Exam 2 - Drugs Flashcards
Albuterol
- Bronchodilators
- relaxes smooth muscle
- most widely prescribed and most effective agents for treatment of bronchoconstriction
- Beta 2-adrenergic agonists
** people with asthma should not take beta (2?) blockers!
Prednisone
- Anti-inflammatory agent
- Glucocorticoid
- inhibits production of inflammatory mediators
- reduces smooth muscle hyper-reactivity and decreases constriction
- inhaled steroids are most effective and prescribed most for inflammation
***drug of choice in newly diagnosed asthma
- Treatment of Inflammatory bowel disease (IBD)
- drug of choice for acute attacks
- inhibits inflam mediators
Olsalazine
- Treatment of IBD
- drug of choice for reoccuring IBD
Montelukast
- (singulair)
- Anti-inflammatory agent
- leukotrience receptor antagonist
- Decreased inflammation and bronchoconstriction
- aspirin-induced asthma
Zafirlukast
- (accolate)
- Anti-inflammatory agent
- leukotrience receptor antagonist
- Decreased inflammation and bronchoconstriction
- aspirin-induced asthma
Omeprazole
- (Prilosec)
- treatment of excess acid
- K+/H+ ATPase inhibitors
- GERD
Lansoprazole
- (prevacid)
- treatment of excess acid
- K+/H+ ATPase inhibitors
- GERD
Bismuth subsalicylate
- (Pepto bismol)
- Treatment of excess acid
- Bismuth compounds + antibiotics
- forms protective barrier (good drug!)
- H. pylori
- also treats diarrhea
Cimetidine
- (tagamet)
- treatment of excess acid
- Histamine (H2) receptor antagonists
Ranitidine
- (Zantac)
- Treatment of excess acid
- Histamine (H2) receptor antagonist
Famotidine
- (Pepcid)
- Treatment of excess acid
- Histamine (H2) receptor antagonist
Dimenhydrinate
- (dramamine)
- anti-emetic (vomiting)
- for motion sickness
Misoprostol
- (cytotec)
- Prostaglandin agonist
- helps prevent ulcers in patients on NSAIDs (combats aspirin anti-prostaglandin stuff)
- side effect
- stimulates abortion
Mg/Al hydroxide (Maalox)
- Al hydroxide = constipation
- Mg hydroxide = laxative
*** Maalox = both. Best drug for antacid!
Loperamide
- Treatment of diarrhea
- BEST OTC choice
Lorazepam
- Used for stage fright-induced or anticipatory vomiting
Mg hydroxide
- (Milk of magnesia)
- Treats constipation (laxative)
- MOA
- water and electrolyte retaining cathartic (laxitive)
- may produce dehydration
Captopril
- ACE inhibitor
- reduces risk of cardio mortality caused by hypertension
- adverse effects = first-dose hypotension and cough
- used for
- Heart failure and hypertension
- MI
- _Diabetic nephropathy _
Lisinopril
- ACE inhibitor
- reduces risk of cardio mortality caused by hypertension
- adverse effects = first-does hypotension and cough
- used for
- hypertension and heart failure
- MI
Losartan
- Ang II receptor blocker (ARBs)
