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Jessica: NPLEX 2 Pharmacology > Pharmaceuticals (Core Only) > Flashcards

Pharmaceuticals (Core Only) Flashcards

1
Q

Atorvastatin

A

Class: Statin

I: high cholesterol/lipids and atherosclerosis

A: HMG CoA reductaste inhibitor

Major SE: inhibits CoQ10 formation = myalgias (depletes CoQ10)

CI: li/ki dz, alcohol, PREG X

Intx: increased effects with CYP3A4 inhibitors, decreased effects with CYP3A4 inducers, and increased toxicity with gemfibrozil and niacin, potentiates warfarin and digoxin

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2
Q

Gembibrozil

A

Class: Fibrates

I: high TGs, CAD risk

A: activate lipoprotein lipase A = decrease TGs

Major SE: gallstones, pancreatitis, myalgias

CI: li/ki dz, cholelithiasis and GB issues

Intx: avoid using with statin b/c rhabdomyolysis can occur, inhibits CYP2C8 enzyme, DEPLETES VITAMIN E

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3
Q

Nitroglycerin

A

Class: Nitrates

A: releases NO = SM relaxes

I: angina, heart spams, CHF

Major SE: syncope, hypOtension, reactive tachycardia — OD CAN BE LETHAL

CI: severe anemia, glaucome, head injury, increased intracranial pressure, hypertrophic cardiomyopathy

Intx: vasodilators and anti-HTN agents, heparin, alcohol

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4
Q

Digoxin

A

Class: Cardiac Glycoside

A: inhibits Na/K ATPase = increases contraction and decreases HR = more efficient beat

I: CHF, A.fib/flutter

Major SE: arrhythmias, yellow-green halos around objects —–OD CAN BE LETHAL (antidote: potassium and digoxin antibodies)

CI: low potassium and magnesium, high or low calcium, heart issues and kidney failure

Intx: MANY SERIOUS INTX - depleted magnesium

MP: serum digoxin levels, electrolytes, renal function, and EKG — must adjust dosage to reflect metabolism

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5
Q

Atropine

A

Class: anticholingeric

A: increases AV/SA node activity

I: bradycardia and heart blocks (mobitz type 1 - second and third degree)

Major SE: anticholingergic effects - urinary retention, confusion, hallucination, tachy, v.fib

CI: NA-glaucome, ischemic heart blocks

Intx: synergy with other anticholingerics and counteracts effects of beta-blockers

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6
Q

Amiodarone

A

Class: Class III Antiarrthymic: NOT FIRST LINE BECAUSE POTENTIAL FATAL TOXICITY

A: sodium channel blocker

I: serious ventricular arrhythmias and afib cardioversion

Major SE: hypotension, bradycardia, QT PROLONGATION, blue skin, tremor, muscle weakness

CI: serious heart dysfunction or 3rd degree heart block, cardiogenic shock, IODINE allergy

Intx: synergy with other anticholingergics and agents that cause QT prolongation

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7
Q

ACEi (lisinopril)

A

A: supresses AngII = vasoconstricts = interfers with aldosterone production

I: HTN, edema, CHF

Major SE: COUGH, angioedema, and high potassium

CI: previous angioedema, Renal artery stenosis, high potassium

Intx: capsaicin worsens cough, NSAIDs (decreases effects), increases digoxin and lithium

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8
Q

ARB (volsartan)

A

A: blocks angiotensin II from competing with angiotensin II receptors = vasodilates

I: HTN, HF - patients that cant tolerate ACEi cough

SE: high ass potassium

CI: renal artery stenosis, high ass potassium

Intx: decrease Vitamin D, decreases NSAID effects

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9
Q

Beta Blockers (atenolol, propranolol)

A

A: blocks beta adrenergic stimulation

I: HTN, angina, essential tremor, HA prevention

Major SE: bradycardia, hypotension, vivid dreams

CI: abrupt withdrawal, Raynauds, any severe heart/GI/lung issues basically

Intx: increased bradycardia and hypotenson with CCB, digoxin and amiodarone
- depleted CoQ10

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10
Q

Calcium Channel Blockers (amlodipine)

A

A: decreases calcium = vasodilation and can increase HR via reflux

I: HTN, angina

SE: edema, bradycardia, constipation

CI: serious heart issues and hypotension, acute MI

Intx: synergy with BB, grapefruit and many others

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11
Q

Clonidine

A

C: sedative and anti-hypertension

A: alpha adrenergic agonist (central) = peripheral vasodilation

I: HTN (2-3rd line), PHEOCHROMOCYTOMA (1st line), ADHD, smoking

SE: hypotension, syncope

CI: CHF and heart blocks, R/O prostate cancer if symptoms of BPH

Intx: other hypotensives and depleted COQ10

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12
Q

Furosemide

A

C: Loop Diuretic

A: inhibits Na and Cl reabsorption in proximal and distal tubules and loop of Henle = WASTES POTASSIUM, MAGNESIUM AND ZINC

I: HTN, edema

SE: low potassium, magnesium, hyperglycemia and uricema and lipidemia, OTOTOXIC

CI: anuria, severe electrolyte imbalance, sulfa intolerance

Intx: synergy with ototoxic drugs, synergy with thiazide diuretics

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13
Q

Hydrochlorothiazide (HCTZ)

A

C: Thiazide diuretic

A: acts in distal tubules and ascending loop = increase NaCl excretion
**WASTES POTASSIUM, SODIUM, MAGNESIUM, ZINC

I: HTN, edema, OP, DI

SE: low potassium/Mg/Na, high uric acid/Ca/glucose

CI: anuria, electrolyte imbalance, sulfa allergy

Intx: hypoglycemics, anticholinergics, digoxin, lithium

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14
Q

Spironolactone

A

C: Diuretic (“water pill”)

A: aldosterone receptor antagonist in distal renal tubule = increased NaCl and H20 excretion
***Potassium-sparing

I: HTN, low Potassium, edema

SE: high ass potassium, gynecomastia, mental confusion, GI bleed

CI: renal issues, anuria, high potassium

Intx: ACEI, ARB, sulf-tri, other potassium sparing diuretics, K+ supplements

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15
Q

Benzoyl Peroxide

A

C: TOPICAL antiseptic

A: keratolytic and antibacterial

I: acne vulgaria

SE: contact derm, xerodermia, hypersensitivity rxn

CI: hypersensitivity to drug

Intx: AVOID with topical hydroquinone and trentinoin

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16
Q

Isotretinoin

A

C: Vitamin A derivative

A: decreases sebum production from sebaceous glands

I: rosacea and severe nodular acne (no other tx worked)

SE: mucocutaneous dryness, high LFT

CI: MUST USE BIRTH CONTROL WHILE TAKING

Intx: alcohol
**DEPLETES ACETYL-L-CARNITINE AND L-CARNITINE

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17
Q

Clindamycin

A

C: Antibiotic

A: bacteriostatic protein synthesis inhibitor

Topical I: acne, rosacea, BV
Oral I: osteomyelitis, OM, PID, Sinusitis, strep

SE: diarrhea and PSEUDOMEMBRANEOUS COLITIS, C.DIFF INFECTIONS

CI: caution in previous colitis or UC

Intx: decreases OCPs, lactobacillus and bifidobacteria

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18
Q

Calcipotriol/Calcipotriene

A

C: Vitamin

A: binds Vitamin D receptors = cell differentiation = inhibits cell proliferation

I: plaque psoriasis

SE: high calcium

CI: high calcium and vitamin D

Intx: other forms of vitamin D

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19
Q

Selenium Sulfide

A

C: Antifungal

A: reduces epidermal and follicular corneocyte production = antifungal

I: Seborrheic dermatitis, tinea capitis/versicolor

SE: alopecia

CI: Hypersensitivity to drug

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20
Q

Triamcinolone

A

C: corticosteroid

A: long action to decrease inflammation and suppresses immune system activity

I: inflammatory and allergic dx

SE: topical - telangiectasia and atrophy/skin thinning, HPA axis suppression

CI: fungal, viral, bacterial mouth/throat infx

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21
Q

Latanoprost

A

C: prostaglandin F2 analog

A: decreases IOP by increasing fluid outflow

I: primary open angel glaucoma

SE: conjunctival hyperemia, changes to iris pigmentation, thick darkened eyelashes

