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Pharm Drug Flashcards > Exam 3 > Flashcards

Exam 3 Flashcards

0
Q

Procainamide

A

Class I sodium channel blocker
Like quinidine
Does not enter CNS
Lupus like in slow acetylators

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1
Q

Quinidine

A 
Class Ia sodium channel blocker 
Used for all arrhythmias
Decrease all muscle fxn
Anticholinergic effects (antiDUMBBELS)
SE: GI nausea vomiting
       Anorexia
       CNS- tinnitus, altered color vision
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2
Q

Disopyramide

A

Class Ia sodium channel blocker
Strong antivagal effects
Antimuscarinic effects opp dumbbels

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3
Q

Lidocaine

A 
Class Ib sodium channel blocker
IV
Less likely to cause arrhythmia
Can enter CNS (tremors, seizures)
DOC for ventricular arrhythmias
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4
Q

Mexiletine

A

Class Ib sodium channel blocker

Like lidocaine but no first pass effect

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5
Q

Propanolol

A

Class II beta blocker
B1 in heart
Decreases firing rate of SA node
SE: bradycardia, hypotension, bronchospasms

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6
Q

Metoprolol

A

Class II Beta blocker
More selective, less B2 effects
SE: bradycardia, hypotension

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7
Q

Esmolol

A

Class II beta blocker
More rapid onset
SE: bradycardia, hypotension, bronchospasms

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8
Q

Sotalol

A

Class III K channel blocker

Beta blocker

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9
Q

Amiodarone

A 
Acts like all 4 classes
Most effective antiarrhythmatic
 *DOC in cardiac arrest*
SE: potentially fatal pulomary fibrosis
       Liver damage
       Corneal deposits, optic neuritis
       Skin deposits (blue gray coloration)
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10
Q

Dronedarone

A

Analog of amiodarone

Fewer SEs, less efficacy

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11
Q

Verapamil
Diltazem
Nifedipine

A

Class IV Ca channel blockers

All but ventricular arrhythmias

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12
Q

Adenosine

A 
Coronary vasodilator
Given IV
decreases firing rate of AV node
T1/2 of 10 seconds
DOC for atrial tachycardia
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13
Q

glyceryl trinitrate

Nitroglycerin, GTN

A 
Treats angina
Rapidly dilates all BVs
(GTN - NO - guanylate cyclase - cGMP - vasodilation)
SE: hypotension, skin flushing, headache
   Rapid tolerance to NO
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14
Q

Isosorbide dinitrate

A

Treats angina
Slow release nitrate formulation
Oral

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15
Q

Digoxin

A

Inhibits Na/K ATPase
Causes Ca retention indirectly
Treats cardiac insufficiency by increasing contractility
SE: yellow/green vision tint
hallucinations
severe nausea, all intensifies with hypokalemia

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17
Q

Sildenafil
Vardenafil
Tadalafil
Avanafil

A

Inhibitors of type-5 cGMP phosphodiesterase
This corpus callosum PDE breaks down cGMP (smooth m relaxer)
…

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18
Q

Citric acid
EDTA
EGTA

A

Ca chelators

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19
Q

Exonaparin

Dalteparin

A 
Partially purified heparin
T1/2 of 4 hours
More effect on Xa than thrombin
Less side effects, more predictable D-R
May cause spinal hematoma w/ tap or anesthesia
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20
Q

Fondaparinux

A

Synthetic heparin
T1/2 = 17 hours
Acts only on factor Xa
Can cross placenta, given IV

21
Q

Hirudin

A

Anticoagulant in leech saliva

Directly inhibits enzymes and thrombin

22
Q

Bivalirudin
Desirudin
Argatroban

A

Synthetic hirudin analogs
Inhibits thrombin
Treats HIT

23
Q

Warfarin

A 
Vitamin K analog
Inhibits enzymes that recycle vitamin K
Must wait for clotting factors to degrade before it works
   (6 hours to 60 hours)
Metabolized by P450
Pregnant category X, OD give vit K
24
Q

Dabigatran

A

Prodrug
Thrombin inhibitor
Works in 1 hour
Metabolized by P450

25
Q

Rivaroxaban

Apixaban

A

Factors Xa & Xb inhibitors respectively
Bleeding after spinal tap surgery
Rapid onset

26
Q

Vorapaxar

A

Thrombin receptor blocker
Prevents aggregation of platelets
SE: CNS hemorrhage

27
Q

Ticlopidine
Clopidogrel
Prasugrel
Ticagrelor

A

Platelet inhibitor
inhibits ADP receptor
SE: neutropenia
agranulocytosis

28
Q

Abciximab
Tirofiban
Eptifibatide

A

Fibrinogen receptor (GP IIb/IIIa receptor) inhibitors
Prevents aggregation of platelets
Given IV
SE: thrombocytopenia

29
Q

Aspirin

A

aka thrombin A2
COX inhibitor
Inhibits thromboxane A2 synthesis

30
Q

Cilostazol

Dipyridamole

A

PDE inhibitor

PDE breaks down cAMP, decreases platelet agg

31
Q

Anagrelide

A

Decreases platelet formation, maturation, and number

32
Q

Streptokinase

Urokinase

A

Urine plasminogen activator
Stimulate endogenin
Thrombolytic agent

33
Q

TPA

A

Tissue plasminogen activator
Thrombolytic agent
Converts plasminogen to plasmin
Hydrolyzes fibrin, degrades fibrinogen & fac V, VII

34
Q

Heparin

A

Binds to antithrombin III and increases its affinity for clotting factors
Made from cow lung and pig intestine slurry
Low doses - inhibits factor Xa and forms thrombin
High doses - inhibits factor IXa, XIa, XIIa and inhibits thrombin
IV or subQ, T1/2 of 1 hr
Degraded by heparinase, OD treat with protamine sulfate
Long term use - osteoporosis and HIT

35
Q

Epoietin alfa
Darbepoietin
Peginesatide

A

Cause excess of RBCs

Increase BP, clotting, MI, stroke

36
Q

Hydroxyurea

A

Increase formation of fetal Hb
fHb doesn’t sickle
Mutagenic, preg cat D

37
Q

-statins

A

Prodrugs, most effective LDL lowering agent
Inhibits HMG CoA reductase - RLS in cholesterol synthesis
No cholesterol synesis, increase LDL receptors on cell, increase LDL uptake, decreases by 25-60% lowers VLDL synth
SE: myositis, at worst rhabdomyolysis
liver toxicity
teratogenic, preg cat X
some memory loss

38
Q

Niacin

Nicotinic Acid, Vitamin B3

A

Inhibits enzymes for VLDL synthesis
Increases HDL
SE: skin flushing and itching (prevented by aspirin)
increase uric acid, diabetes

39
Q

Cholestyramine
Colestipol
Coleselevam

A

Highly charged cationic resins
Irreversibly bind to bile acids in gut, excreted
Decrease circulating cholesterol
Increases LDL receptors
SE: binds acidic drugs (digoxin) and oral anticoagulants
decreased absorption of fat soluble vitamins

40
Q

Gemfibrozil

Fenofibrate

A 
Best triglyceride lowering agents
Binds to peroxisome proliferator acting receptor (PPAR)
Increase transcription of LPlipase
SE: GI upset
      Displacement of warfarin
41
Q

Omega 3 fatty acids

Icosapent ethyl

A

Decreases triglyceride synthesis by inhibiting enzymes

42
Q

Lomitapide

A

Inhibits assembly of VLDL in liver
Enzyme and a transporter
Hepatotoxic

43
Q

Mipomersen

A

Antisense oligonucleotide
Binds to mRNA for APOb
Prevents APO synthesis

44
Q

Ezetimibe

A

Blocks cholesterol transporters in intestine

45
Q

Sitostanol

A

Looks like cholesterol, blocks uptake

Found in some margarines

46
Q

Orlistat

A

Inhibits GI & pancreatic lipases
Decreases fat absorption from gut
Loose stool

47
Q

Olestra

A

Unabsorbable fat.

63
Q

Aminocaproic acid

Tranexamic acid

A

Hemolytic agent
Enhance clotting in hemophiliacs or blood loss
Inhibit plasminogen
Latter is more potent

Pharm Drug Flashcards (4 decks)

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