Pharm Exam 3

Front 1

TCA trycyclic antidepressants: action & adverse effects

Back 1

work for neuropathic pain & ADHD, OCD, panic, bipolar.
direct toxicity to myocardia (also orthostatic hypotension, sedation, seizure, and anticholinergic effects)

Front 2

SSRI selective seratonin reuptake inhibitors: action & adverse effects

Back 2

main treatment for depression. also used for bulimia & OCD.
loss of interest in sex, can increase risk of bleeding, cause weight change, danger in mixing meds.

Front 3

main SSRI & some adverse effects

Back 3

Fluoxetine (Prozac, Sarafem)
3/4 of users lose interest in sex.
nausea, headache, weight gain.
can cause increased nervousness. main problem: takes a long time to take effect and someone has to watch out for that person while waiting for effect b/c of increased risk for suicide

Front 4

MAOI monoamine oxidase: action & some adverse effects

Back 4

Last choice for treating depression b/c it's so unsafe w/ many foods--anything containing tyramine, such as aged meats and cheeses, and anything fermented, bananas & avocadoes. food interaction -> hypertensive crisis. transdermal has less risk for hypertensive effects.

Front 5

Bupropion

Back 5

atypical antidepressant that helps w/ weight loss and to quit smoking; no decreased interest in sex.
headache, tremors, seizure, insomnia, dry mouth, nausea, constipation

Front 6

Lithium action & adverse effects & interactions

Back 6

mood stabilizer that may increase gray matter in brain. fatigue, impaired memory, extreme thirst & polyuria. interactions w/ caffeine & other diuretics b/c of increasing levels of Li. interaction w/ NSAIDs, also increase Li.

Front 7

Valproic acid

Back 7

many physicians' first choice for treating bipolar.

Front 8

how often should Lithium blood levels be checked?

Back 8

every 2-3 days in patients who have just started taking it.

Front 9

SNRI

Back 9

not as safe as SSRI; Cymbalta; risk for suicidal thoughts. same properties as SSRI.

Front 10

antipsychotics in bipolar

Back 10

used in manic (euphoric) episodes.

Front 11

main difference between sedative and hypnotic pharmaceuticals...

Back 11

dosage

Front 12

2 main classes of sedative/hypnotic drugs & which is considered safer

Back 12

Barbiturates & Benzodiazapines (Benzo considered safer; less chance of physical dependence)

Front 13

uses of Benzodiazapines

Back 13

drug of choice for insomnia & anxiety; also used to manage seizures, alcohol w/drawal, panic & muscle spasms

Front 14

adverse effects of Benzodiazapines

Back 14

Respiratory Depression, amnesia, sleep activity (driving)

Front 15

treatment for overdose of Benzos

Back 15

Flumazenil (Romazicon)

Front 16

4 uses for barbiturates

Back 16

seizure, insomnia, induce anasthesia, induce coma

Front 17

unusual adverse effect of barbiturate

Back 17

hyperalgesia

Front 18

treatment for overdose of barbiturates...

Back 18

dialysis & alkalinization of the urine; no antidote.

Front 19

signs of barbiturate toxicity

Back 19

same as opioid toxicity: pinpoint pupils, respiratory depression, coma.

Front 20

top 2 types of drugs for treating anxiety

Back 20

SSRI's and benzodiazapines.

Front 21

Buspirone

Back 21

Benzo treatment for anxiety; no potential for abuse; non-CNS depressant; non-sedative, but anti-anxiety effects develop slowly

Front 22

adverse effects of all CNS stimulants

Back 22

convulsions, tremors, seizures

Front 23

adverse effects & toxic effects of amphetamines

Back 23

adv: tachycardia, vasoconstriction & psychoses; tox: dysrhythmia, convulsion, coma

Front 24

problems w/ amphetamines

Back 24

potential for abuse b/c of euphoria & physical dependence b/c of withdrawal syndrome

Front 25

therapeutic uses of amphetamines

Back 25

ADHD & narcolepsy (no longer used for obesity)

Front 26

caffeine is an example of a...

Back 26

methylxanthine

Front 27

main treatment of ADHD in children

Back 27

amphetamine mixture, Adderall

Front 28

nonstimulant drug therapy for ADHD in children & adverse effects

Back 28

Strattera; anorexia, dizziness, insomnia

Front 29

3 categories of drugs for ADHD in children

Back 29

CNS stimulants (amphetamines; Adderall), nonstimulant (Strattera), antidepressants (Bupropion)

Front 30

Wernicke's encephalopathy

Back 30

neurological damage from alcohol; nystagmus, confusion, abnormal eye movements; reversible w/ Thiamin

Front 31

type of drug used to facilitate alcohol withdrawal

Back 31

benzodiazapines; help to repress seizure

Front 32

drug for aversion therapy for alcohol

Back 32

disulfiram

Front 33

4 nutrient replacements for recovering alcoholics

Back 33

antibiotics
fluid replacement
magnesium (cardiac arrhythmia)
B vitamins

Front 34

non-nicotine drug treatments for smoking cessation

Back 34

Bupropion (lower dose than as antidepressant)
Varenicline--seen most commonly; increased risk for suicide at first

Front 35

meperidine

Back 35

opioid highly effective in oral route; abused by doctors and nurses; occaisionally used in hospitals to prevent tremors.

