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Family Medicine > Family Medicine pharmacology > Flashcards

Family Medicine pharmacology Flashcards

1
Q

formoterol

(family/mechanism/indications)

A

long-acting β-agonists

bronchial smooth muscle relaxation (increased cAMP via adenylate cyclase activation)

step-up from low- or medium-dose inhaled corticosteroid (avoid as monotherapy)

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1
Q

lisinopril

(side effects/contraindications)

A

dry cough

angioedema

hyperkalemia

elevated creatinine

avoid in pregnancy and in patients with bilateral RAS

less effective in African-Americans

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1
Q

spironolactone

(side effects/contraindications)

A

antiandrogenic effects (gynecomastia, ED, impaired libido)

hyperkalemia (esp. in conjunction with ACEIs)

contraindicated in Addison’s disease, renal impairment/insufficiency

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1
Q

canagliflozin

(side effects/contraindications)

A

UTIs, yeast infections

hyperkalemia

volume depletion/dehydration

possible association with bladder cancer (dapagliflozin)

contraindicated in renal failure

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2
Q

ezetimibe

(side effects/contraindications)

A

diarrhea

cough/upper respiratory symptoms

elevated LFTs (potentiates statin effects)

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3
Q

albuterol

(family/mechanism/indications)

A

short-acting β-agonists

bronchial smooth muscle relaxation (increased cAMP via adenylate cyclase activation)

first-line rescue medication for attacks and EIB

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3
Q

pioglitazone

(family/mechanism/indications)

A

thiazolidinediones

increase peripheral insulin sensitivity by activation of PPARγ

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4
Q

cromolyn sodium

(side effects/contraindications)

A

unpleasant taste

inconvenient (q.i.d.) initial dosing schedule

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4
Q

theophylline

(family/mechanism/indications)

A

methylxanthines

bronchial smooth muscle relaxation (increase cAMP by blocking cAMP PDE)

step-up/add-on in patients failing other therapies

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5
Q

metoprolol

(side effects/contraindications)

A

fatigue

bradycardia (avoid in bradycardic pts)

bronchospasm (avoid in asthma or COPD)

reduced peripheral circulation

reduced exercise tolerance

“rebound” effect with abrupt withdrawal

masks effects of hypoglycemia (use caution in DM)

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6
Q

fluticasone

beclomethasone

budesonide

(family/mechanism/indications)

A

inhaled corticosteroids

reduction of inflammation and airway hyperresponsiveness

first-line medication for long-term control

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6
Q

nifedipine

(side effects/contraindications)

A

edema, CHF exacerbation

headache

flushing

gingival hyperplasia

use caution in post-MI, CHF, or in conjunction with β-blockers

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8
Q

cholestyramine

(family/mechanism/indications)

A

bile acid sequestrants

acts as peripheral “sink” for bile acids, causing knock-on increase in LDL uptake by liver

adjunct therapy to statins, esp. for elevated LDL

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9
Q

acarbose

(family/mechanism/indications)

A

α-glucosidase inhibitors

block intestinal glucose uptake at brush border

taken with meals; useful in near-goal patients with elevated postprandial glucose

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10
Q

hydrochlorothiazide

(family/mechanism/indications)

A

thiazide diuretic

disuresis/volume depletion; possible reduction in PVR

standard first-line treatment in essential hypertension

“compelling indications”: CHF, CVD risk, DM, stroke

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10
Q

acarbose

(side effects/contraindications)

A

flatulence, diarrhea

abdominal pain

possible risk of fulminant hepatitis

can cause hypoglycemia with secretagogues (treat with dextrose, not sucrose)

contraindicated in cirrhosis, IBD, intestinal obstruction, malabsorption

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11
Q

ezetimibe

(family/mechanism/indications)

A

2-azetidinones

blocks sterol transporter at intestinal brush border, impairing cholesterol uptake

exact role unclear; can be used in patients failing other therapies or as dose-sparing therapy with statins

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12
Q

repaglinide

(side effects/contraindications)

A

hypoglycemia

weight gain

avoid in pts with high risk of hypoglycemia (elderly, frail, acutely ill)

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13
Q

cromolyn sodium

(mechanism/family/indications)

A

mast cell stabilizers

alternative to ICS for maintenance therapy

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14
Q

sitagliptin

(family/mechanism/indications)

A

DPP-4 inhibitors

block degradation of GLP-1 by DPP-4, increasing GLP-1 levels (and promoting incretin effect)

