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Master drugs Flashcards

1
Q

Epoprostenol

A

Class: PGI2MOA: relax smooth muscle Use: pulmonary HTNAdverse Effects: GI upset

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2
Q

Methazolamide

A

Class: carbonic anhydrase inhibitorsMOA: inhibit CA preventing breakdown of carbonic acid and absorption of bicarbonate –> osmotic diuresisUse: promotes urinary alkalinization and prevents acute altitude sicknessPK/PD: admin oral or topical. decreases NH4 secretion*contraindicated in hepatic cirrhosis (b/c alkaline urine traps NH4 as ammonia –> reabsorbed –> hepatic encephalopathy)Adverse Effects: Type II RTA

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3
Q

Mecamylamine

A

Class: Nicotinic Antagonists - Tertiary Ganglion BlockersMOA: competitive blockage of autonomic nicotinic receptors –> decrease in arteriolar and vasomotor tone.PK/PD: can distribute to CNS

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4
Q

Sorbitol

A

Class: non-digestible sugars/alcoholsMOA: water retentionUse: acidify lumen, drawing water inPK/PD: contraindicated in CHF, pulmonary edema (because these will expand ECF by drawing fluid out of tissue)Adverse Effects: dehydration, hypernatremia, metabolic acidosis

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5
Q

Glycopyrolate

A

Class: Muscarinic Antagonists - Quaternary AminesUse: pre-operative, hyperhidrosis*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

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6
Q

Dimenhydrinate

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

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7
Q

Terbutaline

A

Class: Direct Adrenoceptor Agonists - β2 selectiveMOA: increase cAMP –> bronchodilation and smooth muscle relaxationUse: asthma, status asthmaticus, and uterine relaxation in premature laborAdverse effects: tremors

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8
Q

Procainamide

A

Class: Class 1A anti-arrhythmeticsMOA: moderate Na channel block –> elevating depolarization threshold, decreasing phase 4 for depolarization. Block K channel –> prolonging AP duration. Ganglion blockage –> increase AV node conductionUse: atrial and ventricular arrhythmia, post-MI arrhythmia , wide-complex tachycardiaPK/PD: oral and IV admin, short half life, hepatic metabolism, renal excretion, contraindicated in chronic arthritisAdverse Effects: Cardiotoxic (Torsades de Pointes), lupus-like syndrome*does not elevate digoxin levels

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9
Q

Hydrocortisone

A

Class: Glucocorticoids - short actingUse: adrenal insufficiency, asthmaPK/PD: admin oral aerosol, or topical. inactivated by placenta –> use to treat motherContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

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10
Q

Echothiophate

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleDistributes to CNSPralidoxime (2-PAM) treats poisoning

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11
Q

Diazoxide

A

Class: direct vasodilatorsMOA: K channel activation –> hyperpolarization. Arterial dilationUse: HTN Admin IVAdverse Effects: reflex tachycardia, fluid retention, HA, palpitation

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12
Q

Fosaprepitant

A

Class: Neurokinin-1 receptor antagonistUse: chemo-induced emesis

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13
Q

Norethynodrel

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

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14
Q

Cabergoline

A

Class: dopamine agonistMOA: D2 agonistUse: Parkinsonism, hyperprolactinemia, prolactinomaAdverse Effects: NandV, orthostatic hypotension, fluctuation in efficacy of motor control, abnormal involuntary movements, arrhythmia, hypersexuality, hallucinations, paranoia, anxiety, mania, depression

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15
Q

Phenylephrine

A

Class: Direct Adrenoceptor Agonists - α1 selectiveUse: mydriasis (eye exams) and nasal decongestion

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16
Q

Valsartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

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17
Q

Torsemide

A

Class: Loop diureticsMOA: inhibit NKCC –> decreased Na/Cl/K reabsorption –> osmotic diuresis. Change in potential –> Mg and Ca excretionUse: Pulmonary edema, CHF, HTN, acute hypercalcemia, hyperkalemnia, acute renal failurePK/PD: admin oral, IV, or IM. rapidly absorbed. Elimination = tubular secretion and absorptionAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, ototoxicity, dehydration, hyonatremia, metabolic alkalosis (contraction alkalosis)*hypomagnesemia –> increased PG production and renal blood flow aiding anti-hypertensive effect*Effective when GFR is low*more effective diuretic than thiazide*use ethacrynic acid of pt has sulfa allergy

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18
Q

Soman

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleUse: war gasDistributes to CNSPralidoxime (2-PAM) treats poisoning

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19
Q

Ethinyl Estradiol

A

Class: EstrogensMOA: growth/development of vagina, uterus, uterine tubes. breast enlargement. pubic/axillary hair. pigmentation of areola and genitalia. mildly anabolic. inhibits PTH-induced bone resorptionUse: primary hypogonadism. postmenopausal HRT. oral contraception. osteoporosis prophylaxisPK/PD: contraindicated in breast/endometrial cancer, liver disease, thromboembolic diseases, smoking, pregnancyAdverse Effects: increased risk of breast/endometrial cancer. nausea, bloating, HTN

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20
Q

Quinidine

A

Class: Class 1A anti-arrhythmeticsMOA: moderate Na channel block –> elevating depolarization threshold, decreasing phase 4 for depolarization. Block K channel –> prolonging AP duration. Ganglion blockage –> increase AV node conductionUse: arrhythmiaPK/PD: contraindicated in CHFAdverse Effects: Cardiotoxic (torsades de pointes), block alpha adrenergic and muscarinic, GI toxicity, cinchonism, thrombocytopenia, wide QRS*elevated digoxin levels

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21
Q

Metoprolol

A

Class: Beta Adrenoceptor Antagonists - β1 selectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid), inhibit conversion of T3 to T4Use: hyperthyroidismPK/PD: oral, well absorbedAdverse Effects: due to specificity, no pulmonary effects

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22
Q

Progesterone

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

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23
Q

Sarin

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleUse: war gasDistributes to CNSPralidoxime (2-PAM) treats poisoning

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24
Q

Cabergoline

A

Class: Dopamine receptor agonistsUse: GH excess, tumors secreting GH and PRL

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25
Q

Budesonide

A

Class: GlucocorticoidsMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RAPK/PD: admin oral, IV, or aerosolAdverse Effects: Typical steroid effects (especially w/ oral admin), oral candidiasis, and hoarseness

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26
Q

Dibasic Calcium Phosphate

A

Use: hypocalcemia and osteoporosis prophylaxis

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27
Q

Diltiazem

A

Class: Ca channel blockers - non-dihydropyridinesMOA: block L-type Ca channel –> reduced SA/AV conductionUse: Angina prophylaxis, mild/moderate HTN (esp. in AA and elderly), tocolysis, class IV anti-arrhythmic Contraindicated in CHFAdverse Effects: cardiac arrest, AV block, constipation, CHF*blocks binding site 1B, mostly in myocardium NO REFLEX TACHYCARDIA

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28
Q

Muscarine

A

Class: Direct Muscarinic Agonists - AlkaloidsMOA: Contracts iris sphincter, increases aqueous humor drainageUse: Acute glaucoma

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29
Q

Nesiritide

A

Class: BNP analogMOA: increases cGMP –> arteriolar and venous dilation –> reduced afterload and preload. Causes natuiresisUse: actue tx of HF

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30
Q

Aspart

A

Class: Rapid acting insulinUse: DM I

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31
Q

Calcitriol

A

MOA: 1, 25 dihydroxy vitamin DUse: nutritional rickets, metabolic rickets, hypoparathyroidism, osteoporosis

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32
Q

Estriol

A

Class: EstrogensMOA: growth/development of vagina, uterus, uterine tubes. breast enlargement. pubic/axillary hair. pigmentation of areola and genitalia. mildly anabolic. inhibits PTH-induced bone resorptionUse: primary hypogonadism. postmenopausal HRT. oral contraception. osteoporosis prophylaxisPK/PD: contraindicated in breast/endometrial cancer, liver disease, thromboembolic diseases, smoking, pregnancyAdverse Effects: increased risk of breast/endometrial cancer. nausea, bloating, HTN

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33
Q

Desogestrel

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

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34
Q

Eprosartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

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35
Q

Quinethazone

A

Class: Thiazide-like diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

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36
Q

Sitagliptin

A

MOA: inhibits DDP4 –> preventing incretin degradationUse: DM II (combo w/ other tx)

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37
Q

Amyl Nitrate

A

Class: Nitrates - short actingMOA: sitmulates NO production –> stimulates guanylyl cyclase –> increase cGMP –> decrease phosphorylation of myosin light chain –> vasodilation –> decreased preloadUse: acute anginaAdmin: inhaled or sublingualAdverse Effects: Reflex tachycardia and inotropy (increased O2 demand and reduced perfusion), headacheContraindications: HOCM and patients taking PDE inhibitors (“-fil” ex. sildenafil)*chronic use leads to tolerance (must have nitrate free intervals*toxicity = hypotension, headache, dizziness*veins dilated more than arteries*preferentially dilates epicardial arteries, which is where most ischemia occurs

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38
Q

MDMA

A

Class: Indirect SympathomimeticsAdverse Effects: Insomnia, anorexia, weight loss

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39
Q

Tolvaptan

A

Class: Vasopressin receptor antagonistMOA: decrease aquaporins –> water retention in collecting tubuleUse: SIADH, CHF, hyponatremia*admin oralAdverse Effects: Hypernatremia, nephrogenic DI

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40
Q

Prenalterol

A

Class: Direct Adrenoceptor Agonists - β1 selectiveMOA: increase heart rate*partial agonist

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41
Q

Fludrocortisone

A

Class: mineralocorticoidMOA: mineralocorticoid actionUse: salt-losing syndrome

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42
Q

Vytorin

A

Ezetimibe + simvastatin

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43
Q

Anastrazole

A

Class: Atomatase inhibitorsMOA: Inhibit aromatase –> reduce estrogen synthesisUse: tamoxifen resistant breast cancerPK/PD: non-steroidal and reversible (except exemestane)

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44
Q

Mannitol

A

Class: osmotic diuretic

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45
Q

Ramipril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

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46
Q

Salicylic Acid

A

Class: NSAID - salicylatesMOA: inhibits COX enzymes, inhibits renal secretion of uric acid (low dose), inhibits renal reabsorption of uric acid (high dose)Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregationPK/PD: aspirin (irreversible) is metabolized to salicylic acid (reversible), highly bound to plasma protein (may kick other drugs off), contraindicated in hemophilia, children with viral infections, severe CV diseaseAdverse Effects: same as other NSAIDs, hypersensitivity (due to overutilization of LOX pathway)toxicity: salicycism, hyperthermia, hyperpnea, respiratory alkalosis* treat toxicity with gastric lavage and supportive care.* NSAIDS inhibit renal prostaglandins PGE2 and PGI2, resulting in vasoconstriction and exacerbation of CV disease

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47
Q

Senna

A

Class: AnthraquinonesMOA: stimulant laxativesUse: constipation

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48
Q

Hydroxyzysine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

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49
Q

Yohimbine

A

Class: Alpha Adrenoceptor Antagonists - α2 selectiveUse: nothing (purported to treat ED)Adverse Effects: orthostatic hypotension and reflex tachycardia

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50
Q

Sermorelin Acetate

A

MOA: recombinant GHUse: GH deficiency (ex. growth failure in children, wasting in HIV pts, short bowel syndrome)PK/PD: induce microsomal enzymes, contraindicated in malignancyAdverse Effects: Primarily in adults, peripheral edema, myalgias, arthralgias, carpal tunnel

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51
Q

Oxaprozin

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

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52
Q

Terazosin

A

Class: Alpha Adrenoceptor Antagonists - α1 selectiveUse: hypertension and PTSDPK/PD: long half lifeAdverse Effects: orthostatic hypotension (lowest risk with tamsulosin), reflex tachycardia

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53
Q

Carboprost

A

Class: PGF2MOA: relax smooth muscleUse: post-partum hemorrhage Adverse Effects: GI upset

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54
Q

(Methyl)ergonovine

A

Class: 5-HT agonists - nonselective - ergot alkaloidsMOA: agonists or partial agonists at various receptors, vasoconstrictionUse: migraine (ergotamine or dihydroergotamine), post-partum hemorrhage (ergonovine, if oxytocin fails)PK/PD: caffeine – increases absorption, contraindicated in coronary artery diseaseAdverse Effects: GI upset (most common), prolonged vasospasm (most serious)*for hemorrhage, only use after placenta is delivered

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55
Q

Tolterodine

A

Class: Muscarinic Antagonists - Tertiary AminesMOA: decrease Ach –> inhibits bronchoconstriction and mucus secretionUse: used to relieve bladder spasm after urologic surgery*M3 selective*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

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56
Q

Omalizumab

A

Class: Anti-IgE AbMOA: inhibits IgE binding to mast cells –> decrease mast cell activation –> bronchodilationUse: asthma

