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Unit 4: Pharm > Panic > Flashcards

Panic Flashcards

1
Q

Acetazolamide

A

Carbonic anhydrase inhibitor

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2
Q

Methazolamide

A

Carbonic anhydrase inhibitor

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3
Q

Dichlorphenamide

A

Carbonic anhydrase inhibitor

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4
Q

Uses for CA inhibitors

A

glaucoma, acute mountain sickness, metabolic alkalosis

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5
Q

Side effects of CA inhibitors

A

bicarbonaturia, acidosis, hypokalemia, liver failure, sulfa HS rxn

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6
Q

Furosemide

A

Loop diuretic

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7
Q

Bumetanide

A

Loop diuretic

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8
Q

Torsemide

A

Loop diuretic

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9
Q

Ethacrynic acid

A

Loop diuretic

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10
Q

Special side effects of Loop diuretics

A

hypokalemia, alkalosis, Hypo Ca & Mg, ototoxicity, increased digoxin toxicity, inability to clear Lithium

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11
Q

Chlorothiazide

A

Thiazide

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12
Q

Hydrochlorothiazide

A

Thiazide

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13
Q

Quiethazone

A

Thiazide like

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14
Q

Metolazone

A

Thiazide like

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15
Q

Indapamide

A

Thiazide like

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16
Q

Thiazde side effects

A

Hypokalemia, alkalosis, HYPERCALCEMIA, hyperlipidemia, increase BUN/serum creatinine

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17
Q

Contraindications of thiazides

A

Gout, diabetes mellitus

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18
Q

Amiloride

A

Renal ENaC inhibitors

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19
Q

Triamterene

A

Renal ENaC inhibitors

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20
Q

Side effects of Renal ENaC inhibitors

A

Hyperkalemia, Tiamterene - cirrhosis/megaloblastic anemia

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21
Q

Spironolactone

A

Aldosterone Receptor Antagonist

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22
Q

Aldosterone Receptor Antagonist side effects

A

hyperkalemia, acidosis, gynecomastia, loss of libido, amenorrhea/oligorrhea etc…

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23
Q

Albuterol

A

Short acting B2 agonist

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24
Q

Terbutaline

A

Short acting B2 agonist

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25
Q

Metoproterenol

A

Short acting B2 agonist

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26
Q

Pirbutol

A

Short acting B2 agonist

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27
Q

Salmeterol

A

Long acting B2 agonist

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28
Q

Formoterol

A

Long acting B2 agonist

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29
Q

Indacaterol

A

Long acting B2 agonist

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30
Q

MOA for SABA and LABA

A

B2, Gs, AC, cAMP, PKA, Decrease intracellular Ca, Bronchodilation

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31
Q

Always use LABAs with what?

A

Corticosteroids!

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32
Q

Side effects of SABAs and LABAs

A

Tachycardia, prolonged QTC, paradoxical bronchospasm, tolerance with chronic use

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33
Q

Atropine

A

anti-muscarinic

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34
Q

Ipratropium Bromide

A

anti-muscarinic

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35
Q

Tiotropium

A

anti-muscarinic

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36
Q

Aclidinum Bromide

A

anti-muscarinic

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37
Q

Special things about Tiotropium

A

For chronic COPD, decreases mucus production, anti-inflammatory, longer version of Ipratropium Bromide

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38
Q

Theophylline

A

Methylxathines

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39
Q

Theobromine

A

Methylxanthine

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40
Q

Caffeine

A

Methylxanthine

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41
Q

Romiflumilast

A

Methylxanthine

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42
Q

Methylxanthine MOA?

A

nonselective PDE3, 4, 5 inhibitors - increase cAMP - weak bronchodilation!