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16
Q

nifedipine

(family/mechanism/indications)

A

dihydropyridine calcium channel blocker

reduced cardiac contractility and PVR (via vascular smooth muscle relaxation) - non-DHPs more cardioselective

“compelling indications”: CVD risk, DM

useful in angina

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16
Q

doxazosin

(side effects/contraindications)

A

orthostatic hypotension

syncope (first-dose or in conjunction with PDE5 inhibitor)

fatigue

avoid as monotherapy for HTN

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17
Q

ipratropium

(family/mechanism/indications)

A

anticholinergics

block smooth muscle contraction (by blocking muscarinic cholinergic receptors)

adjunct to albuterol for acute treatment

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17
Q

fluticasone

beclomethasone

budesonide

(side effects/contraindications)

A

candidiasis

irritation/epistaxis

growth impairment

steroid effects: immunosuppression, edema/hypertension, hyperglycemia, osteoporosis, adrenal suppression, catacaract/glaucoma

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19
Q

exenatide

(side effects/contraindications)

A

GI disturbances

dizziness

headache

possible risk of pancreatitis/pancreatic cancer

possible risk of thyroid tumors

contraindicated in gastroparesis, MEN

21
Q

losartan

(side effects/contraindications)

A

dry cough (less than in ACEIs)

angioedema

hyperkalemia

avoid in pregnancy and in patients with bilateral RAS

22
Q

pramlintide

(side effects/contraindications)

A

nausea

headache

abdominal pain

potentiates severe insulin-induced hypoglycemia

contraindicated in gastroparesis, hypoglycemia unawareness (e.g. β-blocker use)

23
Q

sitagliptin

(side effects/contraindications)

A

runny nose, sore throat

headaches

acute pancreatitis

angioedema

contraindicated in CHF, liver/renal failure, cancer (DPP-4 may have tumor suppressor function)

24
Q

repaglinide

(family/mechanism/indications)

A

meglitinides

secretagogue (promotes K channel closure, β cell depolarization, and insulin release); also increased peripheral insulin sensitivity

useful for elevated postprandial glucose

25
Q

losartan

(family/mechanism/indications)

A

angiotensin receptor blockers

blockade of AT1 receptors

alternative to ACEIs in intolerant patients

“compelling indications”: CHF, DM, CKD

27
Q

glyburide

(family/mechanism/indications)

A

sulfonylureas

secretagogue (promotes K channel closure, β cell depolarization, and insulin release); also increased peripheral insulin sensitivity

useful for elevated postprandial glucose

28
Q

albuterol

(side effects/contraindications)

A

tremor

tachycardia, arrhythmias

paradoxical bronchospasm

tachyphylaxis

use caution in CVD, esp. with tachycardia

30
Q

clonidine

(side effects/contraindications)

A

sedation/fatigue

dry mouth

headache

bradycardia

overshoot hypotension

rebound hypertension

31
Q

metoprolol

(family/mechanism/indications)

A

β-blockers (β1-selective)

reduced contractility and heart rate

add-on for blood pressure control

“compelling indications”: CHF, post-MI, CVD risk, DM

useful in angina or supraventricular arrhythmias

33
Q

fenofibrate

(side effects/contraindications)

A

gallstones/cholecystitis

dyspepsia

rhabdomyolysis (esp. with statins)

elevated creatinine, LFTs

DVT/PE

contraindicated in liver/gallbladder disease

34
Q

hydrochlorothiazide

(side effects/contraindications)

A

hypokalemia

hyperuricemia

increase in cholesterol, glucose

avoid in patients with anuria or gout

35
Q

lisinopril

(family/mechanism/indications)

A

ACE inhibitors

block conversion of angiotensin I to angiotensin II

“compelling indications”: CHF, post-MI, CVD risk, DM, CKD, stroke

36
Q

niacin (vitamin B3)

(side effects/contraindications)

A

flushing

pruritus

hyperuricemia/gout

hyperglycemia

contraindicated in liver disease, hypotension, PUD; caution in gout

37
Q

pramlintide

(family/mechanism/indications)

A

amylin analogues

suppresses glucagon production, slows gastric emptying, promotes satiety

adjunct to insulin in type 1 or type 2 DM; given by injection before meals

39
Q

atorvastatin

(side effects/contraindications)

