Pharm Cards Final

  1. What are the three components of post intubation mgmt?
    • Continued sedation
    • Continued pain mgmt
    • Continued tube security
  2. What is the path of blood flow through the heart?
    SVC/IVC > RA > Tricuspid Valve > RV > Pulmonary semilunar valve > Pulmonary artery > Lungs > LA > Bicuspid > LV > Aortic semilunar > Aorta > Body
  3. The elec pathways of the heart follow what route?
    SA node > Internodal > AV node > Bundle of His > R & L bundle branches > Purkinje Fibers
  4. What is Bachmans Bundle?
    Conduction tract in the heart that originates @ SA node & conducts action potentials to the LA
  5. Class IA antidysrhythmics are ___ ___ ___ w/ the mechanism?
    • Sodium Channel Blockers
    • Slow conduction & decrease repolarization rate
  6. Prototype Sodium Channel Blockers (class ____) are what 3 drugs?
    • IA
    • Quinidine, Procainamide & Disopyramide
  7. Class IB (aka ___ ___ ___) include what 4 drugs?
    • Sodium Channel Blockers
    • Lidocaine (xylocaine)
    • Phenytoin (Dilantin)
    • Tocainide (Tonocard)
    • Mexiletine (Mexitil)
  8. The mechanisms for Class IB Sodium Channel blockers are what?
    • Increased rate of repolarization
    • Reduced automaticity in ventricular cells
  9. Class IA Sodium Channel Blockers show on an ECG in the form of . . .
    • Widened QRS
    • Prolonged QT
  10. Class IB Sodium Channel Blockers show on an ECG in the form of . . .
    • Widened QRS
    • Prolonged QT
  11. Class IC sodium channel blockers include what 2 drugs/
    • Flecainide (Tambocor)
    • Propefenone (Rythmol)
  12. Actions of a class IC sodium channel blocker are . . .
    • Decrease conduction velocity thru Atria, ventricles, bundle of His & purkinji network
    • Delay ventricular repolarization
  13. What are the actions of moricizine (Ethmozine) (class ____)?
    • Decreases conduction velocity
    • Depresses myocardial contractility
    • Blocks Na influx during fast potential depolarization
    • Class I miscellaneous
  14. Class II drugs (___ ___) include what 3 drugs?
    • Propranolol (Inderal)
    • Acebutolol (Sectral)
    • Esmolol (Brevibloc)
  15. The non selective beta blocker is ____ while acebutolol & Esmolol are selective for what?
    • Propranalol
    • Beta1 receptors in the heart
  16. Beta blockers are indicated in the treatment of what?
    Tachycardias resulting fr excessive sympathetic stimulation
  17. How does a selective Beta blocker work?
    Blocking Beta1 blocks Ca channels preventing gradual influx of Ca in phase 0 of slow potential
  18. K channel blockers (class ___) include what 2 drugs?
    • Bretylium (bretylol)
    • Amiodarone (Cordarone)
  19. The mechanism of action for Class III (aka ___ ___ ___) drugs is?
    • K channel blockers
    • Blocks efflux of K in fast channels
  20. K channel blockers are indicated for what?
    • V Fib
    • Refractory V Tach
  21. CCB�s or class __ drugs effects are almost identical to ____?
    • IV
    • Beta-Blockers
  22. What are the only 2 CCB�s that affect the heart?
    • Verappamil (calan)
    • Diltiazem (cardizem)
  23. CCB�s slow ____ ____of A fib & flutter & they can terminate ____ ____ originating fr a reentrant circuit.
    • Ventricular conduction
    • Superventricular tachycardias
  24. What are the 2 chief side effects of CCB�s?
    • Hypotension
    • Bradycardia
  25. Adenosine is described as an & what does it act on?
    • Endogenous nucleoside w/ a very short half life (about 10 secs)
