Pharmacology Exam 1 Reverse

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dparks33
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65384
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Pharmacology Exam 1 Reverse
Updated:
2011-02-14 11:23:32
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Pharmacology
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Principles of Drug Action, Narcotic Analgesics, antagonists & related analgesics; Sedative-Hypnotics
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  1. Methadone
    Prototype
    Classification
    Indications for Use
    Special qualities
    • Severe Chronic Pain
    • Detoxification-has a more natural tapering effect so less withdrawl.Methadone
    • maintenance- Switch heroin addiction to methadone so pt can still
    • function and get opiate fix.-oral liquid so no use of needles.
  2. Hydromorphone
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • For severe Chronic Pain
    • 5x more potent than MS but shorter acting; used as push frequently
  3. Meperidine
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Moderate to Sever Pain treatment
    • Shorter acting; Less respiratory depression; Not good for long term use
    • (>48hrs) due to build up and CNS toxicity resulting in adverse mood
    • effects such as restlessness, anger, sadness, apprehenshion. So not for
    • older adults and those with renal dysfunction
  4. Hydrocodone & Acetaminophen
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Moderate to severe pain
    • Used when oral narcotic analgesic needed; Dosage 1-2 tabs q4-6h prn po
  5. Codeine
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Mild Pain, Cough Suppression
    • Weak analgesic alone but used in combination therapy with
    • Tylenol(Percocet) watch for acetominophen toxicity and with ASA
    • (Percodan)
  6. Naloxone
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Anitidote to Narcotic Analgesic (reverses the depressant effects)
    • Also antidote to Pertazocine. Shorter acting than many narcotics so
    • monitor for 24hrs after aparent recovery. May cause withdrawl symptoms
    • to manifest fast. Doesn't get absorbed well orally. Dose: 0.4 mg IV if necessary repeat q2-3 minutes
  7. Pentazocine
    Prototype
    Classification
    Indication for Use
    Special Qualities
    • Pain Management
    • Causes vasoconstriction (unlike morphine) and psychotomimetic
    • (halucination) Talwin Nx (oral) no longer can be made into injectable
    • because manufacturers added Naloxone to cancel the affects when injected
    • (since naloxone isn't absorbed well orally, Talwin Nx still effective
    • pain reliever)
  8. Acetaminophen
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Pain Reliever and Fever Reducer
    • Careful of liver toxicity- cannot exceed 4g/day. (2g/day for alcoholics
    • and fasting pts.) No anti-platelet effects like aspirin so use instead
    • of aspirin for: mylosuppressed pt, blood dyscrasia, pt on anticoagulant
    • therapy, ulcer, aspirin allergy
  9. Pharmacological Effects of Barbiturates (5)
    • Sedation
    • Hypnosis
    • Anticonvulsant
    • Anesthesia
    • Tolerance & Dependence
  10. Adverse Effects of Barbiturates (6)
    • Drowsiness and ataxia
    • Hangover (nausea, depression, listlessness)
    • Allergic Reactions
    • REM rebound
    • Repiratory Depression (High doses)
    • Tolerance and Addiction
  11. Phenobarbital
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Anticonvulsant (seizures), sedative
    • Long Acting
  12. Secobarbital
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • hypnotic for insomnia, sedative for pre-anesthesia
    • short acting, "downer"- highly abused as (red-devils) so use is highly restricted
  13. Special Pharmacology for Benzodiazepines
    • High therapeutic index so relatively safe but most abused drug in US and can be fatal with combination meds
    • sedative-hypnotic
    • antianxiety
    • anticonvulsant
  14. Flurazepam
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Hypnotic, Longest acting
    • Little or no REM rebound, low physical addiction, active metabolite causes hangover effects (especially in older males so use 1/2 dose.)
  15. Temazepam
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Intemediate acting hypnotic
    • No active metabolite so less hangover effect, elderly still unable to
    • metabolize well so use 1/2 dose or 1/4 dose with kidney dysfuntion
  16. Triazolam
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Short acting hypnotic (for those having trouble falling asleep but not staying asleep)
    • Least hangover effect, Only for temporary use, used as antianxiety but
    • has phyiscal withdrawl manifesting in psychiatric disturbances-paranoia,
    • rage, violence
  17. Fumazenil
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Reverse the sedative effects of benzodiazepines but not the respiratory depression and amnesia
    • Used for OD and to bring patients out of sedation. [adverse effects: Seizure, HA, visual disturbances, anxiety]
  18. Advantages of "Z" hypnotics (4)
    • Lacks next day hangover effect
    • Less amnesic effects
    • Less potentiation with alcohol (still should avoid)
    • Less Tolerance
  19. Adverse Effects of "Z" Hypnotics
    • dizziness, drowsiness, loss of concentration
    • nausea, vomiting, diarrhea
  20. Zolpidem
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Non-benzodiazepine selective for omega-1 receptors aka Z hypnotic
    • Short term treatment of insomnia
  21. Zaleplon
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Non-benzodiazepine selective for omega 1 receptors aka Z hypnotics
    • Short term treatment of insomniaPrecaution because it contains tatrazine dye (Yellow #5)
  22. Diphenhydramine
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • none
    • Sedative Hypnotic, antihistamine
  23. Alternative Medicines for Sedative Hypnotics (5)
    • B vitamins
    • lavender
    • chamomile
    • valerian (liver caution)
    • kava kava (liver toxicity)
  24. Pharmacologic Effects of Narcotic Analgesic (13)
    • Analgesia
    • CNS Depression
    • Behaviorial-euphoria, mental clouding, drowsiness
    • Repiratory Depression- less responsice to [CO2]
    • Nausea and Vomiting
    • Cough supression
    • Pupil constriction (miosis)
    • Postural hypotension
    • Vasodilation
    • Constipation
    • Urinary retention
    • Pruritis and Sweating
    • Addiction and Tolerance
  25. Clinical Uses of Narcotic Analgesics (5)
    • Analgesia-MI, APE
    • CNS depression-preop/preanesthesia medication
    • Cough suppression (Codeine, hydrocodone)
    • Vasodilation -MI, APE
    • Constipation- to treat diarrhea (Lomotil)
  26. Adverse Effects of Narcotic Analgesics (11)
    • CNS depression-sedation, lethargy
    • Behaviorial-mental clouding, restlessness, mood changes
    • Respriatory Depression
    • Nausea and Vomiting
    • Cough Supression (if productive cough)
    • Postural Hypotension- fainting, dizziness
    • Vasodilation-fainting, dizziness
    • Constipation
    • Urinary Retention
    • Pruritis and Sweating
    • Addiction and Tolerance
  27. Contraindication and Precautions of using Narcotic Analgesics (4)
    • Increased intracranial pressure- look for mydriasis (pupil dilation)
    • Respiratory disease- asthma, COPD, emphysema
    • Prostatic Hypertrophy-enlarged prostate (added pressure to the urinary tract)
    • Drug interactions- any other drugs that supress Resp or CNS (alcohol, sedative, hypnotics, antihistamines)
  28. Morphine
    Prototype
    Classification
    Indications for Use
    Special Qualities
    • Severe pain
    • Dose:10 mg IM q4h prn (5-20 mg)

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