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PBL Exam3 > Pharm > Flashcards

Pharm Flashcards

0
Q

Blocks ACh-H+ antiporter (STORAGE of ACh) into vesicles

A

Vesamicol

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1
Q

Prevents UPTAKE of CHOLINE for ACh synthesis

A

Hemicholinium-3

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2
Q

Degrades synaptobrevin (snap-25), thus preventing the vesicle fusion with presynaptic membrane/inhibiting RELEASE of ACh

A

Botulinum Toxin

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3
Q

Botulinum Toxin tx:

A

Dystonias, torticollis, achalasia, strabismus, blepharospasm, pain syndromes, wrinkles, hyperhidrosis

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4
Q

Agent used for diagnosis of MG, eaton-lambert, muscle weakness

A

Edrophonium

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5
Q

Agents used for urinary or G.I. motility, glaucoma, or NMJ diseases (I.e. MG)

A

Neostigmine, pyridostigmine, ambenonium

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6
Q

It’s nonpolar/lipophilic structure makes this agent the DOC for tx of CNS anticholinergic toxicity

A

Physostigmine

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7
Q

These inhibitors of ACh degradation are used to tx Alzheimer’s and Dementia

A

Tacrine, donepezil, rivastigmine (“pseudo irreversible”), galantamine

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8
Q

Agent used for diagnosis of asthma

A

Methacholine

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9
Q

Muscarinic receptor agonist for tx of glaucoma

A

Carbachol

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10
Q

Muscarinic receptor agonist as urinary tract motility agent

A

Bethanechol

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11
Q

Muscarinic receptor agonists used for Xerostomia in Sjögren’s syndrome

A

Cevimeline, pilocarpine

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12
Q

Nicotinic receptor agonist used for DEPOLARIZING nm blockade and intubation

A

Succinylcholine

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13
Q

Muscarinic receptor antagonist used for anticholinesterase overdose, acute bradycardia, mushroom poisoning antidote, mydriasis/opth exam,excessive salivation/mucus during surgery

A

Atropine

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14
Q

Muscarinic receptor antagonist for N&V and MOTION SICKNESS

A

Scopolamine

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15
Q

Muscarinic receptor antagonists used for PUD

A

Pirenzepine, methscopolamine, glycopyrrolate

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16
Q

Muscarinic receptor antagonist used to surgically/vagally induce bradycardia

A

Glycopyrrolate

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17
Q

Muscarinic receptor antagonists for COPD and asthma

A

Ipratropium and tiotropium

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18
Q

Muscarinic receptor antagonists used for hyperreflexic/overactive bladder and urge incontinence

A

Oxybutynin, propantheline, terodiline, tolterodine, fesoterodine, darifenacin, solifenacin, trospium

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19
Q

Nicotinic receptor antagonists for NONDEPOLARIZING nm blockade and intubation: long acting? Intermediate acting? Short acting?

A

Pancuronium, tubocurarine. Vecuronium, rocuronium. Mivacurium

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20
Q

These Nicotinic receptor antagonists tx HTN in pts with acute aortic dissection

A

Trimethaphan, mecamylamine

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21
Q

Tx of Pheochromocytoma-assoc. HTN by inhibiting tyrosine hydroxylase, thus inhibiting catecholamine synthesis

A

Alpha-Methyltyrosine

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22
Q

This agent inhibits catecholamine storage in vesicles by inhibiting VMAT. Used for HTN, common SE is psychotic depression.

A

Reserpine

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23
Q

These agents inhibit catecholamine storage by concentrating in vesicles and displacing NE. Used to tx HTN.

A

Guanethidine, guanadrel

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24
Q

Amphetamine and methylphenidate displace catecholamines from storage vesicles, inhibit MAO, and block catecholamine reuptake by NET and DAT. What are their clinical applications?

A

ADHD, narcolepsy (amphetamine only)

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25
Q

Inhibitor of catecholamine storage, for tx of allergic rhinitis and nasal congestion

A

Pseudoephedrine

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26
Q

Agent for local anesthesia and Dx of Horners syndrome pupil. Causes marked vasoconstriction and is cardiotoxic

A

Cocaine

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27
Q

Clinical applications of amitryptiline and imipramine?

