KHIO 2 Flashcards
1
Q
What type of drug is Nexium?
A
Esomeprazole: proton pump inhibitor used to treat GERD, reduce NSAID related gastric ulcers, eradicate H. pylori and treats conditions causing gastric acid hyper secretion.
2
Q
MOA of Nexium?
A
Esomeprazole: binds to H+/K+ ATPase (proton pumps) in gastric parietal cells
- Blockage of acid secretion
- Antisecretory effect lasts longer than 24 hrs due to irreversible binding of esomeprazole to H+/K+ ATPase (new enzymes need to be expressed to resume acid secretion)
3
Q
Indications for Nexium?
A
Acid Reflux Disorders (healing and maintaining):
- erosive esophagitis
- GERD
- peptic ulcer disease
- NSAID gastrointestinal bleeds
- H. Pylori eradication
- long term hyposecretory conditions eg. Zollinger Ellison Syndrome
4
Q
Contraindications of Nexium
A
Hypersensitive to benzimidazoles or any of it’s components
5
Q
Adverse effects of Nexium?
A
- Headaches
- Diarrhea
- Nausea
- Vomiting
- Stomach pain
- Gas
- Constipation
- Rash
- Drowsiness
- Nervousness
6
Q
What type of drug is tropicamide?
A
Muscarinic Receptor Antagonist: induces mydraisis and cycloplegia
7
Q
MOA of Tropicamide?
A
Non selective muscarinic antagonist:
binds to all subtypes of muscarinic receptors
(including CB)
- relaxes the pupillary sphincter muscle
- cause pupil dilation
- prevents accomodation (inhibits parasympathetic drive, allowing sympathetic nervous system to dominate)
8
Q
Indications of Tropicamide?
A
- Induce mydriasis (dilation of pupil)
- Cycloplegia (paralysis of ciliary muscles in eye) for diagnostic procedures
9
Q
Contraindications of Tropicamide?
A
- Hypersensitivity
- Narrow Angle Glaucoma (ACG attack)
10
Q
Adverse Effects of Tropicamide?
A
- Stinging
- Dry Mouth
- Blurred Vision
11
Q
What type of drug is Methotrexate?
A
It is known as Methoblastin. Used typically for RA, cancer and psoriasis.
-Antimetabolite
12
Q
Precautions or Contraindications with Methotrexate?
A
- Not to be used daily
- Use cautiously with NSAIDs
Contraindications:
- renal dysfunction
- active infectious disease
- liver disease
- excessive consumption of alcohol
13
Q
MOA of Methotrexate?
A
Metabolised to methotrexate polyglutamate
-inhibits enzymes involved in nucleotide synthesis = reduces cell devision
-RA: AICART is inhibited and accumulated
>adenosine deaminase inhibition
>adenosine triphosphate accumulation >adenosine receptors stimulated = anti-inflammatory
14
Q
Adverse Effects of Methotrexate?
A
Ocular:
- ocular pain
- blurred vision
- peri-orbital oedema
- photophobia
- blepharitis
- NAION
- conjunctivitis
- reduced reflex tear secretion
Systemic:
- dizziness
- headaches
- swollen/tender gums
- hyperaemia
- hair loss
- mouth ulcers
- loss of appetite
15
Q
Type of drug: Premarin
A
Estrogen: reduces symptoms of menopause like hot flushes/night sweats/urogenital atrophy
16
Q
MOA of Premarin?
A
Conjugated estrogen: agonist for alpha and beta estrogen receptors
Estrogen modulates pituitary secretion of luteinising hormone (LH) and follicle stimulating hormone (FSH) through negative feedback
-levels of these hormones are elevated during menopause, so estrogen helps to reduce these levels.
17
Q
Indications for Premarin?
A
- Menopausal symptoms
- prevention of postmenopausal osteoporosis (high risk of fractures/other tx not appropriate)
18
Q
Contraindications of Premarin?
A
- Breast Cancer (estrogen dependant tumours)
- Hx of Venous Thromboembolism (VTE)
- Cerebrovascular coronary artery disease
- Severe liver disease
19
Q
Side Effects of Premarin?
A
- DED
- Breast enlargement/tenderness
- abnormal mammogram
- Headaches
- Depression
- Bleeding
20
Q
Type of Drug: Alcaine?
