Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

USMLE > Pharm_Part2 > Flashcards

Pharm_Part2 Flashcards

1
Q

1st generation H1 blockers

A

Diphenhydramine, dimenhydrinate, chlopheniramine Clinical uses: Allergy, motion sickness, sleep aid Toxicity: Sedation, antimuscarinic, anti-α-adrenergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

2nd generation H1 blockers

A

Loratadine, fexofenadine, desloratadine, cetirizine (-adine) Clinical uses: Allergy Toxicity: Far less sedating than 1st generation because of ↓ entry into CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ACE inhibitors: Names

A

Captopril, enalapril, lisinopril (-pril)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acetazolamide

A

Mechanism: Carbonic anhydrase inhibitor. Causes self-limited NaHCO3 diuresis and reduction in total-body HCO3- stores Clinical use: Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness Toxicity: Hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Adalimumab

A

TNF-α inhibitors Mechanism: Anti-TNF antibody Clinical use: Rheumatoid arthritis, psoriasis, ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Advantages (5) & Disadvantages (4) of Oral contraception

A

Advantages: Reliable (<1% failure); ↓ risk of endometrial and ovarian cancer; ↓ incidence of ectopic pregnancy; ↓ pelvic infections; regulation of menses Disadvantages: Taken daily; No protection against STDs; ↑ triglycerides; Depression, weight gain, nausea, hypertension; Hypercoagulable state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Albuterol

A

Asthma drug, relaxes bronchial smooth muscle (β2). Use during acute exacerbation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Allopurinol

A

Gout drug, chronic gout. Inhibits xanthine oxidase. ↓ conversion of xanthine to uric acid. Also used in lymphoma and leukemia to prevent tumor lysis associated urate nephropathy. ↑ concentrations of azathioprine and 6-MP (both normally metabolized by xanthine oxidase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alzheimer’s drugs: Two types

A

Memantine: NMDA receptor antagonist Donepezil: Acetylcholinesterase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anastrozole / exemestane

A

Aromatase inhibitors used in postmenopausal women with breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anesthetics - General principles: Drug with ↓ solubility in blood

A

rapid induction and recovery time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anesthetics - General principles: Drugs with ↑ solubility in lipids

A

↑potency = 1/MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antidote: Benzodiazepines

A

Flumazenil (competitive antagonist at GABA benzodiazepine receptor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antidote: Neuromuscular blocking drugs

A

Neostigmine, edrophonium, and other cholinesterase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Antidote: Tricyclic antidepressants

A

NaHCO3 for CV toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Antipsychotic with low potency

A

Thioridazine, chlorpromazine - non neurologic side effects (anticholinergic, antihistamine, and α blockade effects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Antipsychotics (neuroleptics): Names

A

Haloperidol + “-azine”s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Antipsychotics with high potency

A

Haloperidol, trifluoperazine, fluphenazine - neurologic side effects (extrapyramidal symptoms).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Arachidonic acid products

A

Lipoxygenase pathway yields Leukotrienes LTB4 is a neutrophil chemotactic agent LTC4, D4, E4 function in bronchoconstriction, vasoconstriction, contraction of smooth muscle, and ↑ vascular permeability PGI2 inhibits platelet aggregation and promotes vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Asthma drugs (7)

A

①non-specific β-agonists: Isoproterenol ②β2-agonists: Albuterol, Salmeterol ③Methylxanthines: Theophylline ④Muscarinic antagonists: Ipratropium ⑤Cromolyn ⑥Corticosteroids: Beclomethasone, prednisone ⑦Antileukotrienes: Zileuton; Zafirlukast / Montelukast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Atypical antipsychotics: Names

A

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone (-apine, -idone, aripiprazole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Beclomethasone / prednisone

A

Asthma drug, inhibit the synthesis of virtually all cytokines. Inactivate NF-kB, the transcription factor that induces the production of TNF-α, among other inflammatory agents. 1st-line therapy for chronic asthma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Biphosphonates (-dronate)

A

Mechanism: Inhibit osteoclast activity; reduce both formation and resorption of hydroxyapatite Clinical use: Malignancy-associated hypercalcemia, Paget’s disease of the bone, post menopausal osteoporosis Toxicity: Corrosive esophagitis (except zoledronate), nausea, diarrhea, osteonecrosis of the jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bosentan

A

Used to treat pulmonary hypertension. Competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Bupropion

A

Also used for smoking cessation. ↑ NE and dopamine via unknown mechanism. Toxicity: stimulant effects (tachycardia, insomnia), headache, seizure in bulimic patients. No sexual side effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Butorphanol

A

Mechanism: Partial agonist at opioid mu receptors, agonist at kappa receptors. Clinical use: Pain; causes less respiratory depression than full agonists Toxicity: Causes withdraw if on full opioid agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Clinical use: ACE inhibitors

A

Hypertension, CHF, diabetic renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Clinical use: Acetaminophen

A

Antipyretic, analgesic, but lacking anti-inflammatory properties. Used instead of aspirin to prevent Reye’s syndrome in children with viral infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Clinical use: Antipsychotics

