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Systemic Pharmacology II > Comprehensive Drugs to Know for Final > Flashcards

Comprehensive Drugs to Know for Final Flashcards

1
Q

Pilocarpine

A

Parasympathetic

MOA: cholinergic agonist

Clinical Use: glaucoma, urinary retention problems, dry mouth, reverse neuromuscular blockade from surgical anesthesia, Alzheimer’s
SLUD- salivation, lacrimation, urination, diarrhea

Ocular Side Effects: miosis, accommodation, opening of TM (decreases IOP)

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2
Q

Varenicline

A

Parasympathetic

MOA: cholinergic agonist

Clinical Use: glaucoma, urinary retention problems, dry mouth, reverse neuromuscular blockade from surgical anesthesia, Alzheimer’s
SLUD- salivation, lacrimation, urination, diarrhea

Ocular Side Effects: miosis, accommodation, opening of TM (decreases IOP)

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3
Q

Edrophonium

A

Parasympathetic

MOA: short-acting anticholinesterase (indirect-acting cholinomimetic)

Clinical Use: diagnosis of Myasthenia Gravis*, glaucoma, urinary retention problems, dry mouth, reverse neuromuscular blockade from surgical anesthesia, Alzheimer’s;
SLUD- salivation, lacrimation, urination, diarrhea

Ocular Side Effects: miosis, accommodation, opening of TM (decreases IOP)

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4
Q

Atropine

A

Parasympathetic

MOA: cholinoceptor blocking

Clinical Use: cholinomimetic toxicity*, CNS disorders, ocular disorders (accurate refraction, dilated fundus exam, treatment of uveitis), respiratory disorders, urinary disorders, cardiovascular system, cholinergic poisoning;
opposite of SLUD

Ocular Side Effects: mydriasis (contraindicated in glaucoma patients), cycloplegia

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5
Q

Cyclopentolate

A

Parasympathetic

MOA: cholinoceptor blocking

Clinical Use: CNS disorders, ocular disorders (accurate refraction, dilated fundus exam, treatment of uveitis), respiratory disorders, urinary disorders, cardiovascular system, cholinergic poisoning;
opposite of SLUD

Ocular Side Effects: mydriasis (contraindicated in glaucoma patients), cycloplegia

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6
Q

Homatropine

A

Parasympathetic

MOA: cholinoceptor blocking

Clinical Use: cholinomimetic toxicity*, CNS disorders, ocular disorders (accurate refraction, dilated fundus exam, treatment of uveitis), respiratory disorders, urinary disorders, cardiovascular system, cholinergic poisoning;
opposite of SLUD

Ocular Side Effects: mydriasis (contraindicated in glaucoma patients), cycloplegia

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7
Q

Ipratropium

A

Parasympathetic

MOA: cholinoceptor blocking

Clinical Use: cholinomimetic toxicity*, CNS disorders, ocular disorders (accurate refraction, dilated fundus exam, treatment of uveitis), respiratory disorders, urinary disorders, cardiovascular system, cholinergic poisoning;
opposite of SLUD

Ocular Side Effects: mydriasis (contraindicated in glaucoma patients), cycloplegia

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8
Q

Tiotropium

A

Parasympathetic

MOA: cholinoceptor blocking

Clinical Use: cholinomimetic toxicity*, CNS disorders, ocular disorders (accurate refraction, dilated fundus exam, treatment of uveitis), respiratory disorders, urinary disorders, cardiovascular system, cholinergic poisoning;
opposite of SLUD

Ocular Side Effects: mydriasis (contraindicated in glaucoma patients), cycloplegia

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9
Q

Tropicamide

A

Parasympathetic

MOA: cholinoceptor blocking

Clinical Use: cholinomimetic toxicity*, CNS disorders, ocular disorders (accurate refraction, dilated fundus exam, treatment of uveitis), respiratory disorders, urinary disorders, cardiovascular system, cholinergic poisoning;
opposite of SLUD

Ocular Side Effects: mydriasis (contraindicated in glaucoma patients), cycloplegia

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10
Q

Epinephrine

A

Sympathetic

MOA: non-selective alpha and beta agonist

Clinical Use: cardiac arrest, anaphylaxis

Ocular Side Effects: n/a

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11
Q

Phenylephrine

A

Sympathetic

MOA: alpha-1 agonist

Clinical Use: acute hypotension, chronic orthostatic hypotension, induce local vasoconstriction

Ocular Side Effects: mydriasis

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12
Q

Apraclonidine

A

Sympathetic

MOA: alpha-2 agonist

Clinical Use: hypertension, glaucoma, produces dilation of abnormal pupil in Horner syndrome*

