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STEP 3 > PHARMAC > Flashcards

PHARMAC Flashcards

1
Q

ANTIARRYTHMICS CLASS 1
1A
1B
1C

A

SODIUM CHANNEL BLOCKERS

1A QUINIDINE, PROCAINAMIDE, DISOPROPANAMIDE ( queen proclaims diso’s pyramid)

1B LIDOCAINE, MEXELITINE, PHENYTOIN (lettuce mayo, tomato, please)

1C FLECAINAMIDE, PROPAFENONE ( can i have fries please)

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2
Q

ANTIARRYTHMICS CLASS 2

A

POTASSIUM CHANNEL BLOCKERS

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3
Q

H2 BLOCKERS

A

RANITIDINE, FAMOTIDINE, LORATIDINE,
- REVERSIBLY INHIBIT K/H+ PUMP WHICH CAUSES INHIBITION OF H+ SECRETION.

USES:
EOSOPHAGEAL REFLUX- MILD
PEPTIC ULCER
GASTRITIS

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4
Q

PROTON PUMP INHIBITORS

A

IRREVERSIBILY INHIBIT H+/K+ PUMP

USES:

  • SERVERE EOSOPHAGEAL REFLUX
  • COMPONENET IN TREATEMENT OF HELICOBACTER PYLORI
  • STRESS ULCER PROPHYLAXIS
  • GASTRITIS
  • PEPTIC ULCER
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5
Q

HISTAMINE BLOCKERS ADVERSE EFFECTS

A 
CIMETIDINE ADVERSE EFFECTS :
ANTI ANDROGENIC EFFECTS 
- DEC LIBIDO 
-GYNAECOMASTIA
-INC PROLACTIN

RANITIDINE AND CIMETIDINE
-DEC CREATININE CLEARANCE

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6
Q

PPI ADVERSE EFFECTS

A
  • INC C DIFFICILE INFECTION

- DEC ABSORPTION OF MG AND CA AND B12 MALABSORPTION

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7
Q

ANTACIDS

A

MAGNESIUM HYDROXIDE
ALUMINUM HYDROXIDE
CALCIUM CARBONATE

mgOH (Must go bathroom)

  • DIARRHOEA
  • HYPOREFLEXIA
  • CARDIAC ARREST
  • HYPOTENSION

ALOH

  • CONSTIPATION
  • SEIZURES
  • PROXIMAL MUSCLE WEAKNESS
  • HYPOPHOSPHATEMIA

CALCIUM CARBONATE
-HYPERCALCAEMIA MILK ALKALI SYNDROME
Milk-alkali syndrome is a condition in which there is a high level of calcium in the body (hypercalcemia). This causes a shift in the body’s acid/base balance toward alkaline (metabolic alkalosis). As a result, there can be a loss of kidney function.

  • CHELATION( THEREFORE DEC EFFECTIVENESS OF OTHER DRUGS)
  • REBOUND INC IN ACID PRODUCTION
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8
Q

SUCRALFATE

A

IT REQUIRES ACIDIC ENVIRONMENT TO ACT, FORMS A LAYER OF PHYSCIAL PROTECTION ON ULCER BASE AND ALLOWS BICARB SECRETION TO ESATBLISH A PH LEVEL IN THE MUCUS LAYER

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9
Q

OCTREOTIDE

A

MOA
INHIBITS SPLANCHNIC VASODILATORY HORMONES
THERFORE; MAY CAUSE CCK INHIBITION TOO INC RISK OF CHOLELITHIASIS.
USE:
- VARICEAL BLEEDS
-( ACROMEGALY, VIPOMA, CARCINOID TUMOR)

SE

  • STEATORHHOEA
  • CRAMPS
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10
Q

SULFASALAZINE

A

COMBINATION OF 2 COMPONENTS:

  1. SULFAPYRIDINE - ANTIBACTERIAL
  2. 5-AMINO SALICYCLIC ACID- ANTI INFLAMMATORY

USES
-IN CHROHNS DISEASE AND UC ( COLITIS)

MOA:
ACTIVATED BY COLONIC BACTERIA

SE:
- REVERSIBLE OLIGOSPERMIA

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11
Q

ONDANSETRON

A

SEROTONIN MAY CAUSE NAUSEA AND VOMITING
-ONDANSETRON IS A 5HT3 ANTAGONIST, WHICH INHIBITS SEROTONIN AND THEREBY REDUCES EMESIS.

USE

  • IN POSTOP NAUSEA
  • CHEMOTHERAPY NAUSEA
  • POWERFUL ACTING CENTRALLY.

