Drugs - Human Disease and Therapeutics Flashcards
What is Bethanecol? What does it treat?
Cholinergic agonist
Tx urinary retention
What is Civemeline? What does it treat?
Cholinergic agonist
Tx xerostomia in Sjogren’s syndrome
What is Pilocarpine? What does it treat?
Cholinergic agonist
Tx xerostomia after radiation therapy
What is Carbachol? What does it treat?
Cholinergic agonist
Tx glaucoma
What is atropine? What does it treat?
Cholinergic antagonist
Tx Parkinson’s, motion sickness, COPD, urinary urgency
What is Scopalamine? What does it treat?
Cholinergic antagonist
Tx Parkinson’s, motion sickness, COPD, urinary urgency
What is Benztropinemesylate? What does it treat?
Cholinergic antagonist
Tx Parkinson’s
What is Succinylcholine? What is it used for?
Cholinergic antagonist – it is a depolarizing and non competitive inhibitor (it desensitizes the neuromuscular end plate)
Muscle relaxation during surgery, or to tx tetany
What is d-tubocurare? What is it used for?
Cholinergic antagonist – it is a non depolarizing and competitive inhibitor
Muscle relaxation during surgery, or to tx tetany
What is Mecamylamine? What does it treat?
Cholinergic antagonist
Tx serious HTN
What is Trimethaphan? What does it treat?
Cholinergic antagonist
Tx serious HTN
What is Sarin?
Acetylcholinesterase inhibitor
Irreversible long duration nerve gas
What is Neostigmine? What does it treat?
Acetylcholinesterase inhibitor
Long acting – Tx Myasthenia Gravis
What is Edrophonium? What does it treat?
Acetylcholinesterase inhibitor
Short acting – Tx Myasthenia Gravis
What is Physostigmine? What does it treat?
Acetylcholinesterase inhibitor
Tx Glaucoma
What is Donepezil? What does it treat?
Acetylcholinesterase inhibitor
Tx Alzheimer’s
What is Rivastigmine? What does it treat?
Acetylcholinesterase inhibitor
Tx Alzheimer’s
What is Malathion? What is it used for?
Acetylcholinesterase inhibitor
Used as an insecticide/pesitcide to tx lice
What is Pralidoxime? What is it used for?
Binds Acetylcholinesterase, and will “kick off” any poison bound to it
What is Glycopyrrolate? What is it used for?
Muscarinic antagoist
Used to decrease salivation pre-operatively
What is Propantheline? What does it treat?
Muscarinic antagonist
Tx Traveler’s Diarrhea
What is Trihexyphenidyl? What does it treat?
Antimuscarinic
Tx Parkinson’s
What is Phenylephrine? What does it treat?
alpha 1 agonist
Tx Congestion
What is Prazosin? What does it treat?
alpha 1 antagonist
Tx HTN
What is Clonidine? What does it treat?
alpha 2 agonist
Tx HTN (brain mechanism)
What is Guanfacine? What does it treat?
alpha 2 agonist
Tx ADD
What is Yohimbine?
alpha 2 antagonist
What is Isoproterenol?
non selective beta agonist
What is Dobumatine? What does it treat?
beta 1 agonist
Used to treat heart failure
What is Atenolol? What does it treat?
beta 1 antagonist
Tx HTN
What is Metoprolol? What does it treat?
beta 1 antagonist
Tx HTN
What is Propanolol? What does it treat?
non selective beta antagonist
Tx HTN
What is Albuterol? What does it treat?
beta 2 agonist
Tx asthma, COPD
What is Terbutaline? What does it treat?
beta 2 agonist
Tx asthma, COPD
What is Fenoldapam? What does it treat?
Dopamine agonist
Tx shock and heart failure
What is Haloperidol? What does it treat?
Dopamine antagonist (typical antipsychotic)
Tx Schizophrenia
What is used to treat Partial and Generalized Tonic Clonic Seizures?
Carbamazepine, Phenytoin, Topiramate, Valproic Acid
What is used to treat Absence seizures?
Valproic acid (for atypical), Ethosuximide (for uncomplicated)
What is used to treat Status Epilepticus?
Diazepam, Phenytoin
What is used to treat Parkison’s?
L+DOPA with Carbidopa
Benztropine (anticholinergic to tx sialorrhea)
Trihexyphenidyl (anticholinergic to tx sialorrhea)
Selegeline (MAO inhibitor to prevent metabolism of DA)
Entacapone (COMT inhibitor to prevent degradation of neurotransmitters)
Pramipexole (DA agonist - used to treat early before L-DOPA)
What is used to treat Huntington’s disease?
DA antagonists (Haloperidol, Olanzepine) SSRI's for depression
What is used to treat Alzheimer’s disease?
Donepezil (Acetylcholinesterase inhibitor) Antipsychotics (Olanzepine, Quetiapine) Antidepressants (SSRI's and TCAs) Physical/Metnal Exercise (?) NSAIDS (?)
What is used to treat Multiple Sclerosis?