    • Both K & Ca channels; ^ K efflux & inhibiting Ca influx
  26. What are side effects of adenosine?
    • Facial Flushing
    • SOB
    • Chest Pain
    • Marked Bradycardia
  27. When should adenosine dosages be increased?
    In pts taking adenosine blockers such as aminophylline or caffeine
  28. When should adenosine dosages be decreased?
    In pts taking adenosine uptake inhibitors such as dypyridamole (Persantine) or Carbamazapine (Tegretol)
  29. What are the effects of digoxin on the heart?
    • Decreases intrinsic firing rate in the SA node
    • Decreases conduction velocity in the AV node
    • ^ cardiac contractility
  30. What are the effects of digoxin on Purkinji Fibers & ventricular myocardial cells?
    Dig causes a decrease in the effective refract period & ^ automaticity
  31. What are the side effects of digoxin (6)?
    • Bradycardias
    • AV blocks
    • PVCs
    • V Tach
    • V Fib
    • A Fib
  32. What is digoxin indicated for?
    • A Fib w/ rapid ventricular conduction
    • Chronic treatment of CHF
  33. What is Torsades de pointes?
    A polymorphic V Tach
  34. What is the drug of choice for Torsades?
  35. What is the formula for BP?
    BP=Cardiac output x peripheral vascular resistance
  36. What is cardiac output equal too?
    Cardiac output = HR x Stroke Volume
  37. What is a diuretic?
    Drug used to reduce circulating blood vol by ^ amt of urine
  38. What are the 3 main categories of diuretics?
    • Loop or High ceiling diuretics
    • Thiazides
    • K sparing diuretics
  39. What is the prototype loop diuretic?
  40. Loop diuretics are one of the primary tools in treating what?
    Left ventricular heart failure (CHF)
  41. How does Furosemide (aka____) work?
    • Lasix
    • By blocking Na reabsorption in the ascending loop of Henle decreasing the pull of H2O fr the tubule & into the capillary bed
  42. What are furosemides main side effects?
    • Hyponatremia
    • Hypovolemia
    • Hypokalemia
    • Dehydration
  43. What is the difference between loop diuretics & thiazides?
    Thiazides mechanism affects the early part of distal convoluted tubule & therefore cannot block as much Na fr reabsorption
  44. What is the prototype thiazide?
  45. What is the 1 important thing that distinguishes thiazides?
    They depend on glomerular filtration rate
  46. How do K sparing diuretics work?
    Na absorption is affected be inhibiting the effects of aldosterone on the distal tubules or the specific Na/K exchange mechanism
  47. What is the prototype K sparing diuretic?
    Spironolactone (Aldactone)
  48. What are the 5 types of adrenergic inhibiting agents?
    • Beta adrenergic antagonists
    • Centrally acting adrenergic inhibitors
    • Peripheral adrenergic neuron blocking agents
    • Alpha1 antagonists
    • Combined Alpha/Beta antagonists
  49. What is the prototype Selective Beta1 Blocker?
    Metoprolol (Lopressor)
  50. What is the prototype non-selective Beta1 Blocker?
    Propranolol (Inderal)
  51. Of the Centrally Acting Adrenergic Inhibitors, the prototype is ____ (aka ____) w/ side effects of ____ & ____.
    • Clonidine aka Catepres
    • Drowsiness & Dry Mouth
  52. The prototype Peripheral Adrenergic Neuron Blocking Agent is what?
    Reserpine aka Serpalan
  53. What is the prototype Alpha1 antagonist?
    Prazosin aka Minipress
  54. How does an Alpha1 antagonist work?
    Competitively blocks Alpha1 receptors inhibiting sympathetically mediated increases in peripheral vascular resistance
  55. Alpha/Beta antagonists act by . . . .
    Decreasing Alpha mediated vasoconstriction & the Beta1 blockade decreases HR, contractility & rennin release fr kidneys
  56. 2 Alpha/beta antagonist drugs are ____ & ___.
    • Labetalol (normodyne)
    • Carvedilol (Coreg)
  57. What do ACE inhibitors do?
    Interrupt the rennin-angiotensin-aldosterone-sys by preventing the conversion of angiotensin1 to angiotensin2 leading to a decrease in peripheral vascular resistance
  58. What is the prototype ACE inhibitor?
    Catopril (Capoten)
  59. Name 2 common ACE inhibitors other than the prototype which is___.
    • Enalapril (Vasotec) & Lisinipril (Zestril)
    • Catopril (Capoten)
  60. 1 category for CCBs is antidysrhythmic. What is the other & what is the prototype?
