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First Aid > Pharm (First Aid) > Flashcards

Pharm (First Aid) Flashcards

1
Q

Bethanechol

A

Cholinomimetic agent

Posteroperative ileus, neurogenic ileus, urinary retention.

Activates bowel and bladder smooth muscle; resistant to AChE. “Bethany, call (bethanechol) me to activate your bowels and bladder.”

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2
Q

Carbachol

A

Cholinomimetic agent

Constricts pupil and relieves intraocular pressure in glaucoma

Carbon copy of actylcholine

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3
Q

Methacholine

A

Cholinomimetic agent

Challenge test for diagnosis of asthma

Stimulates muscarinic receptors in airway when inhaled.

Highly sensitive but nonspecific measure that can detect the degree of bronchial hyperreactivity in patients suspected of having asthma. A negative methacholine challenge test can help to exclude (rule out) the diagnosis).

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4
Q

Pilocarpine

A

Cholinomimetic agent

Potent stimulator of sweat, tears, and saliva

Open-angle and closed-angle glaucoma

Contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed-angle glaucoma); resistant to AChE. “You cry, drool, and sweat on your ‘pilow.’”

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5
Q

Donepezil

Galantamine

Rivastigmine

A

Indirect cholinergic agonists (anticholinesterase)

Alzherimer disease

Increase Ach

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6
Q

Edrophonium

A

Indirect cholinergic agonists (anticholinesterase)

Historically, diagnosis of myasthenia gravis (extremely short acting). Myasthenia now diagnosed by anti-AChR Ab (anti-acetylcholine receptor antibody) test.

Increase ACh

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7
Q

Neostigmine

A

Indirect cholinergic agonists (anticholinesterase)

Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative).

Increase ACh

Neo CNS = No CNS penetration

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8
Q

Physostigmine

A

Indirect cholinergic agonists (anticholinesterase)

Anticholinergic toxicity; crosses blood-brain barrier -> CNS.

Increase ACh.

Physostigmine “phyxes” atropine overdose.

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9
Q

Pyridostigmine

A

Indirect cholinergic agonists (anticholinesterase)

Myasthenia gravis (long acting); does not penetrate CNS.

Increase ACh; Increase muscle strength.

Pyridostigmine gets rid of myasthenia gravis.

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10
Q

Adverse effects of cholinomimetic agents

A

Exacerbation of COPD, asthma, and peptic ulcers

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11
Q

Cholinesterase inhibitor poisoning

A

Often due to organophosphates, such as parathion, that irreversibly inhibit AChE.

Causes Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation.

DUMBBELSS

Organophosphates are often components of insecticides; positing usually seen in farmers.

Antidote – atropine (competitive inhibitor) + pralidoxime (regenerates AChE if given early).

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12
Q

Atropine

Homatropine

Tropicamide

A

Muscarinic antagonist

Eye

Produce mydriasis and cycloplegia

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13
Q

Benztropine

A

Muscarinic antagonist

CNS

Parkinson disease (“park my Benz”).

Acute dystonia

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14
Q

Glycopyrrolate

A

Muscarinic antagonist

GI, respiratory

Parenteral: preoperative use to reduce airway secretions.

Oral: drooling, peptic ulcer.

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15
Q

Hyoscyamine

Dicyclomine

A

Muscarinic antagonist

GI

Antispasmodics for irritable bowel syndrome.

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16
Q

Ipratropium

Tiotropium

A

Muscarinic antagonist

Respiratory

COPD, asthma (“I pray I can breathe soon!”)

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17
Q

Oxybutynin

Solifenacin

Tolterodine

A

Muscarinic antagonist

Genitourinary

Reduce bladder spasms and urge urinary incontinence (overactive bladder)

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18
Q

Scopolamine

A

Muscarinic antagonist

CNS

Motion sickness

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19
Q

Atropine

A

Muscarinic antagonist.

Used to treat bradycardia and for ophthalmic applications.

Eye: Pupil dilation, cycloplegia

Airway: Decrease secrtions

Stomach: Decrease acid secretion

Gut: Decrease motility

Bladder: Decrease urgency in cystitis

Toxicity

Increased body temperature (due to decreased sweating); rapid pulse; dry mouth; dry, flused skin; cycloplegia; constipation; disorientation

Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with prostatic hyperplasia, and hyperthemia in infants.

