N368 Test 3 Diuretics, Electrolyte and Fluid Replacement, Vaccines, NSAIDs, Immunomodulators, and Antibiotics

Question 1

Loop Diuretics: name the classification and the mechanism of action

Answer 1

Diuretics and HTN: Act on ascending limb of the loop of Henle to block the reabsorption of sodium and water.

Question 2

Loop Diuretics: name the major SEs

Answer 2

Hypokalemia, postural hypotension, tinnitis

Question 3

Loop Diuretics: name two prototypes

Answer 3

Furosemide (Lasix) Bumetanide (Bumex)

Question 4

Thiazides Diuretics: name the classification and the mechanism of action

Answer 4

Act on the early distal tubule to block the reabsorption of sodium and water.

Question 5

Thiazide Diuretics: name the major SEs

Answer 5

Hypokalemia, dehydration, hypotension

Question 6

Thiazide Diuretics: name the two prototypes

Answer 6

Chlorothiazide (Diuril) Hydrochlorothiazide (Microzide)

Question 7

Potassium-Sparing Diuretics: name the classification and the mechanism of action

Answer 7

Act on the late distal tubule and collecting ducts to block the reabsorption of sodium while retaining the secretion of potassium

Question 8

Potassium-Sparing Diuretics: name the major SEs

Answer 8

Hyperkalemia, dehydration, dysrhythmia (hyperkalemia), gynecomastia

Question 9

Potassium-Sparing Diuretics: name the two prototypes

Answer 9

Spironolactone (Aldactone) Amiloride (Midamor)

Question 10

Carbonic Anhydrase Inhibitor: name the classification and mechanism of action

Answer 10

Misc. Diuretic; to produce uresis by inhibiting carbonic anhydrase, a enzyme that affects acid-base balance by its ability to form carbonic acid (H2CO3) from water and carbondioxide (CO2); this inhibition promotes the direction making more CO2 and water, which will be excreted. Used for the management of open-angle glaucoma or other forms of ocular hypertension

Question 11

Carbonic Anhydrase Inhibitor: name the major SEs

Answer 11

Dehydration, pancytopenia

Question 12

pancytopenia

Answer 12

reduction in RBC, WBC, and PLTs

Question 13

Carbonic Anhydrase Inhibitor: name the two prototype drugs

Answer 13

Acetazolamide (Diamox) Methazolamide (Neptazane)

_

Question 14

Osmotic Diuretics: name the classification and the mechanism of action

Answer 14

Misc. Diuretics; Increases the osmotic pressure of the glomerular filtrate, thereby inhibiting reabsoprtion of water and electrolyte, and reduce plasma volume

Question 15

Osmotic Diuretics: name the major SEs

Answer 15

__________Osmotic Diuretics
Misc. Diuretics; Increases the osmotic pressure of the glomerular filtrate, thereby inhibiting reabsoprtion of water and electrolyte, and reduce plasma volume
Fluid and electrolyte imbalances, thrombophlebitis

Question 16

Osmotic Diuretics: name the two prototype drugs

Answer 16

_mannitol (Osmitrol)

glycerin(Colace, Osmoglyn)

Question 17

____Colloids: name the classification and mechanism of action

Answer 17

fluid replacement agent; Provides colloidal oncotic pressure of blood, which serves to mobilize fluid from extravascular space into vascular system; expands plasma volume within minutes of administration

Question 18

Colloids: name the major SEs

Answer 18

Hypertension, Fluid overload, cardiac failure

Question 19

Colloids: name the major prototype drug

Answer 19

Albumin (Albuminar, plasbumin)

Question 20

____Sodium bicarbonate: name the drug classification and mechanism of action

Answer 20

Agents to treat acidosis or bicarbonate deficiency

Question 21

Sodium bicarbonate: name the major SEs

Answer 21

Metabolic Akalosis due to too much HCO3 infusion(confusion, irritability, slow HR); Hyperkalemia; Tx for metabolic alkalosis (give KCL or NH3CL, ammonium chloride)

Question 22

sodium bicarbonate: name the prototypes

Answer 22

Sodium bicarbonate (NaHCO3)

Question 23

_____Ammonium chloride: name the classification

Answer 23

Agents to treat alkalosis

Question 24

Ammonium chloride: name the major SEs

Answer 24

Metabolic Acidosis due to too much loss of HCL

Question 25

Ammonium chloride: name the prototype

Answer 25

Ammonium chloride

Question 26

vaccines: what is the purpose?