- blocks action of Ang II
- dilation of arterioles and veins
- decreases aldosterone
- blocks action of Ang II
- Uses
- diabetic nephropathy
***ARBs end in “SARTAN”
Eplerenone
- Selective aldosterone receptor blocker
- uses
- only for hypertension
- excretion of sodium and water
- adverse effects
- hyperkalemia
Nifedipine
- Calcium channel blocker
- acts on Arterioles
- uses
- Hypertension
- Angina
- Hemodynamic effects
- direct: blocks channels in VSM = dilation
- indirect: NE released & increased heart rate
- Overall: lowers BP, increases HR, increases contractile force
**Drug of choice for people with cardiac failure!
Verapamil
- Calcium channel blocker (Class IV)
- acts on: arterioles and heart
- uses
- Hypertension
- angina
- dysrhythmias
- Migraine
- Hemodynamic effects
- direct = reduce AV conduction, reduce heart rate
- Indirect = NE released & increases heart rate
*** same as diltiazem
diltiazem
- Calcium channel blocker (class IV)
- acts on: arterioles and heart
- uses
- Hypertension
- angina
- dysrhythmias
- Migraine
- Hemodynamic effects
- direct = reduce AV conduction, reduce heart rate
- Indirect = NE released & increases heart rate
*** same as Verapamil
Hydralazine
- Vasodilator
- works on arterioles
- for: hypertension, hypertensive crisis, heart failure
- adverse effects
- reflex tachycardia
- inc. blood vol
- systemic lupus-like syndrome
- min hypotension
Minoxidil
- Vasodilator
- works on arterioles
- uses:
- severe hypertension
- hair growth (rogaine)
- adverse effects
- reflex tachycardia
- sodium and water retention
- hair growth (hypertrichosis)
Sodium Nitroprusside
- Vasodilator
- works on arterioles/veins
- for hypertensive emergencies
- adverse effects
- excessivey hypotension
- cyanide poisoning
- thiocyanate toxicity
Digoxin
- Drug for heart failure
- Cardiac glycoside
-
positive ionotropic action
- increases force of contraction/CO
- inhibits Na+/K+ ATPase
- Calcium accumulation
- facilitates interaction of myosin/actin
- Therapeutic effects: inc contractility, inc urine production, reduce HR & afterload & venouse pressure, dec heart size
- Adverse effects
- dysrhythmias
- visual disturbances (blurred/yellow vision)
***does not prolong life! only provides systomatic relief
Spironolactone
- drug for heart failure
- Potassium-sparing diuretic
- aldosterone receptor blocker
- (aldosterone promotes remodeling of heart)
- (fibrosis and rise in HF)
- (aldosterone promotes remodeling of heart)
- adverse effects
- gynecomastia
- hyperkalemia
Quinidine
- Class I: Sodium channel blocker
- decreas conduction in atria, ventricles, & His-purkinje system
- Class IA
- similar to anesthetics
- acts
- heart: delays repolarization
- EKG: Widens QRS, prolongs QT
Lidocaine
- Class I: sodium channel blocker
- decrese conduction in atria, ventricles, & His-purkinje system
- Class IB
- Heart: accel repolarization
- EKG: no effects
Propranolol
- Class II: beta-blocker
- Effects Beta 1 and 2 receptors
- heart: decreased velocity of conduction (also blocks calcium channels)
- EKG: prolonged PR interval
-
Contraindication
- Asthma patients
Bretylium
- Class III: Potassium channel blocker
- Uses
- short-term therapy
- heart: delay repolarization
- EKG: prolong QT interval
- side effects: hypotension
Amiodarone
- Class III: potassium channel blocker
- use
- heart: delay repolarization
- EKG:
- QRS widening, PR/QT lengthening
- side effects: lung damage, visual impairment, prodysrhythmias
HMG-CoA reductase inhibitors (statins)
- Drug to alter plasma lipids
- LDL = dec
- HDL = inc
- TG = dec
- MOA
- inhibits enzyme needed for cholesterol synthesis
Nicotinic acid
- drug to alter plasma lipids
- LDL = dec
- HDL = inc
- TG = dec
- MOA
- decrease VLDL (LDL are byproducts of VLDL)
***Start with “NIA” (niaspan, niacor)
Bile-acid sequestrants
- Drug to alter plasma lipids
- LDL = dec
- HDL = inc
- TG = no change
- MOA
- cholesterol is required to produce bile-acid. Liver cells inc LDL receptors thereby increasing LDL uptake
Fibric acid (fibrates)
- Drugs to alter plasma lipids
- LDL = little/no effect
