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Pharmacology Step 1 > Pharm Basics > Flashcards

Pharm Basics Flashcards

1
Q

Cholinomimetic agents: direct agonists

A

Bethanechol, carbachol, methacholine, pilocarpine

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2
Q

Cholinomimetic agents: indirect agonists (acetylcholinesterase inhibitors)

A

galantamine, donepezil, rivastigmine, edrophonium, neostigmine, physostigmine, pyridostigmine, echothiophate

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3
Q

Bethanechol

A

direct cholinergic agonist
activates bowel and bladder smooth muscle
used for post-op ileum, neurogenic ileum, urinary retention
resistant to AChE

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4
Q

Carbachol

A 
direct cholinergic agonist
mimics ACh (but is resistant to AChE)
constricts pupil and relieves intraocular pressure in open-angle glaucoma
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5
Q

Methacholine

A

direct cholinergic agonist
stimulates muscarinic receptors in airway when inhaled
Challenge test for diagnosis of asthma (causes bronchospasm)

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6
Q

Pilocarpine

A

direct cholinergic agonist
contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (close-angle glaucoma), resistant to AChE, can cross BBB

Potent stimulator of sweat, tears, and saliva
Open-angle and closed-angle glaucoma, xerostomia (Sjogren syndrome)

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7
Q

Galantamine, donepezil, rivastigmine

A

indirect cholinergic agonist (antiAChE)
increase ACh
used in Alzheimer disease (GDR -> Grandma Doesn’t Remember)

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8
Q

Edrophonium

A

indirect cholinergic agonist (antiAChE)
increases ACh
historically used to dx myasthenia gravis

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9
Q

Neostigmine

A

indirect cholinergic agonist (antiAChE)
increases ACh
No CNS penetration
used for post-op and neurogenic ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade (post-op)

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10
Q

Physostigmine

A

indirect cholinergic agonist (antiAChE)
increases ACh
Antidote for anticholinergic toxicity
Crosses BBB

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11
Q

Pyridostigmine

A

indirect cholinergic agonist (antiAChE)
increases Ach, increases muscle strength
Used for Tx of myasthenia gravis (long acting)
does not cross BBB

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12
Q

Echothiophate

A

indirect cholinergic agonist (antiAChE)

glaucoma

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13
Q

What are potential complications of all ACh agonists to look out for?

A

exacerbation of COPD, asthma, and peptic ulcers when given to susceptible patients

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14
Q

Muscarinic antagonists

A

atropine, homatropine, tropicamide, cyclopentolate, benztropine, glycopyrrolate, hyoscyamine, dicyclomine, ipratropium, tiotropium, oxybutynin, scopolamine

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15
Q

Atropine, homatropine, tropicamide, cyclopentolate

A

muscarinic antagonists
target: eye
applications: produce mydriasis and cycloplegia (paralysis of the ciliary muscles)
homatropine, tropicamide, and cyclopentolate have a shorter duration of action than atropine, so used more often to dilate eyes

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16
Q

benztropine

A

muscarinic antagonist

target: CNS
uses: decreases side effects of antipsychotics, Parkinson disease, acute dystonia

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17
Q

glycopyrrolate

A

muscarinic antagonist

target: GI, respiratory
uses: parenteral: pre-op use to decrease airway secretions
oral: drooling, peptic ulcer

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18
Q

hyoscyamine, dicyclomine

A

muscarinic antagonist

target: GI
uses: antispasmodics for IBS

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19
Q

Ipratropium, tiotropium

A

muscarinic antagonist (inhaled)

target: respiratory
uses: decreases bronchoconstriction, COPD, asthma

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20
Q

oxybutinin

A

muscarinic antagonist

target: GU
uses: reduce bladder spasms and urge urinary incontinence (overactive bladder)

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21
Q

scopolamine

A

muscarinic antagonist (patch)

target: CNS
uses: motion sickness, decreases oral secretions in mechanically ventilated patients

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22
Q

What are adverse effects of atropine use?

A

can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with BPH, and hyperthermia in infants

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23
Q

direct sympathomimetics

A

albuterol, almeterol, dobutamine, dopamine, epinephrine, isoproterenol, norepinephrine, phenylephrine, terbutaline, clonidine

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24
Q

indirect sympathomimetics

A

amphetamine, cocaine, ephedrine

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25
Q

albuterol, salmeterol

A

direct sympathomimetic
B2>B1 (inhaled)
use: albuterol for acute asthma or COPD
Salmeterol for long-term asthma or COPD control

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26
Q

adverse effect of albuterol

A

tachycardia

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27
Q

dobutamine

A

direct sympathomimetic
B1>B2, alpha
uses: HF, cardiac stress testing
effect: increases HR and contractility

