Term
| naloxone hydrochloride (Narcan) |
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Definition
1. opioid agonist
2. Analgesic Chapter
3. drug of choice for the complete or partial reversal of opioid induced respiratory depression
4. primary adverse effect: opioid withdrawal syndrome which occurs when aprupt overreversal inopiod tolerant patients |
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Term
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Definition
1. nonopioid analgesic
2. can cause liver damage when used with alcohol
3. irreversible liver damage can occur in overdose |
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Term
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Definition
1. general anesthetic
2. used for induction and maintenance anesthesia and for sedation for mechanical ventilation in intensive care
3. typically well tolerated, producing few side effects
4. monitor serum lipids |
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Term
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Definition
1. local anesthetic
2. if pts report being allergic to the "caines" use local anesthetic of ester type
3. One of the most commonly used locals
4. avail in topical forms - one type used to ease pain of needles (starting IV)
5. Parenteral forms used for cardiac dysrhythmias
5. pregnancy Category B |
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Term
| succinycylcholine (Anectine) |
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Definition
1. Neuromuscular blocking NMBD drug
2. in general and local anesthetics chapter
3. same neurons as ACh, but metabolizes slower
4. muscles loose ability to contract, flacid muscle paralysis
5. quick acting - used for tracheal intubation
6. adverse effects: causes muscular fasciculation if used too long
7. contraindicated in malignant hyperthermia, skeletal muscle myopathies, and known hypersensitivity to the drug |
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Term
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Definition
1. intermediate acting NMBD
2. used as adjunct to general anesthesia to facilitate tracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation
2. commonly used
3. prolonged paralysis in long-term use and subsequent weaning off from mechanical ventilation |
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Term
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Definition
1. intermediate acting benzodiazepine
2. one of the metabolites of diazepam
3. induces sleep in 20-40 minutes
4. long onset of action - take 1 hour before bed
5. has been replaced by other hypnotic drugs |
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Term
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Definition
1. short acting nonbenzodiazepine hypnotic
2. very short half-life and can take a dose in the middle of the night as long as it is at least four hours before they must arise |
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Term
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Definition
1. short acting nonbenzodiazepine hypnotic
2. lower incidence of daytime sleepiness
3. Ambien CR is longer acting form with two drug reservoirs...one to induce sleep, another that releases more slowly throughout the night
4. adverse effect: somnambulation (sleepwalking)
5. one of only two approved for long term use (lunesta is the other) |
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Term
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Definition
1. muscle relaxant
2. injectable from used with a pump device
3. This method is sometimes used to treat chronic spastic muscular conditions - test dose needs to be administered initially to test for a positive response
3. injection diluted before infusion |
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Term
| cyclobenzaprine (Flexaril) |
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Definition
1. muscle relaxant
2. centrally acting muscle relaxant related to tricyclic antidepressants
3. common marked sedation with use |
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Term
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Definition
1. CNS stimulant
2. used to treat ADHD and narcolepsy
3. Dexadrine and Adderall |
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Term
| methylphenidate (Ritalin) |
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Definition
1. CNS stimulant
2. used for ADHD and narcolepsy
3. controversy with use |
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Term
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Definition
1. anorexiants
2. structurally related to amphetamines, but with less abuse potential
3. Schedule !V drug |
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Term
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Definition
1. used to treat migraines
2. potential vasoconstrictor effects including on the coronary circulation
3. local irritation at site of injection
4. |
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Term
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Definition
1. CNS stimulant
2. use w/caution in pts with peptic ulcers or cardiac dysrhythmias
3. used for respiratory depression in adults (contains benzyl alcohol) |
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Term
| phenobarbital and primidone (Mysoline) |
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Definition
1. commonly used as antiepileptic
2. primidone is metabolized in the liver into phenobarbitol
3. phenobarbital is used for management of status epilepticus and as a prophylactic for febrile seizures
4. most common adverse effect is sedation - tolerance develops with continued use
5. therapeutic effects between 10 - 40 mcg/mL.
6. advantage once/day dosing
7. contraindicated in porphyria (disorder of the synthesis of heme) liver or kidney impairment, respiratory illness
8. adverse effects include cardiovascular, CNS, gastrointestinal and dermatologic readctions. |
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Term
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Definition
1. antiepileptic
2. management of tonic-clonic and partial seizures
3. contraindicated in heart condition that involve bradycardia or blockage of electrocardiac function.
4. Adverse effects: lethargy, abnormal movements, mental confusion GINGIVAL HYPERPLASIA,
5. scrupulous dental care required
6. Dilantin facies -hypertrophy of subcutaneous facial tissue
7. osteoporosis is a long term consequence of therapy
8. at toxic levels causes nystagmus,ataxia, encephalopathy
9. interacts with other meds for 2 reasons: a) highly bound to plasma proteins and competes with other highly protein bound medications and b) it induces pepatic microsomal enzymes which increase metabolism of other drugs.
