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pharm Flashcards

1
Q

bethanicol

A

cholinergic: direct agonist.Tx: ileus, urinary retention. activates bowel and bladder smooth muscle. resistant to AChE

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2
Q

carbachol

A

cholinergic: direct agonist. Tx: constricts pupil and relieves intraocular pressure in glaucoma. = carbon copy of ACh

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3
Q

methacholine

A

cholinergic: direct agonist. Tx: challenge test for Dx of asthma. stimulates muscarinic receptors in airway when inhaled.

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4
Q

pilocarpine

A

cholinergic: direct agonist. Tx: potent stimulator of sweat, tears, and saliva. open-angle and closed-angle glaucoma. contracts ciliary muscle of eye (open-angle), pupillary sphincter (close-angle). resistant to AChE.

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5
Q

donepezil, galantamine, rivastigmine

A

cholinergic: indirect agonist (anticholinesterase). Tx: AD.

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6
Q

edrophonium

A

cholinergic: indirect agonist. Tx: historical Dx for MG. extremely short-acting

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7
Q

neostigmine

A

cholinergic: indirect agonist. Tx: ileus, urinary retention, MG, reversal of NMJ blockade. neo (no) CNS penetration

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8
Q

physostigmine

A

cholinergic: indirect agonist. Tx: ACh toxicity. crosses BBB. phyxes overdose

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9
Q

pyridostigmine

A

cholinergic: indirect agonist. Tx: MG. long acting. no CNS penetration.

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10
Q

w/cholinomimetics, watch out for…

A

COPD, asthma, PUD flairs

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11
Q

Sx of cholinesterase inhibitor poisoning

A

DUMBBELSS: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation (skeletal muscle and CNS), Lacrimation, Sweating, Salivation.

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12
Q

cause of cholinesterase inhibitor poisoning

A

organophosphates (parathion)

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13
Q

atropine, homatropine, tropicamide

A

muscarinic antagonists. target: eyes. -> mydriasis + cycloplegia. also used to Tx bradycardia.

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14
Q

benztropine

A

muscarinic antagonist. target: CNS. Tx: PD, acute distonia

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15
Q

glycopurrolate

A

muscarinic antagonist. target: GI, respiratory. Tx: parenteral: preop -> dec. airway secretions. oral: drooling, PUD.

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16
Q

hyoscyamine, dicyclomine

A

muscarinic antagonist. target: GI. Tx: antispasmodics for IBS

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17
Q

ipratropium, tiotropium

A

muscarinic antagonist. target: respiratory. Tx: COPD, asthma

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18
Q

oxybutynin, solifenacin, tolterodine

A

muscarinic antagonist. target: GU. Tx: reduce bladder spasms and urge incontinence

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19
Q

scopalamine

A

muscarinic antagonist. target: CNS. Tx: motion sickness

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20
Q

effects of muscarinic antagonists:

A

inc. pupil dilation, dec. secretions, dec. acid secretion, dec. motility, dev. urge in cystitis

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21
Q

muscarinic antagonist toxicity

A

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter. can cause acute angle glaucoma.

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22
Q

tetrodotoxin

A

in fugu. binds fast V-gates Na channels -> N/D, paresthesias, weakness, dizziness, loss of DTRs. Tx: supportive

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23
Q

ciguatoxin

A

reef fish (baracuda, snapper, moray eel). opens Na channels -> depolarization. Sx: confused w/cholinergic poisoning. temperature dysesthesia. Tx: supportive

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24
Q

scombroid poisoning

A

dark-meat fish. bacterial histidine decarboxylase converts histidine -> histamine. mimics fish allergy. -> mouth burning, face flushing, erythema, urticaria, pruritus, h/a. can look like anaphylaxis (bronchospasm, angioedema, hypotension. Tx: supportive, antihistamines, antianaphylactics if needed).

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25
Q

albuterol, salmeterol

A

sympathomimetic. beta2>beta1. salmeterol = LABA.

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26
Q

dobutamine

A

sympathomimetic. beta1>beta2, alpha. Tx: HF, inotropic > chronotropic. cardiac stress-test.