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28
Q

dopamine

A 
direct sympathomimetics
Low doses = D1/D2
Medium doses = B1/B2
High doses = alpha1/alpha2
Uses: unstable bradycardia, HF, shock
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29
Q

epinephrine

A

direct sympathomimetics
B>alpha (alpha1, alpha2, B1, B2)
uses: anaphylaxis, asthma, croup, hypotension

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30
Q

isoproterenol

A

direct sympathomimetic
B1=B2
use: electrophysiologic evaluation of tachyarrhythmias
can worsen ischemia

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31
Q

norepinephrine

A

direct sympathomimetic
alpha1>alpha2>beta1
use: hypotension, septics shock, cariogenic shock

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32
Q

phenylephrine

A

direct sympathomimetic
alpha1>alpha2
uses: hypotension, ocular procedures (mydriasis), rhinitis (decongestant)

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33
Q

terbutaline

A

direct sympathomimetic
B2>B1
uses: bronchospasm, tocolysis

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34
Q

clonidine

A

direct sympathomimetic
alpha2
uses: decrease BP (can see significant rebound HTN)

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35
Q

ampethamine

A

indirect sympathomimetic
MOA: indirect agonist, reuptake inhibitor, releases stored catecholamines
uses: narcolepsy, obesity, ADHD

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36
Q

cocaine

A

indirect agonist, reuptake inhibitor
uses: causes vasoconstriction and local anesthesia
never give beta blockers if cocaine intoxication is suspected

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37
Q

ephedrine

A

indirect agonist, releases stored catecholamines

uses: nasal decongestion, urinary incontinence, hypotension

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38
Q

alpha2-agonists

A

clonidine, alpha-methyldopa

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39
Q

alpha-methyldopa

A

alpha2-agonist; Tx HTN in pregnancy

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40
Q

Nonselective alpha blockers

A

phenoxybenzamine, phentolamine

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41
Q

alpha 1 selection alpha blockers

A

prazosin, terazosin, doxazosin, tamsulosin

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42
Q

phenoxybenzamine

A

nonselective alpha blocker
uses: irreversible; pheochromocytoma to prevent catecholamine (HTN) crisis
AE: orthostatic hypotension, reflex tachycardia

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43
Q

Phentolamine

A

nonselective alpha blocker
uses: reversible; given to patients on MAO inhibitors who eat tyramine-containing food
AE: orthostatic hypotension, reflex tachycardia

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44
Q

Prazosin, terazosin, doxazosin, tamsulosin

A

alpha 1 selective blocker
uses: urinary symptoms of BPH, PTSD (prazosin), HTN (except tamsulosin - prostate specific)
AE: orthostatic hypotension, dizziness, headache, reflex tachycardia, rebound HTN with abrupt withdrawl

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45
Q

Nonselective beta blockers

A

nadolol, propranolol, timolol

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46
Q

B1 selectieve beta blockers

A

atenolol, esmolol, metoprolol, nebivolol

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47
Q

Weak B1/B2 agonists

A

acebutolol, pindolol

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48
Q

Nonselective alpha/beta blockers

A

carvedilol, labetalol

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49
Q

uses of beta blockers

A

HTN, CAD, CHF (slows), hyperthyroidism, migraine prophylaxis, anxiety, SVT, glaucoma, aortic dissection

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50
Q

what are the adverse effects of beta blockers?

A

bronchoconstriction, hypoglycemia, increased BP in cocaine user, rebound tachycardia, rebound HTN, arrhythmia

Avoid beta blocker use in patients with lung problems

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51
Q

What drug class has the suffix -afil?

A

phosphodiesterase inhibitors

ex: sildenafil, tadalafil

52
Q

What drug class has the suffix -azepam?

A

benzodiazepines

ex: lorazepam, diazepam

53
Q

What drug class has the suffix -azine?

A

phenothiazine

ex: chlorpromazine, thioridazine (neuroleptics), promethazine (antiemetic)

54
Q

What drug class has the suffix -azolam?

A

benzodiazepines

ex: alprazolam, midazolam, triazolam

55
Q

What drug class has the suffix -barbital?

A

barbiturates

ex: phenobarbital, secobarbital

56
Q

What drug class has the suffix -bendazole?

A

benzimidazoles

ex: mebendazole, albendazole

57
Q

What drug class has the suffix -caine?

A

local anesthetics

ex: lidocaine, tetracaine

58
Q

What drug class has the suffix -chol?

A

muscarinic agonist

ex: bethanechol, carbachol

59
Q

What drug class has the suffix -cillin?

A

penicillin

ex: amoxicillin, methicillin

60
Q

What drug class has the suffix -conazole?

A

imidazole (anti fungal)

ex: fluconazole, ketoconazole

61
Q

What drug class has the suffix -curium?

A

non-depolarizing neuromuscular blocker

ex: atracurium, mivacurium

62
Q

What drug class has the suffix -curonium?

A

non-depolarizing neuromuscular blocker

ex: vecuronium, rocuronium

63
Q

What drug class has the suffix cycline?

A

protein synthesis inhibitor

Ex: tetracycline, doxycycline

64
Q

What drug class has the suffix -dipine?

A

dihydropyridine calcium channel blocker

ex: nifedipine, amlodipine

65
Q

What drug class has the suffix -dronate?

A

bisphosphonate

ex: alendronate, risedronate

66
Q

What drug class has the suffix -etine?

A

SSRI

Ex: fluoxetine, paroxetine, sertraline

67
Q

What drug class has the suffix -flurane?

A

inhaled anesthetics

Ex: isoflurane, sevoflurane

68
Q

What drug class has the suffix -gliptin?

A

DPP-IV inhibitor (T2DM Tx)

Ex: sitagliptin, saxagliptin

69
Q

What drug class has the suffix -glitazone?

A

Thiazolidinedione (T2DM Tx)

Ex: pioglitazone, rosiglitazone

70
Q

What drug class has the suffix -ipramine?

A

TCA

Ex: clomipramine, imipramine

71
Q

What drug class has the suffix -mab?

A

monoclonal antibody

Ex: infliximab, rituximab

72
Q

What drug class has the suffix -mustine?

A

nitrosourea (cancer Tx)

ex: lomustine

73
Q

What drug class has the suffix -navir?

A

protease inhibitor (HIV Tx)
ex: ritonavir, saquinavir
(CYP450 inhibitors)

74
Q

What drug class has the suffix -olol?

A

beta blockers

Ex: atenolol, metoprolol

75
Q

What drug class has the suffix -operidol?

A

neuroleptic

Ex: haloperidol, droperidol

76
Q

What drug class has the suffix -phylline?

A

methylxanthine
Ex: theophylline, aminophylline
(asthma, COPD Tx?)

77
Q

What drug class has the suffix -pril?

A

ACE inhibitor

Ex: enalapril, lisinopril

78
Q

What drug class has the suffix -prost?

A 
prostaglandin analog (glaucoma treatment)
Ex: latanoprost, travoprost
79
Q

What drug class has the suffix -sartan?

A

angiotensin receptor blocker

Ex: losartan, valsartan

80
Q

What drug class has the suffix -statin?

A

HMG-CoA reductase inhibitors

Ex: atorvastatin, simvastatin

81
Q

What drug class has the suffix -stigmine?

A

Acetylcholinesterase inhibitors

Ex: neostigmine, physostigmine, rivastigmine

82
Q

What drug class has the suffix -terol?

A

beta 2 agonist

Ex: albuterol, salmeterol

83
Q

What drug class has the suffix -tidine?

A

H2 histamine antagonist

Ex: cimetidine, ranitidine

84
Q

What drug class has the suffix -triptan?

A

5-HT 1B/1D agonist (migraine Tx)

Ex: sumatriptan, rizatriptan

85
Q

What drug class has the suffix -triptyline?

A

TCA

Ex: amitriptyline, nortriptyline

86
Q

What drug class has the suffix -tropin?

A

pituitary hormone

Ex: somatotropin, thyrotropin (TSH)

87
Q

What drug class has the suffix -zosin?

A

alpha1-antagonist

ex: prazosin, doxazosin

88
Q

What drugs have the side effect of flushing?

A

Vancomycin (red man syndrome) (slow infusion, pretreat with anti H2)
Niacin
Adenosine
Dihydropyridine CCB (via smooth m. relaxation)

89
Q

What drugs have the side effect of coronary vasospasm?

A 
cocaine
amphetamines
triptans (C/I w/ CAD)
ergotamine 
(last 2 are migraine Tx drugs)
90
Q

What drugs have the side effect of dilated cardiomyopathy?

A

doxorubicin

daunorubicin

91
Q

What drugs have the side effect of TdP?

A 
Potassium channel blockers (class III)
Sodium channel blockers (class IA)
Macrolides
Haloperidol (antipsychotic)
chloroquine (malaria Tx)
protease inhibitors (HIV Tx)
92
Q

What drugs have the side effect of thrombocytopenia?

A

heparin (HIT)

Cimetidine (H2 blocker)

93
Q

What drugs have the side effect of agranulocytosis?

A 
clozapine
carbamazepine
colchicine
PTU/methimazole (anti-thyroid)
dapsone
94
Q

What drugs have the side effect of aplastic anemia?