A
Local (ophthalmic) anaesthetic
21
Q
MOA of Alcaine?
A
Reversibly binds and inhibits neuronal transmembrane voltage gated sodium channels
>inhibit nerve conduction
>reversible block of conduction through nerve fibres = local aneasthesia
22
Q
Indications of Alcaine?
A
- Short term ocular surface anaesthesia <20mins
- Short procedures: FB removal/corneal or conj scraping for diagnostic culture/tonometry/gonioscopy
23
Q
Contraindications of Alcaine?
A
- hypersensitivity
- eye infection/inflammation
- overactive thyroid gland
24
Q
Adverse Effects of Alcaine?
A
- Stinging on instillation
- Punctate epithelial erosions
- Diffuse epi. k
- Hyperaemia/Lacrimation
- Corneal opacities
- Corneal ulceration/perforation from misuse
- Allergic reaction
25
Type of Drug: Liftegrast?
Improving signs and symptoms of dry eye with improvement after 2 weeks of usage
26
MOA of Liftegrast?
Lymphocyte function associated antigen 1 (LFA-1) antagonist
-competitively binds and inhibits LFA-1 from interacting with ligand, intracellular adhesion molecule 1 (ICAM-1)
>ICAM-1 over expressed in dry eye
-inhibition of cytokine release
>reducing inflammation and symptoms of dry eye
27
Adverse effects of Liftegrast?
- Irritation
- Reduced VA
- Dysgeusia (altered taste)
28
Type of Drug: Cyclosporin?
Immunomodulator: VKC/severe DED/Keratoconjunctivitis sicca
29
MOA of Cyclosporin?
Immunosuppressant
-inihibit interleukin 2
>prevent cytokine production
>reduced T cell mediated inflammation of lacrimal gland
allows for aqueous production = reduce ADDE
30
Contraindications of Cyclosporin?
- CL cant be worn until 15mins after drops instilled
- Artificial tears used 15mins after
Contraindicated:
- sensitivity
- allergy
31
Adverse effects of Cyclosporine?
- severe ocular pain
- stinging/burning
- swollen eyelids
- crusting eyelids
- hyperaemia
- lacrimation
- blurred vision
- FB sensation
- headaches
32
Type of Drug: Olmetec?
Angiotension receptor blocker used to treat HT
33
MOA of Olmetec?
Competitively blocks binding of angiotensin II to type 1 angiotensin receptors
>reduces angiotensin II
>vasoconstriction/sodium resoroption/aldosterone release
Reduce effect of angiotensin II on sympathetic nervous system activities and growth factors.
34
Indication of Olmetec?
- Hypertension (px unable to tolerate ACE inhibitors)
- Heart Failure
- Diabetic Kidney Disease
35
Contraindication of Olmetec?
- Renal dysfunction
- Severe hepatic impairment
- elderly
- women planning to conceive
- pregnancy
- breastfeeding
- low sodium
36
Adverse effects of Olmetec?
- coughing
- light headed
- HA
- stomach pain
- flu symptoms
- UTI
37
Type of Drug: Zocor?
PRal HMG-CoA reductase inhibitor
-lower cholesterol (LDL) production and reduce dyslipidemia associated complications (cardiac/stroke due to artery damage)
38
MOA of Zocor?
-targets biosynthetic pathway of cholesterol production
>inhibits rate limiting step HMG-CoA reductase = decreased cholesterol concentrations
- inhibits platelet aggregation
- reduction in inflammation at the site of atherosclerotic plaque
- improved endothelial function
39
Indications for Zocor?
- reduce risk of death of coronary artery disease
| - familial or non-familial hypercholesterolaemia
40
Adverse effects of Zocor?
- gastrointestinal disorders
- myalgia
- athralgia
- upper resp. infections
- HA
- abdominal pain
- constipation
41
Contraindications of Zocor?
- active liver disease
- pregnancy/breastfeeding
- CYP3A4 inhibitors (erythromycin/HIV/cyclosprorin)
42
Type of drug: Lexapro?
selective serotonin reuptake inhibitor (SSRI)
43
Indications of Lexapro?
- major depressive disorder
- generalised anxiety disorder
- obsessive compulsive disorder
44
Contraindications of Lexapro?