SE
QT INTERVAL PROLONGATION

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12
Q

METOCLOPROMIDE

A

D2 RECEPTOR ANTAGONIST

MOA
INC RESTING TONE
INC LES TONE
INC GASTRIC MOTILITY AND EMPTYING

SE
ANTI PARKINSON EFFECCT DUE TO D2 RECEPTOR BLOCKADE
INTERACTS WITH DIABETIC AGENTS

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13
Q

ORLISTAT

A

MOA
INHIBITS PANCREATIC AND GASTRIC LIPASE
THEREFORE, DEC THE BREAKDOWN OF DIETARY FATS

SE
DEC IN ABSORPTION OF FAT SOLUBLE VITAMINS

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14
Q

LAXATIVES

A

4 KINDS;

  1. BULK FORMING
    - PSYLLIUM
    - METHYLCELLULOSE
  2. OSMOTIC
    - MGOH, AND MG CITRATE
    - POLYETHYLENE GLYCOL
    - LACTULOSE
  3. STIMULENT
    - SENNA
  4. EMOLIENT
    - DOCUSATE
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15
Q

OSMOTIC LAXATIVES

A

MOA
BY OSMOSIS, THE OSMOTIC LOAD CAUSES WATER TO BE DRAWN INTO GUT LUMEN.

USES
HEPATIC ENCEPHALOPATHY
THE GUT BACTERIA BREAKDOWN LACTULOSE INTO 
-LACTIC ACID 
-ACETIC ACID 
WHICH THEN HELPS IN EXCRETION OF AMMONIA

SE

  • CAN CAUSE DEHYDRATION DUE TO WATER ABSORPTION
  • ABUSED BY BULIMICS
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16
Q

A’p’REPITANT

A

SUBSTANCE P ANTAGONIST
MOA
INHIBITS THE NEUROKININ RECEPTOR ( NK-1 ) IN THE BRAIN

USE:
IN CHEMOTHERAPY INDUCED N&V

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17
Q

TUMOR LYSIS SYNDROME

A

Oncologic emergency triggered by massive
tumor cell lysis, most often in lymphomas/
leukemias.
-Release of K+ hyperkalemia,
-release of PO4 -hyperphosphatemia,
-hypocalcemia due to Ca2+ sequestration by PO4
-nucleic acid breakdown -hyperuricemia, acute kidney injury.

Prevention and treatment include aggressive
hydration, allopurinol, rasburicase

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18
Q

MUSCULOSKELETAL

ACETAMINOPHEN

A
  • ANTIPYRETIC *ANALGESIC
  • REVERSIBLE INHIBITOR OF CYCLOOXYGENASE MANLY CENTRALLY ACTING
  • INACTIVATED PEIPHERALLY

USES:
-USED IN CHILDREN FOR FEVER IN PLACE OF ASPRIN TO PREVENT REYES.

ACETAMINOPHEN METABOLITE (NAPQI) WHICH FORMS DUE TO GLUTATHIONE DEPLETION.
REGENERATE GLUTATHIONE BY N-ACETYLCYSTEINE( ANTIDOTE)
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19
Q

ENDOPEROXIDE SYNTHEIS INHIBITION

CYCLOOXYGENASE INHIBITORS

A

COX 2 ONLY- CELECOXIB

COX 1 and 2
IRREVERISBLE REVERSIBLE
-ASPRIN -Diclofenac, Ketorolac, Ibuprofen
- Naproxen, INDOMETHACIN

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20
Q

ASPRIN

A

IRREVERIBLE INHB OF COX AND THROMBOXANE; UNTIL NEW PLATELETS FORMED

USE
DEPENDS ON DOSE
<300 - INHIB OF PLATELET AGG
300-2400 - ANTIPYRETIC AND ANTI INFLAMM
>2400 - ANTI INFLAMM
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21
Q

ASPRIN SE

A

-TINNITUS
-TOXICITY: EARLY PHASE: RESP ALKALOSIS
LATE ; MIXED MET ACIDOSIS AND RESP
ALKALOSIS
-GASTRIC ULCERATION

KIDNEY : AKI
- INTERSTIAL NEPHRITIS

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22
Q

CELECOXIB

A

REVERSIBLE SELECTIVE INHIBITION OF COX 2(‘S’ELE)

IT DOES NOT HAVE ANY EEFCT ON PLATELT AGG SINCE THROMBOXNANE A2 PRODUCTION IS DEPENDENT ON COX-1.

