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;
343 Cards in this Set
- Front
- Back
|
NDC Number: 12345-6789-10
What does 12345 refer to? What does 6789 refer to? What does 10 refer to? |
12345 refers to the manufacturer
6789 refers to the drug identity 10 refers to the package size |
|
|
How long to patents usually last?
|
20 years
|
|
|
How long to drug trials usually take?
|
6-8 years
|
|
|
How much does it cost to develop a new drug?
|
$860 million
|
|
|
Describe Opioid Analgesics. Name top 3 descriptors.
|
- Pain relievers
- Act on CNS - May become habit-forming if used over long periods |
|
|
In NC, was schedule is Marijuana?
|
Schedule VI
|
|
|
Define NARCOTIC.
|
An addictive drug, such as opium, that reduces pain, alters mood and behavior, and usually induces sleep or stupor.
|
|
|
What Schedule is COCAINE in?
|
C-II
|
|
|
What schedule is HYDROMORPHONE in?
|
C-II
|
|
|
What schedule is MEPERIDINE in?
|
C-II
|
|
|
What schedule is METHADONE in?
|
C-II
|
|
|
What schedule is OXYCODONE in?
|
C-II
|
|
|
What are the top 4 side effects for narcotics?
|
- Constipation
- Abdominal Pain - Dizziness - Drowsiness |
|
|
NC Law regarding C-IIs:
Can C-II medications have refills? What is the expiration date for C-IIs? Who may fax a C-II prescription to a pharmacy? |
- No refills allowed
- No expiration date - Nursing home/Hospice can fax for their patients |
|
|
What schedule is TESTOSTERONE in?
|
C-III
|
|
|
What schedule are ANABOLIC STEROIDS?
|
C-III
|
|
|
What schedule is BUTALBITAL (Fiorinal)?
|
C-III
|
|
|
What schedule is HYDROCODONE?
|
C-III
|
|
|
What schedule is XANAX?
|
C-IV
|
|
|
What schedule is KLONOPIN?
|
C-IV
|
|
|
What schedule is CLORAZEPATE?
|
C-IV
|
|
|
What schedule is VALIUM?
|
C-IV
|
|
|
What schedule is PHENTERMINE?
|
C-IV
|
|
|
What schedule is LOMOTIL (Diphenoxylate)?
|
C-V
|
|
|
What schedule is KAPECTOLIN?
|
C-V
|
|
|
What is the maximum adult dose of APAP?
|
4 grams/day
|
|
|
How much APAP does LORTAB have?
|
500mg APAP
|
|
|
How much APAP does LORCET have?
|
650mg APAP
|
|
|
TYLENOL w/ CODEINE, PHENAPHEN (WITH CODEINE)
Generic Name, Class, Schedule |
Acetaminophen with Codeine
Narcotic Analgesic C-III |
|
|
VICOPROFEN
Generic Name, Class, Schedule |
Hydrocodone Bitartrate w/ Ibuprofen
Opioid Analgesic - C-III |
|
|
LORTAB
VICODIN LORCET NORCO Generic Name, Class, Schedule |
Hydrocodone Bitartrate w/ APAP
Opioid Analgesic - C-III |
|
|
ULTRAM
ULTRAM ER RYZOLT Generic Name, Class, Schedule |
Tramadol HCl
Analgesic - C-VI |
|
|
PERCOCET
ROXICET ENDOCET Generic Name, Class, Schedule |
Oxycodone w/ APAP
Opioid Analgesic C-II |
|
|
OxyIR
ROXICODONE Generic Name, Class, Schedule |
Oxycodone HCl (Immediate Release)
Opioid Analgesic - C-II |
|
|
MS CONTIN
Generic Name, Class, Schedule |
Morphine Sulfate (Extended Release)
Opioid Analgesic - C-II |
|
|
OXYCONTIN
Generic Name, Class, Schedule |
Oxycodone HCl (controlled-released)
Opioid Analgesic - C-II |
|
|
FIORICET
Generic Name, Class, Schedule |
Butalbital/APAP/Caffeine
Analgesic - C-VI |
|
|
ULTRACET
Generic Name, Class, Schedule |
Tramadol HCl/APAP
Analgesic - C-VI |
|
|
DARVOCET-N
DARVOCET-A Generic Name, Class, Schedule NO LONGER ON MARKET |
Propoxyphene Napsylate/APAP
Opioid Analgesic - C-IV NO LONGER ON MARKET |
|
|
Opioids - 4 Common Side Effects
|
- Constipation
- Bradycardia - Dizziness - Drowsiness |
|
|
Opioids - Consult
|
- Avoid Alcohol
- Do not exceed Rx dose - Contins: Take whole - May be habit forming - TWF/M |
|
|
What is cholesterol?
|
- Soft, fat-like, waxy substance found in bloodstream and all the body's cells
|
|
|
What are the 2 main types of lipids?
|
- Cholesterol
- Triglycerides |
|
|
What are the 4 types of cholesterol?
|
- LDL
- HDL - VLDL - Total Cholesterol |
|
|
What is VLDL?
|
- Bad cholesterol
- Very low density lipoprotein - Contains the highest amount of TG - Levels decrease as TGs decrease |
|
|
What organs make cholesterol?
|
Liver and intestines
|
|
|
What is LDL?
|
- Bad cholesterol
- Gets in tissues, builds up in arteries and forms plaques, leads to atherosclerosis |
|
|
What is the desired level for LDL?
|
<100mg/dL
|
|
|
What are triglycerides (TG)?
|
- Chemical form in which most fat exists in body and in food
|
|
|
What is the desired level for TGs?
|
<150mg/dL
|
|
|
Can cholesterol be dissolved in the blood?
|
No
|
|
|
What is HDL?
|
- Good cholesterol
- Carries cholesterol away from the arteries and removes excess cholesterol from the blood - Protects against heart disease |
|
|
What is the desired level for HDL?
|
>40mg/dL
|
|
|
Describe Statins
|
- Inhibit HMG-CoA reductase
- Reduces intracellular cholesterol levels - Increase clearance of LDL lipoproteins from the blood |
|
|
What is Niaspan?