Prednisone (long acting steroid) Methotrexate (immunosuppression) Tamsulosin/Flomax (bladder dysfunction) Metamucin/PSyllium (bowel dysfunction) Fluoxetine/Prozac (SSRI) Modafinil (for fatigue) Gabapentin/Neurontin (antiseizure for pain) Clonazepam/Klonpin (sedative for tremor)
What is used to treat neuropathic pain?
Gabapentin/Neurontin (antiseizure)
Pregabalin/Lyrica (antiseizure)
Cymbalta/Duloxetin (antidepressant/mixed neurotransmitter uptake blocker)
Nortryptiline (antidepressant/NE blocker)
Tramadol/Ultram (non-opioid but some minor addiction?)
Corticosteroids
Endogenous opiod systems
What are the nonselective COX inhibitors? What are the side effects of nonselective COX inhibitors?
Salicylates, Ibuprofen
Tinnitus, Respiratory Alkalosis (Salicylates), Reye’s syndrome, anticlotting, GI ulcers, increased risk of heart attack, renal effects
What is a selective COX 2 inhibitor? What are some side effects of it?
Celecoxib
Renal and CV effects
What is Ketoprofen/Orudis?
An ibuprofen like NSAID
More potent so you can use a lower dose
What is Naproxen/Alleve?
An ibuprofen like NSAID
Longer lasting, slower actig
What is Indomethacin? What does it treat?
An ibuprofen like NSAID
Potent non selective NSAID but has a lot of side effects
Tx Rheumatoid arthritis and chronic TMJ
What is Meloxicam?
An ibuprofen like NSAID
Inhibits COX 2 more than COX 1 so there is less GI and anticlotting problems
What is Diflusinal/Doloboid?
An ibuprofen like NSAID
Related to salicylates, and better for bony pain
What is acetaminophen/Tylenol? What are some side effects of it?
Not a COX 1 or 2 inhibitor (Non NSAID) so not an anti-inflammatory but it has antipyretic and analgesic effects
Sedative in children, liver toxin in high doses
What is Fentanyl? What is the dose?
An opioid narcotic
.1 mg
What is Morphine? What is the dose?
An opioid narcotic
10 mg
What is Hydromorphone? What is the dose?
An opioid narcotic
1.5 mg
What is Oxymoprhone? What is the dose?
An opioid narcotic
1 mg
What is Codeine? What is the dose?
An opioid narcotic
200 mg
What is Hydrocodone? What is the dose?
An opioid narcotic
30 mg
What is Oxycodone? What is the dose?
An opioid narcotic
20 mg
What is Vicodin?
Acetaminophen and hydrocodone
What is Percodan?
Aspirin and oxycodone
What is Meperidine/Demerol? What is it good for?
An opioid narcotic
Good for major oral surgery, for moderate pain
What is Pentazocine/Talwin? Why is it good for?
An opioid narcotic
Mixed agonist/antagonist, causes dysphoria which discrouages abuse, for moderate pain
What is Methadone? What is it used for?
An opioid narcotic
Used to treat opioid addiction, for moderate to strong pain
What is Buprenorphine?
An opioid narcotic
Mixed agonist/antagonist
What are the properties of opioids? What are some major megative opioid side effects? What are the contraindications?
Analgesia, antitussive, antidiarrheal
Respiratory depression and decreased pulmonary reflex, constipation and slow bowel movement, sedation and synergism with other CNS depressants, euphoria/dependence/addiction
History of substance abuse, severe constipation or upset stomach, respiratory problems, allergies
What is the reversal agent for opioids?
Naloxone/Narcan (mu antagonist)
What are some contraindications for the use of NSAIDs?
Anticoagulants (Coumadin/Warfarin, Joint replacement, Heart Attack or Stroke, Major Surgery, Atrial Fibrillation)
Ulcers, hematemesis, bleeding in stools, chronic stomach problems, hemophiliac
Already taking high doses (like in arthritis)
Child or adolescent
Allergy
Kidney disease
What is used to treat Schizophrenia?
Typical Antipsychotics:
Phenothiazines: Chlorpromazine, Thioridazine
Butyrophones: Haloperidol
Atypical Antipsychotics: Clozapine, Quietiapine, Olanzepine these have fewer side effects are are more effective against negative symptoms
- except clozapine has serious agranulocytosis
What is used to treat mood disorders?
Monoamine Oxidase Inhibitors: Phenelzine, Selegiline Tricyclic Antidepressants: Amytryptiline, Desipramine, Doxepin Monoamine Uptake Blockers: SSRI's: Fluoxetine/Prozac Sertraline/Zoloft NE/mixed: Venlafaxine/Effexor Duloxetine/Cymbalta
What is used to treat Bipolar disorder?
Lithium carbonate
Valrpoic acid
Carbamazepine
Lamotrigine
What is used to treat Anxiety Disorder?
Behavioral management Sedatives Benzo-like: Ambien Barbiturates Buspirone/Buspar (non sedating and low abuse potential)
Venlafaxine and Paxil (antidepressant for panic attacks)
What are the Sedative Benzodiazepines? (longer acting)
Dizepam/Valium
Alprazolam/Xanax
Midazolam
What are the Hypnotic Benzodiazepines? (shorter acting)
Lorazepam/Ativan
Triazolam/Halcion
What are the Barbiturates? What are some concerns of Barbiturates?
