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medic11
on FreezingBlue Flashcards.
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What are the three components of post intubation mgmt?
- Continued sedation
- Continued pain mgmt
- Continued tube security
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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
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The elec pathways of the heart follow what route?
SA node > Internodal > AV node > Bundle of His > R & L bundle branches > Purkinje Fibers
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What is Bachmans Bundle?
Conduction tract in the heart that originates @ SA node & conducts action potentials to the LA
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Class IA antidysrhythmics are ___ ___ ___ w/ the mechanism?
- Sodium Channel Blockers
- Slow conduction & decrease repolarization rate
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Prototype Sodium Channel Blockers (class ____) are what 3 drugs?
- IA
- Quinidine, Procainamide & Disopyramide
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Class IB (aka ___ ___ ___) include what 4 drugs?
- Sodium Channel Blockers
- Lidocaine (xylocaine)
- Phenytoin (Dilantin)
- Tocainide (Tonocard)
- Mexiletine (Mexitil)
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The mechanisms for Class IB Sodium Channel blockers are what?
- Increased rate of repolarization
- Reduced automaticity in ventricular cells
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Class IA Sodium Channel Blockers show on an ECG in the form of . . .
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Class IB Sodium Channel Blockers show on an ECG in the form of . . .
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Class IC sodium channel blockers include what 2 drugs/
- Flecainide (Tambocor)
- Propefenone (Rythmol)
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Actions of a class IC sodium channel blocker are . . .
- Decrease conduction velocity thru Atria, ventricles, bundle of His & purkinji network
- Delay ventricular repolarization
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What are the actions of moricizine (Ethmozine) (class ____)?
- Decreases conduction velocity
- Depresses myocardial contractility
- Blocks Na influx during fast potential depolarization
- Class I miscellaneous
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Class II drugs (___ ___) include what 3 drugs?
- Propranolol (Inderal)
- Acebutolol (Sectral)
- Esmolol (Brevibloc)
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The non selective beta blocker is ____ while acebutolol & Esmolol are selective for what?
- Propranalol
- Beta1 receptors in the heart
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Beta blockers are indicated in the treatment of what?
Tachycardias resulting fr excessive sympathetic stimulation
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How does a selective Beta blocker work?
Blocking Beta1 blocks Ca channels preventing gradual influx of Ca in phase 0 of slow potential
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K channel blockers (class ___) include what 2 drugs?
- Bretylium (bretylol)
- Amiodarone (Cordarone)
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The mechanism of action for Class III (aka ___ ___ ___) drugs is?
- K channel blockers
- Blocks efflux of K in fast channels
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K channel blockers are indicated for what?
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CCB�s or class __ drugs effects are almost identical to ____?
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What are the only 2 CCB�s that affect the heart?
- Verappamil (calan)
- Diltiazem (cardizem)
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CCB�s slow ____ ____of A fib & flutter & they can terminate ____ ____ originating fr a reentrant circuit.
- Ventricular conduction
- Superventricular tachycardias
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What are the 2 chief side effects of CCB�s?
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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
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What are side effects of adenosine?
- Facial Flushing
- SOB
- Chest Pain
- Marked Bradycardia
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When should adenosine dosages be increased?
In pts taking adenosine blockers such as aminophylline or caffeine
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When should adenosine dosages be decreased?
In pts taking adenosine uptake inhibitors such as dypyridamole (Persantine) or Carbamazapine (Tegretol)
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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
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What are the effects of digoxin on Purkinji Fibers & ventricular myocardial cells?
Dig causes a decrease in the effective refract period & ^ automaticity
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What are the side effects of digoxin (6)?
- Bradycardias
- AV blocks
- PVCs
- V Tach
- V Fib
- A Fib
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What is digoxin indicated for?
- A Fib w/ rapid ventricular conduction
- Chronic treatment of CHF
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What is Torsades de pointes?
A polymorphic V Tach
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What is the drug of choice for Torsades?
Magnesium
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What is the formula for BP?
BP=Cardiac output x peripheral vascular resistance
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What is cardiac output equal too?
Cardiac output = HR x Stroke Volume
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What is a diuretic?
Drug used to reduce circulating blood vol by ^ amt of urine
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What are the 3 main categories of diuretics?
- Loop or High ceiling diuretics
- Thiazides
- K sparing diuretics
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What is the prototype loop diuretic?