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57
Q

Amiodarone

A

Class: Class 3 anti-arrhythmeticsMOA: blocks K channel, prolonging AP, blocking inactivated Na channels, decreasing pacemaker potential, block beta adrenergic and Ca receptorsUse: life threatening ventricular arrhythmia (first choice), supraventricular arrhythmia, wide-complex tachycardiaPK/PD: admin oral and IV, metabolized by CYP450 (3A4), inhibits microsomal enzymes, contraindicated in lung diseaseAdverse Effects: torsades, bradycardia, pulmonary fibrosis, blue/grey color of skin and cornea, respiratory difficulty, neurotoxicity, thyroid dysfunction

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58
Q

Nateglinide

A

Class: D-phenylalanine derivative (like sulfonylureas)MOA: bind SUR1Use: DM IIPK/PD: rapid onset and short durationAdverse Effects: hypoglycemia*Use if pt has sulfa allergy

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59
Q

Doserelin

A

Class: GnRH analoguesMOA: chronic use desensitizes GnRH receptor –> suppresses gonadotropin releaseUse: controlled ovarian hyperstimulation, endometriosis, uterine fibroids, prostate cancer, central precocious puberty*initially these stimulate gonadotropin release

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60
Q

Testosterone Enanthate

A

Class: Androgens*more androgenicUse: Hypogonadism and anemiaAdverse Effects: feminizing effects in post-pubertal males (due to conversion to estrogen)

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61
Q

Nitroglycerin

A

Class: Nitrates - short actingMOA: sitmulates NO production –> stimulates guanylyl cyclase –> increase cGMP –> decrease phosphorylation of myosin light chain –> vasodilation –> decreased preloadUse: acute angina Admin: inhaled or sublingualAdverse Effects: Reflex tachycardia and inotropy (increased O2 demand and reduced perfusion), headacheContraindications: HOCM and patients taking PDE inhibitors (“-fil” ex. sildenafil)*chronic use leads to tolerance (must have nitrate free intervals*toxicity = hypotension, headache, dizziness*veins dilated more than arteries*preferentially dilates epicardial arteries, which is where most ischemia occurs

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62
Q

Hyoscyamine

A

Class: anticholinergicsMOA: anti-spasmodic activityUse: IBS

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63
Q

Ergotamine

A

Class: 5-HT agonists - nonselective - ergot alkaloidsMOA: agonists or partial agonists at various receptors, vasoconstrictionUse: migraine (ergotamine or dihydroergotamine), post-partum hemorrhage (ergonovine, if oxytocin fails)PK/PD: caffeine – increases absorption, contraindicated in coronary artery diseaseAdverse Effects: GI upset (most common), prolonged vasospasm (most serious)*for hemorrhage, only use after placenta is delivered

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64
Q

Mometasone

A

Class: GlucocorticoidsMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RAPK/PD: admin oral or IVAdverse Effects: Typical steroid effects (especially w/ oral admin)

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65
Q

Dolasetron

A

Class: 5-HT3 antagonists Use: chemo-induced vomiting

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66
Q

Omeprazole

A

Class: proton pump inhibitorsMOA: irreversibly bind H/K-ATPase of parietal cell –> reduced acid secretionUse: peptic ulcer (treatment and prevention), GERD, h. pylori (+ clarithromycin + amoxicillin)PK/PD: activated/degraded in acidic environment: coated to survive stomach –> absorbed in intestine –> enter circulation –> activated in parietal cell canaliculiAdverse Effects: GI upset, rash, CNS effects, diarrhea (chronic use only: low acidity allows bacterial overgrowth)

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67
Q

Latanoprost

A

Class: PGF2MOA: relax smooth muscleUse: open angle glaucomaAdverse Effects: GI upset

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68
Q

Cimetidine

A

Class: H2 antagonistsMOA: inhibit gastric acid secretion (esp. nocturnal secretion)Use: peptic ulcer and h. pylori (+ bismuth + antibiotics)PK/PD: doesn’t impact normal intestinal secretions, contraindicated in pregnant and nursing women. metabolized by CYP450Adverse Effects: GI upset, endocrine effects (cimetidine): gynecomastia, galactorrhea, muscle pain, inhibits microsomal enzymes*nocturnal acid secretion is primarily driven by histamine

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69
Q

Prednisone

A

Class: Glucocorticoids - short actingUse: adrenal insufficiency, asthmaPK/PD: admin oral aerosol, or topical. inactivated by placenta –> use to treat motherContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

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70
Q

Metformin

A

Class: biguanidesMOA: activates AMPK –> reduced hepatic gluconeogenesis. Increase peripheral insulin sensitivityUse: DM II (first choice), reduce triglyceridesPK/PD: admin oral, not metabolized, renal excretionAdverse Effects: GI toxicity (anorexia, diarrhea, nausea, vomiting), lactic acidosis (due to impaired hepatic metabolism of lactic acid)

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71
Q

Trimethaphan

A

Class: Nicotinic Antagonists - Quaternary Ganglion BlockersMOA: competitive blockage of autonomic nicotinic receptors –> decrease in arteriolar and vasomotor tone.

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72
Q

Clemastine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

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73
Q

Timolol

A

Class: Beta Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: open angle glaucoma, HTN, ischemia, angina prophylaxis, migraine prevention (first choice)PK/PD: oral. well absorbed. Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation

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74
Q

Alosetron

A

Class: 5-HT3 antagonists Use: chemo-induced vomiting and IBS w/ diarrhea predominance

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75
Q

Nafarelin

A

Class: GnRH analoguesMOA: chronic use desensitizes GnRH receptor –> suppresses gonadotropin releaseUse: controlled ovarian hyperstimulation, endometriosis, uterine fibroids, prostate cancer, central precocious puberty*initially these stimulate gonadotropin release

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76
Q

Indomethacin

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

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77
Q

Glulisine

A

Class: Rapid acting insulinUse: DM I

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78
Q

Mg Citrate

A

Class: saline laxativesMOA: non-absorbable salt –> increase osmotic activity in lumenUse: constipationContraindications: renal insufficiency, heart disease, diuretic treatment

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79
Q

Betaxolol

A

Class: Beta Adrenoceptor Antagonists - β1 selectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid), inhibit conversion of T3 to T4Use: hyperthyroidismPK/PD: oral, well absorbed Adverse Effects: due to specificity, no pulmonary effects

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80
Q

Bicalutamide

A

Class: anti-androgens MOA: competitively inhibit androgen receptorUse: metastatic prostate cancer (in combo w/ GnRH agonist)*combo tx = maximal androgen blockade (desensitizes pituitary + prevents nadrogen binding)

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81
Q

Dinopristone

A

Class: PGE2MOA: induce cervical ripeningUse: induce labor and NSAID induced ulcerAdverse Effects: GI upset

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82
Q

Zoledronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

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83
Q

Ketoconazole

A

MOA: inhibits CYP17, preventing steroidogenesisUse: Cushing’sAdverse Effects: hepatic dysfunction

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84
Q

Glargine

A

Class: long acting insulinUse: DM I (used to maintain basal insulin levels)

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85
Q

Mestranol

A

Class: EstrogensMOA: growth/development of vagina, uterus, uterine tubes. breast enlargement. pubic/axillary hair. pigmentation of areola and genitalia. mildly anabolic. inhibits PTH-induced bone resorptionUse: primary hypogonadism. postmenopausal HRT. oral contraception. osteoporosis prophylaxisPK/PD: contraindicated in breast/endometrial cancer, liver disease, thromboembolic diseases, smoking, pregnancyAdverse Effects: increased risk of breast/endometrial cancer. nausea, bloating, HTN

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86
Q

Methyldopa

A

Class: Direct Adrenoceptor Agonists - α2 selectiveMOA: increase reuptake of catecholamines –> decreased sympathetic stimulationUse: hypertensionAdverse effects: hypertensive crisis with abrupt withdrawal, autohemolytic anemia, drug induced lupus*preferred in pregnancy *can uncouple autoantigens on RBCs

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87
Q

Chlorthaladone

A

Class: Thiazide-like diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

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88
Q

Olmesartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

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89
Q

Ethacrynic Acid

A

Class: Loop diureticsMOA: inhibit NKCC –> decreased Na/Cl/K reabsorption –> osmotic diuresis. Change in potential –> Mg and Ca excretionUse: Pulmonary edema, CHF, HTN, acute hypercalcemia, hyperkalemnia, acute renal failurePK/PD: admin oral, IV, or IM. rapidly absorbed. Elimination = tubular secretion and absorptionAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, ototoxicity, dehydration, hyonatremia, metabolic alkalosis (contraction alkalosis)*hypomagnesemia –> increased PG production and renal blood flow aiding anti-hypertensive effect*Effective when GFR is low*more effective diuretic than thiazide*use ethacrynic acid of pt has sulfa allergy

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90
Q

Almotriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

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91
Q

Fadrazole

A

Class: Atomatase inhibitorsMOA: Inhibit aromatase –> reduce estrogen synthesisUse: tamoxifen resistant breast cancerPK/PD: non-steroidal and reversible (except exemestane)

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92
Q

Atorvastatin

A

Class: HMG-CoA reductase inhibitorsMOA: reduce hepatic formation of cholesterol. Increase LDL receptors on hepatocytes –> lower plasma LDLUse: lower plasma LDLPK/PD: good GI absorption, hepatic metabolism by CYPs, high first pass metabolism, bile excretion, contraindicated in pregnancy, admin at night when most cholesterol synthesis occursAdverse Effects: hepatotoxicity, rhabdomyolysis (increase CK)*reduces mortality from CVD and MI

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93
Q

Fulvestrant

A

Class: ER antagonist MOA: pure ER antagonistUse: breast cancer (if SERM and aromatase inhibitor tx fails)

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94
Q

Simcor

A

Niacin + simvastatin

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95
Q

Piroxicam

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

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96
Q

Ezetimibe

A

Class: Cholesterol absorption inhibitorMOA: inhibits intestinal absorption of cholesterol and phylosterolsUse: lower plasma LDL, primary hypercholesterolemiaAdverse Effects: steatorrhea, hepatotoxicity

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97
Q

Flutamide

A

Class: anti-androgens MOA: competitively inhibit androgen receptorUse: metastatic prostate cancer (in combo w/ GnRH agonist)*combo tx = maximal androgen blockade (desensitizes pituitary + prevents nadrogen binding)

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98
Q

Pramlintide

A

Class: amylin analogMOA: amylin analog –> increased gastric emptying time, decreased glucagon secretion, reduce appetiteUse: DM I and II (especially in obese pts.)PK/PD: admin IM, renal metabolism and excretionAdverse Effects: hypoglycemia

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99
Q

Nadolol

A

Class: Beta Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: open angle glaucoma, HTN, ischemia, angina prophylaxis, migraine prevention (first choice) PK/PD: oral. well absorbed.Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation

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100
Q

Naratriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

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101
Q

Donepezil

A

Class: Cholinesterase InhibitorsUse: Dementia and Alzheimer’sAdverse Effects: Muscle cramps, GI upset

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102
Q

Bosentan

A

Class: Endothelin receptor antagonistMOA: arterial dilationUse: pulmonary HTNAdverse Effects: hypotension, hepatotoxicity, tachycardia, flushing

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103
Q

Clonidine

A

Class: Direct Adrenoceptor Agonists - α2 selectiveMOA: increase reuptake of catecholamines –> decreased sympathetic stimulationUse: hypertensionAdverse Effects: hypertensive crisis with abrupt withdrawal and dry mouth

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104
Q

Misoprostol

A

Class: PGE1MOA: relax smooth muscle, bind prostaglandin receptors on gastric epitheliumUse: Abortion, NSAID-induced ulcerPK/PD: admin injection*contraindicated in pregnancyAdverse Effects: GI upset

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105
Q

Estradiol

A

Class: EstrogensMOA: growth/development of vagina, uterus, uterine tubes. breast enlargement. pubic/axillary hair. pigmentation of areola and genitalia. mildly anabolic. inhibits PTH-induced bone resorptionUse: primary hypogonadism. postmenopausal HRT. oral contraception. osteoporosis prophylaxisPK/PD: contraindicated in breast/endometrial cancer, liver disease, thromboembolic diseases, smoking, pregnancyAdverse Effects: increased risk of breast/endometrial cancer. nausea, bloating, HTN

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106
Q

Montelukast

A

Class: Leukotriene AntagonistMOA: LTD4 receptor antagonist –> bronchodilationUse: asthmaPK/PD: admin is oral (good for kids)

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107
Q

Phentolamine

A

Class: Alpha Adrenoceptor Antagonists - nonselectiveMOA: reduces TPR and MAPUse: PheochromocytomaAdverse Effects: Orthostatic hypotension and reflex tachycardia*reversible