10. exaggerated effect in pts with very low serum albumin concentrations most commonly occurs in malnourished or chronic renal failure. in these pts it may be necessary to maintain levels below 20 mcg/mL
12. parenteral phenytoin is irritating to veins (pH 12)...give by slow intravenous push through a large gage venous catheter
13. Only dilute with normal saline...follow with a flush. |
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Term
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Definition
1, antiepileptic
2. injectable prodrug of phyenytoin
3. water soluable---can be given intramuscularly or intravenously
4. does not cause burning sensation associated with phenytoin
5. give at 150 mcg or less to avoid hypotension or cardio-respiratory depression
6. implement fall protection measures after infusion : ataxia, dizziness |
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Term
| carbamazepine ( Tegretol) |
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Definition
1. antepileptic
2. first treated for trigeminal neuralgia
3. chemically related to tricyclic antidepressants
4. treatment of partial seizures and generalized tonic-clonic seizures
5. associated with autoinduction of hepatic enzymes
6. worsens myoclonic or absence seizures |
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Term
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Definition
1. antiepileptic
2. adjunct drug for treatment of partial seizures and prophylaxis of partial seizures
3. effective for new-onset epilepsy
4. most commonly used to treat neuropathic pain |
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Term
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Definition
1. epiliptic drug
2. treatment of generalized seizures (absence, myoclonic, tonic-clonic) also effective for partial seizures
3. also used to treat bipolar disorder
4. contraindications: liver impairment and urea cycle disorders
5. common adverse effects include drowsiness, nausea, vomiting and other GI disturbances, tremor, wight gain; transient hair loss
6. most serious: hepatotoxicity and pancreatitis
7. interacts with many meds b/c highly bound meds for binding sites
8. can be sprinkled into food (long acting granules) |
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Term
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Definition
1. antiparkinson drug
2. nonergot NDDRA
3. better adverse effects profile than bromocriptine
4. effective in both early and late Parkinson's
5. appears to delay need for levodopa therapy
6. approved for restless leg syndrome
7. adverse effects include dizziness, GI upset and somnolence
8. interacts with warfarin, ciprofloxacin, P-450 enzyme |
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Term
| carbidopa-levodopa (Sinemet) |
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Definition
1. possible interaction with dietary protein
2. combo used to treat Parkinson's , carbidopa by itself does not
3. possible drug interaction with B6 (pyroxidine)
4. possible interaction with dietary protein
5. best on empty stomach, but if GI upset, take w/food |
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Term
| benztropine mesylate (Cogentin) |
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Definition
1. antiparkinson drug
2. also for extrapyramidal symptoms
3. use with caution in hot weather or during exercise because may cause hyperthermia
4. other adverse effects include tachycardia, confusion, disorientation, toxic psychosis, urinary retention, dry throat, constipation, nausea, vomiting
5. Anticholinergic syndrome can occur when it is given with drugs such as amantadine, phenothiazine, or tricyclic antidepressants
6. avoid alcohol |
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Term
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Definition
1. psychotherapeutic drug
2. for anxiolytic drugs (anxiety)
3. most commonly used anxiolytic drug
4. indicated for panic disorder
5. adverse effects include confusion, ataxia, headache, amnesia, anorexia, sedation, lethargy, fatigue, drowsiness, visual changes, hypotension, weight gain or loss, nausea, weakness
3. interacting drugs: alcohol, antacids, oral contraceptives
4. a benzodiazepine |
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Term
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Definition
1. benzodiazepine psychotherapeutic drug
2. indicated for relief of anxiety, management of alcohol withdrawal, reversal of status epilepticus, preoperative sedation, and as adjunct for relief of muscle spasms
3. active metabolites can accumulate in pts with hepatic dysfunction because it is metabolized primarily in the liver
4. cumulative effects -prolonged sedation, respiratory depression, or coma
5. best avoided in pts with major hepatic compromise
6. adverse effects include headache, slurred speech, confusion
7. interacts with alcohol, oral contraceptives |
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Term
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Definition
1. tricyclic antidepressant
2. oldest and most widely used of TCAs
3. commonly used to treat insomnia and neuropathic pain
4. contraindications include pregnancy, recent mycardial infarction
5. very potent anticholinergic properties
6. adverse effects: dry mouth, constipation, blurred vision, urinary retention, dysrhythmias |
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Term
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Definition
1. 1st SSRI marketed for depression
2. indicated for depression, bulimia OCD, panic disorder, premenstrual dysphoric disorder
3. contraindications: concurrent MAOI therapy
4. adverse effects: anxiety, dizziness, drowsiness, insomnia
5. interacting drugs: benzodiazepines, antipsychotics, propafenone |
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Term
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Definition
1. antidepressant
2. indicated for depression, aid in smoking cessation, adjunct for pts experience sexual adverse effects secondary to SSRI therapy
3. contraindicated in seizure disorder, anorexia nervosa, bulimia, MAOIs
4. common adverse effects: dizziness, confusion, tachycardia, agitation, tremor, drymouth
5. interactions: azole antifungals, CNS depressants |
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Term
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Definition
1. antidepressant