Lasix
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Loop diuretics are one of the primary tools in treating what?
Left ventricular heart failure (CHF)
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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
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What are furosemides main side effects?
- Hyponatremia
- Hypovolemia
- Hypokalemia
- Dehydration
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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
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What is the prototype thiazide?
Hydrochlorothiazide
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What is the 1 important thing that distinguishes thiazides?
They depend on glomerular filtration rate
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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
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What is the prototype K sparing diuretic?
Spironolactone (Aldactone)
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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
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What is the prototype Selective Beta1 Blocker?
Metoprolol (Lopressor)
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What is the prototype non-selective Beta1 Blocker?
Propranolol (Inderal)
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Of the Centrally Acting Adrenergic Inhibitors, the prototype is ____ (aka ____) w/ side effects of ____ & ____.
- Clonidine aka Catepres
- Drowsiness & Dry Mouth
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The prototype Peripheral Adrenergic Neuron Blocking Agent is what?
Reserpine aka Serpalan
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What is the prototype Alpha1 antagonist?
Prazosin aka Minipress
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How does an Alpha1 antagonist work?
Competitively blocks Alpha1 receptors inhibiting sympathetically mediated increases in peripheral vascular resistance
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Alpha/Beta antagonists act by . . . .
Decreasing Alpha mediated vasoconstriction & the Beta1 blockade decreases HR, contractility & rennin release fr kidneys
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2 Alpha/beta antagonist drugs are ____ & ___.
- Labetalol (normodyne)
- Carvedilol (Coreg)
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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
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What is the prototype ACE inhibitor?
Catopril (Capoten)
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Name 2 common ACE inhibitors other than the prototype which is___.
- Enalapril (Vasotec) & Lisinipril (Zestril)
- Catopril (Capoten)
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1 category for CCBs is antidysrhythmic. What is the other & what is the prototype?
- Dihydropiridines
- Nifedipine (Procardia, Adalat)
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What is Stoke-Adams Syndrome?
Heart condition characterized by fainting, blackouts & fainting while sitting
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What is the prototype for selective arteriole dilators?
Hydralazine (Apresoline)
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How does Hydralazine work?
It decreases peripheral vascular resistance & afterload therefore BP.
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Alpha 1 receptors cause what response where?
- Constriction � Arterioles & veins
- Mydriasis � eye
- Ejaculation � penis
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Alpha2 receptors cause what response where?
Inhibits release of norepi in presynaptic terminals
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Beta 1 receptors cause what response where?
- ^ HR, conductivity, automaticity, contractility � heart
- Renin release � kidneys
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Beta 2 receptors cause what response where?
- Bronchodilation � lungs
- Dilation � arterioles
- Inhibition of contractions � uterus
- Tremors � skeletal muscle
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Beta 3 receptors cause what response where?
Lipolysis � adipose tissue
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Dopaminergic receptors cause what response where?
Vasodilation � kidney
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All antidysrhythmics have arythmogenic properties. This means?
All antidysrhythmics have the ability to cause dysrhythmias
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What are the 2 cardiac glycosides?
- Digoxin (Lanoxin)
- Digitoxin (Crystodigin)
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How does digoxin reduce symptoms of CHF?
By ^ myocardial contractility & cardiac output
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What are side effects of digoxin?
- Fatigue
- Anorexia
- Nausea
- Vomiting
- Blurred vision w/a yellowish haze & halos around dark objects
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Name the 2 bronchodilators that are non-specific agonists.
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What are the 4 Beta2 specific agonists that are short acting?
- Albuterol (Ventolin, proventil)
- Metaproterenol (Alupent)
- Terbutaline (Brethine)
- Levalbuterol (Xopenex)
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What is the Beta 2 specific agonist that is long acting?
Saslmeterol (Serevent)
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What are methylxanthines & what 2 drugs are in this category?
- CNS stimulants w/ additional bronchodilatory properties
- Theophylline & Aminophylline
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What are the 2 anticholinergics used to treat asthma?
- Atropine
- Ipratropium (Atrovent)
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What are the 3 inhaled glucocorticoid anti-inflammatory agents for treating asthma?
- Beclomethasone (Beclovent)
- Flucticasone (Flovent)
- Triamcinolone (Azmacort)
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What is the oral glucocorticoid anti-inflammatory agents for treating asthma?
Prednisone (deltasone)
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What are 2 injected glucocorticoid anti-inflammatory agents for treating asthma?
