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Pharmacology > Pharm II - Test 1 > Flashcards

Pharm II - Test 1 Flashcards

1
Q

Class: Morphine (MS Contin)

A

Opioid analgesic

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2
Q

MOA: Morphine (MS Contin)

A

Opioid receptor agonist

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3
Q

Indication: Morphine (MS Contin)

A

Pain relief

Acute MI

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4
Q

Properties: Morphine (MS Contin)

A

Analgesic
Anxiolytic
Vasodilator

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5
Q

Side effects: Morphine (MS Contin)

A 
Respiratory depression
Miosis
Itching (dt histamine release)
N/V
Constipation (paralytic ileus)
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6
Q

Class: Fentanyl/Duragesic

A

Opioid analgesic

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7
Q

Indication: Fentanyl/Duragesic

A

Pain relief, anesthesia

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8
Q

MOA: Fentanyl/Duragesic

A

Opioid receptor agonist

80x the analgesic property of morphine

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9
Q

Route: Fentanyl/Duragesic

A

IV, transdermal patch, buccal lozenge/film, SL spray, lollypop

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10
Q

Contraindications: Fentanyl/Duragesic

A

Direct use with heating pads (inc. dose)

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11
Q

Class: Codeine

A

Opioid analgesic

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12
Q

MOA: Codeine

A

Opioid agonist, converted to morphine, much weaker analgesic than morphine

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13
Q

Contraindications: Codeine

A

CYP2D6 polymorphism, which causes ultra-rapid metabolism of codeine

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14
Q

Side effects: Codeine

A

Sedation
Constipation
Itching

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15
Q

Indication: Tramadol/Ultram

A

Withdrawal of heroin and morphine

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16
Q

Class: Naloxone (Narcan)

A

Opioid antagonist

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17
Q

Indication: Naloxone (Narcan)

A

Opioid overdose

Reverses coma/respiratory depression

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18
Q

MOA: Naloxone (Narcan)

A

Opioid antagonist (bind w/ high affinity, but do not activate response)

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19
Q

Class: Aspirin / Acetylsalicyclic acid (ASA)

A

NSAID (COX 1/2 inhibitor)

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20
Q

MOA: Aspirin / Acetylsalicyclic acid (ASA)

A

Irreversible inhibition of COX-1 and COX-2 enzymes -> blockade of prostaglandin synthesis

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21
Q

Why is aspirin not indicated for post-surgery?

A

Irreversibly affects platelets

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22
Q

Side effects: Aspirin / Acetylsalicyclic acid (ASA)

A

Inc. risk of Reye’s syndrome

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23
Q

Salicylism

A

dizziness, tinnitus, hyperventilation, mental status changes, potential for coma/death

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24
Q

Tx: Salicylism

A

IV hydration, alkalinization of urine, dialysis if necessary

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25
Q

Class: Ibuprofen (Motrin, Advil)

A

NSAID (COX 1/2 inhibitor)

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26
Q

MOA: Ibuprofen (Motrin, Advil)

A

Reversible inhibition of COX-1 and COX-2 enzymes

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27
Q

Class: Celecoxib (Celebrex)

A

NSAID (selective COX-2 inhibitor)

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28
Q

Indication: Celecoxib (Celebrex)

A

adenomatous polyps

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29
Q

MOA: Celecoxib (Celebrex)

A

Reversible, selective COX-2 inhibition

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30
Q

Class: Acetaminophen (Tylenol)

A

NSAID

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31
Q

Acetaminophen (Tylenol) is pregnancy category __.

A

B

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32
Q

Stage 1 - Acetominophen toxicity

A

12-24 hrs - N/V

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33
Q

Stage 2 - Acetominophen toxicity

A

24-48 hrs - mb clinically improved, but rising AST, ALT, bilirubin levels

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34
Q

Stage 3 - Acetominophen toxicity

A

72-96 hrs - peak hepatotoxicity, AST mb > 20,000

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35
Q

Stage 4 - Acetominophen toxicity

A

> 96 hrs - recovery, LV transplant or death

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36
Q

Antidote - Acetominophen toxicity

A

N-acetylcysteine within 8 hours of OD

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37
Q

What serotonin receptor elicits vasoconstriction?

