NR 565 Pharm Midterm Latest Version Graded A+

NR 565 Pharm Midterm Latest Version Graded A+ CYP2D6 Need to increase doses of SSRI, beta blockers etc. Codeine can be deadly CYP2C9 Decrease warfarin dose Test for gene VCORC1 mutation CYP3A4 Decreases elimination Increase toxicity of Amio Schedule I no accepted medical use in the US it may not be prescribed. heroin,various opium derivatives,hallucinogenic substances Schedule II No refills, no telephone orders Narcotics, Stimulants, Depressants Schedule III Drugs in this category are considered to be at moderate or low risk for physical dependence, and with current reasons for medical use Anabolic steroids, most barbituates and ketamine Must prescribe every 6 months, can be by phone Schedule IV Abuse potential exists, but less than Sch III. Examples are: Ambien, Darvocet and Lorazepam Schedule V Not always necessary to have a prescription Loperamide, diphenoxylate and cough medicine with less than 200mg/100 ml pregabalin Preclinical research Research of drug potential, animal testing, preparation for human testing Phase I Initial clinical safety studies in humans. May be as few as 10 subjects, often healthy volunteers Phase II The study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety Phase III The study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely Phase IV A study conducted after a drug has been shown to work and has been granted a license (post-marketing surveillance study) Adrenergic agonists Drugs that stimulate and mimic the actions of the sympathetic nervous system. Also called sympathomimetics. alpha 2 agonists Decrease sympathetic impulses from the CNS to the heart and arterioles, causing vasodilation Lowers blood pressure, diuretic may be needed Clonodine, Methyldopa, Guanabenz SE: dry mouth, urinary retention, weight gain etc. Adrenergic Antagonist A drug that blocks the actions of the sympathetic nervous system. Alpha 1 Antagonist Decreases arterial and venous vasoconstriction Decreases blood pressure, helps relieve bph, Diuretic may be needed -osin Beta adrenergic antagonists drugs that block beta-adrenergic receptors; may be nonselective or selective; also called beta blockers Beta 1 Antagonist Effects heart muscle, blocks receptors in SA node to decrease hr, decrease contractility Reduces bp, reduces arrethymias, decreases angina incidences Metoprolol Beta 2 antagonist Lowers bp Effects lungs, bronchial constriction, avoid in asthma patients Propranolol Propranolol Interactions do not take with acetaminophin or warfarin Propanolol other uses Migraine prophylaxis, tremor, glaucoma Beta Blocker teaching points Monitor bp/hr so it's not too low report difficulty breathing or wheezing alpha and beta adrenergic antagonists Lowers BP and reduces heart failure progression carvedilol, labetalol, epinephrine Cholinergic agonists drugs that stimulate the parasympathetic nervous system, mimic acetylcholine Muscarinic Agonists Treat glaucoma, improve GI/urinary bladder tone Acetylcholine, Pilocarpine, Methacholine, Bethanechol Cholinesterase inhibitors A class of drugs to treat people with dementia that help increase levels of acetylcholine in the brain, also used for myasthenia gravis Donepezil, Rivastigmine, Galantamine Cholinergic blockers Treats parkinsons, bladder overactivity, EPS, N/V from motion sickness, IBS adjunct therapy Cogentin, Artane, Symmertrel, Atropine, Anorexiants drugs that suppress the activity of the brain's appetite center, causing reduced food intake phendimetrazine tartrate, benzphetamine, diethylpropion HCL, phentermine, lorcaserin Anticonvulsants prevent or control seizures clonazepam, phenytoin, gabapentin Hydantoins Inhibit and stabilize electrical discharges in the brain by effecting sodium ions influx during depolarization and repolarization, slows down abnormal discharges Treat tonic-clonic and partial complex seizures, least sedating option Metabolized in liver, decreases bc effectiveness phenytoin (Dilantin), ethotoin (Peganone), fosphenytoin (Cerebyx) Iminostilbenes Partial, Tonic-clonic seizures, Mood stabilizer for bipolar disorder, Reduces pain of trigeminal neuralgia carbamazepine (tegretol) decreases bc effectiveness, risk for stevens-johnson syndrome, can depress bone marrow Succinimides treats absence seizures in children ethosuximide, methsuximide Drugs that affect GABA treats neuropathic pain and migraines eliminated by urine must be tapered off, suicidal risk, drowsiness, topiramate watch for decreased sweating benzodiazepines, gabapentin, topiramate, tiagabine Levetiracetam (Keppra) Approved for: Focal, Generalized tonic-clonic, juvenile myoclonic epilepsy Do not stop suddenly Side effects:Somnolence, dizziness, anxiety, psychiatric manifestations Lamotrigine (Lamictal) Anticonvulsant, bipolar 1 disorder Do not stop suddenly, risk for stevens-johnson syndrome, severe rash, bc will decrease lamictal effectiveness SE: suicidal thoughts, mood change tricyclic antidepressants block reuptake of serotonin and norepinephrine treat depression, anxiety, enuresis in children, ocd, eating disorders do not give to people with cardiac disease, causes sedation and anticholinergic effects Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine. Monoamine Oxidase Inhibitors (MAOIs) antidepressant medications that increase the amount of monoamine neurotransmitter in synapses Liver metabolism, major dietary restrictions (no fermented foods/drinks), must have healthy liver/heart to take Not commonly used phentolamine (regitine) Selective Serotonin Reuptake Inhibitors (SSRIs) a group of second-generation antidepressant drugs that increase serotonin activity specifically, without affecting other neurotransmitters Fluoxetine, paroxetine, sertraline, fluvoxamine