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Pharmacology > Exam 2 but simplified > Flashcards

Exam 2 but simplified Flashcards

1
Q

Statins: Class, indications (1), MOA, AE (3), PK (3)

A

Class: HMG-CoA Reductase Inhibitors
Indications: High cholesterol blood lvl
MOA: Inhibits HMG CoA reductase → inc. LDL receptor proliferation → inc. LDL uptake into cell
AE: All rare, generally well tollerated
- Myopathy (rhabdomyolysis)
- Hepatotoxicity
- Renal injury
PK
- PO at night
- No grapefruit!
- Rosuvastatin is not well metabolized in Asian heritage

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2
Q

Colesevelam // Colestipol // Cholestyramine: Class, indications, MOA, AE

A

Class: Bile acid sequestrants
Indications: High cholesterol blood lvl
MOA: Nonabsorbable from GI tract → binds to bile acid → dec. reabsorption and inc. excretion of cholesterol
- Ultimately inc.s LDL receptors in the liver
AE: GI disturbance (constipation)

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3
Q

Ezetimibe: Indications, MOA, AE (4), PK

A

Indications: High cholesterol blood lvl
MOA: Act on brush border enzyme → prevents dietary cholesterol absorption and inhibits reabsorption of cholesterol secreted in the bile
AE:
- Myopathy (rhabdomyolysis)
- Hepatitis
- Pancreatitis
- Thrombocytopenia
PK: Converted to active metabolite ezetimibe glucuronide

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4
Q

Gemfibrozil // Fenofibrate: Class, indications, MOA, AE (4)

A

Class: Fibric acid derivatives (fibrates)
Indications: To lower VLDL levels
MOA: Inhibits hepatic extraction of free fatty acids → liver cannot synthesize as many triglycerides → dec. VLDL
AE: GI disturbances are most common
- Gallstones
- Myopathy
- Hepatotoxicity

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5
Q

Monoclonal antibody (PCSK9) inhibitor: Indications, MOA, AE (2), PK (2)

A

Indications: High cholesterol blood lvl
MOA: PCSK9 is a protein that binds LDL receptors in the liver
- Inhibition of PCSK9 = freed receptors = inc. LDL uptake
AE:
- Hypersensitivity
- Immunogenicity
PK: SubQ only
- Used with statins

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6
Q

ACL inhibitor: Indications, MOA, AE (2), PK

A

Indications: High cholesterol blood lvl
MOA: Inhibit ACL → dec. cholesterol synthesis → inc. LDL receptor proliferation → inc. LDL cell uptake
AE:
- Increase uric acid (gout risk)
- Increase tendon rupture risk
PK: Converted to active metabolite

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7
Q

Angiotensin-converting enzyme (ACE) inhibitors (-pril): Indications, MOA (5ish), AE (8), PK (3), Cont (2)

A

Indications: HTN
MOA: Inhibits ACE = Inhibition of ANG2 formation
- Inc. vasodilation
- Inc. diuresis, excrete out more Na
- Dec. SNS response = dec. myocardial O2 supply
- Prevention of CV remodeling
AE:
- HypoTN (first dose especially)
- HyperK
- Dehydration
- Cough
- Fetal injury
- Renal failure
- Rare: Angioedema, neutropenia
PK: PO (except enalapril, which is IV)
- All prodrugs (except lisinopril) that are converted in small intestine
- Long 1/2 life
Contraindications:
- Drugs that exacerbate hypotension or K+ levels
- Pregnancy

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8
Q

Angiotensin II receptor blockers (ARBs) (-artan): Indications, MOA, AE (6), PK

A

Indications: HTN
MOA: Blocks the effects of ANG2 at the receptor
- Inc. vasodilation
- Inc. diuresis, excrete out more Na
- Dec. SNS response = dec. myocardial O2 supply
- Prevention of CV remodeling
AE:
- HypoTN
- HyperK (low)
- Dehydration
- Cough (low)
- Fetal injury
- Renal failure
PK: All PO

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9
Q

Aliskiren: Class, indications, MOA (5ish), AE (6)

A

Class: Direct renin inhibitor
Indications: HTN
MOA: Inhibit release of renin = block entire RAAS
- Inc. vasodilation
- Inc. diuresis, excrete out more Na
- Dec. SNS response = dec. myocardial O2 supply
- Prevention of CV remodeling
AE:
- HypoTN
- HyperK
- Dehydration
- Cough, angioedema
- Fetal injury
- Diarrhea

