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Pharmacology > Exam1 -ANS, Heme, Onc > Flashcards

Exam1 -ANS, Heme, Onc Flashcards

1
Q

Isoproterenol

A 
Non-Selective Andrenergic Agonist
B1=B2 
decrease TPR, increase HR and ionotropy
C: bradycardia, heart block, CHF, MI, and electrophysiologic evaluation of tachyarrhythmias 
T: can cause Tornado de pointes
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2
Q

Alteplase
Reteplase
Tenecteplase

A

Fibrinolytics
M: plasminogen to plasmin-cleaves fibrin
C: used for acute MI, acute stroke, tPA, DVT, and PE

*bustin clots all over the plase, unless there’s acid (aminocaproic acid)

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3
Q

Vinblastine

Vincristine

A

Antimicrotubule Agent
M: arrests cells in metaphase
C: solid tumors, leukemia, and lymphoma
T: Vinb cause myelosuppresion, Vinc peripheral neuropathy, paralytic ileus

been blasting bone? yup!
vinCRISTine, think about how jesus would have liked some peripheral neuropathy on the cross

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4
Q

Pilocarpine

Muscarine

A

Direct Cholinomimetics- muscarinic alkaloids
M: contracts ciliary muscle of eye (open angle), pupillary sphincter (closed angle). resistant to AChE
C: potent stimulator of sweat, tears, saliva. open angle and closed angle glaucoma

*cry, drool, and sweat on your pillow

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5
Q

Ephedrine

A

Mixed Acting Adrenergic Agonist
M: indirect general agonist and releases stored NE
C: nasal decongestion, urinary incontinence, and hypotension

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6
Q

Trastuzumab

A

Her-2 Inhibitor (Herceptin)
M: binds HER-2 causing antibody dependent cellular toxicity
C: HER 2 is amplified in 20-25% of breast cancer
T: risk of irreversible cardiac toxicity

Her trASSt tho, heart-ceptin

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7
Q

Dopamine

A

Non Selective Sympathomimetic
M: D1=D2>B>alpha;
C: unstable bradycardia, heart failure, shock; does dependent effects

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8
Q

Tretinoin

A

All trans retinoid acid

M: induces differentiation of AML M3-Acute Promyelocytic Leukemia-highly effective

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9
Q

Tamoxifen

Raloxifene

A

Selective Estrogen Receptor Modulators (SERMs)
M: receptor antagoinsts in breast and agonists in bone block binding of estrogen to ER + cells.
C: breast cancer tx and prevention. Raloxifen used in osteoporosis
T: Tamoxifen increase risk of endometrial CA, hot flashes, and blood clotting.
Raloxifine does not cause endometrial CA

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10
Q

Amphetamine

Tyramine

A

Indirect Sympathomimetic
M: indirect general agonist, reuptake inhibitor, also releases stored catecholamines
C: narcolepsy, obesity, attention deficit disorder
Tryamine important with MAOIs and found in beer, fermented cheese, and chocolate

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11
Q

Carmustine
Iomustine
Semustine
Streptozocin

A

Alkylating Agent-nitrosoureas
M: lipophilic-crosses BBB and cross links DNA so effective against brain tumors; requires bioactivation
T: CNS toxicity

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12
Q

Bevacizumab

A

VEGF Inhibitor
M: binds VEGF which prevents it from bidding to its receptor and thus angiogenesis
C: solid tumors, colorectal, and renal cell CA
T: hemorrhage and impaired wound healing

I’ll Bevac VEGF…

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13
Q

Flutamide

A

M: blocks dihydrotestosterone from binding androgen receptors
C: used in prostate CA

lets you keep playing your skin flute-amide

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14
Q

Anastrozole

Exemestane

A

aromatase inhibitors
M: lowers estrogen and estradiol levels
C: used in postmenopausal women with breast cancer that is estrogen sensitive

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15
Q

Interleukin-2

A

M: increases NK cell activity and T-cell proliferation
C: used to tx renal CA and metastatic melanomas

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16
Q

Atropine
Ipratropium
Benztropine

A

Muscarinic Antagonists
C: atropine used to tx bradycardia and ophthalmic applications (mydriasis and cycloplegia)
ipratropium 1st line COPD and asthma
benztropine 2nd line parkinson’s

Park my Benz
Ipray i can breathe soon

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17
Q

Cisplatin

Carboplatin

A

Platinum Compounds
M: cross link DNA
C: testicular, ovary, bladder, and lung CA
T: nephrotoxicity, ototoxicity, peripheral neuropathy, emesis. PREVENT with amifostine and chloride diuresis for free radicals.
carbo causes myelosuppresion

