Pharma Topic List A Flashcards
1
Q
A.5. Local anesthetics Drugs
A
cocaine
lidocaine
articaine
bupivacaine
2
Q
A.5 Local Anesthetics - MoA
A
blocks Na+ channel inhibiting AP
LA cause vasodilation add vasoconstrictor like E
Frequency dependent Blockade - affects depolarized nerves - sensory, A-delta, C - more than motor
Onset - LA with lower pKa have a quicker onset - since more drug will exist in unionized form. thereby it allows penetration into the neuron easier
3
Q
A.5 Local Anesthetics - Factors Affecting half life of LA
A
- severe liver disease
- competition with other drugs fro the same enzyme
- decrease in hepatic blood flow
4
Q
cocaine
A
Ester - metabolized by pseudocholinesterase
Topical
ISA - reuptake inhibiotr
DoA=1-2h
SE: - allergy, CV and CNS disturbance, coronary spasm, euphoria
A.5. Local anesthetics Drugs
5
Q
lidocaine
A
amide - met CYP450 (CYP3A4)
Fast onset of action - short, local procedures
post-op analgesic
DoA - medium
can produce autonomic block in ischemic conditions - Class Ib antiarrythmic
Lidocaine interacts with antiepileptics
A.5. Local anesthetics Drugs
6
Q
articaine
A
Amide
most rapid onset of action
very high potency
has an ester on its side chain - can be inactivated by hydrolysis
A.5. Local anesthetics Drugs
7
Q
bupivacaine
A
Amide - CYP450 (CYP3A4)
Long duration of action
highest potency
high protein binding
used for long procedures
Cardiotoxic - severe myocardial depression esp if administered into blood
A.5. Local anesthetics Drugs
8
Q
A.6. Glucocorticoids for oral and parenteral use - GC summary
A
GC-R are found through-out the body.
When they bind the GC-R complex dimerizes –> recruits coactivators or corepressors –> translocates into the nucleus, where it attaches to the GC-R gene element (GRE) –> gene expression modulation
Activation:
-Annexin1 –> dec PLA2
- enzymes for gluconeogenesis and AA metabolism
- adrenergic-R on vascular and bronchial smooth muscle
Repression:
COX2, NOS, cytokines, interleukins, cell adhesion molecules
9
Q
A.6. Glucocorticoids for oral and parenteral use -Drugs
A
hydrocortizone
prednisolone
methylprednisolone
dexamethasone
triamcinolone
10
Q
hydrocortizone
A
synthetic cortisol
short acting 8-12 hours
same affinity GC:MC
PO,IM, intra-art
Tx- DoC primary adrenocortical insufficiency (Addisons) or CAH - congenital adrenal hyperplasia
helps with IBD - enema
inibits peripheral conversion T4 to T3 - tx - thyroid storm
A.6. Glucocorticoids for oral and parenteral use
11
Q
prednisolone
A
Active metabolite of prednisone
systemic steroid
PO, topical
intermediate acting 12-36 hr
GC:MC - 4 : 0.8
Tx - DoC for systemic anti-inflamm and immunosupression
inhibits cytokine gene expression
severe persistent asthma
thyrotoxicosis
A.6. Glucocorticoids for oral and parenteral use
12
Q
methylprednisolone
A
Dose: 4 - 250mg
PO, parenteral
intermediate acting 12-36 hr
GC:MC - 5 : 0
TX - DoC for systemic anti-inflamm and immunosupression
thyrotoxicosis
IBD - PO or inj
Antiemetic in CIV
Urgent cases IV - anaphylaxis, bronchial asthma, brain edema, hepatic coma
A.6. Glucocorticoids for oral and parenteral use
13
Q
dexamethasone
A
synthetic GC - Dexathemasone suppression test - suppresses cortical release in normal individuals but not in those with cushings
long acting 36 - 72 hours
DoC - supression of ACTH, anti-inflamm and immunosupress where water retention is unwanted
-IM mother within 48 hr premature birth to hasten fetal lung maturation
Neoplastic - dec brain edema
used in conjuction with aminogluthetimide to dec estrogen in breast cancer
A.6. Glucocorticoids for oral and parenteral use
14
Q
triamcinolone
A
PO, Topical, parenteral
intermediate acting 12-36 hr
GC:MC - 5 : 0
Tx - allergic rhinitis spray
More Toxic than others
15
Q
A.7. Mineralocorticoids. Topically applied glucocorticoids Drugs
A
fludrocortizone
fluocinolon
mometazone
budesonide
fluticazone
metyrapone
16
Q
A.7. Mineralocorticoids. Topically applied glucocorticoids Drugs - Effect of MC
A
MC are steroids produced by the adrenal cortex. MC-R complex effects gene expression.
