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Pharm > B2 Drug Names > Flashcards

B2 Drug Names Flashcards

1
Q

Ibuprofen

A

Reversibly inhibits Cox 1 and 2

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2
Q

Succinylcholine

A

Depolarizing NM blocker

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3
Q

Baclofen

A

Spasmalytic: GABA B agonist

increased K flow–>hyper polarization–> reduces release of excitatory NT

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4
Q

Simvastatin

A

Hypolipidemic: Competitive HMG-CoA reductase inhibitor (rate-limiting step of cholesterol synthesis) and induces high affinity LDL receptors–> reduces LDL levels

Toxicity = myositis and sometimes rhabdomyolysis (monitor creatine kinase) and hepatotoxicity (monitor liver enzymes)

Drugs that inhibit CYP enzymes will increase plasma concentrations of statins!!!

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5
Q

Cholestyramine

A

Bile Acid Binding Resin: Binds BA in intestine and forms complex that’s excreted in feces.

Increased oxidation of cholesterol to BA in liver and increased # of LDL receptors–> decreased LDL levels and increased HDL

Toxicity: constipation, deficiency of fat-soluble vitamins (A, D, E, K)

May also delay or reduce the absorption of other oral medications (digitalis, warfarin)

CONTRAINDICATED in patients with hypertriglyceridemia

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6
Q

Gemfibrozil

A

HYPOlipidemic:

agonist at PPAR alpha and INCREASES the activity of LPL (esp in muscles and hepatocytes) –> hyperTG and reduces VLDL

Toxicity:

  • GI symptoms
  • myopathy
  • cholesterol gallstones

Drug interactions: can displace other albumin-bound drugs like warfarin and sulfonyl ureas

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7
Q

D- Tubocurarine

A

Competitive Nm blocker

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8
Q

Bile acid binding resins are contraindicated in whom?

A

patients with hypertriglyceridemia

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9
Q

Tizanidine

A

alpha 2 agonist used as a spasmolytic –> decreases m tone without causing paralysis

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10
Q

pravastatin

A

Hypolipidemic: Competitive HMG-CoA reductase inhibitor (rate-limiting step of cholesterol synthesis) and induces high affinity LDL receptors–> reduces LDL levels

Toxicity = myositis and sometimes rhabdomyolysis (monitor creatine kinase) and hepatotoxicity (monitor liver enzymes)

Drugs that inhibit CYP enzymes will increase plasma concentrations of statins!!!

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11
Q

colestipol

A

Bile Acid Binding Resin: Binds BA in intestine and forms complex that’s excreted in feces.

Increased oxidation of cholesterol to BA in liver and increased # of LDL receptors–> decreased LDL levels and increased HDL

Toxicity: constipation, deficiency of fat-soluble vitamins (A, D, E, K)

May also delay or reduce the absorption of other oral medications (digitalis, warfarin)

CONTRAINDICATED in patients with hypertriglyceridemia

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12
Q

Vecuronium

A

Competitive Nm blocker

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13
Q

Niacin

A

hypolipidemic: inhibition of VLDL synthesis and esterification of FA in liver –> decreased plasma LDL, VLDL and TG levels!

Toxicity:

  • flushing
  • itching (treated by aspirin or other NSAID)
  • diarrhea
  • hyperuricemia (gout)
  • hyperglycemia
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14
Q

Using what drugs along with statins causes an increased risk of myopathy?

A
  • amiodarone
  • verapamil
  • fibrates
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15
Q

Dantrolene

A

Tx malignant hyperthermia

inhibits release of Ca from SR during excitation/contraction coupling

also inhibits ryanodine receptor and Calcium channels in skeletal m

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16
Q

lovastatin

A

Hypolipidemic: Competitive HMG-CoA reductase inhibitor (rate-limiting step of cholesterol synthesis) and induces high affinity LDL receptors

–> reduces LDL levels

Toxicity = myositis and sometimes rhabdomyolysis (monitor creatine kinase) and hepatotoxicity (monitor liver enzymes)

Drugs that inhibit CYP enzymes will increase plasma concentrations of statins!!!

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17
Q

pancuronium

A

Competitive Nm blocker

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18
Q

colesevelam

A

Bile Acid Binding Resin: Binds BA in intestine and forms complex that’s excreted in feces.

Increased oxidation of cholesterol to BA in liver and increased # of LDL receptors–> decreased LDL levels and increased HDL

Toxicity: constipation, deficiency of fat-soluble vitamins (A, D, E, K)

May also delay or reduce the absorption of other oral medications (digitalis, warfarin)

CONTRAINDICATED in patients with hypertriglyceridemia

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19
Q

How do you treat parities (itching) caused by Niacin?

A

aspirin or other NSAID

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20
Q

Gabapentin

A

spasmolytic

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21
Q

Fenofibrate

A

HYPOlipidemic:

agonist at PPAR alpha and INCREASES the activity of LPL (esp in muscles and hepatocytes) –> hyperTG and reduces VLDL

Toxicity:

  • GI symptoms
  • myopathy
  • cholesterol gallstones

Drug interactions: can displace other albumin-bound drugs like warfarin and sulfonyl ureas

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22
Q

doxacurium

A

Competitive Nm blocker

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23
Q

Ezetimibe

A

HYPOlipidemic

reduces GI absorption of cholesterol–> reduces LDL and TG

Toxicity: diarrhea, abdominal pain

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24
Q

Vigabatrin

A

Anti-epileptic drug

MOA: irreversibly inhibits GABA transaminase (GTA)

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25
Q

Epinephrine

A

Bronchodilator (lasts 60-90m); rapid action

also used in anaphylactic shock (is a physiological antagonist)

Given Subcutaneous/Inhalation

–> tachycardia, arrhythmias

MOA: sympathetic stimulation of Beta2 receptor (adrenergic agonist)

A/E: skeletal m tremor, tachycardia, palpitations tolerance (short acting drugs)

