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Pharm Test 5 MEDS > Meds > Flashcards

Meds Flashcards

1
Q

Sulindac

A

COX1 inhibitor

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2
Q

Piroxicam

A

COX1 inhibitor

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3
Q

ASA

A

COX1
Irreversible (8-10 days)

1200-1500 mg TID
For: Rheumatoid, fever
GI upset

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4
Q

Ibuprofen

A

COX 1= COX 2
Less GI upset than ASA

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5
Q

Meclofenamate

A

COX 1= COX2

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6
Q

Celecoxib
(Celebrex)

A

COX 2
Use: Arthritis
CV thrombus box warn
**with food, Increase CYP2C9

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7
Q

Indomethacin

A

Non-specific COX inhibitor

Inhibits COX AND Lipoxygenase Synthesis

Uses: Arthritis, gout, Patent Ductus Arteriosus
GI issues: 1/3 patients

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8
Q

Diclofenac (Voltaren)

What other med can you give with it to relieve side effect?

A

Non-specific COX inhibitor
Inhibits COX AND Lipoxygenase Synthesis

Use: Pain, inflammation, fever

Decrease the 20% of GI upset with Misoprostol

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9
Q

Tylenol

A

COX2- but not NSAID, no anti-inflammation

TOXIC: 15g = FATAL

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10
Q

Glucocorticoid

^Transcription of:

Inhib synthesis of:

A

^ Transcription of : Annexin 1= suppress phospholipase and AA. Inhib leukocyte response

Inhib Inh-NFxB: pro-inflammatory cytokine

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11
Q

Methotrexate

A

Non-biologic DMARDS
*Adenosine production

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12
Q

Cyclophosphamide

A

Non-biologic DMARDS

Cyclophosphamide – B&T cell suppression

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13
Q

Cyclosporine

A

Non-biologic DMARDS

Cyclosporine – Inhibition of interleukins

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14
Q

Abatacept (Orencia)

A

Biologic DMARDS

Abatacept (Orencia) – Blocks T-cell activation

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15
Q

Rituximab

A

Biologic DMARDS

Rituximab (Rituxan) – Depletes B-lymphocytes

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16
Q

Adalimumab

A

Biologic DMARDS

Adalimumab (Humira) – anti-TNF-α

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17
Q

μ (mu)

Full agonist:
Partial Agonist:
Antagonist:

A

Full agonist: morphine, fentanyl
Partial agonist: codeine, oxycodone
Antagonist: naloxone (Narcan)

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18
Q

Morphine

ADME:

A

Phenanthrene

A: Well absorbed (IM, SQ, Oral)
D: Highly perfused tissues – accumulation

M: Morphine – Phase II to active forms (M3G, M6G)

Esters (heroin) – tissue esterases to morphine

Other – Phase I (CYP3A4, CYP2D6)

E: Mainly in urine

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19
Q

Meperidine (Demerol)

A

POST- OP SHIVERING

Phenylpiperidine

Meperidine (Demerol)
Antimuscarinic effects (tachycardia)
(-) inotrope
Seizures
Usage decreasing due to side effects

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20
Q

Methadone

A

Methadone
Use: Chronic pain (morphine tolerance)

Duration=: 4-6hrs
Long half-life (25-50 hrs)

CYP3A4
Opioid abuse

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21
Q

Fentanyl

A

Phenylpiperidine

Strong Opioid

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22
Q

Propoxyphene (Darvon)

A

Propoxyphene (Darvon) - decreasing

Phenylheptylamine
Moderate Opioid

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23
Q

Percocet
vs
Percodan

A

Percocet: Oxy + Tylenol
Percodan: Oxy+ ASA

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24
Q

Codeine/ Oxycodone

A

Phenanthrenes

Moderate Opioids

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25
Q

Loperamide (Immodium)

A

Phenylpiperidine
Moderate Opioid

Loperamide (Immodium) Use:– diarrhea
Low incidence of abuse

Review: CNS effect with Quinidine

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26
Q

Naloxone
naltrexone

A

Derivatives of Morphine

Naltrexone last longer than Naloxone (1-3mins)

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27
Q

Penicillin

A

Inhibits cell wall synthesis. Gram + / Anaerobes

5 ring+ B lactam ring

Hypersensitivity
Most common drug allergy
Can cross react with similar antibiotics
Allergic reactions
Anaphylactic shock (0.05%)
Skin rash (<1%)
Oral lesions
Hemolytic anemia
Interstitial nephritis

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28
Q

Cephalosporin

A

Inhibits cell wall synthesis. Gram +/ Anarobes

-More resistant to b-lactamase
-Broader spectrum
-First Generation
-Better gram (+) activity
-Uses:UTI, Staph
-Alternative to PCN (less allergy)

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29
Q

Vancomycin

A

-Resistant to beta-lactamase
-Alternative to PCN resistant bacteria (MRSA)
-“Drug of last resort”

Toxicity: 10% adverse reactions

Irritating to tissues, Chills/fever, Ototoxicity, nephrotoxicity, “Red neck” syndrome

