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PHTH 561: Pharmacology > Final Exam Review > Flashcards

Final Exam Review Flashcards

1
Q

What are schedule I substances?

A

Drugs, substances, or chemicals that are defined as drugs with no currently accepted medical use and high potential for abuse

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2
Q

What drugs are schedule I?

A

-Heroin
-LSD
-Marijuana
-MDMA

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3
Q

What are schedule II drugs?

A

Drugs, substances, or chemicals that are defined as drugs with high abuse potential with use potentially leading to severe psychological or physical dependence but have an accepted medical use

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4
Q

What drugs are schedule II?

A

-Methamphetamine
-Oxycodone
-Morphine
-Fetanyl
-Cocaine

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5
Q

What are schedule III drugs?

A

Moderate or lower abuse potential compared to schedule II drugs

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6
Q

What drugs are schedule III?

A

-Anabolic steroids
-Testosterone
-Codeine
-Ketamine

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7
Q

What are schedule IV drugs?

A

Lower abuse potential compared to schedule III drugs

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8
Q

What drugs are schedule IV?

A

-Diazepam
-Lorazepam
-Tramadol

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9
Q

What are schedule V drugs?

A

Lowest abuse potential

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10
Q

What drugs are schedule V?

A

-Low dose opioids in cough medicine
-Lamotil
-Pregabalin

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11
Q

What is the main enzyme in the liver that is responsible for drug metabolism?

A

Cytochrome P450 (CYP450)

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12
Q

What increases CYP activity and drug metabolism?

A

-Rifampin
-Carbamazepine

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13
Q

What inhibits CYP and drug metabolism?

A

-Valproic acid
-Fluoxetine

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14
Q

What drugs are reabsorbed by the kidneys?

A

Lipid soluble drugs

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15
Q

How many half-lives does it usually take to eliminate a drug from the body?

A

5-7

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16
Q

What is the median effective dose (ED50)?

A

Dose at which 50% of the population responds to the drug in a specific manner

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17
Q

What is the median toxic dose (TD50)?

A

Dose at which 50% of the group exhibits adverse effects

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18
Q

What is the median lethal dose (LD50)?

A

Dose that causes death in 50% of the group (animal studies)

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19
Q

What is the therapeutic index? What does a higher therapeutic index (TI) indicate?

A

-TI= TD50/ED50
-The higher the TI, the safer the drug
-A large TI indicates that it takes a much larger dose to evoke a toxic response than it does to produce the desired effect

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20
Q

What are additive effects?

A

The effect of two chemicals is equal to the sum of the effect of two chemicals taken separately

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21
Q

What are synergistic effects?

A

The effect of two chemicals taken together is greater than the sum of their separate effects at the same doses

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22
Q

What are antagonistic effects?

A

The effect of the two chemicals taken together is less than the sum of their separate effects at the same doses

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23
Q

What is the opioid toxicity triad?

A

-CNS depression (coma)
-Respiratory depression (cyanosis)
-Pupillary miosis

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24
Q

What are the adverse effects of opioids with chronic use?

A

-Hypogonadism
-Immunosuppression
-Increased feeding
-Increased growth hormone secretion
-Withdrawal effects
-Tolerance and dependence
-Abuse
-Hyperalgesia
-Impairment while driving

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25
Q

What disease should acetaminophen not be used in? What is this condition and who is most at risk?

A

-Reyes syndrome: a rare but serious condition that causes confusion, swelling in the brain, and liver damage
-Children recovering from a viral infection who have a metabolic condition are most at risk

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26
Q

How does acetaminophen cause liver toxicity?

A

-Metabolized to a toxic intermediate (NAPQI) in the liver, which is quickly detoxified and eliminated via the urine
-High doses can result in an accumulation of the toxic intermediate with subsequent toxicity to liver proteins

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27
Q

What are the acetaminophen & opioid combination drugs?