2. promotes presynaptic release of both serotonin and norepinephrine in the brain
3. strongly associated with sedation(histamine 1 receptor activity) therefore usually dosed at bedtime
4. clearage of drug reduced in elderly
5. indicated for depression, including bipolar disorder, reducing sexual adverse effects in male pts receiving SSRI therapy
6. contraindicated with MAOIs,
7. adverse effects: drowsiness, abnormal dreams, dry mouth, constipation, increased appetite, asthenia
8. interacts with alcohol and CYP inhibitors |
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Term
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Definition
1. atypical antisychotic
2. indicated for schizophrenia, causes minimal extrapyramidal adverse effects at therapeutic dosages of 1-6 mg/day
3. adverse effects: elevated prolactin levels, abnormal dreams, insomnia, dizziness, headache
4. interacting drugs: CNS depressants, antihypertensives |
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Term
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Definition
1. adrenergic
2. beta 1 selective vasoactive adrenergic similar to catecholamine dopamine
3. stimulation of beta 1 receptors on the heart muscle it increases cardiac output by increasing contractility (positive intropy) which increases stroke volume, especially in pts with heart failure.
4. only IV drug, given by continuous infusion |
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Term
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Definition
1. andrenergic drug
2. naturally occuring catecholamine neurotransmitter
3. beta 1 and alpha 1 adrenergic receptor activity as well as dopaminergic
4. at low doses dilates blood vessels in brain heart, kidneys, and mesentery increasing blood flow to those areas
5. at higher doses causes vasoconstriction
6. contraindicated in pts who have a catecholamine-secreting tumor known as pheochromocytoma
7. only IV by continuous infusion |
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Term
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Definition
1. adrenergic drug
2. act on both alpha and beta adrenergic receptors in tissues inervated by SNS
3. administered in emergency situations and is one of the primary vasoactive drugs used in amy advanced cardiac life support protocols
4. low dosages - stimulates mostly beta 1 increasing force of contraction and heart rate
6. indicated acute asthma and MI and anaphylactic shock
7. at high dosages stimulates alpha causing vasoconstriction which elevates bp |
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Term
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Definition
1. adrenergic drug
2. peripheral dopamine 1 agonist
3. parenteral use in lowering bp
4. effective for short term treatment of severe hypertension, may have beneficial effects on renal fnx b/c it increases renal blood flow |
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Term
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Definition
1. adrenergic drug
2. prodrug that is converted to the liver in its active form
3. causes constriction of both arterioles and veins resulting in peripheral vasoconstriction
4. indicated for symptomatic orthostatic hypotension |
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Term
| norepinephrine (Levophed) |
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Definition
1. adrenergic drug
2. vasoconstrictor
3. direct beta effects on heart but none on the lung
4.metabolizes into dopamine
5. indicated in hypotension and shock - given by continuous infusion |
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Term
| phenylephrine (Neo-Synephrine) |
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Definition
1. adrenergic drug
2. works on alpha
3. indicated for short term treatment to raise bp in pts with shock, to control some dysrhythmias, also topically as an ophthalmic drug and nasal decongestant |
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Term
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Definition
1. adrenergic blocking drug
2. used to treat hypertension
3. can also be used in diagnosis of catecholamine secreting tumor (pheochromocytoma)
4. only injevctable
5. most commonly used to treat the extravasation of vasoconstrictiing drugs such as norepinephrine, epinephrine, and dopamine...potential loss of limb if not treated
6. contraindicated in MI, coronary artery disease
7. adverse effects: tachycardia, dizziness, gI upset,
8. drug interactions: alcohol, erectile dysfunction,
9. epinephine and ephedrine can counteract the desired effects of phentolamine |
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Term
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Definition
1. adrenergic blocking drug
2. cardioselective beta blocker -
3. used to prevent another heart attack
4. also treats angina and hypertension and in management of thyrotoxicosis to help block symptoms of excessive thyroid activity |
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Term
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Definition
1. adrenergic blocking drug
2. very short acting beta blocker
3. primarily used in acute situation to provide rapid temporary control of the ventricular rate n pts with supraventricular tachydysrhythmias
3. IV titrated to achieve serum levels that control symptoms |
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Term
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Definition
1. adrenergic blocking drug
2. beta blocker fave of cardiologists for use in pts after MI
3. increased survival in pts given drug |
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Term
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Definition
1. adrenergic blocking drug
2. nonselective beta blocker
3. indications: cardiac MI, tachydysrhythmias associated with cardiac glycoside intoxication, hypertrophic subaortic stenosis, pheochromocytoma, thyrotoxicosis, migraine headache, essential tremor, and many other conditions
4. same contraindications as other beta blockers but add bronchial asthma |
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Term
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Definition
1. cholinergic drug
2. used in treatment of acute postoperative and postpartum nonobstructive urinary retention and for management of urinary retention associated with neurogenic atony of the bladder.
