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Pharmacology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the 3 drugs for Cushing Syndrome?

A
  • ketoconazole: inhibits glucocorticoid synthesis, hepatotoxic
  • Pasireotide: inhibits ACTH secretion
  • osilodrostat: inhibits glucocorticoid synthesis
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2
Q

which is shorter acting: meglitinides or sulfonylureas?

A

meglitinides

must be taken with meals!

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3
Q

what are the two alpha glucosidase inhibitors

A

acarbose

miglitol

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4
Q

Whats the AE of nifedipine as a tocolytic?

A

Decrease uteroplacental blood flow

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5
Q

What is the AE of indomethancin?

A

Can precipitate premature closing of ductus arteriosus

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6
Q

What drug is used to prevent preterm labor

A

Hydroxyprogesterone caproate

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7
Q

What 3 things can misoprostol be used for?

A

Postpartum hemorrhage, induction of labor, abortion (w/ mifepristone)

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8
Q

3 sulfonylureas

A

Glimepiride
Glipizide
Glyburide

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9
Q

What do sulfonylureas do?

A

Bind and block ATP k+ channels in panceeatic beta cells allowing for a a Ca+ influx and insulin release

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10
Q

What are the 2 meglitinides

A

Nateglinide

Repaglinide

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11
Q

Incretin

A

Hormone that stimulates glucose dependent insulin release and suppresses glucagon release post meals

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12
Q

Which drugs increase incretin effects

A

Dipeptidyl peptidase 4 inhibitors

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13
Q

What drugs mimic incretin

A

Glucagon like peptide 1 receptor agonists (the tides)

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14
Q

Eztimibe MOA

A

Acts on brush border of small intestine and inhibits dietary cholesterol absorption and absorption of cholesterol in the bile

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15
Q

Fibric acid derivatives MOA

A

Inhibit hepatic extraction of free fatty acids so the liver cant synthesIze as many TGs

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16
Q

2 enzymes involved in cholesterol synthesis

A

HMG-Coa

ACL

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17
Q

Indications for direct thrombin inhibitors

A

A fib

Knee and hip replacement

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18
Q

Which direct thrombin inhibitor cant be given PO

A

Bivalirudin

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19
Q

T/F: warfarin is contraindicated in pregnancy

A

True

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20
Q

What kind of drug is rivaroxaban

A

Direct Xa inhibitor

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21
Q

Which p2y12 receptor antagonist is reversible

A

Ticagrelor

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22
Q

Most powerful antiplatelets

A

Gp IIb/IIIa receptor antagonists

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23
Q

What drug removes thrombins that already exist

A

Alteplase = tissue plasminogen activator

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24
Q

What do you use calcium gluconate for

A

Hyperkalemia and hyper magnesemia

Offsets hyper k effects on the heart

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25
Q

What are the two thiomaides (drugs for hyperthyroidism)?

A

Methimazole

PTU

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26
Q

What are the SERMs

A

Tamoxifen
Raloxifene
Bazedoxifene

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27
Q

What are the non oral drugs for ED

A

Alprostadil

Papverine + phentolamine

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28
Q

What are the two testosterone esters

A

Testosterone enanthate

Testosterone cypionate

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29
Q

Metformin MOA

A
  • inhibits glucose production in the liver
  • sensitizes insulin receptors in target tissues
  • reduces glucose absorption in the gut
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30
Q

Sulfonylurea MOA

A

-binds and blocks ATP K+ channels in pancreatic beta cell membranes → Ca+ influx and insulin release

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31
Q

meglitinide MOA

A
  • stimulate pancreatic beta cell release of insulin
  • shorter acting than sulfonylureas
  • taken with meals only
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32
Q

glitazones MOA

A

Activate PPAR gamma → glitazones turn on insulin responsive genes in the cell nucleus that regulate carbohydrate and lipid metabolism → cellular insulin response are increased → promotes glucose uptake by skeletal muscle and adipose cells and decreases glucose production by the liver

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33
Q

Sodium Glucose Cotransporter 2 inhibitors MOA

A

-inhibits SGLT2 in renal tubules which allows increased renal excretion of glucose in proximal tubules → excrete excess glucose

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34
Q

effect of myelin mimetic

A

delays gastric emptying, suppression of glucagon

-to decrease glucose rise post meals

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35
Q

amiodarone

A

K+ channel blocker

36
Q

adenosine MOA

A

Binds to A1 receptors → activates opening of K+ channels → hyperpolarization, inhibition of pacemaker cells

potent vasodilator

37
Q

what drug treats BPH and ED?

A

tadalafil

38
Q

what are the 4 direct thrombin inhibitors

A
  • dabigatran
  • desirudin
  • bivalirudin (IV infusion)
  • argatrobin
39
Q

Protease Activated Receptor 1 (PAR-1) Antagonist

A

vorapaxar

40
Q

GP IIb/IIIa Receptor antagonists (3)

A
  • abciximab
  • tirofiban
  • eptifibatide
41
Q

P2Y12 ADP Receptor Antagonists (3)

A
  • clopidogrel (irreversible)
  • prasugrel (irreversible)
  • ticagrelor (reversible)
42
Q

HTN of pregnancy drugs

A

labetalol or methyldopa

43
Q

side effect of sodium nitroprusside

A

cyanide toxicity d/t long term use

44
Q

AE of digoxin

A

Too much: Cardiac dysrhythmias
Most common cause: hypoK+
GI effects: anorexia, N/V
CNS effects: fatigue and visual disturbances
**GI and CNS effects will precede dysrhythmias and act as a warning sign

45
Q

how long does it take for spironolactone to act and why?

