KSU Nursing Pharm Test 1

St. Johns' wort

Herbal supplement to reduce depression and anxiety. Interacts with opioids, alcohol, and other CNS depressants(potentiates sedation); oral contraceptives, cyclosporine (decreased effectiveness).

Sarin gas

Highly toxic, long duration. Potential use in chemical warfare.

Donepezil (Aricept)

Indicated for mild-severe AD. Cholinesterase inhibitor, AE: diarrhea, dyspepsia, bronchoconstirction, and bradycardia. Risk for fainting and falls. Interacts with lanoxin. Interacts with other cholinergic receptor blockers.

clonidine (Catapres)

Indirect-acting Antiadrenergic agent. For hypertension, centrally acting that reduces along sympathetic nerves. Adminstered PO or transdermal. Potential for abuse.

echothiophate

Irreversible cholinesterase inhibitors. Treat glaucoma.

Procaine (Novocain)

Local anesthetic, Ester- low allergic response. Nonselective, block sensory perception then motor perception. Rapid onset, short duration (<1hour).

B-1 Receptor Activated Effect

+inotropic,+chronotropic, and +dromotropic effects in heart, renin relase in kidneys.

carvedilol (Coreg)

A beta-blocker with alpha-1 activity.

metoprolol (Lopressor)

A cardioselective beta blocker.

propranolol (Inderal)

A non-selective beta blocker.

Acetylcholine (Ach)

A preganglionic neurotransmitter that binds to cholinergic receptors. Inactivated by acetylcholinersterase.

resperine

Adrenergic neuron-blocking agents that decrease NE release.

Parasympathetic antagonist

Agent that decreases/blocks parasympathetic response

Sympathetic antagonist

Agent that decreases/blocks sympathetic response

Parasympathetic agonist

Agent that increases/activates parasympathetic response

Sympathetic agonist

Agent that increases/activates sympathetic response

Vecuronium (Norcuron)

An analog of pancuronium. Nondepolarizing NMBA.For ET intubation, mechanical ventilation, ECT therapy. Can cause respiratory arrest and hypotension.

Droperidol (Inapsine)

Antimetics - prevents nausea and vomiting. Post-op.

ondansetran (Zofran)

Antimetics - prevents nausea and vomiting. Post-op.

Rivastigmine (Exelon)

Approved for AD and dementia from Parkinson's disease. Cholinesterase inhibitor,available in patch and table. AE: diarrhea, dyspepsia, bronchoconstirction, and bradycardia. Risk for fainting and falls. Interacts with lanoxin. Interacts with other cholinergic receptor blockers.

B-2 Receptor Activated Effect

Arteriodilation, bronchodilation, uterine relaxation, hepatic glycogenolysis, and enhanced contraction

B-2 Receptor Location

Arterioles (in heart, lungs, and skeletal muscle), bronchi, uterus, liver, and skeletal muscle

Isoproterenol (Isuprel)

Catecholamine, B-1 & B-2 activator.

Dobutamine

Catecholamine, B-1 activator.

Ototoxicity

Caused by aminoglycoside antibiotics. Has a hard time hearing or ringing in the ears.

Pulmonary toxicity

Caused by amiodarone (antidysrhythmic). Having difficulty breathing.

Nephrotoxicity

Caused by amphotericin B and vancomycin

Neostigmine (Bloxiverz)

Cholinesterase inhibitor, treats myasthenia gravis and reverse NMBA. Reversible. Too much causes cholinergic crisis. Can cause increased secretions and respiratory depression.

Succinylcholine (Anectine)

Depolarizing NMBA. For ET intubation, mechanical ventilation, off label for ECT therapy. Can cause respiratory arrest and hypotension. Causes complete flacid paralysis, very fast acting, peaks 1 min, fades after 4-10. No treatment for overdose, just provide supportive care. ADR is malignant hyperthermia.

Dopamine

Dilation of kidney vasculature, catecholamine.

tetracycline

Discoloration of developing teeth in children.

a-1 Receptor Location

Eyes, blood vessels, bladder, male sex organs

BiDril

First drug approved for African-American population in 2005.

