Part 2 Pharm 1-Liners Flashcards
1
Q
Treatment of withdrawal syndrome involves
A
Long-acting sedative-hypnotic or a gradual reduction of dose; clonidine or propranolol
2
Q
These agents are CNS depressants
A
Ethanol; Barbiturates; and Benzodiazepines
3
Q
Withdrawal from this drug causes lethargy; irritability; and headache
A
Caffeine
4
Q
W/D from this drug causes anxiety and mental discomfort
A
Nicotine
5
Q
Treatments available for nicotine addiction
A
Patches; gum; nasal spray; psychotherapy; and bupropion
6
Q
Chronic high dose abuse of nicotine leads to
A
Psychotic state; overdose causes agitation; restlessness; tachycardia; hyperthermia; hyperreflexia; and seizures
7
Q
Tolerance is marked and abstinence syndrome occurs
A
Amphetamines
8
Q
Amphetamine agents
A
Dextroamphetamines and methamphetamine
9
Q
These agents are congeners of Amphetamine
A
DOM; STP; MDA; and MDMA “ecstasy”
10
Q
Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias; seizures; respiratory depression; or severe HTN (MI and stroke)
A
Cocaine “super-speed”
11
Q
Most dangerous of the currently popular hallucinogenic drugs; OD leads to nystagmus; marked hypertension; and seizures; presence of both horizontal and vertical nystagmus is pathognomonic
A
PCP
12
Q
Removal of PCP may be aided
A
Urinary acidification and activated charcoal or continual nasogastric suction
13
Q
THC is active ingredient; SE’s include impairment of judgment; and reflexes; decreases in blood pressure and psychomotor performance occur
A
Marijuana
14
Q
This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention
A
Bethanechol
15
Q
Muscarinic that is very lipid soluble and used in glaucoma
A
Pilocarpine
16
Q
Muscarinic used to treat dry mouth in Sjrogren’s syndrome
A
Pilocarpine or Cevimeline
17
Q
Indirect-Acting ACh Agonist; alcohol; short DOA and used in diagnosis of myasthenia gravis
A
Edrophonium
18
Q
Carbamate with intermediate action and used as off-label for postoperative paralytic ileus and urinary retention
A
Neostigmine
19
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
20
Q
Treatment of myasthenia gravis and sometimes used prophylactically for organophosphate poisoning in chemical warfare
A
Pyridostigmine
21
Q
Antiglaucoma organophosphate; indicated but not used much clinically anymore due to long duration of action
A
Echothiophate
22
Q
Insecticide organophosphate
A
Malathion; parathion
23
Q
Toxicity of cholinergics
A
DUMBELSS (diarrhea; urination; miosis; bronchoconstriction; excitation of skeletal muscle and CNS; lacrimation; salivation; and sweating)
24
Q
The most important cause of acute deaths in cholinesterase inhibitor toxicity
A
Respiratory failure
25
Treatment of muscarinic symptoms in organophosphate overdose
Atropine
26
This agent competes for phosphorylated cholinesterase enzyme and regenerates enzyme if organophosphate-enzymes complex has not "aged"
Pralidoxime
27
Prototypical drug is atropine
Nonselective Muscarinic Antagonists
28
Treat manifestations of Parkinson's disease and EPS
Benztropine; trihexyphenidyl
29
Treatment of motion sickness
Scopolamine
30
Produce mydriasis and cycloplegia
Atropine and other anti-muscarinic agents
31
Bronchodilation in asthma and COPD
Ipratropium; tiotropium
32
Reduce transient hyper GI motility
Dicyclomine; methscopolamine
33
Cystitis; postoperative bladder spasms; or incontinence
Oxybutynin; dicyclomine
34
Toxicity of anticholinergics
Anti-DUMBBELSS
35
Another pneumonic for anticholinergic toxicity
"dry as a bone; red as a beet; mad as a hatter; hot as a hare; blind as a bat"
36
Atropine fever is the most dangerous effect and can be lethal in this population group
Infants
37
Contraindications to use of atropine
Infants; closed angle glaucoma; prostatic hypertrophy
38
Ganglion blockers that were indicated (but not anymore) for severe hypertension
Hexamethonium; trimethaphan
39
Reversal of blockade by neuromuscular blockers
Cholinesterase inhibitors
40
Tubocurarine is the prototype; pancuronium; atracurium; vecuronium are newer short acting agent; produce competitive block at end plate nicotinic receptor; causing flaccid paralysis
Nondepolarizing Neuromuscular Blockers
41
Only member of depolarizing neuromuscular blocker; causes fasciculation during induction and muscle pain after use
Succinylcholine
42