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23
Q

REVERSIBLE AND IRREVERSIBLE

A

ALL REVERSIBLE - CELECOXIB, NSAIDS, ACETAMINOPHEN

ONLY IRRESVERISBLE : ASPRIN

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24
Q

NSAIDS TYPES

A 
Ibuprofen, 
naproxen, 
indomethacin, 
ketorolac, 
diclofenac,

meloxicam, piroxicam.

25
Q

LEFLUNOMIDE MOA AND USES

A

REVERSIBLY INHIBITS dihydroorotate dehydrogenase, WHICH PREVENTS PYRIMIDINE SYNTHESIS.- SUPRESSES T CELL PROLIFERATION.

USES:

  • RHEUMATOID ARTHRITIS
  • PSORAITIC ARTHRITIS
26
Q

BISPHOSPHONATES MOA

A

PYROPHOSPHATE FOUND AND INC PHOSPHATASE ACTIVITY IN EARLY AND LATE STAGE OSTEOBLASTS.

MOA
BP IS A PP ANALOG WHICH BINDS HYDROXYAPATITE IN BONE AND INHIBITS OSTEOCLAST ACTIVITY.

27
Q

BISPHOSPHONATES SE

A

osteonecrosis of jaw,

atypical femoral stress fractures.

28
Q

TERIPARATIDE

A

RECOMBINANT PTH ANALOG

MOA
INCREASES OSTEOBLASTIC ACTIVITY WHEN GIVEN IN PULSATILE FASHION

USES;
OSTEOPOROSIS INC BONE GROWTH AS COMPARED TO ANTI RESORPTIVE ACTVIITY BY BP.

29
Q

TERIPARATIDE SE

A
  1. IT INC RISK OF OSTEOSARCOMA
    • THEREOFORE IF PT. HAS PAGETS OR UNKNOWN CAUSE OF ELEVATED ALK PHOS, SUSPECT OSTEOSARCOMA ,AND DO NOT USE TERIPARATIDE.
      ( IF PT HAS PRIOR RADIATION OR CANCER)- DO NOT USE.

2.HYPER-CALCAEMIA. ( TRANSIENT)

30
Q

GOUT

CHRONIC / PREVENTATIVE DRUGS

A

PREVENT A PAINFUL FLARE

  • PROBENCID
  • ALLOPURINOL
  • PEGLOTICASE (recombinant uricase)
  • FEBUXOSTAT ( xanthine oxidase inhib)
31
Q

URIC ACID PATHWAY

A

XO XO

PURINE– HYPOXANTHINE–XANTHINE–PLASMA URIC ACID–URINE

INHIBTION OF XO

  • ALLOPURINOL ( COMPETITIVE INHIBITION OF XO)
  • FEBUXOSTAT

PEGLOTICASE
-CONVERTS PLASMA URIC ACID TO MORE SOLUBLE ALLANTOIN.

32
Q

ACUTE GOUT DRUGS

A
  • NSAIDS
  • GLUCOCORTICOIDS
  • COLCHICINE
33
Q

ETANERCEPT ( DECOY RECEPTOR)

A
  • IT IS A SOLUBLE TNF RECEPTOR ( WITH ACTIVITIES AGAINST BOTH ALPHA AND BETA)
  • IT BINDS THE TNF WITH HIGHER AFFINITY THAN THE BODYS TNF RECEPTOR.

USES;

  • PSORIASIS
  • RA
  • ANK SPOND
34
Q

ETANERCEPT AND INFLIXIMAD /ADALIMUMAB DIFFERENCE

A

ETAN - IS A DECOR TNF RECEPTOR

ADALI/INLFIX- MONOCLONAL ANTIBODIES.

35
Q

USES OF TNF A INHIBITORS

A

ETANERCEPT , ADALI, INFLIXI

COMMON TO BOTH:

  • RA
  • ANK SPOND
  • PSORIASIS
MONOCLONAL AB( INLIX, ETAN, ADALI)
- INFLAMM BOWEL DISEASE.
36
Q

DIRURETICS

1. OSMOTIC

A

MANNITOL

MOA
IT INC THE BLOOD PLASMA AND THEREFORE, TUBULAR FLUID OSMOLARITY, INC WATER ABSORPTION BY OSMOSIS.
INC URINE PRODUCTION.
INC WATER MOVEMENT FROM TISSUES.
AND SUBSEQUESNT DEC IN ICP AND IO PRESSURE.

37
Q

MANNITOL USED IN DRUG OVERDOSE

MOA

A

Mannitol inhibits water reabsorption at the loop of Henle and the proximal tubule. The increase in urine output usually is accompanied by an increase in solute excretion.