- blood thinners (warfarin)
- late pregnancy
- alcohol
- NSAIDs (cause bleeding and bruising easily)
45
MOA of Lexapro?
enhances serotonergic activity by binding to serotonin transporter
-prevents reuptake of serotonin in presynaptic serotonergic neuron
>desensitisation of auto receptors allowing endogenous serotonin release
46
Adverse effects of Lexapro?
Ocular:
- burred vision
- tunnel vision
- haloes around lights
- eye pain/swelling
Systemic:
- nausea/vomiting/diarrhea
- serotonin syndrome: hallucinations/twitching/loss of coordination
- pain/burning on urination
- insomnia
47
What type of drug is Lipitor?
Oral antilipemic agent
-reversibly inhibits HMG-CoA reductase to lower total cholestorol
>increasing HDL cholesterol
- 14 hr half life
- metabolised in intestine and liver
48
Indications of Lipitor?
- primary hyperlipidemia
- dyslipidaemia
- hypertriglyceridemia
- familial hypercholestorolaemia
- prevent myocardial infarction, stroke, agina
- after CVD event
49
Contraindications of Lipitor?
- pregnancy
- liver dysfunctions
- use of fibric acid derivatives (erythromycin/cyclosporine)
50
MOA of Lipitor?
-competitive inhibitor of HMG-CoA reductase
-converts HMG-CoA to mevalonate (rate limiting step in cholesterol production)
-in the liver
>stimulate upregulation of LDL and increase hepatic uptake of LDL
51
Adverse effects of Lipitor?
Ocular:
- ambylopia
- dry eyes
- refraction disorder
- eye haemorrhage
- glaucoma
Systemic:
- chest pain
- infection
- HA
- edema
52
Type of drug: Sumatriptan?
Serotonin receptor agonist
-treats migraines and cluster headaches
53
Indications of Sumatriptan?
- migraines with/without auras (12> y/o)
| - cluster headache treatment
54
Contraindications for Sumatriptan?
- other selective serotonin receptor agonists
- pregnancy
- MAO-A inhibitors
55
MOA of Sumatriptan?
-serotonin 5-HT1B &D. agonist
>constriction of cranial blood vessels
- inhibits release of pro-inflammatory neuropeptides
- decreases carotid arterial blood flow
- increases the velocity of internal and MCA blood flow
56
Adverse effects of Sumatriptan?
Ocular:
- mydraisis
- accomodation and EOM disorders
- ocular haemmorrhage
- eye pain
- glaucoma
- ocular edema
Systemic:
- flushing tingling feeling
- drowsiness
57
Type of Drug: Somac?
Esomeprazole: proton pump inhibitors
- treat GERD/peptic ulcers/H.pylori/NSAID related ulcer
- treat gastric acid hyper secretion
58
MOA of Somac?
- proton pump inhibitor at the basal gastric parietal cells
| - bind to H+/K+ ATPase enzyme to inhibit these secretion of acid
59
Indications of Somac?
- healing of gastrointestinal disorders
- peptic ulcer
- GERD
- Zollinger-Ellison syndrome
- mod-severe reflux
60
Contraindications of Somac?
- HIV protease inhibitors
| - hypersensitivity
61
Adverse Effects of Somac?
- headache
- rash
- fatigue
- increased sweating
- blurred vision
62
Type of Drug: Cartia?
anti platelet drug
-inhibits aggregation of platelet
>irreversibly inhibiting platelet cyclooxyrgenase for platelet lifespan
63
MOA of Cartia?
COX inihibitor
| -reduce synthesis of thromboxane A2 (inducer of platelet aggregation)
64
Indications of Cartia?
- acute coronary syndromes
- hx of atherosclerosis
- relief of pain, inflammation, fever
- prevention of pre-eclampsia in women with moderate-high risk
65
Contraindications of Cartia?
- severe active bleeding
| - increased risk of severe bleeding
66
Adverse effects of Cartia?
- allergy (bronchospasm)
- GI irritation
- asymptomatic blood loss and increased time of bleeding
- SJS/TEN
- iron deficiency anaemia
- intracranial haemorrhage
67
Type of drug: Nurofen?
