BASIC CONCEPTS

PHARMACEUTICS: The science and engineering of dosage form. XL, CR, SR Brand names (do not
break, crush or chew).
PHARMACODYNAMICS: What the drug does to the body.
1. Agonists: promotes. EX: Epinephrine
2. Antagonist: prevents. EX: Beta blockers, Antihistamine, Proton Pump Inhibitors.

PHARMACOKINETICS: A drugs movement though the body. I.E. what the body does to the drug. 4
phases:
1. A Absorption: The process of the drug entering the blood stream. IV route bypasses absorption (is
quicker and more exact)
2- D Distribution: A drugs distribution to all tissues, BUT they do not distribute to all tissues equally.
3- M Metabolism: Primary is Hepatic (liver)A process of the drug deactivation and/or making the drug
more water soluble
4- E-Elimination: elimination is renal, BUN & CREA are useful labs, If they show high in labs means there is
renal failure, means waste is not being properly discharged by the kidneys.

TOXICOLOGY: Toxicity is a result of the dose, NOT the substance. There is no safe drugs, only safe
doses.

HALF LIFE: the amount of time a drug CP will need to decrease by . At 3X, effects are diminished, at
5X is gone.

1
ST
PASS EFFECT: for PO ONLY. PO is higher dose, IV is lower. EX: Morphine, Betablockers and
Nitroglycerine.
IT TAKES 60 mL OF PO MORPHINE TO HAVE THE SAME EFFECT AS 10 mL OF IV MORPHINE

BRUPTFORCE METHOD: used to overcome the 1
st
pass effect. Therefore therefore give a higher
dose is used on drugs that have a large 1
st
pass effect.

SIDE EFFECTS: when a drug has an effect on other tissues.


ADR: when side effects cause problems.

ALLERGY: when immune system is activated and involved (based on a drug PT took). Are kept separate
in the chart.


THERAPEUTIC INDEX: difference between the dose that is going to help the people and the drug that
is going to hurt the people.

ED 50: effective dose for 50% of population


TD 50: toxic dose for 50% of population


WIDE THERAPEUTIC WINDOW: a drug that is easy to overdose.
NARROW THERAPEUTIC WINDOW: a drug that is hard to overdose.

ALMOST ALL ANTIBIOTICS CAUSE DIARRHEA and BYPASS METABOLISM (ARE
EXCRETED IN URINE UNCHANGED)

SYSTEMIC HYPOTENSION: decrease of blood flow to vital organs.


SUPERINFECTION: in infection on top of another infection.

C&S: Culture & Sensitivity. Lab work that identifies bacteria and what kills it or stops it. Takes 2 days to 2
weeks for data to emerge.

EMPIRIC GUESS: also called best guess. Is using one antibiotic that most likely will kill the bacteria
while waiting for the results of C&S.


BACTERIA TYPES
o Gram Negative (G-) : E. coli, Pseudomonas aurogenosa
o Gram Positive (G+) : Staph/Strep and MRSA
o For skin and soft tissue infections: Empiric therapy should favor G+ coverage.
o For UTI: Empiric therapy should favor G- coverage.



STREAMLINED THERAPY: is the change of an antibiotic after the return of C&S.
REASONS TO STREAMLINE: lower costs, lower toxicity, lowers chances of secondary infection, lowers
resistance.

WAYS TO DECREASE ANTIBIOTIC RESISTANCE:
1- DEFINITE NEED: make sure antibiotic is actually needed
2- TIMING: give it at the same time. If a gap is left, bacteria will regrow and become resistant.
3- FINISH ALL MEDS: if not, bacteria will regrow stronger.
4- DONT SHARE: you cant afford to be short on your med.

ESSENTIAL HYPERTENSION: caused by age, your body declares a new homeostasis ( BP)

PHYSICAL DEPENDENCE: remedy is REACTIVE TAPERED DOSE

PSYCHOLOGICAL DEPENDENCE: remedy is PROACTIVE ATC DOSE

OPIATES work in the brain, NSAIDS, APAP & local anesthetics work on the site of trauma.

OPIATES+ APAP+NSAIDS= analgesic synergy.

