Pharm exam 2 2
Terms
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- Function of the Parasympathetic Nervous System
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decrease heart rate
constrict pupils
constrict brochial smooth muscle
empty gastric/bladder/bowels - Alpha 1
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pupil dialation (mydriasis)
vasoconstriction
ejaculation
contract bladder smooth muscle - alpha 2
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less clinically significant
nerve terminals - alpha antagonist uses
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stop bleeding
decrease nasel congestion
increase blood pressure
pupil dialation -
beta 1
beta 2 -
heart and kidney
increase heart rate
increases force of contraction
Lung-bronchial dialation
uterus-relax
increase glycogenolysis - Uses of beta stim
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if had : heart attack
heart failure
shock - Alpha blocker
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hypertension
raynaud's (vascular) disease
adverse: hypotension w/movement, nasel congestin, inhib ejac, sodium retention - Beta blocker
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decrease heart rate
decrease force of constriciton
adverse: taking off too fast rebound tachycardia - Anticholinergic side effects
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Red
Mad
blurred vision
GI slow
dry mouth
stim heart - Cholinergic agonist
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bethanechol- urinary retention
pilocarpine- eye drops
adverse: slow cardio, diarhea, brochii spasm
posioning with mushroom use blocker (Atropine) - Cholinergic antagonist
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blocks ACh at receptor site
Atropine: increase HR, relax brochi, dialate pupil, CNS excitation
Uses: motion sickness, diarhea
Adverse: anticholinergic effects
poisoning: treat with inhibitor - Cholinergic inhibitor
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inhibts breakdown of ACh
uses in alzheimers
uses in Myosino Gravis - Anticholinergic agents
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blocks action of ACh
drugs: benstropine, diphenhydramine (benadryl)
anticholinergic side effects - Epinephrine
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stim all alpha and beta receptors
uses: anaphalactic shock, ashma, cardiopulmonary arrest - Function of the Sympathetic Nervous System
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vasodialtion
pupil diation
heart rate increase
shunting of blood to muscles
dialate brochi - Alzheimers Disease
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degenorative, neuro, chronic disease
effects older population
Drug: donepezil also for anxiety, depression, agitation
Cholinesterare inhibitor-prevent breakdown ACh slows progression -
Parkinson's Disease
Sign and Symptoms -
disorder of extrapyramidal tract
neuro disorder
dyskinea,tremors,rigidity,akinesia
inbalance between dopamine and ACh - Parkinson's Drug therapy
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increase dopamine:Levodopa/carbodopa=
sinemet
take with food, abnor movement
decrease ACh w/antichoinergic agents: beztropine - Epilepsy S&S
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essesive neuron stimulation
seziure partial and general
antiepiletic drugs to: dicharge seizure
supress Ca and sodium
GABA - Epilepsy Drugs
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Phenytoin-gingival hyperplasia
Valprolic Acid-monitor liver
Carbamazephine-birth defects
Phenobarbital-promotes sleep
goal 1 drug, no other CNS depressants - GABA
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primary neurotrasmitter inhibitor
calming - Muscle Spasm Drug Therapy
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analgesic/anti-inflamatory
ibprofen/asprin
centrally acting muscle relaxants:
diazapam/tizanidine -
Centrally acting muscle relaxants
how they work -
inhibit presynaptic motor neuron
diazepam:through GABA
Tizanidine: agonist action alpha 2
use for local pn, spasm or ROM
adverse: CNS depression, hepatic toxcicity, physical dependence - Drugs for spasticity
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spasticity:movement disorder of CNS origin; cerebral palsy, multiple scler.
heighten muscle tone, spasm, loss of dextarity - Baclofen
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acts on spinal cord
no direct effect on skeletal muscle
adverse: no antidote, gradual withdrawl, CNS depress, constipation, urinary retention - Diazepam
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acts on CNS
mimics action of GABA
adverse: sedation - Dantrolene
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suppress release of Ca from sarcoplasmic reticulum
use: cerebral palsy, multi sclerosis
adverse: weakness, drowsy, diarhea, hepatic tox - Local Anesthetics
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suppress pn by blocking axon conduction
blocks sodium channel, blocks neural function, sensory and motor
adverse: CNS, CV, allergic - What are Esters
- procaine (novacaine)
- what are amides
- lidocane
- Procaine (novocain)
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used with epinephrine (delays absorbtion
allergic reactions - What are CNS depressants
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barbituates
benzodiazepines
alcohol
general anesthetics
antihistamines
phenothiazines - Analgesic Ladder
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1-mild nonopioid analgesic/NSAID
2-more severe add opiod analgesic
3-severe substitute opioid-morphine - Opioid Analgesics
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relieves pn w/o loss of conscious
morphine
codeine
antagoinst: naloxone - Morphine
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strong opioid analgesic (agonist)
decrese pn, emotional reaction to pn
other:sedation, euphoria,respitory depression,nauseam miosis
6-8 hours oral best - Headaches; acute treatment
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NSAIDS, combos w/caffeine
selective seotonin agonists-TRIPTAN
adverse:tingling, dizzy,vertigo, flushing, warm/cold, heavy chest, fatigue - Triptans contraindications
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cadiac or cerebrovascular disease
hypersensitivity
use w/in 24 hour other another - Schizophrenia
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chronic psychotic illness adolescence
reduced ability to comprehend reality - Clozapine
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atypical antipsychotic
blocks dopa and serotonin
fewer EPS sympt
adverse:gain weight, diabetes, antichol - depression therapy's
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tricycline
serotonin reuptake inhibitor
atypical antidepressants
electroconvulsive, psychotherapy - Tricyclic
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antidepression
blocks reuuptake of NE and 5HT allowing more effects to occur
adverse:antichol,cardiac toxicity, seizues,sedation,lethal (get baseline EKG)
antidote:cholinesterase inhibitor - MAOI
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second/third choice depression
adverse: CNS stim,hypotention,drug interations
aviod tyramine rich foods cheese, apple - SSRI
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Prozac (Fluxetine), celexa,zoloft,paxil
first choice, safer
Adverse:diarrhea,anorexia,insomnia,sex - Bupropion
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atypical antidepressant
response:1-2 wks
adverse:dry mouth, headache,weight loss
increase pot. for seziure
narrow theraputic range, withdrawl - Lithium
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bipolar disorder
increase NE uptake/5HT sensitivity
short 1/2 life, toxic
valproic acid (mood stabilizer) given same time (sometimes) - Benzodiazepine
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Lorazepam/Diazepam
anxiety,insomnia,seizure,muscle spasm,painc,alcohol withdrawl
increase effect of GABA
adverse:drowsy,confusion,ataxia,abuse,CNS depression, toxic - Barbiturates
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phenobarbital (hypnotic, seizure)
long acting
check drug interaction - Amphetamine
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CNS stim; release norepi,dopa,inhibits reuptake
adverse:dependence,abuse,dizzy,agitated,palpitations,elevated BP - Methylphenidate (Ritalin)
- attention deficit/hyperactivity