- Methyprednisolone (solu-medrol)
- Dexamethasone (Decadron)
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What are the 2 leukotriene Antagonists for treating asthma?
- Zafirlukast (Accolate)
- Zileuton (Zyflo)
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What is the 1 Mast-cell membrane stabilizer used in treating asthma?
Cromolyn (Intal)
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What are the 2 basic components of the pathophysiology of asthma?
Bronchoconstriction & Inflammation
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Common causes of asthma are ?
Pet dander, mold, dust etc.
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True or false. . . .All that wheezes is asthma.
False
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For asthma, what is the first line mechanism for treatment especially for daily use?
Beta2 specific agents
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How do beta2 specific agents work in asthma?
Relax bronchial smooth muscle resulting in bronchodilation & relief fr bronchospasm
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What is the prototype beta 2 specific agent for daily use in asthma?
Albuterol
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What is rhinitis & what are some symptoms?
Inflammation of nasal lining w/ symptoms nasal congestion, itching, redness, sneezing & rhinorrhea (runny nose)
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What is the main pharmacological classification for nasal decongestants?
Alpha 1 agonists including phenylephrine, pseudoephedrine, phenylpropanolamine
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What is rebound congestion?
A form of tolerance that is caused by long term use of nasal decongestants.
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What are antihistamines?
Med that arrests the effects of histamine by blocking its receptors
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What is a histamine?
An endogenous substance that affects a wide variety of organ systems.
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Name 5 antihistamines.
- Benadryl
- Seldane
- Claritin
- Zyrtec
- Allegro
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What is the chief side effect of antihistamines?
Sedation
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Why do second generation antihistamines not cause sedation?
B/c they do not cross the blood brain barrier
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Why should I not give an antihistamine to my asthma pt?
B/c they can thicken bronchial secretions
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If my pt has a productive cough should I treat it? Why or why not?
No b/c it is performing a useful function
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If a nasal decongestant is overused it can cause an elevation in what?
Pulse Rate & BP
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An antitussive is defined as what?
Med that suppresses a stimulus to cough in the CNS
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What is an expectorant?
Med intended to ^ the productivity of a cough
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What is a mucolytic?
Med intended to make mucus more watery
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What are the 4 main indications for gastrointestinal drug therapy?
- Peptic ulcers
- Constipation
- Diarrhea & emesis
- Digestion
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Peptic ulcer disease is characterized by. . . .
An imbalance between factors in the gastrointestinal sys that ^ acidity & those that protect against acidity
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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
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4 H2 receptor antagonists for treating PUD are?
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Famotidine (Pepcid)
- Nizatidine (axid,pulvulex)
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Proton pump inhibitors used to treat PUD are?
- Omeprazole (prilosec)
- Lansoprazole (prevacid)
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5 treatment modalities for treating PUD are?
- H2 receptor antagonists
- Proton pump inhibitors
- Antacids
- Aluminum, Magnesium or Na compounds
- Anticholinergics
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What is the anticholinergic used for treating PUD?
Pirenzepine (gastrozepine)
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What are the 4 categories of laxatives?
- Bulk forming
- Stimulant
- Osmotic
- Surfactant
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What is a laxative?
Med used to decrease a stools firmness & ^ its water content
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What is surfactant?
Substance that decreases surface tension
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What are 2 examples of bulk forming laxatives?
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What are 2 examples of a stimulant laxative?
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What is an example of an osmotic laxative?
Milk of magnesia
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What is an example of a surfactant laxative?
Colace
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What are the 4 categories of drugs for treating emesis?
- Anticholinergic
- Serotonin antagonists
- Dopamine antagonists
- Cannabinoids
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What is 1 example of a serotonin antagonist?
Ondansetron (zofran)
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Give 4 examples of dopamine antagonists for emesis?
- Compazine
- Phenergan
- Inapsine
- Reglan
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What are 2 examples of cannabinoids used for emesis?
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The sympathetic NS is aka ____ or the ____ division?
- Fight & flight
- Thoracolumbar
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The parasympathetic NS is aka ____ or the ____ division?
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Where are the ganglia located in the sympathetic NS?
Near the spine
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Where are the ganglia located in the parasympathetic NS?
Ganglia are in or near target organs
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Preganglionic fibers release ____ & postganglionic fibers release ____ in the sympathetic NS.