Side effects:

Hot as a hare

Dry as a bone

Red as a beet

Blind as a bat

Mad as a hatter

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20
Q

Tetrodotoxin

A

Highly potent toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing depolarization (blocks action potential without changing resting potential). Causes nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes.

Treatment is primarily supportive.

Poisoning can result from ingestion of poorly prepared pufferfish, a delicacy in Japan.

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21
Q

Ciguatoxin

A

Causes ciguatera fish posioning. Opens Na+ channels causing depolarization. Symptoms easily confused with cholinergic posioning. Temperature-related dysesthesia (e.g., “cold feels hot; hot feels cold”) is regarded as a specific finding of ciguetera.

Treatment is primarily supportive.

Caused by consumption of reef fish (e.g., barracuda, snapper, moray eel).

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22
Q

Scombroid poisoning

A

Acute-onset burning sensation of the mouth, flushing of face, eruthemia, urticaria, pruritus, headache. May cause anaphylaxis-like presentation (i.e., bronchospasm, angioedema, hypotension).

Treat supportively with antihistamines; if needed, antianaphylactics (e.g., bronchodilators, epinephrine).

Caused by consumption of dark-meat fish improperly stored at warm temperature. Bacterial histidine decarboxylase converts histidine -> histamine. Histamine is not degraded by cooking. Frequently misdiagnosed as allergy to fish.

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23
Q

Albuterol

Salmeterol

A

Direct sympathomimetics

Beta-2 > Beta-1

Albuterol for acute ashtma; salmeterol for long-term asthma or COPD control.

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24
Q

Dobutamine

A

Direct sympathomimetics

Beta-1 > Beta-2, alpha

Heart failure (HF) (ionotropic > chronotropic), cardiac stress testing.

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25
Q

Dobutamine

A

Direct sympathomimetics

D1 = D2 > beta > alpha

Ustable bradycardia, HF, shock; ionotropic and chronotropic alpha effects predominate at high doses

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26
Q

Epinephrine

A

Direct sympathomimetics

Beta > alpha

Anaphylaxis, asthma, open-angle glaucoma; alpha effects predominate at high doses.

Significantly stronger effect at beta-2-receptor than norepinephrine.

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27
Q

Isoproterenol

A

Direct sympathomimetic

Beta-1 = Beta-2

Electrophysiologic evaluation of tachyarrhythias. Can worsen ischemia.

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28
Q

Norepinephrine

A

Direct sympathomimetics

Alpha-1 > Alpha-2 > Beta-1

Hypotension (but decreases renal perfusion).

Significantly weaker effect at beta-2-receptor than epinephrine.

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29
Q

Phenylephrine

A

Direct sympathomimetics

Alpha-1 > alpha-2

Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)

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30
Q

Amphetamine

A

Indirect sympathomimetics

Indirect general agonist, reuptake inhibitor, also releases stored catecholamines

Narcolepsy, obesity, ADHD

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31
Q

Cocaine

A

Indirect sympathomimetics

Indirect general agonist, reuptake inhibitor

Causes vasoconstriction and local anesthesia.

Never give beta-blockers if cocaine intoxication is suspected (can lead to unopposed alpha-1 activation and extreme hypertension).

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32
Q

Ephedrine

A

Indirect sympathomimetics

Indirect general agonist, releases stored catecholamines

Nasal decongenstion, urinary incontinence, hypotension.

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33
Q

Clonidine

A

Sympatholytic (alpha-2 agonist)

Hypertensive emergency (limited situations); dose not decrease renal blood flow

ADHD, Tourette syndrome

Toxicity: CNS depression, bradycardia, hypotension, respiratory depression, miosis

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34
Q

Alpha-methyldopa

A

Sympatholytic (alpha-2 agonist)

Hypertensionin pregnancy

Toxicity: Direct Coombs + hemolysis, SLE-like syndrome

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35
Q

Phenoxybenzamine

A

Irreversible alpha-blocker (nonselective)

Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis.

Side effects: Orthostatic hypotension, reflex tachycardia

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36
Q

Phentolamine

A

Reversible alpha blocker (non-selective)

Give to patients on MAO inhibitors who eat tyramine-containing foods.