Binds to amino acid and prevents the cross-link enzyme

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30
Q

polymyxins

A

Disruption of Cell Membrane Function: GRAM (-)

Polypeptide antibiotics (polymyxins)

Act as detergents

Bind to phospholipids

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31
Q

Tetracyclines

A

Inhibit protein synthesis
Bacteriostatic

widest spectrum of activity of any antibiotics

destroy the normal intestinal microbiota =severe gastrointestinal disorders – bone deposition disorder

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32
Q

Macrolides:

Clarithromycin (Biaxin)
Azithromycin (Zithromax)

A

Antibiotic: inhibition of protein synthesis
Semi-synthetic derivatives

Erythromycin:
-Protoype drug
-Streptomyces erythreus

Spectrum: (+), (-), Atypicals

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33
Q

Rifamycin

A

Antibiotic that inhib Nucleic Acid Synthesis

Inhib mRNA synthesis

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34
Q

Quinolones

Types: Cipro, Levaquin, Floxin

A

Antibiotic that inhib Nucleic Acid Synthesis

Inhibit DNA gyrase (bacterial)

Excellent Gram (-) activity
Good Gram (+)

Uses: UTI, RTI
Bone and joint infections
ADR

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35
Q

Sulfonamides

trimethoprim

A

Sulfonamides - Anti-biotics inhibits folic acid synthesis

Similar to PABA
Inhib: Synthesis of folic acid

Use:
-Pneumocystis (pneumonia)
- toxoplasmosis (parasite from uncooked meat)

Conjunction with trimethoprim
Bactrim, Septra

Toxicity:
Allergenic
May precipitate in urine
Hematopoetic disturbances

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36
Q

Zidovudine (Azidothymidine, AZT)

A

Antiretroviral Nucleoside/Nucleotide Analogs

Combined with other antivirals in Highly Active Antiretroviral Therapy (HAART)

Inhibitor of reverse transcriptase

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37
Q

Lamivudine

A

Antiretroviral Nucleoside/Nucleotide Analogs

MOA:
-Inhibits HBV DNA polymerase
-HIV reverse transcriptase

38
Q

Telbivudine

A

Antiretroviral Nucleoside/Nucleotide Analogs

HBV Hepatitis B

MOA: inhibits HBV DNA polymerase (reverse transcriptase) by competing with the natural substrate, thymidine 5’-triphosphate

39
Q

Tenofovir

A

Antiretroviral Nucleoside/Nucleotide Analogs

Hep B

Activity against HBV and HIV-1
Effective in treating lamivudine-resistant Hep B

40
Q

Oseltamivir phosphate (Tamiflu)

A

Early flu med, ok 3 months +

41
Q

Zanamivir (relenza)

A

Powdered inhalant for flu

dont give to COPD- irritant

42
Q

Baloxivir marboxil (Xofluza)

A

One time dose med for FLU

dont give to pregnant women

43
Q

Levodopa

A

Increases DOPAMINE for parkinson

Not a good BBB- give with Carbidopa

give Primavanserin if visuals

Parkinson: SNCA- alpha Synuclein/ lewy bodies in nigro-strial pathway

44
Q

Tetrabenazine

A

Huntington’s: Destruction of GABAnergic neurons
-Only 30-40s, no cure,
-Autosomal Dominant– Chromosome 4
-PROGRESSIVE loss of muscle control –> Chorea/Dementia
-Huntingtin protein

Need to decrease dopamine (tetrabenazine)

45
Q

Carbidopa

A

Improve the uptake of Levodopa by inhibiting dopa-carboxylase

Prevent breakdown of dopamine before it gets to brain

46
Q

tolcapone

A

Improved uptake dopamine with COMT inhibitors

47
Q

pimavanserin (Nuplazid)

A

Decrease toxicity (hallucinations)

for carbidopa, levodopa

48
Q

Selegeline

A

MAO-B inhibitors

Increase dopamine available for parkinson

49
Q

Apomorphine

A

On-Off Phenomenon – Long-term use
Periods of increased mobility, followed by marked akinesia

can decrease symptoms

50
Q

Tetrabenazine

A

Benign Hereditary Chorea
Autosomal Dominant
Chorea in childhood,
no progression, no dementia

also for Huntington’s Disease:
autosomal dominant- chromosone 4

Treatment – symptomatic, tetrabenazine

51
Q

Phenytoin and levodopa

A

Can cause drug induced dyskinesias

52
Q

Med treatment for Duchenne Muscular Dystrophy

A

Corticosteroids, beta-2 agonists, braces

X-linked male recessive— gower childhood

waste away muscles, SM, heart….

53
Q

Intrathecal Baclofen for…..