Genomic Receptor Action:
- inc Na+/K+ transcription
- inc ENaC channel activity
- inc expression of pro-fibrotic molecules
- inc NADPH expression
- inc ROS pro-inflam
Non-Genomic
- inc Na+ reabsorption
- inc K+ and H+ excretion - via collecting duct
17
Q
fludrocortizone
A
MC
DoC for replacement therapy for adrenal hypofn
Acute/Chronic or post Adrenalectomy
PO
long duration of action
inc Na+ reabsorption in distal tubules and K+ ad H+ efflux
A.7. Mineralocorticoids. Topically applied glucocorticoids
18
Q
fluocinolone
A
MC
TX - implanted in chronic non-infectious uveitis
ointment in derma
A.7. Mineralocorticoids. Topically applied glucocorticoids
19
Q
mometazone
A
Topical GC - Aerosol - bronchial asthma
nasal spray - allergic rhinitis
A.7. Mineralocorticoids. Topically applied glucocorticoids
20
Q
budesonide
A
Topical GC Aerosol - bronchial asthma
Nasal Spray - allergic rhinitis
Enema in IBD (suppository)
A.7. Mineralocorticoids. Topically applied glucocorticoids
21
Q
fluticazone
A
Topical GC - aerosol in bronchial asthma
A.7. Mineralocorticoids. Topically applied glucocorticoids
22
Q
metyrapone
A
Adrenocortical antagonist
inhibits beta hydroxylase - in ACTH producing tumors
used to dx test of ACTH fn
can be used to tx Cushings
A.7. Mineralocorticoids. Topically applied glucocorticoids
23
Q
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity - Drugs
A
testosteron-undecanoate
bicalutamide
finasteride
goserelin
degarelix
sildenafil
nandrolon
24
Q
testosteron-undecanoate
A
Synthetic steroid.
NOT PO – high first pass metabolism – transdermal patch, inject, gel.
TX- replacement tx in hypogonadism, maintain libido.
In case of PO needs to be absorbed with lipophilic vehicle into lymphatics.
SE – enhance hematocrit, excessive masculinization.
CI – prostate or breast cc. interact – may improve glucose tolerance, enhance anti-coagul in coumarins.
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
25
bicalutamide
androgen R antagonist, competitive inhib.
PO.
TX – metastatic prostate cc.
CI – hepatotoxicity it’s a CYP3A4 inhibitor.
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
26
finasteride
5-alpha-reducatse inhibitor, dec DHT which dec testosterone.
Moderately effective in dec prostate size in men with BPH.
PO.
TX – male baldness and female hirsutism.
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
27
goserelin
GnRH analogue.
t1/2=4h.
Continuous GnRH until there is a downregulation of the GnRH-R.
Tx – prostate cc. breast cc. severe endometriosis, IVF.
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
28
degarelix
GnRH antagonist.
Blocks GnRH R in the pituitary dec FSH and LH. Dec effect on Leydig cells to produce testosterone.
Tx – prostate cc. women IVF.
SE – QT prolong, heatwave, dec gluc tolerance, dec bone density
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
29
sildenafil
PDE5 inhibitor “Viagra”.
causes inc cGMP - vasodilation
PO.
TX – pulmonary HTN, erectile dysfn.
CI – nitrates.
SE – severe hypotension, priapism
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
30
nandrolon
Synthetic steroid analogue only used for anabolism, not used for hormonal purposes.