A

Schizophrenia (primarily positive symptoms), psychosis, acute mania, Tourette’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Clinical use: Aspirin

A

Low dose (<300 mg/day): ↓ platelet aggregation. Intermediate dose (300-2400 mg/day): antipyretic and analgesic High dose: (2400-4000 mg/day): anti-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Clinical use: Atypical antipsychotics

A

Schizophrenia - both positive and negative symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Clinical use: Barbiturates

A

Sedative for anxiety, seizures, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Clinical use: Benzodiazepines

A

Anxiety, spasticity, status epilepticus, detoxification (especially alcohol withdrawal-DTs), night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxation), hypnotic (insomnia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Clinical use: Buspirone

A

Generalized anxiety disorder. Does not cause sedation, addiction, or tolerance. Does not interact with alcohol (vs. barbiturates, benzodiazepines)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Clinical use: Clomipramine

A

OCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Clinical use: COX-2 inhibitors (celecoxib)

A

Rheumatoid and osteoarthritis; patients with gastritis or ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Clinical use: Duloxetine

A

Depression, diabetic peripheral neuropathy, duloxetine has greater effect on NE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Clinical use: Imipramine

A

Bed wetting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Clinical use: K+-sparing diuretics

A

Hyperaldosteronism, K+ depletion, CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Clinical use: Lithium

A

Mood stabilizer for bipolar disorder; blocks relapse and acute manic events. Also SIADH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Clinical use: Monoamine oxidase (MAO) inhibitors

A

Atypical depression, anxiety, hypochondiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Clinical use: Nonbenzodiazepine hypnotics

A

Insomnia (失眠)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Clinical use: Olanzapine

A

OCD, anxiety disorder, depression, mania, Tourette’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Clinical use: Phenytoin

A

Tonic-clonic seizures. Also a class IB antiarrhythmic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Clinical use: Sildenafil / vardenafil

A

Erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Clinical use: SSRIs

A

Depression, OCD, bulimia, social phobias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Clinical use: Tricyclic antidepressants

A

Major depression, fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Clinical use: Venlafaxine

A

Depression, generalized anxiety disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Clomiphene

A

Estrogen partial agonist, partial agonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and ↑ release of LH and FSH from pituitary, which stimulates ovulation. Used to treat infertility and PCOS. May cause hot flashes, ovarian enlargement, multiple simultaneous pregnancies, and visual disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

CNS stimulants

A

Methylphenidate, dextroamphetamine, mixed amphetamine salts Mechanism: ↑ catecholamines at the synaptic cleft, especially NE and dopamine Clinical use: ADHD, narcolepsy, appetite control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Colchicine

A

Gout drug, acute gout (with NSAIDs). Binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation. GI side effects, especially if given orally. (Note: indomethacin is less toxic, also used in acute gout)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Complications: Succinylcholine

A

Hypercalcemia, hyperkalemia, hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Contraindication: Barbiturates

A

in porphyria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Contraindication: Mannitol

A

Anuria, CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Contraindication: Monoamine oxidase (MAO) inhibitors

A

with SSRI or meperidine (to prevent serotonin syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Contraindication: Oral contraception

A

smokers > 35 years of age (↑ risk of cardiovascular events), patients with history of thromboembolism and stroke or history of estrogen-dependent tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Contraindications: Estrogens

A

ER-positive breast cancer, history of DVTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Cromolyn

A

Asthma drug, prevents release of mediators from mast cells. Effective only for the prophylaxis of asthma. Not effective during an acute asthmatic attack. Toxicity is rare.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Dantrolene

A

Used in the treatment of malignant hyperthermia, which is caused by inhalation anesthetics (except N2O) and succinylcholine. Also used to treat neuroleptic malignant syndrome (a toxicity of antipsychotic drugs) MOA: prevents the release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Dinoprostone

A

PGE2 analog causing cervical dilation and uterine contraction, inducing labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Diuretics: electrolyte changes: Blood pH

A

↓(acidemia): Carbonic anhydrase inhibitors ↑(alkalemia): Loop diuretics and thiazides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Diuretics: electrolyte changes: Details

A

Check FA2011 page475, very important mechanisms!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Diuretics: electrolyte changes: Urine Ca2+

A

↑Loop diuretics ↓Thiazides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Diuretics: electrolyte changes: Urine K+

A

↑ in all except K+-sparing diuretics. Serum K+ may ↓ as a result.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Diuretics: electrolyte changes: Urine NaCl

A

↑ in all diuretics. Serum NaCl may ↓ as a result.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

DOC: 1st line for acute Status epilepsy

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

DOC: 1st line for seizures of eclampsia

A

MgSO4, benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

DOC: 1st line for Status epilepsy prophylaxis

A

Phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

DOC: 1st line for trigeminal neuralgia

A

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

DOC: 1st line of epilepsy drugs in pregnant women, children

A

Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

DOC: Acute pulmonary edema, maintenance programs for addicts

A

Methadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

DOC: ADHD

A

Methylphenidate (Ritalin), Amphetamines (Dexedrine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

