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133 Cards in this Set
- Front
- Back
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What type of headache is characterized by unilateral throbbing head pain of moderate to severe intensity?
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Migraine
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The exact cause of migraine headache is not completely understood, although _______ and _________ are clearly involved.
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Vasodilation/inflammation
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In migraine headaches, the role of CGRP is to ______ migraine, whereas the role of 5-HT is to _____ migraine
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Stimulate/suppress
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Patients with migraine headaches who have mild to moderate symptoms should take ________ medications
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Aspirin-like
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Patients with migraine headaches who have moderate to severe symptoms should take an ___________ or a _________ medication
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Ergot alkaloid/ triptan
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If other agents fail to relieve the pain of a migraine headache a(n) ______ may be needed
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Opioid
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Antiemetics are an important adjunct to migraine therapy. The two most often used antiemetics are ________ and ________
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Metochlorpramide/Prochlorperazine
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The drug of choice for stopping an ongoing migraine attack is _____-
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Ergotamine
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A prominent effect of use of parenteral dihydroergotamine is ______
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Diarrhea
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The drugs of choice for preventing migraine headaches are the ________
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Beta Blockers
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______ is a general term defined as any drug, natural or synthetic, that has actions similar to those of morphine.
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Opioid
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______ is a term that has been used to mean an analgesic, central nervous system depressant and any drug capable of causing physical dependence.
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Narcotic
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Responses to the activation of __________ receptors include analgesia, respiratory depression, euphoria, sedation, and the development of physical dependence.
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Mu
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___________ is the prototype of the strong opioid analgesic and remains the standard by which newer opioids are measured.
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Morphine
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The most serious adverse effect of the opiods is _________
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Respiratory Depression
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When administered at usual therapeutic doses, opioids _________ cause significant respiratory depression. Often, Usually, Rarely, Never
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Rarely
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The adverse effect on the gastrointestinal system related to opioid use is ________
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Constipation
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How does the use of morphine elevate intracranial pressure?
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Decreases respiratory CO2. Increases CO2 content of blood dilating cerebral vasculature. Causes intracranial pressure (ICP)to rise
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Opioid overdose causes three major symptoms. What are they?
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Coma, respiratory depression and pinpoint pupils
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Use of meperidine is on the decline because of 3 major reasons. What are they?
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Short 1/2 life, drug interactions, & toxic metabolite accumulation
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The most effective dosing schedule for morphine is ______
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Around the clock - ATC - fixed schedule
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To minimize physical dependence and abuse, opioid analgesics should be administered how?
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The lowest effective dosages for the shortest time period.
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The underlying cause of the sypmtoms and signs of asthma is ____________
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Immune mediated airway inflammation
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The two major pharmacologic classes of drugs used to treat asthma are ________ and _________
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Anti-inflammatories and bronchodilators
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Beta2 agonists function by promoting _________
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Bronchodilation
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Glucocorticoids are indicated for the treatment of which type of asthma?
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Chronic
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Potential adverse effects of oral glucocorticoids include?
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1.adrenal suppression 2.osteoporosis 3.hyperglycemia 4.peptic ulcer disease 5.growth suppression in young pts
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How does the drug Cromolyn work?
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Stabilizes the membrane mast cells so they can't release histamine & other mediators
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What drug stabilizes the membrane of mast cells so that they can't release histamine & other mediators?
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Cromolyn
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The newest class of drugs for the treatment of asthma is the ____________
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Leukotriene modifiers
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The drug of choice for the treatment of exercise-induced bronchospasm is ____________
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Cromolyn sodium
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What is the substance that plays an important role in allergic reactions and regulation of gastric acid secretion?
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Histamine
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What does histamine do in the vascular system?
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Dilates blood vessels and increases capillary permeability
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What does histamine do in the bronci?
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Constricts
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What does histamine do in the stomach?
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Stimulates acid secretions
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What does histamine do to the central nervous system?
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Acts as a neurotransmitter
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________ and ________ are the two types of cells in which histamine is synthsized and stored
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Mast cells and basophils
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The initial requirement for allergic release of histamine is the production of antibodies of the _______ class
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IgE
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The principal causative agents in anaphylactic shick are ______
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Leukotrienes
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Overdose with antihistamines can produce _______.