Indication – convalescence after trauma, surgery, prolonged immobilization, anemia as a consequence of renal fail.
SE – masculization women, androgen with gestagen activity – CV risk, endometrial bleeding after stopping, sodium retention, edema, elder male- prostate hyperplasia.
CI – pregnancy, prostate cc, infants, young, breast cancer males.
ABUSED in sports
A.8. Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity
31
A.8 Androgens, anabolic steroids, antiandrogens. Agents affecting the sexual activity - Sexual Activity
Sexual Activity
– Hormonal tx – testosterone-udecanoate.
Inhibitor PDE-5 – Sildenafil, tadalafil.
Intracavernous tx used for tx or for dx of erectile dysfn – alprostadil (PGE1)
32
A.9. Estrogens and antiestrogens - Drugs
ethynylestradiol
estradiol
clomifen
tamoxifen
raloxifen
anastrozole
goserelin
degarelix
33
A.9 Estrogens and Antiestrogens - Estrogen fn
Estrogen promotes the proliferation of the endometrium and breasts.
Responsible for sexual maturation and growth, secondary charact, female libido.
Endometrial effects – develop of endometrial lining.
Pharma estrogens cause – dec resorption bone, high levels CBG TBG, SHBG, transferrin, fibrinogen, inc HDL, inc TG and cholesterol, enhanced blood coagulation, sodium retention, edema.
SE – postmenu bleeding, nausea, breast tenderness, hyperpigmentation, incre frequency migraine, cholestasis, gallbladder disease, hepatic adenomas.
CI – patients with estrogen based neoplasms, undx genital bleeding, severe liver disease, history thromboembolic disorder, heavy smoker.
34
ethynylestradiol
synthetic steroidal estrogen.
PO – well absorbed, transdermal, parenteral.
Met CYP450.
TX – parenteral or oral contraceptive, HRT, prevent bone loss and osteoporosis, hypogonadism in girls..
SE – breast cc, endometrial hyperplasia and cc, inc CV risk.
A.9. Estrogens and antiestrogens
35
estradiol
natural estrogen – main secretory product of the ovary.
Used as IM depot in conjugate form.
First high pass so given transdermal or inject – in the liver forms estrone and estriol.
Binds to SHB and albumin in circulation.
Excretion via bile with enterohepatic recycling
A.9. Estrogens and antiestrogens
36
clomifen
SERM – selective estrogen receptor modulator.
Ovulation inducing agent. It selectively inhibits estrogen R in the pituitary dec negative feedback causing inc in FSH and LH secretion.
TX – fertility drug.
SE – multiple preg, visual disturb
A.9. Estrogens and antiestrogens
37
tamoxifen
SERM.
Anti-estrogen.
TX – palliative care of breast cc in postmenu women – hormone responsive breast cc.
SE – hot flashes, thromboembol, inc endometrial cc.
A.9. Estrogens and antiestrogens
38
raloxifen
SERM.
PO.
TX – tx and prophylaxis osteoporosis in post menu
A.9. Estrogens and antiestrogens
39
anastrozole
Anti-estrogen.
Non-steroidal inhibitor – Aromatase inhibitor – causes almost total suppression of estrogen synth.
PO.
TX – breast cc resistant to tamoxifen
A.9. Estrogens and antiestrogens
40
goserelin
GnRH analogue.
Continuous admin of GnRH agonist suppresses GnRH secretion and thereby inhibit ovarian production of estrogens and progestins.
TX – ovulation, suppression women undergoing controlled induction. Ovarian suppression in endometriosis, leiomyoma. Central precocious puberty
A.9. Estrogens and antiestrogens
41
degarelix
GnRH antagonist.
TX – prevention of premature LH surge in women undergoing controlled ovarian hyperstimulation for assisted reproduction.
SE – prolong QT, heat wave, dec gluc tolerance, dec bone density
A.9. Estrogens and antiestrogens
42
A.10. Progestins and antiprogestins - Drugs
medroxyprogesteron-acetate
drospirenone
norethisteron
levonorgestrel
desogestrel
cyproteron-acetate
mifepristone
ulipristal acetate
43
A.10 Progestins and Antiprogestins - function of progestin
natural is progesterone – produced by corpus luteum.