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43
Q

Uses of methylxanthines

A

Improves contractility, reverse diaphragm fatigue in COPD, prevent neutrophil migration (Romflumilast, PDE4i)

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44
Q

Methylxanthine side effects

A

Anorexia, nausea, headache, insomnia GERD, higehr doses can lead to cardiac arrhythmia, seizure! DDI (metabolized by CYP450)

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45
Q

Budesonide

A

Inhaled corticosteroid

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46
Q

Fluticasone

A

Inhaled corticosteroid

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47
Q

Propionate

A

Inhaled corticosteroid

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48
Q

Beclomethasone

A

Inhaled corticosteroid

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49
Q

Dipropionate

A

Inhaled corticosteroid

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50
Q

Mometasone

A

Inhaled corticosteroid

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51
Q

Ciclesonide

A

Inhaled corticosteroid

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52
Q

Uses for inhaled corticosteroids

A

Persistent asthma, severe COPD, in combo with B2 agonist

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53
Q

Side effects of steroids

A

80-90% goes into GI tract, causes emotional problems, moon face, osteoporosis, HTN, cardiac hypertrophy, obesity, etc.

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54
Q

Montelukast

A

Anti-leukotriene

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55
Q

Zafirlukast

A

Anti-leukotriene

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56
Q

Zileuton

A

Anti-leukotriene

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57
Q

Montelukast, Zafirlukast MOA?

A

LT antagonist

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58
Q

Zileuton MOA?

A

Inhibit 5-lipooxygenase (mediates conversion from AA to LTs)

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59
Q

Uses for Anti-leukotrienes

A

add on in mild asthma, prophylaxis for bronchospasm, aspirin induced asthma, less effective than doubling dose of inhaled steroid/adding b2 agonist

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60
Q

Sodium cromoglycate

A

Cromones

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61
Q

Nedocromil sodium

A

Cromones

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62
Q

Cromones MOA

A

Prevent mast cell degranulation and mediator release from macrophages/eosinophils via altering function of the Cl channel

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63
Q

Cromones uses

A

mild persistent asthma, prophylaxis

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64
Q

Omalizumab

A

Anti-IgE

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65
Q

Uses for Omalizumab

A

Subcutaneous injection that decreases need for oral/inhaled corticosteroids (patients with severe asthma and poor control on steroids)

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66
Q

Catopril

A

ACEi

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67
Q

Lisinopril

A

ACEi

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68
Q

Benzapril

A

ACEi

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69
Q

Quinapril

A

ACEi

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70
Q

Ramipril

A

ACEi

71
Q

Enalapril

A

ACEi

72
Q

ACEi side effects

A

cough, angioedema, decreased renal function

73
Q

ACEi contraindications

A

RAS, hyperkalemia, renal failure, pregnancy

74
Q

Losartan

A

ARB

75
Q

Valsartan

A

ARB

76
Q

Irbesartan

A

ARB

77
Q

Amlodipine

A

Dihydropyridine CCB

78
Q

Nifedipine

A

Dihydropyridine CCB

79
Q

Verapamil

A

Nondihydropyridine CCB

80
Q

Diltiazem

A

Nondihydropyridine CCB

81
Q

Uses for CCBs

A

Inhibit contraction of vascular smooth muscle by blocking Ca entry into the cell, decrease BP, Raynaud’s, angina

82
Q

Side effects of CCBs

A

CONSTIPATION, PERIPHERAL EDEMA, heart failure, bradycardia, AV nodal block, worsen angina (reflex tachy)

83
Q

Propranolol

A

Nonselective B1/2 blocker

84
Q

Metoprolol

A

Selective B1 blocker

85
Q

Atenolol

A

Selective B1 blocker

86
Q

Nadolol

A

Selective B1 blocker

87
Q

Bisprolol

A

Selective B1 blocker

88
Q

Carvedilol

A

Selective B1 blocker

89
Q

Esmolol

A

Selective B1 blocker

90
Q

B-blocker side effects

A

decrease exercise, bronchospasm (B2), bradycardia, CHF, masks hypoglycemia symptoms, crosses BBB causing depression, worsen peripheral vascular disease, impotence

91
Q

Terazosin

A

Alpha1-antagonist

92
Q

Doxazosin

A

Alpha1-antagonist

93
Q

Alpha1-antagonist MOA

A

Decrease vascular resistance by blocking receptors on smooth muscle

94
Q

Uses of Alpha1-antagonists

A

BPH, 2nd tier for HTN

95
Q

Side effects of Alpha1-antagonists

A

Orthostatic hypotension, reflex tachy (worsen angina), fluid retention

96
Q

Hydralazine

A

vasodilators

97
Q

Minoxidil

A

vasodilators

98
Q

Clonidine

A

Central alpha2 agonist

99
Q

Alpha-methyl-dopa

A

Central alpha 2 agonist

100
Q

Guanabenz

A

Central alpha 2 agonist

101
Q

Central alpha 2 agonist MOA

A

decrease SNS outflow from vasomotor center in brainstem, decreasing SNS tone, decreasing renin release