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26
Q

Prednisolone

A

oral systemic corticosteroid

MOA: Has anti-inflammatory effects. Binds to an internuclear receptor and inhibits the transcription of genes that are responsible for producing cytokines. ESP interleukins

Use: severe chronic asthma

Chronic use can lead to Cushing’s Disease

A/E:

  • easy brushing
  • adrenal suppression
  • growth retardation
  • increased bone catabolism–> osteoporosis
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27
Q

Rocuronium

A

Competitive Nm blocker

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28
Q

Tiotropium Bromide

A

Bronchodilator: given via inhalation; long acting (24h)

MOA: parasympathetic! Blockage of muscarinic receptors: anticholinergics

Blocks muscarinic receptors in large airways

frequently used in combo with salbutamol (DOC for people on beta blockers)

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29
Q

Tiagabine

A

Anti-epileptic drug

MOA: blocks GABA reuptake by blocking GAT (GABA transporter)

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30
Q

Isoproterenol

A

Bronchodilator

MOA: sympathetic stimulation of Beta2 receptor (adrenergic agonist)

A/E: skeletal m tremor, tachycardia, palpitations tolerance (short acting drugs)

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31
Q

Ipratropium Bromide

A

Bronchodilator: given via inhalation; short acting, slower response

MOA: parasympathetic! Blockage of muscarinic receptors: anticholinergics

Blocks muscarinic receptors in large airways

frequently used in combo with salbutamol (DOC for people on beta blockers)

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32
Q

Levetriracetam

A

Anti-epileptic drug: treats GTC, simple partial seizures

MOA: binds to synaptic vesicular protein (SV2A) –> decreases synaptic release of glutamate

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33
Q

Hydrocortisone

A

IV systemic corticosteroid

MOA: Has anti-inflammatory effects. Binds to an internuclear receptor and inhibits the transcription of genes that are responsible for producing cytokines. ESP interleukins

Use: status asthmatics

Chronic use can lead to Cushing’s Disease

A/E:

  • easy brushing
  • adrenal suppression
  • growth retardation
  • increased bone catabolism–> osteoporosis
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34
Q

DOC for asthmatics on beta-blockeres

A

Ipratropium Bromide in combo with Salbutamol

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35
Q

Albuterol

A

Bronchodilator: onset 5-15m

given via metered dose inhaler, nebulizer, oral tablet

MOA: sympathetic stimulation of Beta2 receptor (adrenergic agonist)

How: stimulates AC –> increase cAMP

Use: acute attacks and maintenance

A/E: skeletal m tremor, tachycardia, palpitations tolerance (short acting drugs)

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36
Q

Theophylline

A

BRONCHODILATOR

MOA: inhibition of phosphodiesterase–> increase cAMP

Narrow therapeutic margin (5-20; A/E above 25)–MONITOR serum levels to avoid toxicity!

Eliminated via CYP450

Slow-release form used to treat nocturnal asthma

Add on Rx where inhaled steroid plus beta agonist ineffective!

A/E:
CNS stimulant: insomnia, tremor, convulstions

heart: positive chronotropic and inotropic effect

Weak vasodilator
weak diuretic
anxiety
tachycardia
diuresis
vomiting
arrhythmia
shock
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37
Q

Felbamate

A

Anti-epileptic drug

MOA: Blocks NMDA (glutamate) receptors

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38
Q

Beclomethasone

A

Inhaled Corticosteroid. Used to treat Asthma. High topical and low systemic activity

MOA: Has anti-inflammatory effects. Binds to an internuclear receptor and inhibits the transcription of genes that are responsible for producing cytokines. ESP interleukins

A/E:

  • dysphonia
  • oropharyngeal candidia (brush teeth after puffing inhaler for prevention)
  • sore throat
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39
Q

Terbutaline

A

Bronchodilator

MOA: sympathetic stimulation of Beta2 receptor (adrenergic agonist)

A/E: skeletal m tremor, tachycardia, palpitations tolerance (short acting drugs)

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40
Q

Zileuton

A

Leukotriene Synthesis Inhibitor: used in aspirin-induced asthma

MOA: Leukotriene Synthesis Inhibitor: 5-lipoxygenase inhibitor

A/E: Hepatotoxicity; elevation of liver enzymes must be monitored

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41
Q

Gabapentin

A

Anti-epileptic drug

MOA: Binds to presynaptic voltage-gated N type of Ca channel –> decreases synaptic release of glutamate

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42
Q

A/E associated with Theophylline

A

A/E:
CNS stimulant: insomnia, tremor, convulstions

heart: positive chronotropic and inotropic effect

Weak vasodilator
weak diuretic
anxiety
tachycardia
diuresis
vomiting
arrhythmia
shock
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43
Q

Formeterol

A

Bronchodilator

MOA: sympathetic stimulation of Beta2 receptor (adrenergic agonist)

A/E: skeletal m tremor, tachycardia, palpitations tolerance (short acting drugs)

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44
Q

Budesonide

A

Inhaled Corticosteroid. Used to treat Asthma. High topical and low systemic activity

MOA: Has anti-inflammatory effects. Binds to an internuclear receptor and inhibits the transcription of genes that are responsible for producing cytokines. ESP interleukins

A/E:

  • dysphonia
  • oropharyngeal candidia (brush teeth after puffing inhaler for prevention)
  • sore throat
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45
Q

Pregbalin

A

Anti-epileptic drug

MOA: Binds to presynaptic voltage-gated N type of Ca channel –> decreases synaptic release of glutamate

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46
Q

Chlorpromazine

A

Phenothiazine typical antipsychotic

MOA: D2 receptor antagonist

Schizophrenia: reduce + symptoms

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Tardive dyskinesias (occurs very late):

  • oral/facial dyskinesias, muscle jerks, writhing lip muscles
  • caused by relative cholinergic deficiency secondary to supersensitivty of DA receptors
  • More common in pots taking typical antipsychotics
  • Tx: switch patient to atypical drug (quetiapine or clozapine)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

Hyperprolactinemia: weight gain

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47
Q

Montelukast

A

leukotriene receptor antagonist: Used as prophylaxis and chronic asthma treatment

Blocks bronchoconstriction, reduces edema, and decreases mucous production

MOA: competitively blocks LTD4, LTE4 receptors

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48
Q

Salmeterol

A

Bronchodilator: onset = 20, long-acting (DOA = 12h);

given via inhalation

Used for prophylaxis (prevents bronchoconstriction at night). NOT used for tx of acute asthma bc delayed onset!

