Exam #1 Pharmacology Flashcards

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1
Q

which salicylates are absorbed at the colon

A

Olsalazine
Sulfasalazine
Balsalazide

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2
Q

IBD treatment

A

obtain remission w corticosteroids and maintain remission w salicylates

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3
Q

Sulfasalazine adverse effects

A

nausea, GI upset, headache
sulfa allergy via sulfapyridine
oligosperimia
inhibits folate absorption

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4
Q

antibiotics used to treat Crohn’s Disease

A

Ciprofloxacin
Metronidazole
**adjunctive

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5
Q

Ciprofloxacin MOA

A

topoisomerase II and IV inhibitor

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6
Q

Ciprofloxacin contraindications

A

Antacid use
Patient w/ arrythmias or who are taking drugs that produce prolongation of QT
Concurrent administration of tizanidine

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7
Q

Metronidazole contraindication

A

alcohol use

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8
Q

Metronidazole MOA

A

Forms toxic free radical metabolites that interacts with DNA disrupting its structure and inhibiting replication

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9
Q

Metronidazole adverse effects

A

peripheral neuropathy

METALLIC TASTE

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10
Q

6-mercaptopurine and Azathioprine active metabolite

A

6-thioionosinic acid

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11
Q

6-mercaptopurine and Azathioprine moa

A

mimic IMP inhibiting RNA and DNA synthesis

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12
Q

6-mercaptopurine and Azathioprine adverse effects

A

bone marrow depression leading to leukopenia
hepatic toxicity
INC RISK FOR MALIGNANCY

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13
Q

Infliximab adverse effects

A

inc risk for infection
headache
abdominal pain

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14
Q

Cimetidine adverse effects

A

Diarrhea, headache, drowsiness
gynecomastia
galactorrhea
big time CYP inhibitor (will inc effects of other drugs)

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15
Q

Cimetidine moa

A

binds H2 receptor on basolateral membrane of parietal cell preventing histamine from binding

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16
Q

Famotidine adveres effects

A

renal insufficiency

prolonged QT interval

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17
Q

Nizatidine adverse effects

A

dec B12 absorption by increasing pH

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18
Q

Proton Pump Inhibitors MOA

A

suppresses both gastric basal and stimulated acid secretion by irreversible binding to and inhibiting the parietal cell H+/K+ ATP pump
**IRREVERSIBLY INHIBIT via disulfide bond

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19
Q

Proton Pump Inhibitors adverse effects

A

OSTEOPOROSIS
abdominal pain, diarrhea, flatulence vomiting, constipation (altered absorption)
headache

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20
Q

Omeprazole drug interaction

A
dec antiviral effects
dec clopedigrel effects
inc methotrexate effects
inc warfarin effects
St. John Wart and Rifampin dec omeprazole effects via induction of CYP
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21
Q

Esomeprazole adverse effect

A

headache most common

osteoporosis

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22
Q

Lansoprazole is special bc

A

has no interaction w clopedigrel

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23
Q

Clarithromycin adverse effects

A
Jaundice
Ototoxicity
Prolonged QT
Hepatoxicity 
CYP 3A4 inhibitor
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24
Q

Amoxicillin adverse effects

A
Nephritis
Neurotoxicity
GI distress
Penicillin allergy (hypersensitivity)
Hematological toxicities
Diarrhea inc when given w Clavulanic acid
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25
Q

H. pylori quadruple therapy

A

PPI or H2R antagonist
Bismuth subsalicylate
Metronidazole
tetracycline

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26
Q

Aluminum hydroxide adverse effect

A

constipation

**slower effect but longer duration

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27
Q

Magnesium hydroxide adverse effect

A

diarrhea via Mg+2 stimulates gastric smooth muscle contraction
**faster effect but shorter duration

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28
Q

Aluminum hydroxide and Magnesium hydroxide are mixed to…

A

dec adverse effects (counteract)

29
Q

Sodium Bicarbonate adverse effects

A

flatulence with CO2 release

30
Q

Sucralfate MOA

A

cytoprotective via viscous polymer that bind to and covers ulcer for up to 6hr

31
Q

Antacids adverse effects

A

belching, nausea, abdominal distention, and flatulence with CO2 release
Hypercalcemia…patients with uremia
Rebound acid secretion…more frequent administration
milk-alkali syndrome

32
Q

the chemotherapeutic agent with higher emetogenic potential

A

Cisplatin

33
Q

Chemotherapy-induced nausea and vomiting treatment

A

5-HT3 receptors antagonist
enhanced by combination therapy with a corticosteroid (dexamethasone), NK1-receptor antagonist, and a dopamine D2 antagonist

34
Q

Odansetron adverse effects

A

prolonged QT interval
serotonin syndrome
headache, dizziness

35
Q

Aprepitant adverse effets

A

CYP 3A4 inhibitor
Ketoconazole inc serum levels
Contraindicated in patients on cisapride or pimozide, in whom life-threatening QT prolongation

36
Q

H1 Receptor Antagonist name

A

Diphenhydramine -> drowsy
Dimenhydrinate -> drowsy
Meclizine (Minimal anticholinergic properties)