ALL OPIATES have a large 1
st
pass effect. PO is higher than IV





MEDS: WHAT THEY DO, SE/ADR & BLACK BOX WARNING
STOMACH
GERD: Gastroesophageal Reflux Disease. Is chronic, painful and meds for it are taken ATC.
1- CIMETIDINE/ZANTAC: H
2
ANTAGONIST. Is a notorious enzyme inhibitor. Slows down
elimination, increasing risk for toxicity. Take 2X to 3X a day. Is older and cheaper.
2- OMEPRAZOLE/PRILOSEC: PROTON PUMP INH. No interactions. Can be taken 1x to 2x a day. Is
newer and more $$.
HEARTBURN: is acute and occurs mostly when we consume fatty meals. Meds are taken PRN.
1- NaCO3/BAKING SODA: cheapest & strongest. Can cause cardiovascular issues because of high sodium.
2- CaCO3/TUMS: the calcium in it causes acid rebound. More acid will be produced, more Tums you will
need.
3- MgOH+ALOH/MALOX: is also a stool softener, used in bedridden patients. Easier to swallow.

IRON SALTS: prescribed to treat Iron Deficiency Anemia. Need an acidic environment to work, take it with OJ
or Vit C tab.
If PT is taking Gerd meds, time iron +/- 2 hrs from antacid.
SE: liver failure, constipation, green or black stools.
BLACK BOX: top 5 causer of child death due to overdose.

METAMUCIL: For constipation. Make sure PT is highly hydrated, this med will soak up the water and making
him more constipated. It gels up. Dont take meds with Metamucil, spread them +/- 2 hrs because med will get
caught in the middle of the gel.

LACTULOSE: for constipation.
BLACK BOX: Discontinue before any surgery involving laser because gases in your bowel will explode and some
ppl have died in the operating table.

ORAL CONTRACEPTIVES
They contain estrogen & progesterone that keep FSH+ LH hormones low. If FSH & LH are high=egg=preg.
Oral contraceptives need gut bacteria to be absorbed. They are hepatically & renally excreted.
IT TAKES 30 DAYS TO ACHIEVE FULL EFFECT!!!
-If taking antibiotics, use alter form for 30 days after last dose.
-IF MISSED A DOSE ON THE 1
ST
DAY, DOUBLE UP THE NEXT DAY.
-IF MISSED A DOSE ON THE 2+ DAYS, CONSULT PACKAGE AND START ALL OVER
SE: change in size of body parts. ACHES, if so, get help asap:
A-abdominal pain
C-chest or calf pain
H-headaches (abnormal ones)
E-Estrogen can change the size of eyeballs. Contacts might not fit.
S- self-exams

BACTERIA/ANTIBIOTICS

1. BETA-LACTAMS (CILLIN) PENICILLIN/AMOXICILLIN: If PT has renal issues, do not increase dose,
lengthen it.
BETA LACTAMS INHIBITORS: MOST COMMON RESISTANCE TO PENICILLIN
CLAVULANIC ACID: BLOCKS ENZYME INHIBITOR SO PENICILLIN CAN WORK.
SE OF BETA-LACTAMS: Diarrhea

2. AMOXICILLIN + CLAVULANIC ACID/AUGMENTIN: given when Amoxicillin only dont work.


3. BETA-LACTAMS (CEPHALO SPORINS):
- 1ST GENERATION: SKIN, SOFT TISSUE, C-DIFF, MRSA. G+ > G-
- 2ND GENERATION: KILLS EQUALLY: G+ = G-. IS THE MOST OVERUSED.
- 3RD GENERATION: FOR UTI, E. COLI, PSEUDOMONAS. KILLS G- > G+

4. ESBL (EXTENDED SUSPENSION BETA - LACTAMS)/VANCOMICYN: FOR C-DIFF. COVERS G+
ONLY INCLUDING MRSA. IV
PEAKS & THROUGHS: document time of infusion!!!
SE: Otoxicity, Nephroxicity, Red Man Syndrome, Systemic Hypotension
TX: longer infusion times

5. AMINOGLYCOSIDES

GENTAMYCIN, TABRAIMYCIN/NEBCIN those are ribosomal, prevent protein synthesis in
bacteria.
Cover G- ONLY, but can cover G+ if combined with Beta-Lactams or Vancomycin. The combination has a synergy
effect.
SE: toxicity, Nephrotoxicity, Ototocicity, Vestibular (balance)

6. MACROLIDES (2
ND
RIBOSOMAL): Given in hospitals AFTER C&S. Covers common G+ & G-. Stops
growth.
1- ERYTHROMICYN/TOO MANY BRAND NAMES
2- CLARITHOMICYN/BIAXIN: SE: leaves a metallic flavor in mouth.
3- AZITHROMICYN/Z-PAK: longest T (65 hrs). Take 2 the 1
st
day and 1 for every day after (4-5 days).
NOT GOOD after Chemo or Organ transplant.
SE: diarrhea, small risk of hepatotoxicity.