CI: uveitis, macular edema, HSV keratitis

Intx: other prostaglandin analogs

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22
Q

Triple antibiotic therapy

A

C: Antibiotic

A: bacitractin + neomycin + polymyxin B

I: ophthalmic infections in cornea and conjunctiva

SE: conjunctival/cutaneous sensitivity, ocular toxicity

CI: deep seated ocular infx

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23
Q

Pseudoephedrine (oral), Oxymetazoline (topical)

A

C: Decongestants

A: sympathomimetic - blood vessel constriction

I: allergic rhinitis and nasal congestion for any issue

SE: HTN, tachycardia, rebound congestion if use over 7 days, CNS over stimulation sx

CI: severe HTN, CAD, kids younger than 6

Intx: other sympathomimetics and agents that increase effects of sympathomimetics

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24
Q

Diphenhydramine (Benadryll)

A

C: Antihistamine

A: central H1 receptor antagonist - CROSSES BBB and anticholinergic

I: allergic rhinitis (not helpful for congestion), insomnia, motion sickness

SE: drowsiness, anticholingergic effects

CI: BPH, GI/GU obstruction, glaucoma *AVOID DRIVING

Intx: synergy with other anticholingergics, MAO and CNS depressants

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25
Q

Hydroxyzine

A

C: Antihistamine

A: central H1 antagonist that crosses BBB

I: allergic rhinitis (not helpful for congestion), insomnia, motion sickness

SE: drowsiness, anticholingergic effects

CI: BPH, GI/GU obstruction, glaucoma *AVOID DRIVING

Intx: synergy with other anticholingergics, MAO and CNS depressants

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26
Q

Loratidine (Claritin)

A

C: Antihistamine

A: central H1 antagonist that crosses BBB

I: allergic rhinitis/conjunctivitis (not helpful for congestion), allergic skin conditions, seasonal allergies

SE: headache

CI: other QT prolongation drugs, macrolides, synergy with anticholinergics and CNS depressants

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27
Q

Epinephrine (adrenalin)

A

C: sympathomimetics

A: sympathetic adrenergic agonist (alpha and beta)

I: anaphylaxis, asthma attack, cardiac arrest

SE: tachycardic arrythmias, v fib, HTN, angina

CI: arrthymias, atherosclerosis of coronary artery, DM, hyperthyroidism, epilepsy, glaucoma

Intx: tamsulosin, antihypertensives, MAOs, synergy with other sympathomimetics

KNOW that there is two different epi solutions
1 mg/mL = 1:1000 solution AND 0.1 mg/mL = 1:10,000 solution

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28
Q

Bromocriptine

A

C: Dopamine receptor agonist

A: inhibits glutamate GLT1 transporter

I: PD, DM2, restless leg syndrome. high prolactin levels

SE: Raynauds syndrome, cardiac valve and pulmonary fibrosis, impulse control disorders
*hallucinations, orthostatic hypOtension

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29
Q

USP Thyroid

A

C: hormone replacement

A: replaces thyroid gland secretions - T3, T4, DIT, MIT

I: hypOthyroidism and post-thyroidectomy

SE: palpitations, tremor

CI: acute MI, thyrotoxicosis without hypothyroidism

Intx: cholestyramine, Ca, Iron, estrogens and OCPs, anticoagulants, decreases insulin and hypoglycemics

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30
Q

Levothyroxine (T4)

A

C: Hormone

A: replaces T4 = increases T3

I: hypOthyroidism

SE: palpitations, tremor

CI: acute MI, thyrotoxicosis without hypothyroidism

Intx: cholestyramine, Ca, Iron, estrogens and OCPs, anticoagulants, decreases insulin and hypoglycemics

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31
Q

Liothyronine (T3)

A

C: Hormone

A: replaces T3

I: hypOthyroidism

CI: acute MI, thyrotoxicosis without hypothyroidism

Intx: cholestyramine, Ca, Iron, estrogens and OCPs, anticoagulants, decreases insulin and hypoglycemics

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32
Q

Propylthiouracil (PTU)

A

C: TPO inhibitor

A: blocks formation of T4 to T3 in thyroid and blocks 5’ deiodinase and conversion in periphery

I: hypERthyroidism and thyroid stom

SE: FDA WARNING = CAN CAUSE FATAL LIVER INJURY - USE METHIMAZOLE OR OTHER TX

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33
Q

Liraglutide

A

C: GLP1 analog (long acting)

A: increases glucose -dependent insulin secretion = decreases glucagon secretion = increases B cell growth = slows gastic emptying = decreases food intake
**Decreases HgA1c by 1%

I: DM2, weight management

SE: thyroid c-cell tumor, increase HR and SI

CI: fhx of medullary thyroid carcinoma and endocrine neoplasia syndrome

Intx: MANY, agents that compound nephrotoxicity

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34
Q

Canagliflozin

A

C: antidiabetic - third line

A: SGLT2 inhibition = increases urinary glucose excretion

I: DM2

SE: increased risk of foot and leg amputation, kidney impairment/failurem high potassium, hypOglycemia and hypOtension

CI: pregnancy, DM1, DM ketoacidosis, kidney issues

Intx: many

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35
Q

Glyburide

A

C: Antidiabetic

A: insuliin secretagogue = increases peripheral glucose utilization = decreases liver glucose production

I: DM2

SE; hypoglycemia - WORSE OF ALL hypoglycemics

CI: DM1 and hypoglycemia

Intx: disulfiram-like rxn, hypoglycemia with anticoagulants, etc.

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36
Q

Metformin

A

C: Biguanide - Antidiabetic

**First line

A: improves insulin sensitivity = decreased hepatic production

I: DM2

SE: GI upset - take with food, LACTIC ACIDOSIS - rare but 50% lethal

CI: metabolic acidosis, DM1, renal failure and liver dz

Intx: ethanol
*depletes CoQ10, folic acid, B12

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37
Q

Sitagliptin

A

C: Antidiabetic

A: inhibits DPP4 = decreases incretin metabolism = increases insulin synthesis/release = decreases glucagon levels

I: DM2

SE: pancreatitis and renal injury

CI: DM1

Intx: many including fluoroquinolones

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38
Q

Thiazolidinediones

A

C: antidiabetic

A: increases insulin sensisitivity and muscle uptake = decreases glucose production

I: DM2

SE: edema, weight gain, worsening CHF - REMOVED FROM US MARKET D/T DEATHS FROM LIVER FAILURE

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39
Q

Deferoxamine

A

C: Iron chelating agent

A: Chelates iron but NOT calcium

I: hemochromatosis, thalassemia, high iron levels

SE: neurotoxic long term

CI: pregnancy, kidney dz

*depletes zinc and vitamin C can cause heart issues

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40
Q

Dimercaptopropane sulfonate (DMPS)

A

C: chelation

A: chelates Hg, Au, arsenc

I: Mercury, Gold and arsenic poisoning

SE: Steven-johnson syndrome

CI: liver insufficiency

Intx: DEPLETES COPPER, SELENIUM, ZINC, MAGNESIUM

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41
Q

EDTA

A

C: Chelator

A: chelates lead out of bone - also calcium, zinc, Mn, and iron

I: lead poisoning, digoxin arrhythmias

SE: hypocalcemia, kidney damage

Intx: depleted calcium

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42
Q

Penicillamine

A

C: Immunosuppressant and heavy metal chelator

A: chelates copper, Hg, Zn and lead, decreases IgM RF levels

I: wilsons disease, copper toxicosis, mercury and lead poisoning

SE: aplastic anemia, leukopenia, proteinuria

CI: penicillin allergy, kidney dz

Intx: gold, antmalarials, other immunosuppressants

DEPLETES COPPER, IRON, MAGNESIUM PYRIDOXINE, FERRITIN

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43
Q

DMSA (succimer, Dimercaptosuccinic acid)

A

C: Chelator

A: chelates Pb, Hg, Cd, Ar and removes in urine

I: lead, mercury, arsenic, cadmium poisoning

SE: transient elevation in liver enzymes

Intx: DEPLETES ZINC, IRON, CALCIUM, MAGNESIUM

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44
Q

Odansetron (Zofran)