MOA: sympathetic stimulation of Beta2 receptor (adrenergic agonist)

A/E: skeletal m tremor, tachycardia, palpitations tolerance (short acting drugs)

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49
Q

Lamotrigine

A

Anti-epileptic drug: treats GTC, simple partial seizures

MOA: prolongs inactivation of Na channels, presynaptic voltage gated N type of Ca channel –> decreases synaptic release of glutamate

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50
Q

Fluticasone

A

Inhaled Corticosteroid. Used to treat Asthma. High topical and low systemic activity

MOA: Has anti-inflammatory effects. Binds to an internuclear receptor and inhibits the transcription of genes that are responsible for producing cytokines. ESP interleukins

A/E:

  • dysphonia
  • oropharyngeal candidia (brush teeth after puffing inhaler for prevention)
  • sore throat
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51
Q

Extrapyramidal syndrome and treatment

A

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

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52
Q

Neuroleptic Malignant Syndrome and treatment

A

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene
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53
Q

Zonisamide

A

Anti-epileptic drug: tx myoclonic seizures

MOA: block high frequency firing via action on Na channels

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54
Q

Zafirlukast

A

leukotriene receptor antagonist: Used as prophylaxis and chronic asthma treatment

Blocks bronchoconstriction, reduces edema, and decreases mucous production

MOA: competitively blocks LTD4, LTE4 receptors

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55
Q

Triamcinolone

A

Inhaled Corticosteroid. Used to treat Asthma. High topical and low systemic activity

MOA: Has anti-inflammatory effects. Binds to an internuclear receptor and inhibits the transcription of genes that are responsible for producing cytokines. ESP interleukins

A/E:

  • dysphonia
  • oropharyngeal candidia (brush teeth after puffing inhaler for prevention)
  • sore throat
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56
Q

Benztropine

A

anti-muscarinic drug used to treat Extrapyramidal syndrome:

due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms
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57
Q

Tardive dyskinesias and treatment

A

Tardive dyskinesias (occurs very late):

  • oral/facial dyskinesias, muscle jerks, writhing lip muscles
  • caused by relative cholinergic deficiency secondary to supersensitivty of DA receptors
  • More common in pots taking typical antipsychotics
  • Tx: switch patient to atypical drug (quetiapine or clozapine)
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58
Q

Typical Anti-psychotics:

A

end in “-zine” and haloperidol

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59
Q

Haloperidol

A

Typical Anti-psychotic;

used to treat touter’s syndrome and to reduce + symptoms in Schizophrenia

MOA: D2 receptor antagonist

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60
Q

Sodium Cromoglycate

A

Inhaled mast cell stabilizer used in prophylaxis of asthma, allergic rhinitis, allergic conjunctivitis

MOA: inhibits degranulation of mast cell by trigger stimuli

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61
Q

Biperiden

A

anti-muscarinic drug used to treat Extrapyramidal syndrome:

due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms
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62
Q

Sumatriptan

A

5HT1 receptor agonist

MOA: 5HT1D agonist

Use: acute migraine attack

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63
Q

Bromocriptine

A

Ergot Alkaloid that acts in the CNS

used to treat hyperprolactinemia and parkinson’s disease

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64
Q

Fluphenazine

A

Phenothiazine typical antipsychotic

MOA: D2 receptor antagonist

Schizophrenia: reduce + symptoms

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Tardive dyskinesias (occurs very late):

  • oral/facial dyskinesias, muscle jerks, writhing lip muscles
  • caused by relative cholinergic deficiency secondary to supersensitivty of DA receptors
  • More common in pots taking typical antipsychotics
  • Tx: switch patient to atypical drug (quetiapine or clozapine)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

Hyperprolactinemia: weight gain

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65
Q

Nedocromil

A

mast cell stabilizer used in prophylaxis of asthma, allergic rhinitis, allergic conjunctivitis

MOA: inhibits degranulation of mast cell by trigger stimuli

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66
Q

trihexphenyl

A

anti-muscarinic drug used to treat Extrapyramidal syndrome:

due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms
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67
Q

Buspirone

A

5HT1 Receptor Agonist

MOA: 5HT1A agonist

Use: anxiolytic drug; DOC for generalized anxiety

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68
Q

Pergolide

A

Ergot Alkaloid acting in the CNS

Used to treat hyperprolactinemia

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69
Q

Thioridazine

A

Phenothiazine typical antipsychotic

Causes retinal deposits–>browning of vision

Prolongs QT interval–> ventricular arrhythmias (patients taking enzyme inhibitors or other drugs that prolong QT interval)

MOA: D2 receptor antagonist

Schizophrenia: reduce + symptoms

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Tardive dyskinesias (occurs very late):

  • oral/facial dyskinesias, muscle jerks, writhing lip muscles
  • caused by relative cholinergic deficiency secondary to supersensitivty of DA receptors
  • More common in pots taking typical antipsychotics
  • Tx: switch patient to atypical drug (quetiapine or clozapine)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

Hyperprolactinemia: weight gain

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70
Q

Ketotifen

A

ORAL mast cell stabilizer used in prophylaxis of asthma, allergic rhinitis, allergic conjunctivitis

MOA: inhibits degranulation of mast cell by trigger stimuli

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71
Q

diphenhydramine

A

anti-muscarinic drug used to treat Extrapyramidal syndrome:

due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms
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72
Q