Pneumonic for beta receptors
You have 1 heart (Beta 1) and 2 lungs (Beta 2)
43
This is the drug of choice for anaphylactic shock
Epinephrine
44
Phenylisopropylamines that are used legitimately and abused for narcolepsy; attention deficit disorder; and weight reduction
Amphetamines
45
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy; it does not cause cycloplegia
Phenylephrine
46
Epinephrine and dipivefrin are used for
Glaucoma
47
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma
Reduce aqueous synthesis
48
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis
Albuterol
49
Longer acting Beta 2 agonists is recommended for prophylaxis of asthma
Salmeterol
50
These agents increase blood flow and may be beneficial in treatment of acute heart failure and some types of shock
Beta1 agonists
51
These agents decrease blood flow or increase blood pressure; are local decongestant; and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion)
Alpha1 agonists
52
Shock due to septicemia or myocardial infarction is made worse by
Increasing afterload and tissue perfusion declines
53
Often mixed with local anesthetic to
Reduce the loss from area of injection
54
Chronic orthostatic hypotension can be treated with
Midodrine
55
Beta 2 agonist used to suppress premature labor; but cardiac stimulatory effects may be hazardous to mother and fetus
Terbutaline
56
Long acting sympathomimetic; sometimes used to improve urinary continence in children and elderly with enuresis
Ephedrine
57
Alpha 1 agonist toxicity
Hypertension
58
Beta 1 agonist toxicity
Sinus tachycardia and serious arrhythmias
59
Beta 2 agonist toxicity
Skeletal muscle tremor
60
The selective agents lose their selectivity at
high doses
61
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
Phenoxybenzamine
62
Nonselective alpha-blocking drug; short acting and reversible; used for rebound HTN from rapid clonidine withdrawal; and Raynaud's phenomena
Phentolamine
63
Selective Alpha 1 blocker used for hypertension; BPH; may cause first dose orthostatic hypotension
Prazosin; terazosin; doxazosin
64
Selective Alpha 2 blocker used for impotence (controversial effectiveness)
Yohimbine
65
Selective B1 Receptor blockers that may be useful in treating cardiac conditions in patients with asthma
Acebutolol; atenolol; esmolol; metoprolol
66
Combined alpha and beta blocking agents that may have application in treatment of CHF
Labetalol and carvedilol
67
Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
Pindolol and acebutolol
68
This beta blocker lacks local anesthetic activity (decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma
Timolol
69
This parenteral beta blocker is a short acting
Esmolol
70
This beta blocker is the longest acting
Nadolol
71
These beta blockers are less lipid soluble
Acebutolol and atenolol
72
This beta blocker is highly lipid soluble and may account for side effects such as nightmares
Propranolol
73
Clinical uses of these agents include treatment of HTN; angina; arrhythmias; and chronic CHF
Beta blockers
74
Toxicity of these agents include bradycardia; AV blockade; exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia; tremor; and anxiety)
Beta blockers
75
Cholinomimetics that increase outflow; open trabecular meshwork; and cause ciliary muscle contraction
Pilocarpine; carbachol; physostigmine
76
Nonselective alpha agonists that decrease aqueous production and increase aqueous outflow
Epinephrine; dipivefrin
77
Selective alpha agonists that decreases aqueous secretion
Apraclonidine; brimonidine
78
These Beta blockers decrease aqueous secretion
Timolol (nonselective); betaxolol (selective)
79
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
Acetazolamide
80
This agent cause increased aqueous outflow
Prostaglandin PGF2a (latanoprost; travoprost; unoprostone)
81
Inhibit angiotensin-converting enzyme (ACE)
ACE inhibitors
82
Captopril and enalapril (-OPRIL ending) are
ACE inhibitors
83
SE of ACE inhibitors
Dry cough; hyperkalemia
84
ACE inhibitors are contraindicated in
pregnancy and with hyperkalemia
85
Losartan and valsartan block
AT1 receptors
86
Side effect associated with ACEI but not ARBs
Dry cough
87
Block L-type calcium channel
Calcium channel blockers
88
CCB with predominate effect on arteriole dilation
Nifedipine
89
SE of CCB
Constipation; edema; and headache
90
Reduce heart rate; contractility; and O2 demand
Beta-blockers
91
Cardioselective Beta 1-blockers
Atenolol; acebutolol; and metoprolol
92
Beta-blockers should be used cautiously in
Asthma (bronchospastic effects); diabetes (block signs of hypoglycemia) and peripheral vascular disease
93
Non-selective Beta-blocker also used for migraine prophylaxis
Propranolol
94
SE of beta blockers
Bradycardia; SEXUAL DYSFUNCTION; decrease in HDL; and increase in Triglycerols (TG)
95
Alpha 1selective blockers
Prazosin; terazosin and doxazosin (-AZOSIN ending)
96
Non-selective Alpha1blockers use to treat pheochromocytoma
Phenoxybenzamine
97
For rebound HTN from rapid clonidine withdrawal
Phentolamine
98
A1a-selective blocker used for BPH
Tamsulosin (Flomax)
99
SE of alpha blockers
Orthostatic hypotension (especially with first dose) and reflex tachycardia
100
Presynaptic Alpha 2 agonist used in HTN
Clonidine; and methyldopa
101
SE of methyldopa
Positive Comb's test; depression
102
Methyldopa is contraindicated in
Geriatrics due to its CNS (depression) effects
103
SE of clonidine
Rebound HTN; sedation; dry mouth
104
Direct vasodilator of arteriolar smooth muscle
Hydralazine
105
SE of hydralazine
Lupus-like syndrome
106
Arterial vasodilator that works by opening K+ channels
Minoxidil
107
SE of minoxidil
Hypertrichosis
108
IV Drug used Hypertensive Crisis
Nitroprusside
109
Nitroprusside vasodilates
Arteries and veins
110
Toxicity caused by nitroprusside and treatment
Cyanide toxicity treated with sodium thiosulfate
111
Carbonic anhydrase inhibitor
Acetazolamide
112
Diuretic used as prophylactic for mountain sickness and glaucoma
Acetazolamide
113
Side effects of acetazolamide
Paresthesias; alkalization of the urine (which may ppt; Ca salts); hypokalemia; metabolic acidosis; and encephalopathy in patients with hepatic impairment
114
Mechanism of action of loop diuretics
inhibits Na+/K+/2Cl- cotransporter
115
Diuretic used in hypertensive patients with renal failure
Loop diuretics (furosemide; ethacrynic acid; butmetanide)
116
Site of action of loop diuretics
Thick ascending limb
117
Side effects of loop (furosemide) diuretics
Hyperuricemia; hypokalemia; metabolic alkalosis and ototoxicity
118
Aminoglycosides used with loop diuretics potentiate this adverse effect
Ototoxicity
119
An electrolyte that is lost in the urine by acute treatment with loop diuretics but can be retained by thiazides
Calcium
120
Mechanism of action of thiazide diuretics
Inhibit Na+/Cl- cotransport
121
Diuretic used as first line for treatment of hypertension
Thiazides
122
Site of action of thiazide diuretics
Early distal convoluted tubule
123
Class of drugs that may cause cross-sensitivity with thiazide diuretics
Sulfonamides
124
Side effects of thiazide (HCTZ) diuretics
Hyperuricemia; hypokalemia; metabolic alkalosis; hyperlipidemia; and hyperglycemia
125
Mechanism of action of amiloride
Inhibit epithelial sodium channels in the distal convoluted tubules and collecting duct
126
Mechanism of action of spironolactone
Inhibit mineralocorticoid receptor and inhibit Na/K-ATPase and ENaC synthesis
127
Diuretic used to treat primary aldosteronism
Spironolactone; eplerenone
128
Side effect of spironolactone
Gynecomastia hyperkalemia; and impotence
129
Diuretic used to reduce intracranial pressure
Mannitol
130
ADH agonist used for central diabetes insipidus
Desmopressin (DDAVP)
131
Agents used for SIADH
Tolvaptan and conivaptan
132
An early generation tetracyclin that may be used for chronic persistant SIADH
demeclocycline
133
Side effect of demeclocycline
Bone marrow and teeth discoloration for children under 8 years of age
134
MOA of class I A (eg; Procainamide); class IB (eg; Lidocaine); and class IC (eg; Flecainide) antiarrhythmics
Sodium channel blockers
135
SE of procainamide
Lupus-like syndrome
136
Limiting side effect of Quinidine
Prolongs QT interval
137
Other side effects of Quinidine
Thrombocytopenic purpura; and CINCHONISM
138
Major drug interaction with Quinidine
Increases concentration of Digoxin
139
DOC for management of acute Ventricular arrhythmias
Lidocaine
140
DOC for digoxin induced arrhythmias
Phenytoin
141
SE of phenytoin
Gingival hyperplasia
142
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial); therefore are used as last line agents
Class IC (flecainide; propafenone; moricizine)
143
Class II antiarrhythmics are
B-blockers
144
Antiarrhythmic that exhibits Class II and III properties
Sotalol
145
Side effect of sotalol
prolongs QT and PR interval
146
Used intravenously for acute arrhythmias during surgery
Esmolol
147
Anti-arrhythmics that decrease mortality
B-blockers
148
MOA of class III antiarrhythmics
Potassium channel blockers
149
Class III antiarrhythmic that exhibits properties of all 4 classes
Amiodarone
150
Specific pharmacokinetic characteristic of amiodarone
Prolonged half-life; up to six weeks
151
Antiarrhythmic effective in most types of arrhythmia
Amiodarone
152
SE of Amiodarone
Thyroid dysfunction; photosensitivity; skin (blue smurf syndrome); corneal deposits; liver damage and pulmonary fibrosis
153
MOA of class IV antiarrhythmics
Calcium channel blockers
154
Life threatening cardiac event that prolong QT leads to
Torsades de pointes
155
Agent to treat torsades de pointes
Magnesium sulfate
156
Drug used supraventricular arrhythmias
Digoxin
157
DOC for paroxysmal supraventricular tachycardia (PSVT)
Adenosine
158
Adenosine's MOA
Activates acetylcholine sensitive K+ channels in SA and AV node
159
Anti-arrhythmic with <10 second duration of action
Adenosine
160
MOA of sildenafil (Viagra)
Inhibits phosphodiesterase-5; enhancing effects of nitric oxide-activated increases in cGMP
161
Drugs used in the management of angina
Aspirin; Nitrates; CCB; and Beta blockers
162
Aspirin reduces mortality in unstable angina by
Platelet aggregation inhibition
163
MOA of nitrates
Relax vascular smooth muscle; at low doses dilate veins and at high doses dilate arterioles
164
Nitrate used for acute anginal attacks
Nitroglycerin sublingual tablets
165
Nitrate used to prevent further attacks
Oral and transdermal forms of nitroglycerin
166
Nitrate free intervals are needed due to
Tolerance
167
SE of nitrates
Postural hypotension; reflex tachycardia; hot flashes; and throbbing headache due to meningeal artery dilation
168
CCB are DOC for
Prinzmetal's angina
169
Beta blockers are used for which type of anginal attack
Classic
170
MOA of Cardiac glycosides (eg; digoxin)
Indirectly increase intracellular calcium and cardiac contractility by inhibit Na+/K+ ATPase
171
Digoxin is used in
Atrial fibrillation and CHF
172
Digoxin toxicity can be precipitated by
Hypokalemia
173
Antidote for digoxin toxicity
Digibind
174
Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects
Amrinone and milrinone
175
SE of amrinone
Thrombocytopenia
176
Beta 1 agonists used in acute CHF
Dobutamine and dopamine
177
Diuretics work in CHF by
Reducing preload
178
Beta blockers work in CHF by
Reducing progression of heart failure (never use in acute heart failure)
179
Agent used in CHF that is a selective alpha and nonselective beta blocker
Carvedilol
180
Agent used in acutely decompensated CHF resembling natriuretic peptide
Nesiritide (Natrecor)
181
Vitamin K dependent anticoagulant
Warfarin (PT)
182
Warfarin is contraindicated in
Pregnancy
183
Anticoagulant of choice in pregnancy
Heparin
184
Heparin (PTT) increases activity of
Antithrombin 3
185
Route of administration of warfarin
Oral
186
Routes of administration of heparin
IV and subQ
187
SE of both warfarin and heparin
Bleeding
188
SE of heparin
Heparin induced thrombocytopenia (HIT)
189
Alternative anticoagulant used if HIT develops
Lepirudin
190
Antidote to reverse actions of warfarin
Vitamin K or fresh frozen plasma
191
MOA of aspirin
Irreversibly blocks COX1 and COX2
192
Agent used to treat MI and to reduce incidence of subsequent MI
Aspirin
193
SE of Aspirin
GI bleeding
194
Antiplatelet drug reserved for patients allergic to aspirin
Ticlopidine
195
SE for ticlopidine
Neutropenia and agranulocytosis
196
Effective in preventing TIA's
Clopidogrel and ticlopidine
197
Prevents thrombosis in patients with artificial heart valve
Dipyridamole
198
Block glycoprotein IIb/IIIa involved in platelet cross-linking
Abciximab; tirofiban and eptifibatide
199
MOA of thrombolytics
Lyse thrombi by catalyzing the formation of plasmin which binds fibrin
200
Thrombolytics are used for
Pulmonary embolism and DVT
201
Thrombolytic that can cause allergic reaction
Streptokinase
202
Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA
Tissue plasmin activator
203
SE of tPA
Cerebral hemorrhage
204
Antidote for thrombolytics
Aminocaproic acid
205
Agent to treat hypochromic microcytic anemias
Ferrous sulfate
206
Chelating agent used in acute iron toxicity
Deferoxamine
207
Agent for pernicious anemia
Cyanocobalamin (Vit B12)
208
Agent used for neurological deficits in megaloblastic anemia
Vitamin B12
209
Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy
Folic acid
210
Agent used for anemias associated with renal failure
Erythropoietin
211
Agent used neutropenia especially after chemotherapy
G-CSF (filgrastim) and GM-CSF (sargramostim)
212
Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy
Interleukin 11 (oprelvekin)
213
Decrease intestinal absorption of cholesterol
Bile acid-binding resins
214
Cholestyramine and colestipol are
Bile acid-binding resins
215
Major nutritional side effect of bile acid-binding resins
Impair absorption of fat soluble vitamin absorption (A;D;E;K)
216
MOA of lovastatin (STATIN)
inhibits HMG COA reductase
217
HMG CoA reductase inhibitors are contraindicated in
Pregnancy
218
How drug or foods (grapefruit juice) increase statin effect
Inhibit Cytochrome P450 3A4
219
SE of HMG COA reductase inhibitors
Rhabdomyolysis and Hepatotoxicity
220
Monitoring parameter to obtain before initiation of STATINS
LFT's
221
Decreases liver triglycerol synthesis
Niacin
222
SE of niacin
Cutaneous flush
223
Cutaneous flush due to niacin can be reduced by pretreatment with
Aspirin
224
Fibrates (gemfibrozil) increase activity of
Lipoprotein lipase
225
Most common SE of fibrates
Nausea
226
Fibrates are contraindicated in
Pregnancy
227
Concurrent use of fibrates and statins increases risk of
Rhabdomyolysis
228
Class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins
Ezetimibe (Zetia)
229
MOA of NSAIDS
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
230
Difference between aspirin and other NSAIDS
Aspirin irreversibly inhibits cyclooxygenase
231
Four main actions of NSAIDS
Anti-inflammatory; analgesia; antipyretic and antiplatelet activity
232
Agent used for closure of patent ductus arteriosus
Indomethacin
233
The reason why aspirin is contraindicated in children with viral infection
Potential for development of Reye's syndrome
234
SE of salicylates
Tinnitus; GI bleeding
235
NSAID available orally; IM; IV; nasally; and ophthalmically
Ketoralac
236
NSAID that is used for acute condition; such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
Ketoralac
237
Newer NSAIDs that selectively inhibit COX-2
Celecoxib
238
COX 2 inhibitors may have reduced risk of
Gastric ulcers and GI Bleeding
239
COX 2 inhibitors should be used cautiously in pts with
Pre-existing cardiac or renal disease
240
Acetaminophen only has what activity?
Antipyretic and analgesic activity
241
SE of acetaminophen
Hepatotoxicity
242
Antidote for acetaminophen toxicity
N-acetylcysteine
243
DMARDs are slow acting drugs for
Rheumatic disease
244
MOA of gold salts
Alter activity of macrophages and suppress phagocytic activity of PMNs
245
SE of gold salts
Dermatitis of the mouth aplastic anemia and agranulocytosis
246
Causes bone marrow suppression
Methotrexate
247
SE of penicillamine
Aplastic anemia and renal
248
Interferes with activity of T-lymphocytes
Hydroxychloroquine
249
Anti-malarial drug used in rheumatoid arthritis (RA)
Hydroxychloroquine
250
SE of hydroxychloroquine
Retinal destruction and dermatitis
251
MOA of Leflunomide (newer agent)
Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
252
Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
Infliximab and etanercept
253
Anti-rheumatic agent also used for ulcerative colitis
Sulfasalazine
254
NSAID used in gout
Indomethacin; ibuprofen
255
NSAID avoided in gout because low doses increases uric acid levels
Aspirin
256
MOA of Colchicine (used in acute gout)
Selective inhibitor of microtubule assembly
257
SE of colchicine
Kidney and liver toxicity; diarrhea; myelosuppression
258
Agent used to treat chronic gout by increasing uric acid excretion through inhibition of URAT1 anion transporter
Probenecid
259
Agent that inhibits xanthine oxidases and used to treat chronic gout
Allopurinol; febuxostat
260
Recombinant uricases that enhance uric acid metabolism
rasburicase; pegloticase