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108
Q

Cascara Sagrada

A

Class: AnthraquinonesMOA: stimulant laxativesUse: constipation

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109
Q

Pravastatin

A

Class: HMG-CoA reductase inhibitorsMOA: reduce hepatic formation of cholesterol. Increase LDL receptors on hepatocytes –> lower plasma LDLUse: lower plasma LDLPK/PD: good GI absorption, NOT METABOLIZED BY CYPs, high first pass metabolism, bile excretion, contraindicated in pregnancy, admin at night when most cholesterol synthesis occursAdverse Effects: hepatotoxicity, rhabdomyolysis (increase CK)*reduces mortality from CVD and MI

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110
Q

NPH humulin N

A

Class: intermediate acting insulinUse: DM I

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111
Q

Pseudoephedrine

A

Class: Indirect SympathomimeticsPK/PD: CNS stimulationAdverse Effects: Insomnia, anorexia, weight loss

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112
Q

Hydralazine

A

Class: direct vasodilatorsMOA: arterial dilationUse: pre-eclampsia Admin IVAdverse Effects: lupus-like syndrome, reflex tachycardia, fluid retention, HA, palpitation

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113
Q

Reserpine

A

Class: Adrenergic Neuron AntagonistsMOA: inhibits VMAT –> prevents NE packaging into vesicles. NE is either chewed up by MAO or spills over into synaptic cleft –> eventually, this will lead to depletion of NEUse: HTN*also blocks packaging of serotonin

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114
Q

Dranabinol

A

MOA: unknown mechanismUse: vomiting

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115
Q

Alprazolam

A

Class: benzodiazepines Use: vomiting

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116
Q

Telmisartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

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117
Q

Pindolol

A

Class: Beta Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: HTN, ischemia, angina prophylaxis, migraine prevention (first choice)PK/PD: oral. well absorbed. Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation*has intrinsic sympathomimetic activity and can protect against asthma, bradycardia, and altered lipid profile

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118
Q

Mexiletine

A

Class: Class 1B anti-arrhythmeticsMOA: mild Na channel block, shorten AP durationUse: diabetic neuropathy, ventricular arrhythmiaPK/PD: admin oral, resistant to first pass metabolismAdverse Effects: neurotoxicity

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119
Q

Cyproheptadine

A

Class: 5-HT2 antagonists Use: serotonin syndrome *serotonin syndrome = HTN, hyperreflexia, tremor, clonus, hyperthermia, mydriasis, agitation, coma

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120
Q

Nizatidine

A

Class: H2 antagonistsMOA: inhibit gastric acid secretion (esp. nocturnal secretion)Use: peptic ulcer and h. pylori (+ bismuth + antibiotics)PK/PD: doesn’t impact normal intestinal secretions, contraindicated in pregnant and nursing women. metabolized by CYP450Adverse Effects: GI upset, endocrine effects (cimetidine): gynecomastia, galactorrhea, muscle pain, inhibits microsomal enzymes*nocturnal acid secretion is primarily driven by histamine

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121
Q

Nifedipine

A

Class: Ca channel blockers - dihydropyridinesMOA: block L-type Ca channel –> smooth muscle relaxation (esp. arteries). Coronary and systemic vasodilation. Uterine smooth muscle relaxationUse: Prinzemetal’s angina prophylaxis, mild/moderate HTN (esp. in AA and elderly), tocolysisAdverse Effects: reflex tachycardia, peripheral edema*blocks binding site 1A, mostly in vasculature

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122
Q

Desmopressin

A

Class: Vasopressin agonistMOA: predominantly V2 agonist, anti-diuresis, vasoconstrictionUse: HTN, neurogenic diabetes insipidus*desmopressin is more potent and longer lasting than vasopressin

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123
Q

Potassium Iodide

A

MOA: thyroglobulin proteolysis and hormone releaseUse: pre-op prepAdverse Effects: depression, insomnia, impotence

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124
Q

Raloxifene

A

Class: SERMMOA: partial ER agonists –> antagonistic activity in presence of normal hormone levelsUse: ER + breast cancerPK/PD: in premenopausal women, SERM is antagonist in all tissues. in postmenopausal women, SERM is agonist in all except mammary tissueAdverse Effects: in postmenopausal women, increased risk of endometrial cancer*in postmenopausal women, hormone levels remain high in mammary tissue

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125
Q

Disopyramide

A

Class: Class 1A anti-arrhythmeticsMOA: moderate Na channel block –> elevating depolarization threshold, decreasing phase 4 for depolarization. Block K channel –> prolonging AP duration. Ganglion blockage –> increase AV node conductionUse: ventricular arrhythmiaPK/PD: contraindicated in prostatismAdverse Effects: anti-muscarinic activity, negative inotropic action –> CHF*not really used anymore

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126
Q

Dopamine

A

Class: CatecholaminesMOA: D1 agonistUse: Shock, heart failure, anaphylaxis, fundoscopic eye exams*Metyrosine inhibits tyrosine hydroxylase, preventing formation of catecholamines*Reserpine inhibits NE uptake into vesicles (VMAT)

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127
Q

Oxybutynin

A

Class: Muscarinic Antagonists - Tertiary AminesMOA: decrease Ach –> inhibits bronchoconstriction and mucus secretionUse: urinary urgency/frequency*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

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128
Q

Oxymetazoline

A

Class: Direct Adrenoceptor Agonists - α1 selectiveUse: mydriasis (eye exams) and nasal decongestion*topical administration

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129
Q

Flulnarizine

A

MOA: Ca channel blockerUse: preventative tx for migraine

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130
Q

Humulin R

A

Class: short acting insulinUse: DM I and DKAAdmin IV for DKA

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131
Q

Ephedrine

A

Class: Indirect SympathomimeticsPK/PD: CNS stimulationAdverse Effects: Insomnia, anorexia, weight loss*direct sympathomimetic activity

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132
Q

Histrelin

A

Class: GnRH analoguesMOA: chronic use desensitizes GnRH receptor –> suppresses gonadotropin releaseUse: controlled ovarian hyperstimulation, endometriosis, uterine fibroids, prostate cancer, central precocious puberty*initially these stimulate gonadotropin release

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133
Q

Homatropine

A

Class: Muscarinic Antagonists - Tertiary AminesMOA: decrease Ach –> inhibits bronchoconstriction and mucus secretion*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

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134
Q

Enalapril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

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135
Q

Fenofibrate

A

Class: fibratesMOA: activates PPAR-α –> decreased plasma TG, VLDL, LDL, increases HDLUse: hypertriglyceridemia and dysbetalipoproteinemiaPK/PD: may increase concentration of statinsAdverse Effects: skin rashes, lymphocytopenia, myopathy (increased risk with stain combo), gall bladder disease

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136
Q

Octreotide

A

Class: Somatostatin analogMOA: inhibits pituitary release of GHUse: GH excess, insulinoma, VIPomaAdverse Effects: GI toxicity, vitamin B12 deficiency

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137
Q

Frovatriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

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138
Q

Katanserin

A

Class: 5-HT2 antagonists *also an alpha 1 antagonistUse: HTN *serotonin syndrome = HTN, hyperreflexia, tremor, clonus, hyperthermia, mydriasis, agitation, coma

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139
Q

Methoxamine

A

Class: Direct Adrenoceptor Agonists - α1 selectiveUse: mydriasis (eye exams) and nasal decongestion

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140
Q

Nicotine

A

Class: Direct Nicotinic AgonistsPK/PD: Excess agonist activity results in depolarizing blockade of autonomic ganglia –> flaccid paralysis Distributes to CNS- Tertiary

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141
Q

Exemestane

A

Class: Atomatase inhibitorsMOA: Inhibit aromatase –> reduce estrogen synthesisUse: tamoxifen resistant breast cancerPK/PD: non-steroidal and reversible (except exemestane)

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142
Q

Xylometazoline

A

Class: Direct Adrenoceptor Agonists - α1 selectiveUse: mydriasis (eye exams) and nasal decongestion*topical administration

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143
Q

Simvastatin

A

*prodrugClass: HMG-CoA reductase inhibitorsMOA: reduce hepatic formation of cholesterol. Increase LDL receptors on hepatocytes –> lower plasma LDLUse: lower plasma LDLPK/PD: good GI absorption, hepatic metabolism by CYPs, high first pass metabolism, bile excretion, contraindicated in pregnancy, admin at night when most cholesterol synthesis occursAdverse Effects: hepatotoxicity, rhabdomyolysis (increase CK)*reduces mortality from CVD and MI

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144
Q

Metoclopramide

A

Class: D2 antagonistsMOA: dopamine receptor antagonistsUse: acute migraine attacks, vomiting (cancer chemo, pot-op)Adverse Effects: extrapyramidal like adverse effects, drowsiness, torsades, neuroleptic malignant syndrome, increased prolactin secretion

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145
Q

Fluprednisolone

A

Class: Glucocorticoids - intermediate actingUse: adrenal insufficiency, asthmaContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

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146
Q

LSD

A

Class: 5-HT agonists - nonselective - ergot alkaloidsMOA: agonists or partial agonists at various receptors, vasoconstrictionUse: migraine (ergotamine or dihydroergotamine), post-partum hemorrhage (ergonovine, if oxytocin fails)PK/PD: caffeine – increases absorption, contraindicated in coronary artery diseaseAdverse Effects: GI upset (most common), prolonged vasospasm (most serious)*for hemorrhage, only use after placenta is delivered

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147
Q

Kaolin

A

MOA: absorb/bind intestinal toxinsUse: diarrhea

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148
Q

Etidronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

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149
Q

Glucagon

A

MOA: promotes glucose release from tissues and gluconeogenesis, increase cAMP in cardiac tissueUse: sever hypoglycemia and cardiac stimulant (as in beta blocker OD)

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150
Q

Metolazone

A

Class: Thiazide-like diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

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151
Q

Degarelix

A

Class: GnRH antagonistsMOA: suppress gonadotropin releaseUse: prostate cancer

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152
Q

Cisapride

A

Class: 5-HT agonists - selective - 5-HT4Use: GERD *for compassionate use only

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153
Q

Mifepristone

A

Class: anti-progestinsMOA: inhibits progesterone binding to receptor. inhibits glucocorticoid receptor (high-doses)Use: termination of early pregnancy (in combo w/ misoprostol). postcoital contraceptive. hypercortisolism (if other tx fail)

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154
Q

Benazepril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

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155
Q

Methyltestosterone

A

Class: Androgens*more androgenicUse: Hypogonadism and anemiaAdverse Effects: feminizing effects in post-pubertal males (due to conversion to estrogen)

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156
Q

Bisoprolol

A

Class: Beta Adrenoceptor Antagonists - β1 selectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid), inhibit conversion of T3 to T4Use: hyperthyroidismPK/PD: oral, well absorbed Adverse Effects: due to specificity, no pulmonary effects

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157
Q

Brinzolamide

A

Class: carbonic anhydrase inhibitorsMOA: decrease aqueous humor productionUse: glaucomaPK/PD: admin ophthalmic

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158
Q

Pimdronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

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159
Q

Irbesartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

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160
Q

Esomeprazole

A

Class: proton pump inhibitorsMOA: irreversibly bind H/K-ATPase of parietal cell –> reduced acid secretionUse: peptic ulcer (treatment and prevention), GERD, h. pylori (+ clarithromycin + amoxicillin)PK/PD: activated/degraded in acidic environment: coated to survive stomach –> absorbed in intestine –> enter circulation –> activated in parietal cell canaliculiAdverse Effects: GI upset, rash, CNS effects, diarrhea (chronic use only: low acidity allows bacterial overgrowth)

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161
Q

Dichlorophenamide

A

Class: carbonic anhydrase inhibitorsMOA: inhibit CA preventing breakdown of carbonic acid and absorption of bicarbonate –> osmotic diuresisUse: promotes urinary alkalinization and prevents acute altitude sicknessPK/PD: admin oral or topical. decreases NH4 secretion*contraindicated in hepatic cirrhosis (b/c alkaline urine traps NH4 as ammonia –> reabsorbed –> hepatic encephalopathy)Adverse Effects: Type II RTA

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162
Q

Iloprost

A

Class: PGI2MOA: relax smooth muscle Use: pulmonary HTNAdverse Effects: GI upset

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163
Q

Loperamide

A

Class: opioid analogues MOA: inhibit Ach release onto intestinal opioid receptors –> decreased motilityUse: diarrhea

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164
Q

Rosiglitazone

A

Class: Thiazolidinediones (TZD)MOA: activated PPAR-γ –> promote adipogenesis, decrease hepatic gluconeogenesis, reduce triglyceridesUse: DM II, reduce triglyceridesPK/PD: hepatic metabolismAdverse Effects: weight gain, hepatotoxicity, peripheral edema

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165
Q

Amiloride

A

Class: ENaC channel blockersMOA: inhibit ENaC (Na reabsorption) –> loss of potential (driving force for K section) –> decreased K/H secretionUse: primary mineralocorticoid hypersecretion, secondary aldosteronism (ex. CHF, hepatic cirrhosis)