Tegaserod

A

5HT4 Receptor Agonist

Use: IBS with constipation (stimulated release of ACh, increasing gastric motility)

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73
Q

Trifluoperazine

A

Phenothiazine typical antipsychotic

MOA: D2 receptor antagonist

Schizophrenia: reduce + symptoms

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Tardive dyskinesias (occurs very late):

  • oral/facial dyskinesias, muscle jerks, writhing lip muscles
  • caused by relative cholinergic deficiency secondary to supersensitivty of DA receptors
  • More common in pots taking typical antipsychotics
  • Tx: switch patient to atypical drug (quetiapine or clozapine)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

Hyperprolactinemia: weight gain

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74
Q

Omalizumab

A

Mast Cell Stabilizer used in prophylaxis of asthma

MOA: inhibits binding of IgE to mast cells and prevents the release of mediators (humanized monoclonal ab to human IgE

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75
Q

Clozapine

A

Atypical antipsychotic

MOA: 5-HT2 and D4 receptor antagonist, weak D2 affinity

Schizophrenia: reduce + symptoms and GREATER effect on negative symptoms

Causes agranulocytosis; weekly blood counts required

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

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76
Q

Drug to treat Tourette’s

A

Haloperidol (typical antipsychotic)

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77
Q

Drug to treat manic episode in bipolar disorder

A

olanzapine and aripiprazole

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78
Q

Neurolept anesthesia

A

Droperidol + fentanyl + NO

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79
Q

Aripiprazole

A

Atypical antipsychotic

MOA: partial agonist at D2

Schizophrenia: reduce + symptoms; manic episode in bipolar disorder

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

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80
Q

Glucocorticoids

A

histamine release inhibitors

MOA: IgE dependent release

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81
Q

Antipsychotic that causes emesis and MOA

A

prochlorperazine

due to DA receptor blockade at the chemoreceptor trigger zone

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82
Q

Nedocromil

A

histamine release inhibitors

MOA: mast cell stabilizers–> prevents degranulation of mast cells

use: allergic asthma, allergic rhinitis, allergic conjunctivitis

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83
Q

Asenapine

A

Atypical antipsychotic

MOA: 5-HT2 and D4 receptor antagonist; weak D2 affinity

Schizophrenia: reduce + symptoms

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

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84
Q

Ketanserine

A

5HT2 Receptor Antagonist

MOA: 5HT2 and alpha receptor blocker

Use: topical preparation for glaucoma

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85
Q

Ergonovine

A

Ergot Alkaloid acting on the uterus

used to treat postpartum hemorrhage, IM

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86
Q

Cromolyn sodium

A

histamine release inhibitors

MOA: mast cell stabilizers–> prevents degranulation of mast cells

use: allergic asthma, allergic rhinitis, allergic conjunctivitis

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87
Q

Olanzapine

A

Atypical antipsychotic

MOA: 5-HT2 and D4 receptor antagonist; weak D2 affinity

Schizophrenia: reduce + symptoms; manic episode in bipolar disorder

Toxicity:

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

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88
Q

Beta 2 receptor agonist

A

histamine release inhibitors

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89
Q

theophylline

A

histamine release inhibitors

MOA: phosphodiesterase inhibitor

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90
Q

Olanzapine

A

5HT2 Receptor antagonist used to treat schizophrenia

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91
Q

Ergotamine

A

Ergot Alkaloid acting on the uterus and on the BV

used to treat postpartum hemorrhage, IM

also used to treat acute migraine

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92
Q

Gi receptor 2nd messengers

A

decreased cAMP

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93
Q

Risperidone

A

Atypical antipsychotic

MOA: 5-HT2 and D4 receptor antagonist; weak D2 affinity

Schizophrenia: reduce + symptoms

Toxicity:

Hyperprolactinemia (along with typical anti-psychotics) and weight gain

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

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94
Q

Lithium Carbonate

A

Inhibits the recycling of PIP2 –> depletion of 2nd messengers DAG and IP3

Used to treat acute mania or bipolar disorder (2-3 weeks for onset)

Prophylaxis of bipolar disorder when given with TCA

Low therapeutic index so plasma levels need to be monitored.

Contraindicated in pregnancy!

A/E:

  • nausea
  • vomiting
  • diarrhea
  • fine tremors
  • polydipsia
  • Nephrogenic DI (tx: amiloride)
  • benign, reversible thyroid enlargement

Toxicity: confusion, drowsiness, ataxia, severe tremors

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95
Q

Gq receptor 2nd messengers

A

increased IP3 and DAG

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96
Q

Gs receptor 2nd messengers

A

increased cAMP

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97
Q

Alternate drugs to lithium

A

Carbamazepine and valproic acid

can be used alone or as adjuncts with lithium

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98
Q

Ziprasidone

A

Atypical antipsychotic

MOA: 5-HT2 and D4 receptor antagonist; weak D2 affinity

Schizophrenia: reduce + symptoms

Toxicity:
Prolongs QT interval–> ventricular arrhythmias (patients taking enzyme inhibitors or other drugs that prolong QT interval)

Extrapyramidal syndrome: due to dopamine receptor blockade of the nigro-striatal pathway:

  • acute dystonia
  • akathisias (agitation, distress, restlessness)
  • parkinson like symptoms

–> treated by benztropine, biperiden, trihexphenyl, diphenhydramine (anti-muscarinic drugs)

Neuroleptic Malignant Syndrome: rare but life threatening

  • caused by rapid blockade of post synaptic Da receptors
  • m rigidity, alterations in BP and HR, hyperthermia, muscle-type CK elevated
  • Tx: IV dantrolene

Adrenoceptor blockade:

  • orthostatic hypotension
  • reflex tachycardia
  • impotence
  • inhibits ejaculation

Muscarinic blockade:
- dry mouth, constipation, blurred vision, tachycardia, urine retention