A

OCD, depression, nocturnal enuresis (imipramine)

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28
Q

These MAO inhibitors block catecholamine degradation, tx Depression, and have common SE of tyramine toxicity

A

Phenelzine, iproniazid, tranylcypromine, clorgyline, selegiline, brofaromine, befloxatone, moclobemide

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29
Q

Alpha1 adrenergic antagonists increase what?

A

Peripheral vascular resistance, BP

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30
Q

Alpha1 agonist to tx hypotension and shock

A

Methoxamine

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31
Q

Phenylephrine, oxymetazoline, and tetrahydrozoline are alpha1 agonists that tx??

A

Ophthalmic hyperemia, nasal congestion, and hypotension(phenylephrine only)

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32
Q

Alpha2 adrenergic agonists inhibit what?

A

Inhibit sympathetic outflow from CNS, which decreases BP

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33
Q

DOC for tx of HTN during pregnancy

A

Methyldopa

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34
Q

Alpha2 agonist that txs opioid withdrawal and CA pain?

A

Clonidine

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35
Q

Alpha2 agonist that’s used for sedation of surgical/ICU pts

A

Dexmedetomidine

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36
Q

Common SE’s of methyldopa

A

Hepatotoxicity and hemolytic anemia

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37
Q

Alpha2 agonists that tx HTN

A

Clonidine, methyldopa, dexmedetomidine, guanabenz, guanfacine

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38
Q

These Beta-adrenergic agonists are BRONCHODILATORS used to tx COPD/asthma

A

Isoproterenol, dobutamine, metaproterenol, terbutaline, albuterol, salmeterol

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39
Q

Alpha ANTAGONISTS cause

A

Vasodilation, decreased BP and peripheral resistance

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40
Q

Alpha antagonists that tx Pheochromocytoma-assoc. HTN and sweating

A

Phenoxybenzamine, phentolamine

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41
Q

Alpha antagonists that tx HTN & BPH. SE is first dose orthostatic hypotension and reflex tachycardia.

A

Prazosin, terazosin, doxazosin

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42
Q

Alpha1A selective antagonist to tx BPH

A

Tamsulosin

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43
Q

Alpha2 selective antagonist to tx organic/psychogenic impotence

A

Yohimbine

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44
Q

Beta-adrenergic antagonists (BETA BLOCKERS) tx

A

HTN, angina, heart failure

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45
Q

Beta blocker with SE of sedation and decreased libido

A

Propranolol

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46
Q

Beta blocker to tx glaucoma

A

Timolol

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47
Q

Beta blocker that requires LFTs bc SE is hepatotoxicity

A

Labetalol

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48
Q

Beta blocker that is preferred in hypertensive pts who have bradycardia or decreased cardiac reserve

A

Pindolol

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49
Q

Beta blocker to tx thyroid storm

A

Esmolol

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50
Q

Nitrate txment of diffuse esophageal spasm

A

Isosorbide dinitrate

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51
Q

Nitrate for angina prophylaxis and chronic IHD. Not susceptible to first pass metabolism in liver. Less rebound angina SE.

A

Isosorbide 5-mononitrate

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52
Q

IV tx of unstable angina or acute heart failure

A

nitroglycerin

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53
Q

Avoid co-administration with phosphodiesterase V inhibitors (sildenafil, etc)

A

Nitrates

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54
Q

Nitrate for hypertensive emergencies, severe cardiac failure, and ergot alkaloid toxicity. SE’s are cyanide toxicity, methemoglobinemia, increase ICP, etc.

A

Sodium nitroprusside

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55
Q

Tx for neonatal respiratory failure, perinatal hypoxia, and pulmonary hypertension

A

Inhaled NO gas

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56
Q

Phosphodiesterase type V inhibitors cause an increase in what?