NSAID to relieve symptoms of fever and pain
68
MOA of Nurofen?
nonselective NSAID
-analgesic/antipyretic/anti-inflammatory
-acts on COX receptors
>inhibit synthesis of prostaglandin
>inhibit COX-1 = impaired gastric and anti platelet effects
>anti-inflammatory and analgesic from COX-2 inhibitor
69
Indications for Nurofen?
- fever
- pain (inflammation)
- HA
- symptomatic relief of: RA/JIA
70
Contraindications of Nurofen?
- coagulation disorders
- heart failure
- asthma
71
Adverse effects of Nurofen?
- GI ulcers/bleeding
- heart failure
- renal impairment
- hypersensitivity reaction
72
What type of drug is Timolol?
non-selective beta-blocker
73
Indications for Timolol?
- closed angle glaucoma
| - open angle glaucoma
74
Contraindications of Timolol?
- reactive airway disease (asthma/COPD)
- CVD conditions (bradycardia, AV block)
- pregnancy & breastfeeding
75
MOA of Timolol?
-reduce intraocular pressure by reducing aqueous humour production
>blocks beta receptors in the ciliary epithelium
-Duration: 12-24 hours
76
Adverse effects of Timolol?
- stinging on instillation
- bradycardia
- blurred vision
- hypotension
- fatigue
- bronchospasm
77
What type of drug is aprachlorodine?
alpha 2 selective adrenergic agonist (weak a-1 adrenergic agonist)
78
Indications of Aprachloridine?
- open angle glaucoma (short term)
| - before and after laser surgery
79
Contraindications of Aprachloridine?
- allergies
| - monoamine oxidase inhibitors/tricyclic antidepressents/sympathomimetics
80
MOA of Aprachloridine?
- enhance aqueous humour uveoscleral outflow
- decrease aqueous production by vasoconstriction
>decreases IOP
81
Adverse effects of Aprachloridine?
- hyperamia
- dry mouth
- HA
- puritis
82
Type of drug: Prednisolone Acetate?
- corticosteriod to reduce inflammation in eye conditions
- known as Prednefrin Forte - 1%
- 1 drop every hour (severe) / 1-2 drops 2-4x daily
83
MOA of Predisolone Acetate?
-bind to glucocorticoid receptor
>inhibits pro-inflammatory signals
>local anti-inflammatory and immunosuppressive effects by mediating and changing gene expression
-short duration of action (2-3 hours half life)
84
Indications of Prednisolone Acetate?
- allergy
- inflammatory conditions of conj and cornea
- postop inflammation
85
Contraindications of Prednisolone Acetate?
- hypersensitivity
| - HSK/FK/untreated infections
86
Precautions with Prednisone Acetate?
- hx/risk of ACG
- ocular hypertension
- increase ocular infection due to suppression of immune system
- children = high IOP risk and cataracts
87
Adverse effects of Prednisolone Acetate?
- ocular hypertension
- ocular infection
- delayed corneal healing
- PSC formation
- eye irritation
- dry eye
88
Type of drug: Metformin?
-antihyperglycaemic dryg - biguanide
89
MOA of Metformin?
-liver to reduce glucose production
>inhibit mitochondrial respiratory chain
>AMPK activation and less insulin resistance
-gut to increase glucose usage
90
Indications for Metformin?
- type 2 diabetes
- gestational diabetes
- pre-diabetes
- management of anti-psychotic weight gain
- PCOS
91
Contraindications of Metformin?
- less than 60mL/min of creatine clearance
- impared renal function
- mod-severe heart failure
- undergoing major surgery
92
Adverse effects of Metformin?
- nasuea/vomiting/diarrhea
- anorezia
- Vit B12 malabsorption
- lactic acidosis
93
Type of Drug: Atozet?
ezetimibe: selective inhibitor of intestinal cholesterol
- HMG-CoA reductase inhibitor
- reduce cholesterol levels
94
MOA of Atozet?
-localises at the small intestine borders and inhibits absorption of cholesterol
>decreased delivery of intestinal cholesterol
-statin inhibits HMG-CoA reductase enzyme (cholesterol synthesis in the liver
>reduce level of cholesterol produced
95
Indication of Atozet?
- hypercholestorolaemia
| - prevention of CBD events
96
Contraindications of Atozet?