|
- Water soluble vitamin B-3
- Functions in the digestive systems, skin, and nerves - Decreases TG & LDL, Increases HDL |
|
|
Statins: Side Effects
|
Constipation
Muscle pain (myopathy) May elevate liver function test levels |
|
|
Statins: Consult
|
- Pregnancy category X
- Do not take with grapefruit - Conduct LFTs q 4-6 wks for 1st 15 months of therapy - Not for use in liver impaired |
|
|
What does grapefruit do to Statins?
|
- It may increase plasma concentrations
|
|
|
What is TriCor?
|
Fenofibrate
- Decreases LDL & TG, Increases HDL - Monitor LFTs periodically - Rash may occur |
|
|
In which part of cholesterol synthesis pathway do statins work?
|
- 1st part
|
|
|
By what percentage do statins usually lower LDL?
|
30-55%
|
|
|
ZOCOR
Generic Name, Class |
Simvastatin
Antihyperlipidemic HMG-CoA Reductase Inhibitor |
|
|
MEVACOR
Generic Name, Class |
Lovastatin
Antihyperlipidemic HMG-CoA Reductase Inhibitor |
|
|
PRAVACHOL
Generic Name, Class |
Pravastatin Sodium
Antihyperlipidemic HMG-CoA Reductase Inhibitor |
|
|
TRICOR
Generic Name, Class, *Unusual Side Effect* |
Fenofibrate
Antihyperlipidemic *May cause RASH* |
|
|
LOPID
Generic Name, Class |
Gemfibrozil
Antihyperlipidemic |
|
|
ZETIA
Generic Name, Class |
Ezetimibe
Antihyperlipidemic |
|
|
VYTORIN
Generic Name, Class |
Ezetimibe/Simvastatin
(Zetia/Zocor) Antihyperlipidemic |
|
|
NIASPAN
Generic Name, Class, *Unique Side Effect* |
Niacin (B-3)
Antihyperlipidemic *May cause FLUSHING |
|
|
CRESTOR
Generic Name, Class |
Rosuvastatin Calcium
Antihyperlipidemic HMG-CoA Reductase Inhibitor |
|
|
LIPITOR
Generic Name, Class |
Atorvastatin Calcium
Antihyperlipidemic HMG-CoA Reductase Inhibitor |
|
|
Define BACTERIOSTATIC.
|
Prevents bacteria from dividing
|
|
|
Define BACTERICIDAL.
|
Kills bacteria
|
|
|
What does MRSA stand for?
|
Methicillin-resistant Staph Aureus
|
|
|
Describe PENICILLINS.
|
- Most commonly used antibiotic
- Skin, dental, URTI, prophylaxis - Beta Lactam - Made from mold |
|
|
Penicillins: Adverse Effects
|
Nausea
Diarrhea Rash |
|
|
Penicillins: Consult
|
- Take on empty stomach if possible
- Take at even intervals - Finish full course of therapy |
|
|
Describe CEPHALOSPORINS.
|
- Beta Lactams
- Divided into 4 generations - 10% chance if allergic to penicillin, allergic to cephalosporins |
|
|
What drugs are 1st generation Cephalosporins?
|
- KEFLEX
-DURICEF *Gram + bacteria |
|
|
What drugs are 2nd generation Cephalosporins?
|
- CEFTIN
-CEFZIL |
|
|
What drug is 3rd generation Cephalosporins?
|
OMNICEF
|
|
|
Cephalosporins: Adverse Effects
|
Nausea
Diarrhea Rash |
|
|
Cephalosporins: Consult
|
Take on an empty stomach if possible
Take at even intervals Complete full course of therapy |
|
|
Describe FLUOROQUINOLONES
|
- Broad Spectrum
- 4 generations - Irreversible nerve damage may occur - Spontaneous tendon damage may occur |
|
|
FLUOROQUINOLONES: Adverse Effects
|
Nausea
Rash Diarrhea Photo-sensitivity |
|
|
FLUOROQUINOLONES: Consult
|
-Complete full course of therapy
- Take with 8 oz of water - Do not take with antacids/multivits |
|
|
VEETIDS
PEN-VEE K V-CILLIN Generic Name, Class |
Penicillin VK
beta lactam antibiotic |
|
|
AMOXIL
TRIMOX Generic Name, Class |
Amoxicillin Trihydrate
Penicillin Antibiotic |
|
|
AUGMENTIN
AUGMENTIN XR Generic Name, Class |
Amoxicillin with Clavulanic Acid
Penicillin Antibiotic |
|
|
DURICEF
Generic Name, Class |
Cefadroxil
1st generation Cephalosporin |
|
|
KEFLEX
Generic Name, Class |
Cephalexin Monohydrate
1st generation Cephalosporin |
|
|
CEFTIN
Generic Name, Class |
Cefuroxime Axetil
2nd generation Cephalosporins |
|
|
OMNICEF
Generic Name, Class |
Cefdinir
3rd generation Cephalosporin |
|
|
CIPRO
CIPRO XR Generic Name, Class |
Ciprofloxacin HCl
Fluoroquinolone |
|
|
LEVAQUIN
Generic Name, Class |
Levofloxacin
Fluoroquinolone |
|
|
AVELOX
Generic Name, Class |
Moxifloxacin
Fluroquinolone |
|
|
Describe MACROLIDES
|
- Broad Spectrum antibiotics
- U&LRTIs - Skin infections - STDs |
|
|
Macrolides: Adverse Effects
|
- Diarrhea
- N/V |
|
|
Macrolides: Consult
|
- TWF
- Antacids slow absorption |
|
|
Describe TETRACYCLINES and common indications
|
- Broad spectrum antibiotics
- URTIs - Acne, Skin infections - Pneumonia |
|
|
Tetracyclines: Adverse Effects
|
- Causes yellowing of teeth for non-adults
- Diarrhea - N/V |
|
|
Tetracyclines: Consult
|
- Discontinue if you become pregnant
- Take on an EMPTY stomach - No dairy - No antacids/multivits/calcium - Not for children < 8 years old |
|
|
FLAGYL
FLAGYL ER Generic Name, Indications, *Special Warning* |
Metronidazole
Treats anaerobic bacteria and protozoa infections ***No EtOH*** |
|
|
SEPTRA
BACTRIM Generic Name, Class, *Special Instructions*, *Unusual Adverse Effect* |
Sulfamethoxazole/Trimethoprim
Sulfa drug *Take with 8 oz of water* *Photo-sensitivity* |