EpiPen

For anaphylaxis with benefits from activation of a-1, B-1, B-2. Good for 12-18 months, store in dark place at room temperature.

ipratropium bromide (Atrovent)

For asthma, COPD, and rhitinis caused by allergies or the common cold.

Acetylcholine

For rapid miosis after cataract surgery.

Galantamine (Razadyne)

From daffodil bulbs. Indicated for Alzheimers Disease. Cholinesterase inhibitor, AE: diarrhea, dyspepsia, dizziness, bronchoconstirction, and bradycardia. More severe AEs. Risk for fainting and falls. Eliminated via liver and kidney. Interacts with lanoxin. Interacts with other cholinergic receptor blockers.

Isoflurane (Forane)

General anesthetics, inhalation.

nitrous oxide

General anesthetics, inhalation. "Laughing gas". Has a high MAC (100%), thus not used alone. 20% nitrous oxide is the same pain relief of morphine. Can cause nausea and vomiting.

Midazolam (Versed)

General anesthetics, intravenous.

propofal (Diprivan)

General anesthetics, intravenous. Often used with short-acting barbiturates. Most widely one utilized. "Micheal Jackson Drug". Narrow therapeutic index, potential for abuse. Decreases respirations and BP.

Ketamine (Ketalar)

General anesthetics, intravenous. Used in lab rats, change burn dressings, etc. A schedule 3 drug, popular drug for abuse.

glucocorticoids

Growth suppression in children.

B-1 Receptors Location

Heart and Kidneys

Scopolamine

Therapeutic doses produce sedation. It suppresses emesis and motion sickness. And mydriasis for ophthalmic procedures. Patient is at risk for falls.

Lidocaine patch

Topical administration of lidocaine. Used to treat sunburns, diaper rash, bug bites, sore throats.

Physostigamine

Treats atropine over dose and myasthenia gravis. Crosses BBB better than neostigmine.

minoxidil

Used for HTN, off label use (Rogaine) is used for hair growth.

Bethanechol - muscarinc agonist

Used to increase GU/GI activity post-op and postpartum.

phentolamine (Regitine)

a-1 blocker

tamsulosin (Flomax)

a-1 blocker for BPH (benign prostate hyperplasia)

Prazosin (Minipress)

a-1 blocker for hypertension.

Epinephrine (Adrenalin)

a-1, a-2, B-1, B-2, catecholamine

Norepinephrine

a-1, a-2, B-1, catecholamine.

Lidocaine (Xylocaine)

local anesthetic - amides, very low allergic response. Nonselective, block sensory perception then motor perception. Rapid onset, short duration (<1hour). Can cause cardio suppression.

pilocarpine

muscarinic agonist

bethancol (Urecholine)

Muscarinic agonist, approved for urinary retention only. (Post-op and post partum)

Atropine

Muscarinic antagonist, treats muscarinic agonist (cholinergic) toxicity. Treats severe bradycardia. Pre-op used to decrease secretions. Opthalmic - mydriasis and cyclopegia.

a-1 Receptor Activated Effect

Mydriasis, vasoconstriction, bladder muscle contraction, ejaculation

Actelycholine

Nicotinic and muscarinic receptors.

Ephedrine

Non-catecholamine, B-1 activator.

Albuterol (Ventolin)

Non-catecholamine, B-2 activator

Phenylephrine (Neo-synephrine)

Non-catecholamine, a-1 activator.

pancuronium

Nondepolarizing NMBA. curoniums. For ET intubation, mechanical ventilation, ECT therapy. Can cause respiratory arrest and hypotension.

Memantine (Namenda)

Only for mod-severe AD, better tolerated. Modulates effects of glutamate to alter calcium influx into neurons. Side effects: dizziness, headache, confusion and constipation. Sodium bicarbonate can cause toxic levels of memantine.

Pralidoxime (Protopam)

Possible antidote for irreversible cholinesterase inhibitors. It reactivates cholinesterase.

a-2 Receptor Activated Effect

Suppression of further norepinephrine release