102
Q

Alpha-methyl-dopa side effects and use

A

Drug induced lupus, CAN BE USED IN PREGNANCY

103
Q

General central alpha 2 agonist side effects

A

Sedation, dry mouth, fatigue, depression, orthostatic hypotension

104
Q

Guanethtedine

A

ganglion blocking agent, blocks NE release

105
Q

Reserpine, Guanabenz

A

Deplete NE, DA, 5HT, decreasing CO and TPR

106
Q

Asprin

A

Irreversible inhibition of COX (Anti platelet)

107
Q

Ticlopidine

A

ADP receptor inhibitor (Anti platelet) - neutropenia

108
Q

Clopidogrel

A

blocks IIb/IIIa (Anti platelet) - std of care after PCI

109
Q

Prasugrel

A

binds P2Y12 (Anti platelet) - std of care after PCI, can’t have history of TIA

110
Q

Ticagrelor

A

blocks ADP receptor in different spot (Anti platelet)

111
Q

Dipyridamole

A

inhibit PDE, increasing AC, inhibiting adenosine uptake, causing more vasodilation

112
Q

Clostazol

A

inhibit PDE, increase cAMP, inhibit platelet agg and causes vasodilation, used for claudication in people with peripheral vascular disease

113
Q

Nitroglycerin (prodrug)

A

Nitrate - converted to NO, activates smooth muscle cGMP, inhibits Ca from entering causing smooth muscle relaxation and subsequent vasodilation

114
Q

Isosorbide dinatrate (long acting)

A

NO, activates smooth muscle cGMP, inhibits Ca from entering causing smooth muscle relaxation and subsequent vasodilation

115
Q

Isosorbid Mononitrate (long acting)

A

NO, activates smooth muscle cGMP, inhibits Ca from entering causing smooth muscle relaxation and subsequent vasodilation

116
Q

Felodipine

A

Dihydropyridine CCB

117
Q

Isradipine

A

Dihydropyridine CCB

118
Q

Dihydropyridine CCB MOA/Use

A

Dilate epicardial coronary arteries, relieving coronary vasospasm, dilate arteriolar resistance vessels to decrease SVR

119
Q

Nondhydropyridine CCB MOA/Use

A

Class IV anti-arrhythmics, negative ionotropes, decrease myocardial contractility, decrease conduction velocity, prolong repolarization in SA/AV node to decrease heart rate

120
Q

3 Beta blockers approved for heart failure

A

Bisoprolol, Carvedilol, Metoprolol

121
Q

Digoxin

A

Cardiac Glycoside

122
Q

Digoxin MOA

A

Inhibit Na/K ATPase, cause intracellular Na to rise, inhibiting NCX, leaving more Ca inside, causing stronger contractility

123
Q

Dobutamine

A

Sympathomimetic, stimulates B1 (need continuous infusion)

124
Q

Milrinone

A

Phosphodiesterase IIIa inhibitor - increases cAMP, increasing ionotropy and increasing vasodilation of peripheral vessels

125
Q

Nesirtide

A

Recombinant B-natriuertic peptide analog (normally BNP is produced by stretched myocardium) - serves as counter regulation of RAAS in acute decompensated HF

126
Q

Quinidine

A

Class IA Anti-arrhythmic

127
Q

Procainamide

A

Class IA Anti-arrhythmic

128
Q

Disopyramide

A

Class IA Anti-arrhythmic

129
Q

Lidocaine

A

Class IB Anti-arrhythmic

130
Q

Mexiletine

A

Class IB Anti-arrhythmic

131
Q

Flecainide

A

Class IC Anti-arrhythmic

132
Q

Propafenone

A

Class IC Anti-arrhythmic

133
Q

Class IA (DQP)

A

Disopyramide, Quinidine, Procainamide

134
Q

Class IB (LM)

A

Lidocaine, Mexiletine

135
Q

Class IC (FP)

