Panic Flashcards
1
Q
Acetazolamide
A
Carbonic anhydrase inhibitor
2
Q
Methazolamide
A
Carbonic anhydrase inhibitor
3
Q
Dichlorphenamide
A
Carbonic anhydrase inhibitor
4
Q
Uses for CA inhibitors
A
glaucoma, acute mountain sickness, metabolic alkalosis
5
Q
Side effects of CA inhibitors
A
bicarbonaturia, acidosis, hypokalemia, liver failure, sulfa HS rxn
6
Q
Furosemide
A
Loop diuretic
7
Q
Bumetanide
A
Loop diuretic
8
Q
Torsemide
A
Loop diuretic
9
Q
Ethacrynic acid
A
Loop diuretic
10
Q
Special side effects of Loop diuretics
A
hypokalemia, alkalosis, Hypo Ca & Mg, ototoxicity, increased digoxin toxicity, inability to clear Lithium
11
Q
Chlorothiazide
A
Thiazide
12
Q
Hydrochlorothiazide
A
Thiazide
13
Q
Quiethazone
A
Thiazide like
14
Q
Metolazone
A
Thiazide like
15
Q
Indapamide
A
Thiazide like
16
Q
Thiazde side effects
A
Hypokalemia, alkalosis, HYPERCALCEMIA, hyperlipidemia, increase BUN/serum creatinine
17
Q
Contraindications of thiazides
A
Gout, diabetes mellitus
18
Q
Amiloride
A
Renal ENaC inhibitors
19
Q
Triamterene
A
Renal ENaC inhibitors
20
Q
Side effects of Renal ENaC inhibitors
A
Hyperkalemia, Tiamterene - cirrhosis/megaloblastic anemia
21
Q
Spironolactone
A
Aldosterone Receptor Antagonist
22
Q
Aldosterone Receptor Antagonist side effects
A
hyperkalemia, acidosis, gynecomastia, loss of libido, amenorrhea/oligorrhea etc…
23
Q
Albuterol
A
Short acting B2 agonist
24
Q
Terbutaline
A
Short acting B2 agonist
25
Metoproterenol
Short acting B2 agonist
26
Pirbutol
Short acting B2 agonist
27
Salmeterol
Long acting B2 agonist
28
Formoterol
Long acting B2 agonist
29
Indacaterol
Long acting B2 agonist
30
MOA for SABA and LABA
B2, Gs, AC, cAMP, PKA, Decrease intracellular Ca, Bronchodilation
31
Always use LABAs with what?
Corticosteroids!
32
Side effects of SABAs and LABAs
Tachycardia, prolonged QTC, paradoxical bronchospasm, tolerance with chronic use
33
Atropine
anti-muscarinic
34
Ipratropium Bromide
anti-muscarinic
35
Tiotropium
anti-muscarinic
36
Aclidinum Bromide
anti-muscarinic
37
Special things about Tiotropium
For chronic COPD, decreases mucus production, anti-inflammatory, longer version of Ipratropium Bromide
38
Theophylline
Methylxathines
39
Theobromine
Methylxanthine
40
Caffeine
Methylxanthine
41
Romiflumilast
Methylxanthine
42
Methylxanthine MOA?
nonselective PDE3, 4, 5 inhibitors - increase cAMP - weak bronchodilation!
43
Uses of methylxanthines
Improves contractility, reverse diaphragm fatigue in COPD, prevent neutrophil migration (Romflumilast, PDE4i)
44
Methylxanthine side effects
Anorexia, nausea, headache, insomnia GERD, higehr doses can lead to cardiac arrhythmia, seizure! DDI (metabolized by CYP450)
45
Budesonide
Inhaled corticosteroid
46
Fluticasone
Inhaled corticosteroid
47
Propionate
Inhaled corticosteroid
48
Beclomethasone
Inhaled corticosteroid
49
Dipropionate
Inhaled corticosteroid
50
Mometasone
Inhaled corticosteroid
51
Ciclesonide
Inhaled corticosteroid
52
Uses for inhaled corticosteroids
Persistent asthma, severe COPD, in combo with B2 agonist
53
Side effects of steroids
80-90% goes into GI tract, causes emotional problems, moon face, osteoporosis, HTN, cardiac hypertrophy, obesity, etc.
54
Montelukast
Anti-leukotriene
55
Zafirlukast
Anti-leukotriene
56
Zileuton
Anti-leukotriene
57
Montelukast, Zafirlukast MOA?
LT antagonist
58
Zileuton MOA?