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166
Q

Triptorelin

A

Class: GnRH analoguesMOA: chronic use desensitizes GnRH receptor –> suppresses gonadotropin releaseUse: controlled ovarian hyperstimulation, endometriosis, uterine fibroids, prostate cancer, central precocious puberty*initially these stimulate gonadotropin release

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167
Q

Ricinoleic Acid (Castor Oil)

A

MOA: stimulant laxativesUse: constipation

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168
Q

Lisdexmethamphetamine

A

Class: Indirect SympathomimeticsUse: ADHDAdverse Effects: Insomnia, anorexia, weight loss

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169
Q

Dexamethasone

A

Class: Glucocorticoids - long-actingMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RAPK/PD: admin oral or IVAdverse Effects: Typical steroid effects (especially w/ oral admin)

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170
Q

Losartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

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171
Q

Parathion

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleUse: InsecticideDistributes to CNSPralidoxime (2-PAM) treats poisoning

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172
Q

Aminoglutethimide

A

MOA: inhibits CYP11A1, preventing steroidogenesisUse: Cushing’sAdverse Effects: adrenal insufficiency

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173
Q

Atropine methyl nitrate

A

Class: Muscarinic Antagonists - Quaternary Amines*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

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174
Q

Captopril

A

Class: ACE inhibitors*active drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

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175
Q

Chlorpromazine

A

Class: D2 antagonistsMOA: dopamine receptor antagonistsUse: acute migraine attacks, vomiting (cancer chemo, pot-op)Adverse Effects: extrapyramidal like adverse effects, drowsiness, torsades, neuroleptic malignant syndrome, increased prolactin secretion

176
Q

Eplerenone

A

Class: Aldosterone antagonistsMOA: increase Na secretion and K/H reabsorptionUse: Hypokalemia (in combo w/ thiazide or loop)Adverse Effects: Hyperkalemia, hyperchloremic metabolic acidosis

177
Q

Moexipril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

178
Q

Potassium

A

Class: Class 5 (misc.) anti-arrhythmeticsMOA: hyperpolarization –> decrease phase 4 slopeAdmin IV

179
Q

Methylprednisone

A

Class: Glucocorticoids - short actingUse: adrenal insufficiency, asthmaPK/PD: admin oral aerosol, or topical. inactivated by placenta –> use to treat motherContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

180
Q

Dostinex

A

Class: Dopamine receptor agonistsUse: GH excess, tumors secreting GH and PRL

181
Q

Stanozol

A

Class: Androgens*more anabolicUse: Hypogonadism and anemiaAdverse Effects: feminizing effects in post-pubertal males (due to conversion to estrogen)

182
Q

Bismuth Subsalicylate

A

Class: mucosal protective agentsMOA: coats ulcer tissue, antibacterial actionUse: h. pylori and diarrheaAdverse Effects: turn tongue black

183
Q

Aspirin

A

Class: NSAID - salicylatesMOA: inhibits COX enzymes, inhibits renal secretion of uric acid (low dose), inhibits renal reabsorption of uric acid (high dose)Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregationPK/PD: aspirin (irreversible) is metabolized to salicylic acid (reversible), highly bound to plasma protein (may kick other drugs off), contraindicated in hemophilia, children with viral infections, severe CV diseaseAdverse Effects: same as other NSAIDs, hypersensitivity (due to overutilization of LOX pathway)toxicity: salicycism, hyperthermia, hyperpnea, respiratory alkalosis* treat toxicity with gastric lavage and supportive care.* NSAIDS inhibit renal prostaglandins PGE2 and PGI2, resulting in vasoconstriction and exacerbation of CV disease

184
Q

Aloe

A

Class: AnthraquinonesMOA: stimulant laxativesUse: constipation

185
Q

Bisacodyl

A

Class: diphenylmethane derivativesMOA: induce low grade inflammation –> water/electrolyte accumulationUse: constipationPK/PD: admin suppository

186
Q

Amlodipine

A

Class: Ca channel blockers - dihydropyridinesMOA: block L-type Ca channel –> smooth muscle relaxation (esp. arteries). Coronary and systemic vasodilation. Uterine smooth muscle relaxationUse: Prinzemetal’s angina prophylaxis, mild/moderate HTN (esp. in AA and elderly), tocolysisAdverse Effects: reflex tachycardia, peripheral edema*blocks binding site 1A, mostly in vasculature

187
Q

Norethinodrone

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

188
Q

Colesevelam

A

Class: Bile acid binding resinsMOA: bind bile acids –> increase lipid excretion –> lower LDL. Increase bile acid synthesis. Increase LDL receptorsUse: primary hypercholesterolemia, digoxin toxicityAdverse Effects: bloating, constipation may impair absorption of other drugs/fat soluble vitamins. increased triglycerides

189
Q

Dihydroergotamine

A

Class: 5-HT agonists - nonselective - ergot alkaloidsMOA: agonists or partial agonists at various receptors, vasoconstrictionUse: migraine (ergotamine or dihydroergotamine), post-partum hemorrhage (ergonovine, if oxytocin fails)PK/PD: caffeine – increases absorption, contraindicated in coronary artery diseaseAdverse Effects: GI upset (most common), prolonged vasospasm (most serious)*for hemorrhage, only use after placenta is delivered

190
Q

Increlex

A

MOA: IGF binding protein 3Use: mutated GH receptorPK/PD: induce microsomal enzymes, contraindicated in malignancyAdverse Effects: Primarily in adults, peripheral edema, myalgias, arthralgias, carpal tunnel

191
Q

Tolzamide

A

Class: first generation sulfonylureasMOA: bind SUR1, which is complexed to K channel, inhibiting it –> depolarization –> Ca influx –> insulin secretionUse: DM IIPK/PD: admin oral. hepatic metabolism, renal excretion,Contraindications: DMI, pregnancy, lactationAdverse Effects: Hypoglycemia, weight gain, disulfiram-like reaction, sulfonamide hypersensitivity*2nd gen binds SUR1 with higher affinity

192
Q

Neostigmine

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedUse: Treat MG, reverse neuromuscular blocking agents, post-op urinary retention Reversible Quaternary

193
Q

Formeterol

A

Class: Direct Adrenoceptor Agonists - β2 selectiveMOA: increase cAMP –> bronchodilation and smooth muscle relaxationUse: asthmaAdverse effects: tremors*long acting

194
Q

Betamethasone

A

Class: Glucocorticoids - long actingUse: adrenal insufficiency, asthma, stimulate surfactant production in prematurityPK/PD: admin oral aerosol, or topical. not inactivated by placenta –> use to treat fetusContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

195
Q

Magnesium

A

Class: Class 5 (misc.) anti-arrhythmeticsMOA: unknownUse: Torsades de pointesAdmin IV

196
Q

Macermin

A

MOA: IGF binding protein 3Use: mutated GH receptorPK/PD: induce microsomal enzymes, contraindicated in malignancyAdverse Effects: Primarily in adults, peripheral edema, myalgias, arthralgias, carpal tunnel

197
Q

Desipramine

A

Class: tricyclic antidepressants Use: IBS associated abdominal pain

198
Q

Doxazosin

A

Class: Alpha Adrenoceptor Antagonists - α1 selectiveUse: BPH and HTNPK/PD: long half lifeAdverse Effects: orthostatic hypotension (lowest risk with tamsulosin), reflex tachycardia

199
Q

Digoxin

A

Class: cardiac glycosideMOA: inhibits Na/K ATPase –> increased Ca –> increased contractility. Increased K conductance –> shorten AP. Parasympathetic stimulation –> decreased AV conduction and HRUse: CHFPK/PD: high dose elicits sympathetic effects, exaggerating toxicity. multiple drug interactionsAdverse Effects: very toxic. GI toxicity, cadiotoxicity, CNS toxicity. Hypokalemia predisposes to toxicity*treat toxicity w/ K, digitoxin antibodies, lidocaine*thyroxine increases renal clearance of digoxin*cholestyramine decreases GI absorption of digoxin

200
Q

Trandolapril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

201
Q

Ritodrine

A

Class: Direct Adrenoceptor Agonists - β2 selectiveMOA: increase cAMP –> bronchodilation and smooth muscle relaxationUse: asthma and uterine relaxation in premature laborAdverse effects: tremors

202
Q

Methamphetamine

A

Class: Indirect SympathomimeticsPK/PD: CNS stimulationAdverse Effects: Insomnia, anorexia, weight loss

203
Q

Dorzolamide

A

Class: carbonic anhydrase inhibitorsMOA: decrease aqueous humor productionUse: glaucomaPK/PD: admin ophthalmic

204
Q

Niacin

A

Class: NiacinMOA: decreased lipase activity –> decreased FA, decreased hepatic synthesis of TG and VLDL, lower plasma LDL and TGUse: lower plasma LDL and raise plasma HDLAdverse Effects: flushing (due to increased PGs), hyperuricemia, hyperglycemia, hepatotoxicity*take aspirin before use to prevent flushing

205
Q

Tetrahydrocannabinol

A

MOA: unknown mechanismUse: vomiting

206
Q

Esmolol

A

Class: Beta Adrenoceptor Antagonists - β1 selectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid), inhibit conversion of T3 to T4Use: hyperthyroidismPK/PD: oral, well absorbed, very short half lifeAdverse Effects: due to specificity, no pulmonary effects

207
Q

Ketoprofen

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

208
Q

Teriparatide

A

MOA: recombinant PTHUse: osteoporosis treatment

209
Q

Lidocaine

A

Class: Class 1B anti-arrhythmeticsMOA: mild Na channel block, shorten AP durationUse: depolarization arrhythmia (ischemia, digoxin toxicity), post-MI arrhythmia, ventricular tachycardiaPK/PD: admin IV, high first pass metabolismAdverse Effects: Least cardiotoxic, neurotoxicity

210
Q

Methyclothiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

211
Q

Iohexol

A

Class: iodinated contract materialMOA: inhibits 5`-deiodinaseUse: hyperthyroidismPK/PD: admin oral or IV, acts in liver, kidney, pituitary and brain

212
Q

Isoproterenol

A

Class: CatecholaminesMOA: β1, β2 agonistUse: Shock, heart failure, fundoscopic eye exams*Metyrosine inhibits tyrosine hydroxylase, preventing formation of catecholamines*Reserpine inhibits NE uptake into vesicles (VMAT)

213
Q

Dofetilide

A

Class: Class 3 anti-arrhythmeticsMOA: block rectifier K channelUse: Afib or flutterAdmin is oralAdverse Effects: prolonged QT and torsades

214
Q

Pantoprazole

A

Class: proton pump inhibitorsMOA: irreversibly bind H/K-ATPase of parietal cell –> reduced acid secretionUse: peptic ulcer (treatment and prevention), GERD, h. pylori (+ clarithromycin + amoxicillin)PK/PD: activated/degraded in acidic environment: coated to survive stomach –> absorbed in intestine –> enter circulation –> activated in parietal cell canaliculiAdverse Effects: GI upset, rash, CNS effects, diarrhea (chronic use only: low acidity allows bacterial overgrowth)

215
Q

Tyramine

A

Class: Indirect SympathomimeticsMOA: outcompetes NE for uptake into vesicles via VMATAdverse Effects: hypertensive crisis especially in those taking MAOIs, insomnia, anorexia, weight loss

216
Q

Docusate

A

Class: stool softenerMOA: softens stool, promoting expulsionUse: constipation (especially in hospitalized pts.)Adverse Effects: decreased absorption of fat soluble vitamins

217
Q

Mineral Oil

A

Class: stool softenerMOA: softens stool, promoting expulsionUse: constipation (especially in hospitalized pts.)Adverse Effects: decreased absorption of fat soluble vitamins

218
Q

Demecarium

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedReversible

219
Q

Letrozole

A

Class: Atomatase inhibitorsMOA: Inhibit aromatase –> reduce estrogen synthesisUse: tamoxifen resistant breast cancerPK/PD: non-steroidal and reversible (except exemestane)

220
Q

Cromolyn Sodium

A

Class: Mast cell stabilizerUse: asthma prophylaxisPK/PD: admin aerosol (give before exercise or cold/allergen exposure) Adverse Effects: mild throat irritation and cough

221
Q

Finasteride

A

Class: anti-androgens MOA: inhibits 5α-reductase, preventing synthesis of DHTUse: BPH and male pattern baldness

222
Q

Diphenoxylate

A

Class: opioid analogues MOA: inhibit Ach release onto intestinal opioid receptors –> decreased motilityUse: diarrheaAdverse Effects: sedation*avoid abuse w/ atropine

