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PTH 509 Pharm > Exam 1 - Drugs > Flashcards

Exam 1 - Drugs Flashcards

1
Q

Aspirin (same for Salicylates?)

  • 4 actions of aspirin
  • Therapeutic uses
A
  • 4 actions =
    • analgesic
    • anti-pyretic
    • anti-inflammatory
    • antiplatelet
  • ​therapeutic uses
    • suppress inflammation/arthritis
    • analgesia
    • reduce fever
    • dysmenorrhea
    • supress platelet aggregation
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2
Q

Aspirin

  • Side effects
  • Toxicity
A
  • Side effects
    • MOA = irreversibly inhibits COX
    • GI: blocks protective prostaglandins
    • blood: increases bleeding
    • Uterus: decreases contractions
    • Kidney: promotes retention
    • Respiration: stimulates
  • Toxicity
    • ​GI-ulcers
    • hypersensitivity
    • overdose
    • pregnancy
    • Reye’s syndrome
    • alcohol
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3
Q

Aspirin

  • Drug interactions
  • Poisoning
  • Contraindications
A
  • Interactions
    • warfarin
    • glucocorticoids
    • alcohol
    • ibuprofen
  • Poisoning
    • death from respiratory failure
    • treat with ventilator
  • Contraindications
    • kidney problems
    • preexisting bleeding disorder
    • history of peptic ulcer/asthma
    • pregnancy
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4
Q

Ibuprofen/Naproxen common names

A
  • Ibuprofen
    • Advil
    • Motrin
    • Nuprin
  • Naproxen
    • Aleve
    • Naprosyn
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5
Q

Ibuprofen/Naproxen

  • Mechanism
  • Which lasts longer?
  • 3 actions
A
  • MOA = inhibits COX
  • Ibuprofen has a shorter duration of action than naproxen
  • 3 actions
    • ​anti-inflammatory
    • antipyretic (fever)
    • analgesic
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6
Q

Ibuprofen/Naproxen

Therapeutic uses

A
  • Therapeutic uses
    • ​suppression of inflammation
    • Rheumatoid arthritis
    • Moderate pain
    • fever
    • Dysmenorrhea (best drug for this)
    • Better tolerated NSAIDs

*** Naproxen only = bursitis/tendonitis

*** Ibuprofen = safe to use with anticoagulants

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7
Q

Piroxicam (aka Feldene)

I dont think we need to know this one

A
  • MOA = inhibits COX
  • antiplatelet like aspirin
  • RA
  • 9.5x higher risk for peptic ulcer and bleeding
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8
Q

Indomethacin: Stuff and common name

A
  • Indomethacin (aka Indocin)
  • MOA = inhibits COX
  • Antiplatelet like aspirin
  • Arthritis, bursitis, tendonitis, ductus arteriosus

* inhibits prostaglandin synthesis and inhibit urate phagocytosis

* initial treatment of gout

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9
Q

Celecoxib: Common name

uses

3 actions

A
  • Celecoxib (aka celebrex)
  • MOA = selective COX-2 inhibition
  • OA and RA
  • 3 actions
    • ​anti-inflammatory
    • anti=pyretic
    • analgesic

*** NO PLATELET AGGREGATION

*** causes fewer GI ulcers than other NSAIDs

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10
Q

Acetaminophen

common name

MOA

what does it inhibit

actions

treating

A
  • Acetaminophen (aka Tylenol)
  • MOA = WEAK inhibition of COX
  • Only able to inhibit prostaglandins in the CNS
  • 2 actions
    • ​analgesic
    • antipyretic
    • ****NOT an anti-inflammatory agent!
  • Treating with acetaminophen
    • ​does not cause GI bleeding
    • rarely hypersensitivity

*** categorized as an analgesic

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11
Q

Ketorolac

common name

MOA

other stuff

A
  • Ketoroloc (aka toradol) - only injectable!
  • MOA = inhibits COX
  • alternative for opioid analgesics
  • LESS anti-inflammatory activity
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12
Q

Sulindac

Common name

other stuff!!

A
  • Sulindac (aka Clinoril)
  • Equipotent to aspirin
  • closely related to indomethacin
  • less potent/fewer adverse effects
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13
Q

DOAN’s and Ben-Gay

A

These are other salicylates. Same stuff as aspirin?

Doan’s = magnesium salicylate

Ben-Gay = topical

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14
Q

Methotrexate (type of DMARDs)

speed

side effects

use how often

A
  • rapid acting
  • side effects
    • ​liver fibrosis
    • bone marrow suppression
  • administered once per week
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15
Q

Sulfasalazine (Azulfidine)

Type of DMARDs

treats?

slows?

side effects?

A
  • treats inflammatory bowel disease
  • retards progression of joint deterioration
  • GI and rash
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16
Q

Leflunomide (Arava)

type of DMARDs

What does it do?

side effects?

