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Pharm I > Final- Drug MOA and distinguishing characteristics > Flashcards

Final- Drug MOA and distinguishing characteristics Flashcards

1
Q

MOA of chloroquine? what is it used to tx? Distinguishing characteristics? be careful to use in what 2 populations?

A

MOA: inhibit reproduction via damaging parasitic DNA; damages membrane of infected RBC and inactivates enzymes of plasmodium that normally polymerizes heme that is released as the parasite digests host Hgb- this leads to soluble heme which is toxic to the parasite
txs malaria
DCs: given PO, rapidly absorbed, given early can allow for cure in less than 1 wk, now some resistance reported; caution in pts w/hepatic dysfxn and can cause severe hemolysis in pts w/G6PD deficiency

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2
Q

MOA of metronidazole? what is it used to tx? Distinguishing characteristics? caution in what pts? C/Is?

A

MOA: inhibits reproduction, binds to protozoan or anaerobic bacterial DNA which halts DNA cell division
txs: ambeiasis, protozoa, trichomoniasis
DCs: inhibits aldehyde dehydrogenase in liver, highly lipid soluble, can cause metallic taste
C/Is: EtOH, caution in pts w/ G6PD deficiency as it can cause severe hemolysis

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3
Q

MOA of mebendazole? what is it used to tx? Distinguishing characteristics?

A

MOA: destroys microtubules
tx: helminthic infxns
MOST COMMONLY USED OF ALL ANTI-HELMINTHICS

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4
Q

MOA of ivermectin? what is it used to tx? avoid with what? cidal or static?

A

MOA: increases GABA transmission which hyperpolarizes excitable tissues so can’t have AP’s appropriately, overall inhibits the inhibitory mechanism of overexcitation which leads to tetany
tx: anti-helminthic
avoid using with benzodiazepines and barbituates
cidal to helminths

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5
Q

MOA of pyrethrins? what is it used to tx? source?

A

MOA: sustain open Na2+ channels in insects which causes tetany- repeated and extended nerve d/c from insects, insect seizures before death, replaced irreversible cholinesterase inhibitor
tx: parasitic infxns, insecticide, insect repellant
from chrysanthemum flower

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6
Q

MOA of artemisinin? what is it used to tx? Distinguishing characteristics?

A

MOA: schizonticide in all malaria forms, possibly via free radical formation
tx: malaria
DCs: derivative of Chinese herbal med- qinghao su; limited resistance so emerging as first line drug over quinine derivatives to tx malaria

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7
Q

MOA of cisplatin? what is it used to tx? SEs?

A

MOA: platinum based drug- platinum reacts w/DNA of rapidly dividing cells which binds to and causes cross-linking of DNA–> apoptosis
tx: neoplasms- carcinomas, sarcomas, small cell lung CA, ovarian CA, lymphomas, germ cell tumors, solid tumors, bladder CA, metastatic testicular carcinoma
SEs: high nephrotoxicity, high frequency hearing loss, tinnitus, possible BM suppression, anaphylaxis

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8
Q

MOA of cyclophosphamide? what is it used to tx? Distinguishing characteristics?

A

MOA: alkylating agent- introduces alkyl group to DNA which prevents DNA or RNA replication and inhibits nucleic acid fxn
txs: neoplasms- acute lymphocytic leukemia, Hodgkin’s dz, non-Hodgkin’s, breast, ovarian, lung CA, MM, sarcomas, CLL

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9
Q

MOA of metotrexate? what is it used to tx? Distinguishing characteristics?

A

MOA: antimetabolite- interferes w/formation of DNA or RNA by preventing access to key metabolic components, DMARD, immunosuppressive, competitively inhibits dihydrofolate reductase
tx: neoplasms- lung, breast CA, leukemia, Hodgkin’s and non-Hodgkin’s, cutaneous T cell lymphoma, head and neck CA, osteosarcoma
DCs: renal excretion is primary route of elimination, inhibits S phase

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10
Q

MOA of doxorubicin? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: antibiotic-like drug, breaks DNA during replication and inhibits protein synthesis
tx: neoplasms
DCs: most efficacious for broadest spectrum, must be administered rapid IV or risk tissue necrosis at site of injection
SEs: cardiotoxicity, alopecia, anorexia, red urine dt pigment in drug and renal excretion

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11
Q

MOA of paclitaxel? what is it used to tx? source? SEs?

A

MOA: microtubule inhibitor, reversibly binds to microtubules which prevents cell division, inhibits M (mitosis) phase
tx: advanced ovarian CA, metastatic breast CA
source: Pacific Yew Tree
SEs: N/V, anorexia, arthralgia, alopecia

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12
Q

MOA of tamoxifin? what is it used to tx? SEs?

A

MOA: hormonal inhibitor- reduces natural stimulation of tissue growth and proliferation; specifically an estrogen antagonist; blocks RNA synthesis
tx: early breast CA
SEs: hot flashes and other menopausal sxs, increased risk for uterine CA

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13
Q

MOA of trastuzumab? what is it used to tx? Distinguishing characteristics? SE?

A

MOA: binds to HER2 sites in breast CA tissue which inhibits proliferation of cells that overexpress HER2 protein
tx: metastatic breast CA
DCs: molecule too lg to cross BBB, administer IV
SE: cardiotoxicity

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14
Q

MOA of acetylcholine? what is it used to tx? Distinguishing characteristics?

A

MOA: muscarinic and nicotinic agonist
tx: possible opthalmic use but other products are better
DCs: quaternary ammonium group= too lg to cross BBB b/c lipid insoluble

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15
Q

MOA of acyclovir? what is it used to tx? Distinguishing characteristics? static or cidal?

A

MOA: guanosine analog that is incorporated into viral DNA and inhibits further viral synthesis
tx: herpes (HSV 1, 2), encephalitis, meningitis, varicella whne given in high enough doses
DCs: can cross BBB, resistance is increasing
static= only works against viruses that are actively replicating

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16
Q

MOA of albuterol? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: B2 receptor agonist, SABA
tx: asthma, COPD (relief only)
DCs: effective orally or by inhalation, limited CV effects, specific for bronchial system so no effects on myocardium really
SEs: weak and occasional tachycardia, vasodilation

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17
Q

MOA of amiodarone? what is it used to tx? SE?

A 
MOA: class 3 anti-arrhythmic= K+ channel blockers
tx: arrhythmias
SE: QT prolongation
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18
Q

MOA of amoxicillin-clavulinate? what is it used to tx? cidal or static? SEs?

A

MOA: penicillin aspect and beta-lactamase inhibitor component- affects cell wall synthesis of beta-lactam ring and neutralizes beta-lactamase
bacteriocidal
SE: c. diff colitis

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19
Q

MOA of amphotericin B? what is it used to tx? Distinguishing characteristics?

A

MOA: effects ergosterol synthesis in cell wall of fungus
tx: mycoses
GOLD STANDARD to tx mycotic infxn

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20
Q

MOA of atenolol? what is it used to tx? effects on target organ? Distinguishing characteristics? SE of abrupt discontinuation?

A

MOA: selective beta-1 antagonist
tx: arrhythmias, prophylaxis, MI, HTN, angina
effects on heart: blunts cardiac stimulation, prevents reflex tachycardia, decreases HR, contractility and BP
DCs: specificity for the heart so no problem for asthmatics or diabetics to use; slows down the heart and decreases force of contractions (negative ionotropic and chronotropic effects)
abrupt discontinuation causes reflex tachycardia

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21
Q

MOA of atorvastatin? what is it used to tx? SEs? how to offset SEs? CYP it utilizes?

