Final Flashcards by Luis Franco

What is the tx for lead poisoning

EDTA

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What are the sx for lead poisoning

headaches
Neurocognitive deficits
Kidney damage
Burtonian lines (gingiva)

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Hg is used primarily in what form

MethylHg

Reacts with Selenium

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What are the sx of Hg poisoning

gingivostomatitis
Neuronlogical
Psychiatric: Memory loss, depression, confusion

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What is the tx for Hg poisoning

Cimercaprol: chronic us can cause renal toxicity

Succimer

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How is arsenic absorbed

Respiratory
GI
Poor absorption through skin

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What are the sx of arsenic poisoning

fatigue
anemia
renal failure
Hyperpigmentation
Hemolytic on RBC

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What is the tx for acute arsenic intoxication

Decontamination
Unithiol (IV)
Dimercaprol (IM)

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What is the tx for chronic arsenic intoxication

Folate dietary supplements

NO CHELATORS; irreversible damage has already occurred.

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What is the tx for acute arsine intoxication

hemodialysis and transfusions
agressive hydration
NO CHELATORS; no benefit

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How do chelators work

they render heavy metal ions unavailable for covalent interactions.
the longer the t1/2 of the heavy metal, the less effective is the chelator

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When is dimercaprol used

for arsenic and Hg combined
It pulls Pb from bone and it goes to brain causing toxicity. contraindicated for lead poisoning alone.
Narrow therapeutic index.
Mostly has been replaced by succimer.

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what is Succimer used for

Tx of
Pb, As and Hg poisoning.
water soluble; oral uses only, urinary excretion.
t1/2= 2-4 hrs

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What is EDTA used for

Tx of Pb poisoning
chelates extracellular Pb only
IV,
100 by kidneys. Not for anuric pts.

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What is Unithiol used for

Tx of Hg, As and Pb poisoning. 
Water soluble
Oral or IV 
t1/2=20hrs 
NOT FDA APPROVED FOR ANY HEAVY METAL POISONINGS.

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How does cyanide work

It is NOT a heavy metal

Prevents cells of the body from getting oxygen and ATP

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What is the antidote for cyanide

Hydroxycobalamin

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Pure Food and Drug Act

Addiction to opium and cocaine.
requires labeling and name ingredients.
patent medications.

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Modified Food, Drug and Cosmetic act

Requires safety; caused by diethleneglycol tragedy

Drugs must be safe.

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Durham Humphrey Amendment

Many new drugs needed to be regulated.

Rx vs OTC

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Kefauver-Harris Amendment

phocomelia caused by thalidomide (morning sickness)

Required testing for safety and efficacy.

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Dietary Supplement Health and Education Act

Due to little regulation 
regulates herbal products like food 
-Serving size 
-Structure function claims 
NOT INTENDED TO DIAGNOSE, TREAT, CURE, PREVENT ANY DISEASE.

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Rx drugs

Addictive potential

Toxic, serious indications.

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What agency controls animal testing

IACUC

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What is phase I

Small group of healthy subjects | Safety, dose, administration and kinetics

What is Phase II

small group of subjects with conditions to be treated to test safety and efficacy.

What is phase III

extended clinical phase | large group of subjects

What is phase IV

Markenting. | See how product does in production.

IRB

Institutional Review Board

NDA

New drug application

IND

Investigational New Drug

Orphan drug act

For rare diseases to encourage drug development.

OTC decongestants

Vasoconstrictors, sympathomimetics Oxymetazoline Phenylephrine Pseudophedrine (restricted sales) -systemic: Increase BP and HR, longer acting -Topical: short acting but more effective.

Antihistamines

Not effective for colds. - dyphenhydramine (drowsiness) - Cholpheniramine (Chlor-trimeton) - Loratidine (claritin) (Less Drowsiness)

Antitussives

Codeine Depenhydramine (Antihistamine) Dextromethorphan (Robitussin)

Expectorants

Guaifenesin

Demulcents

Coat the throat to reduce irritation.

Antivirals

Oseltamivir (Tamiflu) Zanamivir (Relenza) Docosanol (Abreba)

What are the cons of acetaminophen

Not an anti-inflammatory | Liver toxic

What are the cons of Ibuprofen

GI irritation | Anti-clotting

What is Xanthine

caffeine | Adenosine antagonist

What are the side effects of nicotine replacement

Dizziness Headache Nausea

Two drugs, antihistamine and OTC sleep aid

Diphenhydramine | Doxylamine

Antifungal, thrush, vaginal infections

Miconazole

Antibiotic, first aid

Neosporin | polysporin

What drug is used for pain relief, targets TRPV channels | Decreases substance P

Capsacin

Anti-cholinergic drug, tx for motion sickness sx

Scopolamine

What are the side effects of Scopolamine

``` Drowsiness Disorientation Dry mouth Blurred vision dilated pupils constipation ```

anticholinegic drug for tx of motion sickness with less side effects

Dimenhydrinate

side effects of Dimenhydrinate

Dry mouth constipation blurred vision reduced urination.

Vasodialator use for hair growth

Minoxidil | Causes rapid HR

Tx of hemorrhoids

Phelylephrine (vasoconstrictor)

What is the active ingredient in marijuana

anandamine (neurotransmitter THC Schedule I

name of FDA approved marijuana agonist

Marinol (dronabinol) | tx; nausea, appetite, glaucoma, chronic pain

Analog promoted as anti seizure not as addicting as THC

CBD; cannabidiol

What agency regulates herbal products

DSHEA | Once marketed FDA regulates its safety.

herbal for depression

St. John's Wort

Herbal for colds

Echinacea

Herbal for skin care

Aloe vera

Herbal to lower cholesterol

Garlic

Herbal to improve memory

Ginko

Herbal to boost immune system, lower blood sugar

Ginseng

Who is the head of the ONDCP

Drug Czar | oversees DEA, NIDA and NIAAA (NIH)

What is Sch I

No current acceptable medical use in US. lacks accepted safety for use under medical supervision. HIGH potential for abuse. Ex: Heroin, LSD, Cannabis, meth

What is Sch II

High potential for abuse. May lead to severe psychological or physical dependence Ex; Hydromorphone, methadone, meperidine, fentanyl, Hydrocodone.

What is Sch III

have potential for abuse, may lead to moderate or low physical dependence or high psychological dependence. Ex; Codeine, buprenorphine, Ketamine.

What is Sch IV

Low potential for abuse. | Ex; Alprazolam, Diazepan, Triazolam (tramadol)

What is Sch V

Low potential for abuse | Ex; bought preparations, Robitussin

Metabotropic receptor

Not directly linked to Ion channel. Second messenger; G protein Long term effects; seconds to minutes.

Ionotropic receptor

Same as ligand gated Immediate and brief action. Ex. AMPA, NACH, GABA

GABA is

inhibitory

Glutamate

excitatory | directly stimulates N-methyl d aspartate receptors

What does tryptophan hydroxylase do

coverts tryptophan to 5HTP

What does tyrosine hydroxylase do

converts tyrosine to DOPA

What is responsible for the degradation of 5-hydroxytryptamine

monoamine oxidase (MOA)

What would cause a rapid, direct decrease in NE synthesis | and can cause severe orthostatic hypotension

DBH; dopamine ß hydroxylase inhibitor.

What is phentolamine

α inhibitor

Decongestants fall under what category

α1 agonist

Three examples of partial seizures

Simple partial complex partial Onset of secondarily generalized

Ethosuximide is only good for

Absence seizures

Huntingtons disease

Excessive excitation of NMDA receptors by excessive dopamine on striatal cell bodies.

Parkinson's disease

greater than 70% destruction of nigrostriatal dopamine neurons

Depression

Imbalance of CNS noradrenergic or serotonergic systems

Multiple Sclerosis

localized deterioration of myelin in the CNS

Schizophrenia

excessive D2 activity in frontal cortex

Alzheimer's

Most common 3-4 million Excessive abnormal APP (Amyloid Precursor Protein) Beta amyloid plaques Neurofibrillary tangles; tau protein

What drug is particularly effective for bone related pain

Diflunisal (Dolobid)

What analgesic is ude to treat opioid dependance

Methadone

Meds for anxiety

Benzos | Barbiturates: bupropion

What does serotonin decarboxylase do

Converts 5HTP to 5HT

MAO degrades

Dopamine Serotonin NE

Pesticides are? and should be treated with

AChE inhibitors so there is a lot of ACh floating around. | Tx. Muscarinic antagonist

Postganglionic sympathetics can release

DA (Renal vascular smooth muscle) EPI NE

What naturally occurring opioid primarily activates kappa opioid receptors

dynorphins 17 aa

What naturally occurring opioid primarily activate miu and Delta opioid receptors

b-endorphins 91 AA

if it is an endorphin it will have one or both of these

methyanine | Leucine

encephalin

miu and delta | 5 aa