Ocular Side Effects: decreased aqueous production, decreased IOP

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13
Q

Brimonidine

A

Sympathetic

MOA: alpha-2 agonist

Clinical Use: hypertension, glaucoma

Ocular Side Effects: decreased aqueous production, decreased IOP

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14
Q

Albuterol

A

Sympathetic

MOA: beta-2 agonist

Clinical Use: treatment of asthma

Ocular Side Effects: relaxes ciliary muscle, production of aqueous (increases IOP)

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15
Q

Formoterol

A

Sympathetic

MOA: beta-2 agonist

Clinical Use: treatment of asthma

Ocular Side Effects: relaxes ciliary muscle, production of aqueous (increases IOP)

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16
Q

Salmeterol

A

Sympathetic

MOA: beta-2 agonist

Clinical Use: treatment of asthma

Ocular Side Effects: relaxes ciliary muscle, production of aqueous (increases IOP)

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17
Q

Tamsulosin

A

Sympathetic

MOA: alpha-1 antagonist

Clinical Use: chronic hypertension

Ocular Side Effects: intraoperative floppy iris syndrome

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18
Q

Timolol

A

Sympathetic
Cardiovascular Agent

MOA: non-selective beta antagonist

Clinical Use: HTN, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, hyperthyroidism, neurologic diseases

Ocular Side Effects: lowers IOP

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19
Q

Nebivolol

A

Sympathetic
Cardiovascular Agent

MOA: beta-1 selective antagonist

Clinical Use: HTN, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, hyperthyroidism, neurologic diseases

Ocular Side Effects: lowers IOP

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20
Q

Atenolol

A

Sympathetic
Cardiovascular Agent

MOA: beta-1 selective antagonist

Clinical Use: HTN, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, hyperthyroidism, neurologic diseases

Ocular Side Effects: lowers IOP

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21
Q

Carvedilol

A

Sympathetic
Cardiovascular Agent

MOA: non-selective beta antagonist

Clinical Use: HTN, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, hyperthyroidism, neurologic diseases

Ocular Side Effects: lowers IOP

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22
Q

Metoprolol

A

Sympathetic
Cardiovascular Agent

MOA: beta-1 selective antagonist

Clinical Use: HTN, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, hyperthyroidism, neurologic diseases

Ocular Side Effects: lowers IOP

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23
Q

Amoxicillin

A

Antimicrobial- antibiotic

MOA: 3rd generation penicillin; targets transpeptidase in cell wall synthesis

Clinical Use: some gram negative coverage

Ocular Side Effects: n/a

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24
Q

Cephalexin

A

Antimicrobial- antibiotic

MOA: 1st generation cephalosporin; targets transpeptidase in cell wall synthesis

Clinical Use: gram positive coverage; skin infections

Ocular Side Effects: n/a

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25
Q

Cefuroxime

A

Antimicrobial- antibiotic

MOA: 2nd generation cephalosporin; targets transpeptidase in cell wall synthesis

Clinical Use: gram positive, some gram negative, anaerobic; intra-abdominal infections

Ocular Side Effects: n/a

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26
Q

Cefdinir

A

Antimicrobial- antibiotic

MOA: 3rd generation cephalosporin; targets transpeptidase in cell wall synthesis

Clinical Use: gram negative; pneumonia

Ocular Side Effects: n/a

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27
Q

Clavulanic acid

A

Antimicrobial- antibiotic

MOA: beta-lactamase inhibitor, combined with a penicillin to inhibit breakdown of beta-lactamse in penicillin

Clinical Use: combined with penicillin

Ocular Side Effects: n/a

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28
Q

Bacitracin

A

Antimicrobial- antibiotic

MOA: inhibits bacterial cell wall synthesis by weakening peptidoglycan polymerization

Clinical Use: great gram positive coverage, used topically, blepharitis, bacterial corneal ulcers

Ocular Side Effects: n/a

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29
Q

Vancomycin

A

Antimicrobial- antibiotic

MOA: inhibits bacterial cell wall synthesis by weakening peptidoglycan polymerization

Clinical Use: MRSA, very effective against gram positive

Ocular Side Effects: n/a

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30
Q

Doxycycline

A

Antimicrobial- antibiotic

MOA: tetracycline; inhibits protein synthesis by binding to 30s ribosomal subunit

