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Exam 3 Drugs & Drug Classes Flashcards

1
Q

Immunosuppressant Drugs

A

Calcinerurin Inhibitors
- cyclosporine

* Anti-TNF-alpha*
- Adalimumab (Humira)

Other Drugs for RA
- Hydroxychloroquine (Plaquenil)

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2
Q

Calcineurin Inhibitor Drug

A

cyclosporine (Neoral)

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3
Q

What is unique about zolpidem (Ambien)?

A

It is NOT a benzodiazepine, but it works on benzodiazepine receptors

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4
Q

Benzodiazepines used for Anxiety

A
  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)
  • Lorazepam (Ativan)
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5
Q

Drugs used for Anxiety Disorders

A

Benzodiazepines
- Alprazolam (Xanax)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Lorazepam (Ativan)

Non-Benzodiazepiens
- Buspirone (Buspar)

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6
Q

Drugs used for Insomnia

A
  • Zolpidem (Ambien)
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7
Q

3 Drug Classes used as Antidepressants

A
  • TCAs (Tricyclic Antidepressants)
  • SSRIs (Selective Serotonin Reuptake Inhibitors)
  • SNRIs (Serotonin / Norepinephrine Reuptake Inhibitors)
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8
Q

Tricyclic Antidepressant (TCA) Drugs

A
  • Amitriptyline (Elavil)
  • Nortriptyline (Pamelor)
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9
Q

SSRI Antidepressant Drugs

A
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
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10
Q

SNRI Antidepressant Drugs

A
  • Venlafaxine (Effexor)
  • Desvenlafaxine (Pristiq)
  • Duloxetine (Cymbalta)
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11
Q

Atypical Antidepressant Drugs (Miscellaneous in terms of how these drugs work)

A
  • ** Bupropion** (Wellbutrin)
  • Mirtazapine (Remeron)
  • Trazadone (Oleptro
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12
Q

Antidepressant Drugs

A

Tricyclic Antidepressants (TCAs)
- Amitriptyline (Elavil)
- Nortriptyline (Pamelor)

Selective Serotonin Reuptake Inhibitors (SSRIs)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Citalopram (Celexa)
- Escitalopram (Lexapro)

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
- Venlafaxine (Effexor)
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)

Atypical Antidepressants
- Bupropion (Wellbutrin)
- Mirtazapine (Remeron)
- Trazodone (Oleptro)

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13
Q

Drug Classes Used to treat BPH

A
  • alpha-1 antagonists
  • 5-alpha reductase inhibitors
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14
Q

Drug Class Used to treat Erectile Dysfunction

A

PDE5 Inhibitors

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15
Q

Drugs to Treat BPH

A

Non-Selective Alpha-1 Antagonists
- Terazosin (Hytrin)
- Doxazosin (Cardura)
- Prazosin (Minipress)

Selective Alpha-1 Antagonists
- Tamsulosin (Flomax)

5-Alpha Reductase Inhibitors
- Finasteride (Proscar)

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16
Q

Drugs to treat Erectile Dysfunction

A
  • Sildenafil (Viagra)
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17
Q

Non-Selective Alpha-1 Antagonist Drugs & what condition do they treat?

A
  • ** Terazosin** (Hytrin)
  • Doxazosin (Cardura)
  • Prazosin (Minipress)

Used to treat BPH

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18
Q

Selective Alpha-1 Antagonist Drugs & what condition do they treat?

A
  • Tamsulosin (Flomax)

*Used to treat BPH

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19
Q

5-Alpha Reductase Inhibitor Drug & what condition does it treat?

A
  • Finasteride (Flomax)

Used to treat BPH

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20
Q

Which two drugs are vitamins or minerals containing salts?

A

Potassium Salts & Calcium Salts

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21
Q

Vitamin D Drugs & Which form of Vitamin D are these drugs?

A
  • Ergocalciferol = D2 [Calciferol, Drisdol]
  • Cholecalciferol = D3 [Delta-D]
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22
Q

Drug name for Vitamin D2

A

Ergocalciferol

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23
Q

Drug name for Vitamin D3

A

Cholecalciferol

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24
Q

Iron Supplement Drugs

A

Ferrous sulfate (20% elemental iron)

