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Other One-Liners Flashcards

1
Q

The selective agents lose their selectivity at

A

high doses

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2
Q

Another pneumonic for anticholinergic toxicity

A

“dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat”

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3
Q

These beta blockers are less lipid soluble

A

Acebutolol and atenolol

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4
Q

This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis

A

Acetazolamide

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5
Q

Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis

A

Albuterol

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6
Q

Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction

A

Amphetamines

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7
Q

Toxicity of anticholinergics

A

Anti-DUMBBELSS

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8
Q

Selective alpha agonists that decreases aqueous secretion

A

Apraclonidine, brimonidine

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9
Q

Treatment of muscarinic symptoms in organophosphate overdose

A

Atropine

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10
Q

Clinical uses of these agents include treatment of HTN, angina, arrhythmias, and chronic CHF

A

Beta blockers

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11
Q

Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF, signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)

A

Beta blockers

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12
Q

These agents increase blood flow and may be beneficial in treatment of acute heart failure and some types of shock

A

Beta1 agonists

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13
Q

Reversal of blockade by neuromuscular blockers

A

Cholinesterase inhibitors

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14
Q

Reduce transient hyper GI motility

A

Dicyclomine, methscopolamine

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15
Q

Antiglaucoma organophosphate, indicated but not used much clinically anymore due to long duration of action

A

Echothiophate

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16
Q

Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis

A

Edrophonium

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17
Q

Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis

A

Ephedrine

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18
Q

This is the drug of choice for anaphylactic shock

A

Epinephrine

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19
Q

Nonselective alpha agonists that decrease aqueous production and increase aqueous outflow

A

Epinephrine, dipivefrin

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20
Q

This parenteral beta blocker is a short acting

A

Esmolol

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21
Q

Epinephrine and dipivefrin are used for

A

Glaucoma

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22
Q

Ganglion blockers that were indicated (but not anymore) for severe hypertension

A

Hexamethonium, trimethaphan

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23
Q

Shock due to septicemia or myocardial infarction is made worse by

A

Increasing afterload and tissue perfusion declines

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24
Q

Atropine fever is the most dangerous effect and can be lethal in this population group

A

Infants

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25
Q

Contraindications to use of atropine

A

Infants, closed angle glaucoma, prostatic hypertrophy

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26
Q

Combined alpha and beta blocking agents that may have application in treatment of CHF

A

Labetalol and carvedilol

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27
Q

Insecticide organophosphate

A

Malathion, parathion

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28
Q

Chronic orthostatic hypotension can be treated with

A

Midodrine

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29
Q

This beta blocker is the longest acting

A

Nadolol

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30
Q

Carbamate with intermediate action and used as off-label for postoperative paralytic ileus and urinary retention

A

Neostigmine

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31
Q

Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis

A

Nondepolarizing Neuromuscular Blockers

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32
Q

Prototypical drug is atropine

A

Nonselective Muscarinic Antagonists

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33
Q

Cystitis, postoperative bladder spasms, or incontinence

A

Oxybutynin, dicyclomine

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34
Q

Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis

A

Phenoxybenzamine

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35
Q

Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud’s phenomena

A

Phentolamine

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36
Q

Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia

A

Phenylephrine

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37
Q

Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions

A

Physostigmine

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38
Q

Muscarinic that is very lipid soluble and used in glaucoma

A

Pilocarpine

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39
Q

Muscarinic used to treat dry mouth in Sjˆgren’s syndrome

A

Pilocarpine or Cevimeline

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40
Q

Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction

A

Pilocarpine, carbachol, physostigmine

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41
Q

Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma

A

Pindolol and acebutolol

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42
Q

This agent competes for phosphorylated cholinesterase enzyme and regenerates enzyme if organophosphate-enzymes complex has not “aged”

A

Pralidoxime

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43
Q

This beta blocker is highly lipid soluble and may account for side effects such as nightmares

A

Propranolol

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44
Q

This agent cause increased aqueous outflow

A

Prostaglandin PGF2a (latanoprost, travoprost, unoprostone)

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45
Q

Treatment of myasthenia gravis and sometimes used prophylactically for organophosphate poisoning in chemical warfare