7. BDNA / BACTERIAL DNA: FLUOROQUINOLONES:
1- CIPROFLOXACIN/ CIPRO (older). Covers G- > G+
2- LEVOFLOXACIN/ LEVAQUIN (newer). Covers G- = G+
SE: Seizures if overdose, photosensitivity. All human races equally affected. Tell PT to wear sunscreen, inside @
midday, etc.
Avoid (PO route) vitamins and antacids, dairy products within 4 hours
BLACK BOX
- Unusual morbidity and/or mortality
-Gives specifics and what to do for about it
-Increase risk of tendon rupture up to 6 months after treatment.


8. SULFONAMIDES : inbibits Thymidine synthesis
1-SULFAMETHOXAZOLE /BACTRIM & SEPTRA: covers G- ONLY (FOR UTI)
SE: phosensitivity, Crystaluria, risk for hyperkalemia (geriatric). Report muscle weakness/twitching & heart rate
issues ASAP


9. TUBERCULOSIS (ACTIVE):
GENERAL TREATMENT :
-takes 24 hours to divide
-6 months - 2 years to treat
-Can inflect all tissues not just the lungs
- ALL TB REGIMEN MUST CONTAIN 4 DRUGS:
1. RIFAMPIN: causes red/orange tears & urine. Tingling/numbing of extremeties
2. ISONIAZID: causes peripheral neurophathy
3. ETHAMBUTOL/MYABUTOL: report & discontinue if eye issues.
4. PYRAZYNAMIDE/PZA: very hepatotoxic
SE: nausea and vomiting, risk for hepatotoxicity
PT ED: if yellow skin or sclera, call ASAP, avoid APAP, avoid alcohol

10. ANTI FUNGAL: AMBULATORY: AZOLES: disrupt fungal/yeast cell membranes. Potent hepatic
enzyme inhibitors.
1. KETONCONAZOLE/NIROZAL
2. FLUCONAZOLE/DIFLUCAN
3. ITRACONAZOLE/ SPORANOX
SE: Risk for toxicity for other drugs.

11. ANTIVIRAL ... ANTI-HERPETIC CLOVIR:
1. ACYCLOVIR/ZOVIRA
SE: Crytaluria (drink water), alopecia, GI ulceration, Bone marrow supression
2. GANCICLOVIR/CYTOVENE: has a biohazard sticker, is THE MOST TOXIC


DIABETES

TYPE I DIABETES: Pancreas no longer produces insulin, must get it from outside. Is SUBCUT.
1- REGULAR: short onset/duration
2- LANTUS: long onset/duration
BOTH are clear, need 2 separate syringes because LANTUS can cook the regular and it wont work.
CARE OF THE INJECTION SITE:
- AVOID RUBBING (EXCESS, TOO MUCH WILL BE ABSORBED)
- AVOID EXCESS EXPOSURE TO HEAT
- AVOID EXCESS ALCOHOL CONSUMPTION (CONSULT DOCTOR)
- ROTATE INJECTION SITES (SAME TYPE) ARM > ARM, AROUND THE STOMACH
- CONSULT DOCTOR ABOUT EXERCISE
- ROLL IT IN PALM OF HANDS
- AVOID HEAT OR FREEZING
- CARRY A GLUCOSE SOURCE WITH THEM
- DON'T EXERCISE ALONE
SE: HYPOGLYCEMIA-SYMPTOMS:
1- ELEVATED HEART RATE
2- SWEATING
3- ANXIETY/AGITATION
4- ALTERED BREATHING
5- SEIZURE>COMA>DEATH
ACTION: Eat sugar with PB or cheese. Sugar gets glucose up, PB or cheese keeps it up.

TYPE II DIABETES: you still produce insulin but you dont respond to it properly

TX: increase insulin release, decrease sugar absorption
SE: Ashen colored stools, yellow face. ALL insulin drugs have a risk of hepatoxicity, dont take APAP.
1- SULFONYLUREAS GLIPIZIDE/GLUCOTROL: older. PO meds.
SE: risk for hypoglycemia

2- EUGLYCEMIC AGENT-METFORMIN/GLUCOPHAGE: newer.
SE:
- Fishy taste
- Discontinue before any major surgery (general anesthesia) 48 hrs pre/post
- D/c before iodine radio contrast studies
- Risk for Lactic Acidosis
- Lactic acidosis

3- METFORMIN + GLIPIZIDE / METAGLIP
SE: still at risk for hypoglycemia, thanks to Glipizide.