NOT PO, IM admin.
Actions – inhibit proliferation, promote differentiation in:
- endometrium – maturation and secretory changes following ovulation (dec growth inc vascul),
- breast – prolif then alveolobulbar develop of secretory
- implantation, maintenance of preg, inhibition of ovulation
- inc body temp, metabolic
–fat deposition, ketogenesis.
Competes with aldosterone-R so dec Na+ resorption.
Resp – ventilatory response to CO2 inc.
TX – hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress.
SE – inc risk breast cc, dec HDL, impair gluc tole, elevated BP.
44
medroxyprogesteron-acetate
synthetic progestin, pregnan (21-C cmpd).
Improved bioaval – PO or IM – 150mg every 3 months.
Met CYP450.
TX – primary hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress
A.10. Progestins and antiprogestins
45
drospirenone
synthetic progestin, pregnan (21-C cmpd).
Improved bioaval – PO or IM – 150mg every 3 months.
Met CYP450.
TX – primary hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress
A.10. Progestins and antiprogestins
46
norethisteron
is an estran – 19-norsteroid.
Has androgen/anabolic action.
Inhibits implantation – more effective than gonadotropin inhibitors.
PO – minipill.
TX – primary hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress.
A.10. Progestins and antiprogestins
47
levonorgestrel
gonan. – 13-ethyl derivative of 19-nonsteroid.
High dose can be used as morning after.
Can be used as interuterine device
TX – primary hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress
A.10. Progestins and antiprogestins
48
desogestrel
gonan. – 13-ethyl derivative of 19-nonsteroid.
PO.
Lower androgen activity than norethisterone.
Used as contraceptive implant with active metabolite etonorgestrel.
TX – primary hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress
A.10. Progestins and antiprogestins
49
cyproteron-acetate
synthetic progestin, pregnan (21-C cmpd).
Improved bioaval – PO or IM – 150mg every 3 months.
Met CYP450.
TX – primary hypogonadism (HRT), post menu HRT – dec risk endome cc, hormonal contraception, long term ovarian suppress
A.10. Progestins and antiprogestins
50
mifepristone
19-norsteroid progesterone receptor antagonist.
Terminates early pregnancy when in combo with vaginal PGE1 and its analogue misoprostol – used up to 49 days after last period.
Antiglucocorticoid activity.
Indication – endometriosis, breast cc, meningioma.
SE – vomiting, diarrhea, abdominal pain, vaginal bleeding.
A.10. Progestins and antiprogestins
51
ulipristal acetate
SPRM – selective progestin receptor modulator.
morning after pill, tx myomas
A.10. Progestins and antiprogestins
52
A.11. Contraceptives
ethynylestradiol + levonorgestrel
medroxyprogesteron-acetate
levonorgestrel
desogestrel
53
A.11 Contraceptives - how they work
Oral contraceptives: estrogen+progestin combos.
Effects:
MoA- inhibition of pituitary fn, inhibition of ovulation, changes in cervical mucosa, endometrium, motility, secretion.
Chronic use depresses ovarian fn, and ovary becomes smaller.
Uterus – cervical hypertrophy (polyp formation) thicker cervical mucosa, preps containing 19-norsteroid can cause glandular atrophy, less bleeding.
Breast – enlargement, suppression lactation.
ADVANTAGE – lower incidence of ovarian and endome cc, ovarian cysts, mastopathies. Less bleeding, lower incidence of anemia, improve endometriosis, dysmenorrhea.
DISAD – inc risk vascular disorder – venous thromem, MI, cerebrovascular disor, incr risk GI disorder, depression.
CI – thromboem, cerebrovas, estrogen depen neoplasms, before epiphyseal closure complete. Over 35 and smoke more than 15 cigg. HTN, IHD, breast cc, cirrhosis.
54
ethynylestradiol + levonorgestrel
monophasic, biphasic 1-10,11-21, triphasic 1-7. 8-14. 15-21.