A

MOA: inhibits rate limiting step in formation of cholesterol (HmgCoA) so liver can’t produce as much cholesterol and therefore has to increase uptake from blood stream by upregulating # of LDL receptors on liver
tx: first line tx for primary and secondary prevention of ASCVD, familial hypercholesterolemia
SEs: myalgias, can give CoQ10 to help with myalgia
utilizes CYP450, 3A4

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22
Q

MOA of atropine? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: muscarinic receptor antagonist, inhibits SLUD, dilates bronchus
tx: diarrhea, once used to tx asthma, mydriasis and cycloplegia
DC: tertiary ammonium compound= can cross BBB
SEs: inhibits SLUD, can cause toxicity esp in children even after just ophthalmic use

23
Q

MOA of azithromycin? what is it used to tx? Distinguishing characteristics? SEs? static or cidal?

A

MOA: binds reversibly to 50s ribosome subunit
tx: bacterial infxn- respiratory, chlamydia, gonorrhea, sinusitis, bronchitis, COPD, atypical respiratory pathogens
DCs: concentration dependent so have to give the 1st dose as a loading dose, THE leading selling abx in N. America
SEs: QT prolongation, diarrhea
bacteriostatic

24
Q

MOA of bethanechol? what is it used to tx? Distinguishing characteristics?

A

MOA: muscarinic agonist
tx: gastroparesis, urinary bladder paresis, paralytic bowel, urinary retention, xerostomia, ocular diagnostic
DCs: not metabolized by esterase enzymes, relatively long 1/2 life, quaternary ammonium compound, particular affinity for gut and bladder SM, use to keep Ach in synapse longer

25
Q

MOA of carvedilol? what is it used to tx? Distinguishing characteristics? C/Is? effects on end organ?

A

MOA: both alpha and beta antagonist activities
tx: anti-arrhythmic, CHF, MI w/rEF, prophylactic, HTN, angina (off-label use)
DCs: shield myocardium from chronically toxic effects of NE levels, return myocardial density to normal
C/Is: cardiogenic shock, symptomatic bradycardia, 2nd or 3rd degree heartblock w/o pacemaker, severe reactive airway dz, DO NOT USE IN THOSE W/ASTHMA OR ACTIVE BRONCHOSPASM
effects on heart: blunts cardiac stimulation, prevents reflex tachycardia, decreases HR, contractility and BP

26
Q

MOA of cephalexin? what is it used to tx? Distinguishing characteristics?

A

MOA: beta-lactam ring which inhibits formation of bacterial cell wall, cephalosporin, 1st generation, most activity against G(+) bugs
tx: UTIs, skin infxns, some respiratory, surgical prophylaxis
DCs: alt to PNC, does NOT cover enterococcus spp

27
Q

MOA of clopidogrel? what is it used to tx? Distinguishing characteristics?

A

MOA: inhibits aggregation of platelets; irreversibly blocks P2Y12 component on ADP receptors on platelet surface
tx: post-NSTEMI, ACS, CVA, PCI and arterial occlusive dz to prevent clots
DCs: duration lasts for lifespan of platelet

28
Q

MOA of digoxin? what is it used to tx? Distinguishing characteristics? SEs? source?

A

MOA: cardiac glycoside, Na-K-ATP-ase inhibitor, likely dt benefits from neurohormonal inhibition
tx: arrhythmias, CHF, SVT/SVA, indicated w/concurrent a. fib
DCs: very narrow therapeutic range, NO SURVIVAL BENEFIT
SEs: diuresis, changes in yellow/green perception, anorexia, N/V, diarrhea, constipation, bradycardia
source: fox glove

29
Q

MOA of diltiazem? what is it used to tx? C/I? SEs?

A

MOA: calcium channel blocker, class IV anti-arrhythmic, prevents release of Ca2+ which prevents contraction of SM, d/c of impulses in conduction system of heart
tx: atrial arrhythmias, HTN, SVT, angina
C/I in those w/hypotension, reduced LVEF, AV block, Wolff Parkinson White arrhythmia

30
Q

MOA of doxycycline? what is it used to tx? Distinguishing characteristics? SEs? cidal or static?

A

MOA: inhibits protein synthesis by attaching to 30s ribosomal subunit, tetracycline abx
tx: respiratory, intracellular infxns, acne, rosacea, chlamydia, SSTIs
DCs: increasing resistance
SEs: teeth discoloration in children, chelation w/Ca2+, photosensitivity, skin discoloration
bacteriostatic

31
Q

MOA of epinephrine? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: alpha 1, 2; beta 1, 2 stimulation (G protein which facilitates 2nd messengers)
tx: anaphylaxis, adjunct to local anesthesia (alpha 1), arrhythmias, cardiac emergencies, bronchospasms
DCs: more B and less A activity than NE, ineffective orally, very short 1/2 life
SEs: tachycardia, increased CO, HTN

32
Q

MOA of ezetimibe? what is it used to tx?

A

MOA: inhibits absorption of dietary and biliary chol form gut, reduces absorption of chol, disrupts chylomicron formation, ultimately upregulates LDL receptors on the liver and lowers LDL-c
tx: adjunctive tx in homozygous familial hypercholesterolemia and primary hyperlipidemia

33
Q

MOA of fluconazole? what is it used to tx? Distinguishing characteristics?

A

MOA: effects ergosterol formation
tx: mycotic infxns
DCs: #1 prescribed -azole compound as an anti-mycotic

34
Q

MOA of furosemide? what is it used to tx? SEs?

A

MOA: loop diuretic- inhibits Na-K-Cl cotransporter in thick ascending limb of loop of henle to inhibit Na2+ and Cl- reabsorption so as to decrease overall fluid load and CO
tx: HTN, CHF
SEs: hypokalemia

35
Q

MOA of genatmycin? what is it used to tx? Distinguishing characteristics? SEs? cidal or static? don’t administer along with what and why?

A

MOA: binds to ribosomal subunit (irreversibly) so as to inhibit protein synthesis
tx: topical abx therapy of bacterial conjunctivitis
DCs: broad spectrum
SEs: VERY TOXIC! don’t use unless most other abx have failed, MC of all aminoglycosides used, nephrotoxicity, ototoxicity
bacteriocidal
don’t administer w/diuretics b/c they change the composition of endoline which affects protein synthesis w/in cochlea and vestibular appartus

36
Q

MOA of hydralazine? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: vasodilator, antioxidant (inhibits destruction of NO), arteriole dilator
tx: HTN, CHF
DCs: not recommended unless unable to tolerate ACE I, consider in African American population
SEs: reflex tachycardia

37
Q

MOA of hydrochlorothiazide? what is it used to tx? SEs?

A

MOA: increase the osmolality w/in the nephron so Na2+ will stay in nephron which will draw water into the lumen and excrete it, active in DCT
SEs: hypokalemia

38
Q

MOA of ipratropium? what is it used to tx? Distinguishing characteristics?

A

MOA: muscarinic antagonist
tx: rhinorrhea, COPD, asthma
DCs: quaternary ammonium compound= can’t get into CNS

39
Q

MOA of latanoprost? what is it used to tx? Distinguishing characteristics?

A

MOA: prostaglandin analog so increase aqueous outflow
tx: open angle glaucoma (1st line tx or can tx w/Beta blocker as well)
DCs: PGs don’t have single target tissues- also receptors in myometrium SM so can cause uterine contractions

40
Q

MOA of lisinopril? what is it used to tx? SEs?

A

MOA: blocks convsersion of angiotensin 1 to angiotensin 2; inhibiting one of the most potent vasoconstrictors we are capable of producing
tx: HTN, high peripheral resistance, CHF, used in all pts w/reduced EF to prevent HF
SEs: cough, reflex tachycardia, hypotension, angioedema, teratogenic, hyperkalemia

41
Q

MOA of metoprolol? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: B1 receptor antagonist, cardioselective
tx: prophylactic HF, blunts cardiac stimulation, prevents reflex tachycardia, decreases HR, contractility, BP, MI, CHF, angina, HTN
DCs: anti-HTN w/o risk to asthmatics and diabetics b/c no beta 2 activity

42
Q

MOA of metronidazole? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: inhibits nucleic acid synthesis
tx: only tx anaerobes, no G(+) or G(=)s
DCs: cannot use w/EtOH, metallic taste, “disulfiram rxn”