|
|
DIFLUCAN
Generic Name, Class, Common Use, Half-Life |
Fluconazole
Antifungal - YEAST infections 1/2 life is 30 hours |
|
|
NYSTATIN
Generic Name, Class, Common Use in Compounding |
Nystatin
Antifungal Commonly used in Magic Mouthwash |
|
|
TAMIFLU
Generic Name, Class, *Who can't take it?, *When does it work? |
Oseltamivir Phosphate
Antiviral *Not for infants <1 year *Symptoms for < 2 days |
|
|
VALTREX
Generic Name, Class, Indications |
Valacyclovir HCl
Antiviral: Genital herpes, shingles, cold sores |
|
|
BACTROBAN
Generic Name, Class, *2 Special Instructions |
Mupirocin
Topical Antibacterial *Do not rub in *Report swelling to MD |
|
|
CLEOCIN
Generic Name, Class, *Special Instructions |
Clindamycin HCl
Antibiotic *Take with 8 oz of water |
|
|
VIBRAMYCIN
VIBRA-TABS Generic Name, Class, *Special Indications* |
Doxycycline Hyclate
Tetracycline Antibiotic *RMSF & Lyme Disease* |
|
|
SUMYCIN
PANMYCIN Generic Name, Class, *Special Instructions* |
Tetracycline HCl
Tetracycline Antibiotic *Empty Stomach* |
|
|
MINOCIN
Generic Name, Class, *Special Instructions* |
Minocycline Hydrochloride
Tetracycline Antibiotic *Empty Stomach* |
|
|
BIAXIN
BIAXIN XL Generic Name, Class |
Clarithromycin
Macrolide Antibiotic |
|
|
ZITHROMAX
ZMAX Generic Name, Class |
Azithromycin Dihydrate
Macrolide Antibiotic |
|
|
Define HYPERTENSION.
|
Blood pressure that is consistently above 140/90 (Systolic/Diastolic)
|
|
|
What is IDEAL blood pressure?
|
120/80
|
|
|
How do anti-hypertensive medications work?
|
- Decrease blood volume
- Opening blood vessels - Decreasing rate or force of contraction |
|
|
Once you begin anti-hypertensive treatment, what is GOAL blood pressure?
|
140/90
|
|
|
Which is more difficult to control - systolic or diastolic blood pressure?
|
Systolic
|
|
|
Describe ACE Inhibitors.
|
- lowers blood pressure
- Treats heart failure - Protects kidneys (works in kidneys) - block ANGIOTENSIN converting enzyme |
|
|
What does blocking the angiotensin converting enzyme do to help blood pressure?
|
- Relaxes and expands blood vessels
|
|
|
ACE Inhibitors: Adverse Effects
|
- Bradykinin build-up --> COUGH
- Elevates Potassium - Dizziness - Headache - Angioedema |
|
|
LOTENSIN
Generic Name, Class |
Benazepril HCl
ACE Inhibitor |
|
|
MONOPRIL
Generic Name, Class |
Fosinopril Sodium
ACE Inhibitor |
|
|
PRINIVIL
ZESTRIL Generic Name, Class |
Lisinopril
ACE Inhibitor |
|
|
ACCUPRIL
Generic Name, Class |
Quinapril
ACE Inhibitor |
|
|
ALTACE
Generic Name, Class |
Ramipril
ACE Inhibitor |
|
|
VASOTEC
Generic Name, Class |
Enalapril Maleate
ACE Inhibitor |
|
|
Describe ARBs
|
- Block ACTION of Angiotensin II by blocking the AT1 receptor
- Recommended for patients unable to take ACE inhibitors |
|
|
DIOVAN
Generic Name, Class |
Valsartan
ARB Antihypertensive |
|
|
COZAAR
Generic Name, Class |
Losartan Potassium
ARB Antihypertensive |
|
|
AVAPRO
Generic Name, Class |
Irbesartan
ARB Antihypertensive |
|
|
BENICAR
Generic Name, Class |
Olmesartan Medoxomil
ARB Antihypertensive |
|
|
ATACAND
Generic Name, Class |
Candesartan Cilexetil
ARB Antihypertensive |
|
|
Describe ALPHA-1 RECEPTOR BLOCKERS.
|
- Treats hypertension (vasodilation)
- Treats BPH - Prevents re-uptake of catecholamines by smooth muscle cells (prostate) |
|
|
Define CATECHOLAMINE
|
- Chemical compound derived from amino acids that circulate thru bloodstream, increase BP & HR
- Nor-& Epinephrine, dopamine |
|
|
HYTRIN
Generic Name, Class, Indications |
Terazosin
Alpha-1 Receptor Blocker Antihypertensive/ BPH Treatment |
|
|
CARDURA
CARDURA XL Generic Name, Class, 2 Indications |
Doxazosin Mesylate
Alpha-1 Receptor Blocker Antihypertensive/ BPH Treatment |
|
|
Alpha-1 Receptor Blockers: Adverse Effects
|
- Palpitations
- Nausea - Headache |
|
|
Alpha-1 Receptor Blockers: Consult
|
- Take 1st dose at bedtime
- Avoid OTC cough, cold, allergy meds without first consulting MD |
|
|
Describe ALPHA-2 AGONIST (Catapres)
|
- Crosses BBB
- Stimulates receptors that monitor catecholamines - decreases catecholamines, HR, & BP |
|
|
Alpha-2 Agonist (Catapres): Adverse Effects
|
- Dry mouth
- Drowsiness - Dizziness - Headaches |
|
|
Alpha-2 Agonist (Catapres): Consult
|
- TWF/M
- Change transdermal skin sites with each application of patch - Off-label uses |
|
|
CATAPRES
CATAPRES TTS Generic Name, Class, *Off-Label uses |
Clonidine HCl
Alpha-2 Agonist **Off-label uses:migraine, menopause, withdrawals, ADHD, sleep* |
|
|
HYZAAR
Generic Name, Class |
Losartan Potassium/ Hydrochlorothiazide
(Cozaar/HCTZ) ARB Antihypertensive + Diuretic |
|
|
AVALIDE
Generic Name, Class |
Irbesartan/Hydrochlorothiazide
(Avapro/HCTZ) ARB Anithypertensive + Diuretic |
|
|
Describe BETA BLOCKERS
|
- Block effect of adrenaline on beta-receptors
|
|
|
What are Beta-1 receptors responsible for?
