Section 3 - Last minute things that aren't sticking! (everythin until the illegal drug section.) Flashcards

1
Q

Local Anesthetics - the balance between rate of ____ and rate of ____ is of clinical significance.

A

Absorption/Metabolism.

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2
Q

If absorption rate is lower than metabolic rate, then plasma levels will be ___ and so will be ___.

A

Lower/toxicity.

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3
Q

Balanced anesthesia - def

A

refers to use of combinations of drugs to accomplish what inhalation anesthetic can not do alone.

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4
Q

What are some of the drugs used for balanced anesthesia?

A

Short acting barbiturates, neuromuscular blockers, opioids and Nitrous Oxide, etc.

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5
Q

Procaine is an Ester or Amide?

A

Ester.

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6
Q

Drugs not recommended for Treating Cancer Patients - Pure Opioid Agonists - Meperidine -

A

toxic metabolite accumulates with prolonged use.

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7
Q

Drugs not recommended for Treating Cancer Patients - Opioid Agonist-Antagonists - Buprenorphine, Butorphanol, Nalbuphine, Pentazocine -

A

Ceiling to analgesic effects; can precipitate withdrawal in opioid-dependent patients; causes psychomimetic reactions.

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8
Q

Drugs not recommended for Treating Cancer Patients - Opioid Antagonists - Naloxone/Naltrexone

A

Can precipitate withdrawal in opioid-dependent patients - limit use to reversing life-threatening respiratory depression caused by opioid overdose.

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9
Q

Drugs not recommended for Treating Cancer Patients - Benzodiazepines - Diazepam, Lorazepam, and others.

A

Sedation from Benzos limits opioid dosage; no demonstrated analgesic action.

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10
Q

Drugs not recommended for Treating Cancer Patients - Barbiturates - Amobarbital, Secobarbital, and others.

A

Sedation from barbiturates limits opioid dosage; no demonstrated analgesic action.

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11
Q

Drugs not recommended for Treating Cancer Patients - Misc - Cocaine -

A

no analgesic efficacy, either alone or in combination with an opioid.

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12
Q

Drugs not recommended for Treating Cancer Patients - Misc - Marijuana

A

Side effects (dysphoria, drowsiness, hypotension, bradycardia) preclude routine use as an analgesic.

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13
Q

Drugs not recommended for Treating Cancer Patients - Misc - Brompton’s Cocktail

A

analgesic efficacy is no better than that of a single opioid.

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14
Q

WHO Analgesic Ladder - what are the 3 steps?

A

Step 1 - Mild to Moderate Pain (Non-opioid Analgesic)
Step 2 - More severe pain - add opioid analgesic.
Step 3 - Severe pain - substitute opioid - MORPHINE.

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15
Q

Non-drug treatment for pain management (5)

A

Heat, cold, massage, exercise, acupuncture.

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16
Q

Migraine - drugs to abort an attack -

A

opioid analgesics (aspirin like analgesics - motrin - or opioid analgesics, like Demerol), ergot alkaloids (Ergotamine) and Serotonin Receptor Agonist (Sumaptriptan)

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17
Q

Drugs for migraine prevention -

A

Beta blockers (atenolol), Calcium Channel Blockers (verapamil), Tricyclic Antidepressant (amitriptyline), Methysergide (sansert), Sodium Divalproex (depakote.)

18
Q

Conventional Antipsychotic Agents - Classifications (3) and drugs!

A

Low - Chlorpromazine (Thorazine)
Medium - Loxatine
High Potency - Haloperidol (Haldol.)

19
Q

Conventional Antipsychotic Agents - MOA -

A

block receptors within and outside the CNS - block Dopamine, ACH, Histamine, ETC.

20
Q

Therapeutic Uses - Conventional Antipsychotics -

A

Schizophrenia, Bipolar Disorder, Tourette’s Syndrome, Prevention of emesis.

21
Q

Conventional Antipsychotic Agents - Blocking… D2 Dopamingergic receptor

A

EPS, Prolactin Release

22
Q

Conventional Antipsychotic Agents - Blocking… H1 Histamine -

A

Sedation

23
Q

Conventional Antipsychotic Agents - Blocking… - Muscarinic Cholinergic -

A

Dry mouth, blurred vision, urinary retention, constipation, tachycardia.

24
Q

Conventional Antipsychotic Agents - Blocking… - Alpha-1 Adrenergic -

A

Orthostatic Hypotension, Relfex Tachycardia.

25
Q

Conventional Antipsychotic Agents - Blocking… - 5-Ht2 -Serotoninergic -

A

Weight Gain.

26
Q

Tricyclic Antidepressants - toxicity.

A

Avoid lethal dose, only dispense one-week supply..

27
Q

What is the antidote for Tricyclic Antidepressant Toxicity?

A

Cholinesterase inhibitor (physostigmine)

28
Q

Bubroprion (Wellbutrin) Basic info, MOA, Adverse Effects -

A

Similar structure to amphetamines, Response 1-3 weeks, MOA - Unknown, Adverse - agitation, headache, constipation, dry mouth.

29
Q

What are some treatments for benzodiazepine toxicity?

A

Gastric Lavage, Activated Charcoal, Flumazenil (Romazicon) - a benzodiazepine receptor antagonist , dialysis, IV fluids.

30
Q

Barbiturates - for ___ depression of the CNS.

A

Non-specific.

31
Q

Barbiturates - classification (3.) - and drugs for the categories.

A

Ultra-short acting - Thiopental.
Short to intermediate acting - Secobarbital.
Long-acting - Phenobarbital.

32
Q

Barbiturates - MOA -

A

Bind to gaba receptor-chloride channel complex to..enhance inhibitor action of gaba, directly mimic actions of gaba, etc…

33
Q

Since barbiturates can act as agonists, there is no end to how much they can suppress. T/F?

A

True!

34
Q

OCD - Treatment - Drug Therapy -

A

Clomipramine (Anafranil)

35
Q

Clomipramine - Anafranil - only ___ effective in treatment of OCD, Takes ____ to ____ weeks to see maximal improvements. It blocks uptake of __ in addition to ___.

A

TCA/4-12 weeks/NE, Serotonin

36
Q

SSRI Drugs for OCD Treatment - 3

A

Prozac, Luvox, Zoloft

37
Q

What are the drug choices in treating ADHD? (2)

A

Wellbutrin (bupropion) and Inderal (propanolol)

38
Q

CNS Stimulations - used for…and also increase activity of…

A

ADHD, narcolepsy, obesity….. and increase activity of the CNS.

39
Q

Amphetamine - CNS Stimulant - releases….

A

NE, Dopamine, Serotonin…

40
Q

Amphetamine - uses?

A

Arouse mood, increase self confidence, suppress appetite and pain perception.