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10
Q

Nifedipine: Class, indications (2), MOA (3), AE (5), Cont

A

Class: Ca channel blockers
- Dihydropyridines
Indications:
- Prinzmetal angina
- HTN
MOA: Blocks Ca2+ vascular smooth muscle
- Vasodilation of coronary arteries
- Dec. afterload
- Inc. contractility
AE:
- Peripheral edema
- Flushing
- Dizziness
- Headache
- Inc. myocardial O2 demand
Cont: No beta blockers

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11
Q

Verapamil // Dilitiazem: Class, indications (4), MOA, AE (6), cont (3)

A

Class: Ca channel blockers
- Non-dihydropyridines
Indications:
- HTN
- Angina
- Dysrhythmias
- SVT
MOA: Blocks Ca2+ @ vascular smooth muscle and the heart
- Dec. HR, contractility, AV node conduction
- Artery vasodilation → decrease afterload, coronary artery vasoconstriction
AE:
- Constipation
- Flushing, dizziness, headache
- Edema
- Bradycardia
- Heart block
- Hypotension
Contraindications:
- BB and Digoxin
- HF

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12
Q

Hydralazine: Class, indications, MOA, AE (5)

A

Class: Vasodilator
Indications: HTN
Actions: Dec. afterload
MOA: Unknown
- Direct arteriole vasodilation
AE:
- Fluid retention with long-term use
- Headache
- Dizziness
- Hypotension
- Reflex tachycardia

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13
Q

Sodium nitroprusside: Class, indications, MOA, AE, PK

A

Class: Vasodilator
Actions: Dec. preload
Indications:
- Prinzmetal angina
- HTN
MOA: Vasodilate veins via NO
AE: Tolerance can develop rapidly
PK: PO has insane first pass effect

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14
Q

Nitroglycerin: Class, indications, MOA, AE, Cont (4)

A

Class: Organic nitrates
Indications: HTN
- Angina
MOA: Converted to NO = NO activated guan = guan catalyzes cGMP = cGMP inhibits light chain = relax, vasodilation
AE: Tolerance
Contraindications:
Other hypotensive drugs + nitrates (ex: PDE5 inhibitors)
BB, CBB, diuretics

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15
Q

Digoxin: Class, indications, MOA, AE (5), Cont (4)

A

Class: Cardiac glycoside
Indications: HTN
MOA: Selectively inhibits Na/K/ATPase pump
- Build up of Ca2+ intracellularly = inc. actin/myosin interactions
AE: Heart dysrhythmia
GI: Anorexia + N/V (she’s so mean she causes bulimia)
CNS: Fatigue + visual disturbances
Contraindications:
Heart block
Bradycardia
Renal impairment
Electrolyte disturbances

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16
Q

Furosemide: Class, indications, MOA, AE (5), Cont (2)

A

Class: Loop Diuretics
Indications: HTN
MOA: Blocks Na/Cl/K cotransporter in ascending LoH → excrete Na+/K+/2Cl- in urine followed by water
AE:
- HypoK
- HypoNa+
- HypoCl-
- Ototoxicity
- Dehydration/hypotension
Contraindications:
Other ototoxic drugs (aminoglycoside antibiotics)
Digoxin

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17
Q

Hydrochlorothiazide (HCTZ): Class, indications, MOA, AE (6)

A

Class: Thiazide Diuretics
MOA: Block Na/Cl/K reabsorb @early distal convoluted tubule → these are excreted in urine followed by water
AE:
- HypoK
- HypoNa+
- HypoCl-
- Dehydration/hypotension
- Increase uric acid lvl (gout risk)
- Ineffective in kidney disease

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18
Q

Spironolactone: Class, indications, MOA, AE (3)

A

Class: K+ Sparing Diuretics
MOA: Blocks aldosterone
- Decrease prod of Na/K exchange protein transporter
- K+ retention, Na+/H2O excretion @late distal convol tubule
- Dec. remodeling of CV system
AE:
- HyperK
- Endocrine: Menstrual irregularities, gynecomastia

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19
Q

Mannitol: Class, indications, MOA, AE (2)

A

Class: Osmotic Diuretics
MOA: Freely filtered in GFR, stays in filtrate → draw water out to be excreted in urine
AE: Fluid overload/edema
- HF