|
Heart rate and strength of heart beat
HEART |
|
|
What are Beta-2 receptors responsible for?
|
Function of smooth muscle in blood vessels, bronchi, and GI and genitourinary tract
LUNGS |
|
|
Define EPINEPHRINE
|
Hormone secreted by adrenal gland that increases the heart rate and force of heart contractions
|
|
|
Define NOREPINEPHRINE
|
Hormone secreted by adrenal gland that has a strong vasoconstrictive effect, thus increasing blood pressure
|
|
|
Beta Blockers: Indications
|
- HTN
- Angina - Arrythmia - Migraines - Tremors |
|
|
Beta Blockers: Adverse Effects
|
- Photo-sensitivity
- Bradycardia - Dizziness - Depression - SOB, Nightmares |
|
|
Beta Blockers: Consult
|
- Masks symptoms of hypoglycemia
- TWF - Avoid EtOH |
|
|
TENORETIC
Generic Name, Class |
Atenolol with Chlorthalidone
(Tenormin/Thalitone) B-1 Beta Blocker + Diuretic Antihypertensive |
|
|
TENORMIN
Generic Name, Class |
Atenolol
B-1 Beta Blocker Antihypertensive |
|
|
ZIAC
Generic Name, Class |
Bisoprolol Fumarate with Hydrochlorothiazide
(Zebeta/HydroDiuril) B-1 Beta blocker + Diuretic Antihypertensive |
|
|
COREG
COREG CR Generic Name, Class |
Carvedilol
Nonselective Beta Blocker/Some alpha-1 blocking activity Anti-hypertensive |
|
|
INDERAL
INDERAL LA INNOPRAN XL Generic Name, Class |
Propranolol HCl
Nonselective Beta Blocker Anti-hypertensive |
|
|
TOPROL XL
Generic Name, Class |
Metoprolol Succinate
B-1 Beta Blocker Anti-hypertensive |
|
|
LOPRESSOR
Generic Name, Class |
Metoprolol Tartrate
B-1 Beta Blocker |
|
|
NORMODYNE
TRANDATE Generic Name, Class |
Labetolol Hydrochloride
Nonselective Beta Blocker with Alpha-1 blocking activity |
|
|
Define DIURETICS
|
- Cause the kidneys to remove more Na & K, water from the body
- Relaxes the blood vessel wall - Results in lower blood pressure |
|
|
DYAZIDE - capsule
MAXZIDE - tablet Generic Name, Class, *Special characteristic |
Triamterene with Hydrochlorothiazide
Potassium sparing diuretic *Prevents body from absorbing too much salt |
|
|
ALDACTONE
Generic Name, Class |
Spironolactone
Potassium Sparing Diuretic |
|
|
LASIX
Generic Name, Class |
Furosemide
Loop Diuretic |
|
|
HYDRODIURIL
Generic Name, Class, *Adverse Effect |
Hydrochlorothiazide
Thiazide Diuretic *Muscle cramps |
|
|
DIURETICS: Adverse Effects
|
- Weakness
- Dry mouth - Muscle cramps - N/V - Photo-sensitivity |
|
|
DIURETICS: Consult
|
- Take in the morning
- TWF/M |
|
|
Describe CALCIUM CHANNEL BLOCKERS (CCBs)
|
- Inhibits passage of calcium through the smooth muscle cells
- Decreases: force of contraction of heart, heart rate, blood pressure - Treats angina |
|
|
CCBs: Adverse Effects
|
- Edema
- Flushing - Headache - Fatigue - Abdominal Pain |
|
|
CCBs: Consult
|
- Avoid OTC cough/cold meds until checking with MD
|
|
|
Describe ANGINA
|
- Chest pain or discomfort
- Occurs when heart doesn't get enough blood and oxygen to it - Coronary arteries become clogged |
|
|
Describe chest symptoms associated with ANGINA
|
- Tightness
- Heaviness - Burning - May spread up arm, back, and neck |
|
|
VASODILATORS: Adverse Effects
|
- Headache
- Dizziness - hypOtension |
|
|
NITRODUR
Generic Name, Class, *Directions |
Nitroglycerin
SL Vasodilator, Antianginal *Take q 5 minutes for 15 min, then call 911 if chest pain persists |
|
|
IMDUR
Generic Name, Class |
Isosorbide Mononitrate
Antianginal |
|
|
NORVASC
Generic Name, Class |
Amlodipine
CCB antihypertensive |
|
|
CALAN
ISOPTIN SR Generic Name, Class |
Verapamil
CCB antihypertensive |
|
|
CARDIZEM
DILACOR TIAZAC Generic Name, Class |
Diltiazem
CCB antihypertensive |
|
|
PLENDIL
Generic Name, Class |
Felodipine
CCB antihypertensive |
|
|
ADALAT
PROCARDIA Generic Name, Class |
Nifedipine
CCB antihypertensive |
|
|
Define NTI
|
Narrow Therapeutic Index: drugs in which small changes in dose &/or blood concentrations could potentially result in clinically important changes in drug efficacy or safety
|
|
|
Which reference book contains information regarding Approved Drug Products with Therapeutic Equivalence Evaluations?
