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39 Cards in this Set
- Front
- Back
a child presents to the ER with tightness of the neck and jaw muscles, hyperreflexia, tonic extensor thrusts...they parents thing he may have found some type of poison in their tool shed. What got him, moa, and how do you tx?
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strychnine
Produces CNS excitation by blocking glycine-mediated postsynaptic inhibition tx: IV diazepam, lorazepam, or anesthetic dose of short acting barbiturate Respiratory support Quiet surroundings Gastric lavage |
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MOA of caffeine?
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– act as antagonists at adenosine receptors.
Adenosine receptors are located on presynaptic terminals of noradrenergic neurons and blocks NE release. So caffeine increases NE release. |
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adverse effects of caffeine?
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At 1 g dose of caffeine (12 cups coffee)
Insomnia, excitement, mild delirium, sensory disturbances Increased heart rate Increased respiration At higher doses (10 g) Clonic convulsions → death Chronic use in pregnant women may increase rate of spontaneous abortion Tolerance and physical dependence can occur. Withdrawal symptoms include lethargy, irritability, and headache |
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Therapeutic uses of caffeine?
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combination with aspirin or ergot alkaloids (cafergot..tx of headaches)
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Methylphenidate is what kind of drug?
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amphetamine
Ritalin |
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how do amphetamines work?
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release NE, DA, and 5HT from nerve terminals
elevation of mood, euphoria, increased alertness Reduced feeling of fatigue Restlessness, increased motor activity Reduced appetite At very large doses, convulsions may occur |
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adverse effects of amphetamines?
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Peripheral sympathomimetic effects (e.g., increased blood pressure). Avoid in patients with uncontrolled hypertension and coronary artery disease.
CNS irritability → depression Abuse potential Concern about long-term safety of stimulant treatment in children Recent concern about deaths in patients with structural cardiac defects taking methylphenidate and Adderall. FDA reviewing psychiatric (hallucinations) and CV effects of all ADHD drugs |
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therapeutic uses of Amphetamines?
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Narcolepsy – amphetamines/methylphenidate
Attention deficit-hyperactivity disorder – methylphenidate and d-amphetamine most commonly used. Long acting forms of both are now available and make once daily dosing possible (also transdermal). Clonidine may be effective in some children. |
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phentermine is what kind of drug? moa? use?
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Amphetamine
release NE, DA, and 5HT from nerve terminals Appetite suppression |
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how does cocaine produce its CNS effects? what kind of drug was it again?
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Cocaine produces its CNS effects (and peripheral side effects) by inhibiting re-uptake of catecholamines, particularly DA. It acts primarily on centers controlling alertness and responsiveness, and on the brain’s reward center.
local anesthetic (ester) |
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adverse effects of cocaine?
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similar to amphetamine. Vasoconstriction and ↑ BP; cardiac arrhythmias
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What kind of drug is modafinil? moa? use?
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Non-amphetamine stimulants used to treat excessive sleepiness due to narcolepsy, sleep apnea and shift work sleep disorder.
Stimulate cells in sleep/wake centers which release the neurotransmitters hypocretin 1 and 2. Results in increased wakefulness. help get your fil of sleep |
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What kind of drug is armodafinil? moa? use?
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Non-amphetamine stimulants used to treat excessive sleepiness due to narcolepsy, sleep apnea and shift work sleep disorder.
Stimulate cells in sleep/wake centers which release the neurotransmitters hypocretin 1 and 2. Results in increased wakefulness. help get your fil of sleep |
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what are the drug interactions of Modafinil and armodafinil
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induces some CYPs and inhibits others
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adverse effects of this drug include:
Headache, nausea, diarrhea, dry mouth, anorexia are common. Nervousness, anxiety, and insomnia have been reported, but less than amphetamine, or methylphenidate. Psychiatric problems (hallucinations, suicidal ideation) and serious allergic rxns. Less abuse potential than amphetamine or methylphenidate |
Modafinil and armodafinil
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what kind of drug is Atomoxetine? use? moa?
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NOT a stimulant; included here because it is used to treat ADHD
Selectively inhibits NE transporter, blocking NE reuptake and resulting in increased attention and decreased impulsivity and hyperactivity. Since it doesn’t block DA reuptake, it’s not likely to be abused |
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how do stimulants help tx ADHD
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increase attention span
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black box for Atomoxetine
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suicidal behavior in children and liver injury.