A

Onset is 48 hours - lifecycle of current exchange proteins needs to die off

46
Q

osmotic diuretic indications

A

Only used in certain situations like severely increased ICP or Intraocular pressure

47
Q

which diuretic is best for decreased GFR?

A

loop

48
Q

what increases risk for gout (increased uric acid crystals)?

A

ACL inhibitors

thiazide diuretics

49
Q

contraindication of osmotic diuretics

A

Caution with HF and pulmonary edema risk

50
Q

beta blockers effects

A

decreased HR, decreased contractility, decreased node conduction velocity

51
Q

life threatening adverse effect of ACE inhibitors?

A

angioedema

neutropenia

52
Q

AE of hydralazine

A
  • SLE like syndrome
  • HA
  • dizziness
  • fatigue r/t hypotension
  • fluid retention with long term use
53
Q

for what drugs is heart block a contraindication?

A

digoxin
nondihyradpyrodines (vera and dil)
adenosine (high grade heart block)

54
Q

important dosing info for nitroglycerin

A

use lowest effective dose because tolerance can develop rapidly

55
Q

pros of tight glucose control

A

decreased CKD
decreased neuropathy
decreased opthalamic complications
decreased CV events

56
Q

risks of tight glucose control

A

hypoglyemia and hypoglycemic coma

57
Q

bile acid sequestrants MOA

A

Nonabsorbable resin that binds bile acids and other substances in GI tract, prevents absorption and promotes excretion of LDL cholesterol
*bile acids are made from cholesterol

58
Q

Monoclonal antibody PCSK9 inhibitors MOA

A

-PCSK9 = protein that binds LDL receptors in the liver → inhibition = freed receptors = more LDL uptake

59
Q

Ezetimibe AE

A
  • myopathy/rhabdo
  • hepatitis, pancreatitis
  • thrombocytopenia
60
Q

Which lowers LDL levels the most when used alone?

A

Monoclonal antibody PCSK9 inhibitors

61
Q

signs and symptoms of myopathies

A

aches, tenderness, weakness) → can lead to CK + K+ increase which can lead to renal injury

62
Q

what triggers intrinsic pathway

A

blood makes contact with a collagen that has been exposed as a result of trauma to blood vessel wall
Collagen contact simulations XII to XIIa → activates XI which activates IX which activates X

63
Q

what triggers extrinsic pathway

A

damage to vascular wall → release of tissue factor → combines with VII → activates factor X → catalyzing of factor II (pro thrombin) and IIa (thrombin)

64
Q

indications for direct Xa inhibitor

A
  • PE/DVT prevention after ortho procedures
  • CVA prevention with a fib
  • DVT/PE prevention
  • treatment of DVT / PE
65
Q

how to treat acute hemorrhage?

A
  • whole blood replacement
  • FFP
  • aminocaproic acid - will prevent further plasminogen activation
66
Q

MOA of thyroid hormone

A 
iodine uptake via TSH stimulation
iodine gets converted to iodide via peroxidase
binding of iodide and tyrosine
coupling of MIT and DIT 
T3 and T4 created
T4 converts to T3
67
Q

what drugs does levothyroxine alter

A
  • warfarin - increased effects b/c increases breakdown of vit K clotting
  • catecholamines - increases sensitization of myocardium
68
Q

What are your biggest concerns when monitoring your patient taking PTU?

A
  • Can result in goiter

- severe: agranulocytosis, hepatotoxicity, other: vasculitis rash, arthralgias

69
Q

cause of Toxic Nodular Goiter

A

Thyroid adenoma

s/s same as Graves except exophthalmos

70
Q

absolute CIs for OCs/HT

A 
Pregnancy
Breast or endometrial CA
Acute liver disease
Uncontrolled HTN
Thrombosis
Undiagnosed vaginal bleeding
71
Q

Dihydropyridines

A
  • arteriole vasodilation → decreases afterload, lowers arterial pressure
  • reflex tachycardia/contractility increase
72
Q

Antiarrhythmic drugs 4 classes

A

Class I: Na+ channel blockers
Class II: BB
Class III: K+ channel blockers
Class IV: Ca++ channel blockers

73
Q

what glucocorticoid is identical to cortisol

A

hydrocortisone

74
Q

antiarrythmics used for ventricular tachycardia - what to use?

A

Na+ blockers or K+ blockers

75
Q

antiarrythmics originating above the AV node - what to use?

A

Ca+ blockers or beta blockers

76
Q

what would you use if patient has severe tachycardia but you don’t know why?

A

adenosine

77
Q

what BPH drugs target mechanical obstruction

A

PDE 5 inhibitors

78
Q

which BPH drugs target dynamic obstructin (smooth muscle)

A

Alpha 1 adrenergic antagonists

  • selective: silodosin, tamsulosin
  • Nonselective - doxazosin, terazosin
79
Q

what solution would you give if blood is hypertonic?

A

1/2 NS (.45% NaCl)

80
Q

if you blood is isotonic, what solution do you give?

A

0.9% NS
D5W
D5LR

81
Q

if blood hypotonic, what solution do you give?

A

3 or 5% NaCl

D10W

82
Q

eplerenone

A

aldosterone antagonist

83
Q

adverse effects of metformin

A
  • GI upset
  • decrease folic acid/B12 absorption
  • lactic acidosis - inhibits mitochondrial oxidation of lactic acid (rare)
84
Q

INR

A

INR normal values - .8-1.1

Therapeutic INR for warfarin is 2-3

85
Q

drugs for preload

A

Diuretics

ACE, ARBs, aldosterone antagonists

86
Q

drugs for afterload

A

ACE, ARBs
BB - would reduce already reduced contractility
Arteriolar vasodilators

Pharmacology (6 decks)

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