Pharmacology Fluency Practice: Drug Classifications and MOAs

Morphine

Opioid analgesic used for severe pain relief.

Hydromorphone

Stronger opioid analgesic, 7-8 times more potent than morphine.

Meperidine

Synthetic opioid, can be neurotoxic with repeated use.

Fentanyl

Opioid analgesic, 100 times stronger than morphine.

Codeine

Opioid analgesic, often used for mild to moderate pain.

Naloxone

Opioid antagonist used to reverse overdose effects.

Butorphanol

Opioid agonist-antagonist, weaker response than full agonists.

Nalbuphine

Opioid agonist-antagonist, provides pain relief but less effective.

Methadone

Opioid agonist for detoxification and pain management.

Acetaminophen

Non-opioid analgesic, inhibits prostaglandin synthesis.

Liver

Main organ at risk with acetaminophen overdose.

Acetylcysteine

Reversal agent for acetaminophen toxicity.

CNS Depression

Serious side effect leading to respiratory depression.

Nausea

Common side effect of opioid analgesics.

Urinary Retention

Potential side effect of opioid medications.

Diaphoresis

Excessive sweating, a side effect of opioids.

Miosis

Pupil constriction caused by opioid use.

Constipation

Frequent side effect of opioid analgesics.

Itching

Possible side effect of opioid medications.

Prostaglandin

Chemical involved in pain signaling, inhibited by acetaminophen.

Maximum Daily Dose

3000 mg for healthy adults, 2000 mg for elderly.

Half-life

Duration a drug remains active in the body.

Salicylic Acid

NSAID used for antithrombotic effects.

Celecoxib

COX-2 inhibitor with reduced GI effects.

Ibuprofen

Propionic acid derivative, non-selective NSAID.

Naproxen

Propionic acid derivative, fewer drug interactions.

Ketorolac

IV and oral form, non-selective NSAID.

COX Enzyme

Targeted by NSAIDs to inhibit prostaglandins.

Reye's Syndrome

Risk associated with aspirin in children.

MI Risk

Increased risk with COX-2 inhibitors.

Sulfa Allergy

Contraindication for Celecoxib use.

GI Tract Concerns

NSAIDs can cause bleeding and ulcerations.

Renal Toxicity

Risk of acute tubular necrosis from NSAIDs.

Cardiovascular Risks

Noncardiogenic pulmonary edema from NSAIDs.

Misoprostol

Medication for gastric ulcers from NSAIDs.

Prednisone

Corticosteroid with multiple side effects.

Hyperglycemia

Common side effect of Prednisone.

Adrenal Suppression

Risk from abrupt discontinuation of Prednisone.

Sumatriptan

Abortive treatment for migraines, vasoconstricts.

Dihydroergotamine

Second-line migraine treatment, constricts blood vessels.

5-HT-1 Receptors

Stimulated by Sumatriptan to relieve headaches.

Vasoconstriction

Mechanism of action for migraine medications.

Cushing Syndrome

Potential side effect of long-term Prednisone use.

Gastrointestinal Erosion

Risk associated with long-term NSAID use.

Lidocaine

Local anesthetic blocking sodium channels.

Nitrous oxide

Inhalation general anesthetic agent.

Etomidate

Intravenous general anesthetic agent.

Propofol

Intravenous anesthetic blocking sodium flow.

MOA of Lidocaine

Blocks sodium channels, suspending nerve conduction.

Uses of Lidocaine

Local anesthesia for medical or dental procedures.

Lidocaine side effects

CNS excitement, convulsions, respiratory depression.

Epinephrine with Lidocaine

Prolongs action, reduces systemic absorption.

MOA of Propofol

Delays nerve impulses, activates GABA receptors.

Adverse reactions of anesthetics

Allergic reactions, dysrhythmias, respiratory depression.

Malignant Hyperthermia

High fever, unstable BP, myoglobinemia.

Succinylcholine

Depolarizing neuromuscular blocker causing initial contraction.

Mivacurium

Non-depolarizing blocker competing with acetylcholine.

Nursing implications for neuromuscular blockers

Require mechanical ventilation; no analgesia provided.

Assessing anesthesia response

Evaluate past surgeries and medical history.

Diazepam

Benzodiazepine enhancing GABA, decreasing neuronal activity.

Alprazolam

Benzodiazepine affecting limbic and thalamic systems.

Lorazepam

Benzodiazepine depressing CNS activity.

CNS depression symptoms

Hallucinations, confusion, excitability in postoperative period.

Lidocaine antidysrhythmic properties

Class IB agent for cardiac dysrhythmias.

Systemic toxicity early symptoms

Irritability and confusion from lidocaine.

Emergency equipment for neuromuscular blockers

Must be available for respiratory emergencies.

Flumazenil

Reversal agent for benzodiazepine toxicity.

Withdrawal Symptoms

Symptoms after reversal in physically dependent patients.

Lithium

Medication primarily used for bipolar disorder management.

Therapeutic Level of Lithium

0.6−1.2 meq/L for maintenance treatment.

Sodium's Role

Low sodium can lead to lithium toxicity.

Cardiac Dysrhythmia

Serious adverse effect of lithium treatment.

Amitriptyline

Tricyclic antidepressant used for depression treatment.

TCA Mechanism

Blocks neurotransmitter reuptake, increasing serotonin and norepinephrine.

Anticholinergic Effects

Side effects include dry mouth, blurred vision, and constipation.

Phenelzine

MAOI used for treating depression.

Hypertensive Crisis

Risk associated with MAOIs and tyramine interactions.

Tyramine Interaction

Can cause severe hypertension and potential stroke.

Fluoxetine

SSRI used for depression and anxiety treatment.

SSRI Mechanism

Prevents serotonin reuptake, increasing its availability.

Serotonin Syndrome

Potentially life-threatening condition from excessive serotonin.

Haloperidol

Antipsychotic medication for managing psychosis.

Dopamine Receptor Blockade

Haloperidol's mechanism affecting brain dopamine levels.

EPS Management

Benztropine is used to reduce extrapyramidal symptoms.

Parkinson's Disease

Contraindication for haloperidol administration.

Dry Mouth

Common side effect of TCA medications.

Respiratory Depression

Serious risk with benzodiazepine overdose.

Elderly Fall Hazard

Increased risk due to sedative effects of benzodiazepines.