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Module 8 exam
FNU Pharmacology Summer 2013
116
Pharmacology
Graduate
09/02/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
____ is a neurodegenerative disorder.
Definition
Parkinson's disease
Term
Characteristic motor symptoms of Parkinson's disease include_____,_____,______, and ______.
Definition
tremor at rest, rigidity, postural instability, and bradykinesia
Term
The non motor symptoms that Parkinson's disease causes include_____,____, and _____.
Definition
autonomic dysfunction, depression, psychosis, and dementia
Term
The primiary pathology in PD is_______ in the ________ that supply dopamine to the striatum.
Definition
degeneration of neurons and substantia nigra
Term
Degeneration of neurons in PD causes an imbalance between ____ and ___.
Definition
dopamine and ACH
Term
Motors symptoms are tx'd with drugs that activate
Definition
dopamine receptors
Term
Drugs that block____ can also be used to tx motor symptoms.
Definition
cholinergic receptors
Term
_______ is the most effective tx for motor symptoms.
Definition
Levodopa (combined with carbidopa)
Term
What is the goal of ts of PD?
Definition
reduce symptoms
-they do not cure the disease
Term
What are the two patterns of loss of effect of levodopa?
Definition
gradual wearing off or abrupt loss of effect
Term
What are adverse effects of levodopa?
Definition
nausea, dyskinesias, hypotension, and psychosis
Term
First generation antipsychotic drugs block dopamine receptors in the striatum which can negate the effects of
Definition
levodopa
Term
High protein meals can ________ effects of levodopa
Definition
reduce therapeutic effects
Term
_____ compete with levodopa for absorption from the _______ and for transport across the ______.
Definition
Amino acids, intestines, and blood brain barrier.
Term
______ is an oral nonergot dopamine agonist.
Definition
Pramipexole
Term
Name a first line drug for motor symptoms.
Definition
Pramipexole
Term
Pramipexole can be used alone in early PD and in combination with _____ in advanced PD.
Definition
levodopa
Term
Adverse effects from pramipexole are the results of
Definition
excessive activation of dopamine receptors
Term
Adverse effects of pramipexole include
Definition
nausea, dyskinesia, postural hypotension, and hallucinations
Term
How do anticholinergic drugs block the symptoms of PD?
Definition
blocking cholinergic receptors in the striatum
Term
AD can be tx'd with ______ inhibitors or ________.
Definition
cholinesterase and memantine
Term
Cholinesterase inhibitors and memantine only show _____ benefits in pts.
Definition
marginal
Term
Cholinesterase inhibitors incrase the availability of ______ at ______.
Definition
ACH and cholinergic synapses.
Term
Cholinesterase inhibitors enhance transmission of cholinergic neurons that have
Definition
not yet been destroyed by Alzheimer's dementia
Term
Cholinesterase inhibitors produce modest improvements in ____,_____, and ______ in 30%-60% of AD pts.
Definition
cognition, behavior, and fx
Term
Cholinesterase inhibitors do not cure AD but may ____ it for a short time
Definition
delay
Term
By elevating ACD in the periphery, all cholinesterase inhibitors can cause these cholinergic effects:
Definition
n/v, dyspepsia, and diarrhea
Term
First generation antihistimines, tricyclic antidepressants, and conventional antipsychotics block
Definition
cholinergic receptors
Term
Drugs that block cholinergic receptors can ______ response to cholinesterase inhibitors.
Definition
reduce
Term
Memantine is approved for the tx of
Definition
moderate to severe AD
Term
Memantine has only____ beneficial effects for the symptom tx of AD.
Definition
modest
Term
Antiepileptic drugs (AEDs) act through what four basic mechanisms.
Definition
blockade of Na channels, blockade of Ca channels, blockade of glutamate receptors, and potentiation of GABA
Term
The goal of epilepsy is to reduce seizures so that the person may have a
Definition
near normal to normal life
Term
Most AEDs are ______ for particular seizures.
Definition
selective
Term
Successful tx of seizures is dependent upon
Definition
choosing the correct drugs
Term
Nonadherence accounts for nearly _____ of all tx failures in epilepsy.
Definition
half
Term
Carbamazepine can cause ______,_____,_____and _____.
Definition
leukopenia, anemia, thrombocytopenia, and fatal aplastic anemia (rare).