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99
Q

Treatment for nephrogenic DI

A

Amiloride

100
Q

H1 receptor type

A

Gq: increased IP3 and DAG

101
Q

H2 receptor type

A

Gs: increased cAMP

102
Q

H3 receptor type

A

Gi: decreased cAMP

103
Q

H4 receptor type

A

Gi: decreased cAMP

104
Q

H1 receptor located which organ

A

BV–> vasodilation–> decreased BP (by releasing NO)

bronchoconstriction –> features of anaphylaxis

H1 = increased IP3 and DAG

105
Q

H2 receptor located in which organ

A

stomach –> stimulates gastric secretion

H2 = increased cAMP

106
Q

H3 receptor located in which organ

A

presynaptic: brain, myenteric plexus, other neurons

H3 = decreased cAMP

107
Q

H4 receptor located in which organ

A

eosinophils, neutrophils, CD4+ T cells

H4 - decreased cAMP

108
Q

Cyproheptadine

A

5HT2 antagonist used to treat carcinoid tumors

109
Q

Methysergide

A

Ergot Alkaloid acting on BV used to treat carcinoid tumor

110
Q

NSAIDS used to treat acute migraine

A
  • aspirin
  • diclofenax
  • ketorolac
  • ibuprofen
  • naproxen

All used to treat Mild or Moderate Migraine

111
Q

Diphenhydramine

A

first generation H1 receptor antagonist

Use: allergic reactions, anaphylactic reactions

  • and in treating drug-induced EPS
  • anti-emetic action: motion sickness

A/E: sedation, peripheral and central anti-muscarinic actions, adrenoreceptor blocking actions.

112
Q

Ondansetron

A

5HT3 receptor antagonist

MOA: central antiemetic action

Used to control vomiting associated with chemo

113
Q

Drugs used to treat mild or moderate migraine

A

NSAIDS or Acetaminophen

114
Q

Drugs used to treat moderate or severe migraine:

A

Ergot Alkaloids: Ergotamine; Ergotamine + Caffeine;

Triptans: Sumatriptan (all end in -triptan)

NSAIDs (aspirin, diclofenax, ketorolac, ibuprofen, naproxen)

Neuroleptics: Chlorpromazine and haloperidol

115
Q

Chlorpheniramine

A

first generation H1 receptor antagonist

Use: allergic reactions, anaphylactic reactions

  • and in treating drug-induced EPS
  • anti-emetic action: motion sickness

A/E: sedation, peripheral and central anti-muscarinic actions, adrenoreceptor blocking actions.

116
Q

beta blocker used in prophylaxis of migraine

A

propranolol

117
Q

TCA used in prophylaxis of migraine

A

amitriptyline

118
Q

Alosetron

A

5HT3 receptor antagonist used to treat IBS with diarrhea

119
Q

Promethazine

A

first generation H1 receptor antagonist

Use: allergic reactions, anaphylactic reactions

  • and in treating drug-induced EPS
  • anti-emetic action: motion sickness

A/E: sedation, peripheral and central anti-muscarinic actions, adrenoreceptor blocking actions.

120
Q

Ca Channel Blocker used in prophylaxis of migraine

A

flunarizine and verapamil

121
Q

SSRIs used in prophylaxis of migraine

A

Fluxoetine

122
Q

Anti-convulsant used in prophylaxis of migraine

A

sodium valproate

123
Q

Serotonergic antagonist used in prophylaxis of migraine

A

cyproheptadine

124
Q

Alprostadil

A

Eicosanoid; Type: PGE1

Use:

  • cyanotic heart diseases: keeps DA open
  • impotence
125
Q

Hydrozyzine

A

first generation H1 receptor antagonist

Use: allergic reactions, anaphylactic reactions

  • and in treating drug-induced EPS
  • anti-emetic action: motion sickness

A/E: sedation, peripheral and central anti-muscarinic actions, adrenoreceptor blocking actions.

126
Q

misoprostol

A

Eicosanoid; Type: PGE1

Use:

  • NSAID-induced peptic ulcers
  • combined with mifepristone (antiprogestin) –> induce abortion
127
Q

Loratidine

A

second generation H1 receptor antagonist

NON-sedating!

Use: allergic reactions, anaphylactic reactions

128
Q

Dinoprostone

A

Eicosanoid; Type: PGE2

Use: cervical ripening, abortifacient

129
Q

fexofenadine

A

second generation H1 receptor antagonist

NON-sedating!

Use: allergic reactions, anaphylactic reactions

130
Q

Carboprost

A

Eicosanoid; Type: PGF2a

Use: cervical ripening, abortifacient

131
Q

cetirizine

A

second generation H1 receptor antagonist

NON-sedating!

Use: allergic reactions, anaphylactic reactions

132
Q

Cimetidine

A

H2 receptor antagonist

MOA: competitive blockade of H2 receptors

  • Inhibits p450
  • causes gynecomastic bc blocks androgen receptors at hich doses

Uses:

  • duodenal and gastric ulcer
  • drug/stress induced ulcer
  • GERD
  • esophagits
  • ZE syndrome
  • dyspepsia
  • heartburn
133
Q

PGE2 synthesis blocker used to treat dysmenorrhea

A

NSAIDs

134
Q

Latanoprost

A

Eicosanoid; Type: PGF2alpha

Use: glaucoma

135
Q

ranitidine

A

H2 receptor antagonist

MOA: competitive blockade of H2 receptors

Uses:

  • duodenal and gastric ulcer
  • drug/stress induced ulcer
  • GERD
  • esophagits
  • ZE syndrome
  • dyspepsia
  • heartburn
136
Q

azelastin

A

second generation H1 receptor antagonist

NON-sedating!