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27
Q

dopamine

A

sympathomimetic. D1 = D2>beta>alpha. Tx: unstable bradycardia, HF, inotropic + chronotropic alpha effects predominate at high doses.

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28
Q

epinephrine

A

sympathomimetic. beta>alpha. Tx: anaphylaxis, asthma, open-angle glaucoma, alpha effects predominate at high doses. stronger beta2 than NE

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29
Q

isoproterenol

A

sympathomimetic. beta1=beta2. Tx: electrophysiologic eval of tachyarrhythmias. can worsen ischemia.

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30
Q

NE

A

sympathomimetic. alpha1>alpha2>beta1. Tx: hypotension (but decreases renal perf), significantly weaker effect at beta2 than NE

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31
Q

phenylephrine

A

sympathomimetic. alpha1>alpha2. Tx: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant).

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32
Q

amphetamine

A

indirect sympathomimetic: agonist, reuptake inhibitor, releases stores catecholamines. Tx: narcolepsy, obesity, ADHD

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33
Q

cocaine

A

indirect adrenergic agonist, reuptake inhibitor. -> vasoconstriction and local anesthesia. never give beta-blockers if cocaine intoxication is suspected (-> unopposed alpha1 activation -> extreme HTN)

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34
Q

ephedrine

A

indirect adrenergic agonist, releases stored catecholamines. Tx: nasal decongestion, urinary incontinence, hypotension

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35
Q

NE vs. isoproterenol: NE

A

inc. BP via alpha1 vasocontriction -> inc. MAP -> reflex bradycardia

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36
Q

NE vs. isoproterenol: isoproterenol

A

little alpha effect. causes beta2-mediated vasodilation -> dec. MAP + inc. HR via beta1 and reflex activity

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37
Q

clonidine

A

Tx: hypertensive urgency. does not decrease renal blood flow. ADHD, tourettes. toxicity: CNS depression, bradycardia, hypotension, respiratory depression, meiosis

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38
Q

alpha-methydopa

A

Tx: HTN in pregnancy. toxicity: direct coombs + hemolysis, SLE-like syndrome

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39
Q

phenoxybenzamine

A

irreversible alpha-blocker. Tx: pheo (preop). side effects: orthostatic hypotension, reflex tachycardia

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40
Q

phentolamine

A

reversible alpha-blocker. Tx: give to pts on MAO inhibitors who eat tyramine-containing foods. side effects: orthostatic hypotension, reflex tachycardia

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41
Q

prazosin, terazosin, doxazosin, tamsulosin

A

selective alpha1 blocker. Tx: urinary Sx of BPH, PTSD (prazosin), HTN (except tamsulosin). side effects: 1st dose orthostatic hypotension, dizziness, h/a

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42
Q

mirtazepine

A

selective alpha2 blocker. Tx: depression. side effects: desation, inc. serum cholesterol, inc. appetite

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43
Q

timolol

A

beta blocker used to dec. secretion of aqueous humor to treat glaucoma

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44
Q

beta blocker toxicity

A

impotence, CV (bradycardia, AV block, HF), CNS (seizures, sedation. sleep alterations), dyslipidemia (metop), and asthma/COPD. avoid after cocaine use!

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45
Q

selective beta1 blockers

A

acebutolol (partial), atenolol, betaxolol, esmolol, metoprolol (A-M = 1st 1/2 of alphabet)

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46
Q

nonselective beta blockers

A

nadolol, pindolol (partial), propranolol, timolol. (N-Z = 2nd 1/2 of alphabet)

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47
Q

nonselective alpha and beta blockers

A

carvedilol, labetalol (don’t quite end in olol)

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48
Q

nibivolol

A

combines cardiac-selective beta1 blockade w/stimulation of beta3-receptors, which activate NO synthase in the vasculature

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49
Q

acetaminophen antidote

A

n-acetylcysteine (replenishes glutathione)

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50
Q

AchE inhibitor/organophosphate antidote

A

atropine > pralidozime

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51
Q

amphetamine (basic) antidote

A

NH4Cl (acidify urine)