Term
________ is a broad spectrum AED.
Definition
Valproic acid
Term
Valproic acid has activity against ____ seizures and _____ seizures
Definition
partial and generalized
-tonic-clonic, absence, atonic, and myoclonic seizures
Term
All traditional AEDs and some newer ones, can harm the developing fetus during the
Definition
first trimester
Term
Uncontrolled seizures are of greater risk to the ______ and ______ than going untx'd.
Definition
mother and fetus
Term
Women with major seizure disorders should continue
Definition
taking seizure meds throughout their pregnancy
Term
Fetal risk from AEDs can decreased by
Definition
using one medication at the lowest dose
Term
Carbamazepin is associated with fetal malformations and
Definition
should not be used during pregnancy
Term
First generation antipsychotic relieve symptoms of schizophrenia by
Definition
blocking D2 receptors
Term
Therapeutic responses to antipsychotics take ______ to become maximal
Definition
several months
Term
First generation antipsychotic meds produce three types of ______ symptoms
Definition
extrapyramidal symptoms
Term
The types of extrapyramidal symptoms include
Definition
acute dystonia, parkinsonism, and akathisia
Term
Acute dystonia and parkinsonism respond to
Definition
anticholinergic drugs
Term
______ is harder to tx but may respon to ________, __________, 0r __________.
Definition
Akathisia, anticholinergics, benzodiazepines, and beta blockers
Term
_______, a late extrapyramidal symptom, has not reliable tx.
Definition
tardive dyskinesia
Term
For pts with severe TD, switching to an _______ may help.
Definition
atypical agent
Term
The risk of early EPS is much greater with _____ than with _____.
Definition
high potency FGAs and low potency FGAs
Term
The risk of ______ is equal in both high potency and low potency FGAs.
Definition
TD
Term
Antipyschotic drugs increase levels of circulating______ by blocking the inhibitory action of dopamine on ________ release
Definition
prolactin and prolactin
Term
SAGs block receptors for _____ and _____.
Definition
serotonin and dopamine
Term
SAGs cause few to no
Definition
EPS including TD
Term
SAGs carry a higher risk of
Definition
metabolic effects
Term
SAGs may cause ____, ____, and _____.
Definition
wgt gain, diabetes, and dyslipidemia
-could lead to cardiovascular events or premature death
Term
Among the SAGs, the risk of metabolic effects is greastest with
Definition
clozapine and olanzapine
Term
Therapuetic response to antidepressants may take _____. It could take______ in the elderly
Definition
4-6 wks and 2-3months
Term
Antidepressant medications should be continued for ______ after symptoms abate to decrease the risk of relapse.
Definition
6months to a year
Term
Tricyclic antidepressants usu take ___ to obtain benefits but may take as long as ____
Definition
1-3wks and 2months
Term
What are the most common adverse effects of tricyclic antidepressants?
Definition
sedation, orthostatic hypotension, and anticholinergic effects(dry mouth, constipation)
Term
Tricyclic antidepressants can cause a serious adverse effect of
Definition
cardiotoxicity
Term
Tricyclic antidepressants can cause widening of the ____ and should be used in caution with pts with preexisting _______.
Definition
QRS and cardiac conditions.
Term
What are the two advantages that SSRIs have over TCA?
Definition
fewer side effects and are safe when taken in overdose
Term
SSRIs can cause serotonin syndrome when combined _____ and _____.
Definition
MAOIs and serotonergic drugs.
Term
Agitation, confusion, hallucinations, hyperreflexia, tremor, and fever are all symptoms of
Definition
serotonin syndrome
Term
What is the only SSRI studied and ok for use in children?
Definition
fluoxetine
Term
What SSRI is safe for pregnancy and breastfeeding?
Definition
zoloft
Term
The norepi in SNRIs can increase wakefulness in pts with_______ and _____ secondary to depression
Definition
somnolence and psychomotor retardation
Term
If a pt eats tyramine rich foods while taking and MAOI, it could casue a
Definition
hypertensive crisis.
Term
Trazodone tends to be very _______ and is helpful in mildly depressed clients with _______
Definition
sedating and insomnia
Term
List the three kinds of drugs used to tx bipolar disorder.
Definition
mood stabilizers, antipsychotics, and antidepressants
Term
In pts with bipolar depression, using an antidepressant alone may induce
Definition
mania
Term
What are the preferred mood stabilizers for bipolar disorder?
