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Drugs To Know For Final Flashcards

1
Q

What category is acetominophen?

A

Analgesic and antipyretic (sometimes referred to as NSAID)

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2
Q

What is the MOA of acetaminophen?

A

Not fully understood (somewhat strong blockade of prostaglandin synthesis in hypothalamus, but weak peripheral blockade)

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3
Q

What are the distinguising characteristics of acetaminophen?

A

Oral, n-acetyl-p-aminophenol (APAP)
Minimal anti-inflammatory effect
Excreted in urine following phase 2 metabolism
NO increased risk for GI bleeding
NO increased frisk for Reye’s syndrome
Conjugated in the liver with glucuronic acid and sulfate

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4
Q

What are the predicted actions/factoids about acetaminophen?

A

Never mix alcohol and Tylenol
Minimum safe dosage is 4grams/24 hours
Overdose treatment involves removal of any drug in the stomach
Antidote (n-acetylcystein, or NAC) should be administered as early as possible
**not as effective as other COX inhibitors for inflammation
Produces hepatotoxicity via hydroxylation can lead to severe hepatic necrosis, liver failure, coma, and death

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5
Q

What is the category of alprazolam?

A

Anxiolytic
Sedative hypnotic
Anti-epileptic
Muscle relaxant

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6
Q

What is the MOA of alprazolam?

A

GABA receptor agonist (GABA is inhibitory neurotransmitter)

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7
Q

What are the distinguishing characteristics of alprazolam?

A

Benzodiazepine, schedule IV substanc, pregnancy category D, metabolized by cytochrome P450 system of liver

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8
Q

What is the predicted action of alprazolam?

A

Drowsiness and diminished alertness
Interacts with drugs metabolized by same isoenzyme (of which there are lots)
Contraindicated with alcohol/other CNS depressants/pregnancy
RA for anxiety, panic attack, social anxiety

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9
Q

What is the category of amoxicillin?

A

Antibiotic (of the penicillin group)

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10
Q

What is the MOA of amoxicillin?

A

Inhibit bacterial wall synthesis

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11
Q

What are the distinguishing characteristics of amoxicillin?

A

Contains beta lactum ring
Broad spectrum of bacterial activity
Absorbed well from gut
High incidence of hypersenstivity

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12
Q

What are the predicted actions of amoxicillin?

A

Subject to resistance in penicillinase producing organisms
Used on outpatient basis
Must inquire about previous allergies to penicillin

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13
Q

What is the category of aspirin?

A

NSAID

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14
Q

What is the general MOA of aspirin?

A

Inhibition of cox-1 and cox-2 enzymes (irreversible binding)

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15
Q

What are the distinguishing characteristics of aspirin?

A 
Oral
Readily absorbed from upper GI
Metabolized by liver
Excreted in urine
Risk of Reye's syndrome (almost exclusively in children, can progress from rash, HA, vomiting, to CNS damage and death in 30% of cases
Salicylism
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16
Q

What are the predicted actions of aspirin?

A

Treats inflammation, pain, and fever
GI side effects include GI irritation, peptic ulcer disease, nausea, vomiting
Increased risk of bleeding
Prophylactic for stroke and myocardial infarction
Salicylism=dizziness, tinnitus, hyperventilation, mental status changes, and potential for coma and death

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17
Q

What is the category of Azithromycin?

A

Antibiotic (macrolide)

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18
Q

What is the MOA of azithromycin?

A

Bind reversibly to bacterial microsome to inhibit protein synthesis

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19
Q

What are the distinguishing characteristics of azithromycin?

A

Requires large loading dose
Usually effective with 7 day treatment
Bacteriostatic to broad spectrum including gut bacteria

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20
Q

What are the predicted actions of azithromycin?

A

Z-pack (gives larger first loading dose) highly successful because of convenience
Frequent diarrhea
Contains a large lactose ring (10+ members)
This is what makes it a macrolide
Does not kill the bacterial just makes them unable to reproduce

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21
Q

What is the category of celecoxib?

