Pharm 2 - 2/3

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kbryant86
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237770
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Pharm 2 - 2/3
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2013-09-29 21:49:56
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  1. What do you give a patient that you find seizing?
    • 1. Valium OR Benzodiazapin
    • 2. Dilantin
    • 3. Oral meds
  2. Carbamazepine / Tegretol

    SE
    • For partial and tonic-clonic seizures
    • Hyperactive Na+ channel Suppression
    • Bipolar disorder

    • SE= ataxia, vertigo, visual problems, headache, anemia, skin issues
    •  =>Grapefruit- Increases Plasma levels
  3. **Oxcarbazepine / Tripetal
    2nd gen of Tegretol with less SE, but high in $
  4. Valproic Acid

    => 3 names
    • **Na+ and Ca++ channels supressors
    • **Augments GABA inhinitory influence
    • Good for all types of seizures, bipolar, and migraines

    SE= hepatatotoxicity, pancreatitis, teratogenic
  5. Ethosuximide / Zarontin
    • **DOC for Absence seizures
    • suppresses neurons in the hypothalamus responsible for absence seizures
    • **NO significant SE's (drowziness, dizzy, lethargy)
  6. Phenobarbital
    • **Potentiaties effects of GABA
    • Well absorbed, long 1/2 life
    • ***Barbiturate used at low doses for seizures

    SE= dependence, sedation, depression, agitation, confusion, decreases Vit D
  7. Primidone / Mysoline
    nearly identical to Phenobarb, but no significant reduction in SE
  8. Muscle spasm- 2 categories
    • Analgesics-antiinplammitory-(ibuprofen)
    • => work best / few SE

    • Central acting muscle relaxants
    •  => effects are primarily Sedative
  9. Tizanidine / Zanaflex
    • Central Ms Relaxant
    • Presynaptic A2 receptor Agonist

    • SE= weakness, instability
    • = CNS depression
    • = Hepatix toxicity
    • =  Physical Dependenc
  10. Baclofen / Lioresal
    • Central ms relaxant
    • **Works in the spinal cord, not ms
    • **suppress hyperactive reflexes in spin cord
    • Does not effect strength
    • **CNS depressant
    • **GI/GU Sx
    • Abrupt w/d
    • Oral= Hallucinations, seizures, paranoid ideation
    • IV/Intrathecal= Hyperthermia, sustatined ms spasm (rhabdomyolysis
  11. Dantrolene / Dantrium
    • Central ms relaxant
    • **Works directly on the ms
    • **stops Ca++ from sarcoplasmic reticulum
    • Weakens ms
    • **Minimal effects smooth and Cardiac ms
    • **Tx for Malignant Hyperthermia

    SE= weakness, drowsiness, hep-toxicity, diarrhea, acne
  12. local anasthetics - mechanism of action

    local administration
    • mech= suppress pain by blocking inpulse (Na+ Channels)
    • -Esters= (novacain) metab in bld
    • -Amides- (lidocaine) metab in liver

    • Locally admin= block small unmyelinated neurons BFORE larger myelinated
    • =pain lost first, then temp, tounch, deep pressure
    • = blocks both sensory and motor neurons

    • If used centrally, excites then depresses the CNS and cardiac function
    • **EPI is used to becuase of local vasoconstriction properties and to prolong anes. effects
  13. Epidural
    • Spinal/subarachnoid(CSF circulation)
    • Lumbar region

    • SE= HypoTN-most sig. effect
    • = fecal/urine incontinance or retention
    • = Spinal headache
    •   => Place in supine position and apply a Blood Patch b/c CSF is leaking
  14. Cocaine
    blocks NE reuptake, flooding the body with NE
  15. 4 general anesthesia types
    • balanced
    • gas
    • volatile liquids
    • IV-sedation
  16. Balanced anestesia

    Pre-anesthesia- pain, anxiety, amnesia

    Induction- unconciousness, ms relax

    (naming 4 meds)
    unconciousness, anagesia, Ms relaxation, Amnesia

    Pre= Benzodiazapine-midozalam / Versed is DOC and Opioids & NO2 for pain

    • Ind= Short acting barbiturates- Estomidate
    • = Ms relax- nueromuscular blockers
    • = Anti-ACh- Atropine
  17. Minimal Alveolar COncentration

    Nitrous Oxide
    • MAC
    • [ ] that prodices immobility in 50% exposed to painful stimuilation
    • **LOW MAC indicated HIGH potency (use less)

    NO2= inhalation gas - not good to sedate, but is good for pain
  18. Halothane
    • Volatile Liquid
    • Low MAC
    • good to sedate, but SE BAD
    • SE= resp depression, dysrhythmias, hepat-toxic, malignant hyperthermia
  19. Isoflurane / Forane
    • 2nd generation
    • ***DOC for volatile lquids
    • eliminated in exberation
    • No SE

    When mixed with Succs= Malignant Hyperthermia
  20. Pentobarb, Midazolam / Versed
    • Barbiturates, Benzodiazapines
    • IV general anesth. for sedation
  21. Propofol / Diprivan
    • IV general anesth. for sedation
    • conscious sedation
    • ***HypoTN and high risk for infection b/ of high lipid medium of drug
  22. Ketamine / Ketalar
    • IV general anesth. for sedation
    • Dissaciative anesthesia - psychological reactions, peeps going Crazy!
  23. Opioid analgesics
    • Narcotics
    • Activate Mu Receptors
    • Morphine and synthetic drugs
    • produce euphoria, constipation, urine retention, vasodlation, resp depresion
    • increase intracranial pressure
    • Physical dependence = not seem often w/ therapeutic clinical use
    • = pt will have w/d if abruptly stopped
  24. Naloxone / Narcan
    reversal agent for opioids
  25. PCA
    • patient controlled anasgesia
    • regular dose to control pain

    DO not use with IBS becuase it causes constipation
  26. Fentanyl / Sublimaze
    • synthetic morphine, but 100X potency
    • opioid analgesic
  27. Hydromorphone / Dilaudid

    Hydrocodone / Vicodinn

    Oxycodone / Percocet (Oxycontin)
    All are opioid analgesic 

    oxy- most widely proscribed drug in US

    oxycontin- time released oxy
  28. Propoxyohene / Darvocet
    • off the market 2010
    • opioid, affects similar to ASA
    • addiction, overdoes, suicide, abnl heart rhythmm, P450 system (increase effects of Beta blockers)

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