A
  • Slows formation of bone erosion
  • well tolerated, benefits in 1 month
  • stop lymphocyte activation
  • side effects
    • ​GI distress
    • rash
    • liver function
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17
Q

Entanercept (Enbrel)

A
  • Anti-TNF drug (tumor necrosis factor)
  • cytokines play a central part inflammation. TNF alpha stims release of cytokines
  • side effects
    • ​increase risk of infection
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18
Q

Prednisone

A

a steroid used to treat arthritis

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19
Q

Colchicine

A
  • used to treat gout
  • suppress different phases of leukocyte activation
  • prophylaxis of recurrent episodes of gouty arthritis
  • binds to tubulin
  • troublesome diarrhea
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20
Q

Probenacid

A
  • decreases the net reabsorption of uric acid by affecting the transport sites
  • need large urine volume to minimize kidney stones

*decreases the pool of urate available for gout

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21
Q

morphine (everything but drug interactions and overdose)

A
  • Principal alkaloid in opium
  • Mu agonist
  • does not reach brain quickly
  • Lasts 4-5 hours
    • ​relieves pain
    • mental clouding
    • orthostatic hypotension, constipation, pupil constriction, respiratory depression
    • urinary retention
    • emesis (vomiting)
    • elevation of intracranial pressure
    • tolerance and physical dependence
  • ***only for patients with painful disorders and sharp stabbing pain
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22
Q

Morphine (drug interactions and overdose)

A
  • Drug interactions
    • ​alcohol
    • barbiturates
    • antihistamines-increase respiratory depression
  • overdose
    • ​ventilation and give opioid antagonist
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23
Q

Heroin

A

opioid agonist

gets into brain more rapidly than morphine

no evidence that heroin is more effective than morphine

high abuse potential

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24
Q

Codine

A

opioid agonist

mild to moderate pain

side effects limits the max tolerated

often used in comination with aspirin or acetaminophen

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25
Q

Oxycodone (OxyContin, Percocet)

A

opioid agonist

never achieve morphine like efficacy

schedule II drug

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26
Q

Meperidine (Demerol)

A

opioid agonist

shorter duration of action than morphine

forms a toxic metabolite that can accumulate

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27
Q

Fentanyl (sublimaze)

A

opioid agonist. Mu agonist

-100x more potent than morphine

short acting (1-1.5 hours)

synthetic heroin -> health professionals abuse

28
Q

Tramadol (ultraam)

A

opioid agonist. weak Mu agonist

  • mild to moderate pain
  • may cause seizures
  • useful in chronic neuropathic pain
29
Q

Opioid antagoinists

A
  • Naloxone (Narcon) = mu antagonist used to treat opioid overdoses
  • Naltrexone (ReVia, Depade) = useful in the treatment of alcoholism
30
Q

Opioid agonist-antagonist

A
  • Nalbuphine (nubain)
    • moderate pain
    • less side effects than agonist
    • produces more psychotropic effects
  • Opioid A-A
    • agonist at kappa; antagonist at mu
    • less powerful but also less addictive
31
Q

Cromolyn sodium

A

-antihistamines

(Nasalcrom)

  • stabilizes mast cells and prevents release of contents
  • takes 2-3 weeks to be effective
  • side effects
    • burning
    • itching
    • sneezing
    • coughing
32
Q

Diphenhydramine

A

(benadryl)

  • allergies
  • anti-emetic (vomiting)
  • available OTC

**first generation H1 blocker

33
Q

Dimemhydrinate

A
  • Motion sickness
  • causes muscular weakness/drowsiness

*first generation H1 blocker

(Dramamine)

34
Q

Fexofenadine

A
  • Second generation H1 blocker
  • allergies
  • causes less drowsiness
  • the active metabolite of Terfenadine so does NOT cause toxic cardiac effects like terfenadine

(Allegra)

35
Q

Loratidine

A
  • Second generation H1 blocker
  • allergies
  • less sedating
  • once a day, extended release formulas

(Claritin)

36
Q

Cimetidine

A
  • H2 blocker
  • inhibits cytochrome P450 metabolism of other drugs
  • causes headaches, impotence (erectile dysfunction), and gynecosmastia (breast formation in males)
  • better medications (this should not be used anymore)

(tagamet)

37
Q

Ranitidine

A
  • H2 blocker
  • heart burn and gastric acid relief
  • Zollinger-Ellison syndrome (can cause tumors to form?)

(Zantac)

38
Q

Famotidine

A
  • H2 blocker
  • heart burn and gastric acid relief
  • Zollinger-Ellison syndrome (can cause tumors to form?)

(Pepcid)

39
Q

Aldosterone

A

Most potent mineralocorticoid

40
Q

Bethanechol

A
  • Muscarinic agonists
  • Relieves urinary retention
  • side effects
    • hypotension
    • excessive salivation/gastric acid secretion
    • bronchoconstriction
41
Q

Atropine

A
  • Muscarinic Antagonist
  • give this drug when they have muscarinic poisioning
42
Q

Physostigmine (antilirium)

A
  • Used in antimuscarinic poisoning
  • inhibitor of AChE
    • reversible
    • crosses membranes
  • Treats
    • Atroprine poisoning
43
Q

Neostigmine (Prostigmin) *

A
  • Reversible AChE inhibitor
  • MOA
    • binds to cholinesterase preventing it from catalyzing breakdown of ACh
    • treats
      • Myasthenia gravis
44
Q

