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Step 1 > Multidiscipline pharm > Flashcards

Multidiscipline pharm Flashcards

1
Q

alpha-agonist that decreases aqueous humor synthesis via vasoconstriction
Use: glaucoma

A

epinephrine

Adv: mydriasis -> remember fight or flight -> open wide to see

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2
Q

alpha2-agonist decreases aqueous humor synthesis

Use: glaucoma

A

brimonidine

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3
Q

beta blockers used to decrease aqueous humor synthesis

Use: glaucoma

A

Timolol
Betaxolol
Carteolol

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4
Q

diuretic that decreases aqueous humor synthesis by inhibition of carbonic anhydrase
Use: glaucoma

A

acetazolamide

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5
Q

contracts the ciliary muscle and opens the trabecular meshwork to increase outflow of aqueous humor
direct cholinomimetics (2)
indirect cholinomimetics (2)
Use: glaucoma

A

Direct: pilocarpine, carbachol
Indirect: physostigmine, echothiophate
Adv: miosis & cyclospasm (contraction of ciliary muscle)

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6
Q

prostaglandin that increases outflow of aqueous humor

Use: glaucoma

A

Latanoprost

Adv: brown iris

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7
Q
  • opioid receptor agonists that modulate (decrease) synaptic transmission by opening potassium channels & closing Ca2+ channels
  • inhibit release of ACh, NE, 5-HT, glutamate & substance P
A 
morphine
fentanyl
codeine
loperamide
methadone
meperidine
dextromethorphan
diphenoxylate
Adv: addiction, resp depression, constipation, miosis
(no tolerance to miosis & constipation)
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8
Q

opioid receptor antagonists

A

naloxone

naltrexone

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9
Q

mu receptor partial agonist
kappa receptor agonist
Use: severe pain tx with less resp depression side effect

A

butorphanol

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10
Q

very weak opioid agonist
inhibits serotonin & NE reuptake
Use: chronic pain
Adverse: lowers seizure threshold; serotonin syndrome

A

tramadol

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11
Q

drug that induces hepatic enzymes and can result in decreased plasma levels of other medications

A

RIFAMPIN
others: Phenobarbitol, carbamazepine, phenytoin, nevirapine, griseofulvin, St. John’s wart, chronic alcohol use, modafinil

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12
Q

cause coronary vasospasm drug rxn

A

cocaine
sumatriptan
ergot alkaloids

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13
Q

cause cutaneous flushing drug rxn

A

Vancomycin
Adenosine
Niacin
Calcium channel blocker

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14
Q

cause dilated cardiomyopathy drug rxn

A

doxorubicin

daunorubicin

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15
Q

cause Torsades de pointes

A 
Class III antiarrhythmics (sotalol)
Class IA antiarrhythmics (quinidine)
macrolides
antipsychotics
TCAs
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16
Q

cause adrenocortical insufficiency

A

glucocorticoid withdrawal

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17
Q

cause hot flash drug rxn

A

tamoxifen

clomiphene

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18
Q

cause hyperglycemia

A 
tacrolimus
protease inhibitors
Niacin
HCTZ
beta blockers
corticosteroids
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19
Q

cause hypothyroidism

A

Lithium
amiodarone
sulfonamides

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20
Q

cause acute cholestatic hepatitis, jaundice drug rxn

A

erythromycin

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21
Q

cause diarrhea drug rxn

A 
metformin
erythromycin
colchicine
orlistat
acarbose
"might excite colon on accident"
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22
Q

cause focal to massive hepatic necrosis drug rxn

A 
halothane
amanita phalloides (death cap mushroom)
Valproic acid
acetaminophen
"liver Havac"
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23
Q

cause hepatitis drug rxn

A

INH

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24
Q

cause pancreatitis drug rxn

A 
Didanosine
corticosteroids
alcohol
valproic acid
azathioprine
diuretics (furosemide, HCTZ)
"Drugs Causing A Violent Abdominal Distress"
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25
Q

cause pseudomembranous colitis (C diff) drug rxn

A

Clindamycin
ampicillin
cephalosporins

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26
Q

drugs that cause cinchonism

temporary deafness, ringing in ears, headache

A

quinidine

quinine

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27
Q

drugs that cause Parkinson-like syndrome

A

Antipsychotics
Reserpine
Metoclopramide

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28
Q

drugs that cause seizures

A 
INH (Vit B6 deficiency)
Buproprion
Imipenem/cilastatin
tramadol
enflurane
metaclopramide
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29
Q

Causes tardive dyskinesia drug rxn

A

Antipsychotics

Metoclopramide

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30
Q

Causes hemorrhagic cystitis

A

cyclophosphamide

ifosfamide

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31
Q

Causes interstitial nephritis drug rxn

A

methicillin
NSAIDs
furosemide

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32
Q

Causes pulmonary fibrosis drug rxn

A 
Bleomycin
Amiodarone
Busulfan
Methotrexate
"breathing air badly from medications"
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33
Q

Causes SIADH drug rxn

A

carbamazepine
cyclophosphamide
SSRIs
“can’t concentrate serum sodium”

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34
Q

causes diabetes insipidus drug rxn

A

lithium

demeclocycline

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35
Q

causes Fanconi syndrome drug rxn

A

expired tetracycline

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36
Q

Causes SLE-like syndrome drug rxn

A 
Sulfa drugs
Hydralazine
INH
Procainamide
Phenytoin
Etanercept
"having lupus is SHIPP-E"
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37
Q

Causes fat redistribution drug rxn

A

protease inhibitors

glucocorticoids

38
Q

Causes myopathy drug rxn

A 
Fibrates
Niacin
Colchicine
hydroxychloroquine
IFN-alpha
penicillamine
statins
glucocorticoids
39
Q

Causes hemolysis in G6PD deficiency

A 
INH
Sulfonamides
Dapsone
Primaquine
Aspirin
Ibuprofen
Nitrofurantoin
40
Q

nonlinear pharmacokinetics
extensive binding to plasma proteins
Used for tonic-clonic & partial seizures
MOA: blocks voltage-gated sodium channels

A

phenytoin

Adverse: diplopia, ataxia, gingival hyperplasia, hirsutism, neuropathy

41
Q

drugs for absence seizures

A

clonazepam
ethosuximide
valproic acid

42
Q

drugs for myoclonic seizures

A

clonazepam
lamotrigine
valproic acid

43
Q

for absence seizures

MOA: decreases Ca2+ currents (T-type)

A

ethosuximide

44
Q

voltage-gated sodium channel blockers used for seizures

prolong the refractory period for a neuron

A 
Phenytoin
Carbamazepine
Lamotrigine
Zonisamide
Note: lamotrigine blocks both sodium & calcium channels & decreases glutamate
45
Q

increase the frequency of GABA-mediated chloride channel opening

A

benodiazepines

46
Q

increase the duration of the GABA-mediated chloride channel opening
also block glutamic acid
At high concentration: block sodium channels
These depress neuronal activity in the midbrain reticular formation, prolonging the inhibitory effects of GABA & glycine.
Use: anxiety, seizures, insomnia, anesthesia

A 
barbiturates:
Phenobarbital
Pentobarbital
Thiopental
Secobarbital
47
Q

hypnotic drug that activates melatonin receptors in the suprachiasmatic nuclei
decreases latency of sleep onset with minimal rebound insomnia or withdrawal

A

ramelteon

48
Q

Given before niacin to prevent flush

A

Aspirin

Flush is thought to be mediated by prostaglandin

49
Q

increases blood flow to muscle during exercise

A

epinephrine

can decrease diastolic bp

50
Q

NTs thought to be deficient in ADHD

A

DA and NE in the prefrontal cortex

51
Q

growth factor that influences neuron growth and survival

A

brain-derived neurotrophic factor (BDNF)

Note: the two week delay in efficacy of anti-depressants is thought to be due to production of of BDNF

52
Q

amino acid precursor of serotonin

A

tryptophan

53
Q

if have symptoms of depression, check for?

A

levels of thyroid hormone, estrogen & testosterone

54
Q

Mechanism of action of antidepressants

A

Increase availability of NTs

55
Q

bind to SERT and NET to prevent reuptake

A

SNRIs:
Venlafaxine
Desvenlafasine
Duloxetine

56
Q

MOA: inhibition of SERT

A 
SSRIs
Fluoxetine
certroline
Citalopram
drugs are highly lipophilic
57
Q

TCA antidepressant with anticholinergic properties

A

imipramine

MOA: prevention of NT reuptake by NET and SERT

58
Q

found primarily in the brain, gut, placenta and liver

breaks down epi, NE, DA and 5-HT

A

MAO-A

59
Q

associated with the EPS of antipsychotic medications

A

blockade of D2 receptors in nigrostriatal pathway
schizophrenia is thought to involve increased density of D2 receptors
5-HT2A and 5-HT2C receptors modulate the release of dopamine, NE, glutamate, GABA and acetylcholine, as well as other NTs of the cortex, limbic region and striatum

60
Q

unpleasant senstations of inner restlessness

A

akathisia
Note: the most unwanted effect of antipsychotics is tardive dyskinesia
It’s caused by the relative deficiency of ACh because of supersensivity of DA receptors of caudate & putaman

61
Q

enhance effects of GABA allosterically and increase the frequency of chloride channel opening

A

benzodiazepines
Effects on sleep:
○ Decreases latency of sleep onset
○ Increases duration of stage 2 nonREM sleep
○ Duration of REM sleep is decreased
○ Duration of stage 4 nonREM slow-wave sleep is decreased
Tolerance: downregulation of BZ receptors

62
Q

reflects the concentration of anesthetic soluble in the blood

A

blood:gas partition coefficient

63
Q

concentration required to prevent a response to a surgical incision in 50% of population (evidenced by immobility which is mediated by neural inhibition within the spinal cord)

A

Minimal Alveolar Concentration (MAC)

MAC is dependent upon cerebral blood flow and can be reduced by inhaled anesthetics

64
Q

what circumstance would NO be a poor choice for anesthetic

A

fetal manipulation

NO has little effect on uterine smooth muscle.

65
Q

○ Muscle rigidity, hyperthermia, rapid onset of tachycardia and hypercapnia, hyperkalemia and metabolic acidosis
-may occur with use of succinylcholine

A

Malignant hyperthermia
Tx: dantrolene
MOA: decreases Ca2+ release from the SR

66
Q
  • produce analgesia by binding with G protein-coupled receptors located in the brain and spinal cord
    1. Close voltage-gated Ca2+ channels on presynaptic nerve terminals, reducing NT release
    2. Hyperpolarize postsynaptic neurons by opening K+ channels → inhibition
A

opioid agonists

67
Q

GI effects of opioids

A

§ Decreased motility
§ Decreased HCl release
§ Tone increased with periodic spasms of intestine while peristaltic waves are diminished: delays passage of fecal mass

68
Q

what medication class enhances the analgesic effects of opioids

A

amphetamines

69
Q

○ Selective 5-HT1 agonists that decrease nausea and vomiting of migraine

A

triptans

Sumatriptan

70
Q

activation requires release of glutamate onto a receiving neuron that is depolarized

A

NMDA receptor

blocked by magnesium at negative potentials

71
Q

○ Shape and color distortion, depersonalization, hallucinations, distorted time perception, dizziness, nausea, paresthesias, blurred vision
○ Do not induce dependence or addiction
○ Increase glutamate release at the cortex
○ Main target 5-HT2a receptor

A

LSD, mescaline & psilocybin

72
Q

block the magnesium binding site in the NMDA channel, preventing excessive excitability, reducing the rate of clinical deterioration

A

memantine

73
Q

NMDA, AMPA, or kainic acid

A

glutamate receptors

74
Q

decrease sympathetic outflow by activation of alpha2 receptors to reduce blood pressure by reducing cardiac output &/or vascular resistance.

A

Methyldopa -> hemolysis
Clonidine -> rebound HTN if dced
Adverse of both: sedation

75
Q

alpha1 blockers used for HTN

A

prazosin, doxazosin, terzosin
Adverse: orthostatic hypotension
Bonus: relax prostate smooth muscle (BPH tx)

76
Q

how do beta blockers help with HTN?

A

initially, they decrease cardiac output
After a few days they reduce vascular resistance by decreasing ANG II
Note: nebivolol has direct vasodilator action

77
Q

dihydropyridine CCB used to tx HTN

MOA: blocks L-type Ca channels

A

nifedipine**
-dipine drugs
Adverse: excessive cardiac depression; constipation
vasodilator effects are > than cardiac depressor effects

78
Q

drug to treat HTN by opening K+ channels and vasodilation of arterioles
Causes hirsutism so can be used to tx male-pattern baldness

A

minoxidil

79
Q

Used to tx HTN

MOA: causes release of NO from endothelial cells

A

hydralazine
Adverse: lupus-like syndrome
Can be used in combo with isosorbide dinitrate to treat heart failure

80
Q

D1 receptor agonist used for hypertensive emergencies

MOA: marked arteriolar vasodilation

A

fenoldopam

81
Q

Used for prophylaxis in those definitely exposed to N meningitidis, as well as the carrier state

A

Rifampin

82
Q

Antibiotic of choice for lung abscess in alcoholic (most likely due to aspiration)

A

Clindamycin

83
Q

Used in tx of hypoglycemia to inhibit insulin release

Relaxes vascular smooth muscle ( hypertensive crisis)

A

Diazoxide

84
Q

GnRH analog with agonist activity when used in pulsatile fashion; antagonist when used continuously
Used for prostate cancer, uterine fibroids, precocious puberty, infertility (pulsatile for infert)

A

Leuprolide

85
Q

Increases LH and FSH release from ant pituitary

Used to stimulate ovulation

A

Clomiphene

86
Q

Antagonist at breast tissue
Agonist at uterus and bone
Tx: breast cancer

A

Tamoxifen

Raloxifene does not affect uterus and can be used to tx osteoporosis

87
Q

Aromatase inhibitors

A

Anastrozole

Exemestane

88
Q

5 alpha reductase inhibitor

A

Finesteride

89
Q

Nonsteroidal competitive inhibitor of androgens at testosterone receptor

A

Flutamide

90
Q

Alpha 1 antagonist used to treat BPH by inhibiting smooth muscle contraction

A

Tamsulosin

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