223
Q

Isosorbide DInitrate

A

Class: Nitrates - short actingMOA: sitmulates NO production –> stimulates guanylyl cyclase –> increase cGMP –> decrease phosphorylation of myosin light chain –> vasodilation –> decreased preloadUse: acute anginaAdmin: inhaled or sublingualAdverse Effects: Reflex tachycardia and inotropy (increased O2 demand and reduced perfusion), headacheContraindications: HOCM and patients taking PDE inhibitors (“-fil” ex. sildenafil)*chronic use leads to tolerance (must have nitrate free intervals*toxicity = hypotension, headache, dizziness*veins dilated more than arteries*preferentially dilates epicardial arteries, which is where most ischemia occurs

224
Q

Quinapril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

225
Q

Mg Hydroxide

A

Class: AntacidsMOA: weak base neutralizes gastric acidUse: GERD pain relief, inactive peptic ulcer diseasePK/PD: Mg toxicity: CNS depression, sodium bicarb is systemicAdverse Effects: diarrhea (Mg), constipation (Ca, Al), hypophosphatemia (Al), renal stones (Na)

226
Q

Acetylcholine

A

Class: Direct Muscarinic Agonists - Choline EstersUse: Stimulate GI/GU smooth muscle (ex. post-op)PK/PD: poor CNS distribution

227
Q

Lactulose

A

Class: non-digestible sugars/alcoholsMOA: water retentionUse: acidify lumen, drawing water inPK/PD: contraindicated in CHF, pulmonary edema (because these will expand ECF by drawing fluid out of tissue)Adverse Effects: dehydration, hypernatremia, metabolic acidosis

228
Q

Ergocryptine

A

Class: 5-HT agonists - nonselective - ergot alkaloidsMOA: agonists or partial agonists at various receptors, vasoconstrictionUse: migraine (ergotamine or dihydroergotamine), post-partum hemorrhage (ergonovine, if oxytocin fails)PK/PD: caffeine – increases absorption, contraindicated in coronary artery diseaseAdverse Effects: GI upset (most common), prolonged vasospasm (most serious)*for hemorrhage, only use after placenta is delivered

229
Q

Candesartan

A

Class: ARBsMOA: selectively inhibit AT1 receptors –> vasodilationUse: HTNPK/PD: more effective at blocking angiotensin than ACE inhibitors b/c more specific*no effect on bradykinin, thus no cough or edema

230
Q

Propantheline

A

Class: Muscarinic Antagonists - Quaternary Amines*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

231
Q

Gemfibrozil

A

Class: fibratesMOA: activates PPAR-α –> decreased plasma TG, VLDL, LDL, increases HDLUse: hypertriglyceridemia and dysbetalipoproteinemiaPK/PD: may increase concentration of statinsAdverse Effects: skin rashes, lymphocytopenia, myopathy (increased risk with stain combo), gall bladder disease

232
Q

Promethazine

A

Class: D2 antagonistsMOA: dopamine receptor antagonistsUse: acute migraine attacks, vomiting (cancer chemo, pot-op)Adverse Effects: extrapyramidal like adverse effects, drowsiness, torsades, neuroleptic malignant syndrome, increased prolactin secretion

233
Q

Tolbutamide

A

Class: first generation sulfonylureasMOA: bind SUR1, which is complexed to K channel, inhibiting it –> depolarization –> Ca influx –> insulin secretionUse: DM IIPK/PD: admin oral. hepatic metabolism, renal excretion,Contraindications: DMI, pregnancy, lactationAdverse Effects: Hypoglycemia, weight gain, disulfiram-like reaction, sulfonamide hypersensitivity*2nd gen binds SUR1 with higher affinity

234
Q

Amphetamine

A

Class: Indirect SympathomimeticsMOA: promotes Ca-dependent vesicle fusionPK/PD: CNS stimulation. Not catabolized by MAOAdverse Effects: Insomnia, anorexia, weight loss, psychosis

235
Q

Aminophylline

A

Class: MethylxanthinesMOA: inhibits PDE4 –> prevents breakdown of cAMP –> bronchodilation, decreased cytokines, improved contractility of skeletal muscle (diaphragm). Adenosine antagonist –> inhibits bronchoconstrictionUse: asthma (if other tx failed)PK/PD: metabolized in liver by CYP450, monitor plasma levels to prevent toxicityAdverse Effects: GI upset

236
Q

(Dex)chlorpheniramine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

237
Q

Prochlorpromazine

A

Class: D2 antagonistsMOA: dopamine receptor antagonistsUse: acute migraine attacks, vomiting (cancer chemo, pot-op)Adverse Effects: extrapyramidal like adverse effects, drowsiness, torsades, neuroleptic malignant syndrome, increased prolactin secretion

238
Q

Chlorpropamide

A

Class: first generation sulfonylureasMOA: bind SUR1, which is complexed to K channel, inhibiting it –> depolarization –> Ca influx –> insulin secretionUse: DM IIPK/PD: admin oral. hepatic metabolism, renal excretion,Contraindications: DMI, pregnancy, lactationAdverse Effects: Hypoglycemia, weight gain, disulfiram-like reaction, sulfonamide hypersensitivity*2nd gen binds SUR1 with higher affinity

239
Q

Hydrochlorothiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

240
Q

Fenoldopam

A

Class: direct vasodilatorsMOA: D1 agonist –> arterial dilation –> reduced afterloadUse: HTN Admin IVAdverse Effects: reflex tachycardia, fluid retention, HA, palpitation

241
Q

Topiramate

A

Class: anti-convulsants Use: preventative tx for migraine

242
Q

Lispro

A

Class: Rapid acting insulinUse: DM I

243
Q

Estrone

A

Class: EstrogensMOA: growth/development of vagina, uterus, uterine tubes. breast enlargement. pubic/axillary hair. pigmentation of areola and genitalia. mildly anabolic. inhibits PTH-induced bone resorptionUse: primary hypogonadism. postmenopausal HRT. oral contraception. osteoporosis prophylaxisPK/PD: contraindicated in breast/endometrial cancer, liver disease, thromboembolic diseases, smoking, pregnancyAdverse Effects: increased risk of breast/endometrial cancer. nausea, bloating, HTN

244
Q

Na Carbonate

A

Class: AntacidsMOA: weak base neutralizes gastric acidUse: GERD pain relief, inactive peptic ulcer diseasePK/PD: Mg toxicity: CNS depression, sodium bicarb is systemicAdverse Effects: diarrhea (Mg), constipation (Ca, Al), hypophosphatemia (Al), renal stones (Na)

245
Q

Buspirone

A

Class: 5-HT agonists - selective - 5HT1A partial agonistUse: anxiolytic PK/PD: slow onset Adverse Effects: dysphoria (high dose)

246
Q

Rimonabant

A

MOA: reduces appetiteUse: obesity

247
Q

Cortisone

A

Class: Glucocorticoids - short actingUse: adrenal insufficiency, asthmaPK/PD: admin oral aerosol, or topical. inactivated by placenta –> use to treat motherContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

248
Q

Risendronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

249
Q

Liothyronine

A

MOA: isomer of T3Use: hypothyroidism and myxedema comaPK/PD: acts faster than T4,l but shorter half lifeAdverse Effects: cardiotoxicity

250
Q

Loratidine

A
251
Q

Labetalol

A

Class: Beta and Alpha Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: HTN, ischemia, angina prophylaxis, migraine prevention (first choice)PK/PD: oral. well absorbed. Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation*preferred in pregnancy

252
Q

Bendroflumethiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

253
Q

Meclizine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

254
Q

Lovastatin

A

*prodrugClass: HMG-CoA reductase inhibitorsMOA: reduce hepatic formation of cholesterol. Increase LDL receptors on hepatocytes –> lower plasma LDLUse: lower plasma LDLPK/PD: good GI absorption, hepatic metabolism by CYPs, high first pass metabolism, bile excretion, contraindicated in pregnancy, admin at night when most cholesterol synthesis occursAdverse Effects: hepatotoxicity, rhabdomyolysis (increase CK)*reduces mortality from CVD and MI

255
Q

Alprostadil

A

Class: PGE1MOA: relax smooth muscle, bind prostaglandin receptors on gastric epitheliumUse: ED*contraindicated in pregnancyAdverse Effects: GI upset

256
Q

Indapamide

A

Class: Thiazide-like diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

257
Q

Isosorbide Mononitrate

A

Class: Nitrates - long actingMOA: sitmulates NO production –> stimulates guanylyl cyclase –> increase cGMP –> decrease phosphorylation of myosin light chain –> vasodilation –> decreased preloadUse: acute anginaAdmin: oral, ointment, buccal (slow-release), chewable or transdermalAdverse Effects: Reflex tachycardia and inotropy (increased O2 demand and reduced perfusion), headacheContraindications: HOCM and patients taking PDE inhibitors (“-fil” ex. sildenafil)*chronic use leads to tolerance (must have nitrate free intervals*toxicity = hypotension, headache, dizziness*veins dilated more than arteries*preferentially dilates epicardial arteries, which is where most ischemia occurs

258
Q

Ibandronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

259
Q

Nebivolol

A

Class: Beta BlockerMOA: Cardioselective and vasodilatory (NO production)

260
Q

Diatriozate

A

Class: iodinated contract materialMOA: inhibits 5`-deiodinaseUse: hyperthyroidismPK/PD: admin oral or IV, acts in liver, kidney, pituitary and brain

261
Q

Azelastine

A

Class: H1 antagonists - second generationMOA: no anti-cholinergic activityUse: allergic rhinitis PK/PD: don’t cross blood-brain barrier (thus, can’t treat motion sickness)Adverse Effects: fewer than first gen

262
Q

Dycyclomine

A

Class: anticholinergicsMOA: anti-spasmodic activityUse: IBS

263
Q

Tolazoline

A

Class: Alpha Adrenoceptor Antagonists - nonselectiveMOA: reduces TPR and MAPUse: PheochromocytomaAdverse Effects: Orthostatic hypotension and reflex tachycardia

264
Q

Nedocromil Sodium

A

Class: Mast cell stabilizerUse: asthma prophylaxisPK/PD: admin aerosol (give before exercise or cold/allergen exposure)Adverse Effects: mild throat irritation and cough

265
Q

Cyclizine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

266
Q

Ranitidine

A

Class: H2 antagonistsMOA: inhibit gastric acid secretion (esp. nocturnal secretion)Use: peptic ulcer and h. pylori (+ bismuth + antibiotics)PK/PD: doesn’t impact normal intestinal secretions, contraindicated in pregnant and nursing women. metabolized by CYP450Adverse Effects: GI upset, endocrine effects (cimetidine): gynecomastia, galactorrhea, muscle pain, inhibits microsomal enzymes*nocturnal acid secretion is primarily driven by histamine

267
Q

Adenosine

A

Class: Class 5 (misc.) anti-arrhythmeticsMOA: A1 receptor –> decrease inotropy A2 receptor –> coronary vasodilationUse: paroxysmal supraventricular tachyarrhythmia (PSVT) Admin IVAdverse Effects: flushing, SOA, HA*use verapamil or esmolol if this fails*carotid massage can also treat this

268
Q

Pegvisomant

A

MOA: GH receptor antagonistUse: GH excessAdverse Effects: hepatotoxicity*may assist tumor growth

269
Q

Cetirizine

A

Class: H1 antagonists - second generationMOA: no anti-cholinergic activityUse: allergic rhinitis PK/PD: don’t cross blood-brain barrier (thus, can’t treat motion sickness)Adverse Effects: fewer than first gen

270
Q

Carteolol

A

Class: Beta Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: HTN, ischemia, angina prophylaxis, migraine prevention (first choice)PK/PD: oral. well absorbed. Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation*has intrinsic sympathomimetic activity and can protect against asthma, bradycardia, and altered lipid profile

271
Q

Vasopressin

A

Class: Vasopressin agonistMOA: predominantly V2 agonist, anti-diuresis, vasoconstrictionUse: HTN, neurogenic diabetes insipidus*desmopressin is more potent and longer lasting than vasopressin

272
Q

Guanabenz

A

Class: Direct Adrenoceptor Agonists - α2 selectiveMOA: increase reuptake of catecholamines –> decreased sympathetic stimulationUse: hypertensionAdverse effects: hypertensive crisis with abrupt withdrawal

273
Q

Glipizide

A

Class: second generation sulfonylureasMOA: bind SUR1, which is complexed to K channel, inhibiting it –> depolarization –> Ca influx –> insulin secretionUse: DM IIPK/PD: admin oral. hepatic metabolism, renal excretion,Contraindications: DMI, pregnancy, lactationAdverse Effects: Hypoglycemia, weight gain, disulfiram-like reaction, sulfonamide hypersensitivity*2nd gen binds SUR1 with higher affinity

274
Q

Acarbose

A

Class: alpha glucosidase inhibitorsMOA: inhibit pancreatic alpha amylase and intestinal alpha glucosidase –> slow glucose absorption and spread it over a larger surface area –> decrease glucose peakUse: DM IIAdverse Effects: flatulence, bloating, diarrhea