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20
Q

Heparin // LMWH: Class, indications (5), MOA, AE

A

Class: Antithrombin activator
Indications:
- DVT/PE
- Open heart surgery
- Dialysis
- Disseminated intravascular coagulation (DIC)
- Acute MI
MOA: Activate antithrombin → inhibit coagulation factors to prevent
AE: Hemorrhage/bleeding

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21
Q

Warfarin: Class, indications (3), MOA, AE, PK (3)

A

Class: Vitamin K inhibitor
Indications:
- DVT/PE
- Thromboembolism in prosthetic heart valves
- MI/stroke risk
MOA: Inhibits enzyme that activates vitamin K → prevents synthesis of factors 2, 7, 9, 10 → dec. fibrin formation
AE: Hemorrhage/bleeding
PK:
- 99% protein bound
- Free drug crosses membranes (placenta, breastmilk)
- CYP450 hepatic metabolism

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22
Q

Dabigatran // Bivalirudin // Desirudin // Argatroban: Class, indications (2), MOA, AE (2), PK (2)

A

Class: Direct thrombin inhibitors
Indications: Prevent thrombosis
- DVT/PE
MOA: Inhibit thrombin → dec. conversion of fibrinogen to fibrin and activation of factor XIII → prevents fibrin mesh formation
AE: GI upset
- Hemorrhage/bleeding
PK:
- Food affects absorption rate
- Low protein binding

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23
Q

Rivaroxaban: Class, indications (3) , MOA, AE, cont

A

Class: Direct factor Xa inhibitors
Indications:
- DVT/PE
- Prevent thrombosis
- CVA
MOA: Inhibit factor 10a → prevent fibrin mesh formation
AE: Hemorrhage/bleeding
Cont: Pregnancy

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24
Q

Asprin: Class, indications (5), MOA, AE, PK

A

Class: COX inhibitor (irreversible)
Indications:
- Acute MI
- CVA
- TIA
- Chronic stable angina
- Stents
MOA: Inhibit COX → dec. platelet activation/aggregation, dec. TXA2 mediated vasoconstriction → inhibit platelet plug
AE: Hemorrhage/bleeding
PK: Effects last the lifetime of platelet