A

C: anti-emetic

SE: prolonged QT intervals

Intx: Many

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45
Q

Prochlorperazine

A

C: anti-emetic and antipsychotic

A: Dopamine antagonist

I: N/V, psychosis (schizo), anxiety

SE: anticholinergic effects and extrapyramidal symptoms

CI: PD, epilepsy

Intx: MAOis, CNS depressants, anticholinergics

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46
Q

Metoclopramide (Reglan)

A

C: Anti-emetic

A: DA antagonist, pro-PNS, and improves gastric motility

I: N/V, GERD

SE: extrapyramidal symptoms, diarrhea

CI: pheochromocytoma, PD, epilepsy

Intx: synergy with DA antagonists/sedatives/CNS depressants

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47
Q

Sodium Phosphate

A

C and A: OSMOTIC laxative

I: colonoscopy, barium enema, surgery prep, atonic constipation

SE: high phosphates

CI: elderly, kidney failure, IBD, hear issues

Intx: ACEi, ARB, diuretics, NSAIDs
***DEPLETES MAGNESIUM AND PHOSPHORUS

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48
Q

Bisacodyl

A

C: Laxative

A: increased colon motility

I: atonic constipation (short term)

SE: low potassium, long term = can induce atonic constipation and pseudomembraneous constipation

CI: 10+ days, obstruction, appendicitis, IBD, tartrazine allergy

Intx: many drugs and herbs by decreasing TT, potentiates hypokalemia inducing agents

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49
Q

Docusate

A

C: stool softener - NOT LAXATIVE

A: increases fat and water mixing to soften stool

I: atonic constipation, hemorrhoids, anal fissures

SE: minimal

CI: long-term, obstruction

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50
Q

Bismuth subsalicylate

A

C: anti-diarrheal

A: modulates inflam and anti-secretory, protects the mucosa

I: PUD with H.pylori, gastroenteritis

SE: black tongue and stool, high calcium, salicylate toxicity

CI: salicylate allergy, younger than 2 yo, viral infx

Intx: tetracycline, NSAIDs

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51
Q

Loperamide (Imodium)

A

C: Anti-diarrhea

A: Cholinergic muscarinic antagonist (anti-cholinergic)

I: acute diarrhea, IBS-diarrhea

SE: anticholinergic effects (dry mouth, cramping)

CI: acute UC, pseudomembraneous coli

Intx: gemfibrozil, SJW and Valerian (increased toxicity)

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52
Q

Esomeprazole

A

C: PPI

A: blocks Hcl formation in stomach

I: erositive esophagitis, PUD, GERD

SE: decreases B12 absorption, C. diff and gastric infx - more serious SE with long-term

CI: severe liver dz, stomach cancer

Intx: depleted calcium, magnesium, folic acid, iron, B12

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53
Q

Misoprostol

A

C: Prostaglandins

A: inhibits gastric acid secretions = increased bicarb and mucus = increased TT and stool

I: gastric ulcers, pregnancy termination, PP hemorrhagic

SE: uterine contractions

CI: PREGNANCY X

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54
Q

Sucralfate

A

C: Protectants

A: creates a gel barrier = protecting mucosa from injury

I: GERD, PUD, ulcers

SE: constipation, hyperglycemia

CI: renal failure, AD

Intx: interferes with drug absorption

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55
Q

Sulfasalazine

A

C: Anti-inflam

A: converted into 5-ASA = inhibits COX = antiinflam

I: UC, mild Crohns

SE: GI irritation, HA - high dose = BM suppression, liver/kidney toxicity, pancreatitis

CI: sulfa/salicylate allergy, obstruction, kids under 2 yo , G6PD def

Intx: iron, digoxin
*depletes folic acid

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56
Q

Phentermine

A

C: anoretic

A: suppresses appetite

I: obesity

SE: palpitations, HTN, heart valve issues, addiction, hyperglycemia

CI: atherosclerosis, CVD, CAD, stroke, CHF, hyperthyroidism

Intx: MAOIs (hypertensive crisis), SSRI, other stimulants

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57
Q

Dicyclomine

A

C: Anticholinergic

A: GI smooth muscle relaxant

I: IBS with spasms

SE: anticholinergic - esp constipation, blurred vision, dizziness

CI: GI/renal obstruction, GERD, MG

Intx: alcohol and other anticholinergics

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58
Q

Interferon

A

C: Biologic response modifier

A: anticancer and anti-hepatitis

I: cancer, chronic hep B and C, multiple sclerosis

SE: neutropenia, thrombocytopenia, fever/flu-like sx, SI

CI: renal insufficiency, major depression, alcohol, AI dz

Intx: NSAIDs help reduce flu-like SE, synergistic BM suppression with zidovudine

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59
Q

Mebendazole

A

C: Anti-helmintics

A: destroys worms

SE: very safe because not systemically absorbed

Intx: metronidazole = necrolysis

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60
Q

Rivastigmine

A

C: parasympathomimetic

A: increases Acetylcholine in PNS

I: AD, PD

SE: diarrhea, N/V, cholinergic SE, SEIZURES

CI: active GI ulcer/bleed

Intx: other anticholinergics, cholinergics, beta blockers

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61
Q

Donepezil

A

C: parasympathomimetic

A: increases Acetylcholine in PNS

I: AD

SE: diarrhea, N/V, cholinergic SE, SEIZURES

CI: active GI ulcer/bleed

Intx: CYP3A4 inhibitors and inducers, cholinergics, anticholinergics, beta blockers

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62
Q

Trastuzumab

A

C: chemotherapy

A: monoclonal antibody

I: Her2 GI and breast cancer

SE: v. dysfunction, cardiomyopathy, CHF

CI: none but cautiously use

Intx: other cardiotoxic and myelosupressive drugs

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63
Q

Anastrozole

A

C: Aromataste inhibitor

A: presents estrogen production

I: E2+ breast cancer, BPH, prostate cancer (excess testosterone)

SE: hot flashes, vasodilation, HTN, mood changes, OP

CI: caution CVD< angina, MI, OP

Intx: estrogen and testosterone drugs

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64
Q

Norelgestromin/ethinyl estradiol and norgestimate/ethinyl estradiol

A

C: birth control

A: supresses GSH, LD = inhibits ovulation and makes cervical mucus impenetrable = replaces Progesterone made endogenously

I: BC and acne

SE: stroke, MI, DVT, HTN, emdometriol or liver cancer, cholelithiasis

CI: smoker, pregnancy, CVD, HTN, clotting issues, estrogen-sensitive cancers, major surgery/prolonged immobilization

Intx: warfarin, TCA, CYp3A4 inhibitors/inducers

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65
Q

Conjugated estrogens

A

C: Homones

A: blocks bone breakdown and replace estrogen to decrease menopausal sx

I: OP, menopause, AUB

SE: stroke, MI, DVT, HTN, emdometriol or liver cancer, cholelithiasis

CI: smoker, pregnancy, CVD, HTN, clotting issues, estrogen-sensitive cancers, major surgery/prolonged immobilization

Intx: warfarin, TCA, CYp3A4 inhibitors/inducers

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66
Q

Natural estrogens

A

C: Hormones (strongest: E2, weakest: estriol (E3), estrone is 1/3 as strong as estradiol)

A: blocks bone breakdown and replace estrogen to decrease menopausal sx

I: OP, menopause, AUB, vulva atrophy, etc.

