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Drug classes Flashcards

1
Q

albuterol

A

SABA

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2
Q

Pirbuterol

A

SABA

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3
Q

terbutaline

A

SABA

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4
Q

Levoalbuterol

A

SABA

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5
Q

Ipratropium

A

Anticholinergic

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6
Q

Tiatropium

A

Anti-Cholinergic

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7
Q

Atropine

A

Anti Cholinergic

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8
Q

Prednison

A

Systemic Coticosteroid

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9
Q

Methylprednison

A

Systemic corticosteroid

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10
Q

Hydrocortison

A

Systemic corticosteroid

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11
Q

Prednosilone

A

Systemic corticosteroid

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12
Q

Fluticasone

A

ICS

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13
Q

Budenoside

A

ICS

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14
Q

Beclamethasone

A

ICS

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15
Q

flunisolide

A

ICS

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16
Q

Triancinolone

A

ICS

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17
Q

Salmeterol

A

LABA

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18
Q

Formoterol

A

LABA

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19
Q

Theophylline

A

Methyxanthine

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20
Q

Aminophylline

A

Methylxanthine

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21
Q

Zafirlukast

A

Leukotriene modifier

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22
Q

Montelukast

A

Leukotriene modifier

some efficacy in Migraine

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23
Q

Omiluzimab

A

anti IgE Ab

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24
Q

APAP

A

Centrally acting NSAID

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25
Q

Ibprofen

A

peripheral NSAID

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26
Q

Ketoprofen

A

NSAID

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27
Q

Naproxen

A

NSAID- dysmenorrheal

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28
Q

Etodolac

A

cox 2 preferential NSAID

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29
Q

Ketorolac

A

parenteral NSAID for analgesia

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30
Q

Oxaprosin

A

NSAID- long half life, anti inflammatory

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31
Q

piroxicam

A

NSAID- long half life, anti inflammatory

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32
Q

Nambumetone

A

NSAID- anti inflammatory

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33
Q

Sulindac

A

NSAID- anti inflammatory

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34
Q

diclofenac

A

topical NSAID

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35
Q

voltaren gel/ flexor patch

A

diclofenac

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36
Q

Misoprostol

A

protect GI against NSAIDs- PGEI analogue

TERATOGEN

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37
Q

Triad of findings with GI toxicity from NSAID use

A

perforated ulcer
obstruction
bleeding

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38
Q

Omeprazole

A

PPI- DOC for blocking GI symptoms of NSAIDs

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39
Q

Indomethacin

A

NSAID

Gout

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40
Q

Rofecoxic

A

COX-2 inhibitor

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41
Q

Valdecoxib

A

COX-2 inhibitor

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42
Q

Celebrex

A

COX-2 inhibitor- only one still on market

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43
Q

Tramadol

A 
Central analgesic
weak mu agonist
SNRI
DO NOT GIVE IF PT IS AT RICK OF SEIZURE 
NSAID alternative if pt has- hx PUD, renal insufficiency, HF, severe HTN, and opiod alt if pt has substance abuse problems
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44
Q

Capsacin

A

Substance P depletor

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45
Q

transderm lidocaine

A

block neuronal transmission?

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46
Q

Morphine

A

opiod- prototype, mu agonist

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47
Q

Meperidine

A

strong agonist
not recommended for long term use due to toxic metaoblite buildup
Short acting, IV
pupil dilation

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48
Q

Methadone

A

strong agonist

longer life controls withdrawal

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49
Q

Fentanyl

A 
Meperidine like strong agonist
Super strong
fast on set
short duration 
Patch formulation- 8-12 hours to get to therapeutic dose
Anesthesia
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50
Q

Propoxyphene

A

more risk than benefit

methadone like moderate agonist

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51
Q

Codeine

A

Morphine precursor
used as antifussive w/o analgesia
Combined with APAP for analgesia
converted to morphine by CYP2D6 system

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52
Q

Naloxone

A

Tx for opiod OD
competitive mu agonist
can precipitate withdrawal in opioid addict

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53
Q

Oxymorphone

A

Morphine like agonist

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54
Q

Hydromorphone

A

Morphine like strong agonist
10x stronger than morphine
more respiratory depression but less nausea and constipation than morphine