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25
Clopidogrel // Prasugrel // Ticagrelor: Class, indications, MOA, AE (2), PK (3)
Class: P2Y12 ADP receptor antagonists Indications: Prevention of stent thrombosis & thrombotic events MOA: Antagonize P2Y12 receptor so ADP can’t bind → dec. platelet activation/aggregation → inhibit platelet plug AE: Hemorrhage/bleeding
26
Vorapaxar: Class, indications, MOA, AE, PK
Class: PAR-1 antagonist Indications: Use with aspirin/clopidogrel in reduction of thrombotic events MOA: Reversible binding to PAR-1 receptors on platelet surface → dec. effects of thrombin → dec. platelet activation/aggregation AE: Bleeding/hemorrhage PK: Long half life
27
Abciximab: Class, indications, MOA
Class: GP IIb/IIIa receptor antagonists Indications: Short term to prevent ischemic events in those w/ ACS or undergoing PCI MOA: Blocks IIb/IIIa receptors on platelet  inhibition of final common step in platelet aggregation - Inhibits aggregation from all factors (collagen, TXA2, ADP, thrombin, platelet activation factor)
28
Alteplase (tPA) // Tenecteplase // Reteplase: Class, indications, MOA, AE
Class: Thrombolytic drugs Indications: Remove already formed clots - Acute MI - Acute stroke - Acute massive PE MOA: Binds to plasminogen -> plasmin - Plasmin breaks down already-formed clot AE: Special handling
29
Quinidine // Procainamide: Class, indications, MOA (3), AE
Class: IA antidysrhythmic - Na+ channel blocker Indications: Atrial and ventricular arrhythmias MOA: Blocks Na+ channel - Inc. AP - Inc. ERP - Inc. QT interval AE: Anticholinergic (inc HR)
30
Lidocaine: Class, indications (2), MOA (2), AE
Class: IB antidysrhythmic - Na+ channel blocker Indications: - Post MI - Ventricular arrhythmias MOA: Blocks Na+ channel - Dec. AP - Dec. ERP AE: Toxicity at high doses
31
IC antidysrhythmics: Class, indications (2), MOA, AE
Indications: - SVTs - Afib MOA: Blocks Na+ channel - Inc. ERP in AV node (but not ventricular tissue) AE: Can induce life-threatening VT
32
Metoprolol // Esmolol: Class, indications (3), MOA (3), AE (3)
Class: Beta blockers Indications: - SVT - VT - Post-MI MOA: Dec. HR, contractillity, AV node conduction AE: - Bradycardia - HypoTN - Can’t be given with CCB
33
Amiodarone: Class, indications, MOA (4), AE (8), PK
Class: K+ channel blocker Indications: VT MOA: Blocks K channel - Delay repolarization - Inc. AP duration - Inc. ERP - Prolongs QT AE: - Pulmonary fibrosis - Hypothyroidism - Hepatotoxicity - Prodysrhythmic: torsades, bradycardia, AV block - Corneal microdeposits - Skin discoloration PK: Extremely long half life (25-60 days)
34
Adenosine: Class, indications, MOA, AE (4), PK
Class: Class V antidysrhythmic Indications: VT MOA: Binds adenosine receptor in cardiac tissue → open K+ channel → hyperpolarize → prevent next contraction / temporary heart stop AE: - Flushing - Transient hypotension - Transient chest pain - Transient flat line PK: Extremely short half life (10 secs) → needs to be given w saline flush
35
Atropine: Class, indications, MOA, AE (3)
Class: Anti-cholinergic Indications: Symptomatic bradycardia MOA: M antagonism - Inc. HR AE: - Decreased GI/GU activity - Mydriasis - Dry mouth
36
Disulfram: Uses (1), AE (12)
Use: Unpleasant rxn w/ alcohol (abstinence) AE: - Nausea - Vomiting - Palpitations - Weakness - Blurry vision - Hypotension - Dysrhythmias - MI → CV collapse - Respiratory depression - Convulsions - Death
37
Naltrexone: Uses, MOA (2), AE (4)
Use: Dec craving ("most effective") MOA: blocks "fun" effects of alc, blocks opioid euphoria AE: - Nausea - Headache - Dizziness - Sedation
38
Acamprosate: Use
Blocks some bad abstinence feelings
39
Nicotine replacement therapy: MOA, Types (5) + their MOAs (5)
MOA: plasma nicotine rises slowly → less pleasure Types + their MOA: - Gum + lozenge: oral mucosa → systemic circulation - Patch: steady plasma nic concentration - Inhaler: looks like cig - Nasal: level rises quickly but w/o toxic chemicals
40
Buproprion: Use (2), AE (4), Contraindications (2)
Use: Reduce nicotine cravings, lessen withdrawal symptoms AE: - Dry mouth - Insomnia - Headache - Seizures Contraindications: - Seizures with alcohol - MAOI use
