Pharm exam 2 Drugs, facts, EVERYTHING Flashcards
Atropine
Muscarinic blocker. not very selective. week long duration! has minimal CNS effects. Good for pre–anesthesia. Tx cholinergic poisoning (but doesn’t help against nicotinic effects)
MOA: steroid that Triggers production of specific proteins that reduce cell growth and proliferation
Prednisone
__[drug]__ can interfere with penicillins and cephalosporins
Tetracyclines can interfere with penicillins and cephalosporins
What drug goes through P450 metabolism
Vinblastine and Vincristine and
Docetaxel and Paclitaxel
(microtubule inhibitors)
Bethanechol
Direct acting, agonist for ACh. More resistant to AChE
Nm nicotinic receptors are on ___
Skeletal Muscle
Which generation cephalosporin has NORMAL gram positive coverage with improved gram negative coverage (including some Pseudomonal coverage)?
5th generation (Ceftaroline) [end of the -line!]
What is good for accurate refraction?
Homatropine or cyclopentolate
Phenoxybenzamine
Non–selective alpha antagonists. IRREVERSIBLE. Greater affinity for alpha 1 over alpha 2. Used for pre–op treatment in cases of pheochromocytoma to control hypertension
What does sypmathetic/parasympathetic activity do to the Kidney?
Sympathetic alters the secretion of renin. Parasympathetic does nothing
Dactinomycin
Antibiotics – interfere with DNA between GC pair and interferes with RNA polymerase. sometimes combined with methotrexate. via IV. liver excretion. SENSITIZES PATIENT TO RADIATION. Bone marrow depression, Immunosuppression, Nausea, vomiting, diarrhea, stomatitis, alopecia,
Which cephalosporin is good for people with renal deficiency?
Ceftriaxone (3rd generation) because drug is excreted through bile
Carteolol
Non–selective beta antagonists with partial agonist effect
Goserelin
Steroid Hormones and Antagonists ….. Steroid hormone that is GnRH analog. Tx prostate and breast cancer. Fewer side effects with treatment than estrogen
What is Tx for hypertension?
Clonidine (Alpha 2 agonist)
Which receptor is an “autoreceptor”?
Alpha 2
What penicillins are taken IV or IM?
Ticarcillin, piperacillin, ampicillin + sulbactam, ticarcillin + clavulanic acid
<p>Neostigmine</p>
<p>Intermediate Indirect acting, inhibits AChE. Reverses neuromuscular blockade produced during anesthesia. Used in myasthenia Gravis</p>
Ceftazidime
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
Why is a combination of drugs good for cancer treatment?
Provide maximal killing with tolerated toxicity, Effective against broad cell lines, May delay development of resistant cell lines. If use drugs with similar toxicities, dose of each must be reduced
Doripenem
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
Ertapenem
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
Which antibiotic cancer drug is cell cycle specific?
Bleomycin
Tx MRSA, skin infections
Daptomycin, Telavancin
Alprenolol
Beta–1 selective antagonists
Edrophonium (Tensilon)
Short Indirect acting, inhibits AChE. used for diagnosis of Myasthenia Gravis. also Reverses neuromuscular blockade produced during anesthesia
Cefdinir
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
What is the neurotransmitter and receptor of postganglionic sympathetics? Long or short?
Long, NE alpha/beta
What is the tissue target and actions for Alpha 2?
CNS and PNS nerve terminal (inhibits NT release). Also decreases aqueous production and increase uveoscleral outflow
What happens if the miotic pupil does not dilate with phenylephrine?
It’s probably not Horner’s syndrome, then
Terazosin
Alpha–1 antagonists
Which cephalosporin is excreted through the bile?
Ceftriaxone (3rd generation)
Meropenem
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
Which generation cephalosporin has diminished gram positive and improved gram negative coverage?
2nd generation (…Zil-or-Tin)
What happens when you activate Beta 1 receptors?
Affects HEART: higher bp, heart rate, increase contractility. Affects Kidney too (more renin > increase blood volume because more water)
What are the clinical uses of alpha antagonists?
For tumors that secrete NE, hypertension, Urinary obstruction (enlarged prostate), ED
Carmustine
Alkylating Agent. Alkylates DNA. Tx brain tumors (crosses CNS). via IV. Kidney excretion. AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis
What kind of receptor are the Alpha and beta receptors?
G-protein coupled receptors
5–fluorouracil
Antimetabolite – Thymidine analog that prevents DNA synthesis. Tx skin cancer. Through IV and topically. Excreted in the kidney/lungs. Can cause anorexia.