Use: allergic reactions, anaphylactic reactions

137
Q

epoprostenol

A

Eicosanoid; Type: PGI2

Use: pulmonary hypertension

138
Q

famotidine

A

H2 receptor antagonist

MOA: competitive blockade of H2 receptors

Uses:

  • duodenal and gastric ulcer
  • drug/stress induced ulcer
  • GERD
  • esophagits
  • ZE syndrome
  • dyspepsia
  • heartburn
139
Q

5HT1A receptor

a) distribution
b) post-receptor mechanism

A

a) hippocampus, raphe nuclei

b) Gi: decreased cAMP

140
Q

5HT1D receptor

a) distribution
b) post-receptor mechanism

A

a) cranial BV

b) Gi: decreased cAMP

141
Q

5HT2A receptor

a) distribution
b) post-receptor mechanism

A

a) platelets, smooth muscle, CNS

b) Gq: decreased IP3, DAG

142
Q

5HT3 receptor

a) distribution
b) post-receptor mechanism

A

a) area pastrami, sensory and enteric nerves

b) Na+/K+ ion channels

143
Q

5HT4

a) distribution
b) post-receptor mechanism

A

a) NS and myenteric neurons, smooth muscle

b) Gs: increased cAMP

144
Q

NO breakdown inhibitor

A

Sildenafil

145
Q

NO donors

A

nitrates and sodium nitroprusside

146
Q

used to treat diarrhea

A

diphenoxylate and loperamide

147
Q

used to treat chronic malignant pain

A

via patches/lollipop

Fentanyl (or -fentanil derivatives) with droperidol

148
Q

drugs used to precipitate opioid withdrawal

A

nalbuphine and pentazocine

149
Q

Filgrastime

A

used to treat neutropenia caused by anti-cancer drugs

150
Q

used to treat thrombocytopenia caused by anticancer drugs

A

IL-11 aka Oprelvekin

151
Q

used to treat OD on fibrinolytic agents

A

aminocaproic acid–>

inhibits plasminogen activation

152
Q

dipyridamole

A

phosphodiesterase III inhibitor

153
Q

Flunitrazepam

A

used for date rape

154
Q

sargramostim

A

used to treat neutropenia caused by anti-cancer drugs

155
Q

drugs used to treat status epilepticus

A

via high dose IV

Phenobarbital, diazepam/lorazepam

156
Q

Partial agonists at 5HT autoreceptors

A

buspirone and propranolol

157
Q

fulmazenil

A

antagonizes effects of Zolpidem, Eszopiclone and Zaleplon

158
Q

Ramelteon

A

agonist at melatnonin receptors

159
Q

seizures caused by local anesthetics are treated by

A

Diazepam

160
Q

Drug that inhibits xanthine oxidase

A

allopurinol

161
Q

Methotrexate MOA

A

inhibits DHF reductase (inhibits folate metabolism)

So it’s cytotoxic to immune cells

162
Q

Azathioprine

A

purine anti-metabolite = immunosuppressor

163
Q

Highly selective COX-2 inhibitors end in…. and are used to treat

A

-coxib

ie Celecoxib, Valdecoxib, Etoricoxib

Used to treat osteoarthritis and RA

164
Q

Etanercept

A

monoclonal Ab against TNFalpha

highly effective and used to treat RA (s a disease-modifying RA drug)

165
Q

Sulfasalazine

A

Disease-modifying RA drug

risk of allergic rxn if patients allergic to sulfur

5-aminosalycilic acid = anti-inflammatory active metabolite

166
Q

N-acetylcysteine

A

Drug used to treat acetaminophen

MOA: replenishes glutathione stores in liver

Early symptoms of hepatic damage: nausea, vomiting, diarrhea, abdominal pain.

167
Q

Salicylism and treatment

A

vomiting, tinnitus, decreased hearing, vertigo,

Reversible when treated with sodium bicarbonate

When higher doses of Aspirin are given

168
Q

Quinidine

A

Class 1A anti-arrhythmatic–>these drugs slow conduction, cause prolonged QT interval

Primary: blocks voltage sensitive Na channels
Secondary: block inward rectifier K channels

binds to inactivated Na channels and prevents Na influx. slowing upstroke of Phase O

Toxicity:

  • cinchonism: blurred vision, tinnitus, headache, disorientation and psychosis
  • syncope
  • prolonged QT
  • torsades de pointes
169
Q

Flecainide

A

Class 1C anti-arrhythmatic

170
Q

Amiodarone

A

Class III anti-arrhythmatic

Block voltage gated K channel and diminish outward current during repolarization –> prolongs AP

Tx: refractory SVT and VT

Toxicity:

  • thyroid dysfunction (affects peripheral conversion of T4–>T3)
  • interstitial pulmonary fibrosis (pt needs routine CXR)
  • corneal microdeposits
  • blue-skin discoloration “surf skin”
  • hepatotoxic (monitor liver enzymes)
171
Q

Digoxin

A

decrased AV node conduction–>enhances vagal tone

use: Atrial Fibrillation and flutter

Toxicity: ectopic ventricular beats

used IV in emergencies

172
Q

Sotalol

A

Class III anti-arrhythmatic

has strong anti-fibrillary effects in ischemic myocardium–> long-term therapy to decrease the rate of sudden death post-MI.

Prolongs both depolarization and duration of AP–> lengthens ERP

173
Q

Magnesium

A

interferes with Na/K ATPase, Na channels, K channels, Ca channels

Used to treat Torsades de points (QT prolongation syndrome)

given slowly by IV and used with extreme caution!