A

-Loratb, lorcet: hydrocodone + acetaminophen
-Darvocet: propoxyphene
-Percocet: oxycodone

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28
Q

What glucocorticoid (SAID) is used for anaphylaxis?

A

Dexamethasone

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29
Q

How does glucocorticoids breakdown tissue?

A

-Inhibits the genes responsible for production of collagen and other tissue components by increasing the expression of substances that promote breakdown of bone, muscle, etc.
-Interfere with muscle protein synthesis

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30
Q

What are the symptoms of drug induced Cushing’s syndrome?

A

-Roundness and puffiness in the face
-Fat deposition and obesity in the trunk
-Muscle wasting in the extremities
-Hypertension
-Osteoporosis
-Increased body hair
-Glucose intolerance

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31
Q

What are the signs and symptoms of adrenal crisis/shock?

A

-Pain in legs, low back, abdomen
-Low BP, syncope
-Vomiting and diarrhea
-Hyperkalemia
-Hyponatremia

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32
Q

What are the traditional DMARDs for the treatment of RA?

A

-Hydroxychloroquine
-Methotrexate
-Leflunomide
-Sulfasalazine

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33
Q

What is the MOA of hydroxycholorquine?

A

Immunomodulation

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34
Q

What is the MOA of methotrexate?

A

Inhibits DNA synthesis which can lead to the reduction of antibodies

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35
Q

What is the MOA of leflunomide?

A

Inhibits AA synthesis (pyrimidine)

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36
Q

What is the MOA of sulfasalazine?

A

Not well understood

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37
Q

What are the side effects of hydroxycholorquine?

A

-Retinal damage
-Rash

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38
Q

What are the side effects of methotrexate?

A

-Hepatic fibrosis
-Rash
-Thrombocytopenia
-Leukopenia

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39
Q

What are the side effects of leflunomide?

A

-Hepatitis
-Alopexia
-HTN

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40
Q

What are the side effects of sulfasalazine?

A

-Rash
-Photosensitivity
-Alopecia

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41
Q

What are the TNF-⍺ blockers?

A

-Etanercept
-Infliximab
-Adalimumab
-Certolizumab
-Golimumab

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42
Q

What are the side effects of TNF-⍺ blockers?

A

-Local injection site reactions
-Infection
-Malignancy

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43
Q

What are the non TNF-⍺ blockers?

A

-Rituximab
-Abatacept
-Tocilizumab
-Baricitinib
-Anakinra

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44
Q

What are indirect acting cholinergic agonists that are used to treat Alzheimer’s?

A

-Donepezil
-Rivastigmine
-Galantamine

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45
Q

What are indirect acting cholinergic agonists that are used to treat Myasthenia Gravis?

A

-Neostigmine
-Pyridostigmine
-Edrophonium
-Ambenonium

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46
Q

What are indirect acting cholinergic agonists that are used to treat Glaucoma?

A

-Physostigmine
-Echothiopate

47
Q

What are common anticholinergic drugs?

A

-Atropine
-Scopolamine
-Ipratropium bromide
-Tiotropium bromide
-Oxybutynin
-Tolterodine
-Benztropine
-Tropicamide
-Dicyclomine
-Hyoscyamine

48
Q

What are the major side effects of organic nitrates?

A

-Headache
-Reflex tachycardia
-Orthostatic hypotension
-Facial flushing
-Nitroglycerin specifically has significant interactions with sildenafil (Viagra) and can cause fatal hypotension

49
Q

What are the major side effects of β-blockers?

A

-Fatigue
-Bradycardia
-Hypotension
-Bronchoconstriction (only with non-selective β-blockers)

50
Q

What are the major side effects of calcium-channel blockers?

A

-Constipation (especially Verapamil)
-Headache
-Dizziness
-Flushing
-Non-dihydropyridines can cause heart failure to worsen due to negative intotropic effects

51
Q

What are the major side effects of sodium-channel blockers?

A

-Dizziness
-Headache
-Constipation
-QT interval prolongation

52
Q

What is the generic name of the sodium channel blocker?