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52
Q

antimuscarinic anticholinergic antidote

A

physostigmine salicylate: control hyperthermia

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53
Q

benzo antidote

A

flumazenil

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54
Q

beta-blocker antidote

A

glucagon

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55
Q

Cu, As, Au antidote

A

penicillamine

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56
Q

cyanide antidote

A

nitrite + thiosulfate, hydroxocobalamin

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57
Q

digitalis antidote

A

anti-dig Fab fragments

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58
Q

heparin antidote

A

protamine sulfate

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59
Q

iron antidote

A

deferoxamine, deferasirox

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60
Q

lead antidote

A

EDTA, dimercaprol, succimer, penicillamine

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61
Q

mercury, As, Au antidote

A

dimercaprol (BAL), succimer

62
Q

methanol, ethylene glycol antidote

A

fomepizole > ethanol, dialysis

63
Q

methemoglobic antidote

A

methylene blue, vit C

64
Q

opiod antidote

65
Q

salicylate antidote

A

NaHCO3 (alkalinize urine), dialysis

66
Q

TCA antidote

A

NaHCO3 (plasma alkalinization)

67
Q

tPA etc. antidote

A

aminocaproic acid

68
Q

causes coronary vasospasm

A

cocaine, sumatriptan, ergot alkaloids

69
Q

causes cutaneous flushing

A

vanc, adenosine, niacin, CCBs

70
Q

causes dilaed cardiomyopathy

A

anthracyclines (doxorubicin, daunorubicin), prevent w/dexrazoxane

71
Q

causes torsades

A

class III (sotalol) and class IA (quinidine) antiarrhythmics, macrolide antibiotics, antipsychotics, TCAs

72
Q

causes adrenocortical insufficiency

A

glucocorticoid withdrawal

73
Q

causes hot flashes

A

tamoxifen, clomiphene

74
Q

causes hyperglycemia

A

tacrolimus, protease inhibitors, niacin, HCTZ, corticosteroids

75
Q

causes hypothyroidism

A

lithium, amiodarone, sulfonamides

76
Q

causes acute cholestatic hepatitis, jaundice

A

erythromycin

77
Q

causes diarrhea

A

metformin, erythromycin, colchicine, orlistat, acarbose

78
Q

causes focal to massive hepatic necrosis

A

halothane, amanita phalloides (death cap mushroom), valproic acid, acetaminophen

79
Q

causes hepatitis

A

rifampin, isoniazid, pyrazinamide, statins, fibrates

80
Q

causes pancreatitis

A

didanosine, corticosteroids, alcohol, valproic acid, azathioprine, diuretics

81
Q

causes agranulocytosis

A

ganciclovir, clozapine, carbamazepine, colchicine, methimzaole, propylthiouracil

82
Q

causes aplastic anemia

A

carbamazepine, methimazole, NSAIDs, benzene, chloramphenicol, proylthiouracil

83
Q

causes direct coombs-+ AIHA

A

methyldopa, penicillin

84
Q

causes gray baby syndrome

A

chloramphenicol

85
Q

causes hemolysis in G6PD def.

A

isoniazid, sulfonamides, dapsone, primaquine, ASA, ibuprofen, nitrofurantoin

86
Q

causes megaloblastic anemia

A

phenytoin, methotrexate, sulfa drugs

87
Q

causes thrombocytopenia

88
Q

causes thrombosis

89
Q

causes fat redistribution

A

protease inhibitors, flucocorticoids

90
Q

causes gingival hyperplasia

A

phenytoin, CCBs, cyclosporine

91
Q

causes hyperuricemia

A

pyrazinamide, thiazides, furosemide, niacin, cyclosporine

92
Q

causes myopathy

A

fibrates, niacin, colchicine, hydroxychloroquine, IFN-alpha, penicillamine, statins, glucocorticoids