Answer 26

Vaccines; provide weak antigen for disorder to human body, which can produce antibodies on their own. _produce active immunity

Question 27

vaccines: what are the major SEs

Answer 27

pain and inflammation at injection site, transient fever or fatigue

Question 28

vaccines: name the vaccines for hepB and HPV

Answer 28

Hepatitis B (Engerix-B, Recombivax HB); human papillomavirus (Gardasil)

Question 29

Interferon: name the classification and mechanism of action

Answer 29

immunostimulant/biologic response modifier; Natural antiviral and immunoregulatory properties produced by T cell. Suppress cell division, increase phagocytic activity of macrophage, and promote cytotoxic activity of T cells; enhances or stimulates immune system to remove antigens; suppresses growth of cancer cells

Question 30

interferon: name the major SEs

Answer 30

flu-like SXs headache, N/V, immunosuppression, hepatotoxicity, suicidal ideation

Question 31

interferon: name the two prototypes

Answer 31

(Roferon-A) interferon alfacon-1 (Infergen); interferon- beta-1a (Avonex, Rebif)

Question 32

Antimetabolites: name the classification and mechanism of action

Answer 32

Immunosuppressant; Inhibit DNA synthesis by inhibiting DNA polymerase during lymphocyte replication ----> disrupt T cell function

Question 33

Antimetabolites: name the major SEs

Answer 33

Severe nausea and vomiting, bone marrow suppression

Question 34

Antimetabolites: name the prototypes

Answer 34

sirolimus (Rapamune) azathioprine (Imuran) methotrexate

Question 35

Calcineurin inhibitors: name the classification and mechanism of action

Answer 35

mmunosuppressant; Bind to calcineurin, an intracellular messenger, and disrupt T cells (especially, T-helper cells)

Question 36

Calcineurin inhibitors: name the major SEs

Answer 36

hypertension, hepatotoxicity, nephrotoxicity, **reduction in urine flow

Question 37

Calcineurin inhibitors: name the prototype drugs

Answer 37

cyclosporine (Neoral, Sandimmune) tacrolimus (Prograf)

Question 38

Name the three types of NSAIDs

Answer 38

ibuprofen, ASA=aspirin, COX-2 Inhibitors

Question 39

Ibuprofen: name the class of drug and the mechanism of action

Answer 39

Non Steroidal Anti-Inflammatory Drug antipyretics, analgesics work by inhibiting cox-1 and cox-2 decreasing pain and inflammation response

Question 40

ibuprofen: major SEs

Answer 40

N/V

Question 41

Ibuprofen: prototype drugs

Answer 41

Ibuprofen (Advil, Motrin, others)

Question 42

ASA: name the classification and mechanism of action

Answer 42

Antiplatelet/ Anti-inflammatory; inhibiting both COX-1 and COX-2, therefore, inhibiting production of prostaglandins and decreasing platelet aggregation; providing analgesia and reducing inflammation & fiver response.

Question 43

ASA: major SEs

Answer 43

Stomach pain, heartburn (tinnitus-prolonged use); Avoided to children s syndrome

Question 44

ASA: prototype drugs

Answer 44

Asprin(acetylsalicylic acid, ASA) Choline slicylate( Arthropan)

Question 45

Cox-2 Inhibitors: drug classification and mechanism of action

Answer 45

antirheumatics, nonsteroidal anti- inflammatory agents; Selectively inhibit the enzyme COX-2. This enzyme is required for synthesis of prostaglandins; hence Cox-2 Inhib. reduce pain and inflammation response

Question 46

Cox-2 Inhibitor: major SEs

Answer 46

Dyspepsia, headache

Question 47

COX-2 inhibitors: name the prototype

Answer 47

Celecoxib (Celebrex)

Question 48

Glucocorticoids: name the classification and mechanism of action

Answer 48

antiasthmatics, corticosteroids, steroidal anti-inflammatory agents; Inhibit inflammatory response by suppressing histamine and prostaglandins Can inhibit immune system to reduce inflammation

Question 49

Glucocorticoids: name the major SEs

Answer 49

__Suppression of adrenal- gland function, hyperglycemia

Question 50

Glucocorticoids: name the prototypes

Answer 50

prednisone (Meticorten) hydrocortisone (Cortef, Hydrocortone, others)

Question 51

Centrally Acting COX inhibitors example drug

Answer 51

acetaminophen which has NO ANTI-INFLAMMATORY EFFECT

Question 52

acetaminophen (NO ANTI-INFLAMMATORY EFFECT): name the drug classification and mechanism of action

Answer 52

antipyretics, non-opioid analgesics; to reduce fever by direct action at level of hypothalamus and dilation of peripheral blood vessels