37
Q

parietal cell receptors

A

H2: histamine -> Gs -> cAMP
CCKB: gastrin -> Gq -> IP3/DAG
M3: Ach -> Gq -> IP3/DAG

38
Q

Hyoscine (scopolamine) indication

A

motion sickness

39
Q

Metoclopramide MOA

A

Central D2 receptor antagonist with 5-HT3 receptor antagonist properties

40
Q

Prochlorperazine, Promethazine antiemetic effects

A

inhibition of dopamine and muscarinic receptors

41
Q

Olanzapine antiemetic effects

A

inhibition of dopamine D2 and serotonin 5-HT1c and 5-HT3 receptors

42
Q

Droperidol antiemetic effects

indication

A

dopamine blockade

indication: postoperative nausea and vomiting, in conjunction with opiates and benzodiazepines
* *not first line

43
Q

pregnancy nausea treatment

A

Pyridoxine (B6) + doxylamine (H1 antagonist)

44
Q

DIAZEPAM and LORAZEPAM are used

A

before the initiation of chemotherapy to reduce the anticipatory vomiting caused by anxiety

45
Q

Bethanechol, Carbachol MOA

A

Stimulate muscarinic M3 receptors on muscle cells and at myenteric plexus synapses
**uncoordinated motility

46
Q

Neostigmine MOA

A

Acetylcholinesterase inhibitor Increase the action of acetylcholine through inhibition of its metabolism at the myenteric plexus synapses
**uncoordinated motility

47
Q

Significant broad cholinergic effects

A
Bradycardia
Flushing
Diarrhea
Cramps
Miosis
Salivation
48
Q

METOCLOPRAMIDE and DOMPERIDONE MOA

A

inhibitor D2 receptor resulting in dec dopamine inhibition of gastric smooth muscle -> inc motility
- In addition to, antagonism on D2R Metoclopramide also presents HT4R agonism

49
Q

Cisapride
MOA
Adverse Effects

A

MOA: 5-HT4 agonist and weak 5-HT3 antagonist

Adverse Effects: prolonged QT interval, cardiac arrhythmia

50
Q

Tegaserod
MOA
Indication

A

MOA: partial 5-HT4 agonist
Indication: short term constipation in IBS

51
Q

Bulk-forming
Agents
MOA
Adverse Effets

A
MOA: absorb water, forming a bulky, emollient gel that distends the colon and promotes peristalsis
-Psyllium
-Methylcellulose
-Polycarbophil
Adverse Effects: bloating
52
Q

Docusate MOA

A

soften stool material, permitting water and lipids to penetrate
-soften stool material, permitting water and lipids to penetrate

53
Q

OsmoticLaxatives agents

A

Magnesium hydroxide

Magnesium citrate

54
Q

Magnesium citrate MOA

A

treatment of acute constipation or to cleanse the bowel prior to medical procedures

55
Q

Magnesium hydroxide
Magnesium citrate
adveres effects

A

diarrhea
dehydration
hypermagnesium

56
Q

Senna MOA

A

MOA: direct stimulation of the enteric nervous system and colonic electrolyte and fluid secretion
Adverse Effects: brown pigmentation of the colon known as “melanosis coli”

57
Q

Lubiprostone MOA

A

increases chloride-rich fluid secretion via stimulation of type 2 chloride channel (ClC-2) into the intestine, which stimulates intestinal motility and shortens intestinal transit time

58
Q

Linaclotide and Plecanatide MOA

A

stimulate intestinal chloride secretion by binding to and activating guanylate cyclase-C on the luminal surface
**contraindicated in pediatric children

59
Q

Methylnaltrexone
MOA
Indication
Adverse effect

A

MOA: inhibits peripheral u-opioid receptor without effecting CNS
Indication: opioid induced constipation
Adverse effect: cardiotoxicity

60
Q

Bismuth subsalicylate (Pepto-Bismol) MOA

A

antisecretory, anti-inflammatory, and antimicrobial effects. Bismuth also relieves nausea and abdominal cramps.

61
Q

Bismuth subsalicylate (Pepto-Bismol) indication

A
  • traveler’s diarrhea

- direct antimicrobial activity against H pylori

62
Q

Bismuth subsalicylate (Pepto-Bismol) adverse effects

A

Reye’s syndrome
Dark stool
Black staining of the tongue

63
Q

Loperamide MOA

A

agonist of u-opioid receptor without crossing BBB

64
Q

Diphenoxylate MOA

A

agonist of u-opioid receptor that has no analgesic effects at low dose but does at high dose
-prolonged use can lead to opioid dependence

65
Q

Diphenoxylate adverse effects

A

toxic megacolon

opioid dependence

66
Q

Loperamide indication

A

Traveler’s diarrhea in conjunction w antibiotics

67
Q

Octreotide indication

A

VIPoma
varices
carcinoid tumor
acromegaly

68
Q

Crofelemer indication

A

diarrhea associated with antiretroviral therapy for HIV/AIDS

69
Q

Crofelemer MOA

A

by inhibiting the cyclic AMP stimulated CFTR Cl− channel and Ca+2 activated chloride ion channels on the luminal aspect of the enterocyte -> reducing water loss associated w chloride secretion
-dont give if infection is present