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Pharm Exam 4 > Exam 4 flashcards > Flashcards

Exam 4 flashcards

2
Q

Prednisone (Glucocorticoid - corticosteriod) (Short-Med Acting)

A

Effect:

  • PMN increase
  • Lymphocyte/monocyte/granulocyte decrease
  • Decrease response to Ag
  • Decrease release of mediators (IL1,2, TNF-a, collagenase/elastase)
  • Inhibit Phospolipase A2 and COX2
  • liver activation Use:
  • allergic/hemato/collagen disorders
  • hepatic/renal dz SE:
  • short = nothing; see SE card
  • long = iatrogenic Cushing’s, osteoporosis, infection, ulcers
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3
Q

Methylprednisone (Glucocorticoid - corticosteriod) (Short-Med Acting)

A

Effect:

  • PMN increase
  • Lymphocyte/monocyte/granulocyte decrease
  • Decrease response to Ag
  • Decrease release of mediators (IL1,2, TNF-a, collagenase/elastase)
  • Inhibit Phospolipase A2 and COX2 Use:
  • allergic/hemato/collagen disorders
  • hepatic/renal dz SE:
  • short = nothing
  • long = iatrogenic Cushing’s, osteoporosis, infection, ulcers
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4
Q

Cyclophosphamide (Prodrug - cytotoxic/antiprolif. T/B cell)

A

Effect:

  • Alkylating agent, signal 3 inhib.
  • Non-cell cycle spec
  • Inhib B/T Cell (direct cytotox=immune supp.) Use:
  • RA
  • Leukemia SE:
  • Short term = N/V
  • Long term = Bone Marrow Supp. (leukopenia, thrombocytopenia, anemia)
  • Derm (alopecia)
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5
Q

Azathioprine (cytotoxic/antiprolif. T/B cell)

A

Effect:

  • Antimetabolite, Signal 3 inhib.
  • Cell-cycle spec
  • Inhib T > B Use:
  • Renal Allotrasplant.
  • RA (ADULT ONLY) SE:
  • Short term = N/V/D
  • Long term = Bone Marrow supp. (leukopenia, thrombocytopenia, macrocytic anemia)
  • Infections
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6
Q

Methotrexate (cytotoxic/antiprolif. T/B cell)

A

Effect:

  • Antimetabolite, Signal 3 inhib.
  • Cell-cycle spec
  • Inhibit B/T cell Use:
  • Crohn’s
  • RA
  • Leukemia SE:
  • N/V
  • Bone Marrow Supp.
  • Hepatox.
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7
Q

Mycophenolate Mofetil (T-cell supp)

A

Effect:

  • Inhib Purine synth, Signal 3 inhib.
  • Inhibit B/T cell Use:
  • Kidney/Liver/Heart rejection
  • combo w/ cyclosporine/cortico SE:
  • GI
  • neutropenia
  • infection
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8
Q

Cyclosporine (T-cell supp)

A

Effect:

  • Inhibit calcineurin and Signal 1
  • T-cell supp. Use:
  • Kidney/Liver/Heart rejection
  • w/ cortico/azathiprine
  • RA SE:
  • Nephrotox
  • HTN
  • Embryotox
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9
Q

Muromonab-CD3 (Murine - T-cell supp)

A

Effect:

  • Inhibit CD3R and Signal 1
  • T-cell supp. Use:
  • Kidney/Liver/Pancreas/Heart rejection SE:
  • Fever/Chills
  • Murine sensitivity
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10
Q

Lymphocyte Immune Globulin (Horse - T-cell supp)

A

Effects:

  • T-cell supp. Use:
  • Kidney rejection SE:
  • fever/chills
  • horse sensitivity
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11
Q

Daclizumab (Human - T-cell supp)

A

Effect:

  • Inhibit IL-2R and Signal 3 Use:
  • Kidney rejection SE:
  • GI dysfunction
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12
Q

RHO Immune Globulin (Human - Ab immunosupp.)

A

Effect:

  • Supp immune response to Rh+ RBCs Use:
  • prevent erythroblastosis fetalis SE:
  • mild
  • contra for Rh+ pts
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13
Q

Immune Globulin (Human - Replacement tx)

A

Effects:

  • increase passive immunity Use:
  • Hypogammaglobulinemia
  • Prevent infections in HIV+ SE:
  • mild
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14
Q

Interferon Beta-1b (Immunomodulators)

A

Effects:

  • Antiviral/Immunoregulatory Use:
  • MS (relapsing-remitting) SE:
  • Flu-like S/S
  • depression/suicide
  • injection site rxn
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15
Q

Interferon Gamma (Immunomodulators)

A

Effects:

  • activate phagocytic activity
  • Ab-dependent cytotox. Use:
  • chronic granulomatous dz
  • osteoporosis SE:
  • Flu-like S/S
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16
Q

Acetyl Salicylic Acid (Salicylic Acid Deriv.)

A
  • pKa = 3.5 (acidic)
  • Abs favored in LI b/c large SA (even though not favored by kinetics)
  • Kidney excretion; if you increase urine pH = increase excretion Effects:
  • Irreversible COX 1/2 inhibition Use:
  • Analgesic
  • Anitpyretic
  • Antiinflamm
  • Antirheumatic
  • prevent A/V thrombosis SE:
  • GI - inhibit COX1 .: no PGs (protection) leads to S/S
  • Tinnitus
  • Heptic
  • Renal ischemia due to PG inhibition
  • Decrease Hct/Fe serum conc. + decrease RBC lifespan
  • Hypersensativity - urticaria/angioedema
  • Reye’s (children) Rx Interactions
  • protein bound
  • anticoagulants
  • corticosteroids
  • NSAIDs
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17
Q

Diflunisal (Salicylic Acid Deriv.)

A

Effects:

  • Reversible COX1/2 inhibit Use: Analgesic (acute/chronic mild-mod) Antiinflamm RA/Osteoarthritis SE:
  • Mild GI
  • HA
  • Renal
  • Hypersensativity
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18
Q

Indomethacin (Acetic Acid Deriv.)

A

Effects:

  • Reversible COX 1/2 inhibition Use:
  • RA
  • Osteoarthritis
  • Tocolytic agent SE:
  • Severe GI
  • Prolong Gestation
  • Renal
  • HA + aggrevated depression
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19
Q

Etodolac (Acetic Acid Deriv.)

A

Effects: COX 2 > COX 1 inhibition Use: RA Osteoarthritis Post op analgesia (6-8h) SE: GI (Less severe)

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20
Q

Diclofenac (Acetic Acid Deriv.)

A

Effect:

  • Reversible COX1/2 inhibition Use:
  • RA
  • Osteoarthritis
  • Analgesia/Dysmenorrhea SE:
  • GI
  • Dizziness + HA
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21
Q

Tolmetin (Acetic Acid Deriv.)

A

Effect:

  • Reversible COX1/2 inhibition Use:
  • JRA
  • RA
  • Osteoarthritis SE:
  • GI
  • HA
  • anaphylaxis
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22
Q

Ketorolac (Acetic Acid Deriv.)

A

Effect:

  • Reversible COX1/2 inhibition Use:
  • Mod-sev acute pain SE:
  • GI
  • HA
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23
Q

Ibuprofen (Proprionic Acid Deriv.)

A

Effect:

  • Reversible COX1/2 inhibition Use:
  • RA
  • Osteoarthritis
  • Analgesia
  • Dysmenorrhea
  • Fever SE:
  • Mild GI
  • Ocular dysfunction
  • Rash/Dermatitis
  • Contra: preggo/milking
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24
Q

Naproxen (Proprionic Acid Deriv.)

A

Effects:

  • Reversible COX1/2 inhibition Use:
  • JRA
  • RA
  • Osteoarthiritis
  • Anagesia
  • Dysmenorrhea SE:
  • Mild GI
  • HA
  • Hypersensitivity
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25
Q

Ketoprofen (Proprionic Acid Deriv.)

A

Effects:

  • Reversible COX1/2 inhibition Use:
  • RA
  • Osteoarthritis
  • Analgesia
  • Dysmenorrhea SE:
  • GI - 30% of pts
  • HA
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26
Q

Oxaprozin (Proprionic Acid Deriv.)

A

Effects:

  • Reversible COX1/2 inhibition - Used Once daily Use:
  • RA
  • Osteoarthritis SE:
  • GI
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27
Q

Piroxicam (Enolic Acid Deriv. - Oxicams)

A

Effects:

  • Reversible COX1/2 inhibition Use:
  • RA
  • Osteoarthritis SE:
  • GI
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28
Q

Meloxicam (Enolic Acid Deriv. - Oxicams)

A

Effects:

  • Reversible COX 2 > 1 inhibition Use:
  • Osteoarthritis SE:
  • GI
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29
Q

Nabumetone (Non-acidic)

A

Effect:

  • Reversible COX 2 > 1 inhibition Use:
  • RA
  • Osteoarthritis SE:
  • GI
  • HA
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30
Q

Celecoxib (COX-2 Inhibitor)

A

Effect:

  • Selective COX 2 inhibition Use:
  • Osteoarthritis
  • RA
  • dysmenorrhea
  • acute pain
  • familial adenomatous polyposis SE (all minor):
  • GI (less than COX 1 inhibitors)
  • HA and dizziness
  • Respiratory
  • Rash
  • Sulfonamide allergy
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31
Q

Acetaminophen

A

Effect:

  • analgesia (increase pain threshold)
  • weak COX1/2 inhibition
  • antipyresis via reg. @ hypothalamic heat-reg center Use:
  • analgesia
  • antipyretic
  • Osteoarthritis SE:
  • Heptotox
  • Nephrotox
  • Rash (minor)
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32
Q

Epinephrine (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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33
Q

Isoproterenol (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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34
Q

Metaproterenol (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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35
Q

Albuterol/Levalbuterol (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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36
Q

Salmeterol (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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37
Q

Terbutaline (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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38
Q

Pirbuterol (Adrenergic Bronchodilator)

A

Effect:

  • Bronchodilation
  • inhibit degranulation from mast cells Use:
  • acute asthma attacks/asthmatic bronchospasms
  • anaphylactic reactions SE:
  • CNS stimulation
  • Cardiac stimulation
  • tolerance/rebound bronchospasm
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39
Q

Theophylline (Methylxanthine Bronchodilator)

A

Narrow therapeutic window Not used b/c of SEs Effect: bronchodilation inhibit mast cell degranulation inhibit PDE4 -> increase cAMP in mast cell and smooth muscle interact with adenosine receptors Use: oral in conjunction with other Rx for severe asthma SE: Mild: N/V, HA, insomnia, nervousness Severe: arrhythmias, seizures

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40
Q

Aminophylline (Methylxanthine Bronchodilator)

A
  • Narrow therapeutic window
  • Not used b/c of SEs Effect:
  • bronchodilation
  • inhibit mast cell degranulation
  • inhibit PDE4 -> increase cAMP in mast cell and smooth muscle
  • interact with adenosine receptors Use:
  • IV for severe asthma SE:
  • Mild: N/V, HA, insomnia, nervousness
  • Severe: arrhythmias, seizures
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41
Q

Beclomethasone (Corticosteroid)

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting Use:
  • prophylactic NOT acute SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
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42
Q

Flunisolide (Corticosteroid)

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting Use:
  • prophylactic NOT acute SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
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43
Q

Triamcinolone (Intermediate-acting Glucorticoid)

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting
  • no mineralcorticoid activity Use:
  • prophylactic NOT acute
  • intralesional
  • allergic rhinitis
  • ophthalmic
  • bronchial asthma
  • oral ulcerative lesions
  • adrenocortical insuff,
  • DZ: derm, endocrine, GI, hem/neo, NS, nephro, rheumatic , resp, SLE SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
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44
Q

Fluticasone

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting Use:
  • prophylactic NOT acute SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
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45
Q

Budesonide (Corticosteroid)

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting Use:
  • prophylactic NOT acute SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
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46
Q

Mometasone (Corticosteroid)

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting Use:
  • prophylactic NOT acute SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
47
Q

Ciclesonide (Corticosteroid)

A

Effects:

  • antiinflammatory
  • inhibit leukocyte recruitment
  • inhibit synthesis/release of PGs, TXs, leukotrienes, PAFs, etc.
  • reduce cell mediated bronchial epithelial damage
  • slow acting Use:
  • prophylactic NOT acute SE:
  • Cataracts (inhaled steroids)
  • Cushing Syndome
  • Immunosuppression
  • Osteoporosis
  • Peptic ulcer
  • Growth suppression in kids (systemic use)
  • Hypothalamic-Pit axis suppression
  • Menstrual/repro problems
48
Q

Cromolyn Sodium (Mast Cell Stabilizer)

A

Effect:

  • inhibit degranulation Use:
  • prophylaxis of bronchial asthma in conjunction with other agents
  • rhinitis, conjunctivitis, GI allergies SE: (rare)
  • throat irritation
  • cough
  • dry mouth
  • wheezing
  • HA
  • bronchospams
  • laryngeal edema
  • rash
49
Q

Monteleukast (Leukotriene Modulator)

A

Effects:

  • Cysteinyl leukotriene receptor antagonist Use:
  • oral
  • decrease frequency/severity of asthma attacks
  • Seasonal allergies
50
Q

Zafirleukast (Leukotriene Modulator)

A

Effects:

  • Cysteinyl leukotriene receptor antagonist Use:
  • oral
  • decrease frequency/severity of asthma attacks
  • Seasonal allergies
51
Q

Zileuton (Leukotriene Modulator)

A

Effects:

  • 5-lipoxygenase inhibitor Use:
  • oral
  • decrease frequency/severity of asthma attacks
  • 4x daily SE:
  • Heptatotox
  • liver enzyme elevation
52
Q

Ipratropium (Antimuscarinic)

A

Effect:

  • prevent Ach induced bronchospasm
  • Quarternary salt; poor abs .: few systemic effects SE:
  • dry secretions
53
Q

Tiotropium (Antimuscarinic)

A

Effect:

  • prevent Ach induced bronchospasm
  • COPD SE:
  • dry secretions
54
Q

Aclidinium (Antimuscarinic)

A

Effect:

  • prevent Ach induced bronchospasm
  • COPD SE:
  • dry secretions
55
Q

Advair Diskus (Combo prep)

A

Salmeterol + Fluticasone

56
Q

Combivent (Combo prep)

A

Ipratropium + Albuterol

57
Q

Symbicort (Combo prep)

A

Formoterol + Budesonide

58
Q

Dulera (Combo prep)

A

Formoterol + Mometasone

59
Q

Omalizumab (Anti-IgE)

A
60
Q

Diphenhydramine (H1 Antagonist - Sedating)

A

Effect:

  • block H1 receptors Use:
  • allergies
  • rhinitis
  • dermatitis
  • NOT bronchospastic conditions
  • antiemetic - vestibular system/CRTZ
  • antitussive
  • Sedation SE:
  • dry secretions
61
Q

Fexofenadine (H1 Antagonist - Non-sedating)

A

Effect:

  • block H1 receptors Use:
  • rhinitis
  • dermatitis
  • NOT bronchospastic conditions SE:
  • dry secretions
62
Q

Cetirizine (H1 Antagonist - Non-sedating)

A

Effect:

  • block H1 receptors Use:
  • rhinitis
  • dermatitis
  • NOT bronchospastic conditions SE:
  • dry secretions
63
Q

Loratidine (H1 Antagonist - Non-sedating)

A

Effect:

  • block H1 receptors Use:
  • rhinitis
  • dermatitis
  • NOT bronchospastic conditions SE:
  • dry secretions
64
Q

GLUCOCORTICOIDS (Effects)

A

2 types of negative feedback on ACTH secretion enhance Glc production stim hepatic gluconeogenesis decrease periph Glc utilization increase proteolysis/AA release (periph/intestial tissues) enhance FA mobilization/lipolysis/FA + glycerol release/choleserol synth potentiate adrenergic VC on small vessels decrease histamine release -> decrease capillary perm. increase plasma [Hb] increase plasma RBCs, WBCs, PMNs decrease eosinophils, basophils, monocytes, lymphocytes induce lipocortin production -> inhibits phospholipase A2 => decrease PGs/Leukotrienes decrease inflamm mediator release

65
Q

GLUCOCORTICOID - SE

A
  • decrease gastric mucus barrier -> bleeding/ulcers
  • Edema
  • Hyperglycemia
  • increased serum TAGs
  • hypokalema -> arrhythmias
  • metabolic alkalosis
  • hypophosphatemia ->mm weakness/cardiac dys/hemolysis
  • osteonecrosis (femoral head)
  • negative nitrogen balance
  • insomnia, inc appetite, nervousness, irritability, sleep change, psychotic episodes
  • growth supp.
  • myopathy (protein catabolism)
  • skin thinning + purpura
  • SCC/BCC
  • acne, alopecia, hypertrichosis, striae
  • Cushingoid features
  • inc IOP (decreased outflow)
  • enhanced ocular infections/perforations
  • cataracts
  • increase infection risk - reactivate TB
  • HPA supp.
  • Fetus - cross placenta = cleft palate, fetal renal hypoplasia
66
Q

Hydrocortisone (Short-Med Acting)

A
  • GLUCOCORTICOID Effect:
  • See Glucocorticoid effect card
  • strong mineralcorticoid activity
  • 1-2hr half-life
  • urine excretion Use:
  • adrencortical insuff
  • anti-inflamm
  • relief of inflamm to corticosteroid responsive dermatoses
  • ulcerative colitis SE:
  • See SE card
67
Q

Dexamethasone (Long-acting Glucocorticoid)

A

Effect:

  • hepatic meta
  • no mineralcorticoid activity
  • 5+ hr half-life
  • urine/feces excretion Use:
  • anti-inflamm
  • immunosupp.
  • Allergies
  • bacterial meningitis (before ABX)
  • collagen disorders (acute exacerbations) - SLE
  • idiopathic hemolytic anemia/ITP
  • Respiratory distress syndrome
  • conjunctivitis
  • otic inflammation SE:
  • see SE card
68
Q

Metyrapone (Glucocorticoid synth inhibitor + antagonist)

A

Effect:

  • inhibits cortisol and aldosterone Use:
  • hypersecretion of adrenalcorticoids
69
Q

Ketoconazole (Glucocorticoid synth inhibitor + antagonist + Antifungal)

A

Effects:

  • block all sterioid biosynthesis Use:
  • Cushing’s disease
  • antifungal
  • acts synergistically w/ metyrapone
70
Q

Fludrocortisone (mineralocorticoid agonist)

A

Effect:

  • control renal excretion of cations
  • promote reabsorption of Na in distal tubules - maintain blood volume
  • increase Na/K ATPase
  • enchance K/H+ excretion
  • hepatic meta
  • urine/feces excretion
  • 30min half-life Use:
  • aldosterone replacement
  • Adrenocortical insuff. - Addison’s SE:
  • hypokalemia
  • metabolic alkalosis
  • increase plasma volume
  • HTN/edema
  • convusions, HA, dizziness
  • acne, rash, bruising
  • growth supp.
  • HPA supp
  • hyperglycemia
  • peptic ulcer
  • mm weakness
  • cataracts
71
Q

Spironolactone (mineralocorticoid antagonist)

A

Effect:

  • competes w/ aldosterone
  • increase Na/H2O excretion
  • conserve K/H+
  • block aldosterone @ arteriolar sm
  • hepatic meta
  • 10 min half-life Use:
  • manage edema from excessive aldosterone excretion
  • HTN
  • CHF
  • 1˚ hyperaldosteronism
  • hypokalemia
  • cirrhotic liver SE:
  • Edema
  • drowsy, lethargy, HA, confusion, fever, ataxia, fatigue
  • rash, urticaria, hirsutism, eosinophilia
  • gynecomasta
  • hyperkalemia, hyponatremia, dehydration
  • amenorrhea, postmenopausal bleed
  • agranulocytosis
  • hepatotox
  • increased BUN
72
Q

Doxylamine (H1 Antagonist - Very Sedating)

A

Effect:

  • H1 competative antagonist
  • reduce severity of histamine stim: pain, itch, flare, VD, vasc perm increase, and congestion
  • NO inhibition of mediator release
  • NO reversal of anaphylactic bronchospasm Use:
  • Allergies - Rhinitis, sneezing, wheezing, itchy eye/nose/throat, dermatitis
  • Cold - nasal irritation
  • Sedation
  • decrease resp sec
  • anticholinergic - parkinson’s SE:
  • anticholinergic
  • sedation,drowsy,confusion,amnesia,behavior change
  • paradoxic CNS stim (kids)
  • rash
  • interfere w/ allergy testing
73
Q

Promethazine hydrochloride (H1 Antagonist - Very Sedating)

A

Effect:

  • H1 competative antagonist
  • reduce severity of histamine stim: pain, itch, flare, VD, vasc perm increase, and congestion
  • NO inhibition of mediator release
  • NO reversal of anaphylactic bronchospasm Use:
  • Antitussive
  • Allergies - Rhinitis, sneezing, wheezing, itchy eye/nose/throat, dermatitis
  • Cold - nasal irritation
  • Antiemetic - motion sick/vert + N/V in preggo - vestibular system/CRTZ
  • Sedation
  • decrease resp sec
  • anticholinergic - parkinson’s SE:
  • anticholinergic
  • sedation, drowsy, confusion, amnesia, behavior change
  • paradoxic CNS stim (kids)
  • rash
  • interfere w/ allergy testing
74
Q

Hydroxine (H1 Antagonist - Very Sedating)

A

Effect:

  • H1 competative antagonist
  • reduce severity of histamine stim: pain, itch, flare, VD, vasc perm increase, and congestion
  • NO inhibition of mediator release
  • NO reversal of anaphylactic bronchospasm Use:
  • Allergies - Rhinitis, sneezing, wheezing, itchy eye/nose/throat, dermatitis
  • Cold - nasal irritation
  • Antiemetic - motion sick/vert + N/V in preggo
  • Sedation
  • decrease resp sec
  • anticholinergic - parkinson’s SE:
  • anticholinergic
  • sedation, drowsy, confusion, amnesia, behavior change
  • paradoxic CNS stim (kids)
  • rash
  • interfere w/ allergy testing
75
Q

Dimenhydrinate (H1 Antagonist - Sedating)

A

Effect:

  • H1 competative antagonist
  • reduce severity of histamine stim: pain, itch, flare, VD, vasc perm increase, and congestion
  • NO inhibition of mediator release
  • NO reversal of anaphylactic bronchospasm Use:
  • Allergies - Rhinitis, sneezing, wheezing, itchy eye/nose/throat, dermatitis
  • Cold - nasal irritation
  • Antiemetic- vestibular system/CRTZ
  • decrease resp sec
  • anticholinergic - parkinson’s SE:
  • anticholinergic
  • sedation, drowsy, confusion, amnesia, behavior change
  • paradoxic CNS stim (kids)
  • rash
  • interfere w/ allergy testing
76
Q

Chlorpheniamine maleate (H1 Antagonist - Sedating)

A

Effect:

  • H1 competative antagonist
  • reduce severity of histamine stim: pain, itch, flare, VD, vasc perm increase, and congestion
  • NO inhibition of mediator release
  • NO reversal of anaphylactic bronchospasm Use:
  • Allergies - Rhinitis, sneezing, wheezing, itchy eye/nose/throat, dermatitis
  • Cold - nasal irritation
  • decrease resp sec
  • anticholinergic - parkinson’s SE:
  • anticholinergic
  • sedation, drowsy, confusion, amnesia, behavior change
  • paradoxic CNS stim (kids)
  • rash
  • interfere w/ allergy testing
77
Q

Meclizine (H1 Antagonist - Sedating)

A

Effect:

  • H1 competative antagonist
  • reduce severity of histamine stim: pain, itch, flare, VD, vasc perm increase, and congestion
  • NO inhibition of mediator release
  • NO reversal of anaphylactic bronchospasm Use:
  • Allergies - Rhinitis, sneezing, wheezing, itchy eye/nose/throat, dermatitis
  • Cold - nasal irritation
  • Antiemetic - motion sick/vert- vestibular system/CRTZ
  • decrease resp sec
  • anticholinergic - parkinson’s SE:
  • anticholinergic
  • sedation, drowsy, confusion, amnesia, behavior change
  • paradoxic CNS stim (kids)
  • rash
  • interfere w/ allergy testing
78
Q

Cimetidine (H2 - Antagonist)

A

Effect:

  • competative H2 antagonist - inhibit gastric acid sec. (response to vagal stim, gastrin, stress) Use:
  • duo/gastric/stress ulcer
  • GERD
  • ZES
  • pre-op; dec aspiration damage SE:
  • HA, dizzy, nausea, rash, itching (elderly w/ renal dz)
  • antiandrogenic - dec. libido, impotence, gynecomastia
  • cytopenias
  • increase [creatinine]
  • Drug interactions: inhibit hepatic microsomal drug enzymes and alter gastric pH
79
Q

Ranitidine (H2 - Antagonist)

A

Effect:

  • competative H2 antagonist - inhibit gastric acid sec. (response to vagal stim, gastrin, stress) Use:
  • duo/gastric/stress ulcer
  • GERD
  • ZES
  • pre-op; dec aspiration damage SE:
  • HA, dizzy, nausea, rash, itching (elderly w/ renal dz)
  • Drug interactions: inhibit hepatic microsomal drug enzymes and alter gastric pH
80
Q

Famotidine (H2 - Antagonist)

A

Effect:

  • competative H2 antagonist - inhibit gastric acid sec. (response to vagal stim, gastrin, stress) Use:
  • duo/gastric/stress ulcer
  • GERD
  • ZES
  • pre-op; dec aspiration damage SE:
  • HA, dizzy, nausea, rash, itching (elderly w/ renal dz)
  • Drug interactions: inhibit hepatic microsomal drug enzymes and alter gastric pH
81
Q

Nizatidine (H2 - Antagonist)

A

Effect:

  • competative H2 antagonist - inhibit gastric acid sec. (response to vagal stim, gastrin, stress) Use:
  • duo/gastric/stress ulcer
  • GERD
  • ZES
  • pre-op; dec aspiration damage SE:
  • HA, dizzy, nausea, rash, itching (elderly w/ renal dz)
  • Drug interactions: inhibit hepatic microsomal drug enzymes and alter gastric pH
82
Q

Scopolamine

A
  • Transderm prep - prevents some SEs Effects:
  • antimuscarinic
  • act on vestibular system Use:
  • vertigo and motion sickness SE:
  • anticholinergic
  • sedation, confusion, amnesia
83
Q

Prochlorperazine (phenothiazine)

A

antiemetic

84
Q

Metoclopramide

A

Effect:

  • DA antagonist @ CRTZ
  • increase GI tone and motility
  • increase tone of lower eso sphincter Use:
  • antiemetic - chemo/radiation
  • GERD
  • preop - aspiration vomitus SE:
  • sedation
  • extrapyramidal motor dys
85
Q

Ondansetron (5-HT3 antagonist)

A

Effect:

  • depress CRTZ
  • inhibit seratonin med aff input to GI Use:
  • antiemetic - chemo and postop N/V SE:
  • drug interaction - hepatic enzyme meta
  • HA
  • Constipation
86
Q

Granisetron (5-HT3 antagonist)

A

Effect:

  • depress CRTZ
  • inhibit seratonin med aff input to GI Use:
  • antiemetic - chemo and postop N/V SE:
  • drug interaction - hepatic enzyme meta
  • HA
  • Constipation
87
Q

Dronabinol (THC)

A

Use:

  • antiemetic - chemo SE:
  • sedation
  • confusion
  • disorientation
  • Loss of control
  • altered sensation
  • paranoia
  • pyschosis
  • Munchies! - good and bad
88
Q

Aprepitant

A
  • expensive Effect:
  • P/neurokinin receptor (NK1) antagonist
  • inhibit gastric motility and fxn Use: antiemetic - chemo SE:
  • well tolerated
89
Q

Opioid - Codeine/Hydrocodone

A

Use:

  • most effective antitussive
  • lower dose than analgesic SE:
  • sedation
  • light headedness
  • confusion
  • nausea
  • dizzy
  • constipation
  • Abuse potential - dependence
90
Q

Dextromethorphan

A
  • Non-opiod Effect:
  • block NMDA receptors in cough center Use:
  • antitussive - mild/mod
  • lower abuse potential than codeine SE:
  • Mild: sedation, dizzy, confusion
91
Q

Benzonatate

A

Effect:

  • local anesthetic - desens. receptors in airway
  • some effect @ cough center Use:
  • antitussive SE:
  • Mild: constipation, nasal congestion, nausea, drowsy, rash
92
Q

Guaifenesin (Expectorant)

A

Effect:

  • irritate GI -> activate reflexes -> increase mucus in airway Use:
  • antitussive
93
Q

Acetylcysteine (Mucolytic)

A

Effect:

  • break mucus plug
  • disrupt disulfide link -> decrease viscosity Use:
  • antitussive
  • following: surgery, tracheotomy, severe bronch., emphysema
  • Acetaminophen antidote
94
Q

Hydroxychloroquine sulfate (Non-biologic DMARD)

A

Effect:

  • rapid GI abs
  • Half-life: 6-7d
  • deposit in tissues (eyes, brain, liver, spleen, lung, kidney, heart) Use:
  • 2nd-line for moderate RA w/ methotrexate
  • SLE
  • Antimalarial SE:
  • Ocular Tox
  • pigmentation/psoriasis
  • Contra: Preggo
  • hypersensativity
95
Q

Sulfasalzine (Non-biologic DMARD)

A

Effect:

  • Immunosupp.
  • CT affinity
  • High conc. in liver/intestines Use:
  • RA w/ hydroxychloroquine + parentral gold + methotrexate
  • Chronic ulcerative colitis SE:
  • reversible neutropenia
  • Anorexia
  • HA
  • vomiting
  • gastric distress
96
Q

Leflunomide (Non-biologic DMARD)

A

Effect:

  • inhibit pyrimidine synth
  • inhibit dihydroorotate dehydrogenase Use:
  • RA (adult) SE:
  • Diarrhea
  • elevated ALT/AST
  • immunosuppression
  • rash/alopecia
97
Q

Etanercept (Biologic DMARD)

A

Effect:

  • Bind TNF a/b; inhibit receptor binding
  • mod TNF dependent activities Use:
  • RA
  • JRA
  • combo w/ methotrexate SE:
  • hypersensativity
  • discontinue in pt w/ sepsis/infections
98
Q

Infliximab (Biologic DMARD)

A

Effect:

  • Neutralize TNF-a NOT b
  • inhibit TNF-a dep activities Use:
  • RA
  • Crohn’s
  • combo w/ methotrexate SE:
  • hypersensativity
  • immunosupp.
  • infection
  • HACA Abs
99
Q

Levothyroxine (Hypothyroidism)

A

Effect:

  • T4 converted to T3 in periph.
  • increase dose for preggos or pts on estrogen tx Use:
  • hypothyroidism
100
Q

131I (Hyperthyroidism)

A

Effect:

  • thyroid uptakes radioisotope -> damages tissue Use:
  • Hyperthyroidism
  • thyroid cancer SE:
  • low cancer risk
  • contra: nursing mommies
101
Q

Propylthiouracil (Hyperthyroidism)

A

Effect:

  • inhibit iodination reactions (3rd step)
  • Inhibit iodotyrosines (4th step)
  • does not inhibit release of preformed T3/T4
  • block T4->T3 conversion: periph effects before T3/T4 depletion Use:
  • hyperthyroidism
  • good for preggos - more protein binding SE:
  • Rash
  • arthralgia
  • heptatotox - minor/reversible
  • Agranulocytosis - fatal
  • vasculitis - rare
  • lupus rxn - rare
102
Q

Methimazole (Hyperthyroidism)

A

Effect:

  • inhibit iodination reactions (3rd step)
  • Inhibit iodotyrosines (4th step)
  • does not inhibit release of preformed T3/T4 Use:
  • hyperthyroidism
  • periph effects before T3/T4 depletion SE:
  • Rash
  • arthralgia
  • heptatotox - minor/reversible
  • Agranulocytosis - less than PTU
  • vasculitis - rare
  • lupus rxn - rare
103
Q

KI (Lugol’s Solution) (Hyperthyroidism)

A

Effects:

  • 5% iodine + 10% K
  • competative uptake of Iodine
  • inhibit hormone synth (block 1st step)
  • inhibit release of preformed hormone (6th step) Use:
  • radioactive disaster
  • conjunction w/thionamides
  • temporary effects
  • thyroid storm tx SE:
  • Rash
  • salivary gland swelling
  • metallic taste
  • sore teeth
104
Q

Alendronate (Osteoporosis, Paget’s)

A

Effects:

  • inhibit bone resorption w/o impairing mineralization Use:
  • Paget’s - last for mos, good pain reduction
  • osteoporosis - increased bone density/decrease fractures SE:
  • GI distress
  • esophageal erosion
  • take w/ large glass of H2O + sit upright for 30 min
105
Q

Risedronate (Osteoporosis)

A

Effects:

  • binds hydroxyapetite in bone - decrease turnover Use:
  • Paget’s - increase bone density
  • osteoporosis SE:
  • GI distress
  • esophageal erosion
  • Take w/ large glass H2O + sit upright for 30 min
106
Q

Ibandronate (Osteoporosis)

A

Effects: decrease bone turnover Use: 1x/mo dose osteoporosis SE: GI distress Esophageal erosion high dose - constipation, flu-like S/S, extremity pain

107
Q

Zoledronic Acid (Osteoporosis, Hypercalcemia, Paget’s)

A

Effects:

  • very potent osteoclast inhibitor Use:
  • IV - 1x/y SE:
  • fever
  • N/V/D
  • constipation
  • GI pain
  • osteonecrosis of jaw
108
Q

Teriparatide (Osteoporosis)

A

Effects:

  • PTH - increase osteoblast activity -> increase Ca deposition
  • increase bone formation in spine and femoral neck Use:
  • osteoporosis
  • SubQ injection, 1x/d, expensive SE:
  • osteosarcoma
  • nausea
  • dizziness
  • leg cramps
109
Q

Raloxifene (Osteoporosis)

A

Effect:

  • selective estrogen receptor modulation - bone agonist and breast/uterus antagonist (no cancer risk) Use:
  • osteoporosis
  • postmenopasual women SE:
  • venous thromboembolism
110
Q

Calcitriol (Osteoporosis, Hypoparathyroidism)

A

Effects:

  • potent VitD metabolite - increase Ca abs and decrease Ca/phos excretion
  • decrease bone resorption
  • promote osteoblast precursor cell recruitment Use:
  • osteoporosis - decrease fractures
  • hypoparathyroidism
  • No kidney/liver activation
111
Q

Calcitonin (Hypercalcemia, Paget’s)

A

Effects:

  • inhibit osteolysis (decrease serum Ca) and increase Ca excretion
  • from salmon or human Use:
  • hypercalcemia
  • Paget’s
  • postmenopausal osteoporosis SE:
  • well tolerated
  • rash
  • vomit
  • facial flushing (salmon version b/c of Ab against salmon)
112
Q

Pamidronate (Hypercalcemia)

A

Effect:

  • bisphosphonate substitute - decrease bone turnover Use:
  • hypercalcemia of malignancy
  • decrease bone pain/fracture in MM and metastatic breast cancer
  • injection; expensive SE:
  • Nausea
  • anorexia
  • leukopenia
  • injection site rxn

Pharm Exam 4 (1 decks)

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