Question 53

acetaminophen (NO ANTI-INFLAMMATORY EFFECT): name the major SEs

Answer 53

potential liver damage; though less gastric irritation than aspirin

Question 54

acetaminophen (NO ANTI-INFLAMMATORY EFFECT): name the prototype

Answer 54

Tylenol (acetaminophen)

Question 55

PCN (Penicillins): name the classification and mechanism of action

Answer 55

anti-bacterial; antibiotics; to kill bacteria by disrupting their cell walls and allowing water to enter

Question 56

PCN (Penicillins): name the major SEs

Answer 56

``` allergic rxn (rash, fever) Diarrhea ```

Question 57

PCN (Penicillins): name prototype drugs

Answer 57

penicillin G (Pentids) amoxicillin (Amoxil, Trimox)

Question 58

Cephalosporin; cell wall inhibitors: name the classification and mechanism of action

Answer 58

anti-bacterial; antibiotics; act by attaching to PCN-binding protein receptor to inhibit bacterial cell-wall synthesis

Question 59

Cephalosporin; cell wall inhibitors: name the major SEs

Answer 59

Abdominal cramping, pseudomonas colitis, nephrotoxicity

Question 60

Cephalosporin; cell wall inhibitors: name prototypes

Answer 60

cefotaxime (Claforan) cefadroxil (Duricef)

Question 61

Tetracycline, protein synthesis inhibitor: name the classification and mechanism of action

Answer 61

anti-bacterial; antibiotics; inhibit bacterial protein synthesis, slow microbial growth and exert BACTERIOSTATIC EFFECT

Question 62

Tetracycline, protein synthesis inhibitor: name the major SEs

Answer 62

superinfections = i.e., killing natural flora in gut leading to C. difficile infection

Question 63

Tetracycline, protein synthesis inhibitor: name the

Answer 63

``` tetracycline HCL (Achromycin, others) _demeclocycline (Declomycin) ```

Question 64

Macrolide, protein synthesis inhibitor: name the classification and mechanism of action

Answer 64

anti-bacterial; antibiotics; inhibit protein synthesis by binding to the bacterial ribosome; to act as spectrum similar to that of penicillins

Question 65

Macrolide, protein synthesis inhibitor: name the major SEs

Answer 65

nausea, abdominal cramping, Most severe is hepatotoxicity

Question 66

Macrolide, protein synthesis inhibitor: name the prototypes

Answer 66

erythromycin (E- Mycin, Erythrocin) azithromycin (Zithromax, Z-Pak)

Question 67

Aminoglycoside, protein synthesis inhibitors: name the classification and mechanism of action

Answer 67

anti-bacterial; antibiotics; to act as broad-spectrum, bacteriocidal antibiotic, inhibit bacterial protein synthesis

Question 68

Aminoglycoside, protein synthesis inhibitors: name the major SEs

Answer 68

ototoxicity and nephrotoxicity

Question 69

Aminoglycoside, protein synthesis inhibitors: name the prototypes

Answer 69

ciprofloxacin (Cipro) | Moxifloxacin (Avelox)

Question 70

Sulfonamide: name the drug class and the mechanism of action

Answer 70

anti-bacterial; antibiotics; to kill bacteria by inhibiting bacterial metabolism of folic acid

Question 71

Sulfonamide: name the major SEs

Answer 71

skin rashes agranulocytosis or thrombocytopenia

Question 72

Sulfonamide: name the prototypes

Answer 72

trimethoprim- sulfamethoxazole (Bactrim, Septra) sulfadiazine (Microsulfon)

Question 73

Anti-MRSA drug treatment

Answer 73

Vancomycin (Vancocin)

Question 74

Vancomycin (Vancocin): name the major SEs

Answer 74

ototoxicity, nephrotoxicity

Question 75

Vancomycin (Vancocin): name the mechanism of action and drug classification

Answer 75

Anti-MRSA treatment Antibiotics; Bactericidal action is due to inhibition of cell wall biosynthesis and inhibition of bacterial cell membrane permeability

Question 76

Isoniazid (INH, Nydrazid) Pyrazinamide(PZA): Name the indication

Answer 76

Anti-TB

Question 77

Isoniazid (INH, Nydrazid) Pyrazinamide(PZA): Name the indication: name the mechanism of action

Answer 77

Anti-TB meds; Act by interfering with biosynthesis of bacterial proteins, nucleic acid, and lipids, Exerts bacteriostatic action against actively growing tubercle bacilli

Question 78

Isoniazid (INH, Nydrazid) Pyrazinamide(PZA): Name the indication: name major SEs

Answer 78

Nausea, vomiting, Hepatotoxicity