Front 36

methadone

Back 36

long-acting substitution for short-term use for weening off of opioid

Front 37

subjective effects of barbituate overuse & treatment

Back 37

similar to alcohol; coma, respiratory depression. treatment: dialysis, airway maintenance

Front 38

subjective effects of MDMA/ecstasy

Back 38

tachycardia, dysrhythmia, hypertension

Front 39

3 basic functions of diuretics

Back 39

1. cleanse ECF and maintain ECF volume & composition
2. maintain pH
3. excrete metabolic wastes & foreign substances

Front 40

3 adverse effects of diuretics

Back 40

1. hypovolemia
2. pH imbalance
3. electrolyte imbalance

Front 41

3 specific diseases treated by diuretics

Back 41

1. heart failure
2. pulmonary edema
3. hypertension

Front 42

Furosemide (Lasix)

Back 42

most frequently prescribed loop diuretic. Rapid onset. allergy to Sulfa drugs -> allergy to Lasix. adv. effects: Hypokalemia (among other hypos), ottotoxicity, increase LDL, decrease HDL, hyperglycemia, hyperuricemia

Front 43

Lasix drug interactions

Back 43

Digoxin (b/c of hypokalemia), ototoxic drugs, NSAIDs decrease diuretic effects

Front 44

Thiazides

Back 44

similar to Loop diuretics, but less impact. Not effective when urine is scant

Front 45

HCTZ

Back 45

(Hydrochlorothiazide) Widely used; effective and affordable. Peaks 4-6 hours after dose. same adv. effects as Lasix (Hypokalemia, lipids, hyperglycemia.)

Front 46

Spironolactone

Back 46

aldosterone antagonist; potassium-sparing diuretic. modest increase in urine production. increased excretion of sodium. useful in heart failure--decreases mortality. can cause hyperkalemia, tumors & endocrine effects.

Front 47

Mannitol (Osmitrol)

Back 47

Osmotic diuretic; given parenterally. Creates osmotic force w/in nephron. Useful for reduction of intracranial pressure, as well as renal failure.

Front 48

why take HCTZ and spironolactone together?

Back 48

spiro conserves potassium, HCTZ wastes it; together maximize fluid pulled off and balance K.

Front 49

isotonic contraction, causes & treatment

Back 49

water & Na lost proportionately; vomiting diarrhea, kidney disease. 0.9% normal saline. slowly to prevent pulmonary edema.

Front 50

hypertonic contraction

Back 50

more water lost than sodium. give water.

Front 51

hypotonic contraction

Back 51

more sodium lost than water. chronic renal insufficiency; lack of aldosterone. mild--infuse isotonic sodium, severe--infuse hypertonic solution (3% NaCl)

Front 52

2 blood components closely related to potassium

Back 52

acid & glucose; vary similarly

Front 53

normal common range for potassium

Back 53

3.5-5 mEq/L

Front 54

problem w/ administering potassium

Back 54

irritating by whatever route.

Front 55

causes & symptoms of hypomagnesemia

Back 55

C: diarrhea, hemodialysis, kidney disease, prolonged IV feeding, chronic alcoholism. S: muscle irritability, dysrhythmia

Front 56

BNP: brain natiuretic peptide

Back 56

"Natrecor"; BNP is used as test for excessive stretch of heart; test for BNP before administering.

Front 57

actions of aldosterone

Back 57

retention of sodium and water--regulates BP

Front 58

ACE inhibitors

Back 58

"-pril"
dilate vessels; decrease afterload + BP; mainly for hypertension.
early ones were from snake venom.
reduce Angiotensin II. increase bradykinin.

Front 59

adverse effects of ACE inhibitors

Back 59

first-dose hypotension. cough (ACE is in lungs). hyperkalemia (K retention). Dysgeusia (distorted sense of taste). Renal failure possible.

Front 60

ARBs: angiotensin II receptor blockers

Back 60

"sartans"
similar to ACE inhibitors, but don't increase bradykinin.

Front 61

adverse effects of ARBs

Back 61

no cough, angioedema of lips/tongue--can block airway. fetal harm, renal failure.

Front 62

Eplerenone (Inspra)

Back 62

aldosterone antagonist; used for hypertension/heart failure. adv. effects: hyperkalemia

Front 63

calcium channel blockers

Back 63

treat hypertension, angina, dysrhythmia. Verapamil & Diltiazem; act on vascular smooth muscle & heart. Dihydropyridines: act mainly on vascular smooth muscle. controversy: safety for patients w/ hypertension & diabetes.

Front 64

Verapamil can be used to treat what kind of tachycardia?

Back 64

supraventricular--above ventricle.

Front 65

adverse effects of Verapamil

Back 65

constipation, headache, edema of ankles & feet, heart block

Front 66

drug interactions & toxicity of Verapamil

Back 66

Digoxin, Beta-blockers. Severe hypotension, bradycardia, ventricular tachydyrhythmias, esp by IV.

Front 67

adverse effects of Diltiazem

Back 67

similar to Verapamil, but less constipation.

Front 68

Nifedipine

Back 68

Dihydropyridine; vasodilation by blocking Ca channels. Not used to treat dysrhythmia. Less likely than verapamil to exacerbate pre-existing cardiac disorders. can cause reflex tachycardia, since it only affects the vessels. Can be combined with beta blocker to prevent reflex tachycardia

Front 69

Hydralazine (Apresoline)

Back 69

selective dilation of arterioles -> reflex tachycardia (combine w/ beta blocker); therapeutic uses: hypertension, heart failure

Front 70

Minoxidil (Loniten)

Back 70

unwanted hair growth (also sold as rogaine); originally for selective dilation of arterioles.

Front 71

Diazoxide (Hyperstat IV)

Back 71

used for hypertension emergencies; selective dilation of arterioles. Adv. effects: Reflex tachy, NaCl and H20 retention, hyperglycemia, hyperuricemia. interactions w/ diuretics and antihypertensive drugs

Front 72

sodium nitroprusside (nitropress)

Back 72

fastest acting antihypetensive agent; only in critical setting; hypertensive emergency. venous and arteriolar dilation.cyanide poisoning -> death