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