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18
Q

Aspirin

A

Irreversible COX 1,2 inhibitor
M: decreases synthesis of thromboxane A2 and prostaglandins. increase bleeding time until new platelets but no effect on PT, PTT
C: low does for decreased platelet aggregation. Intermediate dose for antipyretic and analgesic. high dose for anti-inflammatory
T: gastric ulceration, tinniuts. chronic use can lead to acute renal failure, interstitial nephritis, and upper GI bleeding. Reye syndrome in children treated with aspirin for viral infection. stimulates respiratory centers causing respiratory alkalosis

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19
Q 
Neostigmine 
Pyridostigmine
Physostigmine
Donepezil
Rivastigmine
Galantamine
Edrophonium
A

Indirect agonists (anticholinesterases)
M: increase endogenous ACh
C: Neostigmine- postoperative and neurogenic ileus, urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade. No (Neo) CNS penetration.
Pyridostigmine- myasthenia gravis 1st line. rid of MG
Physostigmine- tx anticholinergic toxicity (crosses BBB) phyxes atropine overdose
Donepezil, Rivastigmine, and Galantamine tx Alzheimers
Edrophonium- used to be used to dx MG

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20
Q

Dobutamine

A

Direct Sympathomimetics
M: B1>B2-alpha;
C: heart failure and cardiac stress testing; increase ionotropy more than chronotropy, TPR stays about the same due to B2-alpha balance
T: careful with A-fib; increases ectopic foci

*Dont be confused with dopamine, mainly B1 agonist

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21
Q

Phenylephrine

A

Direct sympathomimetic
M: alpha1>alpha2
C: hypotension (vasoconstrict), ocular procedures (mydriasis), and rhinitis (decongestant)

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22
Q

Clonidine

Alpha-Methyldopa

A

Alpha 2 agonists
C: Clonidine- hypertensive urgency; does not decrease renal blood flow. ADHD, sever pain, and a variety of off label indications (ETOH and opioid withdrawal)
a-methyldopa- hypertension in pregnancy
T: C can cause CNS depression, bradycardia, hypotension, respiratory depression, and small pupil size
A-M can cause direct Coombs + hemolytic anemia and SLE like syndrome

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23
Q

Pargyline

Entacapone

A

MAOIs

24
Q

Fenoldopam

A

D1 selective agonist

C: hypertensive crisis- increases flow to kidneys, mesentery, coronaries, and periphery; promotes natriuresis

25
Q

tubocurarine

A

Nicotinic antagonist

non depolarizing neuromuscular blocker

26
Q

Epinephrine

A

Direct sympathomimetic
M: B>alpha
C: anaphylaxis, open angle glaucoma, asthma, hypotension; **alpha effects dominate at high doses

27
Q

Bethanechol
Carbachol
Methacholine

A

Direct cholinomimetic
C: Bethanechol- postoperative ileus, neurogenic ileus, and urinary retention
Carbachol- glaucoma, pupillary constriction, and relief of intraocular pressure
Methacholine- challenge test for diagnosis of asthma

  • Bethany, call me maybe, and we’ll activate your bowel and bladder
  • carbon copy of acetylcholine
28
Q

Propranolol Atenolol Labetalol
Nadolol Metoprolol Carvedilol
Timolol Esmolol
Pindolol Betaxolol
Acebutolol

A

Beta Blockers 1st Gen, 2nd Gen, 3rd Gen
M: 1st B1=B2, 2nd B1»B2, 3rd B1=B2>alpha 1
C: used for angina, MI (metoprolol, carvedilol, and bisoprolol reduce mortality), SVTs (metoprolol and esmolol), hypertension (decrease CO and renin by B1), CHF, and glaucoma (timolol).
T: impotence, bradycardia, AV block, CHF, CNS adverse effects like seizures, sedation, sleep alteration, and may cause exacerbation of asthma/COPD. may mask hypoglycemia in diabetics. dyslipidemia with metoprolol

29
Q

Norepinephrine

A

Direct sympathomimetic
M: alpha1>alpha2>B1
C: hypotension but decreases renal perfusion

30
Q 
Albuterol
Salmeterol
Terbutaline 
Metaproterenol
Ritodrine
A

direct sympathomimetics
M: B2>B1
C: Albuterol used for acute asthma.
Salmeterol and Metaproterenol for long term asthma and COPD control.
Terbutaline to reduce premature uterine contractions
Ritodrine used to arrest preterm labor