Clinical Use: broad spectrum, 50 mg doxycycline can be used for inflammation

Ocular Side Effects: Pseudotumor Cerebri

Other Side Effects: Teeth

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31
Q

Minocycline

A

Antimicrobial- antibiotic

MOA: tetracycline; inhibits protein synthesis by binding to 30s ribosomal subunit

Clinical Use: broad spectrum

Ocular Side Effects: Pseudotumor Cerebri

Other Side Effects: Teeth

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32
Q

Tetracycline

A

Antimicrobial- antibiotic

MOA: inhibits protein synthesis by binding to 30s ribosomal subunit

Clinical Use: broad spectrum, 50 mg doxycycline can be used for inflammation

Ocular Side Effects: Pseudotumor Cerebri

Other Side Effects: Teeth

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33
Q

Tobramycin

A

Antimicrobial- antibiotic

MOA: aminoglycoside; inhibits protein synthesis by binding to 30s ribosomal subunit

Clinical Use: gram negative and some gram positive

Ocular Side Effects: allergic reactions

Other Side Effects: ototoxicity

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34
Q

Gentamicin

A

Antimicrobial- antibiotic

MOA: aminoglycoside; inhibits protein synthesis by binding to 30s ribosomal subunit

Clinical Use: gram negative and some gram positive

Ocular Side Effects: allergic reactions

Other Side Effects: ototoxicity

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35
Q

Neomycin

A

Antimicrobial- antibiotic

MOA: aminoglycoside; inhibits protein synthesis by binding to 30s ribosomal subunit

Clinical Use: gram negative and some gram positive

Ocular Side Effects: allergic reactions

Other Side Effects: ototoxicity

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36
Q

Azithromycin

A

Antimicrobial- antibiotic

MOA: macrolide; inhibits protein synthesis by binding to 50s ribosomal subunit

Clinical Use: good for respiratory infections and chlamydia

Ocular Side Effects: n/a

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37
Q

Erythromycin

A

Antimicrobial- antibiotic

MOA: macrolide; inhibits protein synthesis by binding to 50s ribosomal subunit

Clinical Use: good alternative to PCN, good for gram positive

Ocular Side Effects: n/a

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38
Q

Ciprofloxacin

A

Antimicrobial- antibiotic

MOA: 2nd generation fluoroquinolone; inhibits DNA replication by interfering with DNA gyrase and topoisomerase IV

Clinical Use: Pseudomonas, Anthrax, great gram negative coverage

Ocular Side Effects: n/a

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39
Q

Ofloxacin

A

Antimicrobial- antibiotic

MOA: 2nd generation fluoroquinolone; inhibits DNA replication by interfering with DNA gyrase and topoisomerase IV

Clinical Use: Pseudomonas, Anthrax, great gram negative coverage

Ocular Side Effects: n/a

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40
Q

Levofloxacin

A

Antimicrobial- antibiotic

MOA: 3rd generation fluoroquinolone; inhibits DNA replication by interfering with DNA gyrase and topoisomerase IV

Clinical Use: very broad spectrum

Ocular Side Effects: n/a

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41
Q

Moxifloxacin

A

Antimicrobial- antibiotic

MOA: 4th generation fluoroquinolone; inhibits DNA replication by interfering with DNA gyrase and topoisomerase IV

Clinical Use: gram negative, enhanced gram positive

Ocular Side Effects: n/a

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42
Q

Sulfacetamide

A

Antimicrobial- antibiotic

MOA: sulfonamide; competes with dihydropteroate synthestase and inhibits folate production

Clinical Use: wide spectrum

Ocular Side Effects: n/a

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43
Q

Trimethoprim

A

Antimicrobial- antibiotic

MOA: inhibits dihydrofolate reductase and inhibits folate production

Clinical Use: wide spectrum, potent

Ocular Side Effects: n/a

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44
Q

Cotrimoxazole (Bactrim)

A

Antimicrobial- antibiotic

MOA: trimethoprim + sulfamethoxazole; inhibits folate production

Clinical Use: broad spectrum, UTIs, respiratory tract infections, pneumocystis jiroveci, MRSA

Ocular Side Effects: n/a

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45
Q

Ethambutol

A

Antimicrobial- antimycobacterial

MOA: interferes with cell wall synthesis

Clinical Use: mycobacteria- TB

Ocular Side Effects: optic neuritis

46
Q

Rifampin

A

Antimicrobial- antimycobacterial

MOA: interacts with bacterial RNA polymerase to block transcription

Clinical Use: mycobacteria- leprosy, TB, gram negative and gram positive

Ocular Side Effects: secretions will have an orange-red color, including tears

47
Q

Oseltamivir

A

Antimicrobial- antiviral

MOA: selectively inhibits neuraminidase enzyme, which is essential to life cycle of the virus; prevents release of new virions