- hypersensitivity
- pregnancy and nursing
- active liver disease
97
Side effects of Atozet?
- vomiting nausea diarrhoea
| - myalgia
98
Type of drug: Micardis
angiotensin II receptor antagonists
99
MOA of Micardis?
-lower HBP
-selectively blocks angiotensin II binding to angiotensin I receptors
>blocking angiotensin II vasoconstrictor effects
100
Indication of Micardis?
- HT
| - prevention of CVD events
101
Contraindications of Micardis?
- pregnancy
| - px with renal disease
102
Adverse effects of Micardis?
- upper rest tract infection
- back pain
- sinusitis
103
Type of Drug: Janumet?
-antidiabetic combination drug
104
MOA of Janumet?
-antihyperglycaemic agent with complementary mechanisms
1. Sitagliptin: DPP-4 inhibitor
>slows inactivation of hormones like GLP1/GIP
2. Metformin: anti hyperglycaemic agent
>decrease hepatic glucose production
>decrease absorption of glucose in intestines
>increase uptake of peripheral glucose
105
Indications of Janumet?
glycemic control in adults with type 2 DM
106
Contraindications of Janumet?
- Type 1 DM
- allergy
- diabetic ketoacidosis
107
Adverse effects of Janumet?
- lactic acidosis (metformin)
- pancreatis
- indigestion
- HA
- upper resp infection
- heart failure
108
Type of drug: Perindopril?
-angiotensin converting enzyme (ACE) inhibitor
109
MOA of Perindopril?
-block conversion of angiotensin I to II
-inhibit breakdown of bradykinin
>reduce effects of angiotensin II vasoconstriction/sodium retention/aldosterone release
110
Indications for Perindopril?
- hypertenstion
- prevention of heart attack
- chronic heart failure
111
Contraindications of Perindopril?
-planning to conceive/pregnancy
Precaution:
- black/caribbean descent
- drugs that increase K concentration (cyclosporin)
112
Adverse effects of Perindopril?
- hypotension
- headache
- dizziness
- rash
113
Type of drug: Aspirin?
-platelet aggregation inhibitor
114
MOA of Aspirin?
inhibit platelet aggregation
-irreversibly inhibits cycloxygenase
>reduce synthesis of thromboxane A2 for life of platelet
115
Indications of Aspirin?
- -relief pain/inflammation/fever
- hx of atherosclerosis
- acute coronary syndrome
- prevention of pre-emclampsia
116
Contraindications of Aspirin?
- allergy
- aspirin sensitive asthma
- surgery due to bleeding risk
- breastfeeding (high doses)
117
Adverse effects of Aspirin?
- GI irritation
- asymptomatic blood loss
- SJS/TEN
118
Type of drug: Panadol Oesteo?
-analgesic drug
119
MOA of Panadol Oesteo?
-inhibition of central prostaglandin synthesis
| >modulation of inhibitory descending serotonergic pathways
120
Indications of Panadol Oesteo?
- relief of persistent pain with oesteoathritis
| - muscle ache/back aches
121
Contraindications with Panadol oesteo?
-allergy
122
Adverse effects of Panadol Oesteo?
- shortness of breath
- wheezing
- rash
- swelling of face
123
Type of drug: Ventolin?
-bronchidilator
124
Indications of Ventolin?
- treat and prevent bronchospasm
| - asthma/chronic bronchitis/wheezing
125
Contraindications of Ventolin?
- allergy
- heart problems
- HBP
- seizures
126
MOA of Ventolin?
-selective beta 2-adrenergic receptor agonist
>short acting
=relaxation of bronchial smooth muscle
127
Adverse effects of Ventolin?
- anxiety
- shaking
- HA
- fast heartbeat
128
Type of Drug: Paracetomol?
-analgesic
129
MOA of Paracetomol?
- COX inhibitor
| - inhibition of central prostaglandin synthesis and modulation of inhibitory descending serotonergic pathways
130
Indications of Paracetomol?
- relief of pain
| - mild-mod pain
131
Contraindications of Paracetomol?
- allergy
| - heart failure
132
Adverse effects of Paracetomol?
- shortness breath
- wheezing
- hypotension
133
Type of drug: Methylprednisolone?
corticosteroid
134
Indications of Methylprednisolone?