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Guanfacine use? moa?
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Also not a stimulant, but used as an adjunct in the treatment of ADHD.
It is an α2 –adrenergic agonist that decreases central sympathetic activity. |
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Describe the potential adverse effects of ephedra.
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) have been associated with heart attacks, sudden cardiac death, stroke, brain hemorrhage, seizures, and deaths
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moa of ephedra?
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herbal product containing ephedrine, an indirect and direct acting sympathomimetic amine.
Ephedrine acts indirectly by releasing Norepinephrine and directly by stimulation of a, b1, and b2 adrenergic receptors. |
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moa of LSD?
effects? |
agonist at presynaptic serotonin receptors (5HT2a) in the midbrain
Major effects Heightened awareness of sensory input; synesthesia Passive observer state Inward attention Diminished ability to determine boundaries |
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Psilocybin and psilocin
mescaline all similar to what? so moa? |
LSD
agonist at presynaptic serotonin receptors (5HT2a) in the midbrain |
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moa of marijuana?
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Bind to specific cannabinoid (CB) receptors located in various brain areas. Endogenous ligands (endocannabinoids, EC) have also been identified.
Stimulation of CB receptors leads to activation of brain’s reward center (pleasurable effects) and also activates centers involved with eating. |
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as increased heart rate, dry mouth, increased appetite, and reddening of conjunctiva =
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stoner
probably wearing tie dye listwning to phish with a necklace that has a little mushroom in it weeeeeeeeeeeeed |
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adverse effects of weed
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Decreased testosterone levels
Bronchitis Airway obstruction “Amotivational” syndrome (?) |
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Therapeutic use of marijuana
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Glaucoma
Antiemetic (dronabinol [Marinol] and nabilone [Cesamet]) approved for use) |
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moa of PCP
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Acts by binding to high affinity sites in cortex and limbic system, resulting in blocking of NMDA-type glutamate receptors
http://www.youtube.com/watch?v=LzB03c6Dc10 |
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effects of PCP?
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hallucinations (desired effect), detachment, disorientation, ataxia, violent behavior, distortion of body image, loss of proprioception, numbness, nystagmus, sweating, rapid heart rate, hypertension, acute psychotic reactions, and seizures. Can be fatal in overdose
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3,4 methylenedioxymethamphetamine is what kind of drug? moa?
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An amphetamine analog which produces central stimulation, euphoria, and hallucinations. MDMA causes DA release like amphetamine, but its major effect is on 5HT neurons. It causes 5HT release and blocks 5HT synthesis and reuptake. The net effect is more 5HT in the synapse and depletion of 5HT in the neuron.
this MDMA / Ecstasy |
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pt comes in with in overheating and dehydration. Also causes involuntary grinding of the teeth. What drug were they on?
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3,4 methylenedioxymethamphetamine (MDMA or Ecstasy)
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is reported to cause feelings of empathy, closeness to others and facilitates interpersonal relationships
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3,4 methylenedioxymethamphetamine (MDMA or Ecstasy)
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How do CNS Stimulants (Analeptics) effect the CNS?
(Don't say stimulate, asshole) |
Remove inhibition from CNS
neurons, increase synaptic excitation or alter axonal membrane properties. Net result is CNS stimulation |
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What is the most significant short-term risk associated with MDMA (ecstasy)?
**obj** |
impairment of the body’s ability to regulate temperature, resulting in overheating and dehydration.
Also causes involuntary grinding of the teeth. |
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MOA of Bath Salts? Main ingredients?
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MOA: Inhibit NE/DA reuptake
Ingredients: methylenedioxypyrovalerone or 4-methylmethcathinone |
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Adverse Effects of bath salts?
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Physical: Tachycardia, hyperthermia. seizures
Behavior: paranoia, anxiety, agressive behavior, suicide |
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What are the "subjective" affects of LSD?
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Heightened awareness of sensory input; synesthesia
Passive observer state Inward attention Diminished ability to determine boundaries |
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Adverse effects of ephedera?
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heart attacks, sudden cardiac
death, stroke, brain hemorrhage, seizures, and deaths |
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What is the treatment for strychnine poisoning?
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IV diazepam, lorazepam, or anesthetic dose of short acting barbiturate
Respiratory support Quiet surroundings Gastric lavage |