A

chloramphenicol
benzene
NSAIDs
PTU/methimazole

95
Q

What drugs have the side effect of gray baby syndrome?

A

chloramphenicol
because UDP glucuronyltransferase enzyme is immature
buildup of substrates

96
Q

What drugs have the side effect of hemolysis in G6PD deficiency?

A 
Isoniazid
sulfonamides
primaquine (malaria Tx)
aspirine (high dose)
ibuprofen
nitrofurantoin
dapsone
fava beans
naphthalene
97
Q

What drugs have the side effect of thrombosis?

A

oral contraceptives

98
Q

What drugs have the side effect of pulmonary fibrosis?

A

amiodarone (a-fib Tx)
bleomycin
busulfan
(last two are anti-cancer)

99
Q

What drugs have the side effect of cough?

A

ACE inhibitors (via increased bradykinin; try ARBs)

100
Q

What drugs have the side effect of pseudomembranous colitis?

A

clindamycin

amoxicillin/ampicillin

101
Q

What drugs have the side effect of hepatic necrosis?

A

halothane
acetaminophen
valproic acid
amanita phalloides (mushroom toxin)

102
Q

What drugs have the side effect of hepatitis?

103
Q

What drugs have the side effect of tertiary adrenal insufficiency?

A

corticosteroid withdrawal

104
Q

What drugs have the side effect of gynecomastia?

A 
STACKED
sprinolactone (CHF Tx)
THC
alcohol (chronic use)
cimetidine
ketoconazole
estrogens
digoxin
105
Q

What drugs have the side effect of hot flashes?

A

tamoxifen
clomiphene
(SEMRs)

106
Q

What drugs have the side effect of hypothyroidism?

A

amiodarone
lithium
sulfonamides

107
Q

What drugs have the side effect of gout?

A

diuretics (loop and thiazide)
niacin (for decreased HDL)
cyclosporine
pyrazinamide

108
Q

What drugs have the side effect of gingival hyperplasia?

A

phenytoin

verapamil

109
Q

What drugs have the side effect of osteoporosis?

A

corticosteroids

heparin

110
Q

What drugs have the side effect of photosensitivity?

A

sulfonamides
amiodarone
tetracycline
(SAT for photo)

111
Q

What drugs have the side effect of Stevens-Johnson syndrome?

A 
Flu-like Sx then erythema multiforme
CLAPPPERS 
Carbamazepine
Lamotrigine
Allopurinol
Phenytoin
Phenobarbital
Penicillin
Ethosuximide
RASH
Sulfa drugs
112
Q

What drugs have the side effect of drug-induced lupus?

A 
SHIPP
Sulfonamides
Hydralazine
Isoniazid
Procainamide
Phenytoin
113
Q

What drugs have the side effect of tendinitis/cartilage damage?

A

Fluoroquinolones

114
Q

What drugs have the side effect of interstitial nephritis?

A

NSAIDs
Furosemide (loop)
Antibiotics

115
Q

What drugs have the side effect of diabetes insipidus?

A

lithium

demeclocycline

116
Q

What drugs have the side effect of fanconi syndrome?

A

(proximal tube defect)
Tetracycline
Heavy metals & Wilson Dz

117
Q

What drugs have the side effect of hemorrhagic cystitis?

A

cyclophosphamide

ifosfamide

118
Q

What drugs have the side effect of Parkinson-like syndrome?

A

metoclopramide (gastric paresis Tx)
antipsychotics
reserpine

119
Q

What drugs have the side effect of cinchonism

A

(dizziness with HA, vision changes, tinnitus)
Quinidine
Quinine

120
Q

What drugs have the side effect of seizures?

A 
buproprion
imipenem/cilastatin
isoniazid
tramadol
metoclopramide
benzodiazepine/alcohol withdrawal
121
Q

What drugs have the side effect of tardive dyskinesia?

A

antipsychotics

metoclopramide

122
Q

What drugs have the side effect of disulfiram-like reaction?

A 
metronidazole
certain cephalosporins
procarbazine (alkylating agent - anti-cancer)
first-generation sulfonylureas
disulfiram
123
Q

What drugs have the side effect of nephrotoxicity + neurotoxicity?

A

aminoglycosides
cisplatin
polymixins

124
Q

What drugs have the side effect of nephrotoxicity + ototoxicity?

A

ahminoglycosides
vancomysin
loop diruetics
cisplatin

125
Q

What drugs have the side effect of anticholinergic effect? (dry you up)

A

atropine
TCAs
H1 blockers (diphenhydramine)
Low-potency neuroleptics (thioridazine, chlorpromazine)

Pharmacology Step 1 (8 decks)

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