|
The Orange Book
|
|
|
Name 2 types of drugs with NTI
|
Digoxin
Levothyroxines (Thyroid medications) |
|
|
LANOXIN
Generic Name, Class, *What does it inhibit?* |
Digoxin
Antiarrhythmic *Inhibits Na-K ATPase* |
|
|
LANOXIN
Adverse Effects |
- Nausea, vomiting
- Anorexia - Blurred/yellow vision |
|
|
Where is the THYROID gland?
|
Butterfly shaped gland located in the front of the throat, below the larynx
|
|
|
HYPERTHYROIDISM: Definition and Symptoms
|
- Too much thyroid hormone produced
- Irritability/nervousness - Muscle weakness/tremors - Infrequent, scant menstrual periods - Weight loss - Sleep disturbances - Enlarged thyroid gland - Vision problems or eye irritation - Heat sensitivity |
|
|
HYPOTHYROIDISM: Definition and Symptoms
|
- Too little thyroid hormone produced
- Fatigue - Weight gain - Depression - Cold intolerance - Elevated cholesterol levels - Heart disease and infertility |
|
|
SYNTHROID
LEVOXYL Generic Name, Indication, *Special characteristic |
Levothyroxine
Treatment of hypothyroidism *NTI drug |
|
|
SYNTHROID
LEVOXYL Adverse Effects |
- Hyperthyroidism
- Hypoglycemia - Insomnia - Tachycardia - Anxiety |
|
|
SYNTHROID
LEVOXYL Consult |
- Do not discontinue without consulting a physician
- Take in the morning on an empty stomach *NTI drug |
|
|
Define MAJOR DEPRESSION
|
A disease with certain characteristic signs and symptoms that interferes with the ability to work, sleep, eat, and enjoy once pleasurable activities.
|
|
|
Which reference book provides diagnostic criteria for mental disorders, including depression?
|
DSM IV
|
|
|
What is DOPAMINE's function?
|
The NT that produces feelings of pleasure when released by the brain reward system. Has multiple functions depending on where in the brain it acts. It is usually inhibitory.
|
|
|
GABA (Gamma-aminobutyric acid)
|
The major inhibitory NT in the brain.
|
|
|
NOREPINEPHRINE
|
Acts as a NT & a hormone. In the PNS, it is part of the fight-or-flight response. In the brain, it acts as a NT regulating normal brain processes. It is usually excitatory, but is inhibitory in a few brain areas.
|
|
|
What is SEROTONIN and what does it effect?
|
A NT involved in many functions including mood, appetite, and sensory perception. In the spinal cord, it is inhibitory in pain pathways.
|
|
|
Disease states associated with NTs
|
Depression
Autism (aspergers) ADD ADHD Anxiety |
|
|
SSRIs: Indications
|
Selective Serotonin Reuptake Inhibitors
- Major depression - Anxiety disorders - Panic disorders - OCD - Social phobias - Eating disorders |
|
|
SSRIs: Adverse Effects
|
- Nausea
- Drowsiness - Headache - Changes in weight/appetite - Changes in sexual behavior - Increased feelings of depression/anxiety - Tremors - Increased sweating |
|
|
SSRIs: Consult
|
- Take as directed
- May take 3-4 weeks before full effect - Avoid alcohol - May impair cognitive and motor performance - Suicide risk in children and young adults |
|
|
CELEXA
Generic Name, Class |
Citalopram
SSRI antidepressant |
|
|
LEXAPRO
Generic Name, Class |
Escitalopram
SSRI antidepressant |
|
|
PROZAC
SARAFEM Generic Name, Class |
Fluoxetine
SSRI antidepressant |
|
|
PAXIL
PAXIL CR Generic Name, Class |
Paroxetine
SSRI antidepressant |
|
|
ZOLOFT
Generic Name, Class |
Sertraline
SSRI antidepressant |
|
|
Define TCA
|
Tricyclic Antidepressant (named for the chemical structure)
Slows reuptake of serotonin & norepinephrine |
|
|
TCA: Indications
|
- Clinical depression
- Pain - ADHD - Smoking cessation - Headaches - Bulimia |
|
|
TCA: Adverse Effects
|
(Affects Acetylcholine)
- Dry mouth - Blurred vision - Decreased GI motility & secretion (may lead to constipation) - Urinary retention or difficulty - Hyperthermia |
|
|
TCA: Consult
|
- Do not discontinue therapy unless otherwise directed
- Avoid alcohol |
|
|
ELAVIL
Generic Name, Class |
Amitriptyline
TCA antidepressant |
|
|
SINEQUAN
Generic Name, Class |
Doxepin
TCA antidepressant |
|
|
TOFRANIL
Generic Name, Class |
Imipramine
TCA antidepressant |
|
|
PAMELOR
Generic Name, Class |
Nortriptyline
TCA antidepressant |
|
|
DESYREL
Generic Name, Class, *Special Warning* |
Trazodone
SRIA (Serotonin Reuptake Inhibitor Antagonist) Antidepressant *Not for children < 18 years old* |
|
|
EFFEXOR
EFFEXOR XR Generic, Class, Indications |
Venlafaxine
Serotonin/Norepinephrine Reuptake Inhibitor: Antidepressant - Depression & Anxiety Disorders |
|
|
CYMBALTA
Generic Name, Class, Indications |
Duloxetine
Serotonin/Norepinephrine & slight Dopamine Reuptake Inhibitor - Depression & neuropathic pain (in diabetics) |
|
|
WELLBUTRIN
WELLBUTRIN XL Generic Name, Class, Indications |
Bupropion
Dopamine Reuptake Inhibitor: Antidepressant - Depression - Smoking Cessation |
|
|
REMERON
Generic Name, Class, *Special dosage form |
Mirtazapine
Alpha-2 antagonist: Antidepressant *SolTab formulation available (dissolves on tongue w/i 30 sec) * Increases the release of NTs (not a reuptake med) |
|
|
Which gender is most affected by anxiety/panic?
