OSCI #1

What is the best drug for myasthenia gravis?

Neostigmine (Decrease AChE activity)

What are the MOA of cholinergic agonist?

Stimulate nicotinic/muscarinic receptors (parasympathomimetics) (decrease HR, constrict pupil)

What are the adverse effects of cholinergic agonist?

GI distress, bronchoconstriction, vasodilation

What is the best drug for alzheimer's disease?

Donepezil (Decrease AChE activity)

What is the best drug for urinary retention?

Bethanechol (Increase production of ACh)

What is the best drug for glaucoma?

Pilocarpine (Increase production of ACh)

What drug system do neostigmine, Donepezil, Bethanechol, and Pilocarpine belong to? What does this class do?

Cholinergic agonists
It stimulates nicotinic/muscarinic receptors (decrease HR and constrict pupils by activating parasympathomimetic system)

What is the best drug for bronchoconstriction? What class of drug is this?

Ipratropium
Antimuscarinic agent

What is the best drug for IBS?

Atropine
Antimuscarinic agent

What is the best drug for intubation?

Succinylcholine
Neuromuscular blocker

What do cholinergic antagonists do? What class do Ipratropium, Atropine and Succinylcholine belong to?

Block parasympathetic receptors.
Cholinergic antagonists

What are the best drugs for asthma? What class of drugs do they belong to?

Albuterol (B2 agonist which increases prod of ACh)
Isoproterenol (Catecholamine)

What is the MOA of cholinergic antagonists?

Block parasympathetic receptors

What are the adverse effects of adrenergic agonists?

Headache, arrhythmia

What is the MOA of adrenergic agonists?

Stimulate sympathetic receptors

What are the adverse effects of Cholinergic antagonists?

Increased HR, urinary retention, pupil dilation

What is the best drug for anaphylaxis?

Epinephrine (Increases prod of ACh)

What is the best drug for shock?

Dopamine (Increases prod of ACh)

What is the best drug for nasal congestion?

Phenylephrine (Increases prod of ACh)
Ephedrine ((Increases prod of ACh and Decreases AChE activity)

What is the best drug for hypotension?

Norepinephrine (Decreases AChE activity)

What is the drug class for Albuterol, Isoproterenol, Epinephrine, Dopamine, Phenylephrine, Ephedrine, Norepinephrine?

Adrenergic Agonists

What class of drugs are useful in treating hypertension and migraines?

Beta blockers (specifically, adrenergic antagonists)

What are some drugs that can be useful in treating hypertension and migraines?

Beta blockers: Acebutolol, Labetalol, metoprolol, Pindolol, Atenolol (B1 selective) or Propanolol (B1 or B2 nonselective)

What are some drugs that can be useful in treating hypertension?

Alpha blockers
end in -zosin

What are some drugs that can be useful in treating hypertension with asthma or peripheral vascular disease?

Ca+ channel blockers
- Verapamil

What drugs are useful with treating hypertension with diabetes?

ACE inhibitors
- end in pril (lisinopril)

What drugs can be effective at reducing blood pressure without an associated cough?

ARB inhibitors
- end in sartan.

What are diuretics good for treating?

Hypertension and edema

What class of drugs delay ventricular depolarization?

Na+ channel blocker arrhythmia drugs

What drugs are useful for venous thrombosis, MI or pulmonary edema?

Anticoagulants
- Warfarin, Heparin, Coumadin

What drugs does anticoagulants interact with?

Aspirin, NSAID and thrombolytics

What drugs would you take for arterial thrombosis?

Antiplatelets
- ASPIRIN

What drugs do anti platelets interact with?

Anticoagulants, thrombolytics, antacids

What drugs are used to dissolve clots?

Thrombolytics
- ase

What drugs are good to take for hyperlipidemia?

- Statins (Lower LDL by blocking synthesis of cholesterol).
Lipitor

What drugs would you take for congestive heart failure?

Cardiac glycosides
- Digoxin
Positive inotropes

What drugs would you take for angina?

Nitrates

What drugs would you take for muscle spasms/spasticity?

Diazepam (increase inhibit effects of GABA)
Polysynaptic inhibitors
Baclofen

What classification is Diazepam under?

Benzodiazepine (BNZ)

What is the difference between Diazepam and Baclofen?

Diazepam increases GABA while Baclofen works directly on the CNS for muscle relaxing.

What drugs are useful with spasmodic torticolis, laryngeal dystonia, focal dysontias and spasticity?

Botox

What drugs would you use for inflammation, joint pain, bursitis, tendonitis, ms sprains and strains?

NSAIDs
- Aspirin (fever, pain, ms aches) (Salicylate)
- Ibuprofen (RA, OA, fever) (Non-salicylate)
- Indomethacin (RA, OA, tendonitis, bursitis)
- Selective COX-2 inhibitors)

What drug would you take for headache, ms pain, myalgia, dysmenorrhea, fever (no inflammation)

Acetaminophen (inhibits prostaglandin in PNS which blocks peripheral pain)

What drugs would you use to treat moderate to severe pain?

Opiates!
- Morphine
- Condeine
- Hydrocodone
- Oxycodone

What are the contraindications for morphine?

Asthma, emphysema, head injury, ulcerative colitis

what are the contraindications for Codeine?

Asthma, increased intracranial pressure, respiratory insufficiency

What are the contraindications for oxycodone?

Preggo, antidepressants, antihistamines, pain relievers, muscle relaxants

What are the drugs used for bronchospasm?

