PHARM 2 Flashcards
MOA of adenosine
Gs protein mechanism, decreases AV and SA node action
MOA of digoxin
inhibit Na/K/ATPase (improves contractility)
increases parasympathetic tone (vagus)
ade: yellow halos vision, ventricular arrhythmias, gynecomastia, n/v/diarrhea
what drug moa is selective If channel inhibitor (funny channel of SA node)
Ivabradine
what does metronidazole cover? “GET GAP on the METRO”
Giardia
Entamoeba
Trichomonas
Gardnerella
Anaerobes (clost, actinomycetes)
H. PYLORI
what 2 classes of drugs affect GABA A receptor?
- Barbituates: INC DURATION of Cl channel opening
- Benzos: INC FREQUENCY of Cl channel opening
what drug affects GABA B receptor?
Baclofen:
*G inhibitory mechanism= reduce aden. cyclase and cyclic amp
*I inhibition of excitatory NT release= glutamate and aspartate
what 3 anti neoplastic drugs cause peripheral neuropathy
- Platin drugs (carboplatin, cisplatin)- these also cause acoustic nerve damage
- Vincristine- also causes alopecia
- Paclitaxel- also causes alopecia
what anti neoplastic drug causes pulmonary fibrosis
Bleomycin/busulfan
what anti neoplastic drug causes hemorrhagic cystitis/ increases risk of bladder cancer
cyclophosphamide (DNA cross linkage)
paclitaxel, vinBLASTine, 5FU, mercaptopurine, methotrexate, etoposide, irinotecan/topecan all cause what (antineoplastic drugs)
myelosuppression
MOA of aramotase inhibitors (anastrozole and Letrozole) that treat ER+ breast cancer
inhibit peripheral conversion of androgens –> estrogen
(ade: osteoporosis)
MOA of Tamoxifen in treating ER+ breast cancer
selective estrogen receptor modulator (SERM)
-estrogen receptor antagonist in breast
-estrogen receptor agonist in bone/endometrium
ade: DVT, pulmonary embolism, endometrial hyperplasia/endometrial cancer
MOA of trastuzumab in treating HER2+ breast cancer
monoclonal antibody against HER2 (tyrosine kinase receptor)
ADE: dilated cardiomyopathy
what chemo drug targets CD20 and has ADE of PML in patients with JC virus
Rituximab
What chemo drug inhibits phospholipase A2 and NF -kB? ADE: cushing syndrome
Prednisone
phenylephrine is what
alpha 1 agonist (Gq)
prazosin (tx HTN and BPH)
doxazosin
terazosin
Tamsulosin (tx BPH)
(treat urinary retention)
are what?
alpha 1 BLOCKERS
**take at bed time, can cause orthostatic hypotension
Clonidine= ade: rebound hypertensive crisis
Methyldopa
Brimonidine
are what?
Alpha 2 agonists (Gi)
-Mirtazapine (depression)
-phenoxybenzamine (irreversible, tx pheochromocytoma)
-phentolamine (reversible, tx HTN)
are what?
Alpha 2 BLOCKERS
albuterol (short acting)
terbutaline (short acting)
salmeterol (long acting)
Beta 2 agonists **bronchodilation, uterine relax
Moa of ACE inhibitors (lisinopril)
inhibit ace–> dec ang II–> dec aldosterone–> dec sodium
in CD
what is a direct renin inhibitor
aliskiren
what anti seizure med treats focal seizures and has ADE of decreasing leukocytes? (agranulocytosis)
Carbamazapine
MOA: block voltage gated Na channels in a voltage dependent fashion
acute variceal hemorrhaging: hematemesis (blood in vomit)
cirrhosis/Portal HTN: jaundice, scleral icterus, ascites, splenomegaly
how to treat??
Octreotide (long acting somatostatin analog) prior to endoscopy
**can also treat acromegaly, carcinoid tumors, gastrinoma, glucagonoma, VIPoma
- Lithium- ADE: nephrogenic diabetes insidious, HYPOthyroidism, inc thirst, inc peeing
- Valproic acid (block Na channels to increase GABA) ADE: hepatotoxicity
- Lamotrigine (ade: rashes/SJS)
- Carbamazepine (ade: aplastic anemia, agranulocytosis-low leukocytes)
all treat what?
bipolar
what would treat hyperkalemia in EKG
beta AGONIST, calcium gluconate
**b blocker would worsen hyperkalemia
MOA impair synthesis of LDL due to inhibitory effects on HMG COA reductase
statins
MOA: prevents intestinal absorption of cholesterol (decreases LDL)
ezetimibe
MOA: promotes activity of lipoprotein lipase, which hydralyzes fatty acids from VLDL, CLEARING VLDL and decreasing triglyceride levels
FIBRATES (gemfibrozil)
moa: increases calcium permeability
TX: schistoma
Hemolytic anemia, elevated liver enzymes, low platelets (HELLP) in pregnancy… what should you monitor for
severe pre eclampsia in preg pt
HYPERMAGNESIUM toxicity
MONITOR DEEP TENDON REFLEXES
PSC in UC.. drugs you take are cholestyramine (not absorbed in gut) and ursodeoxycholic acid.. what are the MOA of both and why are they taken 4-6 hours
(PSC is P-anca, ^ ALP, ^ direct conjugated billi)
Cholestyramine: bile acid binding resin
UDA: bile acid
TAKING THEM TOGETHER will decrease UDA absorption, and no change in cholestyramine so you take them 4-6 hours apart
- Fenoldopam (D1 receptor agonist- ^ cAMP, vasodilation) *especially pt w/ renal dz
- Hydralazine (^ cGMP, vasodilator of arteries- REBOUND TACHY *do not use in pt w tachy)
- Labetalol (nonselect a/b blocker- vasodilation)
- Nicardipine (block VG L type CC of smooth muscle- vasodilation)
- Nitroprusside (short acting, ^ cGMP via DIRECT RELEASE OF NO) ADE: cyanide toxicity
HYPERTENSIVE EMERGENCY MEDS
(mc used are nitroprusside, fenoldopam)
**systolic >180, or diastolic >110, evidence of end organ fail (papilledema)
preventing panic attacks (agoraphobia- scared of public places)
*sweating, choking sensation, chills
SSRI (paroxetine)
mood stabilizer used for bipolar, adjunct therapy for depression, can possibly decrease suicide risk
lithium carbonate
Pt with a sub therapeutic INR is potentially caused by
coadministration of CYP450 inducer
Pt with a SUPRAtherapeutic INR is potentially caused by
coadministration of CYP450 INHIBITOR
transposition of great arteries, MC cause of extreme cyanosis in babies, single loud S2 heart sound
TX?
PGE1 analog, Alprostadil