SE: stroke, MI, DVT, HTN, emdometriol or liver cancer, cholelithiasis

CI: smoker, pregnancy, CVD, HTN, clotting issues, estrogen sensitive cancers, major surgery/prolonged immobilization

Intx: warfarin, TCA, CYp3A4 inhibitors/inducers

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67
Q

Progesterone

A

C: Hormone

A: suppresses FSH and LH and replaces progesterone, thickens cervical mucus plug

I: post meno endometrial hyperplasia prevention (given with estrogen), secondary amenorrhea

SE: depression, weight gain

CI: liver dz, breast or uterine cancer, missed abortion, undx vaginal bleeding

Intx: warfarin, TCA, CYp3A4 inhibitors/inducers

NO PREGNANCY CATEGORY - SOMETIMES USED TO PREVENT MISCARRIAGE

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68
Q

Progestins

A

C: Synthetic hormones

A: suppresses FSH and LH and replaces progesterone, thickens cervical mucus plug

I: (oral) - contraception, emergency contraception, PMS, dysfunctional uterine bleeding, secondary amenorrhea, endometriosis, etc

I: (IUD) - contraception, dysmenorrhea

SE: TOXIC - always try natural progesterone first but fluid retention, breast cancer, spotting for 3 months post IUD implant, ectopic pregnancy, PID, uterine/cervical perforation

CI: liver dz, breast or uterine cancer, missed abortion, undx vaginal bleeding, clotting issues, hx ectopic pregnancy (IUD)

Intx: CYp3A4 inhibitors/inducers

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69
Q

Doxorubicin (Adriamycin)

A

C: Antibiotic

A: anthracycline antibiotic

I: one of most useful cancer drug

SE: CHF, necrosis of colon, esophagitis

CI: CHF, heart arrhythmias, previous tx with rx, BM supression

Intx: allopurinal, cyclosporine, progesterone

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70
Q

5 - FU

A

C: pyrimidine antimetabolite

A: interferes with DNA synthesis

I: carcinomas, actinic keratosis, solar keratosis, BCC

SE: stomatitis, leukopenia, GI ulcerations, myelosuppression

CI: poor nutritional status, thrombocytopenia, major surgery

Intx: MT, avoid alcohol

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71
Q

Vinblastine

A

C: anti-neoplastic

A: inhibits mitosis

I: hodgkins and non-hodgkins lymphoma

SE: raynauds disease

CI: severe BM supression, bacterial infx

Intx: SJW

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72
Q

Paclitaxel

A

C: antimicrotubule

A: inhibits microtubule formation

I: cancer - lung, ovary, breast, head/neck

SE: anaphylaxis - REQUIRED TO PRETX WITH STEROID/ANTIHISTAMINE

CI: severe neutropenia

Intx: cyp3a4 inducer/inhibitors

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73
Q

Clopidogrel

A

C: antiplatelet

A: prevents fibrinogen = decreased platelet adhesion and aggregation

I: stroky things and atherosclerosis

SE: diarrhea, rash, hemorrhage, bleeding

CI: allergy, coag dz

Intx: cyclosporine, diltiazem, NSAIS, anticoagulants

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74
Q

Warfarin

A

C; Vitamin K analog

A: anticoagulation - inhibits formation and activity of vitamin K - dependent clotting factors - prothrombin, 7, 9, 10

I: DVT, hypercoagulation, a.fib, artificial heart valves

SE: hemorrhage, necrosis, OD can be lethal (OD: vitamin K, prothrombin)

CI: hemorrhage, Menorrhagic, leukemia, cancer, GI bleed, severe HTN, etc.

Intx: manyyyy - highly protein bound

*MONITOR PT OR INR REGULARLY

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75
Q

Zidovudine

A

C: nucleoside analog (HIV)

A: inhibits HIV transcriptase

I: HIV/AIDs, post-exposure prevention

SE: BM suppression - anemia and neutropenia, muscle wasting, myalgia

CI: caution in BM suppression

Intx: accetaminophen, vinblastin, acyclovir

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76
Q

Acyclovir, Valacyclovir

A

C: nucleoside analog

A: inhibits viral replication

I: HSV

SE: increased liver enzymes

CI: caution in kidney impairment

Intx: synergy with Zidovudine

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77
Q

Cyclosporine

A

C: Immunosuppresant

A: suppresses immune system

I: prevention of organ rejection in transplants

SE: nephrotoxicity, HTN

CI: RA, psoriasis, malignancy

Intx: MANY

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78
Q

Amoxicillin and Penicillin

A

C: B-lactams

A: cell wall synthesis inhibition

I: URTI. AOM, sinusitis, CT, OM

SE: GI upset

CI: allergy is common

Intx: tetracyclies, aminoglycosides

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79
Q

Azithromycin, Clarithromycin

A

C: Macrolide antibiotics

A: inhibits bacterial protein synthesis

I: traveler’s diarrhea, GC/CT, non-gonococcal urethritis/cervicitis

SE: Gi irritation

Intx: serious toxicity with bromocriptine, carbamazepine, cyclosporine, digoxin, theophylline

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80
Q

Cephalexin

A

C: Cephalosporin

*similar drugs - cephalexin (1st generation), cefdinir (3rd generation)

A: inhibits cell wall synthesis

I: 1st gen - impetigo, carbuncles, cellutitis, OM
I: 3rd gen - URTI, GC

SE: allergic rxn, pseudomembraneous colitis, leukopenia

CI: penicillin allergy

Intx: alcohol

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81
Q

Ciprofloxacin

A

C: Fluoroquinolones

A: inhibits DNA gyrase

I: UTI, traveler’s diarrhea, OM, GC, flu

SE: c-diff infections, tendon rupture, QT prolongation

CI: kids

Intx: antacids, sucralfate, chemo drugs, other QT prolongation agents

82
Q

Doxycycline

A

C: Tetracycline antibiotic

A: inhibits protein synthesis

I: rickettsiae, acne, rosacea, PID, syphillis

SE: photosensitivity, yellow teeth in kids

CI: kids under 8 yo, activates SLE

Intx: penicillin

83
Q

Metronidazole

A

C: ANTIBIOTIC

A: reduces organism = DNA damage

I: Trichomonas, Crohns, Hpylori, C. diff

SE: Disulfiram reaction, neurotoxic with long-term usage

CI: liver failure, 1st trimester of pregnancy, lactation

84
Q

Sulfamethoxazole/trimethoprim

A

C: Sulfonamides

A: blocks bacterial enzymes and folate synthesis

I: travelers diarrhea, malaria, MRSA, UTI

SE: SJS

CI: sulfa allergy, porphyria, severe liver/renal dz, G6PD deficiency

Intx: cyclosporine, MTX, phenytoin, etc.

85
Q

Isoniazid

A

C: anti-TB agent

A: pyridoxine (B6) analog

I: TB

SE: peripheral neuropathy from pyridoxine deficiency

CI: hypersensitivity

Intx: alcohol, other drugs that are chemically similar

86
Q

Mupirocin

A

C: carboxylic acid

A: inhibits bacterial protein and RNA synthesis

I: IN for MRSA, topical for impetigo d/t infx

SE: normal shit if apply topically or IN

CI: open wounds and burns

87
Q

Fluconazole

A

C: antifungal

A: inhibits fungal cell wall synthesis

I: Candida, menigitis, other fungal infx

SE: SJS and QT prolongation

Intx; MANYYYY intx because strong multi-CYP inhibitor

88
Q

Nystatin

A

C: antifungal

A: fungicidal

I: vaginal candida, thrush

SE: not systemically absorbed so mild SE

CI: Preg B - swish and spit, Preg C - oral

89
Q

Terbinafine

A

C: Antifungal

A: inhibits squalene epoxidase

I: tinea of all kinds

SE: pancytopenia, neutropenia, SJS, hepatotoxic

CI: SLE

Intx: CYP2D6 inhibitors

90
Q

Permethrin

A

C: scabicides and pediculicides

A: sodium channel inhibitor in arthropods

I: scabies and lice

SE: seizures

CI: keep out of mouth of breast feeding infants, ragweed or chrysanthemium spp allergies.