41
Varencline: Use (1), MOA (3), AE (6)
Use: Nicotine abstinence MAOI: - Block pharmacological effects of nicotine - Promote dopamine release - Partial NAChR agonist AE: - Headache - Nausea - Constipation - Dry mouth - Taste change - Flatulence
42
Methadone: Class, MOA (1), Special (1)
- Class: opioid substitute - MAOI: substitute with longer 1/2 life → less euphoria - Special: higher dose to increase tolerance → street opioid doesn't work
43
Buprenorphine: Class, MOA, Uses (3)
Class: Opioid agonist-antagonist MAOI: Mu agonist, kappa antagonist Uses: - Alleviate cravings - Reduce use - Ceiling to respiratory depression (SAFER)
44
Naloxone (Narcan): Class, DOA, MOA
Class: opioid antagonist DOA: 1hr MOA: Antagonist mu + kappa
45
Flumazenil: Class, MOA, Use (2)
Class: Benzo abstinence MOA: Reverse sedation Use: - Taper - Less withdrawal symptoms
46
Marijuana: MOA (4), Indications (5)
MOA: - THC lipid soluble - Rapid absorption via inhalation - CYP450 inhibitor - Cannabinoid receptor activity in the brain Indications: - Suppress emesis (cancer) - Stimulate appetite in AIDs pts - Seizures - Neuropathic pain - Various unapproved
47
Levodopa: Uses (1), Special (5), AE (6), Contraindications (1)
Uses: Severe PD → most effective Special: - Effects diminish over 5 years - Prodrug → needs to convert to dopamine - Needs help crossing BBB - Need COMT inhibitor + decarboxylase inhibitor - Don't eat high-protein meals AE: - Nausea/vomiting - Dyskinesia - Post-orthostatic hypotension early - Dysrhythmia risk - Psychosis - Anxiety Contraindication: MAOIs (severe HTN)
48
Carbidopa: MOA, Special (3)
MOA: decarboxylase inhibitor Special: - Take WITH Levodopa - NO effects on own - NO crossing BBB
49
Entacapone: MOA, Special (3)
MOA: COMT inhibitor Special: - Take WITH Levodopa - Dec peripheral AE - NO effects on own
50
Pramipexole, Ropinirole, Rotigotine: Class (2), Use, AE (5), Special (2)
Class: - Dopamine selective agonist Use: mild-moderate PD AE: - Nausea/vomiting - Dizziness - Constipation - Weakness - Hallucinations Special: - NO dyskinesia - DO NOT take 5-HT antagonists (orthohypo) or dopamine receptor antagonists (opp effect) if N/V
51
Apomorphine: Class (2), Use, Special (2), AE (6)
Class: - Dopamine agonist - Nonergot alkaloid Use: Hypomobile episodes Special: - NO PO - Morphine derivative AE: - Injection site rxn - Hallucination - Drowsiness - Dyskinesia - Nausea/vomiting - Serious CV events
52
Selegiline: Class, Use, AE (5), Interactions (4)
Class: Irreversible MAO-B binding Use: FIRST LINE mild-moderate PD AE: - HTN (MAO-A binding @ high dose) - Orthostatic hypotension - Dizziness - GI excite - Insomnia Interactions - Intensify Levodopa - Increase AE of opioids - Serotonin syndrome risk (opioids) - Serotonin syndrome risk (SSRIs)
53
Rosagiline: Class, Use, AE (4), Interactions (4)
Class: Irreversible MAO-B binding Use: FIRST LINE mild-moderate PD AE: - HTN (MAO-A binding @ high dose) - Orthostatic hypotension - Dizziness - Malignant melanoma Interactions - Intensify Levodopa - Increase AE of opioids - Serotonin syndrome risk (opioids) - Serotonin syndrome risk (SSRIs)
54
Amantadine: MOA, Use, AE (5)
MOA: Increase dopamine Use: help with dyskinesia via Levodopa AE: - Confusion - Dizziness - Anxiety - Peripheral effects - Mottled discoloration (>1 mo use)
55
Benzotropine: Class, Use, MOA, AE (4)
Class: Anticholinergic Use: 2nd line for tremors MOA: Block M receptors AE: - Sedation - Confusion - Hallucination - Peripheral AEs
56
Donepezil: Class (2), Special (1), AE (3), Contraindications (2)
Class: - Reversible AChE inhibitor - Selective for CNS but some PNS Special: Long 1/2 life (70hr) + time to plateau (15d) AE: - Peripheral chole effects - Bradycardia - Heart block Contraindications - COPD - Anticholinergics
57
Rivastigmine: Class (2), AE (3), Contraindications (2)
Class: - Irreversible AChE inhibitor - More PNS than CNS AE: - Peripheral chole effects - Bradycardia - Heart block Contraindications - COPD - Anticholinergics
58
Galantamine: Class (1), AE (3), Contraindications (2)
Class: Reversible AChE inhibitor AE: - Peripheral chole effects - Bradycardia - Heart block Contraindications - COPD - Anticholinergics