- HDL = inc
- TG = lower
- MOA
- accelerate clearance of VLDL thereby reducing TG
Nitroglycerin
- Treatment for angina pectoris
- organic nitrates (nitrostat, Nitrolingual)
- stable angina = dec o2 demand
- variant angina = inc o2 supply
- ***people develop tolerance!! need to cycle and stuff
Heparin (unfractionated)
- Parenteral anticoagulants
- actions
- helps antithrombin inactivate clotting factors
- suppresses formation of fibrin
- needs lab monitoring
Low-molecuar weight heparins
- Parenteral anticoagulants
- uses
- DVT following hip/knee replacement
- no lab monitoring needed
Warfarin (coumadin)
- Oral anticoagulants
- MOA
- antagonist of Vit. K which is needed for clotting factors
Streptokinase (streptase)
- Thrombolytic drug
- remove thrombi
- binds to plasminogen to form plasmin which digests fibrin
- ***made from a bacteria
- side effects = allergic rx, hypotension, fever, bleeding
Alteplase or tPA (activase)
- Thrombolytic drug
- remove thrombi
- binds to plasminogen to form plasmin which digests fibrin
- ***made in a lab
- tissue plasminogen activator
- Recombinant DNA technology
- side effects = intracranial bleeding
Phenytoin
- MOA
- stops sodium influx
- Treats
- partialized and generalized
- difficult kinetics
- side effects
- overgrowth of gums
- thickening of facial hair
Carbamazepine
- MOA
- stops sodium influx
- Treats
- partial & generalized & bipolar
- NOT absence seizures
Valproic acid
- MOA
- increase GABA conc and dec calcium/sodium
- Treats
- partial & generalized, bipolar disease, and migraines
Ethosuximide
- MOA
- dec calcium
- Treats
- ONLY absence (drug of choice for absence)
- **among the safest antiseizure drugs
Phenobarbital
- MOA
- GABA
- Treats
- partial and generalized
- NOT absence
- Can reduce seizures without causing sedation unlike other barbs
Oxycarbazepine
- Newer AED
- MOA
- dec sodium
- treats
- partial in kids and adults
- derivative of carbamazepine, better tolerated
Toprimate
- MOA
- increase GABA, dec sodium & GLUTAMATE
- Treats
- partial and generalized
Zonisamide
- Newer AED
- MOA
- dec sodium and calcium
- Treats
- partial
- ***only one to Stop the SPREAD!!!!!!
Amitriptyline
- Tricyclic antidepressant
- MOA = inhibit uptake 1
- for chronic pain
Clomipramine
- Tricyclic antidepressant
- MOA = block uptake 1
- for OCD
Fluoxetine
- SSRI
- target serotonin
- Has most effects on other drugs (of the 3 listed)
Sertraline
- SSRI
- target serotonin
- similar to fluoxetine but has less effects
Paroxetine
- SSRI
- target serotonin
- has no effects because it has highest specificity
* atypical antidepressant used for anxiety
Bupropian
- Newer antidepressant
- blocks dopamine uptake
- for nicotine withdrawal
Venlafaxine
- newer antidepressant
- blocks uptake of both NE and serotonin
- effective in severe depression and anxiety
Phenelzine
- MAO inhibitor used in depression
***MAO inhibitors react with tyramine to produce a hypertensive crisis by altering level of NE that regulates cardiac function
Tyramine (found in wine and cheese)
- When combined with MAO inhibitors it is able to reach the nerve terminals and release more NE. resulting in hypertensive crisis
Bipolar drugs
- Lithium
- drug of choice for many acute manic episodes
- suppresses 2nd messengers
- Valproic acid
- AED approved for bipolar disorder
- less side effects than lithium
Diazepam
- BDZ
- most rapidly absorbed
- forms active metabolites
- use
- muscle relaxation
- anesthesia
Lorazepam
- BDZ
- treats general anxiety disorder
- does NOT form active metabolites
- should be used in patients with kidney failure! ***
Alprazolam
- BDZ
- treat general anxiety disorder
- treats Panic disorder ****
Buspirone
- anxiolytic drug
- High affinity for serotonin
- less sedating than BDZ and no abuse potential
- grapefruit juice increases levels
Flurazepam
- Benzodiazepine
- primarily used as hypnotic
- has a rapid onset and long duration of action
Triazolam
- Benzodiazepine (BDZ)
- primarily used as hypnotic
- rapid onset but ultrashort duration of action
- Causes hallucinations!