|
Panic attacks are twice as common in women as in men
|
|
|
BENZOS: Uses
|
- Minor tranquilizer
- Sedative - Hypnotic - Anxiolytic - Anticonvulsant - Muscle relaxant - Intended for short-term use |
|
|
BENZOS: Withdrawal Symptoms
|
- Insomnia
- Rebound REM sleep - Panic attacks/anxiety - Tachycardia - HTN - Tremors - Depression - Loss of appetite |
|
|
How do BENZOS work?
|
Produce their effects by modulating the GABA receptor, the most prolific inhibitory receptor within the brain
|
|
|
BENZOS: Adverse Effects
|
- Dizziness
- Drowsiness - Disorientation |
|
|
BENZOS: Consult
|
- Indicated for short-term use
- Avoid Alcohol - Medication may be habit-forming (psychological dependency 50% @ 6mo) |
|
|
ATIVAN
Generic Name, Class |
Lorazepam
Benzo: Antianxiety |
|
|
RIVOTRIL
KLONOPIN Generic Name, Class |
Clonazepam
Benzo: Antianxiety |
|
|
XANAX
Generic Name, Class |
Alprazolam
Benzo: Antianxiety |
|
|
VALIUM
Generic Name, Class |
Diazepam
Benzo: Antianxiety |
|
|
BUSPAR
Generic Name, Class |
Buspirone
Benzo: Antianxiety |
|
|
4 steps in the ATTENTION process
|
1. Initiate - direct attention to where it is needed or desired at the moment
2. Sustain - pay attention as long as needed 3. Inhibit - avoid focusing on something that removes our attention from where it needs to be 4. Shift - move our attention to other things as needed |
|
|
Can children with ADD/ADHD pay attention?
|
Yes, their problems have to do with what they are paying attention to, for how long, and under what circumstances
|
|
|
Symptoms of INATTENTION
|
- Ignores details, makes careless mistakes
- Difficulty sustaining attention or listening when directly addressed - Difficulty following instructions or finishing tasks - Appears forgetful, disorganized, distracted |
|
|
Symptoms of HYPERACTIVITY
|
- Trouble keeping physically still
- Excessive talking - The mind is a perpetual motion machine - Intense aversion to boredom, need for constant activity - Unremitting lack of internal stillness - Inertia or procrastination for long periods, with restlessness, and bursts of adrenaline and activity when the threat of failure or the promise of reward is imminent - May be absent altogether, especially in girls |
|
|
Symptoms of ADD
|
- ADD is a self-regulatory disorder
- An automatic, unwilled "tuning out", a frustrating non-presence of mind - Trying to concentrate but can't - BIG differences between individuals with ADD |
|
|
Diagnosing ADD/ADHD requires...
|
Consistent, persistent symptoms in a number of settings (home, school, work, extra-curricular activities)
|
|
|
About how many school-aged children have ADHD?
|
4.3% - 12% (most common neurobehavioral disorder among children)
|
|
|
ADHD - associated problems include
|
- social
- marital - academic - career - anxiety - depression - Substance abuse - Can persist into adolescence and adulthood - trouble maintaining self-control - trouble resisting distractions - trouble concentrating on ideas - low working memory, etc. etc. etc. (there are tons of symptoms listed in the lecture) |
|
|
Which NTs are effected by ADHD?
|
- dysfunction is the roles of dopamine and norepinephrine
|
|
|
3 types of ADHD
|
1. Predominantly Hyperactive-Impulse type
2. Predominantly Inattentive type 3. Combined type (requires 6 symptoms from each of previous categories) |
|
|
Diagnostic Criteria for ADD/ADHD
|
- Symptoms of inattention and/or hyperactivity-impulsivity
- Exhibit symptoms < 7 years of age - Persists > 6 months - Present in 2+ settings - Adversely affect functioning in social situations, school, or work - Symptoms cannot be better explained by another mental disorder (autism) |
|
|
Which reference book lists useful diagnostic criteria for ADD/ADHD?
|
DSM-IV-TR
|
|
|
Positive aspects of having ADD/ADHD:
|
- Creativity
- Enthusiasm - Spontaneity - Liveliness - Flexibility - Hyperfocus - Tenacity and drive - Intelligence |
|
|
Desired outcomes of treatment of ADD/ADHD:
|
- Improve behavior and increase attention
- Improve relationships - Decrease disruptive behavior - Improve academic performance - Increase independence in activities - Minimize undesirable adverse effects of therapy |
|
|
Stimulant drugs for treatment of ADD/ADHD include:
|
- RITALIN SR & LA
- ADDERALL, ADDERALL XR - DEXEDRINE, DEXTROSTAT - FOCALIN |
|
|
Non-stimulant drugs for treatment of ADD/ADHD include:
|
- STRATTERA
- TCA antidepressants - CATAPRES - INTUNIV, TENEX - WELLBUTRIN |
|
|
ADD/ADHD Medication Black Box Warning
|
- Serious cardiovascular events
- Potential for drug dependency - Possible suppression of growth |
|
|
RITALIN SR
RITALIN LA Generic Name, Class |
Methylphenidate
CNS Stimulant (CII) |
|
|
RITALIN SR
RITALIN LA Indications for use |
- Treatment of ADD in children 6 years old and older
- Treats narcolepsy in adults |
|
|
RITALIN SR
RITALIN LA Adverse Effects |
- Nervousness
- Headache - Insomnia - Anorexia - Nausea - Dizziness *Black Box Warnings |
|
|
RITALIN SR
RITALIN LA Consult |
Take last dose early in the evening to avoid insomnia
|
|
|
CONCERTA
Generic Name, Class |
Methylphenidate Extended Release
CNS Stimulant (CII) |
|
|
CONCERTA
Indications |
- ADD in children 6 years old and older
- Narcolepsy |
|
|
CONCERTA
Adverse Effects |
- Nervousness
- Headache - Insomnia - Anorexia - Dizziness |
|
|
CONCERTA
Consult |
Take last dose early in the evening to avoid insomnia
|
|
|
DEXEDRINE
DEXTROSTAT Generic Name, Class |
Dextroamphetamine
CNS Stimulant (CII) |
|
|
DEXEDRINE
DEXTROSTAT Indications |
- Narcolepsy
- ADHD for children > 3 years old |
|
|
DEXEDRINE
DEXTROSTAT Adverse Effects |
- Aggression
- Nausea - Tremor - Fatigue - Decrease appetite - Dizziness |
|
|
DEXEDRINE
DEXTROSTAT Consult |
Take last dose early in the evening to avoid insomnia
|
|
|
ADDERALL
ADDERALL XR Generic Name, Class |
Amphetamine/dextroamphetamine Salts
CNS Stimulant (CII) |
|
|
ADDERALL
ADDERALL XR Indications |
- Narcolepsy
- ADHD |
|
|
ADDERALL
ADDERALL XR Adverse Effects |
- Dizziness
- Insomnia - Restlessness - Headache |
|
|
ADDERALL
ADDERALL XR Consult |
- Take as directed
- Can be opened and sprinkled on applesauce |
|
|
STRATTERA
Generic Name, Class |
Atomexatine
Norepinephrine Reuptake Inhibitor (Schedule VI) |
|
|
STRATTERA
Indication |
- ADHD (dose based on weight)
|
|
|
STRATTERA
Adverse Effects |
- Dyspepsia
- N/V - Fatigue - decreased appetite - Dizziness |
|
|
STRATTERA
Consult |
- May impair cognitive and motor performance
|
|
|
Describe AUTISM
|
- Pervasive developmental disorder
- Onset typically < 3 years old - Impairment of communication skills - Males:Females 4:1 - Difficulty regulating emotions |
|
|
What are the 4 types of autism?