CARDIOVASCULAR

HTN (HYPERTENSION):

1- BETABLOCKERS: OLOL. METROPROLOL/LOPRESSOR
SE: mask hypoglycemia symptoms, prevent rescue inhalers from working.

2- OLD CALCIUM CHANNEL BLOCKERS: DILTIAZEM/CARDIZEM, VERAPAMIL/CALAN
SE OF DILTIAZEM/CARDIZEM: constipation (drink water), not use on advanced heart failure PTs

3- ALPHA-BLOCKERS. ZOSIN. TERAZOSIN/HYTRIN
SE: MOST Ortho Hypo. Take at bedtime, stand up slowly( can cause passing out). Also mild edema: elevate legs+
ted hose.
4- NEW CA+ CHANNEL BLOCKERS: DIPINE. NIFEDIPINE/PROCARDIAXL
SE: Ortho hypo, mild edema, constipation

5- ACE INHIBITOR: PRIL (MOST popular choice antihypertensive. CAPTOPRIL/CAPOTEN

6- ANGIOTENSION (II) RECEPTOR BLOCKER (ARB) SARTAN. VALSARTAN/DIOVAN
SE: PRIL vs SARTAN:
-ORTHO HYPO (BOTH)
-DYSGUSIA (BOTH)
-RARE ANGIODEMA (BOTH). DISCONTINUE IF SWELLING OF LIPS, FACE & NECK.
-RISK FOR HYPERKALEMIA IN OLDER PPL (BOTH). REPORT HR ISSUES AND MUSCLE ISSUES ASAP.
-DRY COUGH (PRIL). CALL MD IF PRODUCTIVE

7- DIURETICS: Most Common Add-On. Where Salt Goes, Water Follows
1 STRONG/LOOP. FUROSAMIDE/LASIX: FOR EMERGENCY SITUATIONS
2 MOST COMMON/THIAZIDE. CHLORTHALIDONE/HYGOTRON
3 WEAK/K-SPARING: SPIRONOLACTONE/ALDYCTONE
Mixed with ACE inhibitor greater risk for hyperkalemia
**Higher doses needed for people with renal dysfunction
IV takes 20 minutes
PO takes 45 minutes







LOW BP: SHOCK
BP is so low the vital organs are NOT getting profused
SNS agonists (increase energy expenditure) DOPAMINE
i. Alpha: Vasculature - constriction (peripheral)
ii. Beta
1
: Heart - ^ HR ^contraction strength
iii. Beta
2
: Lungs - bronchodilator
Epinephrine: Alpha, Beta
1
and Beta
2
agonist
Norepinephrine: Alpha, Beta
1
ONLY
***If Nore given instead of Epi patient will have breathing problems***
DOPAMINE: is a SNS agonist (IV only). Is TRIATABLE (diff doses for diff things)
1. LOW DOSE: renal dose
2. MEDIUM DOSE: cardiac dose
3. HIGH DOSE: acts like Norepinephrine
4- CHRONOTROPIC: Heart rate. Positive increases HR, negative decreases it.
5- INOTROPIC: Contraction strength: Positive increases it, negative decreases it.
DIGOXIN: lowers HR, increase strength. Has a negative chronotropic and a positive Inotropic




CAD/ANGINA
Is a mismatch of the O2 supply with the O2 demand in the myocardium
To prevent it:
-Increase O2 supply (use vasodilators)
-Decrease O2 demand (use beta blockers)
NEW CCB & ACE INHIBITORS DO BOTH!!
NITROGLYCERINE SUBLINGUAL: for angina attacks. T is 1 minute. Can drop BP 40 points.
SE: Ortho hypo, headaches.
PT ED: keep in original container, protect from heat, light & moisture. Should give a tingling sensation, if not,
open a new bottle.