Clinical Use: influenza A and B

Ocular Side Effects: n/a

48
Q

Acyclovir

A

Antimicrobial- antiviral

MOA: converted to active form by viral enzyme; inhibits DNA polymerase and is incorporated into the viral DNA

Clinical Use: herpes virus, herpetic keratitis

Ocular Side Effects: n/a

49
Q

Valacyclovir

A

Antimicrobial- antiviral

MOA: converted to active form by viral enzyme; inhibits DNA polymerase and is incorporated into the viral DNA

Clinical Use: herpes virus, herpetic keratitis

Ocular Side Effects: n/a

50
Q

Trifluridine

A

Antimicrobial- antiviral

MOA: inhibits DNA synthesis; also able to incorporate into cellular DNA

Clinical Use: herpes virus- restricted to use in the eye,

Ocular Side Effects: irritation

51
Q

Ganciclovir

A

Antimicrobial- antiviral

MOA: converted to active form by viral enzyme; inhibits DNA polymerase and is incorporated into the viral DNA

Clinical Use: herpes virus, herpetic keratitis, CMV

Ocular Side Effects: n/a

52
Q

Tenofovir

A

Antimicrobial- antiviral

MOA: nucleotide/nucleoside inhibitor; inhibits reverse transcriptase/RNA polymerase, termination of replication

Clinical Use: Hepatitis B/C, HIV

Ocular Side Effects: n/a

53
Q

Efavirenz

A

Antimicrobial- antiviral

MOA: non-nucleoside reverse transcriptase inhibitor (NNRTI); highly selective inhibitor of HIV-1 reverse transcriptase, causes conformational change to enzyme

Clinical Use: HIV

Ocular Side Effects: n/a

54
Q

Ritonavir

A

Antimicrobial- antiviral

MOA: protease inhibitor; inhibits HIV aspartyl protease, prevents maturation of the viral particles

Clinical Use: HIV, used as an enhancer of other protease inhibitors (not used on its own), can also be given as a pharmacological booster for hepatic viral infections

Ocular Side Effects: n/a

55
Q

5-Fluorouracil

A

Anticancer

MOA: antimetabolite; forms a complex that derives the cell of thymidine, stopping DNA synthesis

Clinical Use: topical uses- skin cancer, prevention of scar tissue formation in surgery, some ocular surgeries

Ocular Side Effects: n/a

56
Q

Methotrexate

A

Anticancer

MOA: antimetabolite; dihydrofolate reductase antagonist; leads to decreased production of required nucleic compounds; DNA, RNA, and protein synthesis is depressed, leading to cell death

Clinical Use: cancer, severe psoriasis, Rheumatoid arthritis, Crohn’s disease

Ocular Side Effects: n/a

57
Q

Prednisone

A

Anticancer

MOA: triggers production of specific proteins that reduce cell growth and proliferation

Clinical Use: treatment of lymphomas

Ocular Side Effects: cataract formation, increased IOP

58
Q

Tamoxifen

A

Anticancer

MOA: estrogen antagonist; inhibits RNA synthesis

Clinical Use: breast cancer

Ocular Side Effects: crystalline retinopathy and other vision problems

59
Q

Bevacizumab

A

Anticancer

MOA: monoclonal antibody; antiangiogenesis agent; attaches to and stops VEGF from stimulating the formation of new blood vessels; decreases oxygen supply to tumor cells

Clinical Use: cancer, intravitreal for retinal neovascular diseases

Ocular Side Effects: n/a

60
Q

Hydrochlorothiazide

A

Cardiovascular Agent

MOA: thiazide diuretic; inhibits Na/Cl co-transporter in distal convoluted tubule; increased excretion of Na and Cl; reduced peripheral vascular resistance

Clinical Use: hypertension, heart failure, hypercalciuria, diabetes insipidus

Ocular Side Effects: n/a

61
Q

Furosemide

A

Cardiovascular Agent

MOA: loop diuretic; major action on ascending limb of loop of Henle; inhibits co-transport of Na/K/2Cl; increased Na and K excretion; increased Ca excretion

Clinical Use: drug of choice for reducing acute pulmonary edema of heart failure, useful in emergency situations, useful in treatment of hypercalcemia and hyperkalemia, not as frequently in HTN