Which drug’s adverse effect? : Pulmonary toxicity Alopecia Hypertrophic skin changes and hyperpigmentation Fever and chills
Bleomycin
Sildenafil
(Viagra) Type 5 Phosphodiesterase Inhibitors
Phenylephrine
Alpha–1 agonists. it’s a Mydriatic (eye dilator) and OTC decongestant. Tx for Hypotension. also found in many OTC medications for congestion (local constriction) Used often for acute hypotension caused by severe hemorrhage, decreased blood volume, shock, etc. Diagnosis of Horner’s
What are the clinical uses of Cholinomimetics in the Eye?
Glaucoma (pilocarpine and carbachol are older treatments)
What do muscarinic blockers do to the eye?
They cause mydriasis (constrictor is inhibited), cause cycloplegia (ciliary muscle is inhibited), and reduce lacrimal secretion.
AE:
Fever, chills, phlebitis at injection site, flushing and/or shock if rapid infusion (can pretreat with anti-histamine)
Vancomycin
What can cause Crystalline retinopathy and other vision probs?
Tamoxifen
What can regenerate AChE?
Pralidoxime
Bleomycin
Antibiotics – scission of DNA. Tx testicular cancer. Via subcutaneous, IM, or IV. Kidney excretion. can cause Pulmonary toxicity Alopecia Hypertrophic skin changes and hyperpigmentation Fever and chills
Nilutamide
Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogen. Tx prostate cancer. via oral administration. Kidney excretes. NILUTAMIDE CAN CAUSE VISUAL PROBLEMS
Brimonidine
(Alphagan–P) Alpha–2 agonists. Tx of glaucoma
Scopolamine
Muscarinic blocker. Good for seasickness but can cause drowsiness and amnesia. used for pre–anesthesia.
What is good treatment of Uveitis
Homatropine or Cyclopentolate
What drugs gind guanine in DNA to form cross links?
Cisplatin, Carboplatin, Oxaliplatin
What will be lower than the other? MIC or MBC?
MIC is a lower concentration than MBC
What can treat COPD and Asthma?
Ipratropium or Tiotropium
Which drugs can cause anorexia?
5-fluorouracil and 6-mercaptopurine
Norepinephrine
non–selective Alpha/beta agonist. Little effect on Beta 2 receptors Used often for acute hypotension caused by severe hemorrhage, decreased blood volume, shock, etc.
What receptor stimulates the iris dilator muscle?
Alpha 1
Where are the nonsteroidal antiandrogens drugs (anti-cancer)?
Flutamide, Nilutamide (can cause visual problems) Bicalutamide
Ipratropium (Atrovent)
Muscarinic blocker. Tx COPD and Asthma
What happens when you apply Direct-Acting Cholinoceptor Stimulants to the respiratory system?
Contraction of bronchial smooth muscle: Bronchoconstriction. Stimulation of bronchial glands: Increase mucous secretion. This would be bad for an asthma patient
Echothiophate
Long indirect actin, inhibits AChE
Carbachol
Direct acting, agonist for ACh. more resistant to AChE. Older treatment for glaucoma
What is effect of an Indirect Acting Cholinomimetic on the respiratory tract?
Basically the same as direct.
Contraction of bronchial smooth muscle: Bronchoconstriction. Stimulation of bronchial glands: Increase mucous secretion. This would be bad for an asthma patient
Which “steroid hormone and antagonists” are actually steroids? Which are not steroids?
STEROIDS:
What is MIC?
Minimum Inhibitory Concentration: Lowest concentration of antibiotic that inhibits bacterial growth. Clinically obtainable antibiotic concentration must be greater than the MIC.
Which alkylating agent transforms into an active metabolite?
Dacarbazine
What drug Tx enterocolitis?
Oral Vancomycin
What are some problems associated with chemotherapy?
Resistance, multidrug resistance, toxicity
Do Adrenergic receptors desensitize?
They are non-desensitizing
What does Beta-lactamse inhibitors do?
They bind and inactivate penicillinases allowing combined drugs to work.
AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis
Carmustine, Lomustine
What happens when you apply Direct-Acting Cholinoceptor Stimulants to the heart and blood vessels?
Hyperpolarization of the SA and AV node (decreases AP and contractility), blood vessels release NO from endothelial cells to cause vasodilation
What is the tissue target and actions for Alpha 1?
Vascular smooth muscle (contraction), pupillary dilator muscle (contraction – dilation), and heart (increase force of contraction)
Atenolol
Beta–1 selective antagonists
Which drug has this MoA: Inhibits DNA polymerase. Also can be incorporated into cellular DNA
Cytarabine
Daptomycin
Other” antibiotic. induces rapid depolarization of cell membrane. tx gram positive, skin infections. Inactivated by pulmonary surfactants
Labetalol
Non–selective beta antagonists with partial alpha–1 antagonist activity. Can be used in hypertensive emergency
Cefixime
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
Penbutolol
Non–selective beta antagonists with partial agonist effect
AE: Severe reactions have been fatal: Must infuse slowly. Hypotension, bronchospasm, and angioedema; Chills and fever after first infusion; Cardiac arrhythmias; You don’t see nausea vomiting hair falling out
Rituximab
Which antibiotic cancer drug can cause irreversible cardiotoxicity?
Doxorubicin
Bicalutamide
Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogens. Tx prostate cancer. via oral administration. Kidney excretes.
Telavancin
Other” antibiotic. inhibits cell wall. tx gram positive. (also MRSA). Tx skin infections. Taste disturbances, nausea, vomiting, insomnia, foamy urine, NOT to be used during pregnancy Caution in cardiac conditions”
Which drugs can cause buildup of uric acid in the urine?
Vinblastine and Vincristine (microtubule inhibitors)
Is tamoxifen cell-cycle specific or not?
Tamoxifen is NOT cell-cycle specific
Doxorubicin
Antibiotics – induces cytotoxicity and free radicals. must be given IV. Red urine and dark red veins because of extravasation.
Doxazosin
Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate. Doxazosin has longer half–life
Interferons
Recombinant DNA via bacteria, activation of macrophages and suppression of cell proliferation. Alpha– primarily leukocytic Beta– produced by CT fibroblasts Gamma– produced by T–lymphocytes
What is the mechanism of MRSA resistance?
Altered PBPs (penicillin binding proteins) for reduced drug affinity.
What drug can cause foamy urine?
Telavancin
Name MOA: Forms a stable complex with DNA Intercalates into double helix between G-C base pairs Interferes with RNA polymerase and hinders DNA synthesis
Dactinomycin
What are the long-acting organophosphates? Where are they distributed?
Echothiophate, Malathion, Parathion, Sarin. All are distributed to CNS except echothiophate
Which adregergic receptors lead to a blood pressure decrease?
Alpha 2, Beta 2
Cephalexin (Keflex)
1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney. Tx eye (lid) infections. tx pharyngitis
What is Tx for cardiac arrest?
Isoproterenol, Epinephrine
What do muscarinic blockers do to the GI tract?
Decrease salivation, production of stomach acid, smooth muscle tone and propulsive movements
What is the short-acting Indirect Acting Cholinomimetic? How does it work?
Edrophonium. Forms reversible bond with the enzyme. Not actually a substrate for ACh-esterase
What happens when you activate Beta 2 receptors?
Bronchodilation, elevates blood glucose (via glycogen breakdown) and increases glucagon secretion from pancreas. Also decreases blood glucose vis insulin. Relaxes smooth ciliary muscle to decrease accommodation.
Tx MRSA, infection blepharitis, corneal ulcers…
Bacitracin (“other’)
What is good for seasickness?
Scopolamine and other muscarinic blockers
If you’re allergic to penicillin, what else can you not take?
Other beta-lactams like Cephalosporins. Nor Augmentin
Nafcillin
Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph. High toxicity, causes interstitial nephritis Used only to identify MRSA.
Tiotropium (Spiriva)
Muscarinic blocker. Tx COPD and Asthma
Which generation cephalosporin has further diminished gram positive coverage with improved gram negative coverage and FULL coverage against Pseudomonas?
4th generation (cefepime) [4th gen is almost -prime time!]
Prednisone
Steroid Hormones and Antagonists ….. Steroid hormone that reduces cell growth and proliferation. Tx lymphomas and induces remission. Via oral, excreted urine. Predispose patient to infection, Hyperglycemia, Cataract formation, increased IOP, Osteoporosis, Mood changes: hyper and happy
Isoproterenol
Non–selective beta agonist. Tx cardiac arrest (w/ epinephrine)
What are the common adverse side effects of cancer treatment?
Severe vomiting, Bone marrow suppression, Alopecia, Myelosuppression (patient prone to infection)
Cevimeline
Direct acting, agonist for ACh. Used in Sjogren’s syndrome (for salivation)
What generation of cephalosporins are ok to use with people allergic to penicillin?
3rd, 4th, 5th.
Metaproterenol
Beta–2 agonists. Tx Asthma
What are some AE to penicillins?
Hypersensitivity. Diarrhea, nephritis (esp. with methicillin), neurotoxicity, hematologic toxicity (decreased coagulation).
What is the distribution and elimination of muscarinic blockers?
Most are widely distributed through CNS. They are eliminated via the kidney.
What drug stops VEGF from stimulating new blood vessels?
Bevacizumab
Which antibiotic is safe during pregnancy?
Bacitracin (“other”)
Parathion
Long indirect actin, inhibits AChE
Oxaliplatin
Platinum coordinating complex, IV administration. Little penetration to CSF. Renal excretion. forms cross–links in guanine. Mild nausea, myelosuppression
Which drug has this MoA: Pyrimidine analog Forms a molecular complex that deprives the cell of thymidine (DNA synthesis stops)
5-fluorouracil
Vincristine
Microtubule Inhibitors–halts anaphase. IV injection. Metabolism by the P450 system. Excretion via bile and feces. hyperuricemia (buildup of uric acid in the urine) Nausea, vomiting, diarrhea, alopecia. Phlebtis or cellulitis if extravasation occurs.
What are side effects unique to cholinesterase inhibitors?
Miosis, Salivation, Sweating, and Muscle weakness. Both direct and indirect have Bronchial constriction, Vomiting, Diarrhea, Convulsions,
What can cause vasoconstriction?
Alpha agonists (Epi, Phenylephrine, Tetrahydrozoline)
How are Monoclonal antibodies administered.
NOT orally! IV
Which antimetabolite is given orally?
6-mercaptopurine (and Methotrexate can be oral)
Cefoxitin
2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney.
What is a Pharmacologic Sanctuary?
A place where some tumor cells can “hide” in tissues where chemotherapeutic agents cannot enter. Radiation “finds” these tumors
Ampicillin
Aminopenicillins. tx Gram (+). limited gram (–) coverage Considered extended spectrum. via only oral.
What does a selective receptor mean?
It can become non-selective at high concentration
What drug class would be bad for an asthma patient?
Direct and indirect acting cholinoceptor stimulant, Timolol (beta blocker)
Nadolol
Non–selective beta antagonists. Long duration of action
Cefprozil
2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney.
What do muscarinic blockers do to the urinary tract and sweat glands?
Slows voiding. Reduces sweating
Methotrexate
Antimetabolite – Prevents folic acid conversion to THF leading to decreased DNA/ protein materials. Thymidine depletion is most prominent. Low doses Tx inflammatory diseases (Rheumatoid arthritis, crohn disease). via oral, IM, IV. intrathecal for CNS. Avoid in pregnancy. can lead to crystalluria
Which antibiotic type is often combined with penicillinase inhibitor?
Aminopenicillins (like ampicillin and amoxicillin)
What is effect of an Indirect Acting Cholinomimetic on the Eye?
Basically the same as direct. Contraction of iris sphincter (miosis), ciliary muscle (accommodation), and opening of trabecular meshwork (lower IOP)
What classes of antibiotics show Time-dependent killing?
β-lactams, glycopeptides, macrolides, clindamycin, and linezolid
Docetaxel
Microtubule Inhibitors – binds to tubulin and makes too stable. via IV. P450 metabolism Biliary excretion. Neutropenia, peripheral neuropathy Docetaxel contraindicated in cardiac disease (can cause fluid retention) and is more potent than paclitaxel
Which cancer drug Sensitizes the patient to radiation (sun)?
Dactinomycin
Dobutamine
Beta–1 agonist
Which antibiotic is used to identify resistant strains of S. aureus?
Methicillin
What are the properties of Choline esters?
ACh, Carbachol, Bethanechol are hydrophilic (poorly absorbed), Carbachol and Bethanechol are more resistant to AChE –longer duration of action
What is Tx for chronic orthostatic hypotension?
Midodrine (Alpha 1 agonist)
Which cholinomimetric alkaloid can be absorbed across the skin?
Nicotine
What is the process of making NE?
Tyrosine > DOPA > Dopamine, which enters vesicles > NE via Dopamine β hydroxylase. NE is metabolized by MAO and diffused into surrounding tissue
Which Antibiotic cancer drugs can be given subcutaneously, IM, or IV?
Bleomycin
Clavulanic acid + amoxicillin (Augmentin)
β–lactamase Inhibitor + Antibiotic Combos. bindand inactivate penicillinases allowing combined drugs to work. Used in to treat many eye infections.
What cancer drug is a powerful blistering agent?
Mechlorethamine
AE: Severe vomiting, Nephrotoxicity, Ototoxicity
Cisplatin
Which is more potent:
Docetaxel, Paclitaxel?
Docetaxel
What antibiotic should not be used during pregnancy?
Telavancin