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25
Vitamin B Drugs
- **Folic Acid** - **Cyanocobalamin = B12**
26
Antiplatelet Drugs
- **Aspirin** - **Clopidogrel** (Plavix) = ***ADP Receptor Inhibitor***
27
Which drug is an ADP Inhibitor (ADP Receptor Inhibitor) & What is it used for?
**Clopidogrel** (Plavix) ***Antiplatelet drug***
28
Anticoagulant Drug Classes
- **Vitamin K Antagonists** - **Specific Xa (10-A) Inhibitors** - **Direct Thrombin Inhibitor** - **Heparins** (UFH & LMWH)
29
Drugs for Anticoagulation
***Vitamin K Antagonists*** - **Warfarin** ***Specific Xa (10-A) Inhibitors*** - **Rivaroxaban** (Xarelto) - **Apixaban** (Eliquis) ***Direct Thrombin Inhibitor*** - **Dabigatran** (Pradaxa) **Heparins** - **UFH** (**U**n**f**ractionated **H**eparin) - **LMWH** (**L**ow **M**olecular **W**eight **H**eparin)
30
Vitamin K Antagonist Anticoagulant Drug
- **Warfarin**
31
Specific Xa (10-A) Inhibitor Anticoagulant Drugs
- **Rivaroxaban** (Xarelto) - **Apixaban** (Eliquis)
32
Direct Thrombin Inhibitor Anticoagulant Drugs
- **Dabigatran** (Pradaxa)
33
Heparin Anticoagulant Drugs
- **UFH** (**U**n**f**ractionated **H**eparin) - **LMWH** (**L**ow **M**olecular **W**eight **H**eparin)
34
Ophthalmic Drugs & What they are used to treat
- **Latanoprost** (Xalatan) - **Timolol** (Timoptic) - **Brimonidine** (Alphagan P) ***Used to treat Glaucoma***
35
What preservative is commonly contained in ophthalmic products that can cause irritation & inflammation?
Benzalkonium Chloride
36
Most Common Typical Antipsychotic (1st generation antipsychotic)
- **Haloperidol** (Haldol)
37
"Last Resort" Atypical Antipsychotic that is one of (if not the) most effective antipsychotic & was the first atypical antipsychotic on the market
- **Clozapine** (Clozaril)
38
Atypical Antipsychotic Drugs
- **Olanzapine** (Zyprexa) - **Risperidone** (Risperdal) - **Quetapine** (Seroquel) - **Aripiprazole** (Abilify)
39
Calcineurin Inhibitors MOA & Side Effects
***MOA** - blocks T-cell activation ***Side Effects*** - nephrotoxicity - hyperkalemia - HTN - dyslipidemia
40
Non-Specific & Specific Cytotoxic Agent MOA
**Non-Specific:** target rapidly-dividing cells (T & B cells) **Specific:** inhibit enzymes required for lymphocyte production of purines & pyrimidines
41
What is the difference in Specific & Non-Specific Cytotoxic Agents?
Specific agents target the immune system more accurately & have LESS side effects
42
What are biologic agents?
large molecules produced by living cells
43
***What are Biosimilars? What is unique about them & what must the drug manufacturer prove???*** KNOW THIS
**Biosimilars:** similar to generic for biologics **Unique Features** - amino acid sequence must be same as biologic - cannot be substituted for one another (you have to order / prescribe the specific version you want) **Drug companies must prove:** the same amount of active ingredient / molecule that gets into the blood is in the bio similar as is in the biologic
44
***What is the difference in the dose response curves of Barbiturates & Benzodiazepines????***
***Barbiturates*** - **linear** dose response curve - can be more dangerous - **rate of change is the SAME for ANY dose** ***Benzodiazepines*** - **flat** dose response curve - you don't get as "deep" of an effect as you would with barbiturates (like a medically-induced coma)
45
Benzodiazepine Mechanism of Action
***Facilitate GABA Actions*** - GABA = inhibitory neurotransmitter ** benzodiazepines stabilize neurons making it much LESS likely that they become activated**
46
Adverse Effects of Benzodiazepines
- **CNS Depression:** drowsiness, sedation, dizziness, confusion - **rebound insomnia** (after discontinuing) - **paradoxical reaction:** irritation, aggression, excitement - **amnesia**
47
Explain the Monamine-Deficiency Hypothesis for Major Depressive Disorder
**Depression is likely caused by relative lack of monoamine neurotransmitters** (serotonin, norepinephrine, dopamine, etc.) **in the brain**
48
Tricyclic Antidepressant drugs, mechanism of action, & side effects
- **Amitriptyline** (Elavil) - **Nortriptyline** (Pamelor) ***MOA*** - block neuronal reuptake of monoamine neurotransmitters (NE, 5-HT) - **also antagonize (block) H1, Acetylcholine (ACh), & norepinephrine (NE) receptors** - **NOT SPECIFIC** ***Side Effects** - Orthostatic hypotention - Sedation - Anticholinergic Effect (anti-SLUD + Tach) - Cardiac toxicity
