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First Aid Step 1 Rapid Review > Pharm (Pages 225-248) > Flashcards

Pharm (Pages 225-248) Flashcards

1
Q

α1

G-Protein Class/Major Functions

A

q

Increase vascular smooth muscle contraction, Increase pupillary dilator muscle contraction (mydriasis), Increase intestinal and bladder sphincter muscle contraction

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2
Q

α2

G-Protein Class/Major Functions

A

i

Decreases sympathetic outflow, Decreases insulin release, Decreases, lipolysis, Decreases platelet aggregation

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3
Q

β1

G-Protein Class/Major Functions

A

s

Increase heart rate, Increase contractility, Increase renin release, Increase lipolysis

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4
Q

β2

G-Protein Class/Major Functions

A

s

Vasodilation, bronchodilation, Increase heart rate, Increase contractility, Increase lipolysis, Increase insulin release, DECREASED uterine tone (tocolysis), ciliary muscle relaxation, q aqueous humor production

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5
Q

M1

G-Protein Class/Major Functions

A

q

CNS, enteric nervous system

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6
Q

M2

G-Protein Class/Major Functions

A

i

Decreased heart rate and contractility of atria

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7
Q

M3

G-Protein Class/Major Functions

A

q

Increased exocrine gland secretions (e.g., lacrimal, salivary, gastric acid), increased gut peristalsis, increased bladder contraction, bronchoconstriction, decreased pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accommodation)

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8
Q

D1

G-Protein Class/Major Functions

A

s

Relaxes renal vascular smooth muscle

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9
Q

D2

G-Protein Class/Major Functions

A

i

Modulates transmitter release, especially in brain

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10
Q

H1

G-Protein Class/Major Functions

A

q

Increases nasal and bronchial mucus production, Increases vascular permeability, contraction of bronchioles, pruritus, and pain

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11
Q

H2

G-Protein Class/Major Functions

A

s

Increases gastric acid secretion

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12
Q

V1

G-Protein Class/Major Functions

A

q

Increases vascular smooth muscle contraction

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13
Q

V2

G-Protein Class/Major Functions

A

s

Increases H2O permeability and reabsorption in the collecting tubules of the kidney (V2 is found in the 2 kidneys)

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14
Q

Bethanechol

Clinical applications/action

A

Postoperative ileus, neurogenic ileus, and
urinary retention

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

Direct agonist

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15
Q

Carbachol

Clinical applications/action

A

Glaucoma, pupillary constriction, and relief of
intraocular pressure

Carbon copy of acetylcholine.

Direct agonist

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16
Q

Pilocarpine

Clinical applications/action

A

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.’ ”

Direct agonist

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17
Q

Methacholine

Clinical applications/action

A

Challenge test for diagnosis of asthma

Stimulates muscarinic receptors in airway when inhaled.

Direct agonist

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18
Q

Neostigmine

Clinical applications/action

A

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

Increases endogenous ACh.
Neo CNS = No CNS penetration.

Indirect agonist

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19
Q

Pyridostigmine

Clinical applications/action

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

Increases endogenous ACh; increases strength. Pyridostigmine gets rid of myasthenia gravis.

Indirect agonist

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20
Q

Physostigmine

Clinical applications/action

A 
Anticholinergic toxicity (crosses blood-brain 
barrier to CNS)

Increases endogenous ACh. Physostigmine “phyxes”
atropine overdose.

Indirect agonist

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21
Q

Donepezil,
rivastigmine,
galantamine

Clinical applications/action

A

Alzheimer disease

Increases endogenous ACh.

Indirect agonist

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22
Q

Edrophonium

Clinical applications/action

A

Diagnosis of MG (extremely short acting)
MG is now diagnosed by anti-AChR Ab test

Increases endogenous ACh.

Indirect agonist

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23
Q

With all cholinomimetic agents, watch for:

A

With all cholinomimetic agents, watch for exacerbation of COPD, asthma, and peptic ulcers when giving to susceptible patients.

Indirect agonist

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24
Q

Cholinesterase inhibitor poisoning

Antidote:

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 components of
insecticides; poisoning usually seen in farmers.

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

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25
Q

Atropine,
homatropine,
tropicamide

Clinical organ system/applications

A

Eye

Produce mydriasis and cycloplegia.

Muscarinic antagonist

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26
Q

Benztropine

Clinical organ system/applications

A

CNS

Parkinson disease—“Park my Benz.”

Muscarinic antagonist

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27
Q

Scopolamine

Clinical organ system/applications

A

CNS

Motion sickness.

Muscarinic antagonist

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28
Q

Ipratropium,
tiotropium

Clinical organ system/applications

A

Respiratory

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

Muscarinic antagonist

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29
Q

Oxybutynin,
darifenacin, and
solifenacin

Clinical organ system/applications

A

Genitourinary

Reduce urgency in mild cystitis and reduce
bladder spasms. Other agents: tolterodine,
fesoterodine, trospium.

Muscarinic antagonist

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30
Q

Glycopyrrolate

Clinical organ system/applications

A

Gastrointestinal, respiratory

Parenteral: preoperative use to reduce airway secretions.
Oral: drooling, peptic ulcer.

Muscarinic antagonist

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31
Q

Atropine toxicity

Side effects

A

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

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

Side effects:
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
Jimson weed (Datura) p gardeners pupil 
(mydriasis due to plant alkaloids)
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32
Q

Epinephrine

Effect/application

A

β > α

Anaphylaxis, open angle glaucoma, asthma,
hypotension; α effects predominate at high
doses

Sympathomimetics

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33
Q

Norepinephrine

Effect/application

A

α1 > α2 > β1

Hypotension (but r renal perfusion)

Sympathomimetics

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34
Q

Isoproterenol

Effect/application

A

β1 = β2

Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia.

Sympathomimetics

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35
Q

Dopamine

Effect/application

A

D1 = D2 > β > α

Unstable bradycardia, heart failure, shock; inotropic and chronotropic α effects predominate at high doses

Sympathomimetics

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36
Q

Dobutamine

Effect/application

A

β1 > β2, α

Heart failure (inotropic > chronotropic), cardiac stress testing

Sympathomimetics

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37
Q

Phenylephrine

Effect/application

A

α1 > α2

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

Sympathomimetics

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38
Q

Albuterol, salmeterol,
terbutaline

Effect/application

A

β2 > β

Albuterol for acute asthma; salmeterol for long-term asthma or COPD control; terbutaline to reduce premature uterine contractions

Sympathomimetics

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39
Q

Amphetamine

Effect/application

A

Indirect general agonist, reuptake inhibitor, also releases stored catecholamines

Narcolepsy, obesity, attention deficit disorder

Indirect sympathomimetics

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40
Q

Ephedrine

Effect/application

A

Indirect general agonist, releases stored
catecholamines

Nasal decongestion, urinary incontinence,
hypotension

Indirect sympathomimetics

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41
Q

Cocaine

Effect/application

A

Indirect general agonist, reuptake inhibitor

Causes vasoconstriction and local anesthesia; never give β-blockers if cocaine intoxication is suspected (can lead to unopposed α1 activation and extreme hypertension)

Indirect sympathomimetics

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42
Q

Clonidine

Application/toxicity

A 
Hypertensive urgency (limited situations); does 
not decrease renal blood flow
ADHD, severe pain, and a variety of off-label indications.

CNS depression, bradycardia, hypotension,
respiratory depression, and small pupil size

Sympatholytics (α2-agonists)

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43
Q

α-methyldopa

Application/toxicity

A

Hypertension in pregnancy
Safe in pregnancy

Direct Coombs + hemolytic anemia, SLE-like
syndrome

Sympatholytics (α2-agonists)

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44
Q

Phenoxybenzamine
(irreversible)

Application/toxicity

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

Orthostatic hypotension, reflex tachycardia

Nonselective α-blockers

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45
Q

Phentolamine
(reversible)

Application

A

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

Nonselective α-blockers

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46
Q

Prazosin, terazosin, doxazosin, tamsulosin

Application/toxicity

A

α1 selective blockers

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

1st-dose orthostatic hypotension, dizziness,
headache

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47
Q

Mirtazapine

Application/toxicity

A

α2 selective blockers

Depression

Sedation, increased serum cholesterol, increased appetite

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48
Q

β-blocker toxicity

A

Impotence, cardiovascular adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), dyslipidemia (metoprolol), and asthmatics/COPDers (may cause exacerbation)

Avoid in cocaine users due to risk of unopposed α-adrenergic receptor agonist activityDespite theoretical concern of masking hypoglycemia in diabetics, benefits likely outweigh risks; not contraindicated

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49
Q

β1-selective antagonists

A

(β1 > β2)—acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol

Selective antagonists mostly go from A to M (β1 with 1st half of alphabet)

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50
Q

β Nonselective antagonists

A

(β1 = β2)—nadolol, pindolol (partial agonist), propranolol, timolol

Nonselective antagonists mostly go from N to Z (β2 with 2nd half of alphabet)

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51
Q

Nonselective α- and β-antagonists

A

Nonselective α- and β-antagonists—carvedilol, labetalol

Nonselectives α- and β-antagonists have modified suffixes (instead of “-olol”)

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52
Q

Nebivolol

A

Nebivolol combines cardiac-selective β1-adrenergic blockade with stimulation of β3-receptors, which activate nitric oxide synthase in the vasculature

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53
Q

Acetaminophen

Antidote/treatment

A

N-acetylcysteine (replenishes glutathione)

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54
Q

AChE inhibitors, organophosphates

Antidote/treatment

A

Atropine followed by pralidoxime

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55
Q

Amphetamines (basic)

Antidote/treatment

A

NH4Cl (acidify urine)

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56
Q

Antimuscarinic, anticholinergic agents

Antidote/treatment

A

Physostigmine salicylate, control hyperthermia

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57
Q

Benzodiazepines

Antidote/treatment

A

Flumazenil

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58
Q

β-blockers

Antidote/treatment

A

Glucagon

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59
Q

Carbon monoxide

Antidote/treatment

A

100% O2, hyperbaric O2

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60
Q

Copper, arsenic, gold

Antidote/treatment

A

Penicillamine

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61
Q

Cyanide

Antidote/treatment

A

Nitrite + thiosulfate, hydroxocobalamin

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62
Q

Digitalis

Antidote/treatment

A

Anti-dig Fab fragments

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63
Q

Heparin

Antidote/treatment

A

Protamine sulfate

64
Q

Iron

Antidote/treatment

A

Deferoxamine, deferasirox

65
Q

Lead

Antidote/treatment

A

EDTA, dimercaprol, succimer, penicillamine

66
Q

Mercury, arsenic, gold

Antidote/treatment

A

Dimercaprol (BAL), succimer

67
Q

Methanol, ethylene glycol (antifreeze)

Antidote/treatment

A

Fomepizole > ethanol, dialysis

68
Q

Methemoglobin

Antidote/treatment

A

Methylene blue, vitamin C

69
Q

Opioids

Antidote/treatment

70
Q

Salicylates

Antidote/treatment

A

NaHCO3 (alkalinize urine), dialysis

71
Q

TCAs

Antidote/treatment

A

NaHCO3 (plasma alkalinization)

72
Q

tPA, streptokinase, urokinase

Antidote/treatment

A

Aminocaproic acid

73
Q

Warfarin

Antidote/treatment

A

Vitamin K, plasma (if active bleeding)

74
Q

Coronary vasospasm

Causal agents

A

Cocaine, sumatriptan, ergot alkaloids

75
Q

Cutaneous flushing

Causal agents

A

Vancomycin, Adenosine, Niacin, Ca2+ channel
blockers

VANC

76
Q

Dilated cardiomyopathy

Causal agents

A

Doxorubicin, daunorubicin

77
Q

Torsades de pointes

Causal agents

A

Class III (e.g., sotalol) and class IA (e.g., quinidine) antiarrhythmics, macrolide antibiotics, antipsychotics, TCAs

78
Q

Adrenocortical insufficiency

Causal agents

A

HPA suppression 2° to glucocorticoid withdrawal

79
Q

Hot flashes

Causal agents

A

Tamoxifen, clomiphene

80
Q

Hyperglycemia

Causal agents

A

Tacrolimus, Protease inhibitors, Niacin, HCTZ, β-blockers, Corticosteroids

Taking Pills Necessitates Having Blood Checked

81
Q

Hypothyroidism

Causal agents

A

Lithium, amiodarone, sulfonamides

82
Q

Acute cholestatic hepatitis, jaundice

Causal agents

A

Erythromycin

83
Q

Diarrhea

Causal agents

A

Metformin, Erythromycin, Colchicine, Orlistat,
Acarbose

Might Excite Colon On Accident

84
Q

Focal to massive hepatic necrosis

Causal agents

A

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

Liver “HAVAc”

85
Q

Hepatitis

Causal agents

86
Q

Pancreatitis

Causal agents

A

Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (furosemide, HCTZ)

Drugs Causing A Violent Abdominal Distress

87
Q

Pseudomembranous colitis

Causal agents

A

Clindamycin, ampicillin, cephalosporins

Antibiotics predispose to superinfection by resistant C. difficile

88
Q

Agranulocytosis

Causal agents

A

Dapsone, Clozapine, Carbamazepine,
Colchicine, Methimazole, Propylthiouracil

Drugs CCCrush Myeloblasts and Promyelocytes

89
Q

Aplastic anemia

Causal agents

A

Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil

Can’t Make New Blood Cells Properly

90
Q

Direct coombs-positive hemolytic anemia

Causal agents

A

Methyldopa, penicillin

91
Q

Gray baby syndrome

Causal agents

A

Chloramphenicol

92
Q

Hemolysis in G6PD deficiency

Causal agents

A

INH, Sulfonamides, Dapsone, Primaquine,
Aspirin, Ibuprofen, Nitrofurantoin

Hemolysis IS D PAIN

93
Q

Megaloblastic anemia

Causal agents

A

Phenytoin, Methotrexate, Sulfa drugs

Having a blast with PMS

94
Q

Thrombocytopenia

Causal agents

A

Heparin, cimetidine

95
Q

Thrombotic complications

Causal agents

A

OCPs (e.g., estrogens)

96
Q

Fat redistribution

Causal agents

A

Protease inhibitors, Glucocorticoids

Fat PiG

97
Q

Gingival hyperplasia

Causal agents

A

Phenytoin, verapamil, cyclosporine, nifedipine

98
Q

Hyperuricemia (gout)

Causal agents

A

Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine

Painful Tophi and Feet Need Care

99
Q

Myopathy

Causal agents

A

Fibrates, niacin, colchicine, hydroxychloroquine, interferon-α, penicillamine, statins, glucocorticoids

100
Q

Osteoporosis

Causal agents

A

Corticosteroids, heparin

101
Q

Photosensitivity

Causal agents

A

Sulfonamides, Amiodarone, Tetracyclines, 5-FU

SAT For Photo

102
Q

Rash (Stevens-Johnson Syndrome)

Causal agents

A

Anti-epileptic drugs (ethosuximide, carbamazepine, lamotrigine, phenytoin, phenobarbital), Allopurinol, Sulfa drugs, Penicillin

Steven Johnson has epileptic Allergy to Sulfa drugs and Penicillin

103
Q

SLE-like syndrome

Causal agents

A

Sulfa drugs, Hydralazine, INH,Procainamide, Phenytoin, Etanercept

Having lupus is “SHIPP-E”

104
Q

Teeth discoloration

Causal agents

A

Tetracyclines

105
Q

Tendonitis, tendon rupture, and cartilage damage

Causal agents

A

Fluoroquinolones

106
Q

Cinchonism

Causal agents

A

Quinidine, quinine

107
Q

Parkinson-like syndrome

Causal agents

A

Antipsychotics, Reserpine, Metoclopramide

Cogwheel rigidity of ARM

108
Q

Seizures

Causal agents

A

INH (vitamin B6 deficiency), Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide

With seizures, I BITE My tongue

109
Q

Tardive dyskinesia

Causal agents

A

Antipsychotics, metoclopramide

110
Q

Diabetes insipidus

Causal agents

A

Lithium, demeclocycline

111
Q

Fanconi syndrome

Causal agents

A

Expired tetracycline

112
Q

Hemorrhagic cystitis

Causal agents

A

Cyclophosphamide, ifosfamide

Prevent by coadministering with mesna

113
Q

Interstitial nephritis

Causal agents

A

Methicillin, NSAIDs, furosemide

114
Q

SIADH

Causal agents

A

Carbamazepine, Cyclophosphamide, SSRIs

Can’t Concentrate Serum Sodium

115
Q

Causal agents

Dry cough

A

ACE inhibitors

116
Q

Pulmonary fibrosis

Causal agents

A

Bleomycin, Amiodarone, Busulfan,
Methotrexate

Breathing Air Badly from Medications

117
Q

Antimuscarinic

Causal agents

A

Atropine, TCAs, H1-blockers, antipsychotics

118
Q

Disulfiram-like reaction

Causal agents

A

Metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st-generation sulfonylureas

119
Q

Nephrotoxicity/ototoxicity

Causal agents

A

Aminoglycosides, vancomycin, loop diuretics, cisplatin

120
Q

Sulfa drugs

A

Probenecid, Furosemide, Acetazolamide,
Celecoxib, Thiazides, Sulfonamide antibiotics,
Sulfasalazine, Sulfonylureas

Popular FACTSSS

121
Q

-ovir

Category/example

A

DNA polymerase inhibitor

Acyclovir

122
Q

-cycline

Category/example

A

Protein synthesis inhibitor

Tetracycline

123
Q

-ivir

Category/example

A

Neuraminidase inhibitor

Oseltamivir

124
Q

-navir

Category/example

A

Protease inhibitor

Ritonavir

125
Q

-thromycin

Category/example

A

Macrolide antibiotic

Azithromycin

126
Q

-cillin

Category/example

A

Peptidoglycan synthesis inhibitor

Ampicillin

127
Q

-ane

Category/example

A

Inhalational general anesthetic

Halothane

128
Q

-azine

Category/example

A

Typical antipsychotic

Thioridazine

129
Q

-barbital

Category/example

A

Barbiturate

Phenobarbital

130
Q

-caine

Category/example

A

Local anesthetic

Lidocaine

131
Q

-etine

Category/example

A

SSRI

Fluoxetine

132
Q

-ipramine

Category/example

A

TCA

Imipramine

133
Q

-triptan

Category/example

A

5-HT1B/1D agonists

Sumatriptan

134
Q

-triptyline

Category/example

A

TCA

Amitriptyline

135
Q

-zepam

Category/example

A

Benzodiazepine

Diazepam

136
Q

-zolam

Category/example

A

Benzodiazepine

Alprazolam

137
Q

-chol

Category/example

A

Cholinergic agonist

Bethanechol/carbachol

138
Q

-curium or -curonium

Category/example

A

Non-depolarizing paralytic

Atracurium or vecuronium

139
Q

-olol

Category/example

A

β-blocker

Propranolol

140
Q

-stigmine

Category/example

A

AChE inhibitor

Neostigmine

141
Q

-terol

Category/example

A

β2-agonist

Albuterol

142
Q

-zosin

Category/example

A

α1-antagonist

Prazosin

143
Q

-afil

Category/example

A

PDE-5 inhibitor

Sildenafil

144
Q

-dipine

Category/example

A

Dihydropyridine CCB

Amlodipine

145
Q

-pril

Category/example

A

ACE inhibitor

Captopril

146
Q

-sartan

Category/example

A

Angiotensin-II receptor blocker

Losartan

147
Q

-statin

Category/example

A

HMG-CoA reductase inhibitor

Atorvastatin

148
Q

-dronate

Category/example

A

Bisphosphonate

Alendronate

149
Q

-glitazone

Category/example

A

PPAR-γ activator

Rosiglitazone

150
Q

-prazole

Category/example

A

Proton pump inhibitor

Omeprazole

151
Q

-prost

Category/example

A

Prostaglandin analog

Latanoprost

152
Q

-tidine

Category/example

A

H2-antagonist

Cimetidine

153
Q

-tropin

Category/example

A

Pituitary hormone

Somatotropin

154
Q

-ximab

Category/example

A

Chimeric monoclonal Ab

Basiliximab

155
Q

-zumab

Category/example

A

Humanized monoclonal Ab

Daclizumab

First Aid Step 1 Rapid Review (8 decks)

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