A

cGMP

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57
Q

PDE5 inhibitors for erectile dysfunction

A

Sildenafil (also tx pulmonary HTN), vardenafil, tadalafil (longer elimination half life)

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58
Q

CCB that tx exertional angina,unstable angina,coronary spasm, hypertension,hypertrophic cardiomyopathy, Reynauds phenomenon, pre-eclampsia

A

Nifedipine, amlodipine, felodipine, clevidipine

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59
Q

CCB that can cause a brisk fall in BP, triggering sever reflex tachycardia

A

Nifedipine

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60
Q

CCB administered IV for hypertensive urgency/emergency

A

Clevidipine

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61
Q

CCBs for tx of prinzmetal angina, chronic stable angina, HTN, atrial fibrillation or flutter, PSVT

A

Diltiazem, Verapamil

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62
Q

K+ channel openers for tx of severe/refractory HTN

A

Minoxidil, pinacidil, nicorandil, cromakalim

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63
Q

K+ channel opener for male pattern alopecia

A

Minoxidil

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64
Q

Endothelin receptor antagonists for sever pulmonary HTN. Must monitor LFTs. Pregnancy is contraindication.

A

Bosentan, ambrisentan

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65
Q

ET receptor with greater selectivity for ETa

A

Ambrisentan

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66
Q

Arteriolar vasodilator to tx severe HTN/heart failure. SE’s are agranulocytosis, hepatotoxicity, lupus like syndrome

A

Hydralazine

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67
Q

ACE inhibitors

A

Captopril, enalapril, lisinopril

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68
Q

ACE inhibitor SE’s??

A

Cough, angioedema, hyperkalemia

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69
Q

ACE Inhibitor administered as active drug and processed to active metabolite

A

Captopril

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70
Q

ACE inhibitor that’s an ester prodrug converted to active metabolite in plasma

A

Enalapril

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71
Q

ACE inhibitor administered as active drug and excreted unchanged

A

Lisinopril

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72
Q

AT1 receptor antagonists for tx of HTN, diabetic nephropathy, heart failure, MI, stroke

A

Losartan, valsartan

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73
Q

NA channel inhibitor for tx of status epilepticus, seizures related to eclampsia, arrhythmias

A

Phenytoin

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74
Q

NA channel inhibitor for tx of bipolar disorder, trigeminal neuralgia

A

Carbamezine

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75
Q

NA channel inhibitor for tx of bipolar disorder, atypical absence seizures

A

Lamotrigine

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76
Q

Adjunct therapy for focal seizures

A

Lacosamide

77
Q

CCI’s that inhibit the low threshold T-type calcium channels

A

Ethosuximide, valproic acid

78
Q

CCI’s at inhibit high voltage activated calcium channels

A

Gabapentin, pregabalin

79
Q

Absence seizure agents

A

Ethosuximide, valproic acid

80
Q

Valproic acid clinical applications and common SE’s ?

A

Tonic-clonic, absence, atypical absence, and focal seizures. Hepatotoxicity, pancreatitis, thrombocytopenia, hyperammonemia.

81
Q

Gabapentin clinical applications. Common SE?

A

Focal seizures, diabetic peripheral neuropathy, migraine prophylaxis. Stevens-Johnson syndrome

82
Q

Pregabalin clinical applications. Common SE?

A

Diabetic peripheral neuropathy, fibromyalgia, postherpetic neuralgia. Angioedema.

83
Q

Benzodiazepines for focal and tonic-clonic seizures??? Benzo for absence seizure??

A

Diazepam, lorazepam, midazolam. Clonazepam (“don’t clone me in my absence”).

84
Q

BenzodiaZEPAMs also tx?

A

Status epilepticus, anxiety, alcohol withdrawal

85
Q

Phenobarbital (barbiturate) clinical applications

A

Focal and tonic-clonic seizures, insomnia, preop sedation

86
Q

This agent inhibits GABA metabolism and txs focal epilepsy and infantile spasms

A

Vigabatrin

87
Q

Glutamate receptor inhibitor for refractory epilepsy. Common SE is aplastic anemia and hepatic failure

A

Felbamate

88
Q

This glutamate receptor inhibitor inhibits the glycine binding site of NMDA receptor

A

Felbamate

89
Q

This glutamate receptor inhibitor prolongs sodium channel inactivation. Txs focal seizures and drop attacks assoc with Lennox-Gestaut syndrome. Also a modest P450 inducer.

A

Rufinamide

90
Q

This adjunct to focal and tonic-clonic seizures enhances GABA activity by blocking GABA reuptake into presynaptic neurons. SE’s are unexplained sudden death and GI irritation.

A

Tiagabine

91
Q

This anti epileptic adjunct inhibits burst firing without affecting normal neuronal excitability

A

Levetiracetam

92
Q

Cyclooxygenase inhibitors prevent platelet aggregation by blocking ?