|
- Asperger syndrome
- Childhood Disintegrative Disorder - Rett Syndrome - Pervasive Developmental Disorder |
|
|
Describe ASPERGER SYNDROME
|
- No language problems
- Score in average or above-average range on intelligence tests - Social struggles and limited scopes of interests |
|
|
Describe CHILDHOOD DISINTEGRATIVE DISORDER
|
- Develop normally for > 2 years
- Lose communication and social skills |
|
|
Describe RETT SYNDROME
|
- Occurs only in girls
- Development begins normally, but lose communication and social skills around ages 1-4 - Repetitive hand movements |
|
|
Describe PERVASIVE DEVELOPMENTAL DISORDER (PDD)
|
- Category for children who display some autistic problems but who don't fit into other categories
|
|
|
Symptoms of AUTISM
|
- Impaired social interaction - lack of eye contact, doesn't know how to play with toys, does not smile
- Communication impairment - doesn't babble or point by 1 year of age, may not respond to name, low vocab by 2 years old - Repetitive activities - lines up toys, odd movements, attached to one particular object |
|
|
Types of treatments for AUTISM
|
- Antipsychotics
- Lifestyle Treatments - Herbal/Natural medicines |
|
|
Define EPILEPSY
|
- The tendency to have seizures on a chronic, recurrent basis
- Implies that there are permanent changes in cortical function - Neurons have abnormal electrical behavior |
|
|
Define STATUS EPILEPTICUS
|
- Neurologic emergency that can lead to permanent brain damage or death
- Seizure lasting more than 30 minutes - with or without loss of consciousness, having recurring seizures without regaining consciousness between episodes |
|
|
Some causes of EPILEPSY
|
- Mostly unknown etiology
- Some onset due to head trauma, stroke, or CNS tumors |
|
|
Which NTs are indicated in EPILEPSY?
|
- Glutamate (major excitatory NT in the cerebral cortex) - release results in opening membrane channels to allow Na or Ca to flow into postsynaptic neurons to the degree of excessive excitation
- GABA is critical for shutting off seizure activity |
|
|
What is the significance of protein-binding in epilepsy medications?
|
- Meds are highly bound to plasma protein
- Patients with decreased protein binding (renal failure, hypoalbuminemia, pregnant women, neonates, critical care patients) are at risk for toxicity |
|
|
DILANTIN
Generic Name, Class |
Phenytoin
Anticonvulsant |
|
|
DILANTIN
Adverse Effects |
- Ataxia
- Slurred speech - confusion |
|
|
LUMINAL
Generic Name, Class |
Phenobarbital
Anticonvulsant/Sedative |
|
|
LAMICTAL
LAMICTAL XR Generic Name, Class |
Lamotrigine
Anticonvulsant |
|
|
NEURONTIN
Generic Name, Class |
Gabapentin
Anticonvulsant, Misc. |
|
|
TEGRETOL
TEGRETOL XR CARBATROL ER EQUETROL ER Generic Name, Class |
Carbamazepine
Anticonvulsant |
|
|
DEPAKOTE
DEPAKOTE ER Generic Name, Class |
Divalproex Sodium
Anticonvulsant/Antipsychotic |
|
|
KEPPRA
Generic Name, Class |
Levetiracetam
Anticonvulsant |
|
|
TOPAMAX
Generic Name, Class |
Topiramate
Anticonvulsant |
|
|
LYRICA
Generic Name, Class |
Pregabalin
Anticonvulsant/Antineuralgic |
|
|
DILANTIN
Adverse Effects |
- Ataxia
- Slurred speech - Confusion |
|
|
TOPAMAX
Adverse Effects |
- Fatigue
- Nervousness - Difficulty with concentration |
|
|
ANTICONVULSANTS
Adverse Effects |
- Dizziness
- Somnolence - Nausea |
|
|
ANTICONVULSANTS
Consult |
- Do not discontinue without consulting with physician
- Avoid alcohol - Pregnancy categories C & D (don't become pregnant!) - Do not double doses |
|
|
Describe BIPOLAR DISORDER
|
- Treatable manic-depressive illness
- Develops in late adolescence or early adulthood - Long-term illness - Causes: genetic, environmental, biochemical - Medication adherence is significant problem |
|
|
What are the 3 classifications of BIPOLAR DISORDER?