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CNS stimulation
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Overdose of antihistamines can produce CNS stimulation which can result in ______
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Convulsions
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Despite their widespread presence in cold remedies, antihistamines are of _______ against the common cold
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NO VALUE
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The second-generation antihistamines exert little or no sedative effect because ___________
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They don't cross the Blood Brain Barrier
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The principal drugs used to treat allergic rhinitis include what 4 classes?
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Oral antihistamines, intranasal glucocorticoids, intranasal cromolyn & sympathomimetics
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What is the role of antihistamines in the treatment of the common cold?
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Decrease rhinorrhea but not effective in reducing congestion - NO VALUE
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What Is the role of antihistamines in the treatment of allergic rhinitis?
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H1 blocker, decreases rhinorrhea, itching eyes nose and throat. Most helpful prophylactically - not much help after symptoms appear.
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What is the only antihistamine available for intranasal use?
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Azelastine
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How does cromolyn work?
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Decreases symptoms by suppressing histamine release & other mediators from mast cells
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What drug is a monoclonal antibody that is directed against immunoglobulin E?
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Omalizumab
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The two most frequently used drugs for cough suppression are _____ & ______
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Codeine and hydrocodone
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_______ is the most effective non-opioid cough suppressant available
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Dextromethorphan
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What actions do Beta2 agonists have on the lungs?
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Bronchodilators
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How do Beta2 agonists work?
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Selective activation of Beta2 receptors on smooth muscle in lungs promotes bronchodilation
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Name 2 long acting Beta2 agonists
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Salmeterol (Serevent) & Formoterol(Foradil)
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Name 1 short acting Beta2 agonist
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Albuterol (Proventil)
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Which type of beta2 agonist do you use for quick relief?
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Short acting
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Which type of Beta2 agonist do you use on a fixed schedule?
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Long acting
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Can you "pre-treat" yourself for exercise induced asthma?
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Yes - take SABA prophylactically immediately before exercise or Cromolyn 15 min before
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Should spacers be used for any type of inhaler?
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YES
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What do leukotrienes do?
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Promote bronchoconstriciton and eosinophil filtration causing mucus production and edema
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What type of drug is Singulair?
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Leukotriene blocker
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Name a leukotriene blocker
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Singulair
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What is the purpose of inhaled glucocorticoids?
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Anti-inflammatory
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Why are inhaled glucocorticoids so great?
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They are the most effective medication for the treatment of asthma
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How do inhaled glucocorticoids work?
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They suppress inflammation in the bronchi
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Are inhaled glucocorticoids given PRN or on a fixed schedule?
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Fixed schedule
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Name 2 glucocorticoids
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Budesomide (Pulmicort), Ciclesomide (Azmacort)
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Which do you give first Albuterol or Pulmicort? Why?
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Albuterol - to open bronchioles & allow more surface area for pulmicort to work on
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Why is Cromylin so safe and effective?
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Only 8% is absorbed in the lungs & it is excreted in the urine unchanged. Suppresses inflammation
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Name an anticholinergic drug
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Ipratropium (Atrovent)
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What does Ipratroprium (Atrovent) do?
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Promotes bronchodilation
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What is Ipratroprium (Atrovent) mainly used to treat?
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COPD
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What type of drug is Ipratroprium (Atrovent)?
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Anticholinergic
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Atrovent is a drug used for COPD. Can it be prescribed for asthma as well?
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YES
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What does Theophylline (TheoDur) do to help with COPD?
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CNS excitation and bronchodilation
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What is a COPD medication that is occasionally used as an IV drip in critical care?
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Amminophylline
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Why is it important for people with COPD do get their flu and pneumonia vaccines?
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Do decrease the incidence of illness and death
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How often should a person with COPD get a flu shot?
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EVERY YEAR
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How often should a person with COPD get a pneumococcal vaccine?
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Every 5-10 years
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Is COPD a reversible disease?
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Not Fully NO!
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Why does morphine help dyspnea?
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Mu receptors located in the lung
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Where is histamine synthesized and stored?
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In Mast cells
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What are the S/S of H1 receptor stimulation?
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1.Vasodilation 2.Increased capillary permeability 3.bronchoconstriction 4.mucus secretion 5.sensory nerves - itching & Pain
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What receptors do antihistamines block?