DOC: Alcohol withdrawal

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

DOC: Anorexia/bulimia

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

DOC: Anxiety

A

Benzodiazepines, Buspirone, SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

DOC: Atypical depression

A

MAO inhibitors, SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

DOC: Bipolar disorder

A

“Mood stabilizers”: Lithium, Valproic acid, Carbamazepine Atypical antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

DOC: Closure of a PDA

A

Indomethacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

DOC: Depression

A

SSRIs, SNRIs, TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

DOC: Depression with insomnia

A

Mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

DOC: Diarrhea

A

Loperamide / Diphenoxylate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

DOC: Essential or familial tremors

A

β-blockers, e.g., propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

DOC: Obsessive-compulsive disorder

A

SSRIs, Clomipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

DOC: Pain, cough suppression

A

Dextromethorphan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

DOC: Panic disorder

A

SSRIs, TCAs, Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

DOC: Polycystic ovarian syndrome (to prevent hirsutism)

A

Ketoconazole and spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

DOC: PTSD

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

DOC: Schizophrenia

A

Antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

DOC: Serotonin syndrome

A

Cyproheptadine, 5-HT2 receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

DOC: Social phobias

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

DOC: Tourette’s syndrome

A

Antipsychotics (haloperidol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Donepezil

A

Alzheimer’s drugs, also galantamine, rivastigmine. Mechanism: Acetylcholinesterase inhibitors. Toxicity: Nausea, dizziness, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Drug class: Amiodarone

A

Class III antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Drug class: Amitriptyline

A

Tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Drug class: Amoxapine

A

Tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Drug class: Bretylium

A

Class III antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Drug class: Chlordiazepoxide

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Drug class: Citalopram

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Drug class: Clomipramine

A

Tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Drug class: Desipramine

A

Tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Drug class: Dextromethorphan

A

Opioid analgesics for cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Drug class: Diatiazem

A

Calcium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Drug class: diaze-, -pam, -lam

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Drug class: Diltiazem

A

Class IV antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Drug class: Disopyramide

A

Class IA antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Drug class: Dofetilide

A

Class III antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Drug class: Doxepin

A

Tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Drug class: Duloxetine

A

SNRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Drug class: Encainide

A

Class IC antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Drug class: eszopiclone

A

Nonbenzodiazepine hypnotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Drug class: Flecainide

A

Class IC antiarrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Drug class: Fluoxetine

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Drug class: Ibutilide

A

Class III antiarrhythmics

114
Q

Drug class: Imipramine

A

Tricyclic antidepressants

115
Q

Drug class: Isocarboxazid

116
Q

Drug class: Ketorolac

117
Q

Drug class: Lidocaine

A

Class IB antiarrhythmics

118
Q

Drug class: methimazole

A

Hyperthyroidism drug

119
Q

Drug class: Mexiletine

A

Class IB antiarrhythmics

120
Q

Drug class: Naproxen

121
Q

Drug class: Nifedipine

A

Calcium channel blockers

122
Q

Drug class: Nortriptyline

A

Tricyclic antidepressants

123
Q

Drug class: Paroxetine

124
Q

Drug class: Phenelzine

125
Q

Drug class: Procainamide

A

Class IA antiarrhythmics

126
Q

Drug class: Propafenone

A

Class IC antiarrhythmics

127
Q

Drug class: Quinidine

A

Class IA antiarrhythmics

128
Q

Drug class: Selegiline

A

MAOI, selective MAO-B inhibitor

129
Q

Drug class: Sertraline

130
Q

Drug class: Sotalol

A

Class III antiarrhythmics

131
Q

Drug class: Thiopental

A

Barbiturates, used for induction of anesthesia

132
Q

Drug class: Thiopentals

A

Barbiturates

133
Q

Drug class: Tocainide

A

Class IB antiarrhythmics

134
Q

Drug class: Tranylcypromine

135
Q

Drug class: Venlafaxine

136
Q

Drug class: Verapamil

A

Calcium channel blockers

137
Q

Drug class: Zaleplon

A

Nonbenzodiazepine hypnotics

138
Q

Drug class: Zolpidem (Ambien)

A

Nonbenzodiazepine hypnotics

139
Q

Drug use: Pirenzepine

A

Muscarinic antagonist

140
Q

Drug use: Propantheline

A

Muscarinic antagonists

141
Q

Epilepsy drug toxicities: Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome P-450, SIADH, Stevens-Johnson syndrome

A

Carbamazepine

142
Q

Epilepsy drug toxicities: Ethosuximide

A

EFGH - Ethosuximide, Fatigue, GI, Headache

143
Q

Epilepsy drug toxicities: GI distress, fatigue, headache, urticaria, Stevens-Johnson syndrome

A

Ethosuximide

144
Q

Epilepsy drug toxicities: GI distress, rare but fetal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain. Contraindicated in pregnancy.