Intx: none cause topical application

91
Q

Tdap and DTaP vaccine

A

C: Vaccine

A: immune stimulation

I: diphtheria, pertussis, Tetanus preventon

SE: seizures (uncommon) - normal SE of vaccines

CI: previous reaction to DTaP, fever over 105

Intx: None

92
Q

Hepatitis A

A

C: vaccine

A: immune stimulation

I: HAV

SE: normal shit

CI: moderate/severe illness

Intx: None known

2 doses 1 month apart in kids

93
Q

Hepatitis B

A

C: vaccine

A: immune stimulation

I: HBV

SE: normal shit + hypotension

CI: moderate/severe illness and hypersensitivity to yeast

Intx: None known

94
Q

Haemophilus influenzae type B conjugate vaccine

A

C: vaccine

A: immune stimulation

I: H. influenzae B meningitis and pneumonia prevention

SE: normal shit

CI: moderate/severe illness, immunosuppression

Intx: None known

2 doses 1 month apart in kids

95
Q

HPV Quadrivalent Vaccine

A

C: Vaccine

A: induce immunity against 6, 11, 16, 18

I: HPV infection prevention

SE: AI dz (very rare) otherwise normal SE

CI: administration before 9 yo, moderate/severe illness, pregnancy, low platelets

Intx: None

96
Q

Influenza Vaccine

A

C: vaccine

A: immune stimulation

I: Influenza

SE: normal shit

CI: moderate/severe illness, immunocompromised (if live vaccine)

Intx: None known but if live vaccine, administer 4 weeks between other vaccines

97
Q

Meningococcal Vaccine

A

C: vaccine

A: immune stimulation

I: prevention of neisseria meningitidis

SE: normal shit

CI: moderate/severe illness

Intx: None known

98
Q

MMR Vaccine

A

C: vaccine

A: immune stimulation (live)

I: MMR prevention

SE: rare - febrile seizures, loss of hearing, brain damage, coma, prolonged seizures

CI: moderate/severe illness, pregnancy, blood dyscraasia, leukemia

Intx: None known but decreased efficacy if taken within 4 weeks of another live vaccine

99
Q

Pneumococcal vaccine

A

C: vaccine

A: immune stimulation

I: prevent strep pneumonia, meningitis, sepsis, etc in vulnerable populations

SE: normal shit

CI: moderate/severe illness

Intx: None known

100
Q

Polio vaccine

A

C: vaccine

A: immune stimulation

I: polio prevention

SE: normal shit

CI: moderate/severe illness and anaphylaxis to neomycin, strep and polymyxin

Intx: None known

101
Q

Rotavirus (RGE) Vaccine

A

C: vaccine

A: immune stimulation (live)

I: prevention of RGE gastroenteritis

SE: normal shit + intussception

CI: moderate/severe illness

Intx: None known

102
Q

Varicella Vaccine

A

C: vaccine

A: immune stimulation (live)

I: varicella prevention

SE: normal shit but also rare/serious are rash/seizure

CI: moderate/severe illness, pregnancy, immunodeficiency

Intx: None known

103
Q

Zoster Vaccine

A

C: vaccine

A: immune stimulation

I: Shingles prevention over 50 yo

SE: normal shit but also rare/serious are rash/seizure

CI: moderate/severe illness

Intx: None known

104
Q

Testosterone

A

C: Hormone

A: anabolic on mm but also increased bone density, EPO production, and may be protective against AI disorders

I: AIDS wasting, anorchia, hypogonadism, OP

SE: virilization, gynecomastia, high calcium and cholesterol, liver cancer, edema, jaundice

CI: severe CVD, breast or prostate cancer, BPH (can worsen)

Intx: warfarin and cyclosporin

105
Q

Dehydroepiandrosterone (DHEA)

A

C: Hormone

A: decreases blood lipids, anticancer, anti-glucocorticoid, stimulates immune system, increases hormone production

I: aging, depression, SLE, ED, OP

SE: androgenic effects - acne, hirsutism

CI: G6PD deficiency, cancer of breast, prostate, uterus, ovaries

Intx: estrogen possibly

106
Q

Pregnenolone

A

C: Hormone

A: precursor to steroid hormones - can be converted into many different hormones

I: memory enhancement, AD, etc.

SE: unknown

CI: G6PD deficiency, cancer of breast, prostate, uterus, ovaries

107
Q

Tamsulosin

A

C and A: alpha-adrenergic blocking agent

I: BPH sx reflief

SE: retrograde ejaculation, orthostatic hypotension

CI: caution in CAD< liver dz, sulfa allergy

Intx: other meds in same category or anti HTN agents

108
Q

Finasteride

A

C and A: 5 alpha reductase inhibitors to reduce prostatic volume

I: BPH

SE: ED, low libido

CI: liver dz

Intx: none

109
Q

Sildenafil

A

C: PDE5 inhibitor

A: releases NO in corpus cavernosum = increases cGMP = SM relaxation = inflow of blood

I: ED

SE: HA, flushing, nasal congestion - rare: MI, vision loss

CI: using with nitroglycerin and CHF/MI

Intx: CYP3A4 inducers/inhibitors and increased bleeding in patients with heparin

110
Q

Cocaine

A

C: local anesthetic

A: blocking MAO and NE, HT, DA = anesthesia

I: URT local anesthetic - nasal/lacrimal duct surgery

SE: vasoconstriction locally,, seizures, arrhythmias, perforated nasal septum, etc.
not commonly used d/t hypertensive effects and vasoconstriction

CI: pregnancy

Intx: unknown

111
Q

Sumatriptan

A

C: selective serotonin receptor agonist

A: works in cranial nerves = vasoconstriction and anti-inflammatory

I: tx of migraine with or w/o aura

SE: burning at injection site. dizziness, paresthesias, pain/chest tightness, worm/cold temp sensations

CI: CVD, HTN, peripheral vascular dz - BASILAR AND HEMIPLEGIC MIGRAINES

Intx: bromocriptin, MAOis, SSRIs, TCA

112
Q

Caffeine

A

C: Stimulant

A: adenosine antagonist, diuretic

I: HA, migraine, mental stimulation

SE: tachyarrhythmias, dependence

CI: None?

Intx: fluvoxamine and levofloxacin

113
Q

Modafinil

A

C: controlled substance class 4 drug

A: CNS depressant = increases glutamate (excitatory)

I: narcolepsy, shift workers

SE: rhinitis, anorexia, nausea, restlessness, HTN, SJS

CI: CVD

Intx: alcohol, synnergy with other stimulants - pausin. yohimbe and ephedra sinica, OCPs

114
Q

Ketamine

A

C: anesthetic

A: blocks NMDA receptors = analgesia and sedation

I: anesthesia, nerve pain topically

SE: nystagmus, hallucinations, dissociations, vivid dreams, HTN, tachy, etc.

CI: HTN, eye injury, psychiatric disorders

Intx: opioids, narcotics, barbiturates

115
Q

Levodopa-carbidopa

A

C: Decarboxylase inhibitors

A: decreasing peripheral catabolism of levodopa = levodopa enters CNS = levodopa is converted into dopamine

I: PD, RLS

SE: dyskinesia, dystonia, loss of effect after 5 years, ortho hypOtension

CI: abrupt withdrawal, MAOIs, glaucoma

Intx: iron, isoniazid, meochlopramide, prochlorperazine

116
Q

Pramipexole

A

C and A: Dopamine receptor agonist

I: PD and RLS

SE: ortho hypo, somnolence, compulsive behavior, confusion, edema, etc.

CI: abrupt withdrawal

Intx; SAFE WITH L-DOPA, other agents that can cause ortho hypo

117
Q

Carbamazepine

A

C: Anticonvulsant

A: decreases neurotransmission and excitability in CNS

I: Seizures, trigeminal neuralgia, BPD, schizo, RLS

SE: dizziness, drowsiness, leukopenia, SJS, increased LFT

CI: MAOIs, liver dz, abrupt withdrawal

Intx: MANY

118
Q

Gabapentin

A

C: Anticonvulsant

A: unknown - structurally similar to GABA but doesnt react with GABA receptors

I: adjunct tx for patient seizures, neuro pain, RLS

SE: dizziness, drowsiness, leukopenia, SJS, increased LFT

CI: abrupt withdrawal

Intx: antacids, ethanol, sedatives

119
Q

Phenytoin

A

C: anticonvulsant

A: slows sodium channels = decreasing neuronal firing/excitability

I: adjunct seizures and status epilepticus and trigeminal neuralgia

SE: gingival hyperplasia, hirsutism, rash

CI: arrhythmias and heart blocks, abrupt withdrawal

Intx: MANY

120
Q

Melatonin (N-acetyl-5-methoxytryptamine)

A

C: endogenous hormone

A: antioxidant, immunomodulating, antineoplastic

I: jet lag, shift work, insomnia, SAD, not directly sedative

SE: hyperprolactinemia (rare)

CI: daytime usage

Intx: unsure?