43
Q

MOA of montelukast? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: LTR antagonist (blocks receptor), inhibits inflammation
tx: asthma
DCs: metabolized in the liver, drug interactions and liver effects not evident

44
Q

MOA of mupirocin? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: exerts antimicrobial activity by reversibly inhibiting isoleucyl-transfer RNA, thereby inhibiting bacterial protein and RNA synthesis
tx: bacterial skin infxn, prevention, MRSA
DCs: go to drug when looking for something that is topical

45
Q

MOA of nitroglycerine? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: vasodilator, stimulates NO receptors, relaxation of vascular SM leading to reduced preload and reduced O2 consumption
tx: angina, more specific to venous dilation, prevention of stress induced angina
DCs: short 1/2 life b/c broken down so quickly, metabolized before gets out of gut so can’t take orally, sublingual is the MC way to take it, most destroyed on first pass in liver, immediate sx relief
SEs: hypotension, H/A, flushing, light headedness

46
Q

MOA of phenylephrine? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: alpha 1 agonist
tx: hemorrhoids, nasal congestion, mydriatic (pupillary constriction)
DCs: limited access to CNS, effective orally
SEs: rebound congestion, increased peripheral resistance, reflex bradycardia

47
Q

MOA of propranolol? what is it used to tx? Distinguishing characteristics? avoid in what pts?

A

MOA: beta 1 and 2 antagonist (non-selective)
tx: MI, HTN, angina, migraine prophylaxis, blunts cardiac stimulation, prevents reflex tachycardia, decreases HR, contractility and BP, SVA
DCs: abrupt discont. will cause reflex bradycardia, significant 1st pass metabolism
avoid in pts w/heart block or severe bradycardia

48
Q

MOA of quinidine? what is it used to tx? Distinguishing characteristics? SEs?

A 
MOA: Na channel blocker, class 1 anti-arrhythmic, moderate block of both Na and K channels, slows phase 0 depolarization and slows conduction
tx: ventricular tachyarrhythmias, paroxysmal recurrent a. fib, WPW syndrome
DCs: class 1a anti-arrhythmic
49
Q

MOA of spironolactone? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: inhibits aldosterone responsible for regulating Na and K, diuretic
tx: HTN
DCs: potassium sparing effect! use more often since doesn’t affect K levels

50
Q

MOA of sulfamethoxazole/trimethoprim? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: anti-metabolite, prevents formation of folic acid w/in bacteria
tx: CA-MRSA, UTIs, OM, sinusitis, bronchitis, pneumocytis prophylaxis, SSTI
DCs: increasing resistance
SEs: increases effects of warfarin, Steven Johnson’s Syndrome, (=) SEs in those w/sulfa allergy

51
Q

MOA of tetracycline? what is it used to tx? Distinguishing characteristics? SEs? static or cidal

A

MOA: inhibits protein synthesis by binding to 30s ribosomal subunit
tx: CA-MRSA, respiratory, intracellular infxns, acne, rosacea, chlamydia, SSTIs
DCs: increased resistance limits their use; alt tx for those PNC allergic, can be used in renal failure
SEs: photosensitivity, tooth discoloration in children
bacteriostatic

52
Q

MOA of theophylline? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: phosphodiesterase inhibitor, inhibits breakdown of c-AMP, methylxanthine and mild stimulant, bronchodilatory or anti-inflammatory or diaphragmatic inotrope? think of mostly as a reliever
tx: asthma, COPD
SEs: toxicity- hyperstimulation that includes diarrhea, GI cramping, tremor, tachycardia, may progress to seizures

53
Q

MOA of vancomycin? what is it used to tx? Distinguishing characteristics? SEs?

A

MOA: inhibits 2nd stage of cell wall synthesis of susceptible bacteria, may also alter the permeability of the cell membrane and selectively inhibits ribonucleic acid synthesis
tx: MRSA, SSTI, pneumonia, bacteremia, endocarditis
DCs: delivered IV, PO only for c. diff colitis

Pharm I (18 decks)

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