A

Pyridostigmine

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46
Q

Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma

A

Reduce aqueous synthesis

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47
Q

Often mixed with local anesthetic to

A

Reduce the loss from area of injection

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48
Q

The most important cause of acute deaths in cholinesterase inhibitor toxicity

A

Respiratory failure

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49
Q

Longer acting Beta 2 agonists is recommended for prophylaxis of asthma

A

Salmeterol

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50
Q

Beta 1 agonist toxicity

A

Sinus tachycardia and serious arrhythmias

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51
Q

Beta 2 agonist toxicity

A

Skeletal muscle tremor

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52
Q

Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use

A

Succinylcholine

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53
Q

Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus

A

Terbutaline

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54
Q

Selective Alpha 2 blocker used for impotence (controversial effectiveness)

A

Yohimbine

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55
Q

NSAID avoided in gout because low doses increases uric acid levels

A

Aspirin

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56
Q

Period of time of therapy after which GC therapy will need to be tapered

A

5-7 days

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57
Q

Four main actions of NSAIDS

A

Anti-inflammatory, analgesia, antipyretic and antiplatelet activity

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58
Q

Irreversible, nonselective COX inhibitor

A

Aspirin (or other salicylates)

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59
Q

Difference between aspirin and other NSAIDS

A

Aspirin irreversibly inhibits cyclooxygenase

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60
Q

Long acting GC’s

A

Betamethasone, dexamethasone, and paramethasone

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61
Q

Drug that selectively inhibits COX 2

A

Celecoxib

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62
Q

Newer NSAIDs that selectively inhibit COX-2

A

Celecoxib

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63
Q

Short acting GC’s

A

Cortisone and hydrocortisone (equivalent to cortisol)

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64
Q

Difference between COX 1 and COX 2

A

COX 1 is constitutive while COX 2 may be induced during inflammation, although COX 2 is constitutive in some tissues

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65
Q

Mineralocorticoids

A

Fludrocortisone and deoxycorticosterone

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66
Q

COX 2 inhibitors may have reduced risk of

A

Gastric ulcers and GI Bleeding

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67
Q

Used for Addison’s disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)

A

Glucocorticoids

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68
Q

SE of acetaminophen

A

Hepatotoxicity

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69
Q

NSAID used in gout

A

Indomethacin, ibuprofen

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70
Q

MOA of corticosteroids

A

Induce lipocortins to 1. inhibit phospholipase A2, 2. repress COX-2 gene and enzyme expression, 3. repress cytokines that activate COX-2

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71
Q

MOA of NSAIDS

A

inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)

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72
Q

NSAID available orally, IM, IV, nasally, and ophthalmically

A

Ketoralac

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73
Q

NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity

A

Ketoralac

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74
Q

Major SE of zileuton

A

Liver toxicity

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75
Q

Class of drugs that reversibly inhibit COX

76
Q

Approved for use in severe pulmonary HTN

A

PGI2 (epoprostenol)

77
Q

The reason why aspirin is contraindicated in children with viral infection

A

Potential for development of Reye’s syndrome

78
Q

COX 2 inhibitors should be used cautiously in pts with

A

Pre-existing cardiac or renal disease

79
Q

Intermediate acting GC’s

A

Prednisone, methylprednisolone, prednisolone, oaramethasone, fluprednisone and triamcinolone

80
Q

SE of salicylates

A

Tinnitus, GI bleeding

81
Q

Inhibitor of leukotrienes (LTD4) receptors and used in asthma

A

Zafirlukast and montelukast

82
Q

Inhibit angiotensin-converting enzyme (ACE)