93
Q

causes osetoporosis

A

corticosteroids, heparin

94
Q

causes photosensitivity

A

sulfonamides, amiodarone, tetracyclines, 5-FU

95
Q

causes stevens-johnson

A

anti-epileptic drugs, allopurinol, sulfas, PCN

96
Q

causes SLE-like syndrome

A

sulfas, hydralazine, isoniazid, procainamide, phenytoin, etanercept

97
Q

causes tooth discoloration

A

tetracyclines

98
Q

causes tendonitis, tendon rupture, cartilage damage

A

fluoroquinolones

99
Q

causes cinchonism

A

quinidine, quinine

100
Q

causes parkinson-like syndrome

A

antipsychotics, reserpine, metoclopramide

101
Q

causes seizures

A

isoniazid (vit B6 def), bupropion, imipenem/cilastatin, enflurane

102
Q

causes tardive dyskinesia

A

antipsychotics, metoclopramide

103
Q

causes DI

A

lithium, demeclocycline

104
Q

causes fanconi syndrome

A

expired tetracycline

105
Q

causes hemorrhagic cystitis

A

cyclophosphamide, ifostamide

106
Q

causes interstitial nephritis

A

methicillin, NSAIDs, furosemide

107
Q

causes SIADH

A

carbamazepine, cyclophosphamide, SSRIs

108
Q

causes pulmonary fibrosis

A

bleomycin, amiodarone, busulfan, methotrexate

109
Q

causes antimuscarinic toxidrome

A

atropine, TCAs, H1-blockers, antipsychotics

110
Q

causes disulfiram-like rxn

A

netronidazole, some cephs, griseofulvin, procarbazine, 1st gen sulfonylureas

111
Q

causes nephrotox/ototox

A

aminoglycosides, vanc, loop diuretics, cisplatin (may respond to amifostine)

112
Q

P-450 inducers

A

chronic alcohol, st. john’s wart, phenytoin, phenobarb, nevirapine, rifampin, griseofulvin, carbamazepine: chronic alcoholics steal phen-phen and never refuse greasy carbs

113
Q

P-450 substrates

A

anti-epileptics, theophylline, warfarin, OCPs

114
Q

P-450 inhibitors

A

acute alcohol, ritonavir, amiodarone, cimetadine, ketoconazole, sulfonamides, isoniazid, grapefruit juice, quinidine, macrolides (except azithro)

115
Q

sulfa drugs

A

probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide Abx, sulfasalazine, sulfonylureas

116
Q

effects of sulfa allergies

A

fever, UTI, stevens-johnson, hemolytic anemia, thrombocytopenia, agranulocytosis, hives.

117
Q

-azole

A

ergosterol synthesis inhibitor

118
Q

-bendazole

A

antiparasitic/antihelmintic

119
Q

-cillin

A

peptidoglycan synthesis inhibitor

120
Q

-cycline

A

protein synthesis inhibitor

121
Q

-ivir

A

neuraminidase inhibitor

122
Q

-navir

A

protease inhibitor

123
Q

-ovir

A

DNA polymerase inhibitor

124
Q

-thromycin

125
Q

-ane

A

inhalational general anesthetic

126
Q

-azine

A

typical antipsychotic

127
Q

-barbital

A

barbiturate

128
Q

-caine

A

local anesthetic

129
Q

etine

130
Q

-ipramine, -triptyline

131
Q

-triptan

A

5-HT 1B/1D agonists

132
Q

-zepam, -zolam

133
Q

-chol

A

cholinergic agonist

134
Q

-curium, -curonium

A

nondepolarizing paralytic

135
Q

-olol

A

beta-blocker

136
Q

-stigmine

A

AChE inhibitor

137
Q

-terol

A

beta2 agonist

138
Q

-zosin

A

alpha1 antagonist

139
Q

-afil

A

PDE-5 inhibitor

140
Q

-dipine

A

dihydropyridine CCD

141
Q

pril

142
Q

-sartan

143
Q

-statin

A

HMG-CoA reductase inhibitor

144
Q

-dronate

A

bisphosphonate

145
Q

-glitazone

A

PPAR-gamma activator

146
Q

-orazole

147
Q

-prost

A

prostaglandin analog

148
Q

-tidine

A

H2 antagonist

149
Q

-tropin

A

pituitary hormone

150
Q

-ximab

A

chimeric monoclonal Ab

151
Q

-zumab

A

humanized monoclonal Ab

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