Tubocurarine (Curare) *

A
  • non-depolarizing neuromuscular blocking agents
  • MOA
    • competes with ACh to bind to nicotinicm receptors
    • muscle relaxes etc.
  • side effects
    • respiratory paralysis
    • hypotension
45
Q

Catecholamines (list drugs)

A
  • Epi
  • NE
  • Isoproterenol
  • Dopamine
  • Dobutamine

*not orally

*cannot cross BBB

46
Q

Non-catecholamines (drugs list)

A
  • Ephedrine
  • Phenylephrine
  • Terbutaline

*given orally

*Can cross BBB

47
Q

Epinephrine (Adenalin, EpiPen)

A
  • Receptors
    • alpha 1 & 2
    • Beta 1 & 2
  • for
    • anaphylactic shock, delay absorption of anesthetics, hemostasis, overcome AV heart block, pupil dilation, asthma
  • Catecholamine
48
Q

Isoproterenol (Isuprel)

A
  • Receptors
    • beta 1 & 2
  • for
    • AV heart block, asthma, bronchospasm
  • Catecholamine
49
Q

Dopamine (intropin)

A
  • Catecholamine
  • binds
    • dopamine, alpha 1, beta 1
  • for
    • heart failure, shock, acute renal failure
50
Q

Terbutaline (brethine)

A
  • non-catecholamine
  • binds
    • beta 2
  • for
    • asthma, delay of preterm labor
  • side effect
    • tremor
51
Q

Ephedrine

A
  • Noncatecholamines
  • receptor
    • alpha 1 & 2
    • beta 1 & 2
  • Mixed drug
  • for
    • nasal congestion
    • narcolepsy
52
Q

Prazosin (minipress)

A
  • Alpha-adrenergic antagonist
  • receptor
    • alpha 1
  • for
    • hypertension
    • BPH
  • side effect
    • orthostatic hypotension
53
Q

Phentolamine (regitine)

A
  • alpha-adrenergic antagonists
  • receptors
    • alpha 1 & 2
  • for
    • pheochromocytoma
  • side effects
    • same as prazosin
54
Q

Propranolol (inderal)

A
  • Beta-adrenergic antagonist
  • receptors
    • beta 1 & 2
  • for
    • hypertension
    • angina
    • MI
55
Q

Metoprolol (lopressor)

A
  • beta-adrenergic antagonist
  • receptor
    • Beta 1
  • for
    • hypertension
    • asthma or diabetes & angina or MI

*** asthma person cannot use a beta 2 blocker!! So use this!

56
Q

Reserpine

A
  • adrenergic neuron-blocking agent (indirect?)
  • what it does
    • suppresses NE synthesis
    • and displaces NE from vesicles
    • hypertension
57
Q

Clonidine (Catapres)

A
  • Centrally acting alpha 2 agonist
  • MOA
    • activates a2 receptors to decrease transmitter release
  • for
    • hypertension and severe pain
58
Q

Methyldopa (aldomert)

A
  • centrally acting alpha 2 agonist
  • same MOA as clonidine
    • activates a2 receptors to decrease transmitter release. except must be converted to methyl-NE
  • for
    • hypertension
59
Q

Phenylephrine

A
  • Non catecholamine
  • activates alpha 1
  • for nasal decongestion
60
Q

Furosemide (Lasix)

A
  • High ceiling loop diuretic
    • most effective
    • loop of henle
  • MOA
    • blocks Na+ and CL-
    • reabsorbs K+
  • adverse effects
    • dehydration
    • hypotension
    • hypokalemia
    • ototoxicity (start to lose hearing)
61
Q

Hydrochlorothiazide (hydroDIURIL)

A
  • Thiazide diuretic
  • MOA
    • blocks Na+ and Cl-
    • reabsorbs K+
  • does
    • elevates uric acid and glucose
  • adverse effects
    • dehydration
    • hypotension
    • hypokalemia
    • not in pregnancy
62
Q

Spironolactone (Aldactone)*

A
  • Potassium sparing diuretic
    • modest increase in urine production
    • decrease K+ secretion
  • Aldosterone*
  • action
    • retains potassium
    • excretes sodium
  • adverse effects
    • HYPERKALEMIA****
63
Q

Triamterene (Dyrenium)*

A
  • potassium sparing diuretic
    • modest increase in urine production
    • decrease in K+ excretion
  • non-aldosterone *
  • MOA
    • direct inhibitor of potassium/sodium exchange
    • **quicker
  • adverse effects
    • HYPERKALEMIA***
64
Q

Mannitol

A
  • Osmotic diuretic
    • creates osmotic force as undergoes min reabsorption
  • uses
    • intracranial pressure
    • intraocular pressure
  • adverse effects
    • edema

(osmitrol)

65
Q

Hydrocortisone

A
  • glucocorticoid
  • similar to cortisol
  • also has mineralocorticoid properties
  • generally safe
66
Q

Fludrocortisone

A
  • Only mineralcorticoid available for replacement therapy.
  • treats
    • addison’s
    • hypoaldosteronism
    • congenital adrenal hyperplasia

PTH 509 Pharm (7 decks)

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