A

ACE inhibitors

83
Q

Carbonic anhydrase inhibitor

A

Acetazolamide

84
Q

Nitroprusside vasodilates

A

Arteries and veins

85
Q

Drugs used in the management of angina

A

Aspirin, Nitrates, CCB, and Beta blockers

86
Q

Beta-blockers should be used cautiously in

A

Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease

87
Q

Block L-type calcium channel

A

Calcium channel blockers

88
Q

Beta blockers are used for which type of anginal attack

89
Q

Presynaptic Alpha 2 agonist used in HTN

A

Clonidine, and methyldopa

90
Q

Toxicity caused by nitroprusside and treatment

A

Cyanide toxicity treated with sodium thiosulfate

91
Q

Direct vasodilator of arteriolar smooth muscle

A

Hydralazine

92
Q

SE of minoxidil

A

Hypertrichosis

93
Q

Mechanism of action of spironolactone

A

Inhibit mineralocorticoid receptor and inhibit Na/K-ATPase and ENaC synthesis

94
Q

Mechanism of action of thiazide diuretics

A

Inhibit Na+/Cl- cotransport

95
Q

Mechanism of action of loop diuretics

A

inhibits Na+/K+/2Cl- cotransporter

96
Q

Diuretic used in hypertensive patients with renal failure

A

Loop diuretics (furosemide, ethacrynic acid, butmetanide)

97
Q

Arterial vasodilator that works by opening K+ channels

98
Q

CCB with predominate effect on arteriole dilation

A

Nifedipine

99
Q

Nitrate used for acute anginal attacks

A

Nitroglycerin sublingual tablets

100
Q

IV Drug used Hypertensive Crisis

A

Nitroprusside

101
Q

Nitrate used to prevent further attacks

A

Oral and transdermal forms of nitroglycerin

102
Q

Aminoglycosides used with loop diuretics potentiate this adverse effect

A

Ototoxicity

103
Q

Non-selective Alpha1blockers use to treat pheochromocytoma

A

Phenoxybenzamine

104
Q

For rebound HTN from rapid clonidine withdrawal

A

Phentolamine

105
Q

Aspirin reduces mortality in unstable angina by

A

Platelet aggregation inhibition

106
Q

SE of methyldopa

A

Positive Comb’s test, depression

107
Q

SE of nitrates

A

Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation

108
Q

CCB are DOC for

A

Prinzmetal’s angina

109
Q

Non-selective Beta-blocker also used for migraine prophylaxis

A

Propranolol

110
Q

SE of clonidine

A

Rebound HTN, sedation, dry mouth

111
Q

Class of drugs that may cause cross-sensitivity with thiazide diuretics

A

Sulfonamides

112
Q

Diuretic used as first line for treatment of hypertension

113
Q

Nitrate free intervals are needed due to

114
Q

Alpha-glucosidase inhibitor associated with elevation of LFT’s

115
Q

Examples of alpha-glucosidase inhibitors (AGI)

A

Acarbose, miglitol

116
Q

Drugs available in combination with metformin

A

Acroplus Met progutazone and metformin, Janumet and Janumet XR Sitagliptin and Metformin, Glyburide, glipizide, and rosiglitazone

117
Q

MOA of AGI’s

A

Act on intestine, delay absorption of glucose

118
Q

Sulfonylurea NOT recommended for elderly because of very long half life

A

Chlorpropamide

119
Q

First generation sulfonylurea

A

Chlorpropamide, tolbutamide, tolazamide, etc.

120
Q

MOA of metformin

A

Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity

121
Q

SE of Thiazolindinediones

A

Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism; if used over one year, bladder Cancer; with CHF, may cause new or worsening CHF

122
Q

SE of AGI’s

A

Flatulence (do not use beano to tx), diarrhea, abdominal cramps

123
Q

Ultra long acting insulin, has over a day duration of action

A

Glargine (Lantus)

124
Q

Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation

125
Q

Important in synthesis of glucose to glycogen in the liver

126
Q

Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation

127
Q

Second generation sulfonylurea

A

Glyburide, glipizide, glimepiride, etc.

128
Q

Reason troglitazone was withdrawn from market

A

Hepatic toxicity

129
Q

Major side effect of insulin

A

Hypoglycemia

130
Q

Common SE of sulfonylureas, repaglinide, and nateglinide

A

Hypoglycemia

131
Q

MOA of both generations

A

Insulin release from pancreas by modifying K+ channels

132
Q

MOA of repaglinide

A

Insulin release from pancreas; faster and shorter acting than sulfonylurea

133
Q

Beta cells are found

A

Islets of Langerhans

134
Q

Most important potential SE of metformin

A

Lactic acidosis

135
Q

Very rapid acting insulin, having fastest onset and shortest duration of action

A

Lispro (Humalog)/Apidra (glulisine)