121
Q

Zolpidem

A

C: Nonbenzo Sedative

A: structurally similar to benzos and works on its receptors

I: short-term insomnia tx

SE: impaired memory, complex sleep issues, SI

CI: abrupt withdrawal

Intx: alcohol, CNS depressants, CYP3A4 inducers/inhibitors

122
Q

Pitocin

A

C: synthetic oxytocin

A: stimulates uterine contraction and lactation (nasal)

I: induction of labor, incomplete abortion, postpartum hemorrhage

SE: uterine rupture, water intoxication, fetal death, hemorrhage, arrhythmias

CI: fetal distress, abnormal baby position at birth

Intx: vasoconstrictive agents that increase BP

123
Q

Carisoprodol

A

C: muscle relaxant

A: unknown

I: muscle spasms, myalgia

SE: aggitation, dizziness, vertigo

CI: porphyrias

Intx: CYP2C19 inhibitos, SJW, alcohol, CNS depressants

124
Q

Cyclobenzaprine

A

C: muscle relaxant

A: antispasmodics

I: skeletal muscle spasms

SE: drowsiness, seizures, arrhythmias, normal SNS sx

CI: arrhythmias, acute MI, CHF, heart block

Intx: MAOIs, anticholinergics

125
Q

Methylphenidate

A

C: Sympathomimetic

A: unknown

I: narcolepsy, ADHD, weight loss

SE: hallucainations, zombie-like effects, glassy eye appearance, sudden cardiac death - stop usage if serious side effects

CI: CVD, atherosclerosis, caution with mental health disorders

Intx: MAOIs, other sympathomimetics

126
Q

Dextroamphetamine

A

C: Stimulant - controlled substance

A: sympathomimetic - increases DA and NE/Epi release and blocks reuptake

I: fatigue, ADD, narcolepsy, excess appetite

SE: hallucainations, zombie-like effects, glassy eye appearance, sudden cardiac death - stop usage if serious side effects

CI: CVD, atherosclerosis, caution with mental health disorders

Intx: MAOIs, other sympathomimetics

127
Q

Haloperidol

A

C: antipsychotic

A: works on DA and serotonin

I: psychosis, tourette

SE: extrapyramidal sx, qt prolongation

CI: CNS depression, coma, PD

Intx: drugs that increase QT prolongation, cardiac arrhythmias, and extrapyramidal sx

128
Q

Aripiprazole

A

C: Antipsychotic

A: Antagonizes dopamine in brain

I: schizo, BPD1, MDD as adjunctive tx

SE: anticholinergic sx and QT prolongation

CI: hypersens rxn

Intx: lowers seizure threshold, drugs that increase CNS depression and extrapyramidal s/e

129
Q

Risperidone

A

C: 2nd generation antipsychotic

A: DA and 5HT antagonist

I: psychosis and schizo

SE: increased risk of torsade de pointe and QT prolongation, anticholinergic side effects, tardice dyskinesia, extrapyramidal s/e, ortho hypo

CI: caution in CVD, seizure, PD, low BP

Intx: CNS depressants, anti-HTN, DA agonist (levodopa), CYP3a4 inhibitors/inducers, drugs that cause QT prolongation

130
Q

Phenelzine

A

C: MAOIs

A: inhibits MAO from breaking down Epi, NE, DA, sero = antidepressant

I: Depression and severe anxiety

SE: HTN, ortho hypo, sexual dysfxn

CI: pheochromocytoma, CHF, HTN

Intx: MANY

131
Q

Amitriptyline

A

C: Tricyclic Antidepressants

A: inhibits catecholamine reuptake = sedative, anticholinergic, antihistamine, antidepresant

I: depression, enuresis, chronic pain, OCD

SE: anticholinergic effects, qt prolongation

CI: recent MI, seizure hx

Intx: MANY

132
Q

Fluoxetine

A

C: SSRI

A: inhibits serotinin reuptake

I: depression, panic, bulimia, OCD

SE: insomnia, tremor, SI, HI, serotonin syndrome

CI: liver failure, mania, seizure

Intx; MANY

133
Q

Escitalopram

A

C: SSRI

A: inhibits serotonin reuptake

I: MDD, GAD

SE: insomnia

CI: MAOi

Intx: phenelzine

134
Q

Bupropion

A

C: Antidepressant

A: inhibits reuptake of NE, 5HT, and DA

I: Depression, stop smoking, SAD

SE: agitation, insomnia, mania, seizure risk because lowers threshold

CI: seizure and eating disorders, head trauma hx

Intx: buspirone, dextromethorphan, SJS, TCA, trazodone

135
Q

Trazodone

A

C: SARI antidepressant

A: 5HT receptor antagonist

I: depression, aggression, panic, anxiety

SE: sedation, ortho hypo, anticholinergic sx, increased SI

CI: recent MI

Intx: MANY

136
Q

Venlafaxine

A

C: SNRI

A: serotonin, NE, Da reuptake inhibition

I: depression, anxiety, panic

SE: insomnia

CI: MAOI usage

Intx: phenelzine

137
Q

Lithium

A

C: Antimanic agent

A: increases presynaptic degradation and decreases neuronal synapses release of 5hT, DA and NE

I: Manic-depression, BPD

SE: third, polyuria, hypothyroid - VERY NARROW THERAPEUTIC WINDOW - sluggish, tremor, confusion

CI: renal dysfunction, CHD

Intx: DO not combine with first generation antipsychotics, caffeine

138
Q

Alprazolam (short acting) and Diazepam (long acting)

A

C: benzo

A: increases GABA

I: anxiety, panic

SE: impaired sleep quuality, poor concentration, addictive potential and withdrawal sx possible

CI: acute glaucoma

Intx: CNS depressants - antihistamines, barbiturates, alcohol, MAOIs, opioids, CYP3A4 inducers/inhibitors

139
Q

Buspirone

A

C: Anxiolytic

A: serotonin, Da, NE receptor agonist without muscle relaxation as seen in other benzos

I: anxiety

SE: nervousness, restlessness

CI: liver/kidney issues

Intx: CYP3A4 inducers/inhibitors, SJW, Trazodone, TCAs

140
Q

Nicotine - transdermal patch

A

C: stimulant

A: binds to acetylcholine receptors

I: smoking cessation

SE: burning/sensitivity where patch is located

CI: serious arrthymias, angina, recent MI

Intx: nicotine influences drug clearance

141
Q

Varenicline

A

C and A: smoking cessation aid by blocking acetylcholine receptors

I: stop smoking

SE: abnormal dreams, insomnia

CI: None

Intx: h2 receptor antagonist and quinolones

142
Q

Amantadine

A

C: Dopamine agonist and antiviral

A: inhibits viral RNA transcription, and changes dopamine activitiy

I: prevent and tx influenza A, early PD

SE: anticholinergic SE, CNS issues, livedo reticularis, ankle edema

CI: abrupt withdrawal

Intx: synergy with other anticholinergic agents and CNS stimulants

143
Q

Oseltamivir

A

C: Antiviral

A: inhibits neuraminidase = virus cant penetrate cellls

I: Influenza A or B

SE: N/V, seizure, arrhythmias

CI: CVD

Intx: clopidogrel

144
Q

Guaifenesin (Mucinex)

A

C: expectorant

A: expels mucus

I: clearing plegm and ADHD

SE: bradycardia, hypOtension

CI: None

Intx: TCA, CYP3A4 inducers/inhibitors

145
Q

Dextromethorphan (Robitussin)

A

C: Cough suppressant

A: opioid agonist = antitussive properties and analgesia

I: spasmodic, acute, and chronic cough

SE: confusion, hallucination, HTN, sedation

CI: cough related to other cardiopulm issues

Intx: MAOIs and SSRIS, increase effects with grapefruit juice, CNS depressants

146
Q

Fluticasone

A

C: Corticosteroid

A: vasoconstrictive and anti-inflammatory

I: asthma prevention, COPD, Allergic rhinitis (IN)