Sympathomimetics, Beta agonists, Anticholinergics, Xanthine

What drugs are good for parkinson's?

Dopamine replacement
- Dopamine receptor agonists
- Enzymatic inhibitors

What are the MOA of beta blocker (adrenergic antagonist)?

Block beta-receptor

What are the adverse effects of beta blockers?

Not for DIABETICS! Orthostatic hypotension, bradycardia

What is the MOA of alpha blockers?

Block alpha receptors

What are the adverse effects of alpha blockers?

First-dose syncope, postural hypotension

What are the MOA of Ca+ channel blocker?

Block calcium influx into arterial smooth muscle causing vasodilation

What are the adverse effects of Ca+ channel blockers?

Throbbing headache, hypotension

What are the MOA of ACE inhibitors?

Block ACE, reducing angiotensin II creation causing vasodilation

What are the adverse effects of ACE inhibitors?

Dry cough, rashes

What is the MOA of thiazide diuretics?

Inhibit Na/Cl cotransporter, block reabsorption

What is the MOA of loop diuretics?

Inhibit Na/K/Cl cotransporter, block reabsorption

What is the MOA of potassium sparing diuretics?

Inhibit Na reabsorption and K excretion

What are the adverse effects of arrhythmias?

Fatigue, orthostatic hypotension

What do K channel blocker (arrhythmia) do?

Stop influx of K, prolong contraction duration

What do Ca+ channel blocker (arrhythmia) do?

Block calcium entry into the heart, decrease contraction

What is the MOA for anticoagulants?

Increases length of coagulation

What are the adverse effects of anticoagulants?

Hemorrhage, diarrhea

What is the MOA for anti platelets?

Prevents platelets from binding together.

What are the adverse effects of antiplatelets?

Diarrhea, bleeding

What is the MOA for thrombolytics?

Plasminogen activator

What is the adverse effect of thrombolytics?

Bleeding

What is the MOA of statins?

Lower LDL-block synthesis of cholesterol

What is the MOA of bile-Acid binding renin?

No reabsorption of bile acids - no reuptake of cholesterol

What are the MOA of cardiac glycosides?

Elevate intracellular calcium levels in the heart which increases contractility

What are the adverse effects of cardiac glycosides?

Arrhythmias, nausea

What is the MOA of nitrates?

Vasodilator, decrease O2 demand, increase O2 supply

What is the MOA of Diazepam?

Increase central inhibitory effects of GABA

What are the adverse effects of Diazepam?

Sedation, tolerance.

What is the MOA of Polsynpatic inhibitors?

Decrease polsynaptic reflex in spinal cord

What are the adverse effects of Polsynpatic inhibitors?

Drowsiness and dizziness

What are the two drugs for skeletal muscle relaxants?

Cyclobenzaprine Hydrochloride (Flexeril)
Dichlorodifluoromethane

What are the adverse effects of Aspirin?

Gastric pain, heart burn, bleeding, N/V

What are the contraindications for Aspirin?

hty of peptic ulcer, hypertension, asthma, allergies

What are the interactions of anti platelets?

Anticoagulants, thrombolytic, antacids

What are the adverse effects of Ibuprofen?

Nausea, occult bleeding

What are the contraindications for Ibuprofen?

Antihypertensives, pregnant, thiazide diuretics

What are the adverse effects for Indomethacin?

GI ulcer, GI bleeding

What are the contraindications for Indomethacin?

Antihypertensives, thiazide diuretics, diuretics, pregnancy

What are the adverse effects of Cox-2 inhibitors?

Abdominal pain, diarrhea

What are the contraindications for Cox-2 inhibitors??

Hectic impairment, ACE inhibitors, other NSAIDs

What are the adverse effects of Acetaminophen?

Hypotension, hepatotoxicity

What are the contraindications of Acetaminophen

Malnutrition, thrombocytopenia, alcoholism

What are the adverse effects of nitrates?

Dizziness, headache, flushing, nausea

What do calcium channel blockers end in?

Dipine

When do you want to use Verapamil? What about Dipine?

Verapamil with hypertension with asthma or PVD.
Dipine drugs with diabetes.

What are the thiazide drugs?

HCTZ

What do thiazide drugs end in?

Thiazine

What drug would you give along with loop diuretics for patients with CHF and edema?

Thiazides

What do loop diuretics end in?

Semide

What are the adverse effects of thiazides?

Hypokalemia, acidosis, hyperglycemia, hyponatremia, history of gout!

What are the adverse effects of loop diuretics?

Toxicity

What is the main purpose of ace inhibitors?

Vasodilation

What are the adverse effects of cardiac glycosides?

Visual disturbances, vomiting, fatigue, headache, slow pulse.

What is a loop diuretic drug?

Furosemide or Ethacrynic acid

What are the adverse effects of loop diuretics?

Hypocalcemia, gout, hypomagnesemia, hypokalemia

When would you use Ethacrynic acid? What class is this?

When the person has a sulfa allergy. This drug belongs to the Loop Diuretic class.

What is a potassium sparing diuretic drug?

Spironolactone

What are the adverse effects of potassium-sparing diuretics?

Hyperkalemia, gynecomastia, libido changes.

What is the normal pulse for children (1-7 years old)?

80-120 bpm

What is the normal pulse oximetry reading?

95-100%

Where is the pulse ox placed?

Fingertip of the 2nd or 4th finger

What is the resting BP of a child 1-4 years old?

100-110/60

What is the resting BP of a child 4-12 years old?

100 (2+ per year)/60-70

What is the resting BP of an adolescent?

110-120/65-75