    • Dihydropiridines
    • Nifedipine (Procardia, Adalat)
  61. What is Stoke-Adams Syndrome?
    Heart condition characterized by fainting, blackouts & fainting while sitting
  62. What is the prototype for selective arteriole dilators?
    Hydralazine (Apresoline)
  63. How does Hydralazine work?
    It decreases peripheral vascular resistance & afterload therefore BP.
  64. Alpha 1 receptors cause what response where?
    • Constriction � Arterioles & veins
    • Mydriasis � eye
    • Ejaculation � penis
  65. Alpha2 receptors cause what response where?
    Inhibits release of norepi in presynaptic terminals
  66. Beta 1 receptors cause what response where?
    • ^ HR, conductivity, automaticity, contractility � heart
    • Renin release � kidneys
  67. Beta 2 receptors cause what response where?
    • Bronchodilation � lungs
    • Dilation � arterioles
    • Inhibition of contractions � uterus
    • Tremors � skeletal muscle
  68. Beta 3 receptors cause what response where?
    Lipolysis � adipose tissue
  69. Dopaminergic receptors cause what response where?
    Vasodilation � kidney
  70. All antidysrhythmics have arythmogenic properties. This means?
    All antidysrhythmics have the ability to cause dysrhythmias
  71. What are the 2 cardiac glycosides?
    • Digoxin (Lanoxin)
    • Digitoxin (Crystodigin)
  72. How does digoxin reduce symptoms of CHF?
    By ^ myocardial contractility & cardiac output
  73. What are side effects of digoxin?
    • Fatigue
    • Anorexia
    • Nausea
    • Vomiting
    • Blurred vision w/a yellowish haze & halos around dark objects
  74. Name the 2 bronchodilators that are non-specific agonists.
    • Epinephrine
    • Ephedrine
  75. What are the 4 Beta2 specific agonists that are short acting?
    • Albuterol (Ventolin, proventil)
    • Metaproterenol (Alupent)
    • Terbutaline (Brethine)
    • Levalbuterol (Xopenex)
  76. What is the Beta 2 specific agonist that is long acting?
    Saslmeterol (Serevent)
  77. What are methylxanthines & what 2 drugs are in this category?
    • CNS stimulants w/ additional bronchodilatory properties
    • Theophylline & Aminophylline
  78. What are the 2 anticholinergics used to treat asthma?
    • Atropine
    • Ipratropium (Atrovent)
  79. What are the 3 inhaled glucocorticoid anti-inflammatory agents for treating asthma?
    • Beclomethasone (Beclovent)
    • Flucticasone (Flovent)
    • Triamcinolone (Azmacort)
  80. What is the oral glucocorticoid anti-inflammatory agents for treating asthma?
    Prednisone (deltasone)
  81. What are 2 injected glucocorticoid anti-inflammatory agents for treating asthma?
    • Methyprednisolone (solu-medrol)
    • Dexamethasone (Decadron)
  82. What are the 2 leukotriene Antagonists for treating asthma?
    • Zafirlukast (Accolate)
    • Zileuton (Zyflo)
  83. What is the 1 Mast-cell membrane stabilizer used in treating asthma?
    Cromolyn (Intal)
  84. What are the 2 basic components of the pathophysiology of asthma?
    Bronchoconstriction & Inflammation
  85. Asthma presents with?
    • SOB
    • Wheezing
    • Coughing
  86. Common causes of asthma are ?
    Pet dander, mold, dust etc.
  87. True or false. . . .All that wheezes is asthma.
  88. For asthma, what is the first line mechanism for treatment especially for daily use?
    Beta2 specific agents
  89. How do beta2 specific agents work in asthma?
    Relax bronchial smooth muscle resulting in bronchodilation & relief fr bronchospasm
  90. What is the prototype beta 2 specific agent for daily use in asthma?
  91. What is rhinitis & what are some symptoms?
    Inflammation of nasal lining w/ symptoms nasal congestion, itching, redness, sneezing & rhinorrhea (runny nose)
  92. What is the main pharmacological classification for nasal decongestants?
    Alpha 1 agonists including phenylephrine, pseudoephedrine, phenylpropanolamine
  93. What is rebound congestion?
    A form of tolerance that is caused by long term use of nasal decongestants.