Inhibit 5-lipooxygenase (mediates conversion from AA to LTs)
59
Uses for Anti-leukotrienes
add on in mild asthma, prophylaxis for bronchospasm, aspirin induced asthma, less effective than doubling dose of inhaled steroid/adding b2 agonist
60
Sodium cromoglycate
Cromones
61
Nedocromil sodium
Cromones
62
Cromones MOA
Prevent mast cell degranulation and mediator release from macrophages/eosinophils via altering function of the Cl channel
63
Cromones uses
mild persistent asthma, prophylaxis
64
Omalizumab
Anti-IgE
65
Uses for Omalizumab
Subcutaneous injection that decreases need for oral/inhaled corticosteroids (patients with severe asthma and poor control on steroids)
66
Catopril
ACEi
67
Lisinopril
ACEi
68
Benzapril
ACEi
69
Quinapril
ACEi
70
Ramipril
ACEi
71
Enalapril
ACEi
72
ACEi side effects
cough, angioedema, decreased renal function
73
ACEi contraindications
RAS, hyperkalemia, renal failure, pregnancy
74
Losartan
ARB
75
Valsartan
ARB
76
Irbesartan
ARB
77
Amlodipine
Dihydropyridine CCB
78
Nifedipine
Dihydropyridine CCB
79
Verapamil
Nondihydropyridine CCB
80
Diltiazem
Nondihydropyridine CCB
81
Uses for CCBs
Inhibit contraction of vascular smooth muscle by blocking Ca entry into the cell, decrease BP, Raynaud's, angina
82
Side effects of CCBs
CONSTIPATION, PERIPHERAL EDEMA, heart failure, bradycardia, AV nodal block, worsen angina (reflex tachy)
83
Propranolol
Nonselective B1/2 blocker
84
Metoprolol
Selective B1 blocker
85
Atenolol
Selective B1 blocker
86
Nadolol
Selective B1 blocker
87
Bisprolol
Selective B1 blocker
88
Carvedilol
Selective B1 blocker
89
Esmolol
Selective B1 blocker
90
B-blocker side effects
decrease exercise, bronchospasm (B2), bradycardia, CHF, masks hypoglycemia symptoms, crosses BBB causing depression, worsen peripheral vascular disease, impotence
91
Terazosin
Alpha1-antagonist
92
Doxazosin
Alpha1-antagonist
93
Alpha1-antagonist MOA
Decrease vascular resistance by blocking receptors on smooth muscle
94
Uses of Alpha1-antagonists
BPH, 2nd tier for HTN
95
Side effects of Alpha1-antagonists
Orthostatic hypotension, reflex tachy (worsen angina), fluid retention
96
Hydralazine
vasodilators
97
Minoxidil
vasodilators
98
Clonidine
Central alpha2 agonist
99
Alpha-methyl-dopa
Central alpha 2 agonist
100
Guanabenz
Central alpha 2 agonist
101
Central alpha 2 agonist MOA
decrease SNS outflow from vasomotor center in brainstem, decreasing SNS tone, decreasing renin release
102
Alpha-methyl-dopa side effects and use
Drug induced lupus, CAN BE USED IN PREGNANCY
103
General central alpha 2 agonist side effects
Sedation, dry mouth, fatigue, depression, orthostatic hypotension
104
Guanethtedine
ganglion blocking agent, blocks NE release
105
Reserpine, Guanabenz
Deplete NE, DA, 5HT, decreasing CO and TPR
106
Asprin
Irreversible inhibition of COX (Anti platelet)
107
Ticlopidine
ADP receptor inhibitor (Anti platelet) - neutropenia
108
Clopidogrel
blocks IIb/IIIa (Anti platelet) - std of care after PCI
109
Prasugrel
binds P2Y12 (Anti platelet) - std of care after PCI, can't have history of TIA
110
Ticagrelor
blocks ADP receptor in different spot (Anti platelet)
111
Dipyridamole
inhibit PDE, increasing AC, inhibiting adenosine uptake, causing more vasodilation
112
Clostazol
inhibit PDE, increase cAMP, inhibit platelet agg and causes vasodilation, used for claudication in people with peripheral vascular disease
113
Nitroglycerin (prodrug)
Nitrate - converted to NO, activates smooth muscle cGMP, inhibits Ca from entering causing smooth muscle relaxation and subsequent vasodilation
114
Isosorbide dinatrate (long acting)
NO, activates smooth muscle cGMP, inhibits Ca from entering causing smooth muscle relaxation and subsequent vasodilation
115
Isosorbid Mononitrate (long acting)
NO, activates smooth muscle cGMP, inhibits Ca from entering causing smooth muscle relaxation and subsequent vasodilation
116
Felodipine
Dihydropyridine CCB
117
Isradipine
Dihydropyridine CCB
118
Dihydropyridine CCB MOA/Use
Dilate epicardial coronary arteries, relieving coronary vasospasm, dilate arteriolar resistance vessels to decrease SVR
119
Nondhydropyridine CCB MOA/Use
Class IV anti-arrhythmics, negative ionotropes, decrease myocardial contractility, decrease conduction velocity, prolong repolarization in SA/AV node to decrease heart rate