A

Flecainide, Propafenone

136
Q

Metoprolol

A

Class II Anti-arrhythmic

137
Q

Acebutolol

A

Class II Anti-arrhythmic

138
Q

Esmolol

A

Class II Anti-arrhythmic

139
Q

Class II Antiarrhythmics (MAE)

A

B blockers: Metoprolol, Acebutolol, Esmolol

140
Q

Sotalol

A

Class III Anti-arrhythmic

141
Q

Ibutilide

A

Class III Anti-arrhythmic

142
Q

Dofetilide

A

Class III Anti-arrhythmic

143
Q

Amiodarone

A

Class III Anti-arrhythmic (everything)

144
Q

Dronedarone

A

Class III Anti-arrhythmic

145
Q

Class III Anti-arrhythmic (IDAD)

A

Ibutilide, Dofetilide, AMiodarone, Dronedarone

146
Q

Verapamil

A

Class IV Anti-arrhythmic, Non-dihydropyridine CCB

147
Q

Diltiazem

A

Class IV Anti-arrhythmic, Non-dihydropyridine CCB

148
Q

Class IV Anti-arrhythmic

A

Verapamil, Diltiazem (Non-dihydropyridine CCBs)

149
Q

Class IA MOA

A

Blocks FAST (open) Na+ channels - increasing ERP and APD (slows phase 0 depolarization)

150
Q

Class IB MOA

A

Blocks open, inactivated Na channels (ischemic cells!) shorten phase 3 repolarization (slow sodium current, shrinks plateau length) - decreased APD

151
Q

Class IC MOA

A

Na+ channel block, no effect on APD, markedly slows phase 0 down

152
Q

Class II MOA

A

Beta blockeres

153
Q

Class III MOA

A

K+ channel blockade, prolongs refractoriness (ERP and APD increase)

154
Q

Class IV MOA

A

Calcium channel blockers (L type Ca channel block, slow SA/AV node)

155
Q

Niacin

A

Nicotinic acid

156
Q

Niacin MOA

A

Decrease TG synthesis in liver = less VLDL made, decreases HSL to send less FFA to liver, increase HDL

157
Q

Clofibrate

A

Fibric acid derivative

158
Q

Gemfibrozil

A

Fibric acid derivative

159
Q

Ciprofibrate

A

Fibric acid derivative

160
Q

Bezafibrate

A

Fibric acid derivative

161
Q

Fibric acid derivative MOA

A

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
Q

Fibric acid uses

A

decrease triglycerides (first line!)

163
Q

Cholestyramine

A

Bile acid sequestrants

164
Q

Cholestipol

A

Bile acid sequestrants (kids!)

165
Q

Cholesevalam

A

Bile acid sequestrants

166
Q

Bile acid sequestrants MOA

A

Highly (+) charged, bind (-) charged bile acids, causing liver to make more, increases LDLR, clearing more LDL-C, slight increase in HDL AND TG

167
Q

Fibric acid side effects

A

GI side effects, myositis, potentiates oral anticoagulants (displaces them from binding protein), increases lithogenicity of bile!!

168
Q

Side effects of Bile acid sequestrants

A

Generally safe because NOT absorbed, contraindicated in severe hypertriglyceridemia because it increases TG

169
Q

Side effects of nicotinic acid

A

Flushing, pruritis, rash, hepatotoxicity, hyperglycemia, hyperuricemia (contraindicated in DM), toxic amblyopia, tachy, AF, myopathy

170
Q

Fluvistatin, Pitavistatin, Atorvastatin, Riosuvastatin, Lorvastatin, Simvastatin, Pravastatin

A

HMG-CoA reductase inhibitors (increase LDL-R)

171
Q

Side effects of HMG-CoA reductase inhibitors

A

myopathy, rhabdo (especially in elderly, hepatic/renal dysfunction, hypothyroid, diabetes)

172
Q

Statins + fibrates are the bad because

A

Increases risk for myopathy

173
Q

Statins are contraindicated in

A

pregnancy/nursing women

174
Q

Ezetimibe/Zetia

A

inhibits intestinal transport protein for cholesterol (billiary and dietary cholesterol)

Unit 4: Pharm (1 decks)

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