CHF CONGESTIVE/CHRONIC HEART FAILURE

1. EARLY STAGE: USE ACE INHIBITORS, ARBS, ADD DIURETICS & VASODILATORS
2. LATE STAGE: DIGOXIN/LANOXEN
SE: Anorexia, Nausea & Vomiting, Altered mental status, Altered vision (yellow halos around object)
ASSESMENT: take heart rate daily, if rate lower than 60 BPM, hold med and call MD. Take carotid pulse one a
time, dont rub carotid, keep track of Na intake.
ARRHYTIMIA (Anti-arrhythmics)
1. CLASS I: SODIUM CHANNEL BLOCKER
2. CLASS II: BETA-BLOCKER
3. CLASS III: AMIODARONE/CORDARONE (70% EFFECTIVE)
Dosed in 2 phases: Loading dose (short T ) & Maintenance dose (T is 35 days)
SE: Alters thyroid, retinal deposits (rare) that can lead to blindness, PULMONARY FIBROSIS (PRIORITY!!),
Blue/grey skin.
4. CLASS IV: OLD CALCIUM CHANNEL BLOCKER

BLOOD MODIFIERS/ANTICOAGULANTS
1- HEPARIN, ENOXAPARIN/LOVENOX (INPATIENT CARE)
2- WARFARIN/ COUMADIN (OUTPATIENT CARE)
DRUG INTERACTIONS: interferes with everything. Issues with Salycitates (Aspirin). There are Salycilates in
Pepto Bismol and Oil of Winter green.
WALFARIN & VITAMIN K: INR can go up/down based on diet. If you consume too many green leafy veggies,
INR goes down and you are at risk for clotting. VITAMIN K IS THE ANTIDOTE FOR WALFARIN.
Vitamin K rich food: all green leafy veggies, Sparragus is the highest. Cruciferous (cabbage, coliflower, broccoli).
Sudden increases in vitamin K intake may decrease the effect of Warfarin (Coumadin. On the other hand, greatly
lowering your vitamin K intake could increase the effect of Warfarin /Coumadin.


PLATELET MODIFIERS
1- ASPIRIN: for coronary artery disease. Works on PROSTALANDING TRIGGER.
2- CLOPIDOGEL/PLAVEX: for DVT. Plavix Works on 2
nd
MESSENGER TRIGGER.
TRIGGERS THAT MODIFY PLATELETS:
1- PROSTALANDIN (Aspirin works on this one)
2- 2
nd
MESSENGER (Plavix works on this one)
A PT can be on both and the effects are similar to Warfarin/Coumadin
IF CHF persist after taking Aspirin, MD might switch to Plavix or combine both.

CHOLESTEROL
1- SIMVSTATIN/ZOCOR
2- ATORVASTATIN/LIPITOR
Both decrease and prevent cardiovascular disease.
SE: liver damage, Rhabdomylysis (skeletal muscle breakdown)
PT ED: report dark urine ASAP, avoid APAP, drink red wine, call MD if jaundice or ashen stools. And
unexplained muscle pain in large muscles.





ASTHMA

1- RESCUE INHALERS: ALBUTERLOL/VENTOLIN-FOR ATTACKS! Causes flight or flight,
raises BP & contractions.

2- HELPER INHALERS: IPANOTROPIN/ATROVENT: causes dry mouth

3- MAINTENANCE INHALER: BECLOMETHASONT/BECLOVENT: causes thrush. Dont
swallow, rinse & spit.

4- LONG ACTING B2 ANTAGONIST (LABAS): SALMETEROL/SERVENT
BLACK BOX: Asthma related death r/t tolerance. Decreases efficacy of others.

5- LEUKOTRIENE ANTAGONIST: ZAFIRLEUKAST/SINGULAER (PO)
BLACK BOX: Increased suicides in adolescents

6- THEOPHYLLINE: PO, help bronchodilators work better. Causes jitters.

7- AMINOPHYLINE: is IV. Used in hospitals. Is faster, causes a fictitious effect: shows normal in
blood work but is high in the brain where seizures occur.



PAIN/OPIATES
NATURAL DERIVATES:
1- MORPHINE: is the gold standard.
2- CODEINE: poor analgesic

SEMISYNTHETICS:
1- HYDROCODONE +APAP
2- OXYCODONE +/- APAP
3- HYDROMORPHONE/DILADID: hallucinations
4- OXYMORPHONE/NUMORPHAN/OPANA: stronger, worse SE, given in hospices.

FULL SYNTHETICS:
1- FENATYL/DURAGESIC (PATCH). Last 3 days, FOLD & FLUSH. No shaving area.
2- MEPERIDINE/DEMEROL
SE: respiratory depression: PRIORITY! Sedation/Euphoria, Ortho Hypo, Hives (if given too fast), Vomiting (if
given too fast)
TYLENOL & NSAIDS
APAP/TYLENOL: analgesic & antipytetic ONLY. Causes liver damage/Jaundice.
Antidote: N-ACETYL/MUCOMIST: smells like rotten eggs

IBOPROFEN/MOTRIN: NSAIDS. Short onset/short duration.
NAPROXEN/ALEEVE (OTC)/NAPROSYN (RX): NSAIDS. Long onset/duration.