120
3 Beta blockers approved for heart failure
Bisoprolol, Carvedilol, Metoprolol
121
Digoxin
Cardiac Glycoside
122
Digoxin MOA
Inhibit Na/K ATPase, cause intracellular Na to rise, inhibiting NCX, leaving more Ca inside, causing stronger contractility
123
Dobutamine
Sympathomimetic, stimulates B1 (need continuous infusion)
124
Milrinone
Phosphodiesterase IIIa inhibitor - increases cAMP, increasing ionotropy and increasing vasodilation of peripheral vessels
125
Nesirtide
Recombinant B-natriuertic peptide analog (normally BNP is produced by stretched myocardium) - serves as counter regulation of RAAS in acute decompensated HF
126
Quinidine
Class IA Anti-arrhythmic
127
Procainamide
Class IA Anti-arrhythmic
128
Disopyramide
Class IA Anti-arrhythmic
129
Lidocaine
Class IB Anti-arrhythmic
130
Mexiletine
Class IB Anti-arrhythmic
131
Flecainide
Class IC Anti-arrhythmic
132
Propafenone
Class IC Anti-arrhythmic
133
Class IA (DQP)
Disopyramide, Quinidine, Procainamide
134
Class IB (LM)
Lidocaine, Mexiletine
135
Class IC (FP)
Flecainide, Propafenone
136
Metoprolol
Class II Anti-arrhythmic
137
Acebutolol
Class II Anti-arrhythmic
138
Esmolol
Class II Anti-arrhythmic
139
Class II Antiarrhythmics (MAE)
B blockers: Metoprolol, Acebutolol, Esmolol
140
Sotalol
Class III Anti-arrhythmic
141
Ibutilide
Class III Anti-arrhythmic
142
Dofetilide
Class III Anti-arrhythmic
143
Amiodarone
Class III Anti-arrhythmic (everything)
144
Dronedarone
Class III Anti-arrhythmic
145
Class III Anti-arrhythmic (IDAD)
Ibutilide, Dofetilide, AMiodarone, Dronedarone
146
Verapamil
Class IV Anti-arrhythmic, Non-dihydropyridine CCB
147
Diltiazem
Class IV Anti-arrhythmic, Non-dihydropyridine CCB
148
Class IV Anti-arrhythmic
Verapamil, Diltiazem (Non-dihydropyridine CCBs)
149
Class IA MOA
Blocks FAST (open) Na+ channels - increasing ERP and APD (slows phase 0 depolarization)
150
Class IB MOA
Blocks open, inactivated Na channels (ischemic cells!) shorten phase 3 repolarization (slow sodium current, shrinks plateau length) - decreased APD
151
Class IC MOA
Na+ channel block, no effect on APD, markedly slows phase 0 down
152
Class II MOA
Beta blockeres
153
Class III MOA
K+ channel blockade, prolongs refractoriness (ERP and APD increase)
154
Class IV MOA
Calcium channel blockers (L type Ca channel block, slow SA/AV node)
155
Niacin
Nicotinic acid
156
Niacin MOA
Decrease TG synthesis in liver = less VLDL made, decreases HSL to send less FFA to liver, increase HDL
157
Clofibrate
Fibric acid derivative
158
Gemfibrozil
Fibric acid derivative
159
Ciprofibrate
Fibric acid derivative
160
Bezafibrate
Fibric acid derivative
161
Fibric acid derivative MOA
Bind to PPARalpha - stimulate LPL, clear more TG rich lipoproteins, inhibit apo C III expression to enhance VLDL clearance, increase HDL via more ApoAI and Apo AII
162
Fibric acid uses
decrease triglycerides (first line!)
163
Cholestyramine
Bile acid sequestrants
164
Cholestipol
Bile acid sequestrants (kids!)
165
Cholesevalam
Bile acid sequestrants
166
Bile acid sequestrants MOA
Highly (+) charged, bind (-) charged bile acids, causing liver to make more, increases LDLR, clearing more LDL-C, slight increase in HDL AND TG
167
Fibric acid side effects
GI side effects, myositis, potentiates oral anticoagulants (displaces them from binding protein), increases lithogenicity of bile!!
168
Side effects of Bile acid sequestrants
Generally safe because NOT absorbed, contraindicated in severe hypertriglyceridemia because it increases TG
169
Side effects of nicotinic acid
Flushing, pruritis, rash, hepatotoxicity, hyperglycemia, hyperuricemia (contraindicated in DM), toxic amblyopia, tachy, AF, myopathy
170
Fluvistatin, Pitavistatin, Atorvastatin, Riosuvastatin, Lorvastatin, Simvastatin, Pravastatin
HMG-CoA reductase inhibitors (increase LDL-R)
171
Side effects of HMG-CoA reductase inhibitors
myopathy, rhabdo (especially in elderly, hepatic/renal dysfunction, hypothyroid, diabetes)
172
Statins + fibrates are the bad because
Increases risk for myopathy
173
Statins are contraindicated in
pregnancy/nursing women
174
Ezetimibe/Zetia
inhibits intestinal transport protein for cholesterol (billiary and dietary cholesterol)
