Pharm 1 Flashcards
What is Varenicline used for and how does it work?
It is a partial agonist for nicotinic ACh receptors and assists pts with cessation of tobacco use by reducing withdrawal cravings and attenuating reward effects of nicotine
What is topiramate used for?
It is an anticonvulsant used to treat epilepsy in children and adults and it is an effective med for migraine prophylaxis
MOA of Caspofungin and other echinocandin antifungals
block 1,3-beta-D-glucan synthesis in fungal cell wall
-most active against Candida and Aspergillus
MOA of Amphotericin B
polyene antifungal that binds ergosteral in the fungal cell membrane and leads to pore formation and cell lysis
MOA of itraconAZOLE
azoles are antifungals that inhibit ergosterol synthesis
MOA of Terbinafine
inhibits the fungal enzyme squalene-2,3-epoxidase which results in decreased synthesis of ergosterol
-this accumulates in skin and nails and is used to treat dermatophytosis
MOA of Griseofulvin
binds microtubules and inhibits mitosis
-effective only against dermatophyte fungi and accumulates in keratin containing tissue
MOA of Flucytosine
inhibits synthesis of DNA and RNA in fungal cells
-synergistic with amphotericin B in Tx of cyrptococcal meningitis
What kind of antiarrhythmic is Dofetilide?
Class 3 antiarrhythmic that blocks K+ efflux from cardiac myocyte and prolongs phase 3 of the myocyte AP
What is the most common cause of macrovesicular fatty change?
chronic ethanol consumption
What is a common cause of microvasicular fatty change in children?
Reye syndrome
What is a major side effect of halogenatied inhalation anesthetics and which drug is the most common cause?
Halogenated inhalation anesthetics can cause massive hepatic necrosis d/t direct liver injury and autoantibodies against liver
-halothane is the most common
What drugs are structural analogs of D-Ala-D-Ala that inhibit transpeptidase?
Penicillins
What is the term when when a drug needs to be given at a larger dose to achieve the same clinical effect previously achieved with a smaller dose?
Tolerance
What is the AE of using nitrates with PDE inhibitors?
They both increase intracellular cGMP which causes vascular smooth muscle relaxation and hypotension
What occurs with stimulation of a1 adrenoreceptors?
vasoconstriction in skin and viscera resulting in increased SBP and DBP with decreased renal and hepatic blood flow
Side effects of this antiarrhythmic include thyroid dysfunction, lung fibrosis, liver toxicity, and blue/grey discoloration of skin
amiodarone
Side effects of this antiarrhythmic include nonfocal neurologic signs such as tremor, drowsiness, change in mental status, and generalized seizure
lidocaine
Side effect of this antiarrhythmic include negative inotropy, constipation, and gingival hyperplasia
verapamil
This drug is used as a vasodilator in chemical cardiac stress tests and as a fast acting antiarrhythmic for stopping acute supraventricular tachycardias
Amiodarone
If a pt has lupus-like Sx (erythematous rash on face and trunk, joint pain, photosensitivity) and + ANA and anti-histone, what are the common drug-induced lupus associations?
HIPP hydralazine isoniazid procainamide phenytoin
How does Ezetimibe decrease serum LDL?
decrease intestinal absorption of dietary cholesterol
What is the antidote for tissue necrosis d/t NE infusion through an IV site?
local injection of an alpha1 blocker like phentolamine
What is an example of a poorly soluble gas anesthetic and what are its effects?
N2O
- small amount needed to saturate blood
- low blood/gas partition coefficient
- rapid rise in partial pressure in blood
- rapid equlilbration with brain
- rapid onset
What is an example of a highly soluble gas anesthetic and what are its effects?
halothane
- large amount needed to saturate blood
- high blood/gas partition coefficient
- slow rise in partial pressure in blood
- slow equilibration with brain
- slow onset
What are the properties of drugs with high blood/gas partition coefficients?
more soluble in blood, slower equilibration with brain, longer onset time
What are the properties of drugs wtih low blood/gas parititient coefficients?
less soluble in blood, faster equilibration with brain, shorter onset time
What antidepressant class is particularly useful in pts with atypical depression and treatment-resistant depression?
monoamine oxidase - phenelzine and tranylcypromine
What are the characteristics of atypical depression?
mood reactivity
leaden fatigue (arms and legs feel heavy)
rejection sensitivity
increased sleep and appetite
What is the main characteristic of atypical depression that distinguishes it from major depression?
mood reactivity
-atypical depression pts will improve mood in response to something psotive, typical major depression pts will not have a change in mood
What is the MOA of sucralafate?
It binds to the base of gastric mucosal ulcers and provides physical protection against acid
What is the MOA of bethanecol?
it is a cholinomimetic muscarinic agonist that treats urinary retention and ileus
What class of drugs block the final common pathway of gastric acid secretion of parietal cells that is stimulated by ACh, histamine, and gastrin?
PPIs
What is the MOA of cimetidine?
blocks the gastric parietal cell histamine H2 receptor