Definition
lithium and valproic acid
Term
Lithium in contraindicated in
Definition
breastfeeding and the first trimester of pg
-also in 2nd and 3rd unless benefits outweigh the risk
Term
A reduction in ____ will reduce lithium excretion causing toxic levels
Definition
sodium levels
Term
lithium levels can be increased by ___ and _____
Definition
diuretics and NSAIDS
Term
Antipsychotics are used to tx ______ and for _____ of mood epidsodes
Definition
manic episodes and prevention
Term
Drugs that tx anxiety are called___,____,or______.
Definition
antianxiety agents, anxiolytics, or tranquilizers
Term
Hypnotics are
Definition
sleep medication
Term
_________ and other CNS drugs are undesireable bc they cause respiratory depression, high abuse potential, tolerance and dependence, hepatic drug metabolizing enzymes.
Definition
Barbiturates
Term
______ are preferred to barbituates bc they are______, ________, and_______.
Definition
Benzodiazapines, safer, less dependence and abuse potential, and don't induce drug metabolizing enzymes
Term
Benzos cause profound respiratory depression when used with
Definition
other CNS depressancts (opiods, barbs, etx)
Term
All Benzos have ______pharmacologic effects
Definition
equal
Term
Benzos and benzo like drugs are the drug of choice for
Definition
insomnia
Term
When used for transient insomnia, benzos should only be used for
Definition
2-3wks
Term
Benzos are approved for long term use and are the only sleep aids______ for tx.
Definition
FDA approved
Term
When is anxiety intervention indicated?
Definition
when it is persistent and disabling
Term
Optimal tx for anxiety combines _____ and _____.
Definition
psychotherapy and drug therapy
Term
What drugs are used most often for the tx of anxiety?
Definition
SSRI
-used in all anxiety disorders
Term
Benzos are used for the tx of _________ and _________.
Definition
panic disorders and generalized anxiety disorders
Term
First line tx for generalized anxiety disorder are ______
Definition
benzos
Term
Benzos suppress symptoms of GAD
Definition
immediately
Term
Because of their delayed results, the following medications should be used for long term relief of anxiety symptoms:
Definition
venlafaxine, paroxetine, escitalopram, and duloxetine
Term
Benzos have some potential for
Definition
abuse
Term
Beta blockers are useful in the tx of ________ bc they reduce tachycardia associated with extreme anxiety.
Definition
performance anxiety
Term
SSRIs are first line drugs for the tx of
Definition
panic disorder
Term
SSRIs decrease the frequency of ____,____, and _____ regardless of whether the pt is depressed
Definition
intensity of panic attacks, anticipatory anxiety, and avoidance behavior
Term
What are first line drugs for tx of OCD?
Definition
SSRIs
Term
What are first line tx for pt with social anxiety?
Definition
SSRIs
Term
When social anxiety dieosrder is limited to fear of specific situations which arise freqeuently, _______ should be used for prn tx.
Definition
benzodiazepines
Term
There is no good proof that any drugs are effective in the tx of
Definition
PTSD
Term
what two drugs are FDA approved for the tx of ptsd?
Definition
paroxetine and sertraline (SSRIs)
Term
The amphetamine family consists of ______,_____,______,and _____/
Definition
dextroamphetamine, amphetamine, meth, and lisdexamfetamine
Term
Amphetamine consist of a racemic mix of
Definition
dextroamphtemine and levampheptamine
Term
Amphetamines work by promoting release of _______ and _______
Definition
norepi and dopamine
-also block reuptake of both
Term
Amphetamines increase_________, reduce______, elevate_____, stimulate______, and suppress_____.
Definition
alertness, fatigue, mood, respirations, and appetite
Term
Promoting release of norepi from peripheral neurons, amphetamines can cause
Definition
vasoconstriction and cardiac effects
Term
What cardiac effects do amphetamines cause?
Definition
tachycardia, increased AV conduction, and increased forced of ctx
Term
What are the most common adverse affects of amphetamine use?
Definition
wgt loss and insomnia
Term
Amphetamines may also cause _____,_____,_____, and _____.
Definition
psychosis, dysrhythmias, angina, and HTN
Term
Substance abuse occurs more often in those with_______ who have not been treated.
Definition
ADD OR ADHD
Term
_______ are effective in approx 80% of children with ADD/ADHD
Definition
stimulants
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