SE: URTI, oral candida, sinus infection

CI: hypersensitivity to milk protein, status asthmaticus, acute bronchospasms

Intx: demopressin

147
Q

Salmeterol (serevent)

A

C: Bronchodilator

A: LONG acting beta 2 agonist = bronchodilation

I: prophylactic tx of asthma ( ONLY USE WITH INHALED GC)

SE: asthma - related death when taken alone

CI: acute asthma attack

Intx: hypertensive crisis with MAOIs and TCAs

148
Q

Albuterol (Salbutamol)

A

C: Rescue inhaler - B2 agonist

A: SHORT acting b2 agonist

I: acute bronchospasms, preventing exercise-induced asthma, COPD

SE: paradoxical bronchospasm (life-threatening) and other SNS sx, hypokalemia

CI: caution in CVD, etc

Intx: hypertensive crisis with MAOIs and TCAs, other sympathomimetics, beta-blockers (inhibit bronchodilation), hypokalemia with HCTZ and loops

149
Q

Ipratroprium bromide (atrovent)

A

C: Bronchodilation

A: anticholinergic

I: COPD maintainance tx

SE: COPD exacerbation

CI: hypersensitivity to soy and peanuts (derivative of atropine)

Intx: other anticholinergics

150
Q

Tiotropium bromide

A

C: Bronchodilator

A: LONG acting anticholinergic = bronchodilation with antisecretory effects

I: asthma, COPD

SE: anticholinergic sx, metallic taste, paradoxical bronchospasms

CI: caution in glaucoma and urinary outflow obstruction

Intx: other anticholinergic agents and agents that increase QT prolongation

151
Q

Montelukast (Singular)

A

C: leukotrient receptor antagonist

A: reduces inflam and bronchoconstriction - LONG acting and PREVENTION

I: prevention and chronic tx of asthma

SE: HA and flu-like sx, increased LFT, Churg-strauss syndrome, altered behavior

CI: acute bronchospasm

Intx: CYP3A4 inducers and inhibitors

152
Q

Capsaicin

A

C: TRPV1 receptor agonist

A: depletes substance P = decreased pain levels

I: OA, RA, myalgias, etc

SE: normal shit if apply topically

CI: dont apply to wounds or burns

Intx: increases cough induced by ACEI

153
Q

Codeine

A

C: Opiate analgesics

A: binds to opiate receptors to inhibit pain pathways

I: prodrug converted into morphine and used for mild-mod pain or as antitussive

SE: sedation and constipation are big ones but other normal opiate s/e

CI: respiratory weakness, urinary bladder obstruction, kids under 12 yo

Intx: drugs that cause QT prolongation

154
Q

Heroin

A

C: Opiate analgesics

A: binds to opiate receptors to inhibit pain pathways

I: severe pain

SE: sedation and constipation are big ones but other normal opiate s/e

CI: respiratory weakness, urinary bladder obstruction, kids under 12 yo

Intx: alcohol and CNS depressants

155
Q

Hydrocodone

A

C: Opiate analgesics

A: binds to opiate receptors to inhibit pain pathways

I: semi-synthetic prodrug converted into hydromorphone and used for mild-mod pain or as antitussive

SE: sedation and constipation are big ones but other normal opiate s/e

CI: respiratory weakness, urinary bladder obstruction, kids under 12 yo

Intx: more interactions than morphine drugs that cause QT prolongation

156
Q

Methadone

A

C: Opiate analgesics

A: binds to opiate receptors to inhibit pain pathways

I: severe pain and detox

SE: sedation and constipation are big ones but other normal opiate s/e

CI: respiratory weakness, urinary bladder obstruction, arrhythmias

Intx: MANY d/t usage of CYP450 enzymes

157
Q

Morphine

A

C: Opiate analgesics

A: binds to opiate receptors to inhibit pain pathways

I: severe pain

SE: sedation and constipation are big ones but other normal opiate s/e
antidote: naloxone

CI: respiratory weakness, urinary bladder obstruction, arrhythmias

Intx: less than methadone and oxycodone - avoid with MAOIS and ethanol and CNS depressants

*schedule 2 controlled substance

158
Q

Oxycodone

A

C: Opiate analgesics

A: binds to opiate receptors to inhibit pain pathways

I: semi-synthetic opioid used for pain

SE: sedation and constipation are big ones but other normal opiate s/e

CI: respiratory weakness, urinary bladder obstruction, arrhythmias

Intx: more interactions than morphine drugs and drugs that cause QT prolongation and CNS depression

159
Q

Naloxone (Narcan)

A

C: Opioid antagonist

A: opioid receptor antagonist

I: opioid addiction and OD

SE: seizures, v. fib, tachy, HTN

CI: caution in CVD and seizure hx

Intx: reversal of opioid analgesic effects

160
Q

Naltrexone

A

C: Opioid antagonist

A: opioid receptor antagonist

I: opioid addiction and OD and alcoholism

SE: N/V, headache, hepatitis

CI: patient who requires opiates for pain control

Intx: reversal of opioid analgesic effects

161
Q

Acetaminophen/Paracetamol (Tylenol)

A

C: Analgesic and antipyretic

A: inhibits CNS PG synthesis - DOES NOT affect platelet aggregation or inflam

I: mild pain, MSK pain, RA, OA

SE: nephro/hepatotoxicity, antidote: charcoal, NAC

CI: liver dz/failure, alcoholism

162
Q

Aspirin (acetylsalicyclic acid)

A

C: NSAID

A: inhibits COX1 and COX2 = decreases PG synthesis + analgesia + AI + antipyretic + IRREVERSIBLE platelet aggregation

I: minor pain, fever, OA, RA, thromboembolism (prevent and tx MI and ischemic strokes)

SE: nephrotoxic, salicylism - tinnitus, OD may be lethal

CI: children with viral infx, PUD, bleeding disorders, HF, allergy

Intx: alcohol, SSRI, anticoagulants, hypoglycemics, insulin

163
Q

Ibuprofen and Naproxen

A

C: NSAIDs

A: inhibits COX1 and COX2 = decreases PG synthesis + analgesia + AI + antipyretic + IRREVERSIBLE platelet aggregation

I: minor pain, fever, OA, RA

SE: nephrotoxic, allergy is common, OD may be lethal

CI: PUD, bleeding disorders, HF

Intx: cyclosporine, alcohol, SSRI, anticoagulants

164
Q

Celecoxib (Celebrex)

A

C: NSAIDs

A: selective COX2 inhibitor - less GI irritation so safer choice in patients with pain and PUD because not working on both COX enzymes

I: minor pain, fever, OA, RA, MSK pains

SE: SERIOUS CVD events, nephrotoxic, allergic rxn is common

CI: CVD, bleeding disorders, HF

Intx: alcohol, SSRI, anticoagulants, other NSAIDs, salicylates, anti-HTN drugs

165
Q

Cannabis

A

C and A: anti-emetic, anticonvulsive, psychoactive effects

I: glaucoma, appetite loss, chemo induced nausea and vomiting, tremors and spasticity with MS

SE: Many

CI: CV or respiratory dz, immunocompromised, epilepsy

Intx: theophylline, barbiturates, warfarin, CNS depressants

166
Q

Prednisone

A

C: Glucocorticoid

A: AI, immunosuppressive, catabolic effect on skin, bone, and muscle. Alters fat deposition

I: inflam and allergic conditions, IBD, AI dz

SE: adrenal suppression, cushings, HTN, avascular necrosis of femur, changes in behavior

CI: systemic fungal or other severe infx, live vaccine, abrupt wthdrawal

Intx: estrogens and many more

167
Q

Fluticasone and Mometasone

A

C: Inhaled corticosteroids

A: AI, immunosupressive, vasoconstrictive (IN)

I: prevent asthma

SE: oral thrush is big one, adrenal suppression and cushings

CI: systemic fungal or other severe infx, live vaccine, abrupt wthdrawal

Intx: estrogens and many more

168
Q

Dexamethasone

A

C: Corticosteroids

A: AI, immunosupressive

I: inflam and allergic conditions, AI dz

SE: acne, weight gain, high glucose, low potassium, OP, avascular necrosis of femur

CI: systemic fungal or other severe infx, with a vaccine, abrupt wthdrawal

Intx: estrogens and many more

169
Q

Methylprednisolone

A

C: Corticosteroid

A: synthetic glucorticoid = decreases inflam and immune response = SM relaxation

I: acute or severe persistent asthma, arthritis

SE: weight gain, high glucose, low potassium, OP, etc.