|
- Bipolar disorder I
- Bipolar disorder II - Cyclothymia |
|
|
Describe a MANIC episode
|
- Increased energy, activity, restlessness, etc. (lots listed in lecture)
- Provocative, intrusive, and aggressive behavior - 3+ symptoms persist for 1+ week |
|
|
Describe a DEPRESSIVE episode
|
- Lasting sad, anxious, or empty mood, etc. (lots listed in lecture)
- 5+ symptoms persist 2+ weeks |
|
|
Describe SCHIZOPHRENIA
|
- Psychiatric illness
- Impairments in the perception or expression of reality - Most commonly with auditory hallucinations - Paranoid or bizarre delusions - Disorganized speech and thinking - Onset of symptoms typically occurs in young adulthood |
|
|
LITHONATE
LITHOTABS LITHOBID Generic Name, Class |
Lithium Carbonate
Antipsychotic |
|
|
SEROQUEL
SEROQUEL XR Generic Name, Class |
Quetiapine Fumerate
Antipsychotic |
|
|
RISPERDAL
Generic Name, Class |
Risperidone
Antipsychotic |
|
|
ZYPREXA
Generic Name, Class |
Olanzapine
Antipsychotic |
|
|
LITHONATE
LITHOTABS LITHOBID Adverse Effects |
- Diarrhea
- Vomiting - Drowsiness |
|
|
LITHONATE
LITHOTABS LITHOBID Consult |
- Effects may take 1-2 weeks before optimum effect is seen
- Maintain normal diet and fluid intake of 2-3 quarts daily - Avoid overexposure to heat, sweating |
|
|
SEROQUEL
SEROQUEL XR Adverse Effects |
- Somnolence
- Dizziness - Constipation |
|
|
SEROQUEL
SEROQUEL XR Consult |
- Titration period may be required
- Do not change dosage/discontinue without approval of MD - May be taken without regards to meals |
|
|
RISPERDAL
Adverse Effects |
- Extrapyramidal Symptoms
- Tachycardia - Rash |
|
|
RISPERDAL
Consult |
- May cause fainting during initial doses
- Avoid alcohol - Take with food or milk to avoid GI upset - Avoid overexposure to sunlight/extreme temperatures |
|
|
ZYPREXA
Adverse Effects |
- Somnolence
- Agitation - Insomnia |
|
|
ZYPREXA
Consult |
- Do not change doses/discontinue without approval of MD
- May be taken without regards to meals - Use caution when rising from a prone position |
|
|
Why would someone take a supplement?
|
- Low lab values
- Symptoms of deficiency - Treatment of disorders |
|
|
Where is potassium chloride commonly found?
|
- Mineral used in making fertilizer
- Salt substitutes |
|
|
KLOR-CON
K-DUR MICRO-K Generic Name, Class, Indication |
Potassium Chloride (KCl)
Potassium Supplement, treats hypokalemia |
|
|
KLOR-CON
K-DUR MICRO-K Adverse Effects |
- Diarrhea
- N/V - Abdominal discomfort - Flatulence |
|
|
KLOR-CON
K-DUR MICRO-K Consult |
- Take with food to decrease stomach upset
- Take with 8 ounces of water - Do not crush or chew (except K-Dur) |
|
|
FOLIC ACID is necessary for the formation of?
|
- Neural tube
- RBCs |
|
|
FOLIC ACID is a form of what vitamin?
|
Vitamin B-9 (water soluble)
|
|
|
What foods are high in FOLIC ACID?
|
- Leafy vegetables
- Beans - Peas - Fortified cereal products - Sunflower seeds - Liver |
|
|
What is the recommended dose of FOLIC ACID for ages 1-3?
|
150 micrograms daily
|
|
|
What is the recommended dose of FOLIC ACID for ages 4-8?
|
200 micrograms daily
|
|
|
What is the recommended dose of FOLIC ACID for ages 9-13?
|
300 micrograms daily
|
|
|
What is the recommended dose of FOLIC ACID for ages 14+?
|
400 micrograms daily
|
|
|
What is the recommended dose of FOLIC ACID for pregnant women (14+)?
|
600 micrograms daily
|
|
|
What is the recommended dose of FOLIC ACID for lactating women?
|
500 micrograms daily
|
|
|
What could happen to the baby if mom doesn't get adequate amounts of FOLIC ACID?
|
- Spina bifida
- Skull and brain abnormalities |
|
|
FOLIC ACID
Adverse Effects |
- Slight flushing
- Irritability - Difficulty sleeping - Rash - GI upset |
|
|
GLYCOLAX
MIRALAX Generic Name, Class |
Polyethylene Glycol 3350, NF
Osmotic laxative (increase water to intestines) |
|
|
GLYCOLAX
MIRALAX Adverse Effects |
- Cramps
- Diarrhea - Gas - Bloating - Nausea |
|
|
GLYCOLAX
MIRALAX Consult |
- Mix powder (17g) with 8 ounces of water, juice, cola, tea, etc.
- May take 2-4 days for effect - Do not use for more than 2 weeks |
|
|
DRISDOL
Generic Name, Class |
Vitamin D, Ergocalciferol
Vitamin Supplement |
|
|
DRISDOL (Vitamin D3)
Indications |
- Rickets
- Hypoparathyroidism - Important for calcium and phosphorous absorption |
|
|
What is the recommended dose of VITAMIN D for people < 50?
|
200 IU daily
|
|
|
What is the recommended dose of VITAMIN D for people 71+?
|
600 IU daily
|
|
|
What is the recommended dose of VITAMIN D for pregnant or lactating women?
|
200 IU daily
|
|
|
What foods provide VITAMIN D?
|
- Fatty fish
- Beef liver - Egg yolks - Cheese (small amounts) - Fortified milk (dairy products are not usually fortified) |
|
|
What is Vitamin D2 and what does it do?
|
- Ergocalciferol
- Increases vitamin D in blood |
|
|
What is Vitamin D3 and what does it do?
|
- Cholecalciferol
- Increases vitamin D in blood and keeps levels raised for longer than D2 |
|
|
Can you get Vitamin D from tanning beds?
|
Yes
|
|
|
Can you get Vitamin D via sunlight shining through a window?
|
No - must be direct contact
|