Ocular Side Effects: n/a

62
Q

Acetazolamide

A

Cardiovascular Agent

MOA: carbonic anhydrase inhibitor; inhibits carbonic anhydrase in proximal tubule; decreases the kidney’s ability to exchange Na for H; Na is excreted at a higher rate

Clinical Use: glaucoma (2-250 mg tablets), treatment of pseudotumor cerebri, mountain sickness

Ocular Side Effects: decreases production of aqueous

63
Q

Clonidine

A

Cardiovascular Agent

MOA: centrally acting alpha 2 agonist; acts in vasomotor center within the medulla; decreases sympathetic outflow; decrease in vascular tone and cardiac output

Clinical Use: HTN

Ocular Side Effects: n/a

64
Q

Amlodipine

A

Cardiovascular Agent

MOA: vasodilator- calcium channel blocker; block inward movement of calcium; less calcium available to activate contraction in smooth muscle and cardiac muscle; produces reduction in vascular tone; produces dilation of coronary and peripheral arteries; decreases force of contraction and reduces cardiac workload

Clinical Use: HTN, some arrhythmias, angina

Ocular Side Effects: n/a

65
Q

Benazepril

A

Cardiovascular Agent

MOA: ACE inhibitor; prevents conversion of angiotensin I to angiotensin II; reduces peripheral vascular resistance; reduce the inactivation of bradykinin (a vasodilator); results in vasodilation as well as decreased sodium and water retention

Clinical Use: HTN, diabetic nephropathy, following a heart attack

Ocular Side Effects: n/a

66
Q

Lisinopril

A

Cardiovascular Agent

MOA: ACE inhibitor; prevents conversion of angiotensin I to angiotensin II; reduces peripheral vascular resistance; reduce the inactivation of bradykinin (a vasodilator); results in vasodilation as well as decreased sodium and water retention

Clinical Use: HTN, diabetic nephropathy, following a heart attack

Ocular Side Effects: n/a

67
Q

Losartan

A

Cardiovascular Agent

MOA: Angiotensin-Receptor Blocker; antagonist at angiotensin receptor; results in vasodilation, but does not increase bradykinin levels

Clinical Use: HTN, diabetic nephropathy, following a heart attack

Ocular Side Effects: n/a

68
Q

Nitroglycerin

A

Cardiovascular Agent

MOA: organic nitrate; enzyme activation of drug causes release of nitric oxide; cause a rapid reduction in myocardial oxygen demand; rapid relief of symptoms; relaxation of smooth muscle in arteries and veins; decreases venous return to the heart; dilate coronary vasculature; increase blood supply to the heart; relieves coronary artery spasm

Clinical Use: acute angina from exercise or emotional stress

Ocular Side Effects: n/a

69
Q

Ranolazine

A

Cardiovascular Agent- vasodilator

MOA: sodium channel blocker; inhibits the late phase of the sodium current; reduces intracellular sodium and calcium overload; improves diastolic function and improves oxygen supply

Clinical Use: used mainly to treat chronic angina

Ocular Side Effects: n/a

70
Q

Procainamide

A

Cardiovascular Agent

MOA: class IA anti-arrhythmic; binds to sodium channels and potassium channels; slows the rate of rise of action potential; slows conduction (phase 0) and slows repolarization (phase 3); increase duration of action potential and refractory period

Clinical Use: tachycardia-type rhythms

Ocular Side Effects: n/a

71
Q

Amiodarone

A

Cardiovascular Agent

MOA: class III anti-arrhythmic; K channel blocker; diminishes the outward potassium current during repolarization of cardiac cells; prolong the duration of the action potential (phase 3); prolong the effective refractory period; shows class I, II, III, and IV actions

Clinical Use: atrial fibrillation, sometimes angina

Ocular Side Effects: whorl keratopathy, non-arteritic ischemic optic neuropathy (NAION)

72
Q

Sildenafil

A

Cardiovascular Agent

MOA: type 5 phosphodiesterase inhibitor; potentiates the vasodilative effect of acetylcholine; parasympathetic activation causes release of acetylcholine; acetylcholine activates muscarinic receptors in vascular endothelial cells; increases production and release of NO; type 5 phosphodiesterase breaks down cGMP; these drugs inhibit this step, causing a continuation of vasodilation

Clinical Use: erectile dysfunction

Ocular Side Effects: mild impairment of color vision, blurry vision

73
Q

Tadalafil

A

Cardiovascular Agent

MOA: type 5 phosphodiesterase inhibitor; potentiates the vasodilative effect of acetylcholine; parasympathetic activation causes release of acetylcholine; acetylcholine activates muscarinic receptors in vascular endothelial cells; increases production and release of NO; type 5 phosphodiesterase breaks down cGMP; these drugs inhibit this step, causing a continuation of vasodilation

