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Pharmacology I > final > Flashcards

final Flashcards

1
Q

rapid acting insulins (3)

A
  • lispro
  • aspart
  • glulisine
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2
Q

rapid acting peak

A

•0.5-1 hr

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3
Q

short acting insulin

A

•regular

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4
Q

short acting peak

A

•2-3 hr

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5
Q

intermediate acting insulins (2)

A
  • NPH

* detemir

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6
Q

intermediate acting peak

A

•4-12 hr

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7
Q

long-acting insulin

A

•glargine

*no peak

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8
Q

mixing insulin

A

•draw up short first, then long

*glargine and detemir CANNOT be mixed

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9
Q

thiazide diuretics and glucocorticoids interaction w/ insulin

A

•raise blood glucose, so counteract insulin effects

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10
Q

beta blockers and insulin

A
  • mask SNS response to hypoglycemia

* difficult to ID tachy, tremor s/sx of hypoglycemia

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11
Q

sulfonylureas (4)

A
  • tolbutamide
  • glipizide
  • chlorpropamide
  • glyburide
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12
Q

sulfonylurea considerations

A

•take 30 min before meal

*avoid alcohol

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13
Q

meglitinides (2)

A
  • repaglinide

* nateglinide (starlix)

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14
Q

repaglinide considerations

A
  • eat w/in 30 min
  • tid
  • no GF
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15
Q

biguanide

A

•metformin (glucophage)

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16
Q

biguanide considerations

A 
•GI effects
•B12/folic acid deficiency 
•lactic acidosis
•r/o kidney fail if use w/ iodine 
•contra in infection, shock, hypoxia 
*also used for PCOS
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17
Q

thiazolidinedione

A

•pioglitazone (actos)

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18
Q

pioglitazone considerations

A
  • fluid retention (contra in HF)
  • raises LDL
  • r/o hepatotoxicity
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19
Q

alpha glucosidase inhibitors

A
  • acarbose

* miglitol

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20
Q

acarbose considerations

A
  • GI effects (contra)
  • anemia
  • hepatotoxicity
  • tid w/ first bite
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21
Q

gliptin

A

•sitagliptin (Januvia)

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22
Q

NSAIDS interactions

A
  • inc. hypoglycemic effect w/ insulin/OHAs
  • inc. lithium levels
  • dec. effects of diuretics b/c reduce UOP
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23
Q

OHA important facts

A
  • ALWAYS contra in DKA
  • only used in type 2
  • combined w/ diet/exercise
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24
Q

meds safe in diabetics

A
  • ACE inhibitors
  • ARBs
  • CCBs
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25
Q

meds contraindicated in diabetics

A
  • NSAIDS
  • diuretics
  • beta blockers
  • Niacin
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26
Q

furosemide (lasix)

A

•high ceiling loop diuretic

*ototoxicity, hyperglycemia b/c inhibits insulin release

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27
Q

torsemide
ethacrynic acid
bumetanide

A

•high ceiling loop diuretics

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28
Q

hydrochlorothiazide (hydrodiuril)

A

•thiazide diuretic
•hyperuricemia
*does NOT work in renal-insufficient

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29
Q

Spironolactone (Aldactone)

A

•K+ sparing diuretic (r/o hypERkal)
•preferred HF drug
*endocrine, acne, lethargy, diarhhea

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30
Q

mannitol (Osmitrol)

A

•osmotic diuretic

*caution in HF pt

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31
Q

diuretic considerations

A
  • r/o hyponat, hypokal, hypoten, dehydration, hyperglycemia
  • take in AM
  • additive hypotensive w/ anti-HTN
  • hypokal w/ dig.
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32
Q

“…prils”

A

•ACE inhibitors (dec. BP)

*cough, angioedema, neutropenia, hyperK, distorted taste

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33
Q

“…sartans”

A

•ARBs (dec. BP)

  • angioedema
  • DONT take w/ food
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34
Q

sodium nitroprusside (Nitropress)

A

•vasodilator

  • MAJOR r/o cyanide toxicity (delirium)
  • keep away from light
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35
Q

“…olol”

A

•beta-blocker

  • bronchoconstriction, inhibited glycogenolysis
  • avoid anti-acids and vit. C
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36
Q

Nitroglycerin

A

•nitrate (angina)

  • reflex tachy, ortho, HA
  • lie down when take
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37
Q

verapamil
diltiazem
nifedipine

A

•CCB

  • constipation, peripheral edema, ortho
  • avoid GF juice
  • antidote is calcium gluconate or beta blocker
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38
Q