A

Valproic acid

145
Q

Epilepsy drug toxicities: Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome P-450

146
Q

Epilepsy drug toxicities: Sedation, tolerance, dependence

A

Benzodiazepines

147
Q

Epilepsy drug toxicities: Sedation, tolerance, dependence, induction of cytochrome P-450

A

Phenobarbital

148
Q

Estrogens (ethinyl estradiol, DES, mestranol)

A

Mechanism: Bind estrogen receptors Clinical use: Hypogonadism or ovarian failure, menstrual abnormalities, HRT in postmenopausal women; use in men with androgen-dependent prostate cancer. Toxicity: ↑ risk of endometrial cancer, bleeding in postmenopausal women, ↑ risk of thrombi

149
Q

Etanercept

A

TNF-α inhibitors Mechanism: Recombinant form of human TNF that binds TNF (Decoy receptor) Clinical use: Rheumatoid arthritis, psoriasis, ankylosing spondylitis

150
Q

Ethacrynic acid

A

Mechanism: Phenoxyacetic acid dericative (NOT a sulfonamide). Essentially same action as furosemide. Clinical use: Diuresis in patients allergic to sulfa drugs Toxicity: Similar to furosemide; can be used in hyperuricemia, acute gout (never used to treat gout)

151
Q

Evolution of EPS side effects

A

4h acute dystonia (muscle spasm, stiffness, oculogyric crisis) 4d akinesia (parkinsonian symptoms) 4wk akathisia (restlessness) 4mo tardive dyskinesia

152
Q

Expectorants (2)

A

Guaifenesin: Expectorant - removes excess sputum; does not suppress cough reflex. N-acetylcysteine: Mucolytic - can loosen mucous plugs in CF patients. Also used as an antidote for acetaminophen overdose.

153
Q

Fetal hydantoin syndrome

A

Intrauterine growth restriction with microcephaly and develop minor dysmorphic craniofacial features and limb defects including hypoplastic nails and distal phalanges (birth defects).

154
Q

Finasteride (Propecia)

A

a 5α-reductase inhibitor (↓ conversion of testosterone to dihydrotestosterone). Useful in BPH. Also promotes hair growth - used to treat male-pattern baldness

155
Q

Flutamide

A

a nonsteroidal competitive inhibitor of androgens at the testosterone receptor. Used in prostate carcinoma.

156
Q

Furosemide

A

Mechanism: Sulfonamide loop diuretic. Inhibits cotransport system (Na+, K+, 2Cl-) of thick ascending limb of loop of Henle. Abolishes hypertonicity of medulla, preventing concentration of urine. ↑Ca2+ excretion Clinical use: Edematous states (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia

157
Q

Glaucoma drugs: Cholinomimetics

A

Direct: Pilocarpine, carbachol Indirect: Physostigmine, echothiophate

158
Q

Glaucoma drugs: Diuretics

A

Acetazolamide, dorzolamide (-zolamide)

159
Q

Glaucoma drugs: Emergencies

A

Pilocarpine

160
Q

Glaucoma drugs: Prostaglandin

A

Latanoprost (PGF2α)

161
Q

Glaucoma drugs: α-agonists

A

Epinephrine, Brimonidine

162
Q

Glaucoma drugs: β-blockers

A

Timolol, betaxolol, carteolol

163
Q

Hormone replacement therapy (HRT)

A

Used for relief or prevention of menopausal symptoms (e.g., hot flashes, vaginal atrophy) and osteoporosis (↑estrogen, ↓osteoclast activity) Unopposed estrogen replacement therapy (ERT) ↑ the risk of endometrial cancer, so progesterone is added. Possible ↑ CV risk

164
Q

Huntington’s drugs

A

Disease: ↑dopamine, ↓GABA+ACh Reserpine + tetrabenazine - amine depleting Haloperidol - dopamine receptor antagonist

165
Q

Hydrochlorothiazide

A

Mechanism: Thiazide diuretic. Inhibits NaCl reabsorption in early distal tubule, reducing diluting capacity of the nephron. ↓ Ca2+ excretion Clinical use: Hypertension, CHF, idiopathic hypercalciuria, nephrogenic diabetes insipidus Toxicity: Hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlibidemia, hyperuricemia, and hypercalcemia. Sulfa allergy

166
Q

Infliximab

A

TNF-α inhibitors Mechanism: Anti-TNF antibody Clinical use: Crohn’s disease, rheumatoid arthritis, ankylosing spondylitis Toxicity: Predisposes to infections (reactivation of latent TB)

167
Q

Intravenous anesthetics: Arylcyclohexylamines (Ketamine)

A

PCP analogs that act as dissociative anesthetics. Block NMDA receptors. Cardiocascular stimulants. Cause disorientation, hallucication, and bad dreams. ↑cerebral blood flow.

168
Q

Intravenous anesthetics: Barbiturates

A

Thiopental - high potency, high lipid solubility, rapid entry into brain. Used for induction of anesthesia and short surgical procedures. Effect terminated by rapid redistribution into tissue and fat. ↓cerebral blood flow.