174
Q

Procainamide

A

Class 1A anti-arrhythmatic

Metabolism by acetylation to NAPA which PROLONGS DURATION OF AP (has properties of class III drugs)

Toxicity:

  • reversible Lupus-like syndrome (in slow-acetylators)
  • asystole
  • ventricular arrhythmias
  • depression
  • hallucination
  • psychosis
175
Q

Adenosine

A

Decreases conduction velocity–> prolongs refractory period–> decreases SA and AV nodal activity by stimulating adenosine receptors

Toxicity: flushing, sedation, dyspnea

Used in IV for acute attacks due to its short half-life

176
Q

drug that causes pulmonary fibrosis

A

amiodarone

177
Q

drug that causes smurf skin

A

amiodarone

178
Q

DOC in PSVT and AV nodal arrhythmias

A

Adenosine

179
Q

Adenosine antagonists

A

Theophylline and caffeine

180
Q

anti-arrhythmatic contraindicated in patients with cardiac failure

A

Dispyramide

Class 1A (slows conduction, prolongs QT interval) used to treat ventricular arrhythmias

181
Q

H2 blockers

A

end in -tidine (cimetidine, ranitidine, famotidine, nizatidine)

Competitive inhibition

182
Q

PPIs

A

end in -prazole (omeprazole, pantoprazole, lansoprazole, rabeprazole)

IRREVERSIBLY inhibit H/K atpase pump

183
Q

Side effects of Sodium bicarbonate and calcium carbonate

A

bloating and metabolic alkalosis

184
Q

drug interactions with antacids

A

tetracycline, fluroquinolones, iron salts

antacids decrease their absorption

185
Q

Drug that causes blackening of stool, tongue and dentures

A

colloidal bismuth subsalicylate (ulcer protector, coats ulcer base)

186
Q

Drugs used in triple therapy

A

2 antibiotics and a PPI for 14 days

amoxycillin
clarithromycin
tetracycline
metranidazole/tinidazole

187
Q

Rifampicin

A

CYP inducer

188
Q

CYP inhibitors

A
  • cimetidine
  • SSRIs
  • ketoconazole
  • macrolie antibiotics
  • fluoroquinolones
  • HIV protease inhibitors
  • grapefruit juice
189
Q

Sucralfate

A

Ulcer healing drug

polymerizes at Ph

190
Q

barbiturates and phenytoin

A

CYP inducers

191
Q

Leucovorin

A

foiling acid = active form of folic acid

192
Q

Drugs that cause folate deficiency

A
  • methotrexate
  • phenytoin (CYP inducer and anti-convulsant)
  • sulfonamides (antibiotics)
  • INH
  • OCPs
193
Q

When do you give EPO?

A

anemic of chronic renal failure, chemotherapy or AIDs (i.e. zidovudine)

194
Q

How do you treat acute iron poisoning

A

deferrioxamine (iron chelating agent)

195
Q

factors that decrease Fe absorption

A

antacids, phosphate, phylates, tetracyclines and food

196
Q

factors that increase Fe absorption

A

acids, amino acids, meat

197
Q

When do you use folic acid

A

megaloblastic anemia, pregnancy

198
Q

when do you use VB12

A

megaloblatic anemia, pernicious anemia

199
Q

Meperidine

A

Opioid agonist

used to treat heroin withdrawal and pain of terminal cancer

causes tachycardia because of antimuscarinic action.

Also causes serotonin syndrome when combined with MAOIs (i.e. selegine rasagiline)

SS = muscle rigidity, myoclonus, diarrhea

also the exception, does NOT cause biliary colic

200
Q

Treatment for opioid toxicity

A

Naloxone (rapid action) and Naltrexone

201
Q

Buprenorphine

A

used in opioid dependence

202
Q

LMWH all end in ….and MOA

A

LMWH all end in “-parin” (enoxaparin, dalteparin, tinzaparin)

Selectively inhibits Xa, less effect on thrombin

given subcutaneously. less side effects than heparin and better bioavailability

203
Q

Hirudin

A

Anti-coagulant: Direct Thrombin Inhibitor

MOA: direction binds to thrombin and inhibits the downstream effects

used instead of heparin for anticoagulating patients with heparin-induced thrombocytopenia

204
Q

Protamine

A

basic compound used to neutralize heparin

Toxicity: bleeding, thrombocytopenia, osteporosis

205
Q

Anticoagulant that is Contraindicated in pregnancy

A

Warfarin

206
Q

lepuridin

A

Anti-coagulant: Direct Thrombin Inhibitor

MOA: direction binds to thrombin and inhibits the downstream effects

used instead of heparin for anticoagulating patients with heparin-induced thrombocytopenia

207
Q

Treatment for Warfarin toxicity

A

stop the drug, Vitamin K, fresh frozen plasma

Toxicity: bleeding, skin necrosis (rare)

208
Q

Warfarin MOA

A

interferes with normal gamma carboxylation of VitK dependent clotting factors (including 7) by inhibiting Vit K epoxide reductase

given orally

209
Q

Sinemet

A

DRUG used to treat Parkinsons DOPA preparation containing Carbidopa and levodopa

Carbidopa inhibita dopa decarboxulase –> increase L-dopa amounts in the brain

reduces symptoms of parkinson esp bradykinesia

210
Q

bivalirudin

A

Anti-coagulant: Direct Thrombin Inhibitor

MOA: direction binds to thrombin and inhibits the downstream effects

used instead of heparin for anticoagulating patients with heparin-induced thrombocytopenia

211
Q

Benzodiazepenes

A

end in “-azepam” “-azolam” or Chlordiazepoxide

212
Q

Barbiturates

A

end in “-barbital” or thiopental

213
Q

Bromocriptine

A

Used to treat Parkinson’s

Dopamine receptor aconist–> increases dopamine levels

used for hyperprolactinemia

toxicity: nausea vomiting, postural HYPOtension and dyskinesia

214
Q

argatroban

A

Anti-coagulant: Direct Thrombin Inhibitor

MOA: direction binds to thrombin and inhibits the downstream effects

used instead of heparin for anticoagulating patients with heparin-induced thrombocytopenia