- athritis
- severe allergic reactions
- AAION
- GCA
- immune system disorders
- TED
- optic neuritis
135
Contraindications of Methylprednisolone?
- systemic fungal infections
- live/attenuated vaccines
Precautions:
- allergy
- glaucoma
- heart disease
- DM
- MG
- MS and GI disease
136
MOA of Methylprednisolone?
-binds to glucocorticoid receptors
>bind to DNA promotor regions
>transcription factors activated
>genes inactivated due to histone deacetylation
- inhibiting T cell activation
- facilitating apoptosis of immune cells
137
Adverse effects of Methylprednisolone?
Ocular:
- PSC
- delayed wound healing
- increase risk of SIG (steroid induced glauc)
```
Systemic:-
immunosuppresion
-increased susceptibility to infections
-peptic ulcer
-skin atrophy
```
138
Type of drug: Prednisolone?
-corticosteriod
139
MOA of Prednisolone?
-regulating gene expression
| >local anti-inflammatory and immunosuppressive effects
140
Indications of Prednisolone?
-ocular infections (HK/FK)
Precaution:
- glauc
- ocular NSAIDs
141
Adverse effects of Prednisolone?
- ocular hypertension
- ocular infection
- delayed corneal healing
- rebound inflammation (tx stopped abruptly)
- PSC (long term)
142
What type of drug is: Prednefrin Forte?
topical corticosteroid
-prednisolone acetate 1% & phenylephrine hydrochloride 0.12%
143
MOA of Prednefrin Forte?
glucocorticoid receptors to affect the inflammatory cascade pathways
>responsible for inhibiting oedema
>reduce capillary dilation and permeability
>inhibiting collagen/fibrin deposition
>decrease lymphocyte/leukocyte migration and function
>reduce VEGF expression
phenylephrine:
-vasoconstrictor to reduce ocular redness
144
Contraindications of Prednefrin Forte?
- untreated active infections (HSK)
- fungal infections
- TB
- hypersensitivity
precautions:
- prolong use (2nd infections of cornea)
- adrenal suppression in children
- pregnancy (shortest course possible)
145
Indications of Prednefrin Forte?
```
-severe ocular inflammation
>anterior uveitis
>iritis
>iridocyclitis
>scleritis
>post-op inflammation
```
146
Adverse effects of Prednefrin Forte?
- HA
- PSC
- 2nd corneal infection
- elevated IOP
- dry eyes
147
Type of Drug: Atropine?
-anti-cholinergic
148
MOA of Atropine?
```
-blockage of muscarinic action of ACh
>relaxation of pupillary sphincter muscles
>ciliary muscles relaxation
>pupil dilation
>paralysis of accomodation
```
149
Indications of Atropine?
- mydraisis
- cycloplegia
- fundus examination
- pain relief for uveitis/keratitis
- reduce progression of myopia
- treatment of amblyopia
150
Contraindications of Atropine?
- hypersensitivity
- ACG
- lenticular sublaxation
- DM (cant achieve adequate mydraisis)
151
Adverse effects of Atropine?
- photophobia
- glare
- stinging on instillation
- blurry vision
- transient IOP elevation
152
Type of Drug: Plaquenil?
antimalarial
-anti-inflammatory/immunosupppresive effects
153
Indications of Plaquenil?
- RA
- SLE
- Malaria
- JIA
154
Contraindications of Plaquenil?
- maculopathy present
- allergies to hydroxychloroquine
- long term therapy in children
- antipsychotics/anti-infectives/antiarythmatics
Precaution:
- DM: drug reduces HbA1c = hypoglycaemia
- toxicity with tamoxifen
155
Adverse effects of Plaquenil?
- blurred vision
- retinal toxicity (scotoma > foveal damage (bulls eye))
- vision loss
- corneal changes
- photophobia
156
Type of drug: Chlorsig?
antimicrobial
157
MOA of Chlorsig?
-binds to bacterial ribosome
>inhibit protein synthesis
>prevents bacterial proliferation
158
Indications for Chlorsig?
-prevent of bacterial conjunctivitis
159
Contraindications with Chlorsig?