  94. What are antihistamines?
    Med that arrests the effects of histamine by blocking its receptors
  95. What is a histamine?
    An endogenous substance that affects a wide variety of organ systems.
  96. Name 5 antihistamines.
    • Benadryl
    • Seldane
    • Claritin
    • Zyrtec
    • Allegro
  97. What is the chief side effect of antihistamines?
  98. Why do second generation antihistamines not cause sedation?
    B/c they do not cross the blood brain barrier
  99. Why should I not give an antihistamine to my asthma pt?
    B/c they can thicken bronchial secretions
  100. If my pt has a productive cough should I treat it? Why or why not?
    No b/c it is performing a useful function
  101. If a nasal decongestant is overused it can cause an elevation in what?
    Pulse Rate & BP
  102. An antitussive is defined as what?
    Med that suppresses a stimulus to cough in the CNS
  103. What is an expectorant?
    Med intended to ^ the productivity of a cough
  104. What is a mucolytic?
    Med intended to make mucus more watery
  105. What are the 4 main indications for gastrointestinal drug therapy?
    • Peptic ulcers
    • Constipation
    • Diarrhea & emesis
    • Digestion
  106. Peptic ulcer disease is characterized by. . . .
    An imbalance between factors in the gastrointestinal sys that ^ acidity & those that protect against acidity
  107. What is the most common cause of peptic ulcer disease?
    • Helicobacter pylori bacterium infestation in the space between the endothelial cells & the mucus lining of the stomach & duodenum
    • Often found in pts w/ failing gall bladders
  108. 4 H2 receptor antagonists for treating PUD are?
    • Cimetidine (Tagamet)
    • Ranitidine (Zantac)
    • Famotidine (Pepcid)
    • Nizatidine (axid,pulvulex)
  109. Proton pump inhibitors used to treat PUD are?
    • Omeprazole (prilosec)
    • Lansoprazole (prevacid)
  110. 5 treatment modalities for treating PUD are?
    • H2 receptor antagonists
    • Proton pump inhibitors
    • Antacids
    • Aluminum, Magnesium or Na compounds
    • Anticholinergics
  111. What is the anticholinergic used for treating PUD?
    Pirenzepine (gastrozepine)
  112. What are the 4 categories of laxatives?
    • Bulk forming
    • Stimulant
    • Osmotic
    • Surfactant
  113. What is a laxative?
    Med used to decrease a stools firmness & ^ its water content
  114. What is surfactant?
    Substance that decreases surface tension
  115. What are 2 examples of bulk forming laxatives?
    • Methylcellulose
    • Citrucel
  116. What are 2 examples of a stimulant laxative?
    • Phenolphtalein
    • Ex-lax
  117. What is an example of an osmotic laxative?
    Milk of magnesia
  118. What is an example of a surfactant laxative?
  119. What are the 4 categories of drugs for treating emesis?
    • Anticholinergic
    • Serotonin antagonists
    • Dopamine antagonists
    • Cannabinoids
  120. What is 1 example of a serotonin antagonist?
    Ondansetron (zofran)
  121. Give 4 examples of dopamine antagonists for emesis?
    • Compazine
    • Phenergan
    • Inapsine
    • Reglan
  122. What are 2 examples of cannabinoids used for emesis?
    • Marinol
    • Cesamet
  123. The sympathetic NS is aka ____ or the ____ division?
    • Fight & flight
    • Thoracolumbar
  124. The parasympathetic NS is aka ____ or the ____ division?
    • Feed & breed
    • Craniosacral
  125. Where are the ganglia located in the sympathetic NS?
    Near the spine
  126. Where are the ganglia located in the parasympathetic NS?
    Ganglia are in or near target organs
  127. Preganglionic fibers release ____ & postganglionic fibers release ____ in the sympathetic NS.
    • Ach
    • NE
  128. Preganglionic fibers release ____ & postganglionic fibers release ____ in the parasympathetic NS.
    ACh & Ach
  129. What is meant by cholinergic?
    Pertaining to the neurotransmitter Ach
  130. What is meant by adrenergic?
    Pertaining to the neurotransmitter NE.
  131. What cranial nerves carry parasympathetic fibers?
  132. Adverse effects of cholinergics are known as ____ which stands for what 6 things?
    • SLUDGE
    • Salivation, Lacrimation, Urination, Defacaction, Gastric Motility, Emesis
  133. How do chlolinergics work?
    By stimulating the effects of Ach by binding w/ cholinergic receptors
  134. What do anticholinergics oppose?
    The parasympathetic NS
  135. Name 4 MAO inhibitors.
    • Phenelzine (Nardil)
    • Octamoxen (Ximaol, Nimadol)
    • Caroxazone (Surodil, Timostenil)
    • Linezolid (Zyvox, Zyvoxam, Zyvoxid)
  136. Name the 4 classes of cardiac Drugs.
    • Antidysrhythmics
    • Antihypertensives
    • Hemostatic Agents
    • Anyihyper-lipidemic Agents
  137. Name 2 Na channel blockers.
    • Procainamide
    • Lidocaine
  138. What is the definition of drug?
    Chemical used to diagnose, treat or prevent disease
  139. Define pharmacology.
    Study of drugs & their interaction w/ the body
  140. What are the 4 names for a drug?
    • Chemical
    • Generic
    • Official
    • Brand
  141. Drug info is provided by what 5 sources?
    • US Pharmacopeia
    • PDR
    • Drug Info
    • Monthly prescribing reference
    • AMA Drug eval
  142. What 12 things compromise a drug profile?
    • Name
    • Classification
    • Mechanism of Action
    • Indications
    • Pharmacokinetics
    • Side effects/ Adverse reactions
    • Routes of Admin
    • Contraindications
    • Dosage
    • How Supplied
    • Special considerations
  143. What are characteristics of a Schedule I drug?
    • High abuse potential
    • Possible severe dependance
    • No medical indication
    • Used for research, analysis or instruction only
  144. What are examples of Schedule I drugs?
    Heroin, LSD, Mescaline
  145. What are characteristics of Schedule II drugs?
    • High abuse potential
    • Possible severe dependance
    • Accepted medical indications
  146. Examples of Schedule II drugs are?
    Morphine, Codeine, Oxycodone, Methadone, cocaine
  147. What are characteristics of Schedule III drugs?
    • Less abuse potential than Schedule I & II
    • May lead to moderate to low physical dependance or high psychological dependance
    • Has acceptable medical uses
  148. Examples of Schedule III drugs are?
    • Limited opioid amts or combined w/nonctrled substances
    • Vicodin
    • Tylenol w/codeine
  149. What are characteristics of Schedule IV drugs?
    • Low abuse potential
    • Limited psychological &/or physical dependance
    • Accepted medical indications
  150. Some examples of Schedule IV drugs are?
    Diazepam, Lorazapam, phenobarbital
  151. What are characteristics of Schedule V drugs?
    • Low abuse potential
    • May lead to limited physical or psychological dependance
    • Accepted Medical indications
  152. Some examples of Schedule V drugs are?
    • Limited amts of opioids
    • Often for cough or diarrhea
  153. What is assay?
    Test that determines the amt & purity of a given chemical in a preparation in a laboratory
  154. Define Bioequivalence.
    Relative therapeutic effectiveness of chemically equivalent drugs
  155. Define Bioassay.
    Test to ascertain a drugs availability in a biological model
  156. Medication packages containing a single dose for a single pt. is called?
    Dose Packaging
  157. What is a med that may kill of deform a fetus called?
    Teratogenic Drug
  158. Describe free drug availability.
    The proportion of a drug available in the body to cause either desired or undesired effects
  159. Define pharmacokinetics.
    How a drug is absorbed, distributed, metabolized (biotransformed) & excreted; how drugs are transported into & out of the body
  160. Define pharmacodynamics.
    How a drug interacts w/ the body to cause its effects
  161. What is carrier mediated diffusion or facilitated diffusion?
    Process in which carrier proteins transport lg molecules across the cell membrane
  162. What is the movement of solute in a solution fr and area of higher concentration to an area of lower concentration called?
  163. Osmosis is ______?
    The movement of solvent in a solution fr and area of lower solute concentration to an area of higher solute concentration
  164. Filtration is the movement of ______?
    Molecules across a membrane fr an area of higher pressure to an area of lower pressure
  165. What are the 4 pharmacokinetic processes?
    • Absorption
    • Distribution
    • Biotransformation
    • Elimination
  166. Bioavailability is the amt of a drug _____?
    That is still active after it reaches its target tissue
  167. Describe the blood brain barrier.
    Tight junctions of the endothelial cells in the CNS vasculature thru which only non protein bound highly lipid soluble drugs can pass
  168. Define the Placental Barrier.
    Biochemical barrier at the maternal/fetal interface that restricts certain molecules
  169. What term describes the body's breaking down of chemicals into different chemicals?
  170. What is the special name given to the metabolism of drugs?
  171. What is a prodrug?
    A med that isnt active when administered, but whos biotransformation converts it into active metabolites
  172. What is the first pass effect?
    The livers partial or complete inactivation of a drug b/f it reaches the systemic circulation
  173. What is oxidation?
    The loss of hydrogen atoms or the acceptance of an O2 atom ^ pos charge on the molecule
  174. Hydrolysis is the . . . .
    breakage of a chem bond by adding H2O or by incorporating a hydroxyl group into 1 fragment & a hydrogen atom into the other
  175. Enteral delivery of a med means the med is delivered . . . .
    Through the intestinal tract
  176. Parentarel delivery of a med is any route that . . . .
    Outside the gastrointestinal tract, typically using needles to inject directly into the circulatory sys or tissue
  177. Give 5 examples of enteral med routes.
    • PO
    • Orogastric/Nasogastric Tube (OG/NG)
    • SL
    • Buccal
    • PR
  178. Parenteral Routes include (12):
    • IV
    • ET
    • IO
    • Umbilical
    • IM
    • SC
    • Inhalation/Neb
    • Topical
    • Transdermal
    • Nasal
    • Instillation
    • Intradermal
  179. Give 5 examples of drugs in solid forms. . . .
    • Pills
    • Powders
    • Tablets
    • Suppositories
    • Capsules
  180. Liquid drugs come in what 7 forms?
    • Solutions
    • Tinctures
    • Suspensions
    • Emulsions
    • Spirits
    • Elixers
    • Syrups
  181. What is the difference between a pill & a tablet?
    A pill is a drug shaped spherically where as a tablet is compressed powder
  182. Define a capsule. . . .
    Gelatinus container filled w/ powder or tiny pills
  183. What is a tincture?
    Liquid drug preparation using an alcohol extraction process
  184. Describe an emulsion.
    Drug suspension w/ an oily substance in the solvent
  185. What is a spirit?
    Drug solution of a volatile drug in alcohol
  186. Describe an elixer.
    Alcohol & water solvent usually w/ flavoring to improve taste
  187. What are the 4 types of drug actions?
    • Binding to a receptor site
    • Changing physical props of cells
    • Chemically combining w/other chemicals
    • Altering normal metabolic pathway
  188. A receptor is a. . .
    Specialized protein that combines w/ a drug resulting in a biochemical effect
  189. Define affinity.
    Force of attraction between a drug and receptor
  190. What is efficacy?
    A drugs ability to cause the expected response
  191. A 2nd messenger is a chemical that
    Participates in complex cascading reactions that eventually cause a drugs desired effect
  192. What is the binding of a drug or hormone to a target cell receptor causing number of receptors to decrease called?
    Down Regulation
  193. When a drug causes the formation of more receptors than normal it is known as ____-____.
  194. An agonist is a drug that . . . .
    binds to a receptor but does not cause it to initiate the expected response
  195. An antagonist is a drug that . . . .
    binds to a receptor but does not cause it to initiate the expected response
  196. An agonist-antogonist (partial agonist) is a drug that binds to a receptor & . . .
    stimulates some of its effects but blocks others
  197. Competitive antagonism is when 1 drug . . . .
    binds to a receptor & causes the expected effect while also blocking another drug fr triggering the same receptor
  198. What is non-competative antagonism?
    The binding of an antagonist causes a deformity of the binding site that prevents an agonist fr fitting & binding