A.11. Contraceptives
55
medroxyprogesteron-acetate
parenteral – depot – inject of depot – 150 mg IM – every 3 months.
SE – headache, impair gluc tol, lipid changes, irregular bleeding
A.11. Contraceptives
56
levonorgestrel
intrauterine device.
DoA 5 yr. daily release, low systemic hormone level.
Can be morning after pill – high dose 0.75 – 1.25mg – within 72 hr sex
A.11. Contraceptives
57
desogestrel
progestin comonpent.
Its active component etonorgestrel can be used as an implant.
A.11. Contraceptives
58
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones - Drugs
levothyroxin
thiamazole
propylthiouracil
iodine
octreotide
bromocriptine
desmopressin
oxytocin
59
levothyroxin
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
60
thiamazole
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
61
propylthiouracil
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
62
iodine
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
63
octreotide
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
64
bromocriptine
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
65
desmopressin
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
66
oxytocin
A.12. Thyroid and antithyroid drugs. Hypothalamic and pituitary hormones
67
A.13. Pancreatic hormones and parenterally applied antidiabetic drugs. Pharmacotherapy of IDDM.
regular insulin
lispro insulin
glargin insulin
isophan (NPH)-insulin
liraglutide
68
regular insulin
A.13. Pancreatic hormones and parenterally applied antidiabetic drugs. Pharmacotherapy of IDDM.
69
lispro insulin
A.13. Pancreatic hormones and parenterally applied antidiabetic drugs. Pharmacotherapy of IDDM.
70
glargin insulin
A.13. Pancreatic hormones and parenterally applied antidiabetic drugs. Pharmacotherapy of IDDM.
71
isophan (NPH)-insulin
A.13. Pancreatic hormones and parenterally applied antidiabetic drugs. Pharmacotherapy of IDDM.
72
liraglutide
A.13. Pancreatic hormones and parenterally applied antidiabetic drugs. Pharmacotherapy of IDDM.
73
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus. - Drugs
glipizide
glimepiride
repaglinide
metformin
vildagliptin
dapagliflozin
acarbose
74
glipizide
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
75
glimepiride
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
76
repaglinide
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
77
metformin
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
78
vildagliptin
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
79
dapagliflozin
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
80
acarbose
A.14. Oral antidiabetics. Pharmacotherapy of non-insulin dependent diabetes mellitus.
81
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis. - Drugs
cholecalciferol
teriparatide
raloxifen
zoledronate
alendronate
denosumab
82
cholecalciferol
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis.
83
teriparatide
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis.
84
raloxifen
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis.
85
zoledronate
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis.
86
alendronate
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis.
87
denosumab
A.15. Agents affecting bone mineral homeostasis (calcium, vitamin D, parathyroid hormone, calcitonin, etc.). Pharmacotherapy of osteoporosis.
88
A.16. Drugs used in coagulation disorders I: Antiplatelet agents
acetylsalicylic acid
clopidogrel
prasugrel
ticagrelor
abciximab
89
acetylsalicylic acid
A.16. Drugs used in coagulation disorders I: Antiplatelet agents
90
clopidogrel
A.16. Drugs used in coagulation disorders I: Antiplatelet agents
91
prasugrel
A.16. Drugs used in coagulation disorders I: Antiplatelet agents
92
ticagrelor
A.16. Drugs used in coagulation disorders I: Antiplatelet agents
93
abciximab
A.16. Drugs used in coagulation disorders I: Antiplatelet agents
94
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
heparin
dalteparin
bivalirudin
warfarin
dabigatran-etexilate
rivaroxaban
fondaparinux
95
heparin
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
96
dalteparin
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
97
bivalirudin
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
98
warfarin
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
99
dabigatran-etexilate
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
100
rivaroxaban
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
101
fondaparinux
A.17. Drugs used in coagulation disorders II: Anticoagulant drugs
102
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders. - Drugs
alteplase
reteplase
epsilon-amino-caproic acid
vitamin K
epinephrine
fibrin foam
103
alteplase
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders
104
reteplase
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders
105
epsilon-amino-caproic acid
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders
106
vitamin K
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders
107
epinephrine
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders
108
fibrin foam
A.18. Drugs used in coagulation disorders III: Fibrinolytic drugs. Drugs used in bleeding
disorders
109
A.19. Agents used in anemias - Drugs
iron hydroxide polymaltose
folic acid
vitamin B12
epoetin-alfa
filgrastim
110
iron hydroxide polymaltose
A.19. Agents used in anemias
111
folic acid
A.19. Agents used in anemias
112
vitamin B12
A.19. Agents used in anemias
113
epoetin-alfa
A.19. Agents used in anemias
114
filgrastim
A.19. Agents used in anemias
115
A.23. Inhalational anesthetics - Drugs
nitrous oxide
isoflurane
desflurane
sevoflurane
116
nitrous oxide
104% MAC.