CI: system fungal or other severe infx, abrupt withdrawal, premature infants

Intx: live vrus vaccines, desmopressin

170
Q

Hydrocortisone (cortisol)

A

C: Corticosteroid

A: AI, immunosuppressant

I: acute or severe persistent asthma, arthritis

SE: weight gain, high glucose, low potassium, Cushings, adrenal suppression, OP, etc.

CI: system fungal or other severe infx, abrupt withdrawal, premature infants

Intx: live vrus vaccines, desmopressin

171
Q

Adalimumab

A

C: TNF alpha inhibitor

A: AI and immunosuppressive effects

I: RA, PA, AS

SE: infection site reaction and infx, cancers, lymphomas

CI: SLE, HF, MS, active infx

Intx: increased risk of infx with live vaccinations

172
Q

Hydroxychloroquine

A

C: Anti-malarials

A: inhibits movement of neutrophils and eosinophils = impairs complement dependent antigen-antibody reactons

I: RA, SLE, malaria prevention

SE: ocular toxicity, visual changes, skin pigmentations

CI: G6PD deficiency, eye dz

Intx: digoxin

173
Q

Methotrexate

A

C: Folic acid analog

A: inhibits dihydrofolate reductaste = DNA synthesis cant happen = cytotoxic and immunosuppresant

I: RA, psoriasis, cancer

SE: asx elevation of liver enzymes, hepatotoxicity, diarrhea, ulcerative tomatitis, BM suppression, nephrotoxicity

CI: BM suppression, blood dyscrasia, anemia, alcoholism

Intx: cyclosporin, NSAIDS, Sulf-Tri and penicillin

174
Q

Tofacitinib

A

C: JAK inhibitor

A: decreases hematopoiesis and immune system function

I: PA, RA, UC

SE: infx, viral reactivation, cytopenias

CI: active infx, cytopenia

Intx: live vaccines, other immunosuppressive agents

175
Q

Alendronate

A

C: Bisphosphate Derivatives

A: inhibits bone resorption

I: OP and pagets dz of bone

SE: jaw osteonecrosis and esophageal ulcers, GI irritation

CI: low calcium, cant sit or stand upright for at least 30 minutes

Intx: raloxifene and estrogens, NSAIDs

176
Q

Raloxifene

A

C: SERM

A: acts like estrogen to prevent bone loss without causing a lot of s/e as estrogen

I: OP in post-men females

SE: thromboembolism, DVT, leg cramps - decreasssse estrogen-sensitive breast cancer risk

CI: thromboembolic disorder, child-bearing females

Intx: cholestyramine, warfarin

177
Q

Allopurinol

A

C: Xanthine oxidase inhibitor

A: prevents formation of uric acid

I: hyperuricemia, gout, calcium kidney stones

SE: gout, increase ALK PHOS and LFT

CI: normal shit

Intx: ACEi and antacids

178
Q

Colchicine

A

C: Anti-gout agent

A: inhibits leukocyte microtubule assembly = reduce migration and phagocytosis = decreases cell metabolic activity

I: acute gout

SE: diarrhea, aplastic anemia (long term)

CI: normal shit

Intx: statins, Cyp3A4 inhibitors

179
Q

Phenazopyridine (AZO)

A

C: analgesic

A: locally

I: pain of UTI until other tx works

SE: red/orange urine, jaundice

Intx: None

CI: long-term

180
Q

Nitrofurantoin

A

C: Antibiotic

A: damages bacterial DNA

I: infectious cystitis, chronic bacterial prostatitis

SE: pulmonary and hepatic toxicity with long term usage

CI: pyelonephritis, G6PD def, porphyria

Intx: antacids

181
Q

Tolterodine

A

C: Bladder selective muscarinic antagonist

A: antagonism of cholinergic receptors = increased residual urine volume and decreases detrusor muscle pressure

I: overactive bladder, urinary frequency/urgency/incontinence

SE: all anticholinergic sx

CI: urinary or gastric retention

Intx: other anticholinergics

182
Q

Apixaban (Eliquis)

A

C: Factor Xa inhibitor

A: blocks factor Xa to inhibit blood clotting

I: anticoagulation for strokes/clots/DVT prevention

SE: severe bleeding, thrombocytopenia, anemia

CI: active bleeds, strokes, clots

Intx: many

183
Q

Tamoxifen

A

C: Antiestrogen

A: binds to estrogen receptors

I: hormone receptor positive breast cancer, metastatic dz, DCIS, BrCa prevention

SE: BLACK BOX - uterine malignancy, stroke, PE, endometrial metaplasia, also can drop all WBC and platelets then normal other SE that comes with hormones and cancer shit

CI: prego, breast fx, hx thromboembolism, anticoagulant tx

184
Q

Rifampin

A

C: Antibiotics

A: inhibits DNA dependent RNA polymerase

I: active and latent TB, bioterrorism

SE: hepatitis, hepatotoxic, decreases WBC and platelets, hemolytic anemia

*dont take with other hepatotox meds or alcohol

185
Q

Pregabalin

A

C: Anticonvulsants

A: antinociceptive and anti-seizure effects

I: neuropathic pain, DM, herpes, seizures, fibro

  • caution with alcohol and abrupt withdrawal
186
Q

Phenylephrine

A

Brand: Preparation H

C: nasal decongestants

A: vasoconstriction

I: nasal congestion

SE: arrhythmia, HTN

CI: MAO, 1st trimester of pregnancy and urinary retention

187
Q

Pentoxifylline

A

C: hemorrheologic agent - claudication

A: helps blood flow more easily through narrowed arteries

I: claudication, alcoholic hepatitis

SE: arrhythmias

CI: recent cerebral/retinal hemorrhage

188
Q

Pembrolizumab (Keytruda)

A

A: binds to receptors on T cells to block PD1 pathway = decrease antitumor immune response = decrease tumor growth

I: melanoma, non-small cell lung cancer, SCC

189
Q

Lugol Solution

A

iodine for disinfecting shit

190
Q

Ipilimumab

A

A: binds cytotoxic T cells = changes T cell activation and proliferation

I: melanoma, renal cell cancer, HCC

191
Q

Insulin - Regular (Norvolin)

A

A: stimulates peripheral glucose uptake = inhibits liver glucose production = regulates glucose metabolism

I: DM, Diabetic ketoacidosis

SE: low glucose/potassium, anaphylaxis, edema

*SHORT acting

192
Q

Insulin - Lispro

A

A: stimulates peripheral glucose uptake = inhibits liver glucose production = regulates glucose metabolism

I: DM

SE: low glucose/potassium, anaphylaxis, edema

*RAPID acting

193
Q

Insulin - Glargine

A

A: stimulates peripheral glucose uptake = inhibits liver glucose production = regulates glucose metabolism

I: DM1 and DM2

SE: low glucose/potassium, anaphylaxis, edema

*LONG acting

194
Q

Heparin

A

C and A: Anticoagulant

I: thromboembolism, STEMI, NSTEMI

SE: bleeding, low platelets, prolonged clotting time, increase LFT

195
Q

Exenatide

A

A: activates GLP1 receptors = increases insulin secretion = decreases glucagon secretion and delayed gastric emptying

I: DM2

SE: BLACK BOX - thyroid c- cell tumor risk

CI: thrombocytopenia, DM1

196
Q

Dulaglutide (trulicity)

A

I: DM2 and decrease CVD risk

SE: BLACK BOX - thyroid c cell tumor risk

197
Q

Cefuroxamine

A

A: peptidoglycin - inhibits cell wall synthesis

I: bacterial infx and pneumonia

SE: decrease immune system, c. diff, SJS

CI: sensitivity to penicillin

198
Q

Ceftriaxone

A

C: antibiotic

A: B - lactam: inhibits cell wall synthesis

I: infx - GC, meningitis

SE: increase LFT, leukopenia, eosinophilia

CI: antibiotic associated colitis recