Final other stuff: osteoporosis, reproductive, dementia etc Flashcards
which diuretics cause hypocalcemia
Loop diuretics: furosemide
which diuretics cause hypercalcemia
Thiazides: chlorothiazide, hydrochlorothiazide
classes of osteoporosis drugs
Bisphosphenates: alendronate/Fosamax SERM: Raloxifene/evista Syn calcitonin: calcitonin synth parathyroid: teriparatide Estrogen/HRT: Premarin, Prempro Human anticlonal antibody: Denosumab Statin: lovastatin Phytoestrogens: isoflavones
esophagitis, osteonecrosis of jaw, atypical femur fractures**Bad actor
Bisphosphonates: alendronate
which osteoporosis increase cancer risk
Premarin: endometrial CA and Stroke
Prempro: (E+P) breast CA, stroke, MI
what osteoporosis drug is used in cancer, RA, Multiple myeloma
human monoclonal antibody: denosumab
MOA: osteoporosis drugs
bisphosphonates: alendronate: stop osteoclast
SERM: Raloxifene: modulate estrogen receptor
Synth Calcitonin: stop osteoclasts
synth parathyroid: teriperitide increase turnover, osteoblast increase more
Estrogen/HRD: Prempr, premarin, bind estrogen receptors
Human monoclonal antibodies: denosumab-Target Rankl to stop bone removal
Statin: pathway, may decreas fractures
what osteoporosis drugs increases DVT risk, Stroke?
DVT: SERM - Raloxifene if had prior DVT, not for pregnancy
Stroke: Estrogens, Prempro and premarin
what osteoporosis drug may increase risk of infection
Monoclonal antibody: densumab
Calcium is best when
have not yet had fracture
calcitriol
prescription Vit D, may raise Ca to high
strontium may do what
increase osteoblastic activity, to much may weaken bone
Reproductive, what ones are Category X
Premarin a conjugated estrogen is Category X
- uterine and breast cancer,
- DVT
- atherlsclreosis
reproductive , which one has black box warnarning no longer than 2 years
Progesterone only: Depo-Provera, medroyxprogeserone
- risk of osteoporosis,
- birth defects if pregnant
what reproductive drug reduces endometriosis risk 80%
Progesterone only: Depo provera, don’t use if hs of breast, ovarian or uterine cancer
concern with combo pill
- metformin and antibitics reduce efficacy
- ## Reduce risk of Colorectal, ovarian and endometrial Ca
IUD
Paraguard: copper
Marina: progestin
Skyla
Problem with Nuva ring and patch
increased risk of blood clots over other birth control
Morning afters
Progestin only: levonorgestrel Plan B
SPRM: Ella:
estrogen progestin combo
abortifactant: mifepristone:
fertility drub
SERM: clomid
Viagra: moa
Phosphodiesterase type 5 inhibitor: relaxes smooth muscle in the corpus cavernosum by keeping Cyclic CMP around
Viagra side effects
Priapism: extended erecton cyanopsia hypotension nasal gongestion Pulmonary hypotension***
MOA Tricyclic antidepresant
Tricyclic antidepressant: amitriptyline
- Increase Serotonin and NE
MOA Tetracyclic antidepressant
Tetracyclic antidepressant: trazodone/desyrel
- serotonin reuptake inhibitor and partial agonist to
- increase serotonin
SSRI: Prozac
SSRI: Prozac
- increase serotonin by decreases presynaptic reuptake
SNRI: Cymbalta
SNRI: Cymbalta
- increase serotonin and NE
- Decrease serotonin and NE reuptake
NDRI: Bupropion/wellbutrin
NDRI: Buprobion/wellbutrion
- increase dopamine and NE
- reduce Dopamine and NE reuptake
NDRI: Zyban
NDRI: zyban
- increase dopamine and NE
How to the barbituates work?
Increase GABA binding by binding to receptor near GABA binding sight.
name the barbituates
- Thiopental - ultra short
- Pentobarbital - short
- Butalbital - intermediate
- Phenobarbital- long
How to Benzodiazapenes work
Increase Gaba effect on Cl channel
what are the benzos
- Versed- syrup/endoscope
- Valium- seizures
- Ambien- fall asleep sleep walking
- Lunesta - no tolerance stay asleep
Melatonin agonist: Ramelton
Binds MT1/2 receptors to enhance effects of mellatonin
Benzo overdose
Romazicon: IV only
antidote of Neuroleptic malignant syndrome caused by antipsycotic Haldol
Dopamine agonist/Bromocriptine
What are the typical neuroleptics
Thorazine: D2 block
Compazine: HI block
Haldolol: D2 - neuroleptic malignant
What are the atypical neuroleptics
D2 and Serotonin (blockaide) elderly strokes and wt gain
- clozapine
- Risperdal
- Zyprexa
lithium salts
dampen transmission of NE and diminish glutamate response .
what is the MOA or most dementia drugs
Acetycholinesterase inhibitors
acetycholinesterase inhibitor dementia drugs
- Aricept - dementia
- Exalon - young onset dementia
- Galantamine - brain damaged adults
Non acetyl-cholinesterase inhibitor for dementia
NMDA glutamate receptor blocker: Namenda
increased libido, insomnia and agitation
severe
Status epilepticus drugs
Ativan
valium
Dilantin
Zarontin
Absence seizure drugs
Zarontin: T type Ca channel ; giant gums
tonic clonic drugs
Keppra: skin pigment
Lamactil : bipolar
Topamax
Depakote : birth defects and giant gums (gaba)
MOA of the antiseizure meds
most are barbituates or benzos so they are increasing the sensitivity to GABA
moa dopamine precursor : sinemet
Parkinsons
Increase dopamine levels
Dopamine agonist: Bromocriptine
Parkinsons
Mimic dopamine and stimulate receptors
Anticholinergics: Cogentin
Parkinsons
Anticholinergic antagonist: also to diminish side effects of antipsycotic drugs like halodol
MOA amandatine
antagonist of NMDA receptors, reduce dopamine reuptake
