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Pharmacology > Pharm Test 1 Spring 2016 Drug List BRIEF descriptions > Flashcards

Pharm Test 1 Spring 2016 Drug List BRIEF descriptions Flashcards

1
Q

Famitidine

A

• H2 Receptor Antagonist • Acid reduction • Upper GI (GERD)

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2
Q

Omeprazole

A

• Proton Pump Inhibitor • Upper GI (GERD) drug

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3
Q

Mg(OH)2

A

• Antacid • Diarrhea side effect • Upper GI (GERD), not long-term

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4
Q

Al(OH)3

A

• Antacid • Constipation side effect • Upper GI (GERD), not long-term

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5
Q

CaCO3

A

• Antacid • Upper GI (GERD), not long-term

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6
Q

Sucralfate

A

• Gastric Mucosal protection • Becomes a paste in acidic environment, clings to mucosa • Upper GI

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7
Q

Bismuth Salicylate

A

• Antimicrobial properties • Preferentially binds to ulcerated sites in gastric mucosa • Upper GI • Affects absorption of other drugs because they get stuck

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8
Q

Misoprostol

A

• Prostaglandin E1 analog • Decreases H+ secretion • Increases mucus and bicarbonate secretion • INCREASE UTERINE CONTRACTIONS • Upper GI

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9
Q

Metoclopramide

A

• Antiemetic • Dopamine receptor antagonist • Enhances gastric motility • Upper GI

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10
Q

Ondansetron

A

• Antiemetic • 5-HT3 Serotonin antagonist in pharynx and stomach • Upper GI

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11
Q

Lubiprostone

A

• Stimulant laxative • Cl- channel • Lower GI

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12
Q

Loperamide

A

• Irritable Bowel Syndrome • Antidiarrheal • Mu-opioid receptor agonist slows motility • Negligible CNS effects • Risk of toxic megacolon

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13
Q

Alosetron

A

• Irritable Bowel Syndrome treatment • 5-HT3 receptor antagonist with high potency and duration • Reduces smooth muscle activity in GI • Mostly for recalcitrant IBS-related diarrhea in women • Risk of ischemic colitis (0.3%)

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14
Q

Sulfasalazine

A
  • Inflammatory Bowel Disease (mostly ulcerative colitis, because more activity in the colon)
  • Prodrug of 5-aminosalicylic acid (Mesalamine)
  • Affets both cyclooxygenase and lipoxygenase inflammatory pathways and interferes with synth of cytokines
  • Free radical scavenger
  • Very little absorbed, works topically on wall of gut
  • 40% pts cannot tolerate (diarrhea, HA, hypersens, BONE MARROW SUPPRESSION)
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15
Q

Prednisone (Glucocorticoids)

A

• IBD treatment • Rapid reduction in ulceration and initial remission of inflamm • Not good long term • SE: • BONE MARROW SUPPRESSION risk • Also pancreatitis, elevated LFTs, rash, fever, nausea

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16
Q

Infliximab

A

• Crohn’s mostly, but also some UC (because sulfasalazine mostly in colon) • Antibody to TNF-alpha, blocks inflammatory effects

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17
Q

Azathioprine

A

• Inflammatory Bowel Disease LONG TERM treatment • Anti-metabolites • SE: Bone marrow suppression, rashes, fever, nausea

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18
Q

Propyltiouracil

A

• Thyoamide • Hyperthyroid medication • Reduces iodide organification and iodotyrosine coupling • Reduces deiodination of T4 in periphery • Less birth defects, can be used in 1st trimester then swith to MMU • More hepatotoxicity than MMU

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19
Q

Methimazole

A

• Thyoamide • Hyperthyroid medication • Reduces iodide organification and iodotyrosine coupling • No second mechanism as with Propyltiouracil • More birth defects, so avoid in 1st trimester. Better for 2nd and 3rd trimesters of pregnancy because • Less hepatotoxicity than Propyltiouracil

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20
Q

Iodide

A

• Inhibit organification of iodine and hormone release (just like PTU and MMI) • Used in combo with PTU and ß-blocker in thyroid storm • Escape effect if used alone. Thyroid glands increase the expression of anion channels, and let in more iodide, so more can become hormones. • If there is no escape, can build up and become a goiter.

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21
Q

L-triiodothyronine (T3)

A

• Direct replacement in hypothyroidism • Very short t1/2

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22
Q

L-thyroxine (T4)

A

• Direct replacement for hypothyroidism • Longer t1/2 (7 days)

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23
Q

I-131

A

• Radioactive iodine • Enters thyroid cells and clogs up so that cannot make hormones • Best for thyroid storm

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24
Q

Perchlorate, Pertechnetate, Thiocyanate

A

• Anion inhibitors • Treatment for hyperthyroidism • SE: **APLASTIC ANEMIA!

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25
Q

Nitrous Oxide

A

• Natural Vasodilator and standard for inhaled anesthetics • Anesthesia AND analgesia

26
Q

Desflurane

A
  • Inhaled anesthetic and analgesic
  • D
  • D>S>E>I>H>M for MAC
  • Preserves Cardiac Output (D,S,I) and vasodilates - good for MI patients
  • Not affect baroreceptor response, maintains or increases heart rate (D,I)

• Cough, spasm (D,I)

27
Q

Sevoflurane

A
  • Inhaled anesthetic and analgesic
  • DS>E>I>H>M for MAC

• Preserves Cardiac Output (D,S,I) via vasodilation

  • Decreased baroceptor response, less increase in heart rate (S,E,H)
  • Risk of Nephrotoxicity (S,E)
28
Q

Isoflurane

A
  • Most commonly used inhaled anesthetic and analgesic
  • D>S>E>I>H>M for MAC
  • Preserves Cardiac Output (D,S,I) through vasodilation
  • Not affect baroreceptor response, maintains or increases heart rate (D,I)
  • Cough, spasm (D,I)
  • Most pulmonary diminished response to increased CO2 in blood (all inhaled do this to some degree) (I,E)
29
Q

Enflurane

A
  • Inhaled anesthetic and analgesic
  • D
  • D>S>E>I>H>M for MAC

• SEIZURES risk (no others have that listed)

  • UTERINE contraction
  • Decreased baroceptor response, less increase in heart rate (S,E,H) and greater decrease in myocardial contractility than others –> Decreased Cardiac Output (E,H)
  • Most pulmonary diminished response to increased CO2 in blood (all inhaled do this to some degree) (I,E)
  • Risk of Nephrotoxicity (S,E)
30
Q

Halothane

A
  • Inhaled anesthetic and analgesic
  • D>S>E>I>H>M for MAC
  • HEPATOTIXICITY
  • Decreased baroceptor response, less increase in heart rate (S,E,H) and greater decrease in myocardial contractility than others –> Decreased Cardiac Output (E,H)
  • Can have bradycardia and arrythmias
31
Q

Methoxyflurane

A

• Inhaled anesthetic and analgesic • DS>E>I>H>M for MAC • Does not relax uterus

32
Q

Sodium Thiopental

A

• Barbituate - GABAa receptor enhancement • Now use Propofol for beginning inhaled anesthesia

33
Q

Propofol

A

• GABA-a receptor enhancer • Milk of amnesia - Hypnotic effect only, NO ANALGESIA • No antagonist • Cardioresp depression • Allergy with soy and egg administration

34
Q

Etomidate

A
  • Anterograde amnesia - NO ANALGESIA
  • ETO CAN BE VETOED - there is an antagonist, unlike propofol
  • Accumulates, so slows recovery
  • No Cardioresp effects, good for pts at risk for hypotension
35
Q

Ketamine

A
  • Analgesia and Hypnotic state - possible hallucinations
  • NMDA (Glutamate receptor for excitatory neuron) antagonist
  • No resp depression
  • BP might go up
  • SE: Increase in muscle tone, might need muscle relaxant
36
Q

Insulin Lispro

A

• Short-acting insulin • Rapid peak

37
Q

Insulin Aspart

A

• Short-acting insulin • Rapid peak • Preparation inhibits clumping

38
Q

Insulin Glulisine

A

• Short-acting insulin • Rapid peak • Affects downstream IRS-2 pathway

39
Q

Regular Insulin

A

• Onset 30min • Peak 2-3hr • Lasts 5-8hrs • Slower peak w dimerized preparations

40
Q

NPH or Isophane or Neutral Protamine Hagedorn Insulin

A

• Intermediate onset (2-5hrs) • Duration 4-12hrs • Usually paired with rapid or short-acting

41
Q

Glargine Insulin

A

• Longest-acting insulin, “peakless” • Onset 1-1.5hrs • Max effect 4-6hrs • Lasts 11-24hrs • Admin 1x/day

42
Q

Detemir Insulin

A

• Long-acting insulin • Onset 1-2hrs • Lasts up to 12hrs • Admin 2x/day

43
Q

Metformin

A

• Biguanide • Affects target tissue cAMP-induced kinase activity • Liver - decrease gluconeogenesis, increase glyogen synthesis, decrease VLDL synth, decrease fatty liver accumulation • Muscle - increase Glc uptake • Adipose - Decrease FA breakdown • Slows both MACRO and MICROvascular changes (other diabetes drugs, mostly just micro)

44
Q

Glipizide

A

• Sulfonylurea agonist • Increases ß-cell secretion of insulin • Requires functional ß-cells in pancreatic islets of Langerghans

45
Q

Repaglinide

A

• Non-Sulfonylurea agonist • Same mechanism as sulfonylurea, different binding site, not bound so ACTS FASTER • Increases ß-cell secretion of insulin • Requires functional ß-cells in pancreatic islets of Langerghans

46
Q

Pioglitazone

A

• Thiazolidenedione • Similar to metformin, sensitizes downstream target tissues • Peroxisome-proliferator-activated receptor ligand and ten modifiy gene expression of downstream proteins that deal with glucose and lipid metabolism, insulin transduction (GLUTs), adipocyte and tissue differentiation •

47
Q

Exenatide

A

• GLP-1 receptor agonist • Acts like a natural incretin (usu released in gut to get pancreas to start releasing insulin when intestines first have food) • Depends on functional ß-cells • Only works in presence of glucose • Slows gastric emptying, increases satiety • Potentially increases number of ß-cells surviving, slowing disease process

48
Q

Sitagliptin

A

• Dipeptidyl-Peptidase-4 (DPP-4) inhibitor • DPP4 typically metabolizes incretin (GLP) hormones in pancreas, so this stops that action and lets pancreas continue to release insulin • Glucose-dependent

49
Q

Acarbase

A

• Competitive inhibition of channels that absorb disaccharides in S.I. • Taken with food • Extended use tends to upregulate natural receptors, and so effect lessens over time

50
Q

Canagliflozin

A

• SGLT-2 channel inhibitor in proximal tubule of nephron • Reduces Glc-reabsorption by changing threshold for Glc urine concentration from 180mg/dL to about 70-90mg/dL • Causes fluid loss - weight loss might be transient • Can cause loss of electrolytes

51
Q

Benzocaine

A

• Local anesthetic • Ester - PABA allergy • Short-acting

52
Q

Procaine

A

• Local Anesthetic • Ester - PABA allergy • Short-acting, slower onset than benzocaine

53
Q

Cocaine

A

• Local anesthetic • Ester - PABA allergy • Short-acting • TOPICAL ONLY - mucous membranes (nose and mouth) • Only local anesthetic that is a VASOCONSTRICTOR

54
Q

Lidocaine

A

• Local anesthetic • Amide - Liver metabolism • Rapid onset • Medium-duration • Type IB antiarrythmic

55
Q

Ropivacaine (and Bupivacaine)

A

• Local anesthetic • Amide - liver metabolism • Long-acting • Good alternative for Lidocaine-sensitive patients • S-isomer ONLY, which is the isomer that the heart does NOT have at its Na+ channels, therefore there are fewer cardio SE.

56
Q

Tetrodotoxin

A

• Puffer fish toxin • Same affect as local anesthetics, but external block of the Na+ channel, so not use-dependent

57
Q

Epinephrine

A

• Local anesthetic adjunct for vasoconstriction to reduce likelihood of systemic spread of anesthetic • DO NOT USE in areas of low vascularization - nose, ear pinna, glans of penis

58
Q

Clonidine

A

• Adjunct for local anesthetic, as well • Acts on both fast and slow pain pathways • Inhibits feedback loop of Mu-opioid receptor on C-fibers, thereby reducing Substance-P transmission • Inhibits transmission of glutamate at Adelta fibers in dorsal horn

59
Q

Diazepam

A

• Adjunct for local anesthesia • Chills patient out

60
Q

Cimetidine

A

• H2 Receptor antagonist • Acid reduction • Upper GI drug • MORE SE than Famitidine (CYP3A4)

61
Q

Things all Inhaled Anesthetic Agents do

A
  • Decrease arterial Blood Pressure
  • Blood flow to Kidney
  • Blood flow to liver
  • Depressed myocardial contractility
  • Dose-dependent decrease in tidal volume and minute ventilation –> increase in arterial ppCO2
  • Decrease ventilation response to hypoxia (chemoreceptors in brain)
  • Most are bronchodilators (des and iso can cause spasm)
    *

Pharmacology (7 decks)

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