31
Q 
Phenoxybenzamine
Phentolamine
Prazosin
Terazosin
Doxazosin
Tamsulosin
Mertazapine
A

Alpha Blockers
C: Penoxybenzamine- pheochromocytoma used pre-op to prevent catecholamine crisis.
Phentolamine- give to patients on MAOIs who ate tyrosine containing foods
-osin ending are alpha1 selective- urinary symptoms of BPH; PTSD (prazosin), hypertension (except tamsulosin); dizziness, HA, and 1st dose orthostatic hypotension
Mirtazapine- depression; causes sedation, increase in cholesterol and appetite.

32
Q

Hydroxyurea

A

M: Inhibits ribonucleotide reductase> decreases DNA synthesis; specific to S phase
C: melanoma, CML, sickle cell disease (increase HbF)
T: bone marrow suppression, GI upset

33
Q

Azathioprine
6-mercaptopurine
6-thioguanine

A

Antimetabolite
M: purine thiol analogs that decrease de novo purine synthesis. Activated by HGPRT.
C: Azathioprine- RA, SLE, preventing organ rejection.
6-MP, 6-TG- leukemia, IBD
T: bone marrow, GI, liver. Azathioprine and 6-MP are both metabolized by xanthine oxidase; thus both have increased toxicity with allopurinol, which inhabit their metabolism.

34
Q

5-fluorouracil

A

Antimetabolite
M: pyrimidine analog bioactivated to 5F-dUMP, which covalently complexes folic acid. This complex inhibits thymidylate synthase, decreasing dTMP, DNA, and protein synthesis.
C: colon cancer, pancreatic CA, and basal cell CA (topically)
T: myelosuppression, not reversible with leucovorin. overdose reduce with uridine. also photosensitivity

35
Q

Cytarabine

Gemcitabine

A

Antimetabolite
M: pyrimidine analog that inhibits DNA polymerase
C: leukemias and lymphomas
T: leukopenia, thrombocytopenia, megaloblastic anemia, and CNS toxicity

*CYTarabine cause panCYTopenia, CNS tox

36
Q

Methotrexate

A

Antimetabolite
M: folic acid analog that inhibits dihydrofolate reductase, decreasing dTMP, and thus DNA and protein synthesis.
C: CA-leukemias, lymphomas, choriocarcinoma, sarcomas.
Non-neoplastic- abortion, ectopic pregnancy, RA, psoriasis, IBD
T: myelosuppression which is reversible with leucovorin (folinic acid) rescue. macro vesicular fatty change in liver. mucositis. teratogenic.

Metho cause methyl trapping, prevents THF

37
Q

cyclophosphamide

ifosfamide

A

Alkylating Agents
M: covalently cross link DNA at guanine N-7. require bioactivation by liver.
C: solid tumors, leukemia, lymphomas, and some brain cancers
T: myelosuppression; hemorrhagic cystitis that is partially prevented with mesna (binds toxic metabolites)

38
Q

Paclitaxel

Dectaxel

A

Microtubule inhibitors
M: hyperstabilize polymerized microtubules in M phase so that mitotic spindle cannot break down (anaphase doesn’t occur)
C: ovarian and breast carcinomas
T: myelosuppression, alopecia, peripheral neuropathy, and hypersensitivity

*it’s taxing to stay polymerized

39
Q

Etoposide

Teniposide

A

M: inhibits topoisomerase II, increased DNA degradation
C: solid tumors (particularly testicular and small cell lung CA), leukemias, and lymphomas.
T: myelosuppression, GI irritation, alopecia

*toposide=topo isomerase 2

40
Q

Irinotecan

Topotecan

A

M: inhibit topoisomerase I and prevent DNA unwinding and replication
C: colon cancer (irinotecan), ovarian and small cell lung cancers (topotecan)
T: sever myelosuppression, diarrhea

*tecan=topo isomerase I

41
Q

Bleomycin

A

M: induces free radical formation which causes breaks in DNA strands
C: testicular cancer, Hodgkin lymphoma
T: pulmonary fibrosis, skin changes, mucositis. minimal myelosuppression

*bleo-my skin and lungs alone!