49
Tricyclic Antidepressant MOA
- blocks neuronal uptake of monoamine neurotransmitters (NE, 5-HT) - **antagonizes** (blocks) **H1, ACh, & NE receptors**
50
Tricyclic Antidepressant Side Effects
- **Orthostatic Hypotension** - **Sedation** - **Anticholinergic Effects** - dry mouth - dry eyes - urinary hesitancy - constipation - tachycardia - **Cardiac Toxicity**
51
SSRI Drugs, Mechanism of Action, & Side Effects
- **Fluoxetine** (Prozac) - **Paroxetine** (Paxil) - **Sertraline** (Zoloft) - **Citalopram** (Celexa) - **Escitalopram** (Lexapro ***MOA*** - **block neuronal reuptake of serotonin** - no anti-SLUD, tachy, or sedation ***Side Effects*** - Sexual dysfunction - Weight gain - Serotonin syndrome - Withdrawal syndrome - Anti-platelet activity - Osteoporosis
52
SSRI Mechanism of Action
**block neuronal reuptake of serotonin** - no anti-SLUD, tachy, or sedation
53
SSRI Side Effects
- Sexual dysfunction - Weight gain - Serotonin syndrome - Withdrawal syndrome - Anti-platelet activity - Osteoporosis
54
Symptoms of Serotonin Syndrome
- Altered mental staus - Incoordination - Hyperreflexia - Excessive sweating - Tremor - Fever
55
What side effects are associated with SSRIs & SNRIs?
- sexual dysfunction - weight gain - serotonin syndrome - withdrawal syndrome - antiplatelet activity - osteoporosis
56
SNRI Drugs, MOA, & Side Effects
- **Venlafaxine** (Effexor) - **Desvenlafaxine** (Pristiq) - **Duloxetine** (Cymbalta) ***MOA*** - selective inhibition of both serotonin & norepinephrine ***Side Effects*** - sexual dysfunction - weight gain - serotonin syndrome - withdrawal syndrome - anti-platelet activity - osteoporosis
57
SNRI Mechanism of Action
selective inhibition of both serotonin (5-HT) & Norepinephrine (NE)
58
Side Effects of SNRIs
- sexual dysfunction - weight gain - serotonin syndrome - withdrawal syndrome - anti-platelet activity - osteoporosis
59
What neurotransmitter does **Bupropion** (Wellbutrin) work on?
dopamine
60
What side effects are associated with *Mirtazapine** (Remeron)?
- sedation - orthostatic hypotension - tachycardia - Anti-SLUD (dry eye/mouth, urinary hesitancy, constipation)
61
Which neurotransmitter does **Trazodone** (Oleptro) work on?
serotonin
62
Side Effects of **Bupropion** (Wellbutrin)
- neutral / no weight gain - lowest risk of sexual side effects - can lead to seizures at high doses
63
Side Effects of **Trazodone** (Oleptro) & **Mirtazapine** (Remeron)
- sedation - orthostatic hypotension - tachycardia - Anti-SLUD (dry eyes, dry mouth, urinary hesitancy, constipation)
64
Alpha-1 Antagonist Mechanism of Action & Side Effects
***MOA*** - inhibition of alpha-1 receptors leads to **relaxation / vasodilation** ***Side Effects*** - Hypotension - fainting - dizziness - fatigue - nasal congestion - ↓ ejaculation volume
65
***What are the main differences in Selective & Non-Selective Alpha-1 Antagonists????** KNOW THIS
- **Non-Selectives** block alpha-1 receptors throughout the **ENTIRE** body while **Selectives** block alpha-1 receptors in the prostate - Non-Selectives have a greater risk of hypotension because they cause vasodilation throughout the entire body
66
***Are Non-Selective or Selective Alpha-1 Antagonists more likely to cause hypotension and why????*** KNOW THIS
Non-Selective Alpha-1 Antagonists because they cause relaxation / vasodilation throughout the entire body
67
Erectile Dysfunction Drugs, Drug Classes, MOA, & Side Effects
**Sildenafil** (Viagra) **PDE-5 Inhibitor** ***MOA*** - **prevents the breakdown of cGMP** - cGMP causes vascular relaxation ***Side Effects*** - hypotension - headache - flushing - visual changes - myalgia / back pain - hearing problems
68
PDE-5 Inhibitor MOA
**prevents breakdown of cGMP** - cGMP causes vascular relaxation
69
***What is a vesicant????*** KNOW THIS
**blister causing agent** because the substance is toxic to surrounding tissue
70
***How does Folic Acid mask Vitamin B12 Deficiency?????*** KNOW THIS
1.) Folic acid will treat the anemia of B12 deficiency meaning you will no longer have symptoms of anemia. 2.) This is BAD because **B12 deficiency can lead to CNS effects (like ↓ muscle tone, impaired concentration, muscle weakness, dizziness, syncope, etc.) & which can be IRREVERSIBLE if the deficiency is prolonged**
71
Aspirin MOA
**binds to COX-1 to prevent the production of TXA2** (Thromboxine-A2) - irreversibly binds COX-1
72