275
Q

Trimazosin

A

Class: Alpha Adrenoceptor Antagonists - α1 selectiveUse: hypertensionPK/PD: long half lifeAdverse Effects: orthostatic hypotension (lowest risk with tamsulosin), reflex tachycardia

276
Q

Amrinone

A

Class: PDE inhibitorsMOA: increase cAMP and Ca –> increased contractility and vasodilation (arteriolar). Increased contractilityUse: acute tx of HF

277
Q

Testosterone

A

Class: Androgens*more androgenicUse: Hypogonadism and anemiaAdverse Effects: feminizing effects in post-pubertal males (due to conversion to estrogen)

278
Q

Ibuprofen

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

279
Q

Norgestimate

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

280
Q

Salmeterol

A

Class: Direct Adrenoceptor Agonists - β2 selectiveMOA: increase cAMP –> bronchodilation and smooth muscle relaxationUse: asthmaAdverse effects: tremors*long acting

281
Q

Atropine

A

Class: Muscarinic Antagonists - Tertiary AminesMOA: decrease Ach –> inhibits bronchoconstriction and mucus secretionUse: Asthma, muscarinic poisoning, vagal syncopePK/PD: given IV.*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

282
Q

Lanreotide

A

Class: Somatostatin analogMOA: inhibits pituitary release of GHUse: GH excess, insulinoma, VIPomaAdverse Effects: GI toxicity, vitamin B12 deficiency*long-acting

283
Q

Meprednisone

A

Class: Glucocorticoids - short actingUse: adrenal insufficiency, asthmaPK/PD: admin oral aerosol, or topical. inactivated by placenta –> use to treat motherContraindications: gastric ulcer, anaphylaxis, CML, endotoxic shock, sclerodermaAdverse Effects: abdominal striae, osteoporosis, hyperglycemia, moon facies, typical glucocorticoid effects*sudden withdrawal –> adrenal insufficiency. This is due to suppression of endogenous HPA axis

284
Q

Rizatriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

285
Q

Milrinone

A

Class: PDE inhibitorsMOA: increase cAMP and Ca –> increased contractility and vasodilation (arteriolar). Increased contractilityUse: acute tx of HF

286
Q

Levothyroxine

A

MOA: isomer of T4Use: hypothyroidism (first line)Adverse Effects: headache and nervousness

287
Q

NPH novolin N

A

Class: intermediate acting insulinUse: DM I

288
Q

Cibacalcin

A

MOA: synthetic calcitoninUse: osteoporosis treatment and hypercalcemiaPK/PD: admin IM*high Ca due to vitamin D excess, bone cancer, hyper PTH, etc.

289
Q

Famotidine

A

Class: H2 antagonistsMOA: inhibit gastric acid secretion (esp. nocturnal secretion)Use: peptic ulcer and h. pylori (+ bismuth + antibiotics)PK/PD: doesn’t impact normal intestinal secretions, contraindicated in pregnant and nursing women. metabolized by CYP450Adverse Effects: GI upset, endocrine effects (cimetidine): gynecomastia, galactorrhea, muscle pain, inhibits microsomal enzymes*nocturnal acid secretion is primarily driven by histamine

290
Q

Lansoprazole

A

Class: proton pump inhibitorsMOA: irreversibly bind H/K-ATPase of parietal cell –> reduced acid secretionUse: peptic ulcer (treatment and prevention), GERD, h. pylori (+ clarithromycin + amoxicillin)PK/PD: activated/degraded in acidic environment: coated to survive stomach –> absorbed in intestine –> enter circulation –> activated in parietal cell canaliculiAdverse Effects: GI upset, rash, CNS effects, diarrhea (chronic use only: low acidity allows bacterial overgrowth)

291
Q

Theophylline

A

Class: MethylxanthinesMOA: inhibits PDE4 –> prevents breakdown of cAMP –> bronchodilation, decreased cytokines, improved contractility of skeletal muscle (diaphragm). Adenosine antagonist –> inhibits bronchoconstrictionUse: asthma (if other tx failed)PK/PD: metabolized in liver by CYP450, monitor plasma levels to prevent toxicityAdverse Effects: GI upset

292
Q

Rocuronium

A

Class: Nicotinic Antagonists - Quaternary ParalyticsMOA: competitive blockage of autonomic nicotinic receptors –> decrease in arteriolar and vasomotor tone.

293
Q

Fexofenadine

A

Class: H1 antagonists - second generationMOA: no anti-cholinergic activityUse: allergic rhinitis PK/PD: don’t cross blood-brain barrier (thus, can’t treat motion sickness)Adverse Effects: fewer than first gen

294
Q

Sodium Nitroprusside

A

Class: direct vasodilatorsMOA: increase NO –> venous = arterial dilation –> reduced preload and afterloadUse: HTN, CHF Admin IVAdverse Effects: metabolic acidosis, reflex tachycardia, fluid retention, HA, palpitation

295
Q

Dexmethylphenidate

A

Class: Indirect SympathomimeticsUse: ADHDAdverse Effects: Insomnia, anorexia, weight loss

296
Q

Hydroflumethiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

297
Q

Divalproex

A

Class: anti-convulsants Use: preventative tx for migraine

298
Q

Propafenone

A

Class: Class 1C anti-arrhythmeticsMOA: strong Na channel block. blocks K channels. no change to AP.Use: supraventricular arrhythmia Admin is oralAdverse Effects: metallic taste and constipation*must use on structurally healthy hearts

299
Q

Cocaine

A

Class: Indirect SympathomimeticsMOA: Inhibits NET (reuptake 1)Adverse Effects: Insomnia, anorexia, weight loss

300
Q

Zafirlukast

A

Class: Leukotriene AntagonistMOA: LTD4 receptor antagonist –> bronchodilationUse: asthmaPK/PD: admin is oral (good for kids)

301
Q

Hexamethonium

A

Class: Nicotinic Antagonists - Quaternary Ganglion BlockersMOA: competitive blockage of autonomic nicotinic receptors –> decrease in arteriolar and vasomotor tone.

302
Q

Detemir

A

Class: long acting insulinUse: DM I (used to maintain basal insulin levels)

303
Q

Promethazine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

304
Q

Isoflurophate

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleDistributes to CNSPralidoxime (2-PAM) treats poisoning

305
Q

Celecoxib

A

Class: COX-2 inhibitorMOA: inhibit COX-2, especially decrease PGI2 synthesis in endotheliumUse: RA and OA PK/PD: contraindicated in sulfa allergyAdverse Effects: no anti-platelet activity

306
Q

Guanfacine

A

Class: Direct Adrenoceptor Agonists - α2 selectiveMOA: increase reuptake of catecholamines –> decreased sympathetic stimulationUse: hypertensionAdverse effects: hypertensive crisis with abrupt withdrawal

307
Q

Medroxyprogesterone

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

308
Q

Edrophonium

A

Class: Cholinesterase Inhibitors - Alcohol EsterMOA: Binds anionic site of AChEUse: MG diagnosis (Tinsilon test)ReversibleVery short acting

309
Q

Oxymethalone

A

Class: Androgens*more anabolicUse: Hypogonadism and anemiaAdverse Effects: feminizing effects in post-pubertal males (due to conversion to estrogen)

310
Q

Na Phosphate

A

Class: saline laxativesMOA: non-absorbable salt –> increase osmotic activity in lumenUse: constipationContraindications: renal insufficiency, heart disease, diuretic treatment

311
Q

Glycerin

A

Class: non-digestible sugars/alcoholsMOA: water retentionUse: constipationPK/PD: contraindicated in CHF, pulmonary edema (because these will expand ECF by drawing fluid out of tissue)Adverse Effects: dehydration, hypernatremia, metabolic acidosis

312
Q

Exenatide

A

Class: incretin based therapyMOA: incretin analogue (like GLP-1) –> increased insulin secretion and potentiate it’s effectsUse: DM II (when other therapy is suboptimal)PK/PD: admin IMAdverse Effects: GI upset and pancreatitits

313
Q

Malathion

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleUse: InsecticideDistributes to CNSPralidoxime (2-PAM) treats poisoning

314
Q

Desloratidine

A

Class: H1 antagonists - second generationMOA: no anti-cholinergic activityUse: allergic rhinitis PK/PD: don’t cross blood-brain barrier (thus, can’t treat motion sickness)Adverse Effects: fewer than first gen

315
Q

Somatotropin

A

MOA: recombinant GHUse: GH deficiency (ex. growth failure in children, wasting in HIV pts, short bowel syndrome)PK/PD: induce microsomal enzymes, contraindicated in malignancyAdverse Effects: Primarily in adults, peripheral edema, myalgias, arthralgias, carpal tunnel*may assist tumor growth

316
Q

Oxytocin

A

MOA: stimulates release PG and LT –> uterine contraction. Myoepithelial cell contraction –> milk expression. H2O intoxicationUse: induce labor and post-partum hemorrhagePK/PD: admin IV, short half life, contraindicated in prematurity, fetal distressAdverse Effects: toxicity - fetal distress, uterine rupture, anti-diuresis, vasodilation*only induce labor after cervical ripening

317
Q

Tiludronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

318
Q

Amitryptyline

A

Class: tricyclic antidepressants Use: preventative tx for migraine

319
Q

Succinylcholine

A

Class: Nicotinic Antagonists - Quaternary ParalyticsMOA: Agonist of NMJ nicotinic receptor –> depolarizing blockadeUse: short term paralysisPK/PD: very short duration. Is antagonized by tubocurarineAdverse Effects: fasciculation –> muscle pain

320
Q

Trichlormethiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

321
Q

Pralidoxime (2-PAM)

A

Class: Cholinesterase RegeneratorMOA: displaces phosphate bond, regenerating AchEUse: organophosphate poisoning*must be given before organophosphate bond “ages”

322
Q

Tamsulosin

A

Class: Alpha Adrenoceptor Antagonists - α1 selectiveUse: very selective for BPHPK/PD: long half lifeAdverse Effects: orthostatic hypotension (lowest risk with tamsulosin), reflex tachycardia

323
Q

Miglitol

A

Class: alpha glucosidase inhibitorsMOA: inhibit pancreatic alpha amylase and intestinal alpha glucosidase –> slow glucose absorption and spread it over a larger surface area –> decrease glucose peakUse: DM IIAdverse Effects: flatulence, bloating, diarrhea

324
Q

Minoxidil

A

Class: direct vasodilatorsMOA: arterial dilationUse: Chronic HTN and to grow hair Admin oralAdverse Effects: hypertrichosis, reflex tachycardia, fluid retention, HA, palpitation AKA Rogaine

325
Q

Methacholine

A

Class: Direct Muscarinic Agonists - Choline EstersUse: Stimulate GI/GU smooth muscle (ex. post-op)PK/PD: poor CNS distribution Hydrolyzed by AchE, so has more transient effects

326
Q

Pioglitazone

A

Class: Thiazolidinediones (TZD)MOA: activated PPAR-γ –> promote adipogenesis, decrease hepatic gluconeogenesis, reduce triglycerides, increase peripher insulin sensitivityUse: DM II, reduce triglyceridesPK/PD: hepatic metabolismAdverse Effects: weight gain, hepatotoxicity, peripheral edema

327
Q

Scopolamine

A

Class: Muscarinic Antagonists - Tertiary AminesMOA: decrease Ach –> inhibits bronchoconstriction and mucus secretionUse: motion sicknessPK/PD: given transdermally, crosses BBB –> more side effects but can treat motion sickness*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retentionCNS effects: drowsiness, confusion, delerium

328
Q

Sibutramine

A

MOA: reduces appetiteUse: obesity

329
Q

Norepinephrine

A

Class: CatecholaminesMOA: α1, α2, β1, agonistUse: Shock, heart failure, fundoscopic eye exams*Metyrosine inhibits tyrosine hydroxylase, preventing formation of catecholamines*Reserpine inhibits NE uptake into vesicles (VMAT)

330
Q

Polycarbaphil

A

MOA: bulk forming laxativeUse: constipation

331
Q

Prazosin

A

Class: Alpha Adrenoceptor Antagonists - α1 selectiveUse: hypertension and PTSDPK/PD: long half lifeAdverse Effects: orthostatic hypotension (lowest risk with tamsulosin), reflex tachycardia

332
Q

Sucralfate

A

Class: mucosal protective agentsMOA: selective binding/coating of necrotic ulcer tissueUse: peptic ulcer

333
Q

Leuprolide

A

Class: GnRH analoguesMOA: chronic use desensitizes GnRH receptor –> suppresses gonadotropin releaseUse: controlled ovarian hyperstimulation, endometriosis, uterine fibroids, prostate cancer, central precocious puberty*initially these stimulate gonadotropin release

334
Q

Verapamil

A

Class: Ca channel blockers - non-dihydropyridinesMOA: block L-type Ca channel –> reduced SA/AV conductionUse: Angina prophylaxis, mild/moderate HTN (esp. in AA and elderly), tocolysis, class IV anti-arrhythmicContraindicated in CHF Adverse Effects: cardiac arrest, AV block, constipation, CHF*blocks binding site 1C, mostly in myocardium NO REFLEX TACHYCARDIA