Clinical Use: erectile dysfunction

Ocular Side Effects: mild impairment of color vision, blurry vision (less likely to cause ocular side effects than others)

74
Q

Vardenafil

A

Cardiovascular Agent

MOA: type 5 phosphodiesterase inhibitor; potentiates the vasodilative effect of acetylcholine; parasympathetic activation causes release of acetylcholine; acetylcholine activates muscarinic receptors in vascular endothelial cells; increases production and release of NO; type 5 phosphodiesterase breaks down cGMP; these drugs inhibit this step, causing a continuation of vasodilation

Clinical Use: erectile dysfunction

Ocular Side Effects: mild impairment of color vision, blurry vision

75
Q

Dabigatran

A

Cardiovascular Agent

MOA: anticoagulant- direct thrombin inhibitor; competitive, reversible inhibitor of thrombin

Clinical Use: prevention of stroke in patients with atrial fibrillation

Ocular Side Effects: subconjunctival and retinal hemes are possible

76
Q

Apixaban

A

Cardiovascular Agent

MOA: anticoagulant- factor Xa inhibitor; selectively inhibits only factor Xa

Clinical Use: often used in hip or knee surgery as well as prevention of stroke

Ocular Side Effects: subconjunctival and retinal hemes are possible

77
Q

Rivaroxaban

A

Cardiovascular Agent

MOA: anticoagulant- factor Xa inhibitor; selectively inhibits only factor Xa

Clinical Use: often used in hip or knee surgery as well as prevention of stroke

Ocular Side Effects: subconjunctival and retinal hemes are possible

78
Q

Clopidogrel

A

Cardiovascular Agent

MOA: platelet inhibitor- ADP receptor blocker; when ADP binds to platelet, GP receptors are expressed; ADP receptor blockers inhibit expression of GP receptors for fibrinogen by binding to ADP; inhibits platelet function for the life of the platelet

Clinical Use: prevention of TIA and strokes in patients with previous event or following heart attack, adjunct with aspirin following coronary stent implantation, decrease thrombotic events in patient with acute coronary syndrome

Ocular Side Effects: subconjunctival and retinal hemes are possible

79
Q

Prasugrel

A

Cardiovascular Agent

MOA: platelet inhibitor- ADP receptor blocker; when ADP binds to platelet, GP receptors are expressed; ADP receptor blockers inhibit expression of GP receptors for fibrinogen by binding to ADP; inhibits platelet function for the life of the platelet

Clinical Use: prevention of TIA and strokes in patients with previous event or following heart attack, adjunct with aspirin following coronary stent implantation, decrease thrombotic events in patient with acute coronary syndrome

Ocular Side Effects: subconjunctival and retinal hemes are possible

80
Q

Ticagrelor

A

Cardiovascular Agent

MOA: platelet inhibitor- ADP receptor blocker; when ADP binds to platelet, GP receptors are expressed; ADP receptor blockers inhibit expression of GP receptors for fibrinogen by binding to ADP; does not inhibit platelet for the life of the platelet

Clinical Use: prevention of TIA and strokes in patients with previous event or following heart attack, adjunct with aspirin following coronary stent implantation, decrease thrombotic events in patient with acute coronary syndrome

Ocular Side Effects: subconjunctival and retinal hemes are possible

81
Q

Warfarin

A

Cardiovascular Agent

MOA: anticoagulant- vitamin K antagonist; several protein coagulation factors require vitamin K as a cofactor for synthesis; warfarin inhibits vitamin K epoxide reductase; results in the production of clotting factors with diminished activity

Clinical Use: blood thinner

Ocular Side Effects: subconjunctival and retinal hemes are possible

Other Side Effects: extensive drug interactions!