38
Q

ACETAZOLAMIDE

A

Carbonic anhydrase inhibitor. Causes selflimited
NaHCO3 diuresis and  total body
HCO3 stores.
- Alkalinizes urine.

39
Q

ACETAZOLAMIDE USES AND SE

A

USES;

  1. METABOLIC ACIDOSIS
  2. ALTITIDE SICKNESS
  3. GLAUCOMA

SE:

  1. PROX RENAL TUBULAR ACIDOSIS
  2. SULFA ALLERGY - PTS. ALLERGIC TO SULFONAMIDES, MAY HAVE ALLERGY TO ACTZ, DUE TO CROSS REACTIVITY.
  3. HCO3 AND NA GO OUT THEREFORE K COMES IN AND IS EXCRETED CAUSING HYPOKALAEMIA.
  4. CALCIUM PHOSPHATE STONE FORMMATION.
40
Q

LOOP DIURETICS
FUROSEMIDE, TOSEMIDE. BUMETENIDE
MOA

A

Sulfonamide loop diuretics. Inhibit cotransport
system (Na+/K+/2Cl−) of thick ascending limb
of loop of Henle.

41
Q

SULFA ALLERGY WITH DIURETICS

A

ACETAZOLAMIDE

LOOP DIURETICS

42
Q

DIRURETIC ELECTROLYTE CHANGES

A

NACL:URINE NACL WILL ALWAYS INC AND SERUM NACL WILL DECREASE.
K+: URINE K IS LOST ESP WITH LOOP AND THIAZIDE.

K SPARING: ALDOSTERONE

INC IN PH ( ACIDIC) 1. CARBONIC ANHYDRASE INHIB
2. ALDOSTERONE

CA INHIB: LOSS OF HCO3 IN URINE

ALDOSTERONE: 2 MECHANISMMS:

  1. ALDOSTERONE BLOCKADE CAUSES NO SECRETION OF K AND H+ IN THE TUBULE.
  2. DUE TO NON SECRETION OF K+ THERE IS IINC K IN THE SERUM CAUSING HYPERKALAEMIA– WHICH IN TURN ENTERS THE CELLS, AND CAUSES H+ TO EXIT THE CELLS, INCREASING ACIDOSIS.
43
Q

LOOP AND THIAZIDE DIURETIC ELECTROLYTE CHANGE

A
  1. IT CAUSES K+ SECRETION SO K+ IS LOST IN THE URINE. THIS CAUSES HYPOKALAEMIA AND THUS CAUSING K+ TO COME OUT OF CELLS AND H+ TO ENTER CELLS, THEREFORE CAUSING ALKALOSIS.
  2. WHEN THERE IS A LOW K STATE, THE TUBULE EXCHANGES H+ IN PLACE OF K+ IN THE NA-K+ EXCHANGER.

THEREFORE CAUSING LOSS OF H+ IN THE URINE AND IN TURN CAUSING ALKALOSIS AND “PARADOXICAL ACIDURA’

LOOP DIURECTIS AND CONTRACTION ALKALOSIS
LOOPS STIMULATE THE NA-H+ EXCHANGER AND CAUSE LOSS OF NA AND H+ REABSORPTION CAUSING ACIDOSIS.THEREFORE TO COMPENSATE HCO3 IS ALSO REABOSRBED. ————CONTRACTION ALKALOSIS.

44
Q

ACE INHIB SE

A

COUGH AND ANGIOEDEMA DUE TO INC BRADYKININ

45
Q

ACE INHIB CI IN C1 ESTERASE DEFICIENCY

- HEREDITARY ANGIOEDEMA

A

C1 esterase inhibitor deficiency, also known as hereditary angioedema, results in the unchecked production of the vasodilator bradykinin. This increase in bradykinin leads to an increase in smooth muscle relaxation in the walls of blood vessels and resultant edema in the hands, feet, gastrointestinal tract, and in severe cases, the larynx

Hereditary angioedema results from excessive production of bradykinin. Bradykinin is a vasodilator that causes the larynx to become engorged and swollen, threatening the airway. Due to this pathway, the swelling is not amenable to antihistamines as it is not a histamine-mediated process. While there are other forms of hereditary angioedema, deficiency or dysfunction in C1 inhibitor is the most common form.

46
Q

ALDOSTERONE PHYSIOLOGY

A
  1. WATER REABSORPTION
    2.NA REABSORPTION AND K SECRETION
    3.K SECRETION AND H+ SECRETION ( H+ FOLLOWS K)
    4.NA , WATER AND HCO3 REABSORED
    THEREFORE CAN CAUSE CONTRACTION ALKALOIS

Volume contraction Ž  AT II Ž  Na +/H+ exchange in PCT Ž  HCO3
− reabsorption
(“contraction alkalosis”)

Treatment consists of NaCl infusion to correct ECF volume contraction and administration of K+ to replace urinary losses.

