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Module 1: Mali Rheum/MSK > Pharm MOA and buz words from the table > Flashcards

Pharm MOA and buz words from the table Flashcards

1
Q

what is the MOA of acetaminophen?

A

CNS anti-prostaglanding, blocks periphreal pain impulse generation! Inhibits hypothalmic heat regulation!

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2
Q

Acetminophen: Kidneys? Liver?

A

Kideys YES, liver NO

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3
Q

acetaminophen: increases what?

A

uric acids in the body

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4
Q

acetaminophen with alocohol?

A

absolutely not!

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5
Q

acetaminophen: max ped dose?

A

160/5 ml

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6
Q

acetaminophen interacts with which 3 drugs? what does it do?

A

anticonvulsants
decrease APAP
increase warfarin

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7
Q

what is the MOA for tramadol?

A

opioid analgesic, mu receptor antagonist and inhibits uptake NE and 5HT-both modify ascending pain pathways

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8
Q

what is the max dose of tramadol in 24 hours?

A

400mg

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9
Q

if a person with hepatic or renal impairment and wants to take tramadol what do you have to do?

A

extended release

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10
Q

what is the MOA for ibuprophen?

A

inhibit COX1 and COX2 enzymes, reducing PG, prostacyclin, thromboxane

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11
Q

what are the contraindications for ALL NSAIDS?! (4)

A

HTZ, CKD, HF, CVD

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12
Q

what is a contraindication for ibuprophen?

A

GI bleeding or ulcer!! causes increased bleeding in 20%

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13
Q

what are common side effects of ALL NSAIDS?!

A

increase BP

fluid retention

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14
Q

Celecoxib side effects…..this is why you must do what monitor?

A

increased BP
fluid retention
CV disease, increased clotting

this is why CrCl, CBC, LFT, AND EKG!!!

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15
Q

of the NSAIDS, which is better for a patient with a stomache/gastric bleed/ulcer?

A

celecoxib since only COX-2 involved

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16
Q

what is the MOA for methotrexate?

[dy at the thought of spiders!!]

A

inhibits dihydrofolate reductase and DNA production, inhibits production of cytokines

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17
Q

when do you use methotrexate?

A

recent RA

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18
Q

what is the pregnancy warning for methotrexate?

A

X

DO NOT GET PREGNANT!!

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19
Q

what are common sideffects of methotrexate? (6)

A

arachnoiditis, motor paralysis, CN palsey, coma, pulmonary fibrosis, SJS

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20
Q

when should you not use methotrexate in a patient?

A

AIDS, alcoholic liver disease, peptic ulcer disease, ulcerative colitis

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21
Q

what two things should you not use methotrexate with?

A

live vaccines and ethanol!

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22
Q

what is the mode of action of hydroxychloroquine?

A

possibly suppression of T cell response to mitogens

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23
Q

what are the indications for hydroxycholoroquine?

A

SLE, RA, malaria

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24
Q

what are interesting things hydroxychloroquine can cause?

A

nightmares, ocular toxiticity (need eyes checked q6-12 months)

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25
Q

what are some contraindications that are for hydroxychloroquine?

A

retinal field changes,

G6PD deficiency

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26
Q

what are the only two drugs on our list that are contraindicated with a G6PD deficiency?

A

sulfasalazine and hydroxycholoroquine

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27
Q

where is hydroxycholorquine bound in the tissues? how long does it take to get the full effect and what is the halflife?

A

exclusively in the melanin
3-6 months
T 45 days!

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28
Q

what is the MOA of tofacitinib?

A

inhibits JAK enzymes and prevents gene expression and intracellular activity of immune cells IgG, IgA, IgM

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29
Q

Tofactitinib is the only drug that has a ______ it can cause_____ _____ _____

A

Tofactitnib is the only drug that has a BLACK BOX WARNING and can cause INFECTION, TB, MALIGNANCY

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30
Q

how common is infection when taking tofacitinib which is the black box drug?

A

20 %!!! holy cow

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31
Q

who do you use tofactitnib in? can you combine this with biologic DMARDS?