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Preganglionic fibers release ____ & postganglionic fibers release ____ in the parasympathetic NS.
ACh & Ach
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What is meant by cholinergic?
Pertaining to the neurotransmitter Ach
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What is meant by adrenergic?
Pertaining to the neurotransmitter NE.
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What cranial nerves carry parasympathetic fibers?
3,7,9,10
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Adverse effects of cholinergics are known as ____ which stands for what 6 things?
- SLUDGE
- Salivation, Lacrimation, Urination, Defacaction, Gastric Motility, Emesis
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How do chlolinergics work?
By stimulating the effects of Ach by binding w/ cholinergic receptors
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What do anticholinergics oppose?
The parasympathetic NS
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Name 4 MAO inhibitors.
- Phenelzine (Nardil)
- Octamoxen (Ximaol, Nimadol)
- Caroxazone (Surodil, Timostenil)
- Linezolid (Zyvox, Zyvoxam, Zyvoxid)
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Name the 4 classes of cardiac Drugs.
- Antidysrhythmics
- Antihypertensives
- Hemostatic Agents
- Anyihyper-lipidemic Agents
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Name 2 Na channel blockers.
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What is the definition of drug?
Chemical used to diagnose, treat or prevent disease
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Define pharmacology.
Study of drugs & their interaction w/ the body
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What are the 4 names for a drug?
- Chemical
- Generic
- Official
- Brand
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Drug info is provided by what 5 sources?
- US Pharmacopeia
- PDR
- Drug Info
- Monthly prescribing reference
- AMA Drug eval
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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
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What are characteristics of a Schedule I drug?
- High abuse potential
- Possible severe dependance
- No medical indication
- Used for research, analysis or instruction only
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What are examples of Schedule I drugs?
Heroin, LSD, Mescaline
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What are characteristics of Schedule II drugs?
- High abuse potential
- Possible severe dependance
- Accepted medical indications
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Examples of Schedule II drugs are?
Morphine, Codeine, Oxycodone, Methadone, cocaine
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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
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Examples of Schedule III drugs are?
- Limited opioid amts or combined w/nonctrled substances
- Vicodin
- Tylenol w/codeine
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What are characteristics of Schedule IV drugs?
- Low abuse potential
- Limited psychological &/or physical dependance
- Accepted medical indications
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Some examples of Schedule IV drugs are?
Diazepam, Lorazapam, phenobarbital
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What are characteristics of Schedule V drugs?
- Low abuse potential
- May lead to limited physical or psychological dependance
- Accepted Medical indications
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Some examples of Schedule V drugs are?
- Limited amts of opioids
- Often for cough or diarrhea
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What is assay?
Test that determines the amt & purity of a given chemical in a preparation in a laboratory
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Define Bioequivalence.
Relative therapeutic effectiveness of chemically equivalent drugs
-
Define Bioassay.
Test to ascertain a drugs availability in a biological model
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Medication packages containing a single dose for a single pt. is called?
Dose Packaging
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What is a med that may kill of deform a fetus called?
Teratogenic Drug
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Describe free drug availability.
The proportion of a drug available in the body to cause either desired or undesired effects
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Define pharmacokinetics.
How a drug is absorbed, distributed, metabolized (biotransformed) & excreted; how drugs are transported into & out of the body
-
Define pharmacodynamics.
How a drug interacts w/ the body to cause its effects
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What is carrier mediated diffusion or facilitated diffusion?
Process in which carrier proteins transport lg molecules across the cell membrane
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What is the movement of solute in a solution fr and area of higher concentration to an area of lower concentration called?
Diffusion
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Osmosis is ______?
The movement of solvent in a solution fr and area of lower solute concentration to an area of higher solute concentration
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Filtration is the movement of ______?
Molecules across a membrane fr an area of higher pressure to an area of lower pressure
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What are the 4 pharmacokinetic processes?
- Absorption
- Distribution
- Biotransformation
- Elimination
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Bioavailability is the amt of a drug _____?
That is still active after it reaches its target tissue
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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
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Define the Placental Barrier.
Biochemical barrier at the maternal/fetal interface that restricts certain molecules
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What term describes the body's breaking down of chemicals into different chemicals?
Metabolism
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What is the special name given to the metabolism of drugs?
Biotransformation
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What is a prodrug?
A med that isnt active when administered, but whos biotransformation converts it into active metabolites
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What is the first pass effect?