47
Q

GOSERELIN AND LEUPROLIDE

A

1.PULSATILE - GNRH ANALOG
2. WHEN YOU NEED TO BLOCK LH AND FSH GIVE CONTINUESLY, FIRST IT WILL ACT AS GNRH AGONIST, which may cause a tumor flare.
BUT LATER WILL ACT AS AN GNRH ANTAGONIST.

48
Q

CLOMIPHENE

A

ACTS AS ESTROGEN RECEPTOR ANTAGONIST AT THE HYPOTHALAMUS.
THIS CUTS OFF THE NORMAL FEEDBACK MECHANISM. THUS SIGNALLING THE HYPOTHAL TO PRODUCE MORE LH AND FSH THUS STIMULATING OVULATION.

49
Q

DIFFERENCE BETWEEN RALOXIFENE AND TAMOXIFEN

A

TAMOXIFEN IS AN ANTAGONST AT BREAST BUT AGONIST AT UTERUS AND BONE.

RALOXIFENE IS AN ANTAGONIST AT BREAST AND UTERUS BUT AGONIST AT BONE. THEREFORE IT IS USED FOR OSTEOPORIS.

50
Q

AROMATASE INHIBITORS

Anastrozole, letrozole, exemestane.

A

PREVENTS PERIPHERAL CONVERSION OF ANDROGENS TO ESTROGEN.

USED IN ESTROGEN POSITIVE BREAST CANCER,

51
Q

ANTIPROGESTINS

A

MIFEPRISTONE (MISOPROSTOL)- CONTRACEPTION

ULIPRISTAL- EMERGENCY CONTRACEPTION

52
Q

DANAZOL IN ENDOEMTRIOSIS

A

PARTIAL ANDROGEN AGONIST AT ANDROGEN RECEPTOR
Danazol has antigonadotropic and anti-estrogenic activities. Danazol acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Hepatic, to principal metabolites, ethisterone and 17-hydroxymethylethisterone.

Danazol is an effective treatment for endometriosis, and has the same effectiveness as the other hormonal treatments. However, it has many androgenic (male-like) side effects, including weight gain, increased body hair and acne

53
Q

TESTOSTERONE

A

USED AFTER BURN OR INJURY TO PROMOTE ANABOLISM.

  • EXOGENOUS TESTOSTERONE CAUSES NEGATIVE FEEDBACK MECHANISM AND INHIBITS THE PRODCUTION OF LH AND FSH CAUSING REDUCED INTRATTESTICULAR TESTOSTERONE. THEREBY CAUSING TESTICULAR ATROPHY.
  • INC IN LDL AND DEC IN HDL.
54
Q

Flutamide,
bicalutamide,
apalutamide,
enzalutamide

A

COMPETITVE INHIBITIRS AT ANGROGEN RECEPTORS.

USED FOR PROSTATE CA

55
Q

SPIRONOLACTONE AS AN ANTIANDROGEN

A

WORKS ON ANDROGEN RECEPTORS BY BLOCKING THEM.THEREBY DECREASING ANDROGEN.

56
Q

TAMSULOSIN

A

ALPHA ANTAGONIST, THEREBY PREVENTS SMOOTH MUSCLE CONTRACTION AT THE PROSTATE.

SELECTIVE FOR ALPHA-1A AND D

NOT 1B WHICH IS FOUND ONN VASCULAR.

57
Q

PHOSOPHODIESTERASE INHIBITORS

A

PDE5 INHIBITORS - SILDENAFIL WORKS ON INC CGMP, VASODILATORY EFFECT OF NO

PED4 INHIBITORS ALSO CAUSES BRONCHODILATION BY INC CAMP

58
Q

HEPARINS

A

LMWH - UNDERGOES RENAL CLEARANCE ( cannot be used in renal insufficiency)
UNFRACTIONATED- CAN BE USED IN RENAL INSUFICIENCY

59
Q

Cilostazol, dipyridamole

They block phosphodiesterase.

A

Unlike skeletal and cardiac muscles, high levels of cAMP cause relaxation in smooth muscles. Therefore by preventing hydrosis or decreasing hydrolysis , levels of Camp inc, thereby causing relaxation of smooth muscles

dec CAMP hydrolysis
inc CAMP in platelets.

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