A

Ranolazine

53
Q

What are the generic names of the K+ sparing diuretics?

A

-Spironolactone
-Triamterene

54
Q

What are the side effects of diuretics?

A

-Orthostatic hypotension
-Weakness
-Cardiac arrhythmias
-Fatigue
-Hyponatremia
-Hypokalemia

55
Q

What is the mechanism of action of sprionolactone?

A

Direct antagonist of aldosterone, which prevents salt retention, myocardial hypertrophy, and hypokalemia

56
Q

What is the mechanism of action of eplerenone?

A

Antagonist of aldosterone but with lower incidence of endocrine-related side effects

57
Q

What are the two aldosterone antagonists?

A

-Spironolactone
-Eplerenone

58
Q

What are the common side effects of aldosterone antagonists?

A

Hyperkalemia

59
Q

What is a common arterial dilator used for chronic heart failure?

A

Hydralazine

60
Q

What are the common side effects of hydralazine and isosorbide dinitrate?

A

-Headache
-Hypotension
-Tachycardia

61
Q

What patient population is the combination of hydralazine and isosorbide dinitrate for the treatment of heart failure used in? Why?

A

-Used in black patients
-Used because ACE inhibitors is not recommended in this group as there are excessive side effects

62
Q

What are common positive inotropic drugs used for the treatment of heart failure?

A

-Digoxin
-Dobutamine
-Milrinone

63
Q

What is a major downside of positive inotropic drugs?

A

All positive inotropic drugs have been associated with reduced survival in patients with HF, so they are only used for a short period of time with the exception of Digoxin

64
Q

Which coagulation factors are involved in the extrinsic pathway?

A

-Factor III
-Factor VII

65
Q

Which coagulation factors are involved in the intrinsic pathway?

A

-Factor XII
-Factor XI
-Factor IX
-Factor VIII

66
Q

Which coagulation factors are involved in the rest of the coagulation pathway?

A

-Factor X
-Prothrombin (Factor II)
-Prothrombin activator
-Thrombin
-Fibrinogen (Factor I)
-Fibrin

67
Q

Which coagulation factor is responsible for the conversion from factor X to prothrombin activator?

A

-Factor III
-Factor V

68
Q

What is the role of thrombin in the coagulation cascade?

A

Converts fibrinogen to fibrin

69
Q

What is the role of factor V in the coagulation cascade?

A

Converts prothrombin activator to thrombin

70
Q

What is the role of factor VIII in the coagulation cascade?

A

Converts fibrin to fibrin polymer

71
Q

What is the role of vitamin K in the coagulation pathway?

A

-Involved in the synthesis of vitamin K dependent clotting factors in the liver
-Factor II (prothrombin)
-Factor VII
-Factor IX
-Factor X

72
Q

What are the side effects of warfarin (Coumadin)?

A

-Hemorrhage
-Fetotoxic
-Many drugs interactions

73
Q

What are the side effects of heparins?

A

-Hemorrhage
-Thrombocytopenia
-Osteoporosis with long term use
-Hypersensitivity reactions

74
Q

What is the MOA of aspirin for anticoagulation?

A

Inhibits COX enzyme which converts arachidonic acid to thromboxane A2, which activates platelets and causes them to clump together

75
Q

What is the MOA of Clopidogrel for anticoagulation?

A

Prevents platelets from sticking together by inhibiting a receptor on the platelet called P2Y12

76
Q

What is the MOA of Ticagrelor and Prasugrel for anticoagulation?

A

Same mechanism as Clopidogrel but has different pharmacokinetics and dynamics

77
Q

What is the MOA of Dipyridamole for anticoagulation?

A

-Used in combination with aspirin
-Inhibits phosphodiesterase enzyme which leads to the increase of cAMP in platelets which inhibits their aggregation

78
Q

What is a rare but serious side effect of Clopidogrel?

A

Thrombotic thrombocytopenic purpura (TTP): rare but severe condition where small blood clots form throughout the body

79
Q

What are the antithrombotic/antiplatelet drugs?