- hypersensitvity
- family hx of blood dycrasias
- myelosuppresion due to previous exposure of chloramphenicol
Precaution:
- ineffective coverage for P. Aureginosa
- CL cant be worn during treatment
160
Adverse effects of Chlorsig?
- blurring
- stinging
- irritation
- itching
- extreme fatigue
161
Type of Drug: Cyclopentolate Hydrochloride?
-anticholinergics
162
Contraindications for Cyclopentolate Hydrochloride?
-suspect or confirm ACG
Precaution:
- down syndrome
- children with spastic paralysis/brain damage
- pregnancy/lactation
163
Indications for Cyclopentolate Hydrochloride?
- mydraisis
- cycloplegia
- iritis
- uveitis
164
MOA of Cyclopentolate Hydrochloride?
-reversibly inhibits ACh
>prevention of iris sphincter muscle
>inhibits ciliary muscle
>causing mydriasis
165
Adverse effects of Cyclopentolate Hydrochloride?
- transient increase in IOP
- irritation
- burning
- photophobia
- punctal stenosis
166
Type of drug: Vytorin?
- ezetimibe: cholrestoral absorption inhibitor
| - simibastain: HMG-CoA reductase inhibitor (statin)
167
Indications for Vytorin?
- primary hypercholesterolemia with diet control
- prevent CVD events
- familal hypercholesterolemia
168
Contraindications of Vytorin?
- hypersensitivity
- active liver disease
- pregnancy
- lactation
- concomittant use of cyclosporin
169
MOA of Vytorin?
Ezetimibe:
-selectively inhibits small intestine from absorbing cholesterol and phytosterol
>lowers blood cholesterol leves
Simvastatin:
-acts in liver
>reduces hepatic cholesterol
>upregulation of hepatic LDL receptors (increase uptake)
170
Adverse effects of Vytorin?
Ocular:
- blurred vision
- catracts
- EOM weakness
- diplopia
- jaundice
Systemic:
- dizzines
- HA
- discomfort
- nausea
- vomiting
- rash
171
Type of Drug: Exforge?
-valsartan + amlodipine besylate
>control hypertension and blood pressure
172
MOA of Exforge?
Valsartan:
- vasoconstrictor inhibitor
- blocks aldosterone secreting effects of angiotensin II by selectively blocking angiotensin II to AT1 receptor (in vascular smooth muscles in adrenal gland)
Amlodipine:
-peripheral arterial vasodilator
-calcium channel blocker
>inhibit influx of Ca ions in vascular smooth muscles and cardiac muscle
>reduces peripheral vascular resistance and blood pressure
173
Indications of Exforge?
-HT
174
Contraindications of Exforge?
- allergy
- medications treating blood and heart problems (dihydropyridines)
- pregnancy/intending to conceive
- dialysis
- cholestasis
- blood pressure lowering medications
175
Adverse Effects of Exforge?
- dizzines
- HA
- sensitivity to light
- dry mouth/cough
176
Type of drug: Rituximab?
monoclonal antibody
177
Indications of Rituximab?
Non-hodgkin;s lymphoma
- RA/SLE
- MG/NMO
- OCP
178
Contraindications of Rituximab?
- acute/chronic infections
- severe congestive heart failure
- pregnancy
179
MOA of Rituximab?
- deplete B cells from circulation
- binds to CD20 surface marker expressed on B cells (memory B cells)
- binds to mechanisms of death (cell mediated cytotoxicity)
180
Adverse effects of Rituximab?
Ocular:
- acute retinal necrosis
- CMO
- CMV retinitis
Systemic:
- infections
- infusion reaction
- blood/renal disorders
181
Type of Drug: Fenofibrate?
-angiotensin converting enzyme inhibitor (ACE)
182
MOA of Fenofibrate?
-inibition of ACE converting angiotensin I to vasoconstrictor II
-suppresses the aldosterone system
>decrease vasopressor activity
>decrease aldosterone secretion (reduce BP)
183
Indications of Fenofibrate?
- HT
- heart failure
- acute myocardial infarction (24 hrs)
184
Contraindications of Fenofibrate?
- pregnancy
| - hx of angioedma
185
Adverse effects of Fenofibrate?
- dry cough
- hypotension
- HA
- renal problems
- hyperkalemia (potassium)