169
Q

Intravenous anesthetics: Benzodiazepines

A

Midazolam most common drug used for endoscopy; used adjunctively with gaseous anesthetics and narcotics. May cause severe postoperative respiratory depression, ↓BP (treat overdose with flumazenil), and amnesia

170
Q

Intravenous anesthetics: Opiates

A

Morphine, fentanyl used with other CNS depressants during general anesthesia

171
Q

Intravenous anesthetics: Propofol

A

Used for rapid anesthesia induction and short procedures. Less postoperative nausea than thiopental. Potentiates GABA(A).

172
Q

Ipratropium

A

Asthma drug, competitive block of muscarinic receptors, preventing bronchoconstriction. Also used for COPD, with ↓ production of mucus.

173
Q

Isoproterenol

A

Asthma drug, relaxes bronchial smooth muscle (β2). Adverse effect is tachycardia (β1).

174
Q

K+-sparing diuretics: Names

A

Spironolactone, Triamterene, Amiloride, Eplerenone

175
Q

Latanoprost

A

PGF2α, ↑outflow of aqueous humor Side effects: Darkens color of iris (browning)

176
Q

Leuprolide

A

Mechanism: GnRH analog with agonist properties when used in pulsatile fasion; antagonist properties when used in continuous fasion Clinical use: Infertility (pulsatile), prostate cancer (continuous - use with flutamide), uterine fibroids Toxicity: Antiandrogen, nausea, vomiting

177
Q

Local enesthetics: Two groups

A

Esters - procaine, cocaine, tetracaine Amides - Lidocaine, mepivacaine, bupivacaine (amides have 2 i’s in name)

178
Q

Losartan

A

an angiotensin II receptor antagonist. It is not an ACE inhibitor and does not cause cough.

179
Q

Mannitol

A

Mechanism: Osmotic diuretic, ↑tubular fluid osmolarity, producing ↑ urine flow Clinical use: Shock, drug overdose, ↑intracranial / intraocular pressure Toxicity: Pulmonary edema, dehydration

180
Q

Maprotiline

A

Blocks NE reuptake. Toxicity: sedation, orthostatic hypotension.

181
Q

Mechanism: ACE inhibitors

A

Inhibit angiotensin-converting enzyme, reducing levels of angiotensin II and preventing inactivation of bradykinin, a potent vasodilator. Renin release is ↑ due to loss of feedback inhibition

182
Q

Mechanism: Acetaminophen

A

Reversibly inhibits cyclooxygenase, mostly in the CNS. Inactivated peripherally.

183
Q

Mechanism: Antipsychotics

A

All typical antipsychotics block dopamine D2 receptors (↑[cAMP]1)

184
Q

Mechanism: Aspirin

A

Irreversibly inhibit cyclooxygenase (both COX-1 and COX-2). Block prostaglandin synthesis.

185
Q

Mechanism: Benzodiazepines

A

Facilitate GABA(A) action by ↑frequency of Cl- channel opening. ↓REM sleep. Most have long half-lives and active metabolites

186
Q

Mechanism: Buspirone

A

Stimulates 5-HT1A receptors

187
Q

Mechanism: COX-2 inhibitors (celecoxib)

A

Reversibly inhibit specifically the cyclooxygenase (COX) isoform 2, which is found in inflammatory cells and vascular endothelium and mediates inflammation and pain; spares COX-1, which helps maintain the gastric mucosa. Thus, should not have the corrosive effects of other NSAIDs on the GI lining.

188
Q

Mechanism: L-dopa/carbidopa

A

↑level of dopamine in brain. Unlike dopamine, L-dopa can cross blood-brain barrier and is converted by dopa decarboxylase in the CNS to dopamine

189
Q

Mechanism: Lithium

A

Possibly related to inhibition of phosphoinositol cascade

190
Q

Mechanism: Local anesthetics

A

Block Na+ channels by binding to specific receptors on inner portion of channel. Preferentially bind to activated Na+ channels, so most effective in rapidly firing neurons. 3° amine local anesthetics penetrate membrane in uncharged form, then bind to ion channels as charged form

191
Q

Mechanism: Monoamine oxidase (MAO) inhibitors

A

Nonselective MAO inhibition ↑ levels of amine neurotransmitters (NE, serotonin, dopamine)

192
Q

Mechanism: Nonbenzodiazepine hypnotics

A

Act via the BZ1 receptor subtype and is reversed by flumazenil

193
Q

Mechanism: Selegiline

A

Selectively inhibites MAO-B, which preferentially metabolizes dopamine over NE and 5-HT, thereby increasing the availability of dopamine

194
Q

Mechanism: Sildenafil / vardenafil

A

Inhibit cGMP phosphodiesterase, causing ↑ cGMP, smooth muscle relaxation in the corpus cavernosum, ↑ blood flow, and penile erection. Sildenafil and vardenafil fill the penis.