A

Thromboxane A2 generation

93
Q

This agent inhibits COX1 and COX2 non selectively to Tx arthritis, fever, pain, and for prophylaxis against TIA, MI, or thromboembolism.

A

Aspirin

94
Q

Aspirin common SE’s

A

GI bleeding, Tinnitus

95
Q

Phosphodiesterase inhibitors inhibit degradation of ?

A

Inhibit degradation of platelet cAMP and thereby decrease platelet aggregability

96
Q

This PDI may paradoxically induce angina by causing coronary steal

A

Dipyridamole

97
Q

ADP receptor pathway inhibitors inhibit platelet ?

A

Inhibit platelet activation

98
Q

For pts intolerant of Aspirin, this ADPr inhibitor can prevent thrombotic strokes

A

Ticlopidine

99
Q

This ADPr inhibitor txs acute coronary syndromes and prevents atherosclerotic events. Requires a loading dose to achieve immediate anti platelet effect. SE is atrial fibrillation

A

Clopidogrel

100
Q

This ADPr inhibitor has more efficient platelet inhibition, but increased risk of bleeding

A

Prasugrel

101
Q

These GPIIb-IIIa antagonists prevent binding of platelet to fibrinogen. Inhibiting platelet aggregation and decreases cross-linking.

A

Eptifibatide, Abciximab, tirofiban

102
Q

Chimeric mouse-human monoclonal antibody

A

Abciximab

103
Q

Warfarin inhibits hepatic epoxide reductase that catalyzes the regeneration of Vit. K, which is required for synthesis of coag factors ???? and anticoagulant proteins ??

A

Factors 2, 7, 9, 10. Proteins C and S

104
Q

This anticoagulant is contraindicated in pregnant woman and requires monitoring with PT/ INR.

A

Warfarin

105
Q

This agent combines with antithrombin III and inhibits secondary hemostasis via nonselective inactivation of activated factors II (thrombin), IX, X, XI, XII

A

Unfractionated heparin

106
Q

This agent combines with antithrombin III and inhibits secondary hemostasis via selective inactivation of factor Xa

A

LMW heparins

107
Q

LMW Heparins

A

Enoxaparin, dalteparin, tinzaparin

108
Q

With this unfractionated heparin, discourage concomitant use of ?

A

dong quai, garlic, ginger, ginkgo, motherwort, and red clover

109
Q

This anticoagulant is a selective factor Xa inhibitor

A

Fondaparinux

110
Q

Recombinant polypeptides based on the medicinal leech protein hirudin?

A

Lepirudin, desirudin, bivalirudin

111
Q

Direct thrombin inhibitor for tx of heparin induced thrombocytopenia

A

Lepirudin

112
Q

Direct thrombin inhibitor for prophylaxis of DVT

A

Desirudin

113
Q

Direct thrombin inhibitor for anticoagulation in pts receiving coronary angiography/angioplasty

A

Bivalirudin

114
Q

Recombinant activated protein C inactivated factors?

A

Va and VIIIa

115
Q

r-APC clinical application? r-APC prolongs activated ?

A

Sepsis with organ dysfunction. PTT

116
Q

Prior administration of this thrombolytic agent/bacterial protein is a contraindication to use due to the risk of anaphylaxis. Indicated for ST elevation MI

A

Streptokinase

117
Q

This recombinant t-PA binds to newly formed thrombi, causing fibrinolysis

A

Alteplase

118
Q

This recombinant t-PA is administered as a single weight bolus

A

Tenecteplase

119
Q

This recombinant t-PA is administered as a double bolus

A

Reteplase

120
Q

Heparin overdose agent

A

Protamine

121
Q

This serine-protease reduces perioperative bleeding during CABG surgery

A

Aprotinin

122
Q

These losing analogues tx disorders involving the fibrinolytic system and hemorrhage from increased fibrinolysis(antidote to streptokinase and t-PAs)

A

Aminocaproic acid, tranexamic acid

123
Q

Class I antiarrythmics block?