Zolpidem (ambien)
- Non-BDZ chemically
- binds to BDZ receptor tho
- less effects on stages of sleep
Zaleplon
- sedative
- pyrazolopyrimidine binding to GABA receptor
Secobarbital
- Barbiturate (duration of GABA channels)
- onced used for sleep. problem with physical dependance
- used as a hypnotic
Phenobarbital
- Barbiturate (acts on duration)
- used as an anticonvulsant
Chlorpromazine
- First antipsychotic developed
- LESS potent but HIGHLY sedative and causes many anticholinergic side effects
Haloperidol
- Most commonly used antipsychotic
- HIGH potency, LESS sedation, LESS anticholinergic effects, and more EPS effects
Pimozide
- Only for Tourette’s syndrome ****
- high potency
Clozapine
- newer antipsychotic drug
- works on
- serotonin and dopamine with HIGH sedation and LESS EPS
- improves positive and negative
- Side effects
- fatal agranculocytosis & seizures
Risperidone
- Newer antipsychotic drug
- works on
- serotonin and dopamine with LESS sedation, LESS EPS, and LESS anticholinergic effects
- Improves positive and negative
-
side effects
- dizziness & fatigue **
Olanzapine
- newer antipsychotic
- works on
- serotonin, dopamine, histamine, acetylcholine, and NE
- LESS EPS
- improves positive and negative
- well tolerated
Levodopa (L-dopa)
- dopamine precursor
- only 1-2% actually enters brain
Carbidopa
- has no effects on its own
- take it with levodopa!
- carbidopa inhibits decarboxylation of levodopa in periphery so that 10% enters the brain.
Pramipexole
- dopamine agonist that binds dopamine receptors
- given with levodopa in late stages of parkinson’s
- side effects = dyskinesa and hallucinations
Amantadine
- anti-viral agent
- most likely releases dopamine from neurons
- for parkinson’s
Selegiline
- for parkinson’s
- decreases dopamine metabolism by inhibiting MAO found in brain
- prescribed when disease is seen to slow down progression
Entacapone
- for parkinson’s
- inhibitor of COMT - halts metabolism of dopamine
- prolongs half-life of levodopa
Donepezil
- for alzheimer’s
- somewhat selective brain cholinesterease inhibitor.
- NOT a cure
Baclofen
- treat symptoms of ALS
- is a GABA agonist used to relax muscles
Marijuana
- from cannabis plant
- active ingredient is tetrahydrocannabinol (THC)
- tolerance develops quickly
- therapeutic uses
- AIDS wasting syndrome
Phencyclidine
- “PCP”
- orginally an anesthetic until people experienced psychotic reactions
- effects are different on each person
- MOA
- antagonizing the NMDA receptors
- only hallucinogenic drug that animals will self-administer = very addicting
Lysergic Acid Diethylamide
- “LSD”
- Schedule 1 drug
- effects
- “trips”, vivid colors, flashbacks, hallucinations
- MOA
- stimulating serotonin receptors on neuron
Nicotine
- reaches brain in 8 secs
- MOA
- acts on nicotinic receptors and releases more dopamine
- effects
- relax, inc BP, stim CNS
- use bupropian to help stop
inhalants
- vapors are inhaled, travel to blood, and enter brain
- immediate effects
- relax, slurred speech, euphoria, nausea, hallucinations, and death
- long term use
- leads to memory loss, concentration issues, blindness
Gamma-hydroxybutyrate
- “GHB”
- produced in the brain through GABA synthesis
- rave drug/date rape drug
- releases growth hormones so athletes used to take it
Alcohol
(drugs for withdrawal and abstinence)
- Facilitate withdrawal
- Benzodiazepines such as diazepam
- maintain abstinence
- Naltrexone
- Disulfiram
Disulfiram
- drug used to maintain alcohol abstinence
- inhibits aldehyde dehydrogenase
- effect is acetaldehyde syndrome resulting in flushing and nausea if alcohol is taken
Naltrexone
- drug used to maintain alcohol abstinence
- opioid antagonist
- decreases craving and cuts relapse
Caffeine
- blocks adenosine receptors that normally dec neuronal activity
- stimulates CNS
Cocaine
- CNS stimulant
- blocks reuptake of NT in brain. more present
- unpredictable cardiac effects
Amphetamine
- CNS stim
- longer duration of action than cocaine
- can be sued for weight loss and narcolepsy
Methylphenidate
- CNS stim
- used for narcolepsy
- used for ADD
- reduces impulsiveness
MDMA
- “Ecstasy”
- related to amphetamines
- originally an appetite suppressant
- blahhhhh
Atomoxetine
- For ADD/ADHD
- adults and kids
- non-stimulant