The livers partial or complete inactivation of a drug b/f it reaches the systemic circulation
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What is oxidation?
The loss of hydrogen atoms or the acceptance of an O2 atom ^ pos charge on the molecule
-
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
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Enteral delivery of a med means the med is delivered . . . .
Through the intestinal tract
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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
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Give 5 examples of enteral med routes.
- PO
- Orogastric/Nasogastric Tube (OG/NG)
- SL
- Buccal
- PR
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Parenteral Routes include (12):
- IV
- ET
- IO
- Umbilical
- IM
- SC
- Inhalation/Neb
- Topical
- Transdermal
- Nasal
- Instillation
- Intradermal
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Give 5 examples of drugs in solid forms. . . .
- Pills
- Powders
- Tablets
- Suppositories
- Capsules
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Liquid drugs come in what 7 forms?
- Solutions
- Tinctures
- Suspensions
- Emulsions
- Spirits
- Elixers
- Syrups
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What is the difference between a pill & a tablet?
A pill is a drug shaped spherically where as a tablet is compressed powder
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Define a capsule. . . .
Gelatinus container filled w/ powder or tiny pills
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What is a tincture?
Liquid drug preparation using an alcohol extraction process
-
Describe an emulsion.
Drug suspension w/ an oily substance in the solvent
-
What is a spirit?
Drug solution of a volatile drug in alcohol
-
Describe an elixer.
Alcohol & water solvent usually w/ flavoring to improve taste
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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
-
A receptor is a. . .
Specialized protein that combines w/ a drug resulting in a biochemical effect
-
Define affinity.
Force of attraction between a drug and receptor
-
What is efficacy?
A drugs ability to cause the expected response
-
A 2nd messenger is a chemical that
Participates in complex cascading reactions that eventually cause a drugs desired effect
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What is the binding of a drug or hormone to a target cell receptor causing number of receptors to decrease called?
Down Regulation
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When a drug causes the formation of more receptors than normal it is known as ____-____.
Up-regulation
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An agonist is a drug that . . . .
binds to a receptor but does not cause it to initiate the expected response
-
An antagonist is a drug that . . . .
binds to a receptor but does not cause it to initiate the expected response
-
An agonist-antogonist (partial agonist) is a drug that binds to a receptor & . . .
stimulates some of its effects but blocks others
-
Competitive antagonism is when 1 drug . . . .
binds to a receptor & causes the expected effect while also blocking another drug fr triggering the same receptor
-
What is non-competative antagonism?
The binding of an antagonist causes a deformity of the binding site that prevents an agonist fr fitting & binding
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Irreversible antagonism is a . . . .
Competitive antagonist permanently binds w/a receptor site
-
What are side effects?
Unintended response to a drug
-
List some side effects (13).
- Allergic reaction
- Idiosyncrasy
- Tolerance
- Cross-tolerance
- Tachyphylaxis
- Cumulative Effect
- Drug dependance
- Drug interaction
- Drug antagonism
- Summation
- Synergism
- Potentiation
- Interference
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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
-
The side effect idiosyncrasy is a drug effect that is . . .
Unique to the individual; different than seen or expected i the population in general
-
Tolerance is defined as a . . .
Decreased response to the same amt of drug after repeated administrations
-
Cross-tolerance is defined as. . . .
Tolerance for a drug that develops after administration of a different drug
-
Rapidly occurring tolerance to a drug is called ____.
Tachyphylaxis
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Increased effectiveness when a drug is given in several doses is called ____ ____.
Cumulative Effect
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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
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When the effects of 1 drug alter the response to another drug a ____ ____ occurs.
Drug interaction
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Drug antagonism occurs when the effects of 1 drug ____ the ____ to another drug.
Block, response
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Summation (aka ____ ____) occurs when . . . .
2 drugs that both have the same effect are given together; 1+1=2
-
Synergism occurs when . . . .
2 drugs w/ the same effect are given together & produce a response > the sum of their individual responses; 1+1=3
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Potentiation occurs when . . .
1 drug enhances the effect of another
-
Interference is. . . .
The direct biochemical interaction between 2 drugs; 1 drug affects the pharm of another
-
What is a drug response relationship?
Correlation of different amts of a drug to clinical response
-
What is the plasma level profile?
Describes lengths of onset, duration & termination of action as well as the drugs min effective concentration & toxic levels
-
What is the onset of action?