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55
Q

Hydrocodone

A

Morphine like strong agonist, codeine derivative

similar efficacy to morphine

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56
Q

Oxycodone

A

Morphine like strong agonist, codeine derivative

similar efficacy to morphine

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57
Q

Pentazocine

A

mixed agonist- agonize pain but also antagonize at dif site

can precipitate withdrawal

58
Q

Buprenorphine

A

mixed agonist- agonize pain but also antagonize at a dif site
long duration

59
Q

metoclopramide

A

Tx nausea

Causes drug induced PD (bilateral and sudden)

60
Q

Sinemet

A

CD/LD combo
DOC in PD
LD- precursor of DA crosses BBB and is decarboxylated
CD- inhibits peripheral DA decarboxylase
AE- nausea, orthostatic HypoTN, and hallucinations
CI- high protein diet
Wait to use in younger pts, may accelerate PD

61
Q

Amantadine

A

Antiviral and Anti PD for dyskinesia

also used for tremor and drooling

62
Q

DA agonists

A

cont stim @ DA receptors
AE toxic psychosis, sleep attacks (may or may not have prodrome), impulse control disorders
(overall worse CNS effects but better peripheral)
Use- early mild dz, young pts
CI- dementia

63
Q

Bromocriptine

A

ergot derivative DA agonist

64
Q

Pramipexole

A

DA agonist- non ergot derivative

mono tx or w/ LD

65
Q

Rotigotine

A

non ergot derivative, available as transderm patch

66
Q

Apomorphine

A

DA agonist- subq

used in advanced dz to break off spells but causes bad nausea. give with antinemics

67
Q

Entacapone

A

COMT inhibitor used in PD as adjuct to LD tx to provide longer duration
causes diarrhea and urine discoloration

68
Q

Selegilline

A

MAO-B inhibtor that loses selectivity at higher dose
CI in meperideine
adjunct to LD so can use lower dose
or Monotx in early dz

69
Q

Rasagilline

A

MAO-D inhibitor that is not selective
CI in meperideine
adjunct to LD so can use lower dose
or Monotx in early dz

70
Q

Trihexyphenidyl

A

Anticholinergic
AE are severe in elderly
used in younger pts to manage tremor

71
Q

Benztropine

A

Anticholinergic
AE are severe in elderly
used in younger pts to manage tremor

72
Q

Triptans- MOA

A

5HTB agonism- vasoconstriction
5HT1D presynaptic inhibition- inhibits inflammatory neuropeptide rls from trigeminal nerve
5HT1D- stimulations- prevents pain transmission from trigeminal nuclei

73
Q

Chlorpromazine

A

Triptan- antiemetic and analgesic
CI in CAD
AE med overuse rebound HA, serotonin syndrome
DO not use w/ ergots

74
Q

Prochlorperazine

A

Triptan- IV, oral PR formulas
CI CAD
AE med overuse rebound HA, serotonin syndrome
do not use with ergots

75
Q

Promethazine

A

triptan- lower rade of extrapyramidal problems compared to prochlorperazine
best one
CI in CAD
AE medication overuse HA, serotonin syndrome
DO not use with ergots

76
Q

Propranolol

A

beta blocker for prophylactic use in migraine HA
caution in pts w/ asthma, COPD, Hx of depression or PVD
DOC in prophylaxis and great for pts w/ co morbid conditions ie HTN, post MI, panic disorders
used less frequently than others b/c crosses BBB
gradually inc dose

77
Q

Atenolol

A

betablocker used in prophypactic migraine tx
caution in pts w/ COPD, asthma, Hx of depression or PVD
DOC for prophylaxis and great in pts with HTN, post MI, or panic disorder
use if pts cant tolerate CNS effects of propranolol
gradually inc dose

78
Q

Nadolol

A

betablocker used in migraine prophylaxis
caution in pts w/ asthma, COPD, hx of depression, or PVD
DOC for prophylaxis and great in pts w/ HTN, post MI, or panic disorder
gradually inc dose

79
Q

nortryptilline

A

TCA
better tolerated b/c 2nd gen
can cause: sedation, weight gain, arhymia, dementia
reduces frequency and severity of migraine and tension HA
Ideal in migraine pts w/ comorbid- depression, insomnia, or neuropathic paiin

80
Q

Desiprammine

A

TCA
AE- sedation, weight gain, prolonged QT, dementia
better tolerated b/c 2nd gen
dec frequency and severity of migraines and tension HA
ideal for pts in migraine with comorbid- depression, insomnia, or neuropathic pain