EPILEPSY
LEVETI RACETAM/KEPPRA
Decrease neuronal firing, it has few drug interactions, require much less lab follow up.
4 PRIMARY:
1- PHENYTOIN/DILANTIN
2- CARBAMAZEPINE/TEGRETOL
3- PHENOBARBITAL/LUMINAL-ALL 3 ABOVE ARE ENZYME INDUCERS
4- VALPROIC ACID/DEPOKOTE-ENZYME INHIBITOR
ADJUNCT: GABAPETIN/NEUROTIN (FOR SEDATION
SE IN:
- BLOOD: Folate deficiency anemia, Aplastic anemia (report flu like symptoms)
- GUTS: Liver damage, oral contraceptives less effective, increase in birth defects.
- SKIN: Photosensitivity, self limiting rash, Steven Johnson rash
SEDATIVES & HIPNOTIC
SEDATIVES: TO CALM
HYPNOTIC: TO SLEEP
LOTTA *** short onset, long duration***IF IS NOT LOTTA SHORT ONSET/LONG DURATION:
DIAZEPAM
L: Lorazepam/Adivan
O: Oxazepam/Serax
T: Temarepam/Restoril (NO CHANE IN T with age)
T: Triazolam/Italicon
A: Alprazolam/Xanax (LONG T with age, risk of sedation)
SE: Anterograde amnesia - can't remember while on the med
Hard to overdose until you add alcohol. It can be amplified from 2-200X













< 1% of neurotransmitter binds to post synaptic receptor
80% process of reuptake
20% enzymatic catabolism (MAO, COM-T)

o SSRI:
Serotonin selective reuptake inhibitors
Increase serotonin in synapse
o TCA/NSSRI:
Serotonin and norepinephrine increase
o Dopamine
Post synaptic agonists
L-dopa
Dopamine MAO-inhibitors (MAOI)
Selegiline/Etdepryl
Post synaptic dopamine antagonist
o Norepinephrine: Antagonist
Lithium
Parkinson's
o Too much dopamine gives signs of schizophrenia









Selegiline/Eldepryl
o Pharmacodynamics
Increase dopamine, also Norepinephrine and Serotonin
Cold and cough remedies
Hypertension (severe) and seizures
Pt. Ed.
List meds
Avoid cold and cough remedies
Avoid excess
tyramine (if it tastes
good it ha
tyramine)
L-Dopa/Larodopa
o Switched to L-dopa + C-
dopa/Sinemet
Look for decrease in total
daily dose of L-dopa.
o Dietary:
Limit B6 intake
meats & oysters
Ortho' Hypo'
Safety
Change in urine to red/blue/dark
Schizophrenia
o Typical antipsychotics:
Haloperidol/Haldol
Dopamine antagonist
SE/ADR:
Parkinsonian movement disorder
Document movement disorders
o Atypical antipsychotics:
Quietipine/Seroquel
Not true dopamine antagonist
No movement disorders at "normal" doses
o Tri-cyclic Antidepressants
o SE/ADR
All sedating
Anti-cholinergic - dye eye, dye mouth, urinary retention, constipation
Alpha blockers - significant Ortho' Hypo'
CNS antihistamines
satiety (inability to feel full)
weight gain
Assess for type II diabetes
Na channel blocking
Cardiac arrest in overdose
o Treatment (Tx:) of schizophrenia
Present
***All meds take 3 weeks - 3 months to become effective***
Acute phase: Goal is sedation(calm)
o Haldol, "LOT" for sedation
Maintenance phase: Goal appropriate emotional responses
o More ordered reasoning



Depression
o Decreased serotonin and Norepinephrine
Tx: Increase serotonin and Norepinephrine
o Tri-cyclic antidepressant
Both serotonin/Norepinephrine increased
Amitryptiline/Elavil
o SSRI
Just serotonin increased
Sertraline/Zoloft
Diarrhea, weight loss... followed by weight gain, sedating (activating) increased risk of
bleeding (rare)
o MAOI
Bipolar
o Acute phase:
"LOT"
Atypical antipsychotics
acute dose of Lithium
o Maintenance phase:
Goal: mood stabilization
SSRI and/or atypical antipsychotics
Maintenance dose of Lithium
Lithium
o Preventing mania
polydipsia/polyuria
alters thyroid levels
Therapeutic window
rashes are common