Final Exam Flashcards
What is the most commonly prescribed medication for glaucoma?
Litanoprost
Brimaprost (same class)
What is the primary underlying cause of glaucoma?
increased IOP
When treating glaucoma, what are the 4 classes of drugs that could be effective?
Prostaglandin analog
Beta 2 antagonist
Carbonic anhydrase inhibitor
Parasympathomimetic (muscarinic agonist, cholinesterase inhibitor)
What class is acetylcholine? Which condition can be treated by this?
parasympathomimetic -muscarinic and nicotinic agonist
-Myasthenia Gravis - increases available ACh, can produce sk. m. contraction.
What class is acyclovir?
anti-viral agent
Acyclovir inhibits which aspect of viral replication? What is special about this pharmacologic agent?
guanosine analog; incorporates into the viral DNA and inhibits further synthesis
- can cross BBB, used in herpes meningitis and encephalitis*
- although, gen. used topically for HSV 1 and 2
Albuterol, one of the most important drugs in pharmacology, is in which class? What advantage does it have over other agents in this class?
beta 2 agonist (bronchodilator)
- selective! will not produce effects on myocardium
(most asthma pts cannot tolerate tachycardia s/e)
Amiodarone is in which class and what is it’s MOA?
Class 3 anti arrhythmic
- K channel blocker
What are the two ways in which bacteria can become resistant?
- bacteria can develop beta-lactamase (enzyme against the B-lactam ring in certain antibiotic classes)
- PBP can change conformation and stop specific antibiotics from binding
Penicillins and cephalosporins both contain this specific aspect in their drug class? what does it do?
beta-lactam ring
- inhibits formation and repair of bacterial cell wall
i. e. bactericidal
How can we prevent bacteria from becoming resistant to the effects of a beta-lactam ring? which drug is this represented by?
by adding CLAVULINATE
- prevents formation of beta-lactamase
- Amoxicillin-clavulinate; Augmentin
which drug class is amphotericin B in and what is it’s MOA?
anti-mycotic agent
- MOA – binds to ergosterol in fungal cell membrane forming pores (pokes holes = cell death)
saved for life threatening fungal infections, IV, inexpensive.
What side effect is amphotericin B known for? How do you prevent this?
Shake and Bake
- fever, chills, N/V, renal toxicity
Pre-emptively prescribe aspirin, anti-pyretics, and anti-histamines
How do the -azoles work in regard to fungal infection?
anti-mycotic that prevent formation of ergosterol
fungal-static
Atenolol is in which drug class, what is it’s MOA?
parasympatholytic - selective beta 1 antagonist (cardio-specific)
- negative ionotrophic and chronotrophic effects i.e. reduce timing and force of contraction
What are the two ways to alter hypertensive states?
PR x CO = BP
reduce peripheral resistance (hydration [depending on cause], anti-coagulants/blood thinners)
or
reduce cardiac output (atenolol)
atrovastatin is in which class and what is its class's MOA? What is a common S/E for this drug? How do we try to alter it, although not proven by science?
statin, HMG-CoA reductase inhibitor
S/E - myopathies
supplement with CoQ10
Atropine is in which drug class and what is it’s MOA?
parasympatholytic
MOA - muscarinic antagonist
i.e. - inhibits SLUD*
what muscarinic antagonist is used exclusively to treat respiratory illness such as: asthma and COPD?
Ipratroprium (Atrovent)
Which drug class is azithromycin in and what distinguishes this drug?
MACROLIDE antibiotic
- Z- PACK (5 day, concentration dependent course with front load on the first day)
bacteristatic
What S/E is commonly seen in the macrolides erythromycin and azithromycin? Which of the two examples exhibits lower likelihood of side-effects?
DIARRHEA
Azithromycin has less side-effects
Bethanechol is in which drug class and what is it generally used to treat?
parasympathomimetic, muscarinic agonist
used to treat paralytic bowel or paralyzed urinary bladder (i.e. causes SLUD)
Carvedilol’s class and MOA, go!
Sympathomimetic
non-selective Beta Blocker (beta 1 and 2 antagonist), selective alpha 1 antagonist
What is carvedilol used to treat?
heart failure (mild to severe) and hypertension - could prevent second MI
What class is cephalexin in and what is the MOA? Because of its class and MOA, you know it has a _____.
class: cephalosporin antibiotic
MOA: binds PBP proteins inhibiting bacterial cell wall synthesis
B-lactam ring!