Blood coefficient 0.47 – 0 fractionation by the liver.
Has the lowest blood gas coefficient so the patient easily anesthetized and recovers.
TX – dentistry no resp depression so can combined with other anesthetics.
Risk of spontaneous abortion b/c can trigger uterine contractions. Potential drug abuse.
Second Gas effect – inc conc of 2nd agent due to rapid diffusion of N2O in alveoli.
A.23. Inhalational anesthetics
117
isoflurane
MAC 1.4%
blood coefficient 1.4.
Causes resp irritation so only used for maintenance. Can cause coronary steal syn.
Rapid awakening, low metabol, preferred in neurosurgery.
SE – dose dependent hypoTN
A.23. Inhalational anesthetics
118
desflurane
MAC 6.5%
Blood coefficient 0.42.
very rapid onset and recovery due to low blood solubility – used for short procedures.
Dec vascular resis and perfuses to all major tissues well.
SE – significant resp irritation – not used for inhalation induction
A.23. Inhalational anesthetics
119
sevoflurane
MAC 2%
Blood coefficient 0.69.
is the most used.
Fastest induction and recovery.
Lowest amt respir irritation. Used for induction and maintenance in children.
SE – nephrotoxic with prolonged anesthesia
A.23. Inhalational anesthetics
120
A.24. Intravenous anesthetics. Perioperative medication - Drugs
thiopental
propofol
etomidate
ketamine
midazolam
dexmedetomidine
fentanyl
metoclopramide
atropine
antacid drugs
antihistamines
analgesics
121
thiopental
A.24. Intravenous anesthetics. Perioperative medication
122
propofol
A.24. Intravenous anesthetics. Perioperative medication
123
etomidate
A.24. Intravenous anesthetics. Perioperative medication
124
ketamine
A.24. Intravenous anesthetics. Perioperative medication
125
midazolam
A.24. Intravenous anesthetics. Perioperative medication
126
dexmedetomidine
A.24. Intravenous anesthetics. Perioperative medication
127
fentanyl
A.24. Intravenous anesthetics. Perioperative medication
128
metoclopramide
A.24. Intravenous anesthetics. Perioperative medication
129
atropine
A.24. Intravenous anesthetics. Perioperative medication
130
antacid drugs
A.24. Intravenous anesthetics. Perioperative medication
131
antihistamines
A.24. Intravenous anesthetics. Perioperative medication
132
analgesics
A.24. Intravenous anesthetics. Perioperative medication
133
A.25. Benzodiazepines - Drugs
diazepam
nitrazepam
midazolam
alprazolam
clonazepam
flumazenil
134
diazepam
A.25. Benzodiazepines
135
nitrazepam
A.25. Benzodiazepines
136
midazolam
A.25. Benzodiazepines
137
alprazolam
A.25. Benzodiazepines
138
clonazepam
A.25. Benzodiazepines
139
flumazenil
A.25. Benzodiazepines
140
A.26. Non benzodiazepine anxiolytics and non-benzodiazepine hypnotics. Pharmacotherapy of anxiety disorders. - Drugs
zolpidem
zaleplon
melatonin
ramelteon
buspirone
+SSRISs
141
zolpidem
A.26. Non benzodiazepine anxiolytics and non-benzodiazepine hypnotics. Pharmacotherapy of anxiety disorders.
142
zaleplon
A.26. Non benzodiazepine anxiolytics and non-benzodiazepine hypnotics. Pharmacotherapy of anxiety disorders.
143
melatonin
A.26. Non benzodiazepine anxiolytics and non-benzodiazepine hypnotics. Pharmacotherapy of anxiety disorders.
144
ramelteon
A.26. Non benzodiazepine anxiolytics and non-benzodiazepine hypnotics. Pharmacotherapy of anxiety disorders.
145
buspirone
A.26. Non benzodiazepine anxiolytics and non-benzodiazepine hypnotics. Pharmacotherapy of anxiety disorders.
146
A.27. 1st generation (“typical”) antipsychotic agents - Drugs
chlorpromazine
flupentixole
haloperidol
droperidol
147
chlorpromazine
A.27. 1st generation (“typical”) antipsychotic agents
148
flupentixole
A.27. 1st generation (“typical”) antipsychotic agents
149
haloperidol
A.27. 1st generation (“typical”) antipsychotic agents
150
droperidol
A.27. 1st generation (“typical”) antipsychotic agents
151
A.28. 2nd generation (“atypical”) antipsychotic agents - Drugs
clozapine
olanzapine
quetiapine
risperidone
tiapride
aripiprazole
cariprazine
152
clozapine
A.28. 2nd generation (“atypical”) antipsychotic agents
153
olanzapine
A.28. 2nd generation (“atypical”) antipsychotic agents
154
quetiapine
A.28. 2nd generation (“atypical”) antipsychotic agents
155
risperidone
A.28. 2nd generation (“atypical”) antipsychotic agents
156
tiapride
A.28. 2nd generation (“atypical”) antipsychotic agents
157
aripiprazole
A.28. 2nd generation (“atypical”) antipsychotic agents
158
cariprazine
A.28. 2nd generation (“atypical”) antipsychotic agents
159
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors - Drugs
clomipramine
amitryptiline
maprotiline
bupropion
trazodone
moclobemide
160
clomipramine
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors
161
amitryptiline
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors
162
maprotiline
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors
163
bupropion
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors
164
trazodone
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors
165
moclobemide
A.29. Tricyclic, tetracyclic and unicyclic antidepressants. MAO-inhibitors
166
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors. - Drugs
fluoxetine
sertraline
citalopram
escitalopram
venlafaxine
duloxetine
reboxetine
167
fluoxetine
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
168
sertraline
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
169
citalopram
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
170
escitalopram
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
171
venlafaxine
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
172
duloxetine
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
173
reboxetine
A.30. Selective serotonin and/or norepinephrine reuptake inhibitors
174
A.31. Norepinephrine and serotonin receptor antagonist antidepressants. Agomelatine. Tianeptine. Agents used for treatment of manic phase of bipolar disorders. Pharmacotherapy of affective disorders. - DRUGS
mirtazapine
agomelatine
lithium
carbamazepine
valproate
+egyes atípusos antipszichotikumok
175
mirtazapine
A.31. Norepinephrine and serotonin receptor antagonist antidepressants. Agomelatine. Tianeptine. Agents used for treatment of manic phase of bipolar disorders. Pharmacotherapy of affective disorders.
176
agomelatine
A.31. Norepinephrine and serotonin receptor antagonist antidepressants. Agomelatine. Tianeptine. Agents used for treatment of manic phase of bipolar disorders. Pharmacotherapy of affective disorders.
177
lithium
A.31. Norepinephrine and serotonin receptor antagonist antidepressants. Agomelatine. Tianeptine. Agents used for treatment of manic phase of bipolar disorders. Pharmacotherapy of affective disorders.
178
carbamazepine
A.31. Norepinephrine and serotonin receptor antagonist antidepressants. Agomelatine. Tianeptine. Agents used for treatment of manic phase of bipolar disorders. Pharmacotherapy of affective disorders.
