agonists
anticholinergic agents 5-Lipoxygenase inhibitors leukotriene receptor antagonists corticosteroids mast cell stabilizers theophylline derivatives |
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Asthma: First Line Drugs
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Inhaled beta adrenergic agonists:
- directly activate beta adrenergic receptors that relax the smooth muscle of the airways. - directly counter sm. muscle contraction, mucus secretion, and inflammation |
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Short acting agonists
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rapid onset of action
treat acute attacks for 4-6 hours primary agents for acute treatment Albuterol and Tertbutaline |
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Long acting agonists
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slow onset
longer duration of action prevent attacks from occurring, rather than treating acute episodes Salmeterol and Formoterol **FDA warning on the use of these drugs: more asthma-related deaths in pts using these in combination with other tx than with 1st line tx alone |
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Asthma Anticholinergic Agents
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anticholinergic agents block Vagus nerve impulses that contract the smooth muscle of the airway and stimulate mucous secretion
Used in pts that cannot tolerate adrenergic agonists (i.e. not 1st line) |
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Leukotriene Receptor Antagonists
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Leukotrienes (LT):
- some casue greater infiltration of immune and inflammatory cells, exacerbating symptoms - others directly cause smooth muscle contraction and edema 5-Lipoxygenase (5-LOX): enzyme in mast cells, basophils, eosinophils, and neutrophils that converts arachidonic acid to leukotriens - both prevent normal induction of this inflammatory pathway - Used in the long-term prevention of asthma, NOT acute treatment - By adding these agents to treatment it is possible to reduce adrenergic agonist and corticosteroid use. |
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Corticosteroids
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- If asthma persists, corticosteroid use is considered necessary
- Corticosteroids reduce inflammation reduce number inflammatory cells and their activity in the lungs reduce edema in the airways decrease capillary permeability inhibit release of leukotrienes/ LTs (regulators of inflammation and allergic reactions) generally inhaled, but in severe cases can be taken orally |
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Mast Cell Stabilizers
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- help prevent allery - and exercise-induced asthma
- useful for prevention, but NOT tx of acute attacks - prevents release of histamine, LT and other chemicals of inflammation from mast cells - can cause a bitter taste in the mouth and can irritate the pharynx and larynx |
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Histamine
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-protects the body from environmental factors that produce allergic and inflammatory reactions
- greatest concentration is in the skin - actions: dilate blood vessels contract smooth muscle of bronchial tree contract smooth muscle of GI tract Histamine release can be prevented by mast cell stabilizers Histamine release can cause: sneezing increased nasal secretions itchy, watery eyes Broncho-constriction |
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Theophylline derivatives
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Theophylline was a widely used asthma agent and one of the first discovered. Its use has largely been replaced by adrenergic agonists and corticosteroids
- causes bronchodilation - Theophylline and derivatives: narrow TI - OD can cause seizures and possibly fatal arrhythmias. |
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Chemotherapeutic Agents
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agents that selectively kill or destroy an organism or disease without killing the host.
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Cancer
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unregulated cell growth with the potential to invade other tissues
starts out with self- the body's own cells Tx is very difficult and harsh as there is much similar about the cancerous cells and healthy cells |
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Oncogenesis
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3 key steps:
1. Initiation 2. Promotion 3. Progression Cancer occurs from these changes in this order |
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Initiation
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essentially irreversible damage at cellular level (i.e. radiation, oxidative stress, toxins)
- caused by carcinogenic compounds -occurs rapidly after carcinogen exposure |
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Promotion
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-reversible
-acts only after exposure to an initiating agent -requires repeated administration of a promoter - requires the presence of continuous stimulation which may enhance the possibility of additional genetic alterations |
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Progression
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cancerous growth is no longer dependent on the promoter and growth is autonomous.
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Cardio Vascular System
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the CV system consists mainly of the Heart, Blood Vessels, and Blood.
The right side of the Heart pumps blood through the pulmonary circulation - where O2 and CO2 are exchanged The left side of the Heart pumps blood into systemic circulation to supply the rest of the tissues with oxygen and nutrients as well as to carry waste away from these tissues, ideally to disposal. |
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Blood Pressure
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CO X TRP = BP
CO= cardiac output TRP = total peripheral resistance SV = stroke volume HR = heart rate |
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Cardiac Output
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volume of blood ejected by the ventricles of the heart = SV x HR
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Stroke Volume
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how much blood pushed through contraction of Heart
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Total Peripheral (vascular) Resistance
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degree of resistance to blood flow from systemic blood vessels
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Renin
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an enzyme produced by the kidneys in response to lowered BP. It converts angiotensinogen (an inactive precursor produced by the Liver) to angiotensin I.
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Angiotensin Converting Enzyme (ACE)
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in the lungs and kidneys - converts angiotensin I to angiotensin II.
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Angiotensin II
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stimulates production of aldosterone by the adrenals
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Aldosterone
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causes Na+ retention and thus water retention, increasing intravascular blood volume, and thus SV, CO, and BP.
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Drug Classes Commonly Used in the Tx of HTN
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ACE inhibitors
ARBs Renin Inhibitors Diuretics |
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bradykinin
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a potent vasodilator
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ACE Inhibitors
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cause a decrease in blood volume, SV and BP by blocking the conversion of angiotensin I to angiotensin II, and thus blocking aldosterone secretion
Lower incidence of heart disease, as well as morbidity and mortality of cardiac events Useful in controlling HTN in diabetics (esp type 1)- nephroprotective: so reduces damage to the kidneys in these patients often Rx'd in conjunction with a diuretic for HTN |
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Ex of ACE Inhibitorsn
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Dicarboxylate-containing agents
** Lisinopril Sulfhydryl-containing agents Phosphate-containing agents |
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Angiotensin Receptor Blockers (ARBs)
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aka angiotensin II receptor antagonists
block angiotensin II which is a potent constrictor of small arteries ARBs used when ACEIs not tolerated Prescribed for: HTN Diabetic Nephropathy - shown to be particularly effective in pts with type 2 **Sartans |
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Renin Inhibitors
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Aliskiren
- newer agent that inhibits renin in the juxtaglomerular cells of the kidneys |
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Side Effects of Drugs working on the Renin-Angiotensin System
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hypotension on 1st dose, esp if pt is Na+ depleted
Dry cough - mostly with ACEIs - more in women Hyperkalemia Acute renal failure **ACEIs and ARBs should NOT be used in pregnancy |
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Beta-Adrenergic Blocking Agents
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used for hypertension, heart failure, arrhythmias and angina
usefulness comes from negative inotropic (reduces the force of the heart's contraction) and negative chronotropic (reduces the rate of heart beats) effects that reduce the amount of work the heart needs to do |
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Diuretics
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induce urination
-this is another way to lower BP. Decreasing the amount of water in the system decreases blood volume and thus BP act directly on the kidneys |
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Thiazide Diuretics
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most commonly prescribed and are among the most prescribed of all meds.
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Ex of Thiazide Diuretics
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Hydrochlorothiazide (HCTZ) ** most common
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Thiazide Diuretics Adverse Effects
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**people allergic to sulfa drugs may also be allergic to Thiazides
Hyperuricemia - can lead to gout Orthostatic hypotension hyperlipidemia hyperglycemia and reduced control of blood sugar level in pts with diabetes. |
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Loop Diuretics
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work in ascending loop of Henle
drugs of choice in reducing pulmonary edema of heart failure and other emergency conditions cause excretion of Ca++ and Mg+ K+ depleting |
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Loop Diuretics Ex
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Furosemide (Lasix)
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Loop Diuretics Adverse Effects
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Ototoxicity: permanent effects on hearing and balance
Loop diuretics can precipitate a rapid and severe loss of blood volume and can result in hypotension, shock, and cardiac arrhythmias. |
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Diuretics Adverse Effects
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Potassium depletion a concern for thiazide and loop diuretics
diet can slow down or reverse potassium loss K+ rich foods: bananas, citrus fruits, prunes Limit Na+ |
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Potassium-Sparing Diuretics
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generally work in the collecting tubule, inhibiting Na+ reabsorption and K+ excretion
considered calcium-sparing: actually cause small net increase in calcium lost in urine ** Spironolactone has an anti-androgen effect. It is sometimes used in hormone replacement therapy for tans-women. May be used for hair loss and acne in women and topically for treatment of male baldness. |
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Vasodilators
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Nitroglycerin (Nitro)** used to treat angina
Causes both arterial and venous relaxation. -this will decrease the preload on the heart, and reduce the amount of work the heart has to do. -By dilating the coronary arteries, more oxygenated blood will flow to the heart. *different forms of nitrates have greatly varying times of onset and duration. |
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Platelet inhibitors
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Tx and prevent CV occlusive dzs
Thrombolytic therapy also used in tx of pain Aspirin Plavix |
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Anticoagulants
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prevent and tx thrombosis and embolism and thrombo-embolic disorders
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Oral anticoagulants
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Warfarin
inhibit regeneration of vitamin K (necessary for clotting factor synthesis) |
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Adverse Effects of anticoagulants
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Hemorrhage
- signs include petechiae, bleed from gums and mucous membranes ** Warfarin is highly protein bound as well as has a narrow TI. Pts must be monitored to maintain an appropriate ability to clot. CHM not recommended. |
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abortifacient
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cause abortion
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teratogenic
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makes monsters
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hypertension
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high blood pressure
greater than 140/90 |
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angina
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chest pain
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Therapeutic Margin/Window
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Expression of the TI as a measure of drug safety
a drug with a narrow margin may have significant toxicities when thrown out of its range. |
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inotropic
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strength
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chronotropic
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number
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sympathetic division
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fight or flight - adrenergic
-stimulates metabolism with mobilization of energy reserves -decreased GI motility - contraction of GI sphincters *think of sympathetic reaction as a time to expend energy (ie. run, fight) and NOT a time to take in resources/ energy (digestion) |
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Parasympathetic Division
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rest and digest - cholinergic
* the threat is over. This is the time to heal, relax, take in and process resources, pee and poop. - constriction of pupils -secretion of digestive glands - contraction of urinary bladder during urination -stimulation and coordination of defecation - constriction of respiratory airways - decrease in : heart rate and force of cardiac contraction |
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antitussive
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relieves or suppresses cough
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expectorant
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increases bronchial secretions
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mucolytic
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help loosen thick bronchial secretions
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cyanosis
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the appearance of a blue or purple coloration of the skin or mucous membranes due to the tissues near the skin surface being low on oxygen.
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dyspnea
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shortness of breath
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tachypnea
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rapid breathing
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tachycardia
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rapid heart rate
over 100 beats per min |
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bradycardia
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slow heart rate
less than 60 beats per min |
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edema
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abnormal accumulation of fluid
"swelling" |
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parietal cells
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the stomach epithelial cells that secrete gastric acid (HCl) and intrinsic factor.
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hypochloryhdria
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absent or low gastric acid in the stomach
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hiatal hernia
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herniation of the ST through the diaphragm
contributing factors: vomiting pregnancy |
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Irritation of the LES
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decrease effectiveness in closure = ST acid in lower esophagus
common factors: overeating smoking individual food allergies |
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gynecomastia
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the benign enlargement of breast tissue in males.
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Galactorrhea
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spontaneous flow of milk from the breast, unassociated with childbirth or nursing.
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coronary arteries
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The coronary arteries supply oxygenated and nutrient filled blood to the heart muscle.
Right Coronary Artery - Supplies oxygenated blood to the walls of the ventricles and the right atrium. Left Main Coronary Artery - Directs oxygenated blood to the left anterior descending artery and the left circumflex. |
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TCAs
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prescribed for:
major depression bipolar disorder substance induced mood disorder |
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EX of TCAs
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amitriptyline (Elavil)
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Adverse effects of TCAs
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narrow TI (suicide pts should not be given lg quantities)
can precipitate suicide mutually enhanced effects with MAOIs may cause: HTN fever convulsions coma |
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Depression
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collection of mood disorders
-depressed, irritable, anxious |
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Monoamines
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Serotonin (5-HT = 5 hydroxytryptamine
Dopamine (DA) Norepinephrine (NE) |
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Monoamine Theory of Depression
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monoamine xu in certain areas of the brain causes depression
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Neuroleptic Malignant Syndrome
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is a life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs.
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atypical depression
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improved mood in response to positive events.
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psychosis
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an abnormal condition of the mind
"loss of contact with reality" |
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schizophrenia
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a breakdown of thought processes and by a deficit of typical emotional responses
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Hyperpolarization
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less likely for action potential. IPSP
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Adverse Effects of TCAs
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Can precipitate suicide. Still depressed, but now have energy to carry out.
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What treats both COPD & asthma?
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corticosteroids & B-adrogenic agonists
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Histamine
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protects the body from environmental factors that produce allergic & inflammatory reactions.
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What pathway does aspirin block that Celebrex doesn't block?
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COX 1
Celebrex = COX2 |
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Aspirin CI in children. Why?
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Reyes syndrome
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PPI vs. H2 Antagonists
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PPI stronger & longer lasting
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Anti-androgenic effects
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Gynecomastia/Galactorrhea -
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Sucralfate
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unique mechanism of action
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Bismuth
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forms protective lining
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An increase in TPR w/ no change in CO will
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increase BP
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main organ of metabolism
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Liver
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excretion
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Kidneys
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N
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number of people in a study
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P
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odds the result seen were by chance
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NNT
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# needed to treat
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