A

NSAID

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22
Q

What is the MOA of celecoxib?

A

Selective cox-2 inhibition

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23
Q

What is the distinguishing characteristics of celecoxib?

A

Oral

Presently unlcear if definite increased risk for cardiovascular disease exists

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24
Q

What are the predicted actions of celecoxib?

A 
Anti-inflammatory effects
Minimal irritation of GI tract
Less GI bleeding
No inhibition of platelet aggravation
Treats inflammation and pain 
Used with caution due to the vioxx drug catastrophe
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25
What is the category of clavulinate?
Antibiotic
26
What is the MOA of clavulinate?
Beta lactamase inhibitor
27
What are the distinguishing characteristics of clavulinate?
Given in combo with penicillins or cephalosporins Never by itself It is a support antibiotic
28
What are the predicted actions of clavulinate?
Would give with a penicillin derivative to prevent bacteria rom developing resistance to penicillin
29
What is the category of clotrimazole?
Anti-fungal topical
30
What is the MOA of clotrimazole?
Reduce fungal formation of ergosterol by inhibiting fungal cytochrome P450
31
What are the distinguishing characteristics of clotrimazole?
Used only topically
32
What are the predicted actions of clotrimazole?
Treat vaginal candidiasis Dermatophyte infections (tinea pedis, curries, corporis) Low toxicity Available OTC
33
What is the category of Cromolyn?
Anti-allergy
34
What is the MOA of cromolyn?
Inhibit histamine release in selected tissue
35
What are the distinguishing characteristics of cromolyn?
Poorly absorbed
36
What are the predicted actions of cromolyn?
Used in nasal sprays, nebulizers, eye drops Prophylactic in asthma, allergic rhinoconjunctivitis Minimal side effects
37
What is the category of diphenhydramine?
Anti-inflammatory Anti-emetic Anti-histamine
38
What is the MOA of diphenhydramine?
H1 receptor antagonist
39
What are the distinguishing characteristics of diphenhydramine?
Used orally, IM, and percutaneus Antimuscarinic activity Lipid soluble-can cross the blood brain barrier
40
What are the predicted actions of diphenhydramine?
Drowsiness Xerostomia (dry mouth) Sleep aid Treats nausea, vomiting and motion sickness
41
What is the category of estrogen?
Estrogen (endocrine drug?)
42
What is the MOA of estrogen?
Bind to estrogen receptors in nuclei of target cells to regulate protein synthesis
43
What are the distinguishing characteristics of estrogen?
Absorption varies widely with salt and formulation Transdermal/oral/parenteral forms Highly protein bound-compete with thyroid and other drugs Linked to breast cancer
44
What is the predicted actions of estrogen?
Hormone replacement therapy (postmenopausal) | Oral contraception
45
What is the category of hydrocodone?
Analgesic
46
What is the MOA of hydrocodone?
Opiate receptor agonist (especially thalamus, brainstem, gut, eye)
47
What are the distinguishing characteristics of hydrocodone?
``` Scheduled substance (2-3) Tolerance upon repeated use ```
48
What are the predicted actions of hydrocodone?
``` Pain less objectionable and localizable Depress respiratory center (overdose causes apnea) Physical and psychological dependence Miosis Constipation Similar drugs include oxycodone/morphine ```
49
What is the category of ibuprofen?
NSAID
50
What is the MOA of ibuprofen?
Cox1 and cox2 inhibitor
51
What are the distinguishing characteristics of ibuprofen?
Oral | No increased risk for Reye's
52
What are the predicted actions of ibuprofen?
Inflammation Pain Fever Pretty rapid response, preferred for children over aspirin
53
What category is insulin glargin?
Antidiabetic
54
What is the MOA of insulin glargin?
Binds to insulin receptors and activates tyrosine kinase which phosphorylation proteins after metabolic enzymes Moves glucose into cell from plasma
55
What are the distinguishing characteristics of insulin glargin?
Protein Short half life Multiple forms differ in solubility and release from the site of injection
56