Pentothal (short acting)
Phenobarbital (long acting)
Narrow margin of safety, highly addictive and many side effects, no analgesia
What is used to treat Phobic Disorders?
Counseling and behavior management
Sertraline/Zoloft (SSRI)
What is used to treat ADHD/ADD?
Stimulants: Amphetamines/Adderall Methylphenidate/Ritalin Non-Stimulants: Modafinil Atomoxetine (NE uptake blocker)
What is used to treat Autism Spectrum disorder?
Counseling/Behavioral management Atypical antipsychotics (Clozapine, Quitiapine, Olanzepine) and SSRI's for psychotic or aggressive behavior
What is used to treat eating disorders?
Supportive psychotherapy
Fluoxetine/Prozac
What is the reversal agent for Benzodiazepines?
Flumazenil
What are some other drugs used for IV anesthesia? What are some properties of these drugs?
Propofol: NOT ANALGESIC, short duration
Ketamine: dissociative anesthesia, increases CNS blood flow, unpleasant emergence
What inhaled anesthetics have a low coefficient of blood solubility and will need a higher concentration for effects?
Nitrous oxide and Desflurane – but this also means there is a rapid induction and recovery times
What inhaled anesthetics has a high coefficient of blood solubility and only needs a lower concentration for effects?
Halothane and Isoflurane – but this also means that they have moderate induction and recovery times
What is a contraindication of Halothane? What are some
Liver damage – because it has a hepatotoxic metabolite (unlike other inhaled anesthetics that are eliminated by ventilation only)
What is used as skeletal muscle relaxants?
D-tubocurare Rocuronium Diazepam (spasmolytic) Baclofen (spasmolytic) Botulinum toxin (spasmolytic)
What is used to treat alcohol use disorder?
Disulfuram
Naltrexon
Acamprosate
Antidepressant (?)
What are the 6 different classes of antihypertensive drugs?
Diuretics Drugs that alter sympathetic tone Arteriole dilators Calcium Channel Blockers Angiotensin Affectors (ACE inhibitors) Ganglionic blocking
What is hydrochlorthiazide? What is it used to treat? What are some concerns with the use of hydrochlorthiazide?
It is a thiazide diuretic and is used to treat hypertension. Be aware of electrolyte imbalances (especially potassium so have them eat bananas) and that this drug can cause glucose intolerance/hyperglycemia and problems with diabetes.
What is furosemide? What is it used to treat? What are some concerns with the use of furosemide?
It is a loop diuretic and is used to treat hypertension. Be aware that this drug is more potent and will have more potent side effects
What is spironolactone, amiloride and triamsterene? What is it used to treat? What are some concerns with the use of these drugs?
They are aldosterone blocking diuretics and are used to treat hypertension. Be aware that this is a potatssium spring drug and is usually combined with other diuretics, but do not use with ACE inhibitor antiHTN because it will worsen hyperkalemia
What is mannitol? What is it used to treat?
It is an osmotic diuretic used to treat HTN
What is acetazolamine? What is it used to treat?
It is a carbonic anhydrase inhibitor and is used to treat HTN
Which drugs alter sympathetic tone to treat HTN?
Beta blockers: Propanol, atenolol, metoprolol
Alpha blockers: Prazosin, phentolamine/phenoxybenzamine
Alpha 2 agonist: Clonidine
Alpha and Beta blocker: Labetatol
Guanethidine
How does clonidine work to reduce blood pressure?
Through centrally (brain) acting mechanisms
How does Guanethidine work to reduce blood pressure?
Inhibits release of NE from sympathetic nerve endings – works by depleting NE stores (NE can act as an agonist on sympathetic nerves)
Which drugs are vasodilators and are used to treat HTN?
Hydralazine, Minoxidil, Diazoxide, Nitroprusside, Nitroglycerine
How does Hydralazine work to reduce blood pressure?
It hyperpolarizes smooth muscle by opening K+ channels
Which drugs are calcium channel blockers used to treat HTN? How do they work?
Verapimil and Diltiazem
By inhibiting the movement of calcium through channels, they slow down the heart and widen blood vessels
What is Captopril? How does it work? What are some concerns with the use of Captopril?
It is a Angiotensin Converting Enzyme Inhibitor. It inhibits the conversion of Angiotensin I into II and increases bradykinin, which causes vasodilation.
Captopril can cause a dry cough or hyperkalemia if combined with K-sparring diuretics
Angiotensin II is a potent vasoconstrictive peptide that causes blood vessels to narrow, resulting in increased blood pressure.[3] Angiotensin II also stimulates the secretion of the hormone aldosterone[3] from the adrenal cortex. Aldosterone causes the renal tubules to increase the reabsorption of sodium and water into the blood, while at the same time causing the excretion of potassium (to maintain electrolyte balance), which also increases blood pressure.
What is mecamylamine? What is it used for and what are some concernse with its use?
It is a ganglionic blocking drug (nicotinic receptors). It is rarely used because of its serious side effects