82
Q

Rosuvastatin

A

Cardiovascular Agent

MOA: HMG CoA reductase inhibitor; inhibit the first committed enzymatic step of cholesterol synthesis; analogs of HMG, a precursor of cholesterol; compete with HMG CoA reductase enzyme; end result- lowers intracellular supply of cholesterol in liver; causes hepatocyte to increase LDL receptors on surface; internalize circulating LDL and prevent release of VLDL

Clinical Use: first line therapy for increased LDL, effective in lowering plasma cholesterol levels in all types of hyperlipidemias

Ocular Side Effects: n/a

83
Q

Simvastatin

A

Cardiovascular Agent

MOA: HMG CoA reductase inhibitor; inhibit the first committed enzymatic step of cholesterol synthesis; analogs of HMG, a precursor of cholesterol; compete with HMG CoA reductase enzyme; end result- lowers intracellular supply of cholesterol in liver; causes hepatocyte to increase LDL receptors on surface; internalize circulating LDL and prevent release of VLDL

Clinical Use: first line therapy for increased LDL, effective in lowering plasma cholesterol levels in all types of hyperlipidemias

Ocular Side Effects: n/a

84
Q

Atorvastatin

A

Cardiovascular Agent

MOA: HMG CoA reductase inhibitor; inhibit the first committed enzymatic step of cholesterol synthesis; analogs of HMG, a precursor of cholesterol; compete with HMG CoA reductase enzyme; end result- lowers intracellular supply of cholesterol in liver; causes hepatocyte to increase LDL receptors on surface; internalize circulating LDL and prevent release of VLDL

Clinical Use: first line therapy for increased LDL, effective in lowering plasma cholesterol levels in all types of hyperlipidemias

Ocular Side Effects: n/a

85
Q

Colesevelam

A

Cardiovascular Agent

MOA: bile acid sequestrant; binds bile acids and bile salts in the small intestine (prevents reabsorption into liver); liver must then increase conversion of cholesterol to bile acids; cell surface LDL receptors increase

Clinical Use: lower LDL levels, hyperlipidemias

Ocular Side Effects: n/a

86
Q

Ezetimibe

A

Cardiovascular Agent

MOA: cholesterol absorption inhibitor; inhibits absorption of cholesterol from the small intestine; decreases delivery of intestinal cholesterol to the liver; reduces hepatic cholesterol stores and increases clearance of cholesterol from blood

Clinical Use: hyperlipidemia

Ocular Side Effects: n/a

87
Q

Fluoxetine

A

CNS Medication

MOA: SSRI; blocks reuptake of 5HT; leads to increased concentration in the synaptic gap

Clinical Use: depression

Ocular Side Effects: n/a

88
Q

Sertraline

A

CNS Medication

MOA: SSRI; blocks reuptake of 5HT; leads to increased concentration in the synaptic gap

Clinical Use: depression

Ocular Side Effects: n/a

89
Q

Duloxetine

A

CNS Medication

MOA: SNRI; blocks reuptake of NE and 5HT; non-selective

Clinical Use: depression, may be more effective if pain is experienced along with depression

Ocular Side Effects: n/a

90
Q

Bupropion

A

CNS Medication

MOA: atypical antidepressant; weak dopamine and NE reuptake inhibitor

Clinical Use: depression, also assists in decreasing the craving and attenuating the withdrawal symptoms for nicotine

Ocular Side Effects: n/a

91
Q

Alprazolam

A

CNS Medication

MOA: benzodiazepine; binding to receptor increases the affinity of GABA for its receptor; enhances the inhibitory effects of GABA; also decreases the release of GABA

Clinical Use: anxiety, sedative and hypnotic, anterograde amnesia, anticonvulsant, muscle relaxant, anesthesia, alcohol or opiate physical dependence/addiction (sedates patient during withdrawal)

Ocular Side Effects: n/a

92
Q

Diazepam

A

CNS Medication

MOA: benzodiazepine; binding to receptor increases the affinity of GABA for its receptor; enhances the inhibitory effects of GABA; also decreases the release of GABA

Clinical Use: anxiety, sedative and hypnotic, anterograde amnesia, anticonvulsant, muscle relaxant, anesthesia, alcohol or opiate physical dependence/addiction (sedates patient during withdrawal)

Ocular Side Effects: n/a

93
Q

Eszopiclone

A

CNS Medication

MOA: benzo-like; high affinity for the benzodiazepine binding site of GABA receptors; mimic effect of BZDs

Clinical Use: sleep problems

Ocular Side Effects: n/a

94
Q

Zolpidem

A

CNS Medication

MOA: benzo-like; high affinity for the benzodiazepine binding site of GABA receptors; mimic effect of BZDs

Clinical Use: sleep problems

Ocular Side Effects: n/a

95
Q

Aripiprazole

A

CNS Medication

MOA: second generation antipsychotic; dopamine and 5HT receptor antagonist; have activity at more dopamine receptors than first generation; also called “atypical” antipsychotics; do not produce movement disorders

Clinical Use: effective control of positive and negative signs, antiemetic effects, adjunct treatment of depression or a treatment of bipolar disorder

