Pharm Flashcards
1
Q
Precursor of 6-mercaptopurine
A
Azathioprine
2
Q
Antibody that binds CD3 on T cells
A
Muromonab
3
Q
Antibody that binds IL-2 receptor on activated T cells
A
Daclizumab
4
Q
Inhibits inosine monophosphate dehydrogenase
A
Mycophenolate mofetil
5
Q
Inhibits calcineurin–>loss of IL-2 production–> blockage of T cell differentiation and activation
A
Cyclosporine
6
Q
Metabolized by Xanthine Oxidase, therefore allopurinol increases its toxicity
A
Azathioprine
7
Q
What are the main actions of Captopril?
A
ACE inhibitor
- decrease Angiotensin II
- lower GFR by preventing constriction of efferent arterioles
- Prevents inactivation of bradykinin (vasodilator)
8
Q
What are the main AE of ACE inhibition?
A
“Captopril’s CATCHH”
- Cough (due to increased bradykinin)
- Angioedema (contra in C1 esterase inhibitor deficient pts)
- Teratogen
- Creatinine increase (due to decreased GFR)
- Hyperkalemia
- Hypotension
9
Q
Why is Captopril contraindicated in pts with bilateral renal artery stenosis?
A
ACE inhibitors will further decrease GFR, leading to renal failure
10
Q
What antibiotics are safe in pregnancy?
A
Penicillins and aminopenicillins Piperacillin Cephalosporins Macrolides (erythromycin, azithromycin) Metronidazole Nitrofurantoin
11
Q
What are the two low potency typical antipsychotics?
A
Chlorpromazine, Thioridazine
12
Q
What is the typical AE of the low potency typical antipsychotics?
A
Anticholinergic AE
13
Q
What are the typical AE of high potency typical antipsychotics?
A
EPS, Tardive dyskinesia, NMS
14
Q
Name 5 high potency typical antipsychotics
A
Haloperidol Fluphenazine Loxapine Thiothixene Trifluoperazine
15
Q
Drug class: Loxapine
A
high potency typical antipsychotic
16
Q
Drug class: Haloperidol
A
high potency typical antipsychotics
17
Q
Drug class: Fluphenazine
A
high potency typical antipsychotics
18
Q
Drug class: Chlorpromazine
A
Low potency typical antipsychotics
19
Q
Drug class: Thioridazine
A
Low potency typical antipsychotic
20
Q
Drug class: Thiothixene
A
high potency typical antipsychotics
21
Q
Drug class: Trifluoperazine
A
high potency typical antipsychotics
22
Q
Are the (+) or (-) symptoms of schizophrenia easier to treat?
A
Positive symptoms are easier to treat
23
Q
Name 5 Atypical antipsychotics
A
Clozapine Olanzapine Quetiapine Risperidone Aripiprazole
24
Q
How do the adverse affects of the atypical antipsychotics differ from the typical antipsychotics?
A
Fewer EPS, LEss anticholinergic AE (atypicals used preferentially over the typicals!)
-WEIGHT GAIN
25
Drug class: Clozapine
Atypical antipsychotic
26
Drug class: Olanzapine
Atypical antipsychotic
27
Drug class: Quetiapine
Atypical antipsychotic
28
Drug class: Risperidone
Atypical antipsychotic
29
Drug class: Aripiprazole
Atypical antipsychotic
30
Which class of antipsychotics work better on the negative symptoms of schizophrenia?
Atypicals. Atypicals still have greater effect on the positive symptoms however
31
What are the three drugs used for treating Tourette syndrome???
Fluphenazine (High potency typical antipsychotic)
Pimozide (High potency typical antipsychotic)
Tetrabenazine (degrades DA)
32
What affect does DA have on prolactin release? What affect would this have on a patient taking an antipsychotic drug?
DA inhibits prolactin release
| D2 receptors antagonists can lead to amennorhea or galactorrhea (due to increased prolactin secretion)
33
What receptors do low potency neuroleptics have effect on?
Block D2 DA receptors
Block Muscarinic receptors
Block alpha 1 receptors --> hypotension
Block histamine receptors --> sedation
34
What are the symptoms of Neuroleptic malignant syndrome?
Muscle rigidity-->Hyperpyrexia-->Myoglobinuria-->Delirium-->ANS instability
35
How do we treat NMS?
Dantrolene, Bromocriptine (DA agonist)
36
What receptors do the atypical antipsychotics have effect on?
Block DA receptors
Block serotonin receptors
Block alpha receptors (hypotension)
Block Histamine receptors (Weight gain, sedation)
37
What disorders are Atypical antipsychotics used to treat?
Mania disorders
Bipolar disorder
Refractory depression
Anxiety disorders
38
Which atypical antipsychotic has the highest risk of Weight gain (and diabetes as a result)?
Olanzapine
39
What is the strongest atypical antipsychotic?
Clozapine
40
WHAT AE DO YOU HAVE TO KNOW ABOUT CLOZAPINE
Agranulocytosis
41
What antipsychotic call for weekly monitoring of the CBC?
Clozapine (checking for agranulocytosis)
42
What atypical antipsychotic is used to treat psychosis from Parkinson meds?
Quetiapine (lowest risk of EPS)
43
Which drug used to treat bipolar disorder can concurrently be used to treat SIADH?
Lithium
-Causes nephrogenic diabetes insipidus by blocking the integration of aquaporins into the membrane after stimulation by ADH
44
What teratogenic effect is caused by lithium?
Ebstein anomaly
- Tricuspid leaflets displaced inferiorly into right ventricle
- Hypoplasia of right ventricle
- Tricuspid regurge or stenosis
- Patent foramen ovale
45
What is the MC side effect of taking lithium?
Tremor
46
What mood stabilizers are used in the tx of bipolar disorder?
Lithium
Atypical antipsychotics
-Risperidone, aripiprazole, Olanzapine
Seizure medications
-Lamotrigine, valproic acid, carbamazepine
47
What are the potential AE of lithium?
```
Teratogenic
Polyuria (nephrogenic diabetes insipidus)
Arrhythmias
Hypothyroidism
Tremor, sedation, lethargy, dizziness
```
48
Name 4 SSRIs
Citalopram
Sertraline
Paroxetine
Fluoxetine
49
What are the two SNRIs?
Venlafaxine
| Duloxetine
50
Name 7 TCAs
```
"triptylines, ipramines, doxepin, duloxetine"
Amitriptyline
Nortriptyline
Imipramine
Desipramine
Clomipramine
Doxepin
Amoxapine
```
51
What is Imipramine classically used for?
TCA used for bedwetting (enuresis)
52
Which TCA can be used for Fibromyalgia and Neuropathic pain?
Amitriptyline
53
What are the notable AE of TCA overdose?
```
"Tri-C's"
Convulsion
Coma
Cardiotoxicity
-also respiratory depression, Hyperpyrexia, confusion, hallucination
```
54
How to treat cardiotoxicity caused by TCAs?
Sodium Bicarb (alkalinize the urine, TCAs are weak acids)
55
What are the MAO inhibitors?
```
"MAOI Takes Pride In Shanghai"
Phenelzine
Tranylcypromine
Isocarboxazid
Selegiline
```
56
Is Selegiline used as an antidepressant?
No, Selegiline is an MAO-B inhibitor used to treat Parkinsonism. MAO-B selectively breaks down DA, so inhibiting it is helpful for Parkinson pts
57
A pt stops taking their SSRI bc of lack of libido. What is a good alternative antidepressant this patient could take?
Bupropion (no sexual side effects)
- Atypical antidepressant
- NDRI (NE, DA reuptake inhibitor)
58
What are the Atypical Antidepressants?
Bupropion
Mirtazepine
Trazodone
59
What are the indications for Bupropion?
Atypical antidepressant used for both smoking cessation and depression
60
What is the MOA for Bupropion?
NDRI=> NE, DA reuptake inhibitor
61
Drug class: Mirtazepine
Atypical antidepressant
62
Drug class: Bupropion
Atypical antidepressant
63
Drug class: Trazodone
Atypical antidepressant
64
What is the MOA of Mirtazepine?
Alpha-2 receptor antagonist (allows for increased NE and 5-HT)
- recall the alpha2 receptor is located on the presynaptic terminal and has an inhibitory effect on NT release
- Mirtazepine also antagonizes 5-HT receptors
65
WHat is the MOA of Trazodone?
Blocks 5-HT and alpha1 adrenergic receptors
66
What is Trazodone typically used for?
Treatment of insomnia (high levels are required for any antidepressant effects, so not used as an antidepressant often)
67
What is the primary AE effect of Trazodone?
Priapism (trazoBONE)
68
Why is bupropion contraindicated in an epileptic patient?
Lowers the seizure threshold
69
Drug class: Nortriptyline
TCA
70
Drug class: Selegiline
MAOI
71
Drug class: Bupropion
Atypical antidepressant, NDRI
72
Drug class: Mirtazepine
Atypical antidepressant, alpha2 antagonist
73
Drug class: fluvoxamine
SSRI
74
Drug class: doxepin
TCA
75
Drug class: Phenelzine
MOAI
76
Drug class: Fluoxetine
SSRI
77
Drug class: Clomipramine
TCA
78
Drug class: Imipramine
TCA
79
Drug class: Amitriptyline
TCA
80
Drug class: Milnacipran
SNRI
81
Drug class: Desipramine
TCA
82
Drug class: Sertraline
SSRI
83
Drug class: Venlafaxine
SNRI
84
Drug class: Paroxetine
SSRI
85
Drug class: Tranylcypromine
MAOI
86
Drug class: Duloxetine
SNRI
87
Drug class: Citalopram
SSRI
88
Drug class: Desvenlafaxine
SNRI
89
Drug class: Trazodone
Atypical antidepressant, alpha1 blocker and 5-HT blocker
90
Works well with SSRIs and increases REM sleep
Trazodone
91
Appetite stimulant that's likely to result in weight gain (Atypical antidepressant)
Mirtazepine
92
Can be used for bed wetting in children
Imipramine
93
Symptoms of serotonin syndrome?
Muscle rigidity
Hyperthermia
Cardiovascular collapse
94
What happens if you ingest Tyramine while on MAOIs?
Hypertensive crisis, Hypertensive stroke, Cardiac arrhythmias.
-MAO normally metabolizes tyramine. Tyramine in excess will be converted to NE, which raises bp
95
What drug is associated with dry mouth, blurred vision, tinnitus, mania
Amitriptyline (anticholinergic AE)
96
For what condition is Buspirone indicated?
Generalized anxiety disorder