59
Memantine: Class (1), Special (2), Drug interaction (1)
Class: NDMA receptor antagonist Special: - Minimal AE - Allows normal cell signaling Interaction: Other NDMA blockers (ketamine, amantidine)
60
Interferon beta: Class (1), Use, AE (9), Special (1)
Class: Immunomodulator Use: MS AE: - Hypersensitivity rxn - Neutralize antibody production - Infection - Hematological changes - Liver injury - Decrease vaccine responsiveness - Flu-like rxn - Depression - Injection site rxn Special: Pregnant RNs handle with care!
61
Mitoxantrone: Use, Class (1), MOA (1), AE (4)
Use: MS Class: Immunosuppressant MOA: Inhibit DNA synthesis/repair → dec demyelination AE: - Myelosuppression (all -nias) - Irreversible cardiotoxicity → heart failure - Fetal injury - Cancer + infection
62
Dalfampridine: Class (1), Use (1)
Class: K+ channel blocker Use: Gait issues
63
Traditional anti-seizure drugs: overall
LOTS of AEs and drug interactions
64
Penytoin: MOA, Type, AE (6), Special (1), Drug interactions (3)
MOA: Selective Na+ channel inhibitor on HYPERACTIVE neurons Type: Traditional anti-seizure medication AE: - CV effects (DILUTE to avoid) - CNS depression - Gum issues - Skin issues - Teratogen - Necrosis w/ extravasation Special: High toxicity risk → monitor dose Interactions: - Decreases the effects of other drugs - Affected by CYP450 inhibitors/inducers - Avoid with other CNS depressants
65
Fosphenytoin: Type (2), MOA
Type: prodrug, traditional antiseizure med MOA: converts to penytoin
66
Carbamazepine: MOA, Type, AE (4), MOA (1)
MOA: Selective Na+ channel inhibitor on HYPERACTIVE neurons Type: Traditional anti-seizure medication AE: - CNS depression - Bowel movement suppression - H2O retention - Skin issues MOA: Metabolized by + induces CYP450
67
Valproate: MOA, Type, AE (6), Drug Interaction (1)
MOA: Enhance GABA transmission + Na+ block Type: Traditional anti-seizure medication AE: - Life-threatening pancreatitis - Fetal liver failure - Teratogen - Weight gain - Hair loss - Tremors Interaction: DON'T combine with other antiseizure drugs → CNS depression
68
Ethosuximide: Use (1), Type, MOA, Special (1)
Use: Absence seizures Type: Traditional anti-seizure medication MOA: Suppress Ca+ channels Special: Minimal AE
69
Phenobarbital: MOA, Type, Special (2), AE (4)
MOA: Potentiate GABA effects (Direct receptor agonist) Type: Traditional anti-seizure medication Special: - Long 1/2 life (4 days) - Used for anesthesia AE: - CNS depression - Acute intermittent porphyria - Vitamin D metabolism interference - Physical dependence
70
Oxcarbazepine: MOA, Type, AE (5), Drug interactions (4)
MOA: Na+ channel inactivation Type: New-gen anti-seizure meds AE: - CNS depression - Hyponatremia - Hypothyroidism - Skin issues - Hypersensitivity Interactions: - Other antiseizure medication - CYP450 inducer - Avoid alcohol - Avoid other hyponatremic drugs
71
Lamatrigine: MOA (2), Type, AE (1), Contraindication (1)
MOA: - Na+ channel inactivation - Ca+ channel blockage Type: New-gen anti-seizure meds AE: Suicidal ideation (?) Contraindication: Estrogen decreases levels (OC)
72
Gabapentin: MOA, Type, Special (1)
MOA: Enhance GABA release (?) Type: New-gen anti-seizure meds Special: Well tolerated
73
Pregabalin: MOA (3), Type, AE (3)
MOA: - Bind Ca+ presynaptically - Inhibit glutamate - Inhibit norepinephrine Type: New-gen anti-seizure meds AE: - Hypersensitivity - Euphoria - Decreased fertility
74
Levetiracetam: Type, AE (1)
Type: New-gen anti-seizure meds AE: Maybe renal injury?
75
Topiramate: MOA (3), Type, AE (2), Drug interaction (1)
MOA: - Na+ block - Ca+ block - Glutamate receptor block Type: New-gen anti-seizure meds AE: - Metabolic acidosis - Increase suicidal ideation Interaction: Penytoin
76
Tiagabine: MOA (1), Type
MOA: Dec GABA reuptake Type: New-gen anti-seizure meds
77
Baclofen: Use (1), MOA (1), AE (5), Contraindications (3)
Use: Muscle spasticity MOA: Mimics GABA @ synaptic cleft (does NOT decrease muscle strength) AE: - CNS depression - OD→ coma + respiratory depression - Nausea/vomiting - Constipation - Withdrawal symptoms Contraindications: - CNS depressants - Urinary retention - Psych conditions
78