Side effects: Orthostatic hypotension, reflex tachycardia

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37
Q

Prazosin

Terazosin

Doxazosin

Tamsulosin

A

Alpha-1 selective blockers

(-osin ending)

Urinary symptoms of BPH; PTSD (prazosin); hyperstension (except tamsulosin)

Side effects: 1st-dose orthostatic hypotension, dizziness, headache

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38
Q

Mirtazapine

A

Alpha-2 selective blocker

Depression

Side effects: Sedation, increased serum cholesterol, increased appetite

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39
Q

Acebutolol

Atenolol

Betaxolol

Esmolol

Metoprolol

A

Beta-1-selective antagonist (Beta-1 > beta-1_

(acebutolol – partial agonist)

Selective antagonists mostly go from A to M

(Beta-1 with 1st half of alphabet)

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40
Q

Nadolol

Pindolol

Propranolol

Timolol

A

Nonselective beta antagonists (beta-1 = beta-2)

pindolol = partial agonist

Nonselective antagonists mostly go from N to Z

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41
Q

Carvedilol

Labetalol

A

Nonselective alpha and beta antagonists

Nonselective alpha and beta antagonists have modified suffixes (instead of “olol”)

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42
Q

Nebivolol

A

Combines cardiac selective beta-1-adrenergic blockade with stimulation of beta-3 receptors, which activate nitric oxide synthase in the vasculature.

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43
Q

Acetaminophin: antidote

A

N-acetylcysteine (replenishes glutathione)

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44
Q

AChE inhibitors, organophosphates: antidotes

A

Atropine > pralidoxime

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45
Q

Amphetamines (basic): antidote

A

NH4Cl (acidify urine)

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46
Q

Antimuscarinic, anticholinergic agents: antidotes

A

Physostigmine salicylate, control hyperthermia

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47
Q

Benzodiazepines: antidote

A

Flumazenil

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48
Q

Beta-blockers: antidote

A

Glucagon

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49
Q

Carbon monoxide: antidote

A

100% O2, hyperbaric O2

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50
Q

Copper, arsenic, gold: antidote

A

Penicillamine

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51
Q

Cyanide: antidote

A

Nitrite + thiosulfate, hydroxocobalamin

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52
Q

Digitalis (digoxin): antidote

A

Anti-dig Fab fragments

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53
Q

Heparin: antidote

A

Protamine sulfate

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54
Q

Iron: Antidote

A

Deferoxamine, deferasirox

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55
Q

Lead: Antidote

A

EDTA

dimercaprol

succimer

penicillamine

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56
Q

Mercury, arsenic, gold: Antidote

A

Dimercaprol (BAL)

succimer

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57
Q
A
58
Q

Methanol, ethylene glycol (antifreeze): antidote

A

Fomepizole > ethanol, dialysis

59
Q

Methemoglobin: antidote

A

Methylene blue, vitamin C

60
Q

Opioids: antidote

A

Naloxone

Naltrexone

61
Q

Salicylates: antidotes

A

NaHCO3 (alkalinzie urine)

Dialysis

62
Q

TCAs: antidote

A

NaHCO3 (plasma alkalinization)

63
Q

tPA, streptokinase, urokinase: antidotes

A

Aminocaproic acid

64
Q

Warfarin: antidote

A

Vitamine K (delayed effect)

Fresh frozen plasma

65
Q

Drug reaction: coronary vasospasm

A

Cocaine

Sumatriptan

Ergot alkaloids

66
Q

Drug reaction: Cutaneous flushing

A

Vancomycin

Adenosine

Niacin

Ca2+ channel blockers

(VANC)

67
Q

Drug reactions: Dilated cardiomyopathy

A

Anthracyclines (e.g., doxorubicin, daunorubicin); prevent with dexrazoxane

68
Q

Drug reaction: Torsades de pointes

A

Class III (eg., sotalol) arrhythmics

class IA (e.g., quinidine) antiarrhythmics

macrolide antibiotics,

antipsychotics

TCAs

69
Q

Drug reaction: Hot flashes

A

Tamoxifen

Clomiphene

70
Q

Drug reaction: Hyperglycemia

A

Tacrolimus

Protease inhibitors

Niacin

Hydrochlorothiazide

Corticosteroids

(Taking Pills Necessitates Having blood Checked)

71
Q

Drug reaction: Hypothyroidism

A

Lithium

Amiodarone

Sulfonamides

72
Q

Drug reaction: Acute cholestatic hepatitis, jaundice

A

Erthromycin

73
Q

Drug reaction: Diarrhea

A

Metformin

Erythromycin

Colchicine

Orlistat

Acarbose

Might Exite Colon On Accident

74
Q

Drug reaction: Focal to massive hepatic necrosis

A

Halothane, Amanita phalloides (death cap mushroom), Valproic acid, Acetaminophen

Liver “HAVAc”

75
Q

Drug reaction: Hepatitis

A

Rifampin

Isoniazid

Pyrazinamide

Statins

Fibrates

76
Q

Drug reaction: Pancreatitis

A

Didanosine

Corticosteroids

Alcohol

Valproic acid

Azathioprine

Diuretics (furosemide, hydrochlorathiazide)

Drugs Causing A Violent Abdominal Distress

77
Q

Drug reaction: Agranulocytosis

A

Ganciclovir

Clozapine

Carbamezepine

Colchicine

Methimazole

Propylthiouracil

Gangs CCCrush Myeloblasts and Promyelocytes

78
Q

Drug reaction: Aplastic anemia

A

Carbamazepine

Methimazole

NSAIDs

Benzene

Chloramphenicol

Propylthiouracil

Can’t Make New Blood Cells Properly

79
Q

Drug reaction: Direct Coombs-positive hemolytic anemia

A

Methyldopa

Penicillin

80
Q

Drug reaction: Hemolysis in G6PD deficiency

A

Isoniazid

Sulfonamides

Dapsone

Primaquine

Aspirin

Ibuprofen

Nitrofurantoin

Hemolysis IS D PAIN

81
Q

Drug reaction: Megaloblastic anemia

A

Phenytoin

Methotrexate

Sulfa drugs

Having a blast with PMS

82
Q

Drug reaction: Thrombocytopenia

A

Heparin

83
Q

Drug reactions: Thrombotic complications

A

OCPs

Hormone replacement therapy

84
Q

Drug reaction: Fat redistrubition

A

Protease inhibitors

Glucocorticoids

85
Q

Drug reaction: Gingival hyperplasia

A

Phenytoin

Ca2+ channel blockers

cyclosporine

86
Q

Drug reaction: Hyperuricemia (gout)

A

Pyrazinamide

Thiazides

Furosemide

Niacin

Cyclosporine

Painful Tophi and Feet Need Care

87
Q

Drug Reaction: Myopathy

A

Fibrates

Niacin

Colchicine

Hydroxychloroquine

Interferon-alpha

Penicillamine

Statins

Glucocorticoids

88
Q

Drug reaction: Photosensitivity

A

Sulfonamides

Amiodarone

Tetracyclines

5-FU

SAT For Photo

89
Q

Drug reaction: Rash (Stevens-Jonshon syndrome)

A

Anti-epileptic drugs (espeically lamotrogine), allopurinol, sulfa drugs, penicillin

90
Q

SLE-like syndrome

A

Sulfa drugs

Hydralazine

Isoniazid

Procainamide

Phenytoin

Etanercept

Having lupus is “SHIPP-E”

91
Q

Drug reaction: Tendonitis, tendon rupture, and cartilage damage

A

Fluoroquinolones

92
Q

Drug reaction: Cinchonism

A

Quinidine

Quinine

93
Q

Drug reaction: Parkinson-like syndrome

A

Antipsychotics

Reserpine

Metoclopramide

Cogwheel rigidity of ARM

94
Q

Drug reaction: Seizures

A

Isoniazid (vitamin B6 deficiency), Buproprion, Imipenem/cilastatin, Enflurane

With seizures, I BItE my tongue

95
Q

Drug reaction: Tardive dyskinesia

A

Antipsychotics

Metoclopramide

96
Q

Drug reaction: Diabetes insipidus

A

Lithium

Demeclocycline

97
Q

Drug reaction: Fanconi syndrome

A

Expired tetracycline

98
Q

Drug reaction: Hemorrhagic cystitis

A

Cyclophosphamide

Ifosfamide

Prevent by coadministering with mesna

99
Q

Drug reaction: Interstital nephritis

A

Methicillin

NSAIDs

Furosemide

100
Q

Drug reaction: SIADH

A

Carbamazepine, Cyclophosphamide, SSRIs

Can’t Concentrate Serum Sodium

101
Q

Drug reaction: Pulmonary fibrosis

A

Bleomycine

Amiodarone

Busulfan

Methotrexate

Breathing Air Badly from Medications

102
Q

Drug reaction: Antimuscarinic

A

Atropine

TCAs

H1-blockers

Antipsychotics

103
Q

Drug reaction: Disulfiram-like reaction

A

Metronidazole

Certain cephalosporins

Griseofulvin

Procarbazine

1st generation sulfonylureas

104
Q

Drug reaction: Nephrotoxicity/ototoxicity

A

Aminoglycosides

Vancomysin

Loop diuretics

Cisplatin

Cisplatin toxicity may respond to amifostine

105
Q

Sulfa drugs
Examples

Adverse Effects

A

Probenecid

Furosemide

Acetazolamide

Celecoxib

Thiazides

Sulfonamide antibiotics

Sulfasalazine

Sulfonylureas

Popular FACTSSS

Patients with sulfa allergies may develop fever, UTI, Stevens-Johnson, hemolytic anemia, thrombocytopenia, agranulocytosis, and urticaria (hives).

106
Q

-azole

A

Ergosterole synthesis inhibitor

E.g., ketoconazole

107
Q

-bendazole

A

Antiparasitic/antihelminthic

E.g., Mebendazole

108
Q

-cillin

A

Peptidoglycan synthesis inhibitor

E.g., ampicillin

109
Q

-cycline

A

Protein synthesis inhibitor

E.g., Tetracycline

110
Q

-ivir

A

Neuraminidase inhibitor

E.g., Oseltamivir

111
Q

-navir

A

Protease inhibitor

Ritonavir

112
Q

-ovir

A

DNA polymerase inhibitor

E.g., Acyclovir

113
Q

-thromycin

A

Macrolide antibiotic

E.g., azithromycin

114
Q

-ane

A

Inhalational general anesthetic

e.g., Halothane

115
Q

-azine

A

Typicla antipsychotic

Thioridazine

116
Q

-barbital

A

Barbituate

E.g., Phenobarbital

117
Q

-caine

A

Local anesthetic

E.g., Lidocaine

118
Q

-etine

A

SSRI

E.g., fluoxetine

119
Q

-ipramine, -tryptyline

A

TCA

E.g., Imipramine, amitriptyline

120
Q

-triptan

A

5-HT1B/1D agonists

Sumatriptan

121
Q

-zepam, -zolam

A

Benzodiazepine

Diazepam, alprazolam

122
Q

-chol

A

Cholinergic agonist

E.g., Bethanecol, carbachol

123
Q

-curium, -curonium

A

Nondepolarizing paralytic

E.g., atracurium, vecuronium

124
Q

-olol

A

Beta blocker

E.g., propranolol

125
Q

-stigmine

A

AChE inhibitor

E.g., Neostigmine

126
Q

-terol

A

Beta-2-agonist

E.g., Albuterol

127
Q

-zosin

A

Alpha-1-antagonist

E.g., Prazosin

128
Q

-afil

A

PDE-5 inhibitor

E.g., Sildenafil

129
Q

-dipine

A

Dihydropyridine calcium channel blocker

E.g., Amlodopine

130
Q

-pril

A

ACE inhibitor

E.g., Captopril

131
Q

-sartan

A

Angiotensin-II receptor blocker

E.g., Losartan

132
Q

-statin

A

HMG-CoA reductase inhibitor

E.g., Atorvastatin

133
Q

-dronate

A

Bisphosphonate

E.g., Alendronate

134
Q

-glitazone

A

PPAR-gamma activator

E.g., Rosiglitazone

135
Q

-prazole

A

Proton pump inhibitor

E.g., omeprazole

136
Q

-prost

A

Prostaglandin analog

E.g., Latanoprost

137
Q

-tidine

A

H2-antagonist

E.g., Cimetidine

138
Q

-tropin

A

Pituitary hormone

E.g., somatotropin

139
Q

-ximab

A

Chimeric monoclonal Ab

E.g., Basiliximab

140
Q

-zumab

A

Humanized monoclonal Ab

Daclizumab

First Aid (4 decks)

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