What are the predicted actions of insulin glargin?
Causes decreased plasma glucose Treat type 1 diabetes, occasionally type 2 Ineffective orally (Rx subcutaneously) Repeated injections will cause hypoglycemia when in excess
57
What is the category of levoflaxacin?
Antibiotic-quinolone (synthetic, fluoridated compound)
58
What is the MOA of levoflaxacin?
Inhibits DNA gyrase which uncoils DNA during transcription
59
What are the distinguishing characteristics of levoflaxacin?
``` Broad spectrum Effective orally Chelates calcium Causes tendinitis Wide distributed Slows breakdown of caffeine Excreted unchanged in urine ```
60
What are the predicted actions of levoflaxacin?
Urinary tract infection ENT Upper and lower respiratory tract infections Bacteriocidal-actually kills the bacteria by destroying the DNA
61
What is the category of levothryoxine?
Thyroid drug
62
What is the MOA of levothyroxine?
Bind to gene receptors in cell nucleus where hormone modulates genetic transcription and protein synthesis
63
What are the distinguishing characteristics of levothyroxine?
T4 converted to T3 (active form) in periphery Half life of 7 days 80% bioavailability following oral administration
64
What are the predicted actions of levothyroxine?
Slow onset of action (week or more) Daily administration Numerous drug and herb interactions due to metabolism and protein binding Considered drug of choice for replacement and suppression therapy by most physicians
65
What is the category of metformin?
Oral hypoglycemic
66
What is the MOA of metformin?
Suppression of hepatic gluconeogenesis via several molecular mechanism (hepatic gluconeogenesis is elevated in type 2 diabetic)
67
What are the distinguishing characteristics of metformin?
Effective orally Biguanide GI upset (diarrhea) most common side effect Lactic acidosis-most serious side effect
68
What are the predicted actions of metformin?
First line drug for treatment of type 2 diabetes Avoid use with co-morbidities that will increase lactic acid (impaired renal function) Often combined with other oral hypoglycemic agents
69
What is the category of Metronidazole?
Antibiotic (anaerobes) | Antiparasitic
70
What is the MOA of metronidazole?
Binds DNA and inhibits anaerobic replication | Antiparasitic action is unclear
71
What are the distinguishing characteristics of metronidazole?
Use in anaerobic infections such as bacteriodes and clostridium Also used in protozoan infection such as entamoeba histolytica, trichomonas, and giardia
72
What are the predicted actions of metronidazole?
Side effects include GI, N/V, cramping, HA, and dizziness Avoid use of alcohol due to Flagyl's Antabuse-like property (severe N/V with alcohol) Potentials the actions of drugs metabolized by P450 system
73
What is the category of N-acetylcysteine (NAC)?
Mucolytic/expectorant
74
What is the MOA of N-acetylcysteine?
Decreases viscosity of mucous Breaks disulfide bonds Replenishes glutathione
75
What are the distinguishing characteristics of N-acetylcysteine?
Used in IV to treat acetaminophen overdose
76
What are the predicted actions of n-acetylcysteine?
COPD Allergies Overdose of acetaminophen
77
What is the category of pioglitazone?
Oral antidiabetic
78
What is the MOA of pioglitazone?
Decreases insulin resistance by regulating genes involved in glucose and lipid metabolism
79
What are the distinguishing characteristics of pioglitazone?
Often used in conjunction with other oral antidiabetic agents like metformin May cause fluid retention (edema) Used in prediabetics to prevent diabetes
80
What are the predicted actions of pioglitazone?
``` Treat type 2 diabetes Slow onset (gene regulation) Weight gain is common ```
81
What is the category of prednisone?
Glucocorticoid
82
What is the MOA of prednisone?
Modify gene transcription and interfere with inflammatory activities
83
What are the distinguishing characteristics of prednisone?
``` Short to medium acting Strong anti-inflammatory effect Orally effective Modest salt retention activity Converted to prednisolone ```
84
What are the predicted actions of prednisone?
Protein, lipid, and carbohydrate metabolism Secondary followed by primary adrenal insufficiency with prolonged use Side effects customary of all glucocorticoids
85
What are the effects of corticosteroids?
``` Metabolic effects (gluconeogenesis, protein catabolism, lipolysis) Anti-inflammatory and immunosuppressive effects (suppress activation of T lymphocytes and production of cytokines by T helper cells, prevent release of chemical mediators, stabilized lysosomal membranes) ```
86
What are the adverse effects of corticosteroid therapy?
``` Cushings-like syndrome (2 weeks of therapy) Osteoporosis Sodium retention Hypertension Muscle wasting Cataracts and glaucoma Infection (immunosuppressant) Peptic ulcers Secondary followed by primary adrenal insufficiency CNS stimulation with insomnia ```
87
What is the category of progesterone?
Progestin
88
What is the MOA of progesterone?
Bind to progesterone receptor in nuclei of target cells | Regulate gene transcription in diverse cells
89
What are the distinguishing characteristics of progesterone?
Rapidly absorbed following oral administration | Metabolized in liver on first pass
90
What are the predicted actions of progesterone?
Hormone replacement therapy | Contraception
91
What is the category of sertraline?
Antidepressant
92
What is the MOA of sertraline?
Selective serotonin reuptake inhibition (SSRI)
93
What are the distinguishing characteristics of sertraline?
Must "titration" dose for optimum effect
94
What are the predicted actions of sertraline?
Anti depressant similar to other SSRI, increase neurotransmitter Side effects include insomnia, headache (vascular headache , nausea, dry mouth (xerostomia)
95
What is the category of sulfamethoxazole?
Antibiotic
96
What is the MOA of sulfamethoxazole?
Folate synthesis antagonist (inhibits the action of dihydropteroate synthase, blocking synthesis of dihydrofolate)
97
What are the distinguishing characteristics of sulfamethoxazole?
Often used with trimethoprim due to high incidence of hypersensitivity in sulfonamides
98
What is the category of tetracycline?
Antibiotic
99
What is the MOA of tetracycline?
Binds reversibly to bacterial ribosome and inhibits protein synthesis
100
What are the distinguishing characteristics of tetracycline?
Cheating agent (binds covalently to calcium ions) Very broad spectrum Photosensitive
101
What are the predicted actions of tetracycline?
Mottling of teeth in children Interferes with calcium absorption Avoid use with dairy products
102
What is the category of trimethoprim?
Antibiotic
103
What is the MOA of trimethoprim?
Folate synthesis antagonist | Inhibits the action of dihydrofolate reductase blocking the formation of tetrahydroflolate
104
What are the distinguishing characteristics of trimethoprim?
Excreted in urine unchanged | Often used with sulfonamides which have a high incidence of hypersensitivity
105
What are the predicted actions of trimethoprim?
One of the drugs of choice for UTI
106
Where are H2 receptors located?
In acid secreting cells of stomach
107
Where are H1 receptors located?
Bronchial muscle
108
What is the term used to describe that quality in which repeated administration of a drug produces lower and lower efficacy?
Tolerance
109
What is the term for repeated administration of drug and results in lower and lower killing power?
Resistance
110
How do the azole's work?
Inhibit the formation of ergosterol an essential constituent in the cell walls of many infectious mycotic organisms
111
What is the inflammation related process of leukotrienes?
Bronchoconstriction and secretion
112
What is the inflammation related process of thromboxane?
Platelet aggregation
113
What is the inflammation related process of prostacyclin?
HCl reduction and gastric mucosal protection
114
What is the inflammation related process of prostaglandins?
Pain fever and peri-capillary leakage
115
How does aspirin work specifically as an anti-inflammatory, analgesicc, antipyretic,
Blockade of prostaglandin synthesis at target tissues and thermoregulatory centers in the hypothalamus And decreases tissue sensitivity to chemical mediators of pain

pharmacology (3 decks)

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