195
Q

Mechanism: SNRIs

A

Inhibit serotonin and NE reuptake

196
Q

Mechanism: Spironolactone

A

a competitive aldosterone receptor antagonist in the cortical collecting tubule

197
Q

Mechanism: SSRIs

A

Serotonin-specific reuptake inhibitors

198
Q

Mechanism: Triamterene / Amiloride

A

act at the cortical collecting tubule by blocking Na+ channels in the DCT

199
Q

Mechanism: Tricyclic antidepressants

A

Block reuptake of NE and serotonin

200
Q

Memantine

A

Alzheimer’s drug Mechanism: NMDA receptor antagonist; helps prevent excitotoxicity (mediated by Ca2+) Toxicity: Dizziness, confusion, hallucinations

201
Q

Mifepristone (RU-486)

A

Mechanism: Competitive inhibitor of progestins at progesterone receptors Clinical use: Termination of pregnancy. Administered with misoprostol (PGE1) Toxicity: Heavy bleeding, GI effects (nausea, vomiting, anorexia), abdominal pain

202
Q

Mirtazapine

A

α2 antagonist (↑ release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist. Toxicity: sedation, ↑ appetite, weight gain, dry mouth.

203
Q

MOA: Atypical antipsychotics

A

Block 5-HT2, dopamine, α, and H1 receptors

204
Q

MOA: Barbiturates

A

Facilitate GABA(A) action by ↑duration of Cl- channel opening, thus ↓neuron firing

205
Q

MOA: Carbamazepine

A

↑Na+ channel inactivation

206
Q

MOA: Ethosuximide

A

Blocks thalamic T-type Ca2+ channels

207
Q

MOA: H1 blockers

A

Reversible inhibitors of H1 histamine receptors

208
Q

MOA: Ketoconazole

A

Inhibits steroid synthesis (inhibits desmolase)

209
Q

MOA: Opioids analgesics

A

Act as agonists at opioid receptors (mu=morphine, delta=enkephalin, kappa=dynorphin) to modulate synaptic transmission - open K+ channels, close Ca2+ channels → ↓synaptic transmission. Inhibit release of ACh, NE, 5-HT, glutamate, substance P

210
Q

MOA: Phenytoin

A

Use-dependent blockade of Na+ channels; ↑refractory period; inhibition of glutamate release from excitatory presynaptic neuron

211
Q

MOA: Spironolactone

A

Inhibits steroid binding

212
Q

MOA: Valproic acid

A

↑Na+ channel inactivation, ↑GABA concentration

213
Q

Molecular: GABA(A)-R

A

A ligand-gated chloride channel binded by benzos, barbs, and EtOH

214
Q

Monitoring: Lithium

A

Narrow therapeutic window requires close monitoring of serum levels. Almost exclusively excreted by the kidneys; most is reabsorbed at the proximal convoluted tubules following Na+ reabsorption

215
Q

Monoamine oxidase (MAO) inhibitors: Names

A

Phenelzine, tranylcypromine, isocarboxazid, selegiline (selective MAO-B inhibitor)

216
Q

Name Inhaled anesthetics (3)

A

Halothane, -flurane, nitrous oxide

217
Q

Neuroleptic malignant syndrome (NMS)

A

rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Treatment: dantrolene, D2 agonists (e.g., bromocriptine) FEVER: Fever, Encephalopathy, Vitals unstable, Elevated enzymes, Rigidity of muscles

218
Q

Neuromuscular blocking drugs: Two groups

A

Depolarizing: Succinylcholine Nondepolarizing: Tubocurarine, -curium, -curonium

219
Q

NSAIDs

A

Ibuprofen, naproxen, indomethacin, ketorolac Mechanism: Reversibly inhibit cyclooxygenase (both COX-1 and COX-2). Block prostaglandin synthesis. Clinical use: Antipyretic, analgesic, anti-inflammatory. Toxicity: Renal damage, fluid retention, aplastic anemia, GI distress, ulcers.

220
Q

Order of nerve blockade: Local anesthetics

A

Small myelinated fibers > Small unmyelinated fibers > Large myelinated fibers > Large unmyelinated fibers

221
Q

Parkinson’s disease drugs: Four groups

A

Agonize dopamine receptors: a.ergot: Bromocriptine b.non-ergot: pramipexole ropinirole ↑dopamine: Amantiadine, L-dopa/carbidopa Prevent dopamine breakdown: Selegiline, -capone Curb excess cholinergic activity: Benztropine

222
Q

Principle: Local anesthetics in acidic tissue

A

In infected (acidic) tissue, alkaline anesthetics are charged and cannot penetrate membrane effectively. More anesthetic is needed in these cases.

223
Q

Probenecid

A

Gout drug, chronic gout. Inhibits reabsorption of uric acid in PCT (also inhibits secretion of penicillin)

224
Q

Progestins

A

Mechanism: Bind progesterone receptors, reduce growth, and ↑ vascularization of endometrium Clinical use: Used in oral contraceptives and in the treatment of endometrial cancer and abnormal uterine bleeding

225
Q

Raloxifene

A

Estrogen partial agonist, agonist on the bone; reduces resorption of bone; used to treat osterporosis

226
Q

Reason: Why not use salicylates to treat gout?

A

All but the highest doses depress uric acid clearance. Even high doses (5-6 g/day) have only minor uricosuric activity

227
Q

Ritodrine / Terbutaline

A

β2-agonists that relax the uterus; reduce premature uterine contractions

228
Q

Salmeterol

A

Asthma drug, long-acting agent for prophylaxis. Adverse effects are tremor and arrhythmia.

229
Q

Seizures: Almost always from temporal lobe (mood changes, illusions, hallucinations); impaired consciousness and postictal state are present

A

Complex partial, DOC: Carbamazepine

230
Q

Seizures: Brief arrhythmic jerking movements, last < 1 sec, usually occur in clusters for a few minutes; no loss of consciousness

A

Myoclonic, DOC: Valproic acid

231
Q

Seizures: Brief episode of staring, but no postictal confusion

A

Absence, DOC: Ethosuximide, valproate

232
Q

Seizures: Generalized tonic extension of the extremities, followed by clonic rhythmic movements; loss of consciousness and prolonged postictal confusion are present

A

Tonic-clonic, DOC: Phenytoin, carbamazepine, and valproate

233
Q

Seizures: One body part is involved; no loss of consciousness and no postictal confusion

A

Simple partial, DOC: Carbamazepine

234
Q

Serotonin syndrome

A

Hyperthermia, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures

235
Q

Short acting benzodiazepines (3)

A

Triazolam, Oxazepam, Midazolam → Highest addictive potential

236
Q

Side effects: Tricyclic antidepressants

A

Sedation, α-blocking effects, atropine-like side effects. 3° TCAs (amitriptyline) have more anticholinergic effects than do 2° TCAs (nortriptyline). Desipramine is the least sedating and has lower seizure threshold.

237
Q

SNRIs: Names

A

Venlafaxine, duloxetine

238
Q

SSRIs: Names

A

Fluoxetine, paroxetine, sertraline, citalopram

239
Q

Steven-Johnson syndrome

A

Prodome of malaise and fever followed by rapid onset of erythmatous / purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing

240
Q

Sumatriptan

A

Mechanism: 5-HT(1B/1D) agonist. Causes vasoconstriction, inhibition of trigeminal activation and vasoactive peptide release. Half-life < 2 hours Clinical use: Acute migraine, cluster headache attacks. Toxicity: Coronary vasospasm (contraindicated in patients with CAD or Prinzmetal’s angina), mild tingling

241
Q

Tamoxifen

A

Estrogen partial agonist, antagonist on the breast tissue; used to treat and prevent recurrence of ER-positive breast cancer

242
Q

Tamsulosin

A

α1-antagonist used to treat BPH by inhibiting smooth muscle contraction. Selective for α1(A,D) receptors (found in prostate) vs. vascular α1(B) receptors

243
Q

Tardive dyskinesia

A

stereotypic oral-facial movements due to long-term antipsychotic use. Often irreversible.

244
Q

Testosterone (methyltestosterone)

A

Mechanism: Agonist at androgen receptors Clinical use: Treat hypogonadism and promote development of 2° sex characteristics; stimulation of anabolism to promote recovery after burn or injury; treat with ER-positive breast cancer (exemastane) Toxicity: Causes masculinization in females; reduces intratesticular testosterone in males by inhibiting release of LH (via negative feedback), leading to gonadal atrophy. Premature closure of epiphyseal plates. ↑LDL, ↓HDL

245
Q

Theophylline

A

Asthma drug, likely causes bronchodilation by inhibiting phosphodiesterase, thereby ↓ cAMP hydrolysis. Usage is limited because of narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by P-450. Blocks actions of adenosine.

246
Q

Toxicity: ACE inhibitors

A

Cough, Angioedema, Proteinuria, Taste changes, hypOtesion, Pregancy problems, Rash, Increased renin, Lower angiotensin II. CAPTOPRIL. Also, hyperkalemia. Avoid with bilateral renal artery stenosis because ACE inhibitors significantly ↓ GFR by preventing constriction of efferent arterioles

247
Q

Toxicity: Acetaminophen

A

Overdose produces hepatic necrosis; acetaminophen metabolite depletes glutathione and forms toxic tissue adducts in liver. N-acetylcysteine is antidote - regenertates glutathione.

248
Q

Toxicity: Antipsychotics

A
  1. Highly lipid soluble and stored in body fat; thus, very slow to be removed from body. 2. Extrapyramidal system (EPS) side effects. 3. Endocrine side effects (e.g., dopamine receptor antaganism → hyperprolactinemia → galactorrhea) 4. Side effects arising from blocking muscarinic (dry mouth, constipation), α (hypotension), and histamine (sedation) receptors. 5. Neuroleptic malignant syndrome (NMS) / Tardive dyskinesia
249
Q

Toxicity: Aspirin

A

Gastric upset. Chronic use can lead to acute renal failure, interstitial nephritis, and upper GI bleeding. Reye’s syndrome in children with viral infection.

250
Q

Toxicity: Atypical antipsychotics

A

Fewer extrapyramidal and anticholinergic side effects than traditional antipsychotics

251
Q

Toxicity: Barbiturates

A

Dependence, additive CNS depression effects with alcohol, respiratory or cardiovascular depression (can lead to death), drug interactions owing to induction of liver microsomal enzymes (cytochrome P-450)

252
Q

Toxicity: Benzodiazepines

A

Dependence, additive CNS depression effects with alcohol. Less risk of respiratory depression and coma than with barbiturates

253
Q

Toxicity: Bupivacaine

A

CNS excitation, severe cardiovascular toxicity

254
Q

Toxicity: Chlorpromazine

A

Corneal deposits

255
Q

Toxicity: Clozapine

A

may cause agranulocytosis

256
Q

Toxicity: Cocaine

A

Hypertension, hypotension, and arrhythmias

257
Q

Toxicity: COX-2 inhibitors (celecoxib)

A

↑ risk of thrombosis. Sulfa allergy. Less toxicity to GI mucosa (lower incidence of ulcers, bleeding than NSAIDs)

258
Q

Toxicity: Enflurane

A

Proconvulsant

259
Q

Toxicity: Halothane

A

Hepatotoxicity

260
Q

Toxicity: K+-sparing diuretics

A

Hyperkalemia (can lead to arrhythmias), endocrine effects with aldosterone antaganists (e.g., spironolactone causes gynecomastia, antiandrogen effects)

261
Q

Toxicity: L-dopa/carbidopa

A

Arrhythmias from peripheral conversion to dopamine. Long-term use can → dyskinesia following administration, akinesia between doses. Carbadopa, a peripheral decarboxylase inhibitor, is given with L-dopa in order to ↑ the bioavailability of L-dopa in the brain and to limit peripheral side effects

262
Q

Toxicity: Lithium

A

Tremor, sedation, edema, heart block, hypothyroidism, polyurea (ADH antagonist causing nephrogenic diabetes insipidus). Fetal cardiac defects include Ebstein anomaly and malformation of the great vessels.

263
Q

Toxicity: Methoxyflurane

A

Nephrotoxicity

264
Q

Toxicity: Monoamine oxidase (MAO) inhibitors

A

Hypertensive crisis with tyramine ingestion (in many foods, such as wine and cheese) and β-agonists; CNS stimulation.

265
Q

Toxicity: Nitrous oxide

A

Expansion of trapped gas

266
Q

Toxicity: Nonbenzodiazepine hypnotics

A

Ataxia, headaches, confusion. Shorter duration because of rapid metabolism by liver enzymes. Unlike older sedative-hypnotics, cause only modest day-after psychomotor depression and few amnestic effects. Lower dependence risk than benzodiazepines

267
Q

Toxicity: Olanzapine / Clozapine

A

may cause significant weight gain

268
Q

Toxicity: Opioid analgesics

A

Addiction, respiratory depression, constipation, miosis (pinpoint pupils), additive CNS depression with other drugs. Tolerance does not develop to miosis and constipation.

269
Q

Toxicity: Phenytoin

A

Nystagmus, ataxia, diplopia, sedation, SLE-like syndrome, induction of cytochrome P-450. Chronic use produces gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia (↓folate absorption). Teratogenic (fetal hydantoin syndrome).

270
Q

Toxicity: Selegiline

A

May enhance the adverse effects of L-dopa

271
Q

Toxicity: Sildenafil / vardenafil

A

Headache, flushing, dyspepsia, impaired blue-green color vision. Risk of life-threatening hypotension in patients taking nitrates.

272
Q

Toxicity: SNRIs

A

↑ BP most common; also stimulant effects, sedation, nausea

273
Q

Toxicity: SSRIs

A

Fewer than TCAs. GI distress, sexual dysfunction (anorgasmia). “Serotonin syndrome” with any drug that ↑ serotonin (e.g., MAO inhibitors)

274
Q

Toxicity: Thioridazine

A

Retinal deposits

275
Q

Toxicity: Tricyclic antidepressants

A

Tri-C’s: Convulsions, Coma, Cardiotoxicity (arrhythmias); also respiratory depression, hyperpyrexia. Confusion and hallucinations in elderly due to anticholinergic side effects.

276
Q

Tramadol

A

Mechanism: Very weak opioid agonist; also inhibits serotonin and NE reuptake (works on multiple neurotransmitters - “tram it all” in) Clinical use: Chronic pain Toxicity: Similar to opioids. Decreases seizure threshold

277
Q

Trazodone

A

Primarily inhibits serotonin reuptake. Used for insomnia, as high doses are needed for antidepressant effects. Toxicity: sedation, nausea, priapism, postural hypotension.

278
Q

Tricyclic antidepressants: Names

A

Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin, amoxapine (-ipramine, -triptyline, doxepin, amoxapine)

279
Q

Zafirlukast, montelukast

A

block leukotriene receptors. Especially good for aspirin-induced asthma.

280
Q

Zileuton

A

A 5-lipoxygenase pathway inhibitor. Blocks conversion of arachidonic acid to leukotrienes

USMLE (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions