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72 Cards in this Set

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TCA trycyclic antidepressants: action & adverse effects
work for neuropathic pain & ADHD, OCD, panic, bipolar.
direct toxicity to myocardia (also orthostatic hypotension, sedation, seizure, and anticholinergic effects)
SSRI selective seratonin reuptake inhibitors: action & adverse effects
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.
main SSRI & some adverse effects
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
MAOI monoamine oxidase: action & some adverse effects
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.
Bupropion
atypical antidepressant that helps w/ weight loss and to quit smoking; no decreased interest in sex.
headache, tremors, seizure, insomnia, dry mouth, nausea, constipation
Lithium action & adverse effects & interactions
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.
Valproic acid
many physicians' first choice for treating bipolar.
how often should Lithium blood levels be checked?
every 2-3 days in patients who have just started taking it.
SNRI
not as safe as SSRI; Cymbalta; risk for suicidal thoughts. same properties as SSRI.
antipsychotics in bipolar
used in manic (euphoric) episodes.
main difference between sedative and hypnotic pharmaceuticals...
dosage
2 main classes of sedative/hypnotic drugs & which is considered safer
Barbiturates & Benzodiazapines (Benzo considered safer; less chance of physical dependence)
uses of Benzodiazapines
drug of choice for insomnia & anxiety; also used to manage seizures, alcohol w/drawal, panic & muscle spasms
adverse effects of Benzodiazapines
Respiratory Depression, amnesia, sleep activity (driving)
treatment for overdose of Benzos
Flumazenil (Romazicon)
4 uses for barbiturates
seizure, insomnia, induce anasthesia, induce coma
unusual adverse effect of barbiturate
hyperalgesia
treatment for overdose of barbiturates...
dialysis & alkalinization of the urine; no antidote.
signs of barbiturate toxicity
same as opioid toxicity: pinpoint pupils, respiratory depression, coma.
top 2 types of drugs for treating anxiety
SSRI's and benzodiazapines.
Buspirone
Benzo treatment for anxiety; no potential for abuse; non-CNS depressant; non-sedative, but anti-anxiety effects develop slowly
adverse effects of all CNS stimulants
convulsions, tremors, seizures
adverse effects & toxic effects of amphetamines
adv: tachycardia, vasoconstriction & psychoses; tox: dysrhythmia, convulsion, coma
problems w/ amphetamines
potential for abuse b/c of euphoria & physical dependence b/c of withdrawal syndrome
therapeutic uses of amphetamines
ADHD & narcolepsy (no longer used for obesity)
caffeine is an example of a...
methylxanthine
main treatment of ADHD in children
amphetamine mixture, Adderall
nonstimulant drug therapy for ADHD in children & adverse effects
Strattera; anorexia, dizziness, insomnia
3 categories of drugs for ADHD in children
CNS stimulants (amphetamines; Adderall), nonstimulant (Strattera), antidepressants (Bupropion)
Wernicke's encephalopathy
neurological damage from alcohol; nystagmus, confusion, abnormal eye movements; reversible w/ Thiamin
type of drug used to facilitate alcohol withdrawal
benzodiazapines; help to repress seizure
drug for aversion therapy for alcohol
disulfiram
4 nutrient replacements for recovering alcoholics
antibiotics
fluid replacement
magnesium (cardiac arrhythmia)
B vitamins
non-nicotine drug treatments for smoking cessation
Bupropion (lower dose than as antidepressant)
Varenicline--seen most commonly; increased risk for suicide at first
meperidine
opioid highly effective in oral route; abused by doctors and nurses; occaisionally used in hospitals to prevent tremors.
methadone
long-acting substitution for short-term use for weening off of opioid
subjective effects of barbituate overuse & treatment
similar to alcohol; coma, respiratory depression. treatment: dialysis, airway maintenance
subjective effects of MDMA/ecstasy
tachycardia, dysrhythmia, hypertension
3 basic functions of diuretics
1. cleanse ECF and maintain ECF volume & composition
2. maintain pH
3. excrete metabolic wastes & foreign substances
3 adverse effects of diuretics
1. hypovolemia
2. pH imbalance
3. electrolyte imbalance
3 specific diseases treated by diuretics
1. heart failure
2. pulmonary edema
3. hypertension
Furosemide (Lasix)
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
Lasix drug interactions
Digoxin (b/c of hypokalemia), ototoxic drugs, NSAIDs decrease diuretic effects
Thiazides
similar to Loop diuretics, but less impact. Not effective when urine is scant
HCTZ
(Hydrochlorothiazide) Widely used; effective and affordable. Peaks 4-6 hours after dose. same adv. effects as Lasix (Hypokalemia, lipids, hyperglycemia.)
Spironolactone
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.
Mannitol (Osmitrol)
Osmotic diuretic; given parenterally. Creates osmotic force w/in nephron. Useful for reduction of intracranial pressure, as well as renal failure.
why take HCTZ and spironolactone together?
spiro conserves potassium, HCTZ wastes it; together maximize fluid pulled off and balance K.
isotonic contraction, causes & treatment
water & Na lost proportionately; vomiting diarrhea, kidney disease. 0.9% normal saline. slowly to prevent pulmonary edema.
hypertonic contraction
more water lost than sodium. give water.
hypotonic contraction
more sodium lost than water. chronic renal insufficiency; lack of aldosterone. mild--infuse isotonic sodium, severe--infuse hypertonic solution (3% NaCl)
2 blood components closely related to potassium
acid & glucose; vary similarly
normal common range for potassium
3.5-5 mEq/L
problem w/ administering potassium
irritating by whatever route.
causes & symptoms of hypomagnesemia
C: diarrhea, hemodialysis, kidney disease, prolonged IV feeding, chronic alcoholism. S: muscle irritability, dysrhythmia
BNP: brain natiuretic peptide
"Natrecor"; BNP is used as test for excessive stretch of heart; test for BNP before administering.
actions of aldosterone
retention of sodium and water--regulates BP
ACE inhibitors
"-pril"
dilate vessels; decrease afterload + BP; mainly for hypertension.
early ones were from snake venom.
reduce Angiotensin II. increase bradykinin.
adverse effects of ACE inhibitors
first-dose hypotension. cough (ACE is in lungs). hyperkalemia (K retention). Dysgeusia (distorted sense of taste). Renal failure possible.
ARBs: angiotensin II receptor blockers
"sartans"
similar to ACE inhibitors, but don't increase bradykinin.
adverse effects of ARBs
no cough, angioedema of lips/tongue--can block airway. fetal harm, renal failure.
Eplerenone (Inspra)
aldosterone antagonist; used for hypertension/heart failure. adv. effects: hyperkalemia
calcium channel blockers
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.
Verapamil can be used to treat what kind of tachycardia?
supraventricular--above ventricle.
adverse effects of Verapamil
constipation, headache, edema of ankles & feet, heart block
drug interactions & toxicity of Verapamil
Digoxin, Beta-blockers. Severe hypotension, bradycardia, ventricular tachydyrhythmias, esp by IV.
adverse effects of Diltiazem
similar to Verapamil, but less constipation.
Nifedipine
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
Hydralazine (Apresoline)
selective dilation of arterioles -> reflex tachycardia (combine w/ beta blocker); therapeutic uses: hypertension, heart failure
Minoxidil (Loniten)
unwanted hair growth (also sold as rogaine); originally for selective dilation of arterioles.
Diazoxide (Hyperstat IV)
used for hypertension emergencies; selective dilation of arterioles. Adv. effects: Reflex tachy, NaCl and H20 retention, hyperglycemia, hyperuricemia. interactions w/ diuretics and antihypertensive drugs
sodium nitroprusside (nitropress)
fastest acting antihypetensive agent; only in critical setting; hypertensive emergency. venous and arteriolar dilation.cyanide poisoning -> death