What is cephalexin used to treat?
bacterial infections - URI, UTI, skin, ear, genital
- alternative in patients with penicillin allergy
What is the class and MOA of clopidogrel?
prodrug, metabolized by cyp450 to active form
inhibits platelet activation and aggregation
irreversibly binds P2Y12 class of ADP receptors on platelets.
Clopidogrel is used to treat?
used for MI and stroke prevention
commonly prescribed post MI, stroke, or peripheral vascular disease.
used with aspirin to treat new/worsening chest pain (MI, unstable angina) works to dilate blood vessel
What is the MOA of digoxin? Which class of drugs is it in? And what’s a common S/E?
class: digitalis glycoside; ATPase inhibitor
MOA: inhibits sodium-potassium ATP-ase enzyme regulating quantity of Na+ and K+ inside cells.
S/E - Diuresis
When is digoxin prescribed? When is it C/I? How does it work?
A-fib, CHF (some pts)
C/I if PREVIOUS MI*
It works by increasing the force of contraction (positive ionotrophic effect) and slowing rate (negative chronotrophic).
what is the class and MOA of diltiazem?
class: Ca channel blocker (Class IV anti-arrhythmic); anti-HTN, anti-angina
MOA: prevents Ca from being released; prevents smooth muscle contraction
- heart and periphery
Which antibiotic has the distinguishing characteristic of chelation - i.e. commonly chelates Ca so should not be consumed with dairy products or Ca supplements? Which class of antibiotics also chelates Ca?
Doxycycline
- TOOTH DISCOLORATION C/I CHILDREN
- also causes photosensitivity*
Fluoroquinolones
- broad spectrum
- avoid taking with dairy.
doxycycline, is in which class?
tetracycline antibiotic
MOA: bind 30S ribosomal subunit - bacteriostatic
When is doxycycline indicated?
IND: N. gonorrhea or severe acne
- good alternative to penicillin allergy
what class is epinephrine in? what is the MOA?
class: sympathomimetic
MOA: α- and β-adrenergic receptor agonist
when is epinephrine indicated?
MC tx for anaphylaxis
prolong action of local anesthetics
decreases bleeding
ophthalmic indications
what is the class and MOA of ezetimibe?
MOA: reduces intestinal absorption of cholesterol and sugar
- without affecting absorption of triglycerides or fat-soluble vitamins
when is ezetimibe used?
tx of elevated blood cholesterol
what is the class and MOA of fluconazole?
class: azole anti-mycotic
MOA: decreases ergosterol synthesis; inhibiting cell membrane formation.
when is fluconazole indicated?
fungal (candida, MC) infection
what class is furosemide in and what is it’s MOA?
class: loop diuretic
MOA: acts by inhibiting the Na-K-Cl cotransporter in the loop of Henle (thick ascending limb)
when is the diuretic furosemide indicated for use? what is a s/e we should be aware of?
edema, HTN
S/E - ototoxicity
what class is gentamicin in and what is the MOA?
class: aminoglycoside (broad-spectrum) antibiotic
MOA: inhibit protein synthesis, irreversibly binds 30s ribosomal sub-unit, bactericidal
what are the common s/e we need to be cautious of with gentamicin?
NEPHROTOXICITY OTOTOXICITY (esp w. diuretic rx)** -irreversible HL
what class is hydralazine in and what is the MOA? what is a S/E of this drug?
class: direct arterial vasodilator
MOA: increases cGMP relaxes smooth muscle
S/E - Reflex tachycardia
(lupus like syndrome)
when is hydralazine indicated for use?
severe HTN, CHF
First line therapy for HTN in pregnancy
hydrochlorothiazide - class and MOA
thiazide diuretic
MOA: Inhibits Na and Cl transporters in Ascending and DCT
what is a common s/e of hydrochlorothiazide
hypokalemia, hyponatremia
- also, avoid in patients with sulfa allergy
what class is ipratropium in and what is the MOA?
class: anticholinergic (parasympatholytic)
MOA: Brochodilator
- blocks muscarinic receptor, antagonist of acetylcholine
When is ipratropium indicated?
asthma