Time from administration until a med reaches its minimum effective concentration
-
The minimum effective concentration of a drug is. . . .
Minimum level of a drug needed t cause a given effect
-
The duration of action of a drug is what?
The length of time a drug remains above its minimum effective concentration
-
Define termination of action.
Time fr when a drugs level drops below its minimum effective level until it is eliminated fr the body
-
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
-
What is biological half-life?
Time the body takes to clear 1/2 of a drug.
-
What is a prototype drug?
Drug that exhibits a classes common properties & illustrates its particular characteristics
-
What is the prototype opiod agonist?
Morphine
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What is an analgesic?
Med that relieves the sensation of pain
-
What is analgesia?
The absence of the sensation of pain
-
What is anesthesia?
Absence of all sensations
-
What is an adjunct med?
Agent that enhances the effects of other drugs
-
What are the 2 components of the CNS?
Brain & spinal cord
-
What makes up the peripheral nervous sys?
Everything that doesn't fall into the CNS
-
WHat does the somatic nervous sys control?
Ctrls voluntary or motor functions
-
The autonomic nervous sys ctrls what & is further divided into ____ & ____?
- Involuntary or automatic functions
- Sympathetic & parasympathetic nervous sys
-
What are the effects of opiod agonists?
- Analgesia
- Euphoria
- Sedation
- Miosis
-
What effect does morphine have on the heart?
Decreases preload & afterload
-
What are the 3 types of nonopiod meds w/analgesic properties?
- Salcylates (ie aspirin)
- NSAIDS (ie ibuprofen)
- Para-aminophenol derivates (ie acetaminophen)
-
What are opiod antagonists?
Drug that completely binds w/opiod receptors w/o causing the effects of opiod bonding. (ie Narcan)
-
What is an opiod agonist-antagonist?
- Drug that displays both agonist & antagonistic props.
- ie Nubain decreases pain response w/o resp & addictive side effects
-
What is a anesthetic?
Med that induces loss of sensation to pain or touch
-
What is neuroleptanesthesia?
Anesthesia that combines decreased sensation of pain w/amnesia while pt remains conscious
-
Define sedation.
State of decreased anxiety & inhibitions
-
Define hypnosis.
Instigation of sleep
-
What is the benzodiazepine antagonist and what is its dose?
Romazicon dosed @ 0.2 mg up to 1mg
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What is a seizure?
State of hyperactivity in either a section of the brain or all of the brain
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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)
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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
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How do Ca ion blockers work for seizure treatment?
They inhibit influx of Ca in Ca channels in the hypothalmus
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What are the 2 Na ion blockers used for seizure treatment?
- Phentoin aka Dilantin
- Carbamazapine aka Tegratol
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What is the Ca ion blocker used for seizure treatment?
Valproic Acid
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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
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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
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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
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What are the effects of a prototype benzo?
- Antianxiety
- Hypnotic
- Anesthetic
- Anticonvulsant
- Sedative
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What are the 2 methods used to stimulate the CNS?
- ^ release or effectiveness of exicitatory neurotransmitters
- Decrease release or effectiveness or inhibitory neurotransmitters
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What are the most common uses of amphetamines?
Treating drowsiness, fatigue & appetite suppressant
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What are the side effects of amphetamines?
- Tachycardia & Dysrhythmias
- Hypertension
- Convulsions
- Insomnia
- Psychosis w/hallucinations & agitation
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What is the most commonly prescribed drug for ADHD?
Methylphenidate aka Ritalin
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What is the prototype amphetamine?
Caffeine even tho it has few clinical uses
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What is EPS (aka ___) & what causes it?
- Extrapyramidal Symptoms
- Dystonic Reaction
- Caused by brain damage & antipsychotic drugs
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How to TCA's work?
By blocking the reuptake or nor-epi & serotonin thus extending the duration of their action
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How do SSRIs work?
By selectively blocking the reuptake of serotonin but they do not affect dopamine or nor-epi
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Whats used to treat ODs of TCAs?
Sodium Bicarbonate
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3 SSRIs are____, ____ & ____.
- Prozac
- Sertaline (Zoloft)
- Paroxetine (Paxil)
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MAOIs work by what mechanism?
Inhibiting monoamine oxidase & blocking monoamines breakdown thus ^ their availability
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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.
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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
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What is dyskinesia?
Disfunctional movements such as involuntary tremors, unsteady gait & postural instability
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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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