335
Q

Carbachol

A

Class: Direct Muscarinic Agonists - Choline EstersUse: Stimulate GI/GU smooth muscle (ex. post-op)PK/PD: poor CNS distribution Resistant to AchE Has some nicotinic-like activity

336
Q

Ganirelix

A

Class: GnRH antagonistsMOA: suppress gonadotropin releaseUse: controlled ovarian hyperstimulation

337
Q

Granisetron

A

Class: 5-HT3 antagonists Use: chemo-induced vomiting

338
Q

Rabeprazole

A

Class: proton pump inhibitorsMOA: irreversibly bind H/K-ATPase of parietal cell –> reduced acid secretionUse: peptic ulcer (treatment and prevention), GERD, h. pylori (+ clarithromycin + amoxicillin)PK/PD: activated/degraded in acidic environment: coated to survive stomach –> absorbed in intestine –> enter circulation –> activated in parietal cell canaliculiAdverse Effects: GI upset, rash, CNS effects, diarrhea (chronic use only: low acidity allows bacterial overgrowth)

339
Q

Pilocarpine

A

Class: Direct Muscarinic Agonists - AlkaloidsMOA: Contracts iris sphincter, increases aqueous humor drainageUse: Acute glaucoma Distributes to CNS because it is tertiary Resistant to AchE

340
Q

Cabergoline

A

Class: dopamine agonistMOA: D2 agonistUse: Parkinsonism, hyperprolactinemia, prolactinomaAdverse Effects: NandV, orthostatic hypotension, fluctuation in efficacy of motor control, abnormal involuntary movements, arrhythmia, hypersexuality, hallucinations, paranoia, anxiety, mania, depression

341
Q

Fluticasone

A

Class: GlucocorticoidsMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RAPK/PD: admin oral, IV, or aerosolAdverse Effects: Typical steroid effects (especially w/ oral admin), oral candidiasis, and hoarseness

342
Q

Pirenzepine

A

Class: Muscarinic Antagonists - Tertiary Amines MOA: decrease Ach –> inhibits bronchoconstriction and mucus secretion*M1 selective*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

343
Q

Sulindac

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

344
Q

Chlorothiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

345
Q

Albuterol

A

Class: Direct Adrenoceptor Agonists - β2 selectiveMOA: increase cAMP –> bronchodilation and smooth muscle relaxationUse: asthmaAdverse effects: tremors

346
Q

Colestipol

A

Class: Bile acid binding resinsMOA: bind bile acids –> increase lipid excretion –> lower LDL. Increase bile acid synthesis. Increase LDL receptorsUse: primary hypercholesterolemia, digoxin toxicityAdverse Effects: bloating, constipation may impair absorption of other drugs/fat soluble vitamins. increased triglycerides

347
Q

Tubocurarine

A

Class: Nicotinic Antagonists - Quaternary ParalyticsMOA: competitive blockage of autonomic nicotinic receptors –> decrease in arteriolar and vasomotor tone and agonist of NMJ nicotinic receptor –> depolarizing blockadeUse: lethal injection and paralysis*antagonizes succinylcholine. increases potency of inhaled anesthetics and antibioticsAdverse Effects: Causes histamine release –> may precipitate asthma

348
Q

Furosemide

A

Class: Loop diureticsMOA: inhibit NKCC –> decreased Na/Cl/K reabsorption –> osmotic diuresis. Change in potential –> Mg and Ca excretionUse: Pulmonary edema, CHF, HTN, acute hypercalcemia, hyperkalemnia, acute renal failurePK/PD: admin oral, IV, or IM. rapidly absorbed. Elimination = tubular secretion and absorptionAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, ototoxicity, dehydration, hyonatremia, metabolic alkalosis (contraction alkalosis)*hypomagnesemia –> increased PG production and renal blood flow aiding anti-hypertensive effect*Effective when GFR is low*more effective diuretic than thiazide*use ethacrynic acid of pt has sulfa allergy

349
Q

Diphenhydramine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

350
Q

Perindopril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

351
Q

Ketorolac

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

352
Q

Lorazepam

A

Class: benzodiazepines Use: vomiting

353
Q

Cetrorelix

A

Class: GnRH antagonistsMOA: suppress gonadotropin releaseUse: controlled ovarian hyperstimulation

354
Q

Norgestrel

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

355
Q

Ipratoprium

A

Class: Muscarinic Antagonists - Quaternary AminesMOA: BronchodilationUse: asthma/COPDRoute: aerosol*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

356
Q

Tiotoprium

A

Class: Muscarinic Antagonists - Quaternary AminesMOA: BronchodilationUse: asthma/COPD Route: aerosol*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

357
Q

Pectin

A

MOA: absorb/bind intestinal toxinsUse: diarrhea

358
Q

Zolmitriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

359
Q

Tropicamide

A

Class: Muscarinic Antagonists - Tertiary AminesMOA: decrease Ach –> inhibits bronchoconstriction and mucus secretion*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

360
Q

Sotalol

A

Class: Class 3 anti-arrhythmeticsMOA: nonselective beta blockerUse: life threatening ventricular arrhythmia (first choice), supraventricular arrhythmia, wide-complex tachycardia. Can be used in kidsAdmin is oralAdverse Effects: Torsades de pointes

361
Q

Flecainide

A

Class: Class 1C anti-arrhythmeticsMOA: strong Na channel block. blocks K channels. no change to AP.Use: supraventricular arrhythmia Admin is oralAdverse Effects: increased mortality with cardiac arrest or MI*must use on structurally healthy hearts

362
Q

Bumetanide

A

Class: Loop diureticsMOA: inhibit NKCC –> decreased Na/Cl/K reabsorption –> osmotic diuresis. Change in potential –> Mg and Ca excretionUse: Pulmonary edema, CHF, HTN, acute hypercalcemia, hyperkalemnia, acute renal failurePK/PD: admin oral, IV, or IM. rapidly absorbed. Elimination = tubular secretion and absorptionAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, ototoxicity, dehydration, hyonatremia, metabolic alkalosis (contraction alkalosis)*hypomagnesemia –> increased PG production and renal blood flow aiding anti-hypertensive effect*Effective when GFR is low*more effective diuretic than thiazide*use ethacrynic acid of pt has sulfa allergy

363
Q

Al Hydroxide

A

Class: AntacidsMOA: weak base neutralizes gastric acidUse: GERD pain relief, inactive peptic ulcer diseasePK/PD: Mg toxicity: CNS depression, sodium bicarb is systemicAdverse Effects: diarrhea (Mg), constipation (Ca, Al), hypophosphatemia (Al), renal stones (Na)

364
Q

Carbaryl

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedReversible

365
Q

Butoxamine

A

Class: Beta Adrenoceptor Antagonists - β2 selective*not used for anything really

366
Q

Glimepiride

A

Class: second generation sulfonylureasMOA: bind SUR1, which is complexed to K channel, inhibiting it –> depolarization –> Ca influx –> insulin secretionUse: DM IIPK/PD: admin oral. hepatic metabolism, renal excretion,Contraindications: DMI, pregnancy, lactationAdverse Effects: Hypoglycemia, weight gain, disulfiram-like reaction, sulfonamide hypersensitivity*2nd gen binds SUR1 with higher affinity

367
Q

Aprepitant

A

Class: Neurokinin-1 receptor antagonistUse: chemo-induced emesis

368
Q

Polythiazide

A

Class: Thiazide diureticsMOA: inhibit Na/Cl in DCT –> decreased Na/Cl reabsorption –> osmotic diuresis. Increased Ca reapsorptionUse: HTN (especially in AA and elderly), mild CHF, nephrolithiasis, nephrogenic DIPK/PD: oral admin, decrease Ca excretion, secretion = same as uric acid, anti-HTN as low doses, diuresis at high dosesAdverse Effects: hypokalemia, hyperuricemia, hyperglycemia, hyperlipidemia, contraction alkalosis*ineffective when GFR is low*more effective for HTN than loop diuretics

369
Q

DHEA

A

DihydroepiadrostenedioneUse: Addison’s Dz

370
Q

Lisinopril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

371
Q

Diisopropylfluorophosphate

A

Class: Cholinesterase Inhibitors - Organophosphates IrreversibleDistributes to CNSPralidoxime (2-PAM) treats poisoning

372
Q

Ipodate

A

MOA: inhibits 5`-deiodinaseUse: hyperthyroidism

373
Q

Orlistat

A

MOA: inhibits lipase –> decreased fat absorptionUse: obesityAdverse Effects: fatty stools

374
Q

Rivastigmine

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedUse: Dementia Reversible

375
Q

Ca Carbonate

A

Class: AntacidsMOA: weak base neutralizes gastric acidUse: GERD pain relief, inactive peptic ulcer diseasePK/PD: Mg toxicity: CNS depression, sodium bicarb is systemicAdverse Effects: diarrhea (Mg), constipation (Ca, Al), hypophosphatemia (Al), renal stones (Na)

376
Q

Acbertoline

A

Class: dopamine agonistMOA: D2 agonistUse: Parkinsonism, hyperprolactinemia, prolactinomaAdverse Effects: NandV, orthostatic hypotension, fluctuation in efficacy of motor control, abnormal involuntary movements, arrhythmia, hypersexuality, hallucinations, paranoia, anxiety, mania, depression

377
Q

Nitroglycerin

A

Class: Nitrates - long actingMOA: sitmulates NO production –> stimulates guanylyl cyclase –> increase cGMP –> decrease phosphorylation of myosin light chain –> vasodilation –> decreased preloadUse: acute anginaAdmin: oral, ointment, buccal (slow-release), chewable or transdermalAdverse Effects: Reflex tachycardia and inotropy (increased O2 demand and reduced perfusion), headacheContraindications: HOCM and patients taking PDE inhibitors (“-fil” ex. sildenafil)*chronic use leads to tolerance (must have nitrate free intervals*toxicity = hypotension, headache, dizziness *veins dilated more than arteries*preferentially dilates epicardial arteries, which is where most ischemia occurs

378
Q

Metyrapone

A

MOA: inhibits CYP11B1, preventing cortisol activationUse: hypercortisolismAdverse Effects: hirsutism, nausea, rash*only for compassionate use

379
Q

Guanadrel

A

Class: Adrenergic Neuron AntagonistsUse: HTN

380
Q

Spirinolactone

A

Class: Aldosterone antagonistsMOA: Increase Na secretion and K/H reabsorption. Also inhibits 17α-hydoxylaseUse: Hypokalemia (in combo w/ thiazide or loop), and PCOSAdverse Effects: Gynecomastia, impotence, hyperkalemia, hyperchloremic metabolic acidosis.

381
Q

Propranolol

A

Class: Beta Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: HTN, ischemia, supraventricular and ventricular arrhythmia, prevention of vfib, angina prophylaxis, migraine prevention (first choice), and tremorPK/PD: oral. well absorbed. extensive first pass metabolismAdverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation

382
Q

Clomiphene

A

Class: ER agonistMOA: partial ER agonist –> reduce negative feedback by estradiol –> inc FSH/LH –> stimulate ovulationUse: infertility

383
Q

Acetaminophen

A

MOA: unknown, does inhibit PG synthesisUse: analgesic and anti-pyreticPK/PD: metabolized by CYP450 and CYP2E1Adverse Effects: no anti-platelet activity, no GI side effects

384
Q

Aliskiren

A

Class: Direct renin inhibitorMOA: inhibits reningUse: HTNPK/PD: dose-dependent reduction in renin*don’t use with renal disease

385
Q

Novolin R

A

Class: short acting insulinUse: DM I and DKAAdmin IV for DKA

386
Q

Bromocriptine

A

Class: dopamine agonistMOA: D2 agonistUse: Parkinsonism, hyperprolactinemia, prolactinomaAdverse Effects: NandV, orthostatic hypotension, fluctuation in efficacy of motor control, abnormal involuntary movements, arrhythmia, hypersexuality, hallucinations, paranoia, anxiety, mania, depression

387
Q

Alendronate

A

Class: bisphophonatesMOA: pyrophosphate analogs –> inhibit osteoclasts, thereby inhibiting bone resorptionUse: hypercalcemia (in malignancy), osteoporosis, ectopic calcification, Paget’s diseasePK/PD: poorly absorbedAdverse Effects: gastric/esophageal irritation, osteonecrosis of the jaw –> fractures*bone remodeling occurs in jaw more than other bones, which requires osteoclast activity

388
Q

Beclomethasone

A

Class: GlucocorticoidsMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RAPK/PD: admin oral, IV, or aerosolAdverse Effects: Typical steroid effects (especially w/ oral admin), oral candidiasis, and hoarseness

389
Q

Oxandrolone

A

Class: Androgens*more anabolicUse: Hypogonadism and anemiaAdverse Effects: feminizing effects in post-pubertal males (due to conversion to estrogen)

390
Q

Rosuvastatin

A

Class: HMG-CoA reductase inhibitorsMOA: reduce hepatic formation of cholesterol. Increase LDL receptors on hepatocytes –> lower plasma LDLUse: lower plasma LDLPK/PD: good GI absorption, hepatic metabolism by CYPs, high first pass metabolism, bile excretion, contraindicated in pregnancy, admin at night when most cholesterol synthesis occursAdverse Effects: hepatotoxicity, rhabdomyolysis (increase CK)*reduces mortality from CVD and MI

391
Q

Methylcellulose

A

MOA: bulk forming laxativeUse: constipation

392
Q

Penbutolol

A

Class: Beta Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: HTN, ischemia, angina prophylaxis, migraine prevention (first choice)PK/PD: oral. well absorbed. Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation

393
Q

Ethynodiol Diacetate

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

394
Q

Zileuton

A

Class: 5-LOX inhibitorUse: Asthma

395
Q

Mivacurium

A

Class: Nicotinic Antagonists - Quaternary ParalyticsMOA: competitive blockage of autonomic nicotinic receptors –> decrease in arteriolar and vasomotor tone.