  199. Irreversible antagonism is a . . . .
    Competitive antagonist permanently binds w/a receptor site
  200. What are side effects?
    Unintended response to a drug
  201. List some side effects (13).
    • Allergic reaction
    • Idiosyncrasy
    • Tolerance
    • Cross-tolerance
    • Tachyphylaxis
    • Cumulative Effect
    • Drug dependance
    • Drug interaction
    • Drug antagonism
    • Summation
    • Synergism
    • Potentiation
    • Interference
  202. An allergic reaction (aka ____) occurs when the drug is. . . .
    Antigenic & activates the immune sys, causing effects that are normally more profound than seen in general population
  203. The side effect idiosyncrasy is a drug effect that is . . .
    Unique to the individual; different than seen or expected i the population in general
  204. Tolerance is defined as a . . .
    Decreased response to the same amt of drug after repeated administrations
  205. Cross-tolerance is defined as. . . .
    Tolerance for a drug that develops after administration of a different drug
  206. Rapidly occurring tolerance to a drug is called ____.
  207. Increased effectiveness when a drug is given in several doses is called ____ ____.
    Cumulative Effect
  208. Define drug dependance.
    When a pt becomes accustomed to the drugs presence in his body & will suffer fr w/d symptoms upon its absence; psychological or physical
  209. When the effects of 1 drug alter the response to another drug a ____ ____ occurs.
    Drug interaction
  210. Drug antagonism occurs when the effects of 1 drug ____ the ____ to another drug.
    Block, response
  211. Summation (aka ____ ____) occurs when . . . .
    2 drugs that both have the same effect are given together; 1+1=2
  212. Synergism occurs when . . . .
    2 drugs w/ the same effect are given together & produce a response > the sum of their individual responses; 1+1=3
  213. Potentiation occurs when . . .
    1 drug enhances the effect of another
  214. Interference is. . . .
    The direct biochemical interaction between 2 drugs; 1 drug affects the pharm of another
  215. What is a drug response relationship?
    Correlation of different amts of a drug to clinical response
  216. What is the plasma level profile?
    Describes lengths of onset, duration & termination of action as well as the drugs min effective concentration & toxic levels
  217. What is the onset of action?
    Time from administration until a med reaches its minimum effective concentration
  218. The minimum effective concentration of a drug is. . . .
    Minimum level of a drug needed t cause a given effect
  219. The duration of action of a drug is what?
    The length of time a drug remains above its minimum effective concentration
  220. Define termination of action.
    Time fr when a drugs level drops below its minimum effective level until it is eliminated fr the body
  221. What is a drugs therapeutic index?
    Ratio of a drugs lethal dose for 50% of the population to its effective dose for 50% of the population
  222. What is biological half-life?
    Time the body takes to clear 1/2 of a drug.
  223. What is a prototype drug?
    Drug that exhibits a classes common properties & illustrates its particular characteristics
  224. What is the prototype opiod agonist?
  225. What is an analgesic?
    Med that relieves the sensation of pain
  226. What is analgesia?
    The absence of the sensation of pain
  227. What is anesthesia?
    Absence of all sensations
  228. What is an adjunct med?
    Agent that enhances the effects of other drugs
  229. What are the 2 components of the CNS?
    Brain & spinal cord
  230. What makes up the peripheral nervous sys?
    Everything that doesn't fall into the CNS
  231. WHat does the somatic nervous sys control?
    Ctrls voluntary or motor functions
  232. The autonomic nervous sys ctrls what & is further divided into ____ & ____?
    • Involuntary or automatic functions
    • Sympathetic & parasympathetic nervous sys
  233. What are the effects of opiod agonists?
    • Analgesia
    • Euphoria
    • Sedation
    • Miosis
  234. What effect does morphine have on the heart?
    Decreases preload & afterload
  235. What are the 3 types of nonopiod meds w/analgesic properties?
    • Salcylates (ie aspirin)
    • NSAIDS (ie ibuprofen)
    • Para-aminophenol derivates (ie acetaminophen)
  236. What are opiod antagonists?
    Drug that completely binds w/opiod receptors w/o causing the effects of opiod bonding. (ie Narcan)
  237. What is an opiod agonist-antagonist?
    • Drug that displays both agonist & antagonistic props.