2. also use dot treat and prevent bladder dysfunction induced by phenothiazine and tricyclic antidepressants
3. used in treatment of postoperative GI atony and gastric retention, chronic refractory heartburn, diagnostic testing for infantile cystic fibrosis
4. contraindicated in: hyperthyroidism, peptic ulcer, active bronchial asthma, cardiac disease or coronary artery disease, epilepsy and Parkinsonism
5. avoid in pts in whom the strength or integrity of the GI tract or bladder wall is questionable or with conditions in which increased muscular activity could prove harmful
6. adverse effects: hypotension with reflex tachycardia, syncope, headache, seizure, GI upset, asthmatic attacks
7. DRug interactions: acetylcholinesterase inhibitors, |
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Term
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Definition
1. cholinergic drug
2. cholinesterase inhibitor increases levels of acetycholine
3. used for mild to moderate Alzheimer's disease
4. adverse effects: GI upset, ulcer risk, drowsiness, dizziness, insomnia, muscle cramps, bradycardia, syncope, hypotension with reflex tachycardia or hypertension
5. Interacting drugs: anticholinergics, nonsteroidal antiinflammatory drugs. |
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Term
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Definition
not a cholinergic drug a NMDA receptor agonist
1. alzheimer's drug
2. memantine helps to reduce pts degenerative cognitive symptoms
3. effects likely temporary, but may afford some improvement in quality of life and general functioning
4. adverse effects: hypotension, headache, GI upset, musculoskeletal pain,dyspnea, ataxia, and fatigue |
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Term
| pyridostigmine (Mestinon) |
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Definition
1. cholinergic drug
2. synthetic quatternary ammonium compound
3. imporves muscle strength and is used to relieve symptoms of myasthenia gravis
4. used to reverse effects of nondepolarizing neuromuscular blocking drugs
5. used in treatment of severe overdoses of tricyclic antidepressants
6. antidote to toxic exposure to nondrug anticholinergic agents, including those used in chemical warfare
7. contraindications: asthma, gangrene, hyperthyroidism, cardiovascular disease, mechanical obstruction of the GI or GU tracts
8. Adverse effects: GI upset, excessive salivation,
9. interacting drugs: anticholinergic drugs |
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Term
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Definition
1. cholinergic blocking drug
2. effective in treatment of many conditions : parkinson's, drug induced extrapyramidal reactions, low doses slow rate, high dosages, increase heart rate,
3. used primarily in management of cardiovascular disorders such as in the diagnosis of sinuus node dysfunction and treatment of pts with symptomatic second degree atrioventricular black and provison of advanced life support in the treatment of sinus bradycardia tha tis accompanied by hemodynamic compromise
4. used as antidote for anticholinesterase inhibitor toxicity or poisoning
5. used preoperatively to reduce salivation and GI secretions
6. contraindicated in pts with angle closure glaucoma, adhesions between the iris and lens, certain types of asthma, advanced hepatic and renal dysfunction, hiatal hernia assoc with reflux esophagitis, intestinal atony, obstructive GI or GU conditions and severe ulcerative colitis
7. use with caution in pts with dysrhythmias
8. overdose is associated with flushing dry skin and mucous membranes, mydriasis and altered mental status and fever
9. serios effects: sinus tachycardia, urinary retention, hypertension, hallucinations, respiratory depression and cardiovascular collapse
10. antidote is physostigmine |
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Term
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Definition
1. cholinergic blocking drug
2. used primarily in treatment of functional disturbances of GI motility such as irritable bowel syndrome
3. used in treatment of colic and enterocolitis in infants
4. contraindicated in those with angle closure glaucoma, GI tract obstruction, myasthenia gravis, paralytic ileus, GI atony, or toxic megacolon |
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Term
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Definition
1. cholinergic blocking drug
2. muscarinic receptor blocker
3. use in treatment of urinary frequency, urgency, incontinence
4. avoid if you anve angle closure glucoma or urinary retention |
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