A

only those not responding to methotrexate, it still is a non-biologic dmard, DO NOT COMBINE WITH BIOLOGIC DMARDS!!

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32
Q

what is the MOA of Etanercept? what is it used for?

A

binds TNF preventing it from binding to TNF receptors. Aggressive RA that won’t work with NB-DMARDS

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33
Q

what drug class is etanercept?

A

TNF-alpha blocker (biologic DMARDS

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34
Q

what is an interesting thing that etanercept is known for doing?

A

reactivation of TB, hepatitis, lymphoma, infection, varicella

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35
Q

what is the MOA of abatacept?

A

inhibits T cell activity by binding to CD80, CD86 on APC, and CD28 in interaction

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36
Q

what is the indication for abatacept

A

RA non responsive to other DMARDs

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37
Q

what drug class is abatacept?

A

T-cell activator inhibitor (biologic dmards)

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38
Q

what is the drug class for rituximab?

A

monoclonal antibody (biologic dmard)

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39
Q

what is the MOA of rituximab?

A

chimeric monoclonal antibody that inhibits CD20 on B celss, and decreases presentation to T cells

40
Q

what is the indication for rituximab?

1 major and 3 others!

A

severe RA that didn’t respond to etanercept and methotrexate combination

  • leukemia
  • non-hodgkins lymphoma
  • granulomatosis with polyangitis
41
Q

what is a interesting side effect experienced by 30% of people on rituximab?

A

a rash with first infusion so important to put them on a steroid first to pre-treat them

42
Q

what is the drug class for anakinra?

A

IL-1 receptor agonist

43
Q

what is the MOA of anakinra? what is this used for?

A

NATURALLY OCCURING antagonist of IL-1 which reduces degredation of cartilage and inhibits bone reabsorption so used for RHEUMATOID ARTHRITIS

44
Q

what are the negative side effects of anakinra? (3)

A

infections
malignancy
neutropenia

45
Q

what is the drug class for mycophenolate mofeti?

A

semi-synthetic DMARDS

46
Q

what is the MOA for mycophenolate mofetil?

A

supresses the t and b cells, pretty generic huh

47
Q

what are the indications for mycophenolate mofetil?

A

TRANSPLANTS!!

48
Q

what is the drug class for sulfasalazine?

A

synthetic NONBIOLOGIC DMARD

49
Q

what is the MOA of sulfasalzine? (2, systemic and local)

A

sulfapryradine inhibits PG, and decreases IgA, IgM, and RF SYSTEMICALLY

5-aminoblahblahblah acid reduces colon inflammation LOCAL

50
Q

what are the indications for sulfasalzine? On and off label? (5 total)

A

RA, ulcerative colitis

off-label: chrohns, psoriasis, psoratic arthritis

51
Q

what is a interesting thing sulfasalzine can cause? (2)

A 
reversible oliospermia (infertility) MEN ONLY
cholestatic jaundice
52
Q

what percent of the oral dose of sulfasalzine is absorbed?

A

10-20%

53
Q

what drug class does prednisone?

A

glucocorticoids

54
Q

what is the MOA of prednisone?

A

inhibits cytokines and inflammatory mediators

55
Q

what are some interesting side effects seen with prednisone?

A 
weight gain
osteoporosis
mood changes
striae
EVERYTHING ELSE
56
Q

what is the drug class for colchicine?

A

leukocyte migration inhibitor (gout)

57
Q

what is the MOA of colchicine?

A

inhibits leukocytes from migrating and phagocytosis

58
Q

what is the most common and stark side effect of colchicine?

A

D, N, V in 80%!!!!!!!! wow thats a ton!

59
Q

does colchicine have a high or low therapeutic index?

A

LOW! means that there is increased risk if you get out of that range you will have negative effects!!!

60
Q

what is the drug class of probenicid?

A

uriosuric (gout)

61
Q

what is the MOA of probenicid?

A

blocks PCT reabsorption of uric acid (gout), so avoid in people who have history of kidney stones!