A

Muscle relaxant for cerebral palsy (non-progressive)

could be hyper or hypotonia

54
Q

Huntington’s Disease

A

GABA reduced in basal ganglia

Reduction in Choline acetyltransferase (ChAT)

Treat:
Tetrabenazine
(Depletes dopamine)

Dopamine Receptor Blockers:
Haloperidol

Genetic counseling, speech therapy, PT/OT

55
Q

Riluzole

A

sodium channel blocker (damaged neurons)

Amyotrophic Lateral Sclerosis (ALS)

loss of motor neurons, late 40-60 onset

56
Q

Edaravone

A

antioxidant

Amyotrophic Lateral Sclerosis (ALS)

57
Q

Alzheimer Disease
treatments:

A

CNS ACh esterase Inhibitors (Tacrine),

NMDAr Antagonist (Memantine)

58
Q

Tacrine

A

CNS ACh esterase Inhibitors

Alzheimer Disease

59
Q

Memantine

A

NMDAr Antagonist

Alzheimer Disease

60
Q

Treatment for Restless Leg Syndrome

What kind of opiate:

A

Dopamine agonists
Gabapentin
Benzodiazepines
Opiates (clonazepam)

61
Q

Cyclophosphamide

CCNS

A

Alkylating Agent for CA

**cancer and immunosuppressive
-Graft vs host, rheumatoid, etc

Chlorambucil – least toxic

62
Q

Chlorambucil

CCNS

A

Alkylating Agent for CA

Less toxic than cyclophosphamide

63
Q

Nitrosureas

CCNS

A

Alkylating Agent that can cross BBB

So like meningeal tumors

64
Q

Cisplatin

CCNS

A

Uses
Testicular cancer (85% - 95 % curative )
Ovarian cancer
Other solid tumors: lung, esophagus, gastric

65
Q

Methotrexate
CCS

What are the 3 effects of this drug?

A

Inhibits dihydrofolate reductase (DHFR) – Interferes with DNA/RNA synthesis

FOLATE ANALOG

Cytotoxic:
Mostly bone marrow
GI intestinal ulcers
Tetrogenic-fetal malform

Immunosuppressive: prevent B/T cells

Anti-inflammatory: release inflame cytokines

66
Q

Trastuzumab, Rituximab
“mab”

CCNS

What cancers do they both treat?

A

monoclonal antibiodies for CA!!

Trastuzumab: Breast CA (HER2)

Rituximab: Non-Hodgkins

67
Q

Imatinib

“tinib”

CCNS

A

Inhibitor of growth factors (for CA)

68
Q

Tamoxifen

CCNS

A

Hormonal Agent for CA:
anti-estrogen

69
Q

Fulvestrant

CCNS

A

Hormonal Agent for CA:
Selective estrogen receptor down regulator (SERD)

70
Q

Dactinomycin, Doxorubicin, Bleomycin

CCNS

A

Anti-cancer antibiotics

block DNA/RNA synthesis

71
Q

Vincristine

CCS

A

Plant based for CA:

dissolution (disolve) of mitotic spindle= cell death

block tubulin polymerization

72
Q

Paclitaxel (Taxol)

CCS

A

Plant based for CA:

Stabilize miotic spindle

Cant depolymerize= cell death for CA

73
Q

6-MP

CCS

A

Anti-metabolites– CA

6-MP: Purine antag, interfere with nucleic acid synthesis

Post- transplant, IBD, autoimmune

74
Q

5-FU

CCS

types of CA? (5)

A

Anti-metobolites–CA

5-FU interferes with DNA synthesis/repair

Use: stomach, colon, breast, ovarian, liver CA

75
Q

Prednisone, hydrocortisone, Dexamethasone

A

Immunosuppressive Agent

Glucocorticoids (corticosteroids)

Suppress immune response, mimic naturally occurring adrenal corticosteroids

76
Q

Cyclosporine, Tacrolimus

A

Immunosuppressive Agent

Calcineurin Inhibitors - necessary for T-cell receptor signaling, activation
T-cell activation pathway

Inhibit T-cells

77
Q

Azothioprine, Cyclophosphamide, Hydroxychloroquine

A

Cytotoxic Agents
Kill rapidly proliferating cells (many are antineoplastics)

78
Q

Muromonab (CD3), RhoGAM, Adalimumab (TNF-a)

A

Immunosuppressive Antibodies

Antibodies created in lab, directed against cell-surface antigens/receptors

79
Q

Sirolimus,
Mycophenylate Mofetil, Thalidomide Derivatives

A

Immunosuppressive Agents

80
Q

Thalidomide

A

Morning sickness but teratogen in 1950s

Current use: Multiple Myeloma

81
Q

Echinacea

A

Stimulation of immune system,
Anti-inflammatory

82
Q

Garlic

A

HMG CoA Reductase inh

83
Q

Ginkgo

A

Improved blood flow, free radical scavenger

84
Q

St. John’s Wort

A

antidepressant

85
Q

Ginseng

A

Multiple claims (memory, immune, analgesia, etc.)

86
Q

Milk Thistle

A

Reduction in hepatotoxicity

87
Q

Saw Palmetto

A

Benign prostatic hyperplasia

88
Q

Kava kava

A

anxiety, muscle relaxant, sedative

89
Q

Kombucha tea – yeast and bacteria

A

blood pressure, cancer, GI health

90
Q

Aloe

A

laxative, burn ointment

91
Q

Black cohosh

A

menstrual discomfort

Pharm Test 5 MEDS (1 decks)

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