A

-Aspirin
-Clopidogrel
-Ticagrelor
-Prasugrel
-Dipyridamole

80
Q

What are the thrombolytic drugs?

A

-Alteplase (tPA)
-Reteplase
-Tenecteplase
-Streptokinase
-Urokinase

81
Q

What are the suffixes for thrombolytic drugs?

A

-“plase”
-“kinase”

82
Q

What are the suffixes for direct thrombin inhibitors?

A

-“tran”
-“ban”
-“udin”

83
Q

What are the suffixes for anti-thrombotics?

A

-“grel”
-Aspirin
-Dipyridamole

84
Q

What are the suffixes for factor Xa inhibitors?

A

“xaban”

85
Q

What is the MOA of statins?

A

Inhibits the HMG-CoA reductase enzyme which plays a role in production of cholesterol

86
Q

What are the major side effects of statins?

A

-Muscle pain and weakness
-Fatigue
-Rhabdomyolysis

87
Q

What is the mechanism of action of bile acid sequestrants?

A

-Bind to bile acid in the intestines, forming a complex that is excreted in the feces
-Bile acids are made in the liver from cholesterol
-By binding these acids and promoting excretion, the liver compensates by converting

88
Q

What is the only cholesterol absorption inhibitor?

A

Ezetimibe

89
Q

What are the rapid acting insulin?

A

-Lispro
-Aspart
-Glulisine

90
Q

What are the short acting insulin?

A

Crystalline

91
Q

What are the intermediate acting insulin?

A

-NPH
-Lente

92
Q

What are the long acting insulin?

A

-Detemir
-Glargine

93
Q

What are the suffixes of sulfonylureas?

A

-First generation: “amide”
-Second generation: “ide”
-Third generation: “piride”

94
Q

What are the adverse effects of sulfonylureas?

A

-Hypoglycemia
-Cholestatic jaundice
-Weight gain
-Fetal hypoglycemia

95
Q

What are the suffixes of meglitinides?

A

“glinide”

96
Q

What are the common adverse effects of meglitinides?

A

Hypoglycemia

97
Q

What is the only biguanide?

A

Metformin

98
Q

What are the adverse effects of metformin?

A

-GI side effects
-Lactic acidosis

99
Q

What is the suffix for thiazolidinediones?

A

“glitazone”

100
Q

What are the adverse effects of thiazolidinediones?

A

Edema

101
Q

What are the alpha-glucosidase inhibitors?

A

-Acarbose
-Miglitol

102
Q

What are the adverse effects of alpha-glucosidase inhibitors?

A

-Flatulence
-Diarrhea

103
Q

What is the suffix for GLP-1 analogs?

A

“tide”

104
Q

What are the adverse effects of GLP-1 analogs?

A

-GI issues
-Injection site reactions
-Pancreatitis

105
Q

What is the suffix for DPP-4 inhibitors?

A

“gliptin”

106
Q

What are the adverse effects of DPP-4 inhibitors?

A

-Nasopharyngitis
-Headache
-Pancreatitis

107
Q

What is the suffix for SGLT-2 inhibitors?

A

“gliflozin”

108
Q

What are the adverse effects of SGLT-2 inhibitors?

A

-Genital yeast infections
-Urinary tract infections
-Bone fracture risk
-Ketoacidosis

109
Q

What are the short acting β-2 agonists?

A

-Albuterol
-Levalbuterol

110
Q

What are the long acting β-2 agonists?

A

-Salmeterol
-Formoterol

111
Q

What are the injectable disease modifying drugs for MS?

A

-Avonex
-Betaseron
-Copaxone

112
Q

What are the oral disease modifying drugs for MS?

A

-Gilenya
-Tecfidera

113
Q

What are the infused disease modifying drugs for MS?

A

-Novantrone
-Ocrevus
-Tysabri

PHTH 561: Pharmacology (7 decks)

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