396
Q

Pyridostigmine

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedUse: Treat MG Reversible

397
Q

Naproxen

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

398
Q

Tegaserod

A

Class: 5-HT agonists - selective - 5-HT4Use: IBS w/ constipation*for emergencies only

399
Q

Conivaptan

A

Class: Vasopressin receptor antagonistMOA: decrease aquaporins –> water retention in collecting tubuleUse: SIADH, CHF, hyponatremia*admin IVAdverse Effects: Hypernatremia, nephrogenic DI

400
Q

Glyburide

A

Class: second generation sulfonylureasMOA: bind SUR1, which is complexed to K channel, inhibiting it –> depolarization –> Ca influx –> insulin secretionUse: DM IIPK/PD: admin oral. hepatic metabolism, renal excretion,Contraindications: DMI, pregnancy, lactationAdverse Effects: Hypoglycemia, weight gain, disulfiram-like reaction, sulfonamide hypersensitivity*2nd gen binds SUR1 with higher affinity

401
Q

Triamcinolone

A

Class: Glucocorticoids - intermediate-actingMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RA PK/PD: admin oral, IV, or aerosolAdverse Effects: Typical steroid effects (especially w/ oral admin), oral candidiasis, and hoarseness

402
Q

Ibutilide

A

Class: Class 3 anti-arrhythmeticsMOA: block rectifier K channelUse: Afib or flutter Admin is oralAdverse Effects: prolonged QT and torsades

403
Q

Flunosilide

A

Class: GlucocorticoidsMOA: inhibits cytokines –> decrease airway reactivity –> bronchodilation, decrease edema. Increase lipocortin, which inhibits PLA2Use: Asthma and RAPK/PD: admin oral, IV, or aerosolAdverse Effects: Typical steroid effects (especially w/ oral admin), oral candidiasis, and hoarseness

404
Q

Trimethobenzamide

A

Class: D2 antagonistsMOA: dopamine receptor antagonistsUse: acute migraine attacks, vomiting (cancer chemo, pot-op)Adverse Effects: extrapyramidal like adverse effects, drowsiness, torsades, neuroleptic malignant syndrome, increased prolactin secretion

405
Q

Brompheniramine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

406
Q

Abarelix

A

Class: GnRH antagonistsMOA: suppress gonadotropin releaseUse: prostate cancerAdverse Effects: allergy and syndrome of androgen deprivation

407
Q

Triamterene

A

Class: ENaC channel blockersMOA: inhibit ENaC (Na reabsorption) –> loss of potential (driving force for K section) –> decreased K/H secretionUse: primary mineralocorticoid hypersecretion, secondary aldosteronism (ex. CHF, hepatic cirrhosis) Adverse Effects: nephrolithiasis

408
Q

Dobutamine

A

Class: CatecholaminesMOA: α1, β1 agonistUse: Shock, heart failure, anaphylaxis, fundoscopic eye exams*Metyrosine inhibits tyrosine hydroxylase, preventing formation of catecholamines*Reserpine inhibits NE uptake into vesicles (VMAT)

409
Q

Ondansetron

A

Class: 5-HT3 antagonists Use: chemo-induced vomiting

410
Q

Ambenonium

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedReversible

411
Q

Tamoxifen

A

Class: SERMMOA: partial ER agonists –> antagonistic activity in presence of normal hormone levelsUse: ER + breast cancerPK/PD: in premenopausal women, SERM is antagonist in all tissues. in postmenopausal women, SERM is agonist in all except mammary tissueAdverse Effects: in postmenopausal women, increased risk of endometrial cancer*in postmenopausal women, hormone levels remain high in mammary tissue

412
Q

Tacrine

A

Class: Cholinesterase InhibitorsUse: Dementia and Alzheimer’sAdverse Effects: Hepatotoxicity

413
Q

Cypropheptadine

A

Class: H1 antagonists - first generationMOA: anti-cholinergic. blocks Na channel (anesthesia)Use: allergic rhinitis or urticaria​, motion sickness, local anesthesia, nausea, vomiting, insomnia PK/PD: well-absorbed, inhibit CYP450, cross BBBAdverse Effects: sedation (anti-cholinergic), urinary retention (anti-muscarinic)*cyclizine, meclizine have least sedative effect

414
Q

Methylphenidate

A

Class: Indirect SympathomimeticsUse: ADHDAdverse Effects: Insomnia, anorexia, weight loss

415
Q

Lobeline

A

Class: Direct Nicotinic AgonistsPK/PD: Excess agonist activity results in depolarizing blockade of autonomic ganglia –> flaccid paralysis Distributes to CNS- Tertiary

416
Q

Acebutolol

A

Class: Beta Adrenoceptor Antagonists - β1 selectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid), inhibit conversion of T3 to T4Use: hyperthyroidismPK/PD: oral, well absorbed Adverse Effects: due to specificity, no pulmonary effects *has intrinsic sympathomimetic activity and can protect against asthma, bradycardia, and altered lipid profile

417
Q

Diclofenac

A

Class: NSAIDMOA: block PGE2 in CNS –> resets temp control –> anti-pyretic Use: analgesic, anti-pyretic, anti-inflammatory (high dose only), inhibit platelet aggregation, gout (indo), ankylosing spondylitis (indo), OA (indo), patent ductus arteriosus (indo)PK/PD: admin oral or parenteral (ketorolac). COX-1 inhibition –> no thromboxane –> anti-platelet activityover-activation of LOX pathway –> hypersensitivityAdverse Effects: GI (esp. ulcers), hepatotoxicity, nephrotoxicity, prolonged bleeding time, hypersensitivity, hematologic toxicity (indo), sore throat (indo)*when used chronically, give misoprostol or PPI to prevent ulcers

418
Q

Megesterol

A

Class: ProgestinsMOA: proliferation of mammary acini. thermogenic. moderately anabolic. growth of endometrium. progestational (esp. norgestrel). estrogenic activity (esp. norethynodrel, ethynodiol diacetate). anti-estrogenic activity. androgenic activity (exc. norgestrel, desogestrel)Use: Oral contraception (combo or alone [not at effective])PK/PD: high first pass metabolism. admin oral (norethindrone, norgesterel), implant (norgesterel), IM (medroxy)Adverse Effects: Increase appetite, fatigue

419
Q

Bethanechol

A

Class: Direct Muscarinic Agonists - Choline EstersUse: Stimulate GI/GU smooth muscle (ex. post-op)PK/PD: poor CNS distribution Resistant to AchE

420
Q

Atenololol

A

Class: Beta Adrenoceptor Antagonists - β1 selectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid), inhibit conversion of T3 to T4Use: hyperthyroidismPK/PD: oral, well absorbed, better tolerated in elderlyAdverse Effects: due to specificity, no pulmonary effects

421
Q

Methoscopolamine

A

Class: Muscarinic Antagonists - Quaternary Amines*Contraindicated in glaucoma, BPH, and gastric ulcersAdverse Effects: tachycardia, dry mouth, mydriasis, blurred vision, constipation, urinary retention

422
Q

Cholestyramine

A

Class: Bile acid binding resinsMOA: bind bile acids –> increase lipid excretion –> lower LDL. Increase bile acid synthesis. Increase LDL receptorsUse: primary hypercholesterolemia, digoxin toxicityAdverse Effects: bloating, constipation may impair absorption of other drugs/fat soluble vitamins. increased triglycerides

423
Q

Fluvastatin

A

Class: HMG-CoA reductase inhibitorsMOA: reduce hepatic formation of cholesterol. Increase LDL receptors on hepatocytes –> lower plasma LDLUse: lower plasma LDL PK/PD: good GI absorption, hepatic metabolism by CYPs, high first pass metabolism, bile excretion, contraindicated in pregnancy, admin at night when most cholesterol synthesis occursAdverse Effects: hepatotoxicity, rhabdomyolysis (increase CK)*reduces mortality from CVD and MI

424
Q

Phenoxybenzamine

A

Class: Alpha Adrenoceptor Antagonists - nonselectiveMOA: reduces TPR and MAPUse: PheochromocytomaAdverse Effects: Orthostatic hypotension and reflex tachycardia*irreversible*also a 5-HT2 antagonist

425
Q

Treprostinil

A

Class: PGI2MOA: relax smooth muscle Use: pulmonary HTNAdverse Effects: GI upset

426
Q

Dobutamine

A

Class: Direct Adrenoceptor Agonists - β1 selectiveMOA: increase heart rate

427
Q

Epinephrine

A

Class: CatecholaminesMOA: α1, α2, β1, β2 agonistUse: Shock, heart failure, anaphylaxis, fundoscopic eye exams*Metyrosine inhibits tyrosine hydroxylase, preventing formation of catecholamines*Reserpine inhibits NE uptake into vesicles (VMAT)

428
Q

Fosinopril

A

Class: ACE inhibitors*pro-drugMOA: prevents formation of angiotensin II, decreases aldosterone, increases bradykinin, cumulatively, these have the effect of decreasing afterload and preloadUse: HTN, CHF, diabetic neuropathyAdverse Effects: dry, hacking cough (due to bradykinin), hyperkalemia

429
Q

Droperidol

A

Class: D2 antagonistsMOA: dopamine receptor antagonistsUse: acute migraine attacks, vomiting (cancer chemo, pot-op)Adverse Effects: extrapyramidal like adverse effects, drowsiness, torsades, neuroleptic malignant syndrome, increased prolactin secretion

430
Q

Repaglinide

A

Class: meglitinide (like sulfonylureas)MOA: bind SUR1Use: DM IIPK/PD: rapid onset and short durationAdverse Effects: hypoglycemia*Use if pt has sulfa allergy

431
Q

Physostigmine

A

Class: Cholinesterase Inhibitors - CarbamatesMOA: substrates for AChE –> bind serine hydroxyl and are hydrolyzedUse: Glaucoma, anti-cholinergic overdose Reversible Distributes to CNS - TertiaryAdverse Effects: CNS toxicity

432
Q

Eletriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

433
Q

Carvedilol

A

Class: Beta and Alpha Adrenoceptor Antagonists - nonselectiveMOA: slowed AV conduction –> decreased chronotropy and inotropy, decreased HR, decreased MAP + decreased BP, bronchoconstriction, decreased aqueous humor production, inhibits lipolysis/glycogenolysis –> increased VLDL and decreased HDL, blocks excess catecholamine production (hyperthyroid)Use: HTN, ischemia, angina prophylaxis, migraine prevention (first choice)PK/PD: oral. well absorbed. Adverse Effects: asthma exacerbation, supersensitivity (with chronic use and abrupt discontinuation), delayed recovery of normoglycemia*toxicity = rash and sedation

434
Q

Carteolol

A

Class: Beta BlockerMOA: Intrinsic sympathomimetic activity (NO production)

435
Q

Difenoxin

A

Class: opioid analogues MOA: inhibit Ach release onto intestinal opioid receptors –> decreased motilityUse: diarrhea

436
Q

Sumatriptan

A

Class: 5-HT agonists - selective - 5-HT1B/1DMOA: counteract CGRP –> cerebral vasoconstrictionUse: acute migraines (better choice than ergots)PK/PD: contraindicated in CADAdverse Effects: tingling, warm sensation, may mimic angina

437
Q

Acetazolamide

A

Class: carbonic anhydrase inhibitorsMOA: inhibit CA preventing breakdown of carbonic acid and absorption of bicarbonate –> osmotic diuresisUse: promotes urinary alkalinization and prevents acute altitude sicknessPK/PD: admin oral or topical. decreases NH4 secretion*contraindicated in hepatic cirrhosis (b/c alkaline urine traps NH4 as ammonia –> reabsorbed –> hepatic encephalopathy)Adverse Effects: Type II RTA

IC (32 decks)

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