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Pharm Drug Flashcards > Exam 4 > Flashcards

Exam 4 Flashcards

0
Q

Clemastine

A

First gen H1 blocker

Like all, Can act on peripheral and central H1 receptors, slightly lipid soluble, nonionized

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1
Q

Diphenhydramine

A

Benadryl
First gen H1 blocker
Sedative
Can be used for motion sickness

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2
Q

Chlorpheniramine

A

First gen H1 Blocker

Not as sedative

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3
Q

Hydroxyzine

A

First gen H1 blocker
Sedative
Anti itch

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4
Q

Promethazine

A

First gen H1 blocker
Strong sedative
Strong antiemetic

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5
Q

Tripelennamine

A

First gen H1 Blocker

Sedative with local anesthetic effects

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6
Q

Diminhydronate

A

First gen H1 Blocker
Motion sickness
Do not operate heavy machinery

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7
Q

Loratadine
Fexofenadine
Desloratadine
Cetirizine

A

Second gen H1 Blockers
Fewer CNS SEs
Ionized in blood
Non drowsy

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8
Q

Cimetidine
Ranitidine
Famotidine
Nizatidine

A

H2 Blockers
Used to decrease gastric secretions
Don’t cross BBB
Antiandrogenic effects (gynecomastia, decrease sperm)

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9
Q

Sumatriptan

Other -triptans

A

Serotonin receptor agonists
Treat migraines
Cause vasoconstriction
Not used with MAOIs (causes Serotonin Syndrome hyperthermia & mm twitch)

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10
Q

Ergotamine

Dihydroergotamine

A 
Partial serotonin agonists
Affect adrenergic, dopaminerrgic neurons
SE: ergotism
     St. Anthony's Fire
     Hallucinations
     Uterine contractions (preg cat X)
     Severe vasospasms --> gangrene
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11
Q

Epinephrine (asthma)

A

Bronchodilator, beta-2 agonist
Activates all alpha and beta adrenergic receptors
Inhalation or injection
Increase HR, vasoconstriction, increase BP

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12
Q

Isoproterenol

A

First specific beta-2 agonist
Bronchodilator
Has been supplanted by more specific beta-2 agonists

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13
Q 
Albuterol
Pirbuterol
Bitolterol
Levabuterol
Terbutaline
A

Relatively selective beta-2 agonists (B/rols)
T1/2 - 6 hours
Inhaled
Can cause downregulation of beta-2 receptors with prolonged use
SE: tremors, tachycardia, palpitations (beta-1 SEs)

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14
Q

Formoterol
Arformoterol
Salmeterol
Indicaterol

A

Longer-acting beta-2 agonists
Not for rapid relief
SE: tremors, tachycardia, palpitations (beta-1 SEs)

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15
Q

Ipratropium bromide

Tiotropium

A

Muscarinic receptor blockers (atropine derivatives)
Used mainly for COPD
SE: opposite DUMMBELS
Mad hatter, blind bat, dry bone, hot pistol

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16
Q

Theophylline

A

PDE inhibitor, methylxanthine
For chronic asthma
Inhibits cAMP PDE, elevates cellular cAMP
SE: cardiac stimulation - arrhythmia
CNS stimulation - tremors, insomnia, seizures
GI upset

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17
Q

Cromolyn sodium

Nedocromil

A

Anti-inflammatory agents for asthma
Mast cell inhibitors
Inhibit release of mediators from immune cells
Inhibit Cl channels, decrease Ca uptake

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18
Q 
Beclomethasone
Budesonide
Fluticasone
Mometasone
Ciclesonide
A

DOC for asthma prophylaxis
Inhaled
Bind to intracellular receptors to alter DNA transcription
Increase lipocortin (inhibits phospholipase A2 synthesis)
SE: thrush (oral), dysphonia

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19
Q

Prednisone

Dexamethasone

A

DOC for asthma prophylaxis
NOT Inhaled
Bind to intracellular receptors to alter DNA transcription
Increase lipocortin (inhibits phospholipase A2 synthesis)
SE: thrush (oral), dysphonia

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20
Q

Omalizumab

A

Anti IgE MAB for asthma
Humanized immune system MAB
Injection only

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21
Q

Zileuton

A

Leukotriene synthesis enzyme inhibitor
Inhibits 5-lipoxygenase
SE: increased liver enzymes

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22
Q

Zafirlukast

Montelukast

A

Leukotriene receptor blocker

Asthma

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23
Q

Aspirin (ASA)

A 
Inhibits COX 1&2
Prevents prostaglandin synthesis
Weak acid, absorbed better in stomach than intestine
Forms salicyclic acid once metabolized, binds to plasma proteins
Antipyretic
Analgesic
Anti-inflammatory
Anticlotting
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24
Q

Acetaminophen

A 
Non-narcotic analgesic
NOT AN NSAID
No anti platelet effects
Less GI problems than aspirin
OD: 10-15g (20-30 tablets)
      Leading cause of acute liver failure
SE: decreased GSH in liver
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25
Q 
Ibuprofen
Naproxyn
Fenoprofen
Ketoprofen
Fluribiprofen
Oxaprozin
Suprofen
A