Dantrolene: Use (1), MOA (1), AE (4), Contraindication (1)
Use: Muscle spasticity MOA: Decrease Ca+ effux from the sarcoplasmic reticulum AE: - Decrease strength/function - Hepatic toxicity - Drowsiness - Diarrhea Contraindication: - CCB
79
Cyclobenzaprine: Use (1), MOA (1), AE (2), Drug interactions (2)
Use: Muscle spasms MOA: Acts on brainstem to motor neuron pathways AE: - CNS depression - Cardiac rhythm changes Interactions: - Serotonin syndrome risk (MAOIs, TCAs, SSRIs, SNRIs) - CNS depression with depressants (alcohol
80
2 types of localized anesthetics + what metabolizes them
Esters: plasma esterase Amides: hepatic enzymes
81
Chloroprocaine, Benzocaine: Class, MOA (1), AE (8), Special (1)
Class: Ester MOA: Block Na+ channels AE: - CNS excitation → CNS depression - Bradycardia - Heart block - Decrease contractility - Cardiac arrest - Vasodilation - Allergic rxn - Fetal toxicity (ion trapping) Special: AVOID IV injection for nerve blocks
82
Methemoglobinemia: MOA
Convert Hgb → MetHgb (can't carry O2)
83
Cocaine: Class, MOA (2), Contraindications (1)
Class: Ester MOA: - Block Na+ channels - Block NE reuptake Contraindications: Any CV disease
84
Lidocaine: Class, MOA, Administration (3)
Class: Amide MOA: Block Na+ channels Administration: - Topical - IV - Injection
85
General anesthesia: General indication (1), Special (1)
General indication: Loss of consciousness → decreased response to painful stimuli Special: Does NOT imply pain relief
86
Propofol: MOA (3), AE (6), Onset time
MOA: -Enhance GABA → hyperpolarization → hard to get an AP - Inc CNS depression - Low dose for sedation, high for anesthetic AE: - Apnea - Hypotension - Reflex tachycardia - Reflex bradycardia - Injection site pain Onset time: <60sec
87
Ketamine: MOA (2), Indications (2), AE (2)
MOA: - Dec NMDA transmission - Dec CNS excitation Indications: - Analgesia - Dissociative anesthesia AE: - Hallucinations → maintain peaceful environment - Bad dreams
88
Inhalation general anesthesia: AE (5)
Respiratory depression - Cardiac depression - Sensitive the myocardium to catecholamines → dysrhythmias - Nausea/vomiting post-op
89
NSAIDs: MOA (1), Actions (9)
MOA: COS inhibiters dec COS activity → dec conversion of arachidonic acid to prostaglandins, prostacyclin, TXA2 Actions: - Dec inflammation - Dec pain receptor sensitivity - Inc gastric acid secretions - Dec platelet aggregation - Dec vasodilation - Dec vasodilation of renal artery - Mediate fever - Dec perception of pain - Dec long-term uterine contractions
90
Aspirin, Ibuprofen: MOA (2), Indications (5), AE (5), Contraindications (4), Drug Interactions (4)
MOA: - Nonselective COX inhibitor (1st gen) - Aspirin irreversible binding → high levels of inhibiting platelet aggregation Indications: - Suppress inflammation - Analgesia of mild-mod pain - Fever reduction - Suppress platelet aggregation - Cancer prevention (colorectal) AE: - GI effects - Renal impairment - Reye syndrome - Toxic to fetus - Hypersensitivity rxn Contraindications: - Bleeding disorder - Propensity for bleeding - Children - Pregnancy Drug interactions: - Anticoagulants → inc bleeding - Glucocorticoid → gastric ulcers - ARBS/ACEi → renal impairment - Vaccines → suppress immune response
91
Celecoxib: MOA, Indications (3), Special (2), AE (3), Contraindications (2)
MOA: Selective COX-2 (2nd gen) Indications: - Rheumatoid arthritis - Ankylosing spondylitis - Acute pain Special: - Less AE due to dec inhibition of "good" COX - No suppression of platelet aggregation + inhibiting vasodilation AE: - GI ulcer (low) - Renal impairment - Biggest concern: CV events Contraindications: - Heart disease - Coronary artery bypass
92
Acetaminophen: MOA (2), Indications (5), Special (3), AE (4)
MOA: - COX inhibitor - NOT NSAID Indications: - Pain relief + fever - NO anti-inflammatory - NO platelet aggregation suppression - NO GI disturbance - NO change in renal blood flow Special: - Only works in CNS - Major metabolization CYP450 oxidation - @ high doses: run out of glutathione → toxic metabolite accumulate + liver damage AE: - OD → liver dmg (4g/day MAX) - NVD - Sweating - Hepatic injury

Pharmacology (15 decks)

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