Final Final Review Flashcards
AE of Glitazone (TZDs)?
AE - FLUID RETENTION, weight gain, edema, exacerbates CSF, contraindicated in pts with class III and IV heart failure, MONITOR LIVER FUNCTIONING
Effect of mercury?
Mercury reacts with -SH groups in vivo inhibiting enzymes and altering cell membranes.
Busiprone?
2nd line agent for GAD
- partial 5-HT1a agonist
- gradual onset of 2 weeks
- no abuse potential
- no withdrawal reaciton
- no alcohol potentiation
- no sedative-hypnotic effect
AE of amantadine?
Livedo reticularis [purple, mottled skin]
How do you treat anorexia in end of life care?
Dronabinol
Dexamethasone
Action of acamprosate?
NMDA antagonist
AE of tubocurarine?
Hypotension
Bronchospasm
Excessive secretions
**all of this is b/c it is Benzylisoquinolines which causes massive histamine release – DO NOT GIVE TO PATIENT WITH ASTHMA
How are ester anesthetics metabolized?
Via esterases - extrahepatically
Ex. procain
What is morphine used for in end of life care?
Pain and dyspnea
Other than anesthetic property, what else does propofol provide?
Anti-emetic effect
Primidone?
Phenobarbital analog used for ESSENTIAL TREMOR
AE - QT prolongation
Fulvestrant?
ER antagonist everywhere in the body used to treat estrogen receptive breast cancer that is unresponsive to other treatment
Levothyroxine vs Liothyronine?
Levothyroxine: T4, longer half-life
Liothyronine: T3, 10x more potent
What receptor does oxytocin bind to?
Gq (GPCR)
Tx theophylline-induced seizures?
Benzos and barbiturates
Pt has thyroid storm but has history of asthma?
Give CCB NOT B-blockers – aka give diltiazem and verapamil
Danazol?
Partial agonist at androgen receptors
Tx endometriosis and fibrocystic disease of the breast
AE - acne, weight gain, hepatotoxicity, decrease HDL
Tyramine?
Indirect-acting sympathomimetic that enhances catecholamine release from presynaptic neuron
Parathion?
Organophosphate that binds ACHE inhibiting it – reverse with pralidoxime or Atropine
Which SSRIs have the lowest potential for drug interactions?
Citalopram, escitalopram and sertraline
*fluoxetine, paroxetine and Fluvoxamine have lots of CYP interactions
AE of Clozapine?
Agranulocytosis [continue to do blood draws]
Weight gain
Seizures
Which insomnia medication has the least day after drowsiness?
Zaleplon
Buprenorphine?
partial mu agonist and kappa antagonist used to treat opioid addiction
Acrodynia?
pink discoloration of hands and feet due to exposure to heavy metals such as mercury – treat with acute (DUS) and chronic (US)
Which corticosteroids do not have any mineralocorticoid activity?
Dexamethasone and Triamcinolone
Antidote for non-depolarizing ACh blockers?
Endrophonium and Neostigmine
Aripiprazole?
Atypical antipsychotic that is a PARTIAL agonist at D2 receptor – all other atypical antipsychotics are competitive antagonists
AE metformin?
- GI irritation
- lactic acidosis
- vit B12 deficiency
- weight loss
Which TCAs have less anticholinergic effects?
secondary amines - Desipramine and Nortryptilline
Which antidepressants can cause orthostatic hypotension?
TCAs or MAOIs
Adverse effects of Mirtazepine?
a2 blocker and 5HT2 agonist
AE - sedation, constipation, dry mouth, weight gain
Which atypical antipsychotic causes the least amt of extrapyramidal effects?
Clozapine
Oxandrolone?
anabolic-androgen steroid
AE of somatropin?
Hyperglycemia
Weight gain
Muscle ache
Headache
AE of octreotide?
- hypothyroidism
- cardiac conduction changes
- GI reactions
- GALLSTONES
- hyperglycemia/hypoglycemia
What form of vitamin D is found in milk?
cholecalciferol or ergocalciferol
Metformin contraindications?
contraindicated in pts with renal disease, hepatic disease, hypoxia, alcoholism
Parathion mechanism?
Inhibits AChE increasing amt of ACh in cleft – pt has pinpoint pupils!
What benzo do you use for short term treatment of panic disorders?
Alprazolam
Which medications have paradoxical reactions?
- Benzo
- barb
- antipsychotics
- antidepressants
- antibiotics
Which anesthetic decreases intracranial pressure?
Propofol
Which anesthetics are pungent?
Desoflurane
Isoflurane
Which anesthetics are non-pungent?
Halothane
Nitrous oxide
Sevoflurane
AE of Thioamides?
nausea, gastrointestinal disturbances, rash, AGRANULOCYTOSIS, hepatitis, HYPOTHYROIDISM
Lugol’s iodine?
Lugol’s solution and Potassium iodide
MOA - large doses of iodide inhibit thyroid hormone synthesis (decrease organification and release) via brief TPO inhibition. There is no long term-use b/c thyroid “escapes” from effects after 10-14 days [“Wolff-Chaikoff effect”]
Lugol’s solution - mixture of iodine and potassium iodide
Potassium iodide - saturation solution
Used prior to surgical thyroidectomy to reduce size, fragility and vascularity of thyroid gland. These are used in conjunction with PTU and B-blockers in thyrotoxic crises.
Oral admin -takes 2-7 days for onset of activity
AE - Wolkff-Chaikoff effect or Jod-Basedow phenomenon (hyperthyroidism at the onset of iodine admin?), anaphylactic reaction leading to angioedema, brassy taste, burning of teeth and gums, enlargement of parotid and maxillary glands (with chronic iodide intoxication)
Which parkinsons drug may cause livedo reticularis?
Amantadine
Stanozolol?
synthetic anabolic steroid derived from dihydrotestosterone
Which sulfonyurea causes the worst hypoglycemic episodes?
Glyburide
What does physostigmine administration to a pt with TCA toxicity lead to?
heart block and asystole (cardiotoxicity)