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H1 receptors
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What type of drug is the first line therapy for allergic rhinitis?
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Anti histamines
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Give an example of a 1st generation antihistamine
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Diphenhydramine (Benadryl)
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What is a side effect of diphenhydramine?
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It is highly sedating
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Give 4 examples of 2nd generation antihistamines
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Loratadine (Claritin), Astelin, Astepro, Pantanase
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What are some side effects of 2nd generation antihistamines?
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Drowsiness and headache
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What are 2 benefits of 2nd generation antihistamines?
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Less sedating and they don't cross the BBB
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What are the side effects of anticholinergic drugs?
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Blurred vision, drying effects in the mucosa, constipation (can't see, can't pee, can't spit, can't poop)
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Name 2 glococorticoids
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Flonase, Nasonex
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What type of allergy medication is given orally?
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Leukotriene antagonist
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Why does Singulair (a leukotriene antagonist) have little impact in itching/sneezing?
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They don't block histamine receptors
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What is the term for a complex reflex involving the CNS, peripheral nervous system and the muscles of respiration?
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COUGH
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Why is a cough often beneficial?
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It brings the mucus up out of the lungs (mucus can trap bacteria)
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When should a cough be suppressed?
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When it is non-productive, associated with a cold or caused by an upper respiratory infection
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How do opioid anti-tussives work?
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They act in the CNS to elevate the cough threshold
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What is the most commonly used opioid anti-tussive?
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Codeine
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What is the most commonly used non-opioid anti-tussive?
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Dextromethorphan
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Name one side effect of dextromethorphan?
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Can cause hallucinations in high doses
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Can dextromethorphan reduce pain?
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YES
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Is Benadryl an anti-tussive?
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YES - in larger doses
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What medication makes a cold go away?
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NONE
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What type of medication may be helpful during a cold to dry up mucus membranes?
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Antihistamines
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What type of medication may be helpful during a cold to relieve nasal congestion?
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Decongestants
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Name 1 decongestant that is and oral tablet or a liquid
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Pseudoephedrine (Sudafed)
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Name 1 decongestant that is a nasal spray
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Phenylephrine (Neo-Synephrine)
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What is a side effect of using decongestant nasal sprays?
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Rebound nasal congestion
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How can rebound nasal congestion be limited when using decongestant nasal sprays?
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Don't use more than 3 days
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What are the 3 properties of an "ideal" drug?
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Effectiveness, safety and selectivity
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What does the term agonist mean?
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It makes something work better - activates receptors
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Name a drug that is an agonist
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Morphine
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What does the term antagonist mean?
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It prevents receptor activation
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Name a drug that is an antagonist
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Naloxone
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What is the term that refers to the dose that is effective in 50% of people?
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ED50
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What is the term that refers to the dose that is lethal to 50% of people?
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LD50
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What is the drug metabolizing enzyme system that inactivates drugs and can also accelerate them?
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Cytochrome P-450
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Name 2 prodrugs
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Codeine and morphine
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What is a prodrug?
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What is the term that means the ability of a drug to reach systemic circulation from the site of administration?
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Bioavailability
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What is the term that means the ability to change a drug into a water soluble form?
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Biotransformation
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Where in the body does biotransformation primarily occur?
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LIVER
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Where in the body other than the liver can biotransformation occur?
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Plasma, kidneys, and membranes of intestines
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What are 2 diseases that can slow metabolism?
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Cirrhosis and CHF
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What is the term that refers to the amount of drug given to ellicit an effect?
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Potency
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What is the term that refers to the minimum amount of drug necessary to get a response?
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Plasma drug level
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What is the term that refers to how a drug moves across a membrane into the blood?
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Absorption
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What are 5 things that can affect absorption?
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1.Surface area 2.how fast drug dissolves 3.blood flow 4.lipid solubility 5.pHpartitioning
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What is the term that refers to how a drug is delivered to the site of action?
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Distribution
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What is the term that means the process to remove drugs from the body?
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Excretion
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The ______ rate (a process to remove drugs from the body) determines drug concentration in tissues and affects the duration of a drugs action
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Excretion
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What does a bolus or a loading dose do?
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It brings concentration of drug in the blood up to a certain level where a normal dose can then be administered
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