215
Q

Drugs that displace the protein binding of warfarin

A

aspirin, phenytoin, sulfonamides

216
Q

drugs that inhibit the metabolism of warfarin

A
  • CYP inhibitors (cimetidine, SSRIs, ketoconazole, macrolide AB, fluoquinolones, HIV protease inhibitors, grapefruit juice)
  • antifungals
217
Q

drugs that decrease Vitamin K production

A

antibiotics, cephalosporins

218
Q

drugs that induce metabolism of warfarin

A

CYP inducers: barbiturates, rifampicin, phenytoin, glucocorticoids, chronic alcohol use, carbamazepine

219
Q

Which anticoagulant is used for immediate anticoagulation

A

Heparin (activates antithrombin III; inactivates clotting factors in intrinsic pathway)

Toxicity: bleeding, thrombocytopenia, osteporosis

220
Q

pramipexole

A

Used to treat Parkinson’s

Dopamine receptor agonist–>increase dopamine levels

agonist at D3 receptor. Considered 1st line drug bc fewer side effects

toxicity: nausea vomiting, postural HYPOtension and dyskinesia

221
Q

MAO-B inhibitor

A

Used to treat Parkinson’s

end in -giline (selegiline, rasagiline)

Inhibition of enzymatic degradation of dopamine–> increased dopamine

use with Levodopa

can cause serotonin syndrome when combined with SSRIs or TCAs

Toxicity: insomnia, HYPOtension, GI distress, mood chnages,

When used with meperidine: agitation, delirium, death

222
Q

COMT-inhibitor

A

Used to treat Parkinson’s

Inhibition of enzymatic degradation of dopamine–> increased dopamine

end in -capone (entacapone, tolcapone)

Entacapone: doesn’t cross BBB, peripheral effects only, preferred bc Tolcapone causes hepatic damage

Toxicity: dyskinesias, postural HYPERtension

223
Q

Drug that may activate malignant melanoma

A

Levodopa (used to treat parkinson. Dopamine precursor)

also contraindicated in psychotic patients and those with angle-closure glaucoma

224
Q

Amide Local Anesthetics

A
  • Lidocaine (surface anesthetic)
  • Bupivacaine (most cardiotoxic –>arrhythmias)
  • mepivacaine
  • etidocaine
  • prilocaine (can cause black urine)

all are hepatic metabolized

225
Q

Esther Local Anesthetics

A
  • cocaine (DON’T give with EPI, causes vasoconstriction–>HTN, and used in nasal surgeries)
  • procaine (short t 1/2)
  • tetracaine
  • benzocaine (surface anesthetic
226
Q

Anti epileptics that block Na channels

A
  • phenytoin
  • carbamazepine
  • topiramate
  • phenobarbitone (also enhances GABA transmission
  • valproic acid (also enhances GABA transmission and blocks T channels in the Thalamus)
  • lamotrigine (also blocks gluamine receptors)
  • Topiramate
227
Q

DOC to treat GTC

A

phenytoin or Carbamazepine

228
Q

Anti epileptics that Enhances GABA transmission

A
  • phenobarbitone
  • valproic acid
  • diazepam
  • clonazepam
  • Vigabatrin (inhibits GABA transaminase)
  • Tiagabine (interferes with GABA re-uptake)
  • Topiramate
  • Gabapentin (interferes with GABA reuptake)
229
Q

Anti epileptics that block T channels

A

valproic acid, Ethosuximide, Valproate

230
Q

DOC to treat simple partial and complex partial seizures

A

phenytoin, carbamazepine, valproate

231
Q

DOC to treat absent seizures

A

Valproate, Ethosuximide, Clonazepam

232
Q

DOC to treat febrile convulsions

A

diazepam

233
Q

DOC to treat status epilepticus

A

Diazepam, lorazepam, phenytoin

234
Q

DOC to treat bipolar disorder

A

Carbamazepine, valproate

235
Q

DOC to treat seizures that develop after IV administration of lidocatine

A

Diazepam

also used to cause skeletal muscle relaxation

236
Q

Temezepam

A

BZD used to treat insomnia

Works by increasing the frequency of GABA-mediated chloride channel openings

237
Q

Alprazolam

A

BZD used to treat panic and phobias

Works by increasing the frequency of GABA-mediated chloride channel openings

238
Q

IV anesthesia

A

diazepam, midazolam, lorazepam

Works by increasing the frequency of GABA-mediated chloride channel openings

239
Q

ozazepam

A

BZD used to treat insomnia

Works by increasing the frequency of GABA-mediated chloride channel openings

240
Q

Preferred agents to treat insomnia that cause no cognitive impairment

A

zolpidem
zolplone
eszopiclone

work by stimulating specific BZD receptors

241
Q

Thiopentone

A

barbiturate used to induce GA

works by prolonging the duration of GABA-mediated chloride channel openings

242
Q

Carbamazepine toxicity

A
  • diplopia
  • ataxia
  • increased ADH secretion (dilution hyponatremia)

Carbamazepine = antiepileptic, and CYP enzyme inducer

243
Q

Phenobarbitone toxicity

A

Phenobarbitone = antiepileptic and CYP enzyme inducer

  • sedation
  • drowsiness
  • mood changes
244
Q

valproic acid toxicity

A

= antiepileptic and CYP enzyme inhibitor

  • neural tube defects
  • hepatotoxicity in children
245
Q

Phenytoin toxicity

A

= antiepileptic and CYP enzyme inducer

  • gingival hyperplasia
  • hirsutism
  • nystagmus
  • megalobalastic anemia
  • osteomalacia
  • teratogenia
  • ataxia
  • vertigo
  • drowsiness
246
Q

side effects of typical antipsychotics

A
  • M block = dry secretions, constipation
  • alpha block = postural hypotension, inhibition of ejaculation, reflex tachycardia
  • H2 block = sedation
  • D2 antagonism = hyperprolactinema (amenorrhea, galactorrhea, gynecomastia and impotence)
  • D2 antagonism in nigrostriatal = EPS
247
Q

order of sensitivity of nerve fibers to LAs

A

Type B and C > Type A

small unmyelinated fibers are more sensitive to the block

Pharm (32 decks)

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