Propionic acid derivatives (pro)

NSAIDs

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26
Q

Indomethacin
Tolmetin
Sulindac

A

Acetic acid derivatives
NSAID
Indomethacin- very potent COX inhibitor
Used for latent ductus arteriosus (held open by excess PG)
SE: thrombocytopenia, aplastic anemia, cornel opacity ex

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27
Q 
Pyroxicam
Diclofenac
Bromfenac
Nepafenac
Etodolac
Nabumetone
A

NSAIDs

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28
Q

Celecoxib

A 
Cox-2 inhibitor
SE: increase risk of MI and stroke due to vasoconstriction
       Inhibits PGI2 (vasod) more than TxA2 (vasoc)
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29
Q

Cortisone

Hydrocortisone

A 
Glucocorticoids
Immunosuppressive potency: 1
Minerallocorticoid activity: 1
T1/2: 8-12 hours
CORTISONE = PRODRUG
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30
Q

Prednisone
Triamcinolone
Prednisolone

A 
Glucocorticoids
Immunosuppressive potency: 4
Minerallocorticoid activity: 0.25
T1/2: 18-36 hours
PREDNISONE = PRODRUG
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31
Q

Dexamethasone

Betamethasone

A

Glucocorticoids
Immunosuppressive potency: 25
Minerallocorticoid activity: <0.01
T1/2: 36-54 hours

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32
Q

Atgam
antithymocyte globulin
ATG

A

IS
treats acute renal transplant rejection
Polyclonal antibodies

33
Q

Abatacept

A

Inhibits receptors for CD80, CD86

Affects T cell activation

34
Q

Belatacept

A

Renal transplant IS
Binds to CD80 & CD86
increase in malignancies

35
Q

Natalizumab

A 
Humanized immune cell MAB
Treats Crohn's, MS
Binds to alpha-integrins on CD4+ cell
Linked with progressive multifocal leukoencephalopathy (PML)
-fatal viral disease of CNS
36
Q

Tocilizumab

A

Humanized immune cell MAB
Treats RA
Binds to IL-6 receptors

37
Q

Ustekinumab

A

Fully human interleukin MAB
Treats psoriasis
Binds to IL-12 & IL-23

38
Q

Etanercept

A

Binds to TNF
Treats RA
given subQ

39
Q

Infliximab

A 
Chimeric immune system MAB
Treats RA, Crohn's
Binds to TNF
Can cause immune response, given IV
SE: itching, hypotension, feverW
       SEs made worse by preexisting infxn with fungus or TB
40
Q

Adalimumab

A

Fully human immune system MAB
Treats RA
Binds to TNF

41
Q

Certolizumab

A

Humanized immune system MAB

Treats RA, Crohn’s

42
Q

Golimumab

A

Fully human immune system MAB

Treats RA, UC, psoriatic arthritis

43
Q

Anakinra

A

Blocks IL-1 receptor
Treats RA
subQ, used with other IS like methotrexate
Should not be used with TNF inhibitors

44
Q

Rilonacept

A

Binds to IL-1 molecule

Like anakinra

45
Q

Cyclosporine

A

Enzyme inhibitor
For transplantation, psoriasis, dry eye
Binds to intracellular ptn cyclophyllin, this complex inhibits enzyme calcineurin phosphatase
Prevents activation of NFAT, which thus blocks gene that codes for IL-2/3, TNF-alpha
T cell not activated, P450 metabolism
SE: nephrotoxic, hepatotoxic, hypertrichosis, gingival hyperplasia

46
Q

Tacrolimus

A

Transplantation
Binds to FKBP, complex then inhibits phosphatase
Causes inhibition of cytokines synthesis
More efficacious than cyclosporin
P450
SE: nephrotoxic, neurotoxic, alopecia, diabetes

47
Q

Glucocorticoids as immunosuppressants

A

Inhibit all immune processes
Significant SEs with long term use
Often used with other ISs

48
Q

Sirolimus

Everolimus

A

Transplantation and psoriasis
Bind to FKBP, inhibits kinase required for binding IL-2 induced factors to DNA
Decreased cytokines production
P450
SE: some renal and lung tox, but not as much renal as tacrolimus

49
Q

Basiliximab

A

Mostly human chimeric MAB
blocks IL-2 receptor
Used with CSA
SE: hypersensitivity, bronchospasms, pulmonary edema

50
Q

Tofacitinib

A

Janus Kinase inhibitor
Inhibits signal pathways of cytokines & interleukins
Prevents activation of Signal Transducers & Activators of Transcription
JAK-STAT
SE: increased risk of infxn,
malignancy

51
Q

Azathioprine

A

Inhibits T cell replication (relatively nonspecific)
Prodrug, converts to 6-mearcaptopurine
Inhibits synthesis of purines & GMP synthesizing enzymes
SE: decreased bone marrow, megaloblastic anemia, thrombocytopenia, leukopenia

52
Q

Mycophenolate mofetil

A

Transplants, lupus
More specific replacement for azothioprine
Inhibits enzyme (inosine monophosphate dehydrogenase)
Inhibits guanosine synthesis

53
Q

Methotrexate (RA)

A 
DOC for early treatment of RA
Analog of folic acid
Inhibits dihydrofolate reductase
Inhibits mammalian cell division and all rapidly transcripting cells
SE: GI, FETAL DAMAGE, blood
54
Q

Leflunomide

Teriflunomide

A

Former is prodrug, converts to latter
Inhibits pyramidine synthesis
Inhibits enzyme dihydroorolate dehydrogenase
Affects lymphocytes more than other cells
SE: diarrhea, abdominal pain
Teratogen, but not when used with bile acid binding resins

55
Q

Hydroxychloroquine

A

Interferes with macrophage processing of antigens
Taken up by macrophage, concentrated in lysosomes
SE: rare
GI dysfxn, dermatitis
Irreversible retinal damage (long term high dose)

56
Q

Cyclophosphamide

A 
Non-specific neoplasia agent
Nitrogen mustard
Prodrug, orally or IV 
Alkylating agent, x-links DNA to inhibit cell repro and RNA synth
Inhibits nonreplicating tumor cells
57
Q

Lomustine

A

Non-specific neoplasia agent
Prodrug, IV
Alkylating agent, x-links DNA to inhibit cell repro and RNA synth
Inhibits nonreplicating tumor cells

58
Q

Cisplatin

A

Non-specific neoplasia agent
Contains platinum
Alkylating agent, x-links DNA to inhibit cell repro and RNA synth
Inhibits nonreplicating tumor cells
SE: renal damage, ototoxic (due to platinum)

59
Q

Doxorubicin
Danunorubicin
Other rubicins

A

Nonspecific antineoplastic
Antibiotic, acts on human cells
Given IV, intercalates with DNA to block DNA/RNA synth
Produces free radicals to break DNA strands
SE: irreversible heart mm degeneration

60
Q

Dacinomycin

A

Nonspecific antineoplastic antibiotic
Intercalates with DNA
Interefers with mRNA synthesis

61
Q

Bleomycin

A

Nonspecific antineoplastic antibiotic
Intercalates with DNA
Causes DNA strand breakage
SE: pulmonary fibrosis

62
Q

Methotrexate (antineoplasm)

A

Cell cycle specific antineoplastic antimetabolite
Inhibits dihydrofolate reductase as a folic acid analog
Myelosuppression, but not with leucovorin
Can rescue normal cells, but not malignant cells

63
Q

5-fluorouracil (5-FU)

A

Cell cycle specific antineoplastic antimetabolite
Prodrug
Pyrimidine analog
Inhibits enzyme thymidylate synthetase

64
Q

Cytarabine

A

Cell cycle specific antineoplastic antimetabolite
Prodrug
Pyrimidine analog
Inhibits DNA polymerase

65
Q

6-mercaptopurine

A

Cell cycle specific antineoplastic antimetabolite
Prodrug
Purine analog
Inhibits enzyme for purine synthesis

66
Q

Vincristine

Vinblastine

A

Inhibits microtubules

Given IV, binds to microtubules

67
Q

Paclitaxel

Other taxels

A

Inhibits microtubules

Forms abnormal microtubules

68
Q

Etoposide

A

Inhibits DNA topoisomerase II
Prevents coiling and uncoiling of DNA
Breaks DNA

69
Q

Topotecan

A

Inhibits topoisomerase I

Prevents DNA coiling and uncoiling

70
Q

Flutamide

Other lutamides

A

Blocks androgen receptor
Androgen activity blocker
For prostatic tumors

71
Q

Abiraterone

A

Inhibits 17 hydroxylase lyase (CYP17)

Inhibits androgen synthesis

72
Q

Leuprolide

A

Activates GnRH receptor

Initially increased testosterone, but receptor down regulates with time and causes very low testosterone

73
Q

Tamoxifen

Flovestrant

A

Blocks estrogen receptor/activity

SE: retinal changes, increase in cataracts

74
Q

Anastrozole

A

Inhibits aromatase

Blocks estrogen production/activity

75
Q

Prednisone (antineoplastic)

A

Glucocorticoid
Inhibits immune system functions
Treats neoplasia of immune system (leukemia, lymphoma)

76
Q

Imitnib

Other nibs

A

Kinase inhibitor
Treats chronic myelogenous leukemia (CML)
Inhibits kinase that inhibits normal cell apoptosis
SE: edema

77
Q

Bortezomib

Carfiozomib

A

Proteasome inhibitor
Prevents excess degraded protein buildup
Used for multiple myeloma

78
Q

Trastuzumab

A

Humanized tumor MAB

vs. Human Epidermal Growth Factor receptor

79
Q

Bevacizumab

A

Humanized circulatory system MAB

Blocks receptor for Vascular Epithelial Growth Factor

80
Q

Rituximab

A

Chimeric tumor MAB
CLL, RA
Inhibits CD20

Pharm Drug Flashcards (4 decks)

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