81
Q

Amitriptyline

A

1st gen TCA clinically shown to work for migraine but high AE
AE: sedation, weight gain, prolonged qt interval, dementia
1st gen so not tolerated as well as 2nd
dec frequency and severity of migraines and tension HA
great for migraine pts w/ comorbid depression, insomnia, or neuropathic pain

82
Q

Imipramine

A

TCA - 1st gen so not tolerated as well as 2nd
AE: sedation, weight gain, prolonged qt, and dementia
reduce severity and frequency of migraine and tension HA
great in pts with comorbid depression, panic disorders, or neuropathic pain

83
Q

Valproate and Depakote

A

antiepileptic that reduces neuronal firing and enhances GABA
can cause significant weight gain
cat D in pregnancy
ideal for migraines in epileptics or bipolar disorder (RAPID CYCLERS/ MIXED MANIA0

84
Q

Verapamil

A

CCB- used to dec frequency of migraines

only after BB, TCAs, and valproate have failed

85
Q

Topiramate

A

Shows efficiency in 1st month
looks similar to DA
causes cognitive dysfunction and language
BUT also causes weight loss

86
Q

Riboflavin

A

prevent migraines, safe during pregnancy but takes 2 weeks

87
Q

Gabapentic

A

best tolerated antiepilectic drug

88
Q

estrogen gel

A

start 2 days bfr menstral HA

89
Q

Botox for migraines

A

can reduce migraines with injection

90
Q

ACE/ ARB

A

show reduced migraine frequency

91
Q

Fluoxetine

A

SSRI- long t1/s, DOC for MDDduring preg, most activating,

OCD

92
Q

Citalopram

A

SSRI- least activating

93
Q

Paroxetine

A 
SSRI- 
DONT USE IN PREG, short t1/2 beware of withdrawal
GAD
OCD
PTSD
94
Q

Sertaline

A

SSRI
OCD
PTSD

95
Q

Fluvoxamine

A

SSRI

OCD

96
Q

Escitalopram

A

SSRI

GAD

97
Q

SSRI

A

inhibit presmpatic 5HT Reuptake, down regulate receptors 5HT2 agonism
AE- transient jitters, insomnia, diarrhea, and anxiety.
sexual dysfunction
serotonin syndrome
SSRI- withdrawal- anxiety, electric shock feeling flu
Take time to work (takes a few weeks to down-regulate the postynaptic beta receptors)
DOC- in MDD, Panic disorder, OCD

98
Q

TCA

A 
SNRI, alpha adrenergic agonist, H1 receptor agonist, anticholinergic
AE- 
CARDIAC TOXICITY- TORSADES DE POINTES
othrostatic HypoTN, weight gain, anticholinergic
sexual dysfunction
5HT syndrome w/ other antidepressants
lowers seizure threshold
low risk teratoginicity
OD can kill- tx with NaHCO3
CI- CAD, seizure disorders
99
Q

TCA uses

A

antidepression
chronic pain
migraine HA
atypical depression

100
Q

MAO-Is

A

inhibit breakdown of biogenic amines
AE
TERAOTOGENIC
wine and cheese rxn (tyrammine OD, HTN crisis –> hemorrhagic stroke)
orthostatic hypoTN, weight gain, anticholinergic
sexual dysfunciton
serotonin syndrome

101
Q

MAO-Is drug interactions

A

serotonin syndrome- meperdine, tramadol, dextromethorphan

fever, HTN, delirium- meperidine, sympathomimetics, phenylephrine,

102
Q

MAO- USES

A 
atypical depression (weight gain, sleeping, inc sensitivity to rjxn)
WAIT 2 WEEKS WHEN SWITCHING TO AN MAOI FROM ANOTHER DRUG
103
Q

Isocarboxacid

A

MAOI

104
Q

Phenelzine

A

MAOI

105
Q

Tranylcypromine

A

MAOI

106
Q

Venlafaxime

A

SSRI @ low dose
SNRI @ high dose
avoid in uncontrollable HTN
used in depression, GAD

107
Q

Duloxetine

A

SNRI at all doses
DIABETIC NEUROPATHY, GAD
watch for liver toxicity

108
Q

Nefazodone

A

SNRI and blocks 5HT2A (ELIMINATES ANXIETY, INSOMNIA, AND SEXUAL DYSFUNCTION)
used for depression, anxiety, insomnia
AE- sedation, GI, dry mouth, constipation
drug interactios and deadly hepatic failure

109
Q

Trazodone

A

SSRI and blocks 5HT2A (RI and antagonist) as well as H1 and alpha 1
AE- orthostatic hypotn, sedating, PRIAPRISM
use- use w/ SSRI to counter insomnia (“trazodoze”)