42
Q

doxorubicin

daunorubicin

A

M: generate Fe free radicals. intercalate in DNA causing breaks in DNA and decreasing replication
C: solid tumors, leukemias, lymphomas
T: dilated cardiomyopathy, myelosuppression, alopecia. toxic to tissues following extravasation. *dexrazoxane (iron chelating agent) used to prevent cardiotoxicity

*rubicin>rubella>cardiomyopathy

43
Q

Dactinomycin

A

M: intercalates in DNA
C: Wilms tumor, Ewing sarcoma, rhabdomyosarcoma. used for childhood tumors.
T: myelosuppression

*children be d-actin a fool when they have Wilms tumor, Ewing sarcoma, and rhabdomyosarcoma

44
Q

Busulfan

A

M: cross links DNA
C: CML. also used to ablate patients’ bone marrow before bone marrow transplantation
T: sever myelosuppression in almost all cases, pulmonary fibrosis, hyper pigmentation.

45
Q

Imatinib (Gleevec)

A

M: tyrosine kinase inhibitor of bcr-abl (fusion gene in CML) and c-Kit (common in GI stromal tumors)
C: covered ^
T: fluid retention

*I mat B crabl-e

46
Q

Rituximab

A

M: monoclonal antibody against CD20, which is found on most B-cell neoplasms
C: non-Hodgkin lymphoma, RA with MTX, and ITP
T: increase risk of progressive multifocal leukoencephalopathy

47
Q

Vemurafenib

A

M: small molecule inhibitor of forms of the B-Raf kinase with the V600E mutation
C: metastatic melanoma

48
Q

Warfarin

A

M: albumin bound drug that interferes with gamma-carboxylation of vit K dependent clotting factors (2,7,9,10) and proteins C and S. metabolized by the CYP450 pathway. measured with PT
C: chronic anticoagulation after STEMI, DVT prophylaxis, stroke prevention in A-fib. Not used in pregnancy
T: bleeding, teratogenic, skin/ tissue necrosis, and many drug drug interactions. reversal with vitamin K or fresh frozen plasma in emergent cases

49
Q

Argatroban
Bivalirudin
Dabigatran

A

M: hirudin derivatives and direct thrombin inhibitors.
C: used instead of heparin for anticoagulating patients with HIT
T: no antidote

50
Q

Dipyridamole

Cilostazol

A

M: phosphodiesterase III inhibitor; increase cAMP in platelets thus inhibiting platelet aggregation. also vasodilate
C: intermitten claudication, coronary vasodilation, prevention of stroke or TIAs (combined with aspirin), angina prophylaxis
T: nausea, HA, facial flushing, hypotension, and abdominal pain.

51
Q

Clopidogrel
Prasugrel
Ticagrelor
Ticlopidine

A

M: inhibit platelet aggregation by irreversibly blocking ADP receptors. inhibit fibrinogen binding by preventing glycoprotein IIb/IIIa form binding to fibrinogen
C: acute coronary syndrome; coronary stenting. decrease incidence or recurrence of thrombotic stroke
T: neutropenia (ticlopidine), TTP/HUS may be seen

52
Q

Heparin
Enoxaparin
Fondaparinux

A

M: cofactor for the activation of antithrombin and bridges AT to thrombin. decrease thrombin and factor Xa. short half life for heparin. LMW Heparin (enoxaparin) acts only on factor Xa
C: immediate anticoagulation for PE, acute coronary syndrome, MI, DVT. used during pregnancy. follow PTT.
T: bleeding, thrombocytopenia (HIT), osteoporosis, drug drug interactions. rapid reversal with protamine sulfate.

53
Q

Apaxaban

Rivaroxaban

A

M: bind and directly inhibit the activity of factor Xa
C: treatment and prophylaxis of DVT and PE, stroke prophylaxis in patients with A-fib. Oral agents do not require coagulation monitoring
T: belleding. no specific reversal agent

54
Q

Abciximab
Eptifibatide
Tirofiban

A

M: bind to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation. abciximab is made from monoclonal antibody for Fab fragments
C: unstable angina, percutaneous transluminal coronary angioplasty
T: bleeding, thrombocytopenia

55
Q

Prednisone (anti-neoplastic)

Prednisolone

A

M: may trigger apoptosis. may even work on non dividing cells.
C: most commonly used glucocorticoids in cancer chemotherapy. used in CLL, non-Hodgkin lymphomas (combo therapy).
T: Cushing-like symptoms; weight gain, central obesity, muscle breakdown, cataracts, acne, osteoporosis, hypertension, peptic ulcers, hyperglycemia, and psychosis.

Pharmacology (4 decks)

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