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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
exenatide (side effects/contraindications)
GI disturbances dizziness headache possible risk of pancreatitis/pancreatic cancer possible risk of thyroid tumors contraindicated in gastroparesis, MEN
21
losartan (side effects/contraindications)
dry cough (less than in ACEIs) angioedema hyperkalemia avoid in pregnancy and in patients with bilateral RAS
22
pramlintide (side effects/contraindications)
nausea headache abdominal pain potentiates severe insulin-induced hypoglycemia contraindicated in gastroparesis, hypoglycemia unawareness (e.g. β-blocker use)
23
sitagliptin (side effects/contraindications)
runny nose, sore throat headaches acute pancreatitis angioedema contraindicated in CHF, liver/renal failure, cancer (DPP-4 may have tumor suppressor function)
24
repaglinide (family/mechanism/indications)
meglitinides secretagogue (promotes K channel closure, β cell depolarization, and insulin release); also increased peripheral insulin sensitivity useful for elevated postprandial glucose
25
losartan (family/mechanism/indications)
angiotensin receptor blockers blockade of AT1 receptors alternative to ACEIs in intolerant patients "compelling indications": CHF, DM, CKD
27
glyburide (family/mechanism/indications)
sulfonylureas secretagogue (promotes K channel closure, β cell depolarization, and insulin release); also increased peripheral insulin sensitivity useful for elevated postprandial glucose
28
albuterol (side effects/contraindications)
tremor tachycardia, arrhythmias paradoxical bronchospasm tachyphylaxis use caution in CVD, esp. with tachycardia
30
clonidine (side effects/contraindications)
sedation/fatigue dry mouth headache bradycardia overshoot hypotension rebound hypertension
31
metoprolol (family/mechanism/indications)
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
fenofibrate (side effects/contraindications)
gallstones/cholecystitis dyspepsia rhabdomyolysis (esp. with statins) elevated creatinine, LFTs DVT/PE contraindicated in liver/gallbladder disease
34
hydrochlorothiazide (side effects/contraindications)
hypokalemia hyperuricemia increase in cholesterol, glucose avoid in patients with anuria or gout
35
lisinopril (family/mechanism/indications)
ACE inhibitors block conversion of angiotensin I to angiotensin II "compelling indications": CHF, post-MI, CVD risk, DM, CKD, stroke
36
niacin (vitamin B3) (side effects/contraindications)
flushing pruritus hyperuricemia/gout hyperglycemia contraindicated in liver disease, hypotension, PUD; caution in gout
37
pramlintide (family/mechanism/indications)
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
atorvastatin (side effects/contraindications)
myopathy/rhabdomyolysis rash elevated LFTs, liver damage/failure mild, reversible cognitive impairments avoid abrupt discontinuation
40
hydralazine (family/mechanism/indications)
direct-acting vasodilator binds K channels to cause K efflux/hyperpolarization of vascular smooth muscle first-line in pregnancy-induced hypertension
41
metformin (family/mechanism/indications)
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
metformin (side effects/contraindications)
GI disturbances weight loss B12 malabsorption lactic acidosis contraindicated in CHF, renal/liver failure, with iodinated radiocontrast media, and prior to surgery
43
exenatide (family/mechanism/indications)
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
ipratropium (side effects/contraindications)
dry mouth urinary retention worsening of narrow-angle glaucoma paradoxical bronchospasm
45
niacin (vitamin B3) (family/mechanism/indications)
B vitamins component of coenzymes involved in lipid metabolism most effective medication for increasing HDL
46
formoterol (side effecs/contraindications)
tremor, tachycardia, arrhythmias hypokalemia paradoxical bronchospasm loss of efficacy increased risk of hospitalization/death - do not use as monotherapy without ICS
47
montelukast (side effects/contraindications)
GI and sleep disturbances possible association with eosinophilia/Churg-Strauss possible association with suicidality contraindicated in liver failure
48
clonidine (family/mechanism/indications)
central α2 agonist binds α2 receptors in vasomotor center, causing reduced norepinephrine release useful in acute hypertensive urgency or severe, refractory hypertension
49
pioglitazone (side effects/contraindications)
liver failure (monitor LFTs) edema/fluid retention, CHF exacerbation osteoporosis possible association with bladder cancer contraindicated in CHF, liver failure
50
cholestyramine (side effects/contraindications)
constipation, flatulence, dyspepsia hyperchloremic acidosis malabsorption of fat-soluble vitamins
51
glyburide (side effects/contraindications)
hypoglycemia (lower risk with later SUs) weight gain avoid in sulfa-allergic and pts with high risk of hypoglycemia (elderly, frail, acutely ill)
52
montelukast (family/mechanism/indications)
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
hydralazine (side effects/contraindications)
reflex tachycardia/palpitations rebound hypertension on withdrawal headache lupus-like syndrome fluid/sodium retention contraindicated in CAD, mitral valve disease
54
theophylline (side effects/contraindications)
tachycardia hyperstimulation dysrhythmias/PVCs narrow therapeutic index avoid in pts with PUD, uncontrolled seizures
55
canagliflozin (family/mechanism/indications)
SGLT-2 inhibitors block renal glucose reuptake (peripheral "sink" effect) possibly additional weight loss/BP benefits due to diuretic effect
57
doxazosin (family/mechanism/indications)
peripheral α1 antagonists smooth muscle relaxation/vasodilation via α1 receptor blockade causes prostate smooth muscle relaxation; potentially useful for treatment of HTN + BPH
58
spironolactone (family/mechanism/indications)
aldosterone antagonist (potassium-sparing diuretic) blocks aldosterone-dependent Na/K exchange in distal tubule "compelling indications": CHF, post-MI
59
atorvastatin (family/mechanism/indications)
statins block HMG-CoA reductase decreased LDL, TG and increased HDL first-line agent for elevated LDL; effective in secondary \> primary prevention
60
fenofibrate (family/mechanism/indications)
fibrates activate lipoprotein lipase via PPARα decrease VLDL, LDL, TG and increase HDL

Family Medicine (1 decks)

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