Vitamin K Antagonists MOA
- warfarin prevents the liver from making new functional clotting factors by **inhibiting Vitamin K Epoxide Reductase** (prevents the body from recycling Vitamin K) - ↓ activity of Factors II, VII, IX, X, Protein C, & Protein S
73
What do you do if a patient comes to a clinic who's on Warfarin & has an INR of 8 but they are not actively bleeding?
↑ vitamin K intake
74
What do you do if a patient comes into a clinic on Warfarin with an INR of 8 & is actively bleeding? Would giving Vitamin K help?
NO, because vitamin K takes 5-7 days to start working. Instead give the patient **fresh frozen plasma**
75
Specific Xa Inhibitor Drug MOA
binds & inhibits Xa (10-A) factor in the blood
76
If an individual presents to a clinic actively bleeding & is on a specific Xa inhibitor, should plasma or whole blood be given?
No, the patient's body will continue to inhibit clotting factors that are being prouduced
77
Direct Thrombin Inhibitor Drugs MOA
targets Factor II
78
What is unique about **Dabigatran** (Pradaxa) / Direct Thrombin Inhibitors?
must be discarded **120 days** after opening because they are incredibly sensitive to humidity
79
Ophthalmic Drugs (for glaucoma) MOA
**1.) ↑ outflow of fluid** - prostaglandin analogs & alpha-2 agonists **2.) ↓ production of fluid** - alpha-2 agonists & beta-blockers
80
**Lantanoprost** (Xalatan) MOA
**↑ outflow of fluid** - prostaglandin analogs
81
**Timolol** (Timoptic) MOA
**↓ production of fluid** - beta-blockers
82
**Brimonidine** (Alphagan P) MOA
**↑ outflow of fluid** - alpha-2 agonists **↓ production of fluid** - alpha-2 agonists
83
What are the differences in Typical & Atypical Antipsychotics?
***Typical (1st gen)*** - Dopamine Receptor Antagonist - ↑ risk of extrapyramidal symptoms - few adverse metabolic effects - mainly effective for "positive" symptoms ***Atypical (2nd gen)*** - works on 5-HT receptors (little / no DA activity) - low risk of extrapyramidal symptoms - ↑ risk of metabolic effects (weight gain) - effective for positive & negative symptoms
84
***What are the similarities & differences between Typical & Atypical Antipsychotics???*** KNOW THIS
***Similarities*** - strong antihistamine actions (**sedation**) - anticholinergic effects (**SLUD + tachycardia**) - block peripheral alpha-1 receptors (**risk of orthostatic hypotension**) - both work on positive symptoms ***Differences*** - Typical (1st gen) is a Dopamine Receptor Antagonist & Atypical (2nd gen) has strong effects on 5-HT but weak effects on dopamine - **Typical = ↑** risk of EPS **&** Atypical = ↓ risk of EPS - Typical = few metabolic effects **&** Atypical = ↑ metabolic effects (weight gain, DM, HTN, bad cholesterol) - Typical works on Positive symptoms **&** Atypical works on both positive & negative symptoms
85
***What is Neuroleptic Malignant Syndrome (NMS)???*** KNOW THIS
**sustained contraction of opposing muscle groups at the same time causing limb rigidity (limbs are frozen / stiff)** - biceps & triceps fire at the same time
86
***What are the similarities & differences in Neuroleptic Malignant Syndrome (NMS) & Serotonin Syndrome????*** KNOW THIS!!!!
**NMS is only caused from taking antipsychotics. Serotonin Syndrome is due to taking antidepressants & causes involuntary muscle contraction & ↑ temperature** ***Similarities*** - caused by taking certain medications - fever & sweating - altered consciousness / mental status ***Differences*** - **NMS:** caused by antipsychotics (dopamine antagonists); "lead-pipe" rigidity, hyporeflexia - ***Serotonin Syndrome:** caused by antidepressants (serotonergic agents); hyperreflexia, myoclonus (sudden, brief involuntary twitching / jerking of muscles)
87
What is the cause of NMS & what are features of it?
***Cause:*** antipsychotics (dopamine antagonists) - **contraction of opposing muscle groups at the same time** ***Features*** - "lead pipe" rigidity - hyporeflexia - fever & sweating - autonomic instability (altered BP & dysrhythmias) - altered consciousness
88
What is the cause of serotonin syndrome & what are some unique features?
***Cause:*** antidepressants (serotonergic agents) ***Features*** - hyperreflexia - altered mental status - fever & sweating - tremor & incoordination - myoclonus (sudden, brief involuntary twitching / jerking of muscles)

Pharmacology (5 decks)

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