A

Na channels

124
Q

Class IA antiarrythmics

A

Quinidine, procainamide, disopyramide

125
Q

Quinidine SE’s

A

Prolongs QT interval, torsades de pointes

126
Q

Procainamide SE

A

Lupus like syndrome

127
Q

Class IB antiarrythmics

A

Lidocaine, mexiletine, phenytoin

128
Q

Class IC antiarrythmics

A

Encainide, flecainide, moricizine, propafenone

129
Q

Class II antiarrythmics block?

A

They are beta blockers

130
Q

Class III antiarrythmics block?

A

K channels

131
Q

Class III antiarrythmics

A

Ibutilide, dofetilide, sotalol, bretylium, amiodarone, dronedarone

132
Q

Must monitor QT interval during administration of this class III antiarrythmic.

A

Ibutilide

133
Q

This mixed class II & III antiarrhythmic is used frequently in pts who cannot tolerate SE’s of amiodarone

A

Sotalol

134
Q

This is both a class III antiarrhythmic and anti hypertensive agent. SE is marked orthostatic hypotension

A

Bretylium

135
Q

Mixed class I, II, III, IV antiarrhythmic agent with many SE’s (pulmonary toxicity, thyroid dysfunction, hepatic failure, blue-gray skin pigmentation, etc)

A

Amiodarone

136
Q

Class IV antiarrhythmics block

A

Ca channels (agents are verapamil and diltiazem)

137
Q

This antiarrhythmic agent converts a PSVT into a normal sinus rhythm by inhibiting the SA nodal, atrial, and AV nodal conduction

A

Adenosine

138
Q

Tx for chronic angina pectoris

A

Ranolazine

139
Q

These cardiac glycosides tx systolic heart failure and atrial fib/flutter/tachycardia

A

Digoxin, digitoxin

140
Q

This agent txs digitalis and digoxin toxicities

A

Digoxin Immune Fab

141
Q

Beta-adrenergic agonists increase ?

A

CO & BP

142
Q

Beta agonists for cardiogenic shock

A

Dopamine, dobutamine

143
Q

Dopamine at low doses causes ? At high doses?

A

Low doses cause vasodilation, high doses cause vasoconstriction

144
Q

Beta agonist for tx of bronchospasm, hypersensitivity/anaphylactic shock, cardiac resuscitation, open angle glaucoma, nasal congestion

A

Epinephrine

145
Q

This beta agonist is used for BP support in acute hypotensive states (shock)

A

Norepinephrine

146
Q

PDE inhibitor for asthma/COPD

A

Theophylline

147
Q

This beta agonist is given IV to tx heart block/shock, atropine-resistant bradycardia, and emergency tx of arrhythmias

A

Isoproterenol

148
Q

These PDE inhibitors are used as short term tx of severely falling circulation in pts refractory to conventional tx

A

Inamrinone, milrinone, vesnarinone

149
Q

GnRH agonists to Dx hypogonadism and stimulate ovulation(pulsatile form)

A

Gonadorelin

150
Q

These GnRH agonists tx breast CA, prostate CA, endometriosis, precocious puberty, and acute intermittent porphyria

A

Goserelin, histrelin, leuprolide, nafarelin

151
Q

GnRH agonists with SE’s of DVT.

A

Goserelin and Leuprolide (also pituitary apoplexy)

152
Q

These GnRH antagonists are used for inhibition of premature LH surges in women undergoing controlled ovarian hyperstimulation

A

Ganirelix, cetrorelix

153
Q

GnRHr antagonist with SE’s of ectopic pregnancy, thrombotic disorder, and spontaneous abortion

A

Ganirelix

154
Q

GnRHr antagonist with SE of anaphylaxis

A

Cetrorelix

155
Q

These agents inhibit 5alpha reductase conversion of testosterone to DHT to tx BPH

A

Dutasteride, finasteride (androgenic alopecia too)

156
Q

Competitive inhibitors of aromatase to decrease estrogen levels, tx ER+ breast CA

A

Anastrozole and letrozole

157
Q

Irreversible/covalent inhibitors of aromatase to decrease estrogen levels, tx ER+ breast CA

A

Exemestane and formestane

158
Q

This SERM is an ER antagonist in breast and partial agonist in endometrium. Breast CA tx that’s Administered for no more than 5 years to minimize risk of iatrogenic endometrial CA.

A

Tamoxifen

159
Q

This SERM txs female infertility due to an ovulatory disorder

A

Clomiphene

160
Q

This SERM txs osteoporosis and decreases breast CA incidence. Contraindicated during pregnancy

A

Raloxifene

161
Q

This SERM txs vulvovaginal atrophy and vaginal dryness

A

Ospemifene

162
Q

This ER antagonist is used for the tx of ER+ metastatic breast CA in postmenop. women with disease progression following anti-estrogen therapy

A

Fulvestrant

163
Q

This androgen receptor antagonist txs metastatic prostate CA and BPH. SE is hepatotoxicity

A

Flutamide

164
Q

This androgen receptor antagonist txs hirsutism, acne vulgaris, HTN, primary aldosteronism, edema, hypokalemia. Common SE’s are gynecomastia, hyperkalemia, and impotence.

A

Spironolactone

165
Q

Progesterone receptor antagonist for abortion

A

Mifepristone (RU-486)

166
Q

Investigational agent for tx of endometriosis and uterine fibroids

A

Asoprisnil

167
Q

Emergency/morning-after contraception agent

A

Levonorgestrel

168
Q

Estrogens of estrogen-progestin contraceptives

A

Ethinyl estradiol, mestranol

169
Q

Progestin only contraceptive that’s a silastic implant effective for 3 years

A

Etonogestrel

170
Q

This progestin only contraceptive is injectable/given parenterally every 3 months

A

Medroxyprogesterone acetate

171
Q

Other progestin only contraceptives

A

Norgestrel, norethindrone

172
Q

Androgens used for hypogonadism. SE’s are BPH and prostate CA

A

Testosterone enanthate, testosterone cypionate

173
Q

Alpha-glucosidase inhibitors for tx of DM type 2. Should monitor serum aminotransferase levels during therapy

A

Acarbose, miglitol, voglibose

174
Q

Alpha-glucosidase inhibitor SE’s

A

Ab pain, diarrhea, flatulence, elevated plasma TGs and serum aminotransferase

175
Q

Prandial bolus insulins administered subQ 30 minutes before meal

A

Insulin lispro, insulin aspart, insulin glulisine

176
Q

Intermediate acting insulin administered twice per day. Contains protamine to prolong absorption.

A

NPH insulin

177
Q

Long acting insulins injected once per day

A

Insulin glargine, insulin detemir

178
Q

Insulin secretagogues (sulfonylureas and meglitinides) inhibit the pancreatic beta cell ? channel at the ? subunit, stimulating insulin release

A

K/ATP channel. SUR1 subunit

179
Q

First generation sulfonylureas

A

Acetohexamide, chlorpropamide, tolazamide, tolbutamide

180
Q

Second generation sulfonylureas (*all begin with G)

A

Glimepiride, glipizide, glyburide, gliclazide, gliquidone

181
Q

Meglitinides. Also contraindicated for type 1 DM

A

Nateglinide, repaglinide

182
Q

This insulin sensitizer also lowers serum lipids and decreases weight. Used in type 2 DM and PCOS.

A

Metformin

183
Q

This amylin analogue slows gastric emptying, reduces post prandial glucagon/glucose release, and promotes satiety. Txs type 1 & 2 DM.

A

Pramlintide

184
Q

GLP-1 analogues for type 2 DM

A

Exenatide, liraglutide

185
Q

These DPP-4 inhibitors prolong GLP-1 activity and tx type 2 DM

A

Sitagliptin, saxagliptin

186
Q

These thiazolidinediones (TZDs) bind and stimulate PPARgamma, increasing insulin sensitivity. (**TZDs don’t increase insulin levels so do not induce hypoglycemia)

A

Pioglitazone, rosiglitazone

187
Q

Agent for tx of hypoglycemia due to hyperinsulinism and malignant HTN (off label). Binds to SUR1 and stabilizes open state of K/ATP channels, beta cells remain hyper polarized and decrease insulin secretion.

A

Diazoxide

188
Q

This somatostatin analogue inhibits GH release. Txs acromegaly, flushing/diarrhea from carcinoid syndrome, carcinoid crisis, TSH producing adenomas, diarrhea from VIP-secreting rumors

A

Octreotide

189
Q

This agent txs hypoglycemia and as an intestinal relaxant before radiography of GI tract

A

Glucagon

PBL Exam3 (1 decks)

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