Pharm Flashcards
Glaucoma drugs:
First-Line:
Prostaglandin analogues: Contra. Herpatic keratitis
○ Latanoprost (xalatan)
○ Bimatoprost
Beta-Blockers: Contra. COPD, Brachycardia
○ Timolol
○ Betaxolol
Second-Line:
A-2 Adrenergic Agonists: Contra. Children
○ Aprachlonidine
CAI: Contra. Sulfra allergy, renal faliure, metabolic acidosis
○ Acetazolamide (Diamox)
○ Brinzolamide
New agents:
Rho Kinase inhibitors
Medical management of AACG:
Acetazolamide 500mg IV
Timolol 0.5%
Aprachlonidine
Mannitol
Pilocarpine (late)
Prostaglandin analogues contra. > too slow as they work via uveoscleral
Pharmacology of nexium
Esomeprazole irreversibly inhibits H/K ATPase proton pump in gastric parietal cells, inhibiting acid production
Indicated for GERD
Pharmacology of tropicamide
Anticholinergic (muscarinic antagonist)
Binds M3 receptors > prevents Ach stimulation from sympathetic drive > Mydriasis (iris sphincter) and Cycloplegia (Ciliary muscle)
* Onset 30min, lasts 6h
* Increases IOP
Contra. ACG
Somac Pharmacology
Pantoprazole: Proton pump inhibitor (PPI)
○ Inhibits H/K ATPase proton pump in gastric parietal cells, inhibiting acid production
Indicated for GERD
Lipitor Pharmacology
Atorvastatin: HMG-CoA reductase inhibitor
Inhibition > decreased HMG-CoA conversion to mevalonate > decreased cholesterol synthesis > upregulation of LDL receptors > decreased LDL level
Pharmacology of Zocor and Olmetec
Zorcor (simvastatin): HMG-CoA reductase inhibitor, Decreases cholesterol
○ Inhibition > decreased HMG-CoA conversion to mevalonate > decreased cholesterol synthesis > upregulation of LDL receptors > decreased LDL levels
○ Contra. Ketoconazole
Olmesartan: Angiotensin 2 receptor blocker:
○ Selectivley blocks AT1 receptor for AT-2 > inhibited vasoconstriction, aldosterone secretion > Vasodilation and decreased BP
Contra. Renal faliure
Sumatriptan Pharmacology
5-HT1 receptor agonist
○ Activation > BV constriction
Inhibition of pro-inflammatory peptides
Lexapro Pharmacology
Escitalopram: Selective Serotonin Reuptake Inhibitor (SSRI)
Inhibits 5-HT reuptake > ^ serotonin
Cartia Pharmacology
Diltiazem: Calcium Channel blocker
○ Inhibition on cardiac muscle > Dilated coronary vessels
○ Slows AV node conduction > reduced heart rate
Indicated for hypertension
Contra. Beta blockers
Diamox Pharmacology
Acetazolamide: Carbonic anhydrase inhibitor
○ Inhibition > reduced aqueous Humor
○ Renal inhibition > decreased Na+ and Bicarb reabsorbtion > diuresis > metabolic acidosis
○ Acidosis > decreased CSF
Dosage for glaucoma:
○ 250mg twice a day
500mg for AGC
Neurofen Pharmacology
Ibuprofen: Nonsteroidal Anti-Inflammatory Drug
COX-1/2 inhibition > reduced conversion of arachidonic acid to prostaglandins > decreased inflammation/fever/pain
Prednisolone acetate Pharmacology
Glucocorticoid
○ Cortisol mimicry > glucocorticoid receptor binding > inhibition of phospholipase A2 enzyme > reduced arachidonic acid > decreased inflammatory cytokines, prostaglandins
○ Stabilised vascular endothelium > reduced edema
Dosage: 1% drops
○ Uveitis: 6/d > Tapered 2 per week
○ Allergic: BID
Side effects:
○ ^IOP
○ Cataracts
○ Delayed wound healing
○ Immunosuppression
Contra. Active infection
Metformin Pharmacology
Biguanide
○ Insulin sensitization (primary) > increased glucose uptake
○ Inhibits glucogenesis > decreased blood glucose
Indicated T2DM
Atozet Pharmacology
Atorvastatin and Ezetimibe: Statin and Cholesterol absorbtion inhibitor
○ Inhibition > decreased HMG-CoA conversion to mevalonate > decreased cholesterol synthesis > upregulation of LDL receptors > decreased LDL level
○ Inhibits NPC1L1 transporter > decreased cholesterol absorbtion
Indicated hyperlipidemia
Micardis Pharmacology
Telmisartan: andiotensin 2 receptor blockers
○ Angiotensin 2 inhibition > Vasodilation
○ Decreased aldosterone > decreased BP
Indicated HT
Fenofibrate Pharmacology (evidence)
MOA:
○ Activates PPAR-a receptors > expression of genes for FFA oxidation
○ Decreases VLDLs and LDLs, increases HDLs
Indicated hyperlipidaemia, T2DM
Studies:
○ FIELD / ACCORD: No significant improvment for major cardiovascular events
○ FIELD: Reduced progression of early DR
Decreases oxidative stress and inflammation
Azithromycin pharm:
Macrolide bacteriostatic: inhibits bacterial protein synthesis
○ Binds 50S ribosomal subunit
○ Inhibits peptidyl transferase enzyme
Prevents protein synthesis
Latanoprost pharm:
Prostaglandin F2a analog:
○ Remodels ECM in ciliary muscle > ^Uveoscleral outflow
Side effects:
○ Iris/Lash/skin pigmentation
Contra:
○ Active inflammation
○ Pseudophakia > macular edema
Concurrent use with other prostaglandin analogues > IOP increase
Timolol pharm:
Non-selective B-blocker:
○ Inhibits B2 receptors in ciliary body > decreased aqueous production
Systemic effects:
○ Decreased heart rate, BP
○ Bronchoconstriction
Side effects:
○ Bradycardia, Hypotension
○ Bronchospasm
Contra:
○ Asthma, COPD
○ Heart failure
○ Hypotension
DM (masks hypoglycaemia)
Aprachlonidine pharm:
A-2 Adrenergic agonist
○ A2 simulation on CB > decreased aqueous humor secretion
○ Stimulation > increased uveoscleral outflow
Side-effects:
○ Tachyphylaxis
Allergic conjunctivitis
