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N3540 Final
Pharm Final
| Question | Answer |
|---|---|
| What causes contraction of detrusor muscle and relaxation of trigone sphincter and can be used to treat post op and postpartum urinary retention? | bethanechol - muscarinic agonist |
| Treatment of muscarininc poisoning, manifested by salivation, lacrimation, visual disturbance, brochospasm, diarrhea, bradycardia, hypotension, and cardiovascular collapse? | atropine - muscarinic blocking agent |
| Cholinergic Receptor Subtypes and function | Nicotinic (n)- stimulation of parasympathetic and sympathetic postganglionic nerved and release of epinephrine form adrenal medulla |
| Cholinergic Receptor Subtypes and function | Nicotinic (m) - contraction of skeletal muschle |
| Cholinergic Receptor Subtypes and function | Muscarinic - all parasympathetic target organs: miosis, dec HR, bronchi constriction, voiding, salivation, GI motility, defecation, erection, vasodilation (BP decreases) |
| Muscarinic antagonist | Atropine - adverse effects (BUDCAT) |
| What does BUDCAT, the adverse effects of anticholinergic drugs, stand for? | Blurry vision, urinary retention, dry mouth, constipation, anhidrosis, tachycardia |
| What drug would you use in mysasthenia gravis, reversal of neuromuscular blockade in postoperative patients, glaucoma, Alzheimer's, and poisoning by muscarinic antagonists? | neostigmine - choinesterase inhibitor |
| What drug would you use for relaxation during an endotracheal intubation? (This drug can also CAUSE malignant hyperthermia, which is treated with dantrolene) | Succinylcholine - neuromuscular blocker |
| What drug activate all four adrenergic receptors (alpha1, alpha2, beta1, beta1) and can be used for cardiac arrest, heart failure, anaphalactic shock, AV heart block and asthma? | epinephrine - adrenergic agonist |
| What drug is used for treatment of nasal congestion, delay of anesthetic absorption, dilation of the pupil for ocular exam? (activate alpha1 receptors) | phenylephrine - adrenergic agonist (noncatecholamine) |
| What would you used in essential hypertension, reversal of toxicity from alpha1 agonists, benign prostatic hyperplasia, pheochromocytoma, and Raynaud's disease? | prazosin - alpha-adrenergic antagonist |
| Name this drug: MOA - Blocks beta1 and beta2 Uses - hypertension, angina pectoris, cardiac sysrhythmias, myocardial infarction, hyperthyroidism, migrain headache prophylaxis, and "stage fright" | propranolol - beta-adrenergic antagonist (first-gen nonselective beta blocker) |
| nonselective beta blocker for dysrhythmias? | sotalol - beta adrenergic antagonists (first-gen nonselective beta blocker) |
| Cardioselective beta blocker for hypertension, angina pectoris, heart failure, myocardial infarction? | metoprolol - beta adrenergic antagonist (second-gen cardio selective beta blocker) Others include: acebutolol, atenolol, betaxolol, bisoprolol, esmolol |
| What would you use with hypertension and hypertensive emergencies? | labetalol - beta adrenergic antagonist (third-gen vasodilating alpha and beta blocker) Others include: carvedilol (heart failure) |
| Name the drug: MOA - CENTRALLY acting, net effect of cardiac suppression and vasodilation is decreased blood pressure. Uses: Hypertension, epidural infusion to relieve severe cancer pain | clonidine - centrally acting alpha2 agonist Others include: guanabenz, guanfacine, methyldopa |
| Which drug would be used to treat Parkinson's? | levodopa - dopaminergics Others include: pramipexole, selegiline, amantadine, ropinirole, entacapone |
| Which used in Alzheimer's? | donepezil - cholinestrase inhibitor Others include: memantine, rivastigmine, galntamine |
| Name the drug: Used in epilepsy, cardiac dysrhythmias Adverse effects: gingival hyperplasia, hirsutism, narrow therapeutic range, induction of P450 | phenytoin - antiepileptic drugs (AEDs) Others include: carbamazepine, valproic acid, ethosuximide, phenobarbitol |
| What drug works on GABA and is used for epilepsy, bipolar, and migraines? | valproic acid - antiepileptic drugs (AEDs) Others include: oxcarbazepine, tiagabine |
| Which drug causes relaxation, possibly by sedative properties and is used to relieve spasm resulting from muscle injury? (Adverse effects: CNS depression, hepatotoxicity, physical dependence) | metaxalone - muscle relaxants Others include: baclofen, diazapam, dnatrolone, carisoprodol, cyclobenzaprine, cyclobenzarine, chlorzoxazone (sucks, don't use), methocarbamol, orphenadrine, tizanidine |
| Which drug stops axonal conduction by blocking sodium channels in axonal membrane and stops nerve conduction and is used in surgical anasthesia? | lidocaine - local anesthetic |
| Which pain reliever activates mu receptors, produces analgesia, eurphoria, and sedation? | morphine - opioid analgesics |
| Which drug is 100x stronger than morphine? | fentanyl - strong opioid agonist |
| Which drug is 1000x stronger than morphine? | alfentanyl and sufentanil - strong opiod agonist |
| What will reverse adverse effects of opioid analgesics? | naloxone - opiod antagonist |
| Moderate to strong opiod agonists include: | codeine (alone class II), oxycodone, hydrocodone, propoxyphene |
| Strong opioid agonists include: | fenttanyl, alfentanil, remifentanil, meperidine (use in preg; dec res dep), heroin, hydromorphone, oxymorphone, levorphanol |
| Name the drug: MOA - acts on kappa receptos and antagonist at mu, produces alagesia and sedation, mild res depression, increased cardiac work. Used: relief of mild to moderate pain | pentazocine - agonist-antagonist opiods Others include: nalbuphine, butorphanol, buprenorphine |
| Name the drug: MOA: analog of codeine, weakly activates mu opioid receptors, blocks uptake of NE and seratonin Uses: relieves moderate to severe pain (low potential for abuse, not a scheduled drug) | tramadol - nonopioid centrally acting analgesics Other include: clonidine, ziconotide |
| Preferred treatment for depression? | imipramine - tricyclic antidepressants (TCAs) Others include: amitriptyline, clominpramine, desipramine, doxepin, maptotiline, nortiptyline, protripyline, triminpramine |
| What drug category is used for major depression, bipolar, OCD, Panic, bulimia, premenstrual dysphoria? | Selective serotonic reuptake inhibitors (SSRIs) Includes: fluoxetine (Prozac), paroxetine (Paxil), fluvoxamine (Luvox), sertaline (Zoloft), citalopram (Celexa), escitalipram (Lexapro) |
| Why are SSRIs preferred to MAOI's? | MAOIs have too many drug interactions and can cause hypertensive crisis from high levels of dietary tyramine. Includes: isocarboxazid |
| What is used for major depression, SAD, smoking cessation, relief of neuropathic pain (unlabeled), ADHD (unlabeled) and may have adverse effect of risk of seizure, suicide, and other adrenergic type side effects? | bupropion - atypical antidepressant Others include: nefazodone (cause liver failure), mirtazapine, amoxapin, reboxetine, trazodone (sedative effects) |
| Examples of mood-stabilizing drugs: | antiepileptic drugs: valproic acid, carbamazepine, lamotrigine atypical antipsychotics: olanzaine, aripiprazole, ziprasidone |
| What class of drugs depresses the CNS, reduces anxiety, promotes sleep, and potentiate GABA with little respiratory depression (oral)? | benzodiazepines: alprazolam (Xanax), and "pam"/"lam" |
| What are the uses of benzodiazepines? | anxiety, insomnia, seizure disorder, induction of anesthesia, muscle spasm, panic disorder, and withdrawal from alcohol |
| What is the reversal agent for benzodiazepines? | flumazenil |
| Would you discontinue taking anti-epileptics (Valproic acid (monitor LFT), carbamazepine (monitor CBC) if you become pregnant? | No, the risk of seizure and status elipticus is far more dangerous than the risk to fetus...although the drugs are very dangerous too. |
| Name the benzodiazapine-like drugs that potentiate GABA and are used for short term management of insomnia | zolpidem (Ambien), zaleplon (Sonata), Eszopiclone (Lunesta: no limit on treatment because of study)...and melatonin agonist remelteon. |
| CNS stimulants used for ADHD and narcolepsy (schedule II) | methylphenidate (Ritalin), dexmethylphenidate, amphetimine, atomoxetine (Strattera: non stimulant) |
| What would you use as a FAST acting diuretic? (profound diuresis) | furosemide - high-ceiling loop diuretic Others include: torsemide |
| Adverse effects of furosemide - high ceiling loop diuretic? | hypokalemia, hypotension, hyperglycemia, ototoxicity, may cause dysrhythmias with used with digoxin (reduces potassium - cardiac glycoside used to treat heart failure with narrow therapuetic range) |
| What diuretic would you use for treatment of hypertension, mobilization of edema with mild heart failure, hepatic or renal disease, and it is ineffective when GFR is low? | hydrocholorothizide - thiazide diuretics Others: chlorothiazide, methyclothiazide, chlorthalidone, metolazone |
| Adverse effects of hydrochlorothiazide - thiazide diuretic? | hypokalemia (mild, treat with food), hypotension, hyperglycemia, cause dysrhythmias with used with digoxin |
| Uses of potassium sparing diuretics? | spironolactone hypertension and edema, used in combo with other diuretics to counterbalance potassium loss, heart failure |
| Adverse effects of potassium sparing diuretics? | hyperkalemia (potassium SPARING), gynecomastia, hirsutism |
| Osmotic diuretics: creates osmotic force in the lumen of the nephron, promotes diuresis by inhibiting passive reabsorption of water. Uses: prophylaxis of renal failure, reduce intracranial pressure, reduce intraocular pressure | mannitol |
| Adverse effects of mannitol - osmotic diuretic? | edema, heart failure, pulmonary edema |
| What are the uses of ramipril - ACE inhibitor? | hypertension, heart failure, MI, diabetic and nondiabetic nephropathy, prevention of MI/stoke/death |
| Adverse effects of ramipril - ACE? | hypotension, cough, hyperkalemia, renal failure in patients with renal artery stenosis, fetal injury, angioedema, neutropenia |
| What are the uses of losartan - ARB? | hypertension, heart failure, MI, diabetic nephropathy, prevention of MI/stroke/death |
| Adverse effects of losartan - ARB? | renal failure in patients with reanl artery stenosis, hypotension, angioedema, fetal harm |
| Name the drug: MOA: block calcium channels in the heart and blood vessels, dilate peripheral arterioles to reduce BP, increase coronary perfusion, reduce force of myocardial contraction Uses: angina, essential hypertension, cardiac dysrhythmias | verapamil and diltiazem - nondihydropyridine calcium channel blocker |
| Name the drug: MOA: blocks calcium channels in the blood vessels, little effect on heart rate or contractility Uses: hypertension, angina | amlodipine - dihydropyridine calcium channel blocker |
| Name the drug: MOA: selective dilation of arterioles, decrease in peripheral resistance and arterial blood pressure, increase in heart rate and myocardial contractility Uses: essential hypertension, hypertensive crisis, heart failure | hydralzine - vasodilator Other vasodialators: ACE, ARB, DRI (direct renin inhibit), CCB, alpha adrenergic blocking, ganglionic blocking, adrenergic neuron blocking, drugs used for pulmonary artery hypertension |
| Drugs used to treat heart failure: | cardiac glycosides (digoxin), diuretics, ACE, ARB, Beta blocker, Aldosterone blocker |
| What treats digoxin overdose (therapeutic level: 0.5 to 0.8 ng/mL)? | Digibind |
| What are some nursing considerations of digoxin? | hold if HR <60BPM or potassium is low, inject slowly over 5 minutes, can cause visual disturbances, dysrhymias |
| What is nitroglycerin - organic nitrate used to treat and why? | angina, myocardial infarction; dilates veins and decreases venous return to the heart, reduces ventricular filling and wall tension (preload), reduces cardiac demand. |
| The following are antianginal agents: | nitroglycerin - organic nitrate, beta blockers (-lol), calcium blockers (Very Nice Drugs: verapamil, nifedipine, diltiazem), ranolazine |
| Benefits of ACE inhibitors: | decrease peripheral vascular resistance WITHOUT increasing cardiac output, cardiac rate, and cardiac contractility |
| What are the common antidysrhythmic drugs? | -diltiazem (watch for bradycardiac, edema, dizziness -propranolol (watch for hypotension, bradycardia) -quinidine sulfate -amiodarone |
| The following are antiepileptics: | phentoin: watch for gingival hyperplasia carbamazepine: watch for visual problems, ataxia, vertigo valproic acid: watch for GI upset and hepatotoxicity |
| Nursing implications with antiepileptic drugs? | never abrubtly discontinue medication, with phenytoin encourage prophalactic routine dental care and instruct client to take with meals |
| Which drug is commonly used to suppress nausea and vomiting that are associated with surgery, chemotherapy, and varied noxious stimuli? | prochlorperazine - antiemetic |
| Which drug is commonly used for nausea and vomiting caused by noxious stimuli and motion sickness? | promethazine - antiemetic; antihistamine |
| Which drug is used for conscious sedation and induction of anesthesia? | midazolam - benzodiazepine |
| Name the short duration/rapid acting insulins: | lispro, aspart, glulinsine |
| Name the short duration/slow acting insulins: | regular insuline |
| Name the intermediate duration insulin: | NPH |
| Name the long duration insulin: | glargine |
| Nursing implications for insulin? | NPH is the only cloudy, rotate sites within same region, regular and NPH can be obtained OTC |
| What are the uses for aCARBose? | delays absorption of CARBs; type II diabetes not controled by diet or exercise and can be used in conjunction with insulin or a sulfonurea |
| Side effects of acarbose? | flatulence, cramps, abdominal distention |
| Why would you use a sulfonylureas? | stimulate beta cells of pancreas to increase release insulin; mild to moderate type 2 diabetes mellitus. Side effects: hypoglycemia Nursing: take before meal |
| Prefix/suffix: ARB's | sartan |
| Prefix/suffix: ACE | pril |
| Prefix/suffix: PPI (proton pump inhibitor) | prazole |
| Prefix/suffix: H2 receptor antagonists (used in PUD/GERD) | tidine |
| Prefix/suffix: penicillin | cillin |
| Prefix/suffix: tetracyclines | cycline |
| Prefix/suffix: fluoroquinolones adverse effects: tendon rupture, photosensitivity, C. diff resistant, only cipro for kids tx: UTI, anthrax, pseudomonas | floxacin |
| Prefix/suffix: macrolides (causes p.colitis) | thromycin |
| Prefix/suffix: lincosamides more toxic than macrolides, cause bone marrow depression and pain, and toxic colitis | ex: chloramphenicol |
| Prefix/suffix: aminoglycosides AE: auditory nerve damage, tinnitus, renal tox | cin |
| Prefix/suffix: cephalosporins AE: cross sensitivity to penicillins, GI effects, nephrotoxicity | cef/ceph |
| Prefix/suffix: sulfonamides AE: GI, rash, birth defects | mainly sulf prefix |
| Anti-mycobacterial antibiotics - treat TB | isoniazid, rifampin, ethionamide, pyrazinamide |
| Category X drugs | warfarin (Coumadin), misoprostol, androgens, statins, live vacccines |
| Bacterial vaccines | DPT, H influenzae b, pneumococcal, meningococcal |
| Antidotes: Opiods | naloxone or nalmefene |
| Antidotes: Benzodiazepines | flumazenil, slowly IV and repeat PRN |
| Antidotes: heparin (unfractionated) | protamine sulfate |
| Antidotes: neostigmine | atropine |
| Antidotes: anticoagulant warfarin | vitamin K1 |
| Antidotes: tricyclic antidepressants | gastric lavage followed by activated charcoal. Also, physostigmine salicylate to coutneract anticholinergic effect. Give propranolol, phenytoin, or lidocaine for dysrythmias |
| Antidotes: bethanecol | atropine |
| Antidotes: atropine | physostigmine |
| Name narrow therapeutic range drug: | digoxin - 0.5-0.8 heparin - aPPT between 60-80 sec, or INR 2-4.5 theophylline PO - no effect inhalation, no antidote chloramphinicol, carbamazepine, and phenytoin |
| Drug of Choice: Intracranial pressure | mannitol |
| Drug of Choice: hypertension during pregnancy | methyldopa for maintenance; hydralzine for emergency |
| Drug of Choice: Primary hypertension | hydrochlorothiazide HCTZ (thiazide diuretic) |
| Drug of Choice: Severe heart failure | furosemide (loop diuretic) |
| Drug of Choice: terminating Paroxysmal Supraventricular Tachycardia (SVT) | adenosine |
| Drug of Choice: deep vein thrombosis (DVT) | heparin low molecular weight |
| Drug of Choice: addison disease | fludrocortisone |
| Drug of Choice: bortetella pertussis | macrolide |
| Drug of Choice: systemic fungal infection | amphotericin B |
| Drug of Choice: hyperthyroid | PTU or methimazole (PTU preferred in preg) |
| Drug of Choice: hypothyroidism | levothyroxine (T3) |
| Drug of Choice: myoclonic seizure | valproic acid and topramate |
| Drug of Choice: petit mal absense seisures | ethosuximade |
| Which drugs cause hyperkalemia? | ACE (pril), ARB (sartan), K sparing diuretics (spironolactone) |
| Which drugs cause hypokalemia? | loop diuretics (furosemide) and thiazide diuretics (hydrochlorothiazide) |
| Which drugs cause hyperglycemia? | thiazide diuretics (hydrochlorothiazide), beta 2 agonists (albuterol, levalbuterol, salmeterol) |
| Which drugs cause hypoglycemia? | glucocorticoids stopped abruptly, sulfonyreas (act by increasing insulin release from the beta cells in the pancreas), meglitinides (repaglinide, nateglinide), amylin mymetics (pramlintide), incretin mimetics (exenatide) |
| Prefix/suffix: alpha1 blockers tx: Hypertension and benign prostatic hyperplasia (BPH) | zosin (prazosin, terazosin, doxazosin) |
| What are the centrally acting vasodilators? | clonidine, guanabenz, guafacine, methyldopa (for preg) |
| Sequence of heart failure tx | Stage A: ACE (or ARB) Stage B: + beta blocker Stage C: + diuretic + Digoxin Stage D: need transplant |
| What are the Class I Na channel blocker antidysrhymics? | quinidine, procainamide, lidocaine, phenytoin, flacainide, propafenone |
| What are the Class II beta blocker antidysrhythmics? | propranolol, acebutolol, emolol, sotalol (also k blocker) |
| What are the Class III K channel blocker antidysrhythmics? | amiodarine, bretyllium, dofetilide, ibutilide, sotalol (also beta blocker) |
| What are the Class IV Ca channel blocker antidysrhythmics? | verapamil, diltiazem |
Created by:
lgoodpasture
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