clinical pharm 2nd set of meds

  1. Name the 4 adrenergic agonists
    • 1. epinephrine (OTC primatene mist)
    • 2. pseudoephedrine (sudafed OTC)
    • 3. phenylephrine (neo-synephrine, sudafed PE)
    • 4. ephedrine
  2. Norepinephrine and epinephrine both have a common ____________ structure
    catecholamine (benzene ring with two OH groups)
  3. Why cant catecholamine structures be taken orally
    they disolve to quickly by MAO and COMT in the intestinal wall and liver this is called first pass effect
  4. Can Noncatecholamines such as ephedrine be taken orally? Why?
    YES, because they metabolize slowly, and they cross the BBB
  5. Epinephrine (OTC primatene Mist)
    • cant be bought OTC but can get online
    • stimulates all adrenergic receptors
    • Full fight or flight respone
    • Catecholamine (no oral)
    • must be taken nasal, IV, SQ, or topical
  6. what are the 5 clinical uses for epinephrine?
    • 1. asthma-- Beta2 activity (inhalation)
    • 2. treatment of anaphylactic shock (EpiPen)
    • 3. combined with local anesthetic to minimize absorption of "local" into bloodstream and maximize duration.
    • 4. used as an adjunct in cardiac arrest along with cardioversion
    • 5. used to induce hemostasis to reduce bleeding.
  7. Norepinephrine stimulates all the adrenergic receptors except _____________. It also is used to treat _______ and _______
    • Beta 2
    • treat shock and hypertension
  8. Pseudoephedrine (Sudafed--OTC)
    • effects all adren recptors
    • NON-catecholamines used for nasal decongestion
    • Decongestion is a result of nasal vasoconstriction
    • no longer OTC but available behind the counter, because METH
  9. Phenylephrine (Neo-synephrine, sudafed PE)
    • Cold formulas are replacing psudoephedrine with phenylephrine
    • phenylephrine is NOT better then placebo
  10. Ephedrine
    • an isomer of pseudoephedrine
    • in chinese herb mahuang (herb XTC) stimulant
    • requires a prescription, but rarely prescribed
    • supplements were available OTC, but several deatchs had them removed in 3/2004
  11. 5 Examples of "UPPERS"
    • 1. Amphetamine (Benzedrine, crank)
    • 2. MDA (methylenedioxyamphetamine--love drug) Mello Drug of America
    • 3. MDMA(methylenedioxyamphetamin--XTC)
    • 4. Quat (Khat)
    • 5. Bath salts
  12. Amphetamine and methylamphetamine
    • synthetic epinephrine with similar structures
    • originally for nasal congestion and appetite suppressants
    • "ice" free base smokign
    • "crystal" hydrochloride salt
  13. what is the condition called when meth heads hallucinate bugs crawling on themselves
  14. MDA (methylenedioxyamphetamine--love drug, "mellow drug of america"
    • similar structure to amphetamines
    • produces self awareness while eliminating anxiety and inhibition. (awesomeness)
    • RAVES
  15. MDMA (methylenedioxymethamphetamines--ecstasy XTC)
    • similar to MDA
    • changes serotonin receptors permanently ( nothing will ever feel soooo goood)
    • 750,000 users in 2000
    • briefly legal in 70's
    • can increase heart rate, heat stroke, death
  16. Quat (Khat)
    • shrub in Arabian peninsula (yemen) and East Africa
    • leaves contain active adrenergic agonists
    • chewed to stimulate
  17. Bath salts
    • uppers
    • synthetic derivatives of cathinone (not for human consumption)....or are they haha
    • 6000 calls in 2011 to poison control
  18. 3 main treatments for hyperactivity
    • 1 methylphenidate (ritalin, concerta)
    • 2. amphetamine (slow release adderall)
    • 3. modafinil (provigil)
  19. Methylphenidate ( ritalin, concerta)
    • used to treat ADHD
    • if in short acting form must be give bid or tid can conflict with schedules
    • slow relese forms are available
    • schedule II widely abused
    • reuptake of dopamine and norepinephrrine in the brain
  20. Dexmethylphenydate (focalin)
    a pure enantiomeric (right hand glove) form of methylphenidate
  21. Amphetamine
    • used for ADHD too
    • legal, control II, gives a HIGH
    • used for study aid in college (glad i got some haha just kidding)
  22. Modafinil (provigil)
    • treats narcolepsy
    • increases release monamines like epinephrine
    • and norepinephrine
    • off label use for ADHD "congnitive enhancement"
  23. name the 3 things Beta2 agonists cause
    • 1. bronchodilation
    • 2. uterine relaxation
    • 3. glycogenolysis
  24. how are asthma meds usually administered?
    MDI (metered dose inhaler) or DPI (dry powder inhaler)
  25. what are MDI (metered dose inhaler) filled with
    • gas propellant under pressure. when canister is pushed down aerosol mist is sprayed in mouth.
    • patient should breathe slowly and deep
  26. A spacer increases the amount that the drug reaches the lungs by how much 
    10% to 20% doubles
  27. Albuterol or salbutamol (ProAir, HFA)
    • most common beta2 agonist
    • primarily used to stop asthma attack
    • onset 5-15 minutes after inhalation
    • duration 3-6 hours
  28. why was chlorofluorcarbons (CFCs) discontinued
    what replaced them
    • ozone depletion
    • replaced by hydrofluoroalkanes which are underpatent $$$$$
  29. Combivent is a combination of _____ and ____ which are used for
    • ipratropium bromide and albuterol
    • used for COPD
Card Set
clinical pharm 2nd set of meds
2nd set after he told us to start using cards