Ocular Side Effects: n/a

96
Q

Quetiapine

A

CNS Medication

MOA: second generation antipsychotic; dopamine and 5HT receptor antagonist; have activity at more dopamine receptors than first generation; also called “atypical” antipsychotics; do not produce movement disorders

Clinical Use: effective control of positive and negative signs, antiemetic effects, adjunct treatment of depression or a treatment of bipolar disorder

Ocular Side Effects: n/a

97
Q

Levodopa

A

CNS Medication

MOA: anti-Parkinson drug; boosts DA synthesis; increases content of DA vesicles; increases amount of DA released; increased activation of postsynaptic receptors

Clinical Use: Parkinson’s

Ocular Side Effects: n/a

98
Q

Carbidopa

A

CNS Medication

MOA: anti-Parkinson drug; given along with levodopa to inhibit PNS conversion to dopamine; allows therapeutic levels of levodopa to reach the CNS at a lower dose; essentially makes levodopa more bioavailable

Clinical Use: Parkinson’s

Ocular Side Effects: n/a

99
Q

Amantadine

A

CNS Medication

MOA: antiviral; also used for Parkinson’s, but MOA is not known; possibly more than usual DA-containing vesicles in the axon terminal are induced to release contents into the synapse

Clinical Use: Parkinson’s, influenza A

Ocular Side Effects: n/a

100
Q

Memantine

A

CNS Medication

MOA: NMDA receptor antagonist; binds to glutamine receptors on the post-synaptic neuron; prevents binding of glutamine; theory is that blockage of NMDA receptors reduces cytotoxic effects on neurons caused by Ca influx across the plasma membranes

Clinical Use: Alzheimer’s Disease

Ocular Side Effects: n/a

101
Q

Rivastigmine

A

CNS Medication

MOA: cholinesterase inhibitor; binds reversibly to acetylcholinesterase; leads to an increase in acetylcholine in the synapse

Clinical Use: Alzheimer’s Disease, Myasthenia Gravis

Ocular Side Effects: n/a

102
Q

Dexmethylphenidate

A

CNS Medication

MOA: amphetamine; is a substrate for the enzyme responsible for reuptake of NE and DA; is not metabolized by MAO and is instead stored in neurotransmitter storage vesicles (leaves NE and DA out); causes release of intracellular stores of neurotransmitter via a reversal of the reuptake enzyme; also inhibits MAO to a certain extent

Clinical Use: ADHD, narcolepsy

Ocular Side Effects: n/a

103
Q

Lisdexamfetamine

A

CNS Medication

MOA: amphetamine; is a substrate for the enzyme responsible for reuptake of NE and DA; is not metabolized by MAO and is instead stored in neurotransmitter storage vesicles (leaves NE and DA out); causes release of intracellular stores of neurotransmitter via a reversal of the reuptake enzyme; also inhibits MAO to a certain extent

Clinical Use: ADHD, narcolepsy

Ocular Side Effects: n/a

104
Q

Fentanyl

A

Opiate

MOA: opioid agonist

Clinical Use: pain control and in conjunction with general anesthesias; analgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic

Ocular Side Effects: pupillary constriction (withdrawal = dilation)

105
Q

Methadone

A

Opiate

MOA: opioid agonist

Clinical Use: treatment of opioid addiction- eases cravings, does not produce high; analgesic, sedative, respiratory depression, and antitussive effects

Ocular Side Effects: pupillary constriction (withdrawal = dilation)

106
Q

Oxycodone

A

Opiate

MOA: opioid agonist

Clinical Use: pain control, in conjunction with general anesthesia; analgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic

Ocular Side Effects: pupillary constriction (withdrawal = dilation)

107
Q

Codeine

A

Opiate

MOA: partial opioid agonist

Clinical Use: antitussive action at doses that do not produce analgesia (some OTC preparations), analgesic

Ocular Side Effects: pupil constriction

108
Q

Hydrocodone

A

Opiate

MOA: partial opioid agonist

Clinical Use: pain control, in conjunction with general anesthesia; analgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic

Ocular Side Effects: pupil constriction

109
Q

Tramadol

A

Opiate

MOA: binds to opioid receptor and weakly inhibits reuptake of NE and serotonin

Clinical Use: moderate to moderately severe pain

Ocular Side Effects: pupil constriction

110
Q

Naloxone

A

Opiate

MOA: opioid antagonist; reverse all effects of agonist except induction of coma

Clinical Use: opiate overdose; allows stabilization prior to transportation to an emergency center

Ocular Side Effects: n/a

Systemic Pharmacology II (4 decks)

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