A

myopathy/rhabdomyolysis

rash

elevated LFTs, liver damage/failure

mild, reversible cognitive impairments

avoid abrupt discontinuation

40
Q

hydralazine

(family/mechanism/indications)

A

direct-acting vasodilator

binds K channels to cause K efflux/hyperpolarization of vascular smooth muscle

first-line in pregnancy-induced hypertension

41
Q

metformin

(family/mechanism/indications)

A

biguanides

block hepatic glucose production; also promote peripheral insulin sensitivity

first-line treatment in DM2, especially in IFG and obese patients with normal kidney function

42
Q

metformin

(side effects/contraindications)

A

GI disturbances

weight loss

B12 malabsorption

lactic acidosis

contraindicated in CHF, renal/liver failure, with iodinated radiocontrast media, and prior to surgery

43
Q

exenatide

(family/mechanism/indications)

A

GLP-1 analogues

incretin effect (promotes insulin secretion and reduce glucagon release; slows gastric emptying)

adjunct to oral hypoglycemics in type 2 only; Bydureon is long-acting (weekly) formulation

44
Q

ipratropium

(side effects/contraindications)

A

dry mouth

urinary retention

worsening of narrow-angle glaucoma

paradoxical bronchospasm

45
Q

niacin (vitamin B3)

(family/mechanism/indications)

A

B vitamins

component of coenzymes involved in lipid metabolism

most effective medication for increasing HDL

46
Q

formoterol

(side effecs/contraindications)

A

tremor, tachycardia, arrhythmias

hypokalemia

paradoxical bronchospasm

loss of efficacy

increased risk of hospitalization/death - do not use as monotherapy without ICS

47
Q

montelukast

(side effects/contraindications)

A

GI and sleep disturbances

possible association with eosinophilia/Churg-Strauss

possible association with suicidality

contraindicated in liver failure

48
Q

clonidine

(family/mechanism/indications)

A

central α2 agonist

binds α2 receptors in vasomotor center, causing reduced norepinephrine release

useful in acute hypertensive urgency or severe, refractory hypertension

49
Q

pioglitazone

(side effects/contraindications)

A

liver failure (monitor LFTs)

edema/fluid retention, CHF exacerbation

osteoporosis

possible association with bladder cancer

contraindicated in CHF, liver failure

50
Q

cholestyramine

(side effects/contraindications)

A

constipation, flatulence, dyspepsia

hyperchloremic acidosis

malabsorption of fat-soluble vitamins

51
Q

glyburide

(side effects/contraindications)

A

hypoglycemia (lower risk with later SUs)

weight gain

avoid in sulfa-allergic and pts with high risk of hypoglycemia (elderly, frail, acutely ill)

52
Q

montelukast

(family/mechanism/indications)

A

leukotriene antagonists

block leukotriene receptors to reduce inflammation, bronchospasm, and mucus production

(ziluteon blocks leuktoriene synthesis)

adjunct or alternative to ICS; may have better compliance

53
Q

hydralazine

(side effects/contraindications)

A

reflex tachycardia/palpitations

rebound hypertension on withdrawal

headache

lupus-like syndrome

fluid/sodium retention

contraindicated in CAD, mitral valve disease

54
Q

theophylline

(side effects/contraindications)

A

tachycardia

hyperstimulation

dysrhythmias/PVCs

narrow therapeutic index

avoid in pts with PUD, uncontrolled seizures

55
Q

canagliflozin

(family/mechanism/indications)

A

SGLT-2 inhibitors

block renal glucose reuptake (peripheral “sink” effect)

possibly additional weight loss/BP benefits due to diuretic effect

57
Q

doxazosin

(family/mechanism/indications)

A

peripheral α1 antagonists

smooth muscle relaxation/vasodilation via α1 receptor blockade

causes prostate smooth muscle relaxation; potentially useful for treatment of HTN + BPH

58
Q

spironolactone

(family/mechanism/indications)

A

aldosterone antagonist (potassium-sparing diuretic)

blocks aldosterone-dependent Na/K exchange in distal tubule

“compelling indications”: CHF, post-MI

59
Q

atorvastatin

(family/mechanism/indications)

A

statins

block HMG-CoA reductase

decreased LDL, TG and increased HDL

first-line agent for elevated LDL; effective in secondary > primary prevention

60
Q

fenofibrate

(family/mechanism/indications)

A

fibrates

activate lipoprotein lipase via PPARα

decrease VLDL, LDL, TG and increase HDL

Family Medicine (1 decks)

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