110
Q

Buproprion

A

NE and DA reuptake inhibitor- same MOA as cocaine
AE- anorexia, psychosis, HA, insomnia, psychomotor activation
AE- inc seizures and inc sexual function
can also cause weight loss
DO NOT GIVE TO PTS WITH SEIZURE HX, ANXIETY, OR BULIMIA
used for depression, quit smoking

111
Q

Mirtazapine

A

Sleep, sex, food antidepressant
antagonizes presynaptic alpha 2 to inc NE release also blocks 5HT2, 3 and H1
used for- comorbid anxiety, reduced sexual dysfunciton, and has a low potential for OD
AE- agranulocytosis, weight gain, sedation

112
Q

BZD

A

inc frequency of GABA channel opening
has ceiling effect
AE- ataxia, sedation, anterograde amnesia, resp depression, paradoxical excitement, aggression NO NYSTAGMUS

113
Q

BZD use

A

short term while waiting for SSRI to kick in
long term in pts with anxiety disorder and somatic symptoms
insomnia, acute mania, akasthesia, RLS, seizures, EtoH detox
taper b/c withdrawal can be deadly
CI in EtoH and Narcotic ingestion

114
Q

BZD tolerance

A

to euphoria but not anxiolytic effects

115
Q

Lorazepam

A

BZD- short acting- met is glucronidation better in elderly and liver

116
Q

Oxazepam

A

BZD- short acting- met is glucoronidation, better in elderly and liver dz

117
Q

Diazepam

A

BZD- long acting and most lipophillic

118
Q

Temazepam

A

BZD- least lipophillic

119
Q

Clorazepate

A

BZD- long acting

120
Q

Chlodiazepozide

A

BZD- long acting

121
Q

Flumazenil

A

ccompetitive to BZD @ GABA A

AE- can precipitate withdrawal in BZD dependent individuals

122
Q

Buspirone

A

partial agonist @ presynaptic 5HT1A
scheduled med GAD, sleep apena, substance abuse, h/o of BZD tx
AE- HA, N, dizziness, nervousness, SLOW ACTING
AE are mild
used in GAD esp if pt has hx of substance abuse, sleep apnea, or hx of falls

123
Q

Clonazepam

A

BZD- scheduled basis for panic disorder

124
Q

alprazolam

A

BZD- assoc w/ withdrawal and seizures

125
Q

Clomipramine-

A

TCA with strong seratonergic component good for OCD

126
Q

OCD tx

A

if using SSRI- use higher dose than depression
clomipramine
also need CBT

127
Q

PTSD tx

A

SSRI (paroxetine, sertaline), MAOI, TCA
BZD or alcohol after event make it worse
antipsychotic or anticonvulsant can help
betablockers can help

128
Q

SAD tx

A

SSRI, MAOI

129
Q

specific phobia tx

A

CBT

130
Q

performance anxiety

A

beta blocker

131
Q

LI

A

DOC in Bipolar disorder- prevents relapse of mania and depression (mania more than depression) and dec suicide rates.
1-2 weeks to see effect- use adjuncts until then (antipsychotics or benzos)
AE- tremor, psoriasis, weight gain, acne, hypothyroidism, nephrogenic diabetes, bad for kidneys.

132
Q

LI- actue intoxication

A

seizures, arrhythmias permanan neurologic impairment, kidney damage, maintain adequate Na ad fluid levels.

133
Q

LI- drug interactions

A

anything that dec GFR–> inc of serum levelsNSAIDs, ACE, ARB, HCTZ

134
Q

LI-CI

A

prenancy

135
Q

Li- baseline lab tests

A 
CBC
SCr
Thyroid
urinalysis
electrolytes
136
Q

Li- monitor lab tests

A

Li levels
CBC
SCr/ BUN
TSH

137
Q

carbamazapine/ oxcarbazepine

A

antiepileptics for when Li/ Valproate fail

138
Q

Lamotrigine

A

blocks voltage gated Na channels to block glutamate and aspartate
2 mnth sto get therapeutic dose
AE- rash
Used to prevent depression but use with Li

139
Q

SSRI in bipolar disorder

A

careful about using dont want to throw them into mania, make sure they are on a mod stabilizer first

140
Q

bipolar disorder and preg

A

use atypical antipsychotics- they are fast acting

Pharm main (26 decks)

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