    • ie Nubain decreases pain response w/o resp & addictive side effects
  238. What is a anesthetic?
    Med that induces loss of sensation to pain or touch
  239. What is neuroleptanesthesia?
    Anesthesia that combines decreased sensation of pain w/amnesia while pt remains conscious
  240. Define sedation.
    State of decreased anxiety & inhibitions
  241. Define hypnosis.
    Instigation of sleep
  242. What is the benzodiazepine antagonist and what is its dose?
    Romazicon dosed @ 0.2 mg up to 1mg
  243. What is a seizure?
    State of hyperactivity in either a section of the brain or all of the brain
  244. Explain tonic clonic seizures.
    Periods of muscle rigidity (tonic stage) followed by spazmotic twitching (clonic stage) then flaccidity & a gradual return to consciousness (postictal stage)
  245. How do Na ion blockers work for seizure treatment?
    They inhibit the influx of Na into the cell decreasing the cells ability to depolarize & propagate seizures
  246. How do Ca ion blockers work for seizure treatment?
    They inhibit influx of Ca in Ca channels in the hypothalmus
  247. What are the 2 Na ion blockers used for seizure treatment?
    • Phentoin aka Dilantin
    • Carbamazapine aka Tegratol
  248. What is the Ca ion blocker used for seizure treatment?
    Valproic Acid
  249. How do Benzos mitigate seizures?
    They interact w/the GABA receptor-chloride ion channel complex. They hyperpolarize the membrane of the CNS neurons decreasing their response to stimuli
  250. What is the prototype benzo & what is it dosed @?
    • Lorazapam aka Ativan
    • 2-4 mg IM, 0.5-2mg IV for sedation
    • 2mg slow IV/PR for status epilepticus
  251. What are the 2 benzos we use & their doses?
    • Lorazapam
    • 2-4mg IM, 0.5-2mg IV for sedation
    • 2 mg slow IV/PR for status epilepticus
    • Diazepam
    • 5-10mg IV/IM seizure
    • 2-5mg IV/IM acute anxiety
    • 5-15mg IV premed
  252. What are the effects of a prototype benzo?
    • Antianxiety
    • Hypnotic
    • Anesthetic
    • Anticonvulsant
    • Sedative
  253. What are the 2 methods used to stimulate the CNS?
    • ^ release or effectiveness of exicitatory neurotransmitters
    • Decrease release or effectiveness or inhibitory neurotransmitters
  254. What are the most common uses of amphetamines?
    Treating drowsiness, fatigue & appetite suppressant
  255. What are the side effects of amphetamines?
    • Tachycardia & Dysrhythmias
    • Hypertension
    • Convulsions
    • Insomnia
    • Psychosis w/hallucinations & agitation
  256. What is the most commonly prescribed drug for ADHD?
    Methylphenidate aka Ritalin
  257. What is the prototype amphetamine?
    Caffeine even tho it has few clinical uses
  258. What is EPS (aka ___) & what causes it?
    • Extrapyramidal Symptoms
    • Dystonic Reaction
    • Caused by brain damage & antipsychotic drugs
  259. How to TCA's work?
    By blocking the reuptake or nor-epi & serotonin thus extending the duration of their action
  260. How do SSRIs work?
    By selectively blocking the reuptake of serotonin but they do not affect dopamine or nor-epi
  261. Whats used to treat ODs of TCAs?
    Sodium Bicarbonate
  262. 3 SSRIs are____, ____ & ____.
    • Prozac
    • Sertaline (Zoloft)
    • Paroxetine (Paxil)
  263. MAOIs work by what mechanism?
    Inhibiting monoamine oxidase & blocking monoamines breakdown thus ^ their availability
  264. What is the prototype MAOI & when are they used?
    • Phenelzine (Nardil)
    • They aren't commonly used but when they are its usually for treating depression refractory to TCAs & SSRIs.
  265. What is parkinsons disease?
    A nervous disorder caused by the destruction of dopamine releasing neurons in the substantia nigra, part of the basal ganglia, which is a specialized area of the brain that crtl fine motor movement
  266. What is dyskinesia?
    Disfunctional movements such as involuntary tremors, unsteady gait & postural instability
  267. What is the drug of choice for treating Parkinsons & why?
    Levodopa b/c it can readily cross the blood brain barrier where it is absorbed by dopamine releasing neuron terminals
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