179
valproate
A.31. Norepinephrine and serotonin receptor antagonist antidepressants. Agomelatine. Tianeptine. Agents used for treatment of manic phase of bipolar disorders. Pharmacotherapy of affective disorders.
180
A.32. Antiepileptics used in partial seizures and generalized tonic-clonic seizures except for the “broad spectrum” agents.
phenytoin
carbamazepine
phenobarbital
vigabatrine
181
phenytoin
A.32. Antiepileptics used in partial seizures and generalized tonic-clonic seizures except for the “broad spectrum” agents.
182
carbamazepine
A.32. Antiepileptics used in partial seizures and generalized tonic-clonic seizures except for the “broad spectrum” agents.
183
phenobarbital
A.32. Antiepileptics used in partial seizures and generalized tonic-clonic seizures except for the “broad spectrum” agents.
184
vigabatrine
A.32. Antiepileptics used in partial seizures and generalized tonic-clonic seizures except for the “broad spectrum” agents.
185
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus - Drugs
ethosuximide
valproate
lamotrigine
clonazepam
levetiracetam
diazepam
186
ethosuximide
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus
187
valproate
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus
188
lamotrigine
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus
189
clonazepam
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus
190
levetiracetam
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus
191
diazepam
A.33. Antiepileptics used in absence seizures. “Broad spectrum” antiepileptic drugs. Drugs used for treatment of status epilepticus
192
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
levodopa+carbidopa
ropinirole
pramipexole
selegiline
entacapone
amantadine
procyclidine
memantine
rivastigmine
piracetam
193
levodopa+carbidopa
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
194
ropinirole
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
195
pramipexole
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
196
selegiline
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
197
entacapone
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
198
amantadine
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
199
procyclidine
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
200
memantine
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
201
rivastigmine
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
202
piracetam
A.34. Drugs used for treatment of neurodegenerative disorders. Nootropic drugs
203
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions. - Drugs
papaverine
drotaverine
butylscopolamine
misoprostol
oxytocin
ergotamine
terbutaline
atosiban
Mg++
ethanol
solifenacin
oxybutinine
tamsulosin
204
papaverine
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
205
drotaverine
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
206
butylscopolamine
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
207
misoprostol
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
208
oxytocin
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
209
ergotamine
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
210
terbutaline
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
211
atosiban
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
212
Mg++
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
213
ethanol
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
214
solifenacin
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
215
tamsulosin
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
216
oxybutinine
A. 35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.
217
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS). - Drugs
dimenhydrinate
droperidol
metoclopramide
ondansetron
palonosetron
aprepitant
some cannabinoids
218
dimenhydrinate
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS)
219
droperidol
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS)
220
metoclopramide
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS)
221
ondansetron
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS)
222
palonosetron
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS)
223
aprepitant
A.36. Antiemetic drugs. Prokinetic agents. Drugs for irritable bowel disease (IBS)
224
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract - Drugs
plant fibers
MgSO4 magnesium-sulfate
lactulose
paraffin oil
sennoside
bisacodyl
diphenoxilate
loperamide
active charcoal
ursodeoxycholoc acid
acetylcysteine
silimarin
225
plant fibers
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
226
MgSO4 magnesium-sulfate
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
227
lactulose
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
228
paraffin oil
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
229
sennoside
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
230
bisacodyl
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
231
diphenoxilate
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
232
loperamide
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
233
active charcoal
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
234
ursodeoxycholoc acid
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
235
acetylcysteine
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
236
silimarin
A.37. Drugs used in constipation (laxatives) and diarrhea. Drugs promoting digestion. Pharmacology of liver and biliary tract
237
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
esomeprazole
omeprazole
pantoprazole
famotidine
sucralfate
MgO magnesium oxide
Al2(OH)3 aluminum-hydroxide
238
esomeprazole
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
239
omeprazole
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
240
pantoprazole
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
241
famotidine
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
242
sucralfate
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
243
MgO magnesium oxide
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
244
Al2(OH)3 aluminum-hydroxide
A.38. Drugs used in peptic ulcer diseases. Pharmacotherapy of peptic ulcer diseases. - Drugs