136
Q

Biguanide

137
Q

Endogenous insulin

A

Normal C-peptide

138
Q

Thiazolidinediones

A

Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)

139
Q

Alpha cells in the pancreas

A

Produce glucagon

140
Q

Beta cells in the pancreas

A

Produce insulin

141
Q

Delta cells in the pancreas

A

Produce Somatostatin

142
Q

Rapid acting, crystalline zinc insulin used to reverse acute hyperglycemia

A

Regular (Humulin R)

143
Q

Meglitinide

A

Repaglinide

144
Q

MOA of thiazolindinediones

A

Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism

145
Q

MOA of nateglinide

A

Stimulates rapid and transient release of of insulin through closure of the ATP-sensitive K+ channel

146
Q

Anti-seizure medication also used in the prevention of migraines

A

Valproic acid

147
Q

Adenosine’s MOA

A

Activates acetylcholine sensitive K+ channels in SA and AV node

148
Q

DOC for paroxysmal supraventricular tachycardia (PSVT)

149
Q

Anti-arrhythmic with <10 second duration of action

150
Q

MOA for Valproic acid at high doses

A

Affect calcium, potassium, and sodium channels

151
Q

Carbamazepine may cause

A

Agranulocytosis

152
Q

Class III antiarrhythmic that exhibits properties of all 4 classes

A

Amiodarone

153
Q

Antiarrhythmic effective in most types of arrhythmia

A

Amiodarone

154
Q

SE for Felbamate

A

Aplastic anemia and acute hepatic failure

155
Q

Class II antiarrhythmics are

A

B-blockers

156
Q

Anti-arrhythmics that decrease mortality

A

B-blockers

157
Q

MOA of class IV antiarrhythmics

A

Calcium channel blockers

158
Q

MOA for Ethosuximide

A

Calcium channels

159
Q

Anti-seizure drugs used also for Trigeminal neuralgia

A

Carbamazepine

160
Q

Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida

A

Carbamazepine

161
Q

Anti-seizure drugs used as alternative drugs for mood stabilization

A

Carbamazepine, gabapentin, lamotrigine, and valproic acid

162
Q

Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents

A

Class IC (flecainide, propafenone, moricizine)

163
Q

Drugs that can be used for infantile spasms

A

Corticosteroids

164
Q

Drug used supraventricular arrhythmias

165
Q

Used intravenously for acute arrhythmias during surgery

166
Q

MOA for benzodiazepines and barbiturates

A

GABA-related targets

167
Q

SE of phenytoin

A

Gingival hyperplasia

168
Q

Most frequent route of metabolism

A

Hepatic enzymes

169
Q

Major drug interaction with Quinidine

A

Increases concentration of Digoxin

170
Q

Drugs of choice for status epilepticus

A

IV diazepam (or lorazapam) followed by phenytoin

171
Q

Agent to treat torsades de pointes

A

Magnesium sulfate

172
Q

DOC for febrile seizures

A

Phenobarbital

173
Q

DOC for digoxin induced arrhythmias

174
Q

Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism

175
Q

MOA of class III antiarrhythmics

A

Potassium channel blockers

176
Q

Specific pharmacokinetic characteristic of amiodarone

A

Prolonged half-life, up to six weeks

177
Q

Side effect of sotalol

A

prolongs QT and PR interval

178
Q

Laboratory value required to be monitored for patients on valproic acid

A

Serum ammonia and LFT’s

179
Q

Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine

A

Sodium blockade

180
Q

Antiarrhythmic that exhibits Class II and III properties

181
Q

SE for Lamotrigine

A

Stevens-Johnson syndrome

182
Q

Other side effects of Quinidine

A

Thrombocytopenic purpura, and CINCHONISM

183
Q

SE of Amiodarone

A

Thyroid dysfunction, photosensitivity, skin (blue smurf syndrome), corneal deposits, liver damage and pulmonary fibrosis

184
Q

Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress

A

Valproic acid

185
Q

Anti-seizure drugs used also for bipolar affective disorder (BAD)

A

Valproic acid, carbamazepine, phenytoin and gabapentin

PBL Pharm Block 3 (14 decks)

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