A

Serotonin 1 (5 HT-1)

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38
Q

What serotonin receptor elicits vasodilation?

A

Serotonin 2 (5 HT-2)

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39
Q

Indication: Propranolol (Inderal)

A

HTN, angina, AMI, panic attacks, migraines (prophylaxis), hyperthyroidism

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40
Q

Contraindications: Amitriptyline (Elavil)

A

Do not use with monoamine oxidase (MAO) inhibitors

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41
Q

Class: Topiramate (Topamax)

A

Anticonvulsant

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42
Q

Inidication: Topiramate (Topamax)

A

Epilepsy, migraines (prophylaxis), weight loss, bipolar d/o (off-label)

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43
Q

MOA: Topiramate (Topamax)

A

Block voltage-dependent Na channels in CNS -> affects GABA activity

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44
Q

Class: Methysergide (Sansert)

A

Ergot derivative (serotonin 2 antagonist)

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45
Q

Indication: Methysergide (Sansert)

A

Migraine (prophylaxis) and cluster HA

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46
Q

MOA: Methysergide (Sansert)

A

Serotonin 2 receptor antagonist

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47
Q

Contraindications: Methysergide (Sansert)

A

Should not be used longer than 6 months

Do not use within 24 hrs of a triptan bc of inc. risk of vasoconstrictive spasm

Category X

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48
Q

Prodromal phase of migraines medications (1)

A

Sumatriptan (Imitrex)

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49
Q

Prophylaxis of migraines medications (4)

A

Propranolol (Inderal)
Amitryptyline (Elavil)
Methysergide (Sansert)
Topiramate (Topamax)

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50
Q

Indication: Sumatriptan (Imitrex)

A

Migraine and cluster HA

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51
Q

MOA: Sumatriptan (Imitrex)

A

Serotonin agonist at 5-HR 1D/1B receptors

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52
Q

Side effects: Sumatriptan (Imitrex)

A

Serotonin syndrome

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53
Q

Contraindications: Sumatriptan (Imitrex)

A

Use w/ caution in pts with HTN or angina

Category C

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54
Q

Serotonin syndrome

A

agitation, tremor, ataxia, fever, chills, diarrhea

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55
Q

Class: Butorphanol (Stadol)

A

Opioid analgesic

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56
Q

Indication: Butorphanol (Stadol)

A

Migraine HA refractory to triptans

57
Q

MOA: Butorphanol (Stadol)

A

Mixed agonist-antagonist of opioid receptors

58
Q

Anti-emetic for migraines medications (1)

A

Prochlorperazine (Compazine)

59
Q

Category: Ondansetron (Zofran)

A

Antiemetic

60
Q

MOA: Ondansetron (Zofran)

A

Blockade of serotonin (5HT3) receptor sites

61
Q

If a patient is taking Aspirin and you add an NSAID, ___

A

you reduce the cardioprotective effects of aspirin

62
Q

Treatment of acute gouty attack includes:

A

NSAIDs
Steroids
Colchicine

63
Q

Prophylactic tx of gout includes:

A

Colchicine
Allopurinol
Probenecid

64
Q

Category: Indomethacin (Indocin)

A

NSAID

65
Q

Indication: Indomethacin (Indocin)

A

Gout, arthritis, bursitis, migraine, hemicrania, pain, swelling

66
Q

MOA: Indomethacin (Indocin)

A

COX-I and COX-II inhibition

67
Q

Category: Colchicine

A

Mitotic inhibitor

68
Q

Indication: Colchicine

A

Gout (acute and prophylaxis)

69
Q

MOA: Colchicine

A

Inhibits microtubule polymerization via tubulin binding -> Tubulin essential for mitosis

Inhibits neutrophil motility/activity -> anti-inflammatory

70
Q

Side effects: Colchicine

A

PERIPHERAL NEUROPATHY, GI upset, anemia, neutropenia, hair loss

71
Q

Category: Allopurinol (Zyloprim)

A

Purine analog

72
Q

Indication: Allopurinol (Zyloprim)

A

Hyperuricemia, gout, prophylaxis against tumor lysis syndrome

73
Q

MOA: Allopurinol (Zyloprim)

A

Xanthine oxidase inhibitor

74
Q

Category: Probenecid (Probalan)

A

Uricosuric

75
Q

Indication: Probenecid (Probalan)

A

Hyperuricemia, gout

76
Q

MOA: Probenecid (Probalan)

A

Interferes w/ kidneys’ organic anion transporter (OAT), which normally retains uric acid from urine

77
Q

Contraindications: Probenecid (Probalan)

A

Pts with G6PD deficiency (hemolytic anemia)

Pts w/ renal insufficiency (formation of uric acid stones)

Use w/ salicylates

78
Q

PARQ: Probenecid (Probalan)

A

Drink water, stay hydrated to prevent stone formation

79
Q

Side effects: corticosteroids

A

Inc susceptibility to infx, poor wound healing, hyperglycemia, inc. risk for osteoporosis, Cushing’s syndrome, potential adrenal suppression

80
Q

First-line drug for juvenile arthritis

A

Methotrexate

81
Q

Class: Methotrexate (MTX)

A

Anti-metabolite and anti-folate immunosuppressant and chemotherapeutic

82
Q

MOA: Methotrexate (MTX)

A

Anti-metabolite, anti-folate drug

83
Q

For cancer patients on Methotrexate (MTX), never give ___

A

folic acid

84
Q

Class: Azathioprine (Imuran)

A

Purine anti-metabolite immunosuppressant

85
Q

Indication: Azathioprine (Imuran)

A

Prevention of transplant rejection, IBD, SLE, RA

86
Q

MOA: Azathioprine (Imuran)

A

Metabolic breakdown products of Azathioprine inhibit purine synthesis -> block protein synthesis

87
Q

Class: Cyclosporine (Sandimmune)

A

Immunosuppressant (derived from soil fungus)

88
Q

Indication: Cyclosporine (Sandimmune)

A

Prevent rejection of KD, LV, and heart transplants, RA, severe psoriasis

89
Q

MOA: Cyclosporine (Sandimmune)

A

T-cell inhibition -> inhibition of IL-1, IL-2, IL-3, IL-4, IFN-gamma

90
Q

Class: Tacrolimus (Prograf)

A

Immunosupressant (derived from soil microorganism)

91
Q

Indication: Tacrolimus (Prograf)

A

Protection against rejection of organ transplantation

Topical for severe eczema

92
Q

MOA: Tacrolimus (Prograf)

A

T-cell inhibition

100x more potent than Cyclosporine

93
Q

Contraindications: Tacrolimus (Prograf), Cyclosporine (Sandimmune)

A

Use w/ grapefruit juice

94
Q

Which immunosuppressant can be used in the eye to stimulate tear production?

A

Cyclosporine (Sandimmune) as Restasis

95
Q

Class: Etanercept (Enbrel)

A

DMARD, recombinant-DNA drug

96
Q

Indication: Etanercept (Enbrel)

A

Mod-sev RA, mod-sev. polyarticular juvenile arthritis, psoriatic arthritis, ankylosing spondylitis, mod-sev. plaque psoriasis

97
Q

MOA: Etanercept (Enbrel)

A

Reduction of inflammation via anti-TNFalpha action

98
Q

Class: Infliximab (Remicade)

A

DMARD, recombinant-DNA drug

99
Q

Indication: Infliximab (Remicade)

A

RA, Crohn’s, UC

100
Q

MOA: Infliximab (Remicade)

A

prevents binding of TNF-a with its receptors by binding to free TNF-a

101
Q

MOA: Infliximab (Remicade) vs Etanercept (Enbrel)

A

Infliximab causes apoptosis of TNFa-expressing activated T-cells

Why infliximab has been used with success in Crohn’s and UC, while Etanercept has not

102
Q

Which of the drugs used for RA or lupus is also used to treat malaria?

A

Hydroxychloroquine (Plaquenil)

103
Q

MOA: Hydroxychloroquine (Plaquenil)

A

Blocks activation of TLRs on plamacytoid dendritic cells

Increases lysosomal pH

104
Q

Class: Hydroxychloroquine (Plaquenil)

A

Immunosuppressant and anti-malarial

105
Q

Indication: Hydroxychloroquine (Plaquenil)

A

RA, SLE, Sjogren’s, malaria

106
Q

Side effects: Hydroxychloroquine (Plaquenil)

A

Corneal/macular damage, D, HA, N/V, hives, itching rash, loss of hair

Pts with G6PD deficiency: severe anemia

OD: drowsiness, HA, vision problems, SOB, convulsions

107
Q

Which immunosuppressant requires regular ophthalmologic exams dt the possibility of corneal and macular damage?

A

Hydroxychloroquine (Plaquenil)

108
Q

What is a last-option drug for RA?

A

Gold salts - Auranofin (Ridaura)

109
Q

What is tachyphylaxis?

A

rapid decrease in the response to a drug over a relatively short period of time

110
Q

Corticosteroids: Short-acting (8-12 hrs)

A

Hydrocortisone

111
Q

Corticosteroids: Intermediate-acting (18-36 hrs)

A

Prednisone

112
Q

Corticosteroids: Long-acting (24-72+ hrs)

A

Dexamathasone

Betamethasone

113
Q

If hydrocortisone is considered a “1” for its anti-inflammatory effect, prednisone is a ___.

A

4

114
Q

If hydrocortisone is considered a “1” for its anti-inflammatory effect, dexamethasone is a ___.

A

30

115
Q

If hydrocortisone is considered a “1” for its anti-inflammatory effect, betamethasone is a ___.

A

35

116
Q

Abrupt discontinuation of a glucocorticoid can result in ___, which can be lethal.

A

Acute adrenal insufficiency syndrome (Addisonian crisis)

117
Q

SSx: Addisonian Crisis

A 
Severe lethargy
Severe V/D (dehydration)
Low blood pressure
Confusion
Hyponatremia, hypoglycemia
LOC
Convulsions
118
Q

Class: Prednisone (Deltasone)

A

Glucocorticoid (corticosteroid)

119
Q

MOA: Prednisone (Deltasone)

A

Alters gene transcription

120
Q

Class: Dexamethasone (Decadron)

A

Fluorinated corticosteroid

121
Q

Indications: Dexamethasone (Decadron)

A

IV (intracranial pressure)

122
Q

MOA: Dexamethasone (Decadron)

A

Affects gene transcription

123
Q

Class: Triamcinolone inhaler (Azmacort)

A

Corticosteroid

124
Q

Indications: Triamcinolone inhaler (Azmacort)

A

Asthma (not acute attack), COPD

125
Q

MOA: Triamcinolone inhaler (Azmacort)

A

Dec. inflammation of bronchial wall

Affects gene transcription

126
Q

Aldosterone is reduced in __ and increased in __.

A

Addison’s dz

Conn’s syndrome

127
Q

Class: Fludrocortisone (Florinef)

A

Halogenated glucocorticoid (mineralcorticoid agonist)

128
Q

Indications: Fludrocortisone (Florinef)

A

Mineralcorticoid replacement for pts w/ Addison’s dz and other cases of hyponatremia

129
Q

MOA: Fludrocortisone (Florinef)

A

Na retention at renal tubular cells

130
Q

Contraindications: Fludrocortisone (Florinef)

A

Not indicated as an anti-inflammatory agent

131
Q

High potency corticosteroids (2)

A

Betamethasone

Dexamethasone

132
Q

Medium potency corticosteroids (4)

A

Methylprednisolone

Triamcinolone

Prednisolone

Prednisone

133
Q

Low potency corticosteroids (2)

A

Hydrocortisone

Cortisone

134
Q

Mineralcorticoid activity (2)

A

Cortisone

Hydrocortisone

135
Q

More Corticosteroid effect than Mineralcorticoid effect (2)

A

Prednisolone

Prednisone

136
Q

No Mineralcorticoid activity (4)

A

Betamethasone

Dexamethasone

Methylprednisolone

Triamcinolone

137
Q

DEA - Schedule I

A

No currently accepted medical use, high potential for abuse

138
Q

DEA - Schedule II

A

High potential for abuse (less than schedule I)

Pharmacology (4 decks)

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