Digoxin

A

•cardiac glycoside (dysrhythmias)

*dysrhythmias, N/V/D, fatigue, visual disturb

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39
Q

dig therapeutic range

A

•0.5-2.0

*toxicity occurs at 1.75 in some

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40
Q

s/sx dig toxicity

A
  • fatigue
  • GI distrubances (anorexia)
  • visual changes
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41
Q

dig and diuretics r/o…

A

•hypokalemia

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42
Q

dig and ACEI/ARB r/o…

A

•hyperkalemia

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43
Q

dig r/o toxicity w/…

A
  • quinidine

* verapamil

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44
Q

dig and anti-acids r/o…

A

•decreased effectiveness

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45
Q

dig and sympathomimetics r/o…

A

•inc. FOC

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46
Q

quinidine

A

•Na+ channel blocker (dysrhyth)

  • diarrhea, cinchonism
  • PO w/ meals
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47
Q

amiodarone

A

•K+channel blocker (dysrhyth)

  • pulmonary tox, liver dys, hypothyroid, photosensitivity
  • draw up slowly
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48
Q

adenosine (Adenocard)

A

•anti-dysrythmic

  • flushing
  • caution in OA & asthmatics
49
Q

colesevelam

A

•lowers LDL

  • take w/ food
  • safest lipid lowering
50
Q

“…statins”

A

•lower LDL, HDL, and TG

  • myopathy, HA, GI, rash
  • take in PM, lifelong, no GF
51
Q

niacin

A

•lowers LDL, HDL, TG

  • flushing, hyperglycemia
  • NO myopathy
52
Q

Gemfibrozil (Lopid)

A

•lowers TG
•raises VLDL and HDL
*GI, rash, myopathy, gallstones

53
Q

Ezetimibe (Zetia)

A

•lowers LDL

54
Q

bethanechol (urecholine)

A

•muscarinic agonist

*bronchoconstriction

55
Q

SLUDGE BAM

A 
*muscarinic agonist effects
Salivation, secretion, sweating
Lacrimation
Urination
Defecation
GI effects
Emesis
Bradycardia
Abd pain
Myosis
56
Q

atropine

A

•muscarinic antagonist (anti-cholinergic)

*inc. IOP

57
Q

succinylcholine Anectine)

A

•NMB during intubation (sedate 1st)

*caution w/ abx & burns

58
Q

neostigmine

A

•cholinesterase inhibitor

  • urinary urgency, nausea
  • assess muscle (swallow) status 1st
59
Q

epinephrine & norepinephrine

A

•catecholamine

*vasoconstriction, HTN, hypergly

60
Q

dopamine

A

•catecholamine

  • avoid K+, whole grain, protein
  • get Hct 1st
61
Q

prazosin (minipress)

A

•sympatholytic adrenergic blocker

*ortho hypo

62
Q

clonidine & methyldopa

A

•central adrenergic blocker

*drowsiness, dry mouth

63
Q

heparin & enoxaparin

A

•anti-coagulant

*antidote is protamine sulphate

64
Q

labs to monitor heparin therapy

A

•aPTT
•60-80
*norm is 30-40

65
Q

warfarin (Coumadin)

A

•anti-coagulant (long term)

*antidote is vit. K

66
Q

labs to monitor warfarin therapy

A

•PT of 22-26
*norm is 11-13
•INR of 2-3
*norm is 0.8-1.1

67
Q

Dabigatran (Pradaxa)

A

•thrombin inhibitor

  • dyspepsia
  • less freq. blood testing
68
Q

Bivalirudin & Lepirudin

A

•thrombin inhibitors

69
Q

argatroban

A

•thrombin inhibitor

70
Q

rivaroxaban

A

•clotting factor inhibitor

71
Q

aspirin (Ecotrin)

A

•anti-platelet

*GI, tinnitus

72
Q

Clopidogrel (Plavix)

A

•anti-platelet

  • gastric bleed
  • contra in thrombocytopenia; PUD
73
Q

altepase

A

•thrombolytic (MI)

*HA (-> IC bleed)

74
Q

epoetin alpha (Epogen, Procrit)

A

•erythropoietic stimulating agent
•anemia; CRF
*hypertension

75
Q

morphine, Demerol, & Fentanyl

A
  • strong pure opioid

* Mu activation

76
Q

Mu activation causes…

A
  • analgesia
  • resp. depression
  • myosis
  • dec. peristalsis
  • euphoria
  • dependence
77
Q