62
Q

what drug can cause nephrolithiasis?

A

colchicine

63
Q

what CrCl level should you avoid in probenicis??

A
64
Q

how long does it take to see the effects of colchicine?

A

6-12 months! aw boo they have to wait!

65
Q

what is the drug class for allopurinol?

A

xanthine oxidase inhibitor

66
Q

what is the MOA of allopurinol?

A

inhibits xanithine oxidase and blocks the formation of uric acid

67
Q

what is the indication for allopurinol?

A

gout prophylaxis

68
Q

what does allopurinol do when combined with ampicillin/amoxicillin?

A

A RASH!

69
Q

what is the primary metabolite of allopurinol and what happens in people who have CKD?

A

oxypurinol

it has a long half life and accumulates in people with CKD

70
Q

what is the drug class for febuxostat?

A

non purine xanthine oxidase inhibitor, anti gout

71
Q

what is the MOA of febuxostat?

A

selectively inhibits xanthine oxidase to reduce uric acid levels (anti gout)

72
Q

what should you use with febuxostat?

A

azathioprine or mercaptapurine (anti gout)

73
Q

what is the drug class for baclofen? when do you use it?

A

centrally acting muscle relaxant, used for MS and spinal cord lesions

74
Q

what is the MOA of baclofen?

A

inhibits transmission of synaptic reflexes at spinal cord level

75
Q

what are some interesting side effects seen with baclofen?

A

vertigo, psych disturnances, slurred speech

need to monitor mental status!

76
Q

what are some common drug interactions with baclofen?

A
  • increases opiates/benzos
  • increase alcohol
  • clindamycin
  • CNS depressants
77
Q

what should you never do with baclofen

A

NEVER STOP ABRUPTLY!!

78
Q

what is the max dose for baclofen

A

80 mg, dose 5 mg

79
Q

what drug class is cyclobenzapine? what is it related to?

A

centrally acting muscle relaxant, related to tricyclic antidepressants to reduce tonic somatic motor activity

80
Q

what patient population should you avoid with cyclobenzapine?

A

elderly!!

81
Q

how much does it cost for 60 capsuls of cyclobenzapine the the ER?

A

~1500 wow! keep this in mind!!

82
Q

cyclobenzaprine can cause? (3)

A

xerostomia, anticholinergic effects, CNS depression

83
Q

what is the drug class for dantrolene?

A

preiphreally acting muscle relaxant

84
Q

what is the MOA of dantrolene?

A

acts directly on the skeletal muscle to inhibit the release of CA+++ from sacroplasmic reticulum

85
Q

what enzymes does dantrolene rely on? therefore you shouldn’t have it with what thing?

A

CYP34A

DON”T HAVE GRAPEFRUIT JUICE!!!

86
Q

what is the drug class of amitriptyline?

A

tricyclic antidepressant (neurologic pain)

87
Q

what is the MOA of amitriptyline?

A

inhibits the reuptake of serotonin, NE in CNS?

88
Q

what are the indications for amitriptyline?

A

depression, diabetic neuropathy, migraine

89
Q

what should you be monitoring in someone taking amitriptyline?

A

SUICIDE IDEATION!!!!! IT IS A BLACK BOX WARNING WITH SUICIDE RISK!!!

90
Q

what is the drug class for cyclophosphamide?

A

anti-neoplastic alkylating agent

91
Q

what is the MOA of cyclophosphamide?

A

alkalating agent prevent cell division and cross linking

92
Q

what drug class is pillocarpine?

A

cholingeric effect

93
Q

what is the MOA of pillocarpine?

A

agnonist impact on muscarinic receptors that stimulate salivary gland secretion

94
Q

what do you use pillocarine for?

A

sjrogrens

95
Q

if the patient has closed angle glaucoma should you use pillocarpine

A

NO!

96
Q

what do you need to monitor in a patient taking pilocarpine?

A

IOP, fundiscopic changes, visual fields

97
Q

what forms does pilocarpine come in?

A

oral and opthalmic drops!

Module 1: Mali Rheum/MSK (4 decks)

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