Codeine, Hydrocodone, Oxycodone

A

•moderate pure opioid

78
Q

Butorphanol, Buprenorphine

A
  • agonist/antagonist opioid
  • kappa agonist
  • Mu antagonist
79
Q

kappa activation causes…

A
  • analgesia
  • resp. depression
  • myosis
  • sedation
80
Q

Naloxone (Narcan)

A

•opioid antagonist

*tachy, increased pain, inc. bleeding, N/V

81
Q

DiazePAM (Valium)

A

•benzodiazepine

*antidote is flumazenil

82
Q

benzodiazepine therapeutics

A
  • anti-anxiety
  • anti-convulsant
  • muscle relaxant
  • sedative
83
Q

PhenobarbiTAL

A

•barbiturate

84
Q

barbiturate therapeutics

A

•sedation

85
Q

Halothane, Isoflurane

A

•inhaled anesthetics

*hypotension

86
Q

Propofol (Diprivan)

A

•IV anesthetic

*euphoria

87
Q

LidoCAINE

A

•local anesthetic

*seizure

88
Q

Phenytoin

A

•AED
•partial, generalized, tonic-clonic
nystagmus, gingival hyperplasia, endocrine,

89
Q

Carbamazepine (Tegretol)

A

•AED
•partial, generalized, tonic-clonic
*FVE, leukopenia/anemia

90
Q

Gabapentin (Neurontin)

A

•AED
•partial, generalized
*peripheral edema

91
Q

Oxcrbazepine

A

•AED
•partial, generalized
*skin, HA

92
Q

ethosuximide (Zarontin)

A
  • AED

* absence

93
Q

Valproic acid (Depakene)

A

•AED
•all seizures
*GI effects, thrombocytopenia

94
Q

Lamotrigine (Lamictal)

A
  • AED

* all seizures

95
Q

common AE of AEDs

A
  • nystagmus
  • sedation
  • double vision
  • rash
  • dysrhythmias
  • hypotension
  • drowsiness
  • dizziness
  • N/V
  • dec. OCP effects
96
Q

Baclofen (Lioresal)

A

•CENTRALLY acting muscle relaxant

*urinary retention, drowsiness

97
Q

Dantrolene (Dantrium)

A

•PERIPHERALLY acting muscle relaxant

*hepatotoxicity, weakness

98
Q

NMBs do NOT…

A
  • decrease pain

* cause LOC

99
Q

activation of alpha 1 receptor causes…

A
  • vasoconstriction
  • mydriasis
  • urinary retention
100
Q

alpha 1 agonist therapeutics

A
  • hemostasis
  • nasal decongestion
  • anesthesia adjunct
  • elevate BP
  • anaphylaxis
101
Q

alpha 1 agonist AE

A
  • hypertension
  • necrosis
  • bradycardia
102
Q

activation of beta 1 receptors causes…

A
  • inc. FOC
  • inc. HR
  • inc. conduction
  • renin release
103
Q

beta 1 agonist therapeutics

A
  • cardiac arrest
  • HF
  • AV block
  • shock
  • elevates BP
  • anaphylaxis
104
Q

beta 1 agonist AE

A
  • dysrhythmias

* angina

105
Q

activation of beta 2 receptors causes…

A
  • bronchodilation
  • uterine smooth muscle relaxation
  • vasodilation
  • glycogenolysis
106
Q

beta 2 agonist therapeutics

A
  • asthma

* delay of preterm labor

107
Q

beta 2 agonist AE

A
  • hyperglycemia

* tremor

108
Q

main muscarinic poisoning symptom

A

•blurred vision

109
Q

anticholinergics are often used to treat

A

•overactive bladder

110
Q

how do barbiturates/phenytoin affect drug metabolism

A
  • stimulate liver enzymes so cause faster metabolism

* may need to increase therapeutic doses

111
Q

normal HgbA1C

A
  • 3.9-6%

* diabetic goal is < 7%

112
Q

normal BUN

A
  • 7-22
  • high= kidney dz
  • low= liver dz
113
Q

normal Cr

A

•0.5-1.4

*most important lab in OA

114
Q

trough level

A
  • lowest level of drug in a person

* should be obtained just before next dose

115
Q

morphine onset times

A
  • IV: 7 min
  • IM: 30 min
  • SQ: 90 min
116
Q

drug for hyperkalemia

A

•Kayexalate

117
Q

if platelets < 1,000…

A

•discontinue heparin

118
Q

anti-dysrhythmic for short term ONLY

A

•Procainamide

-too many AEs

119
Q

propryothiouracil AE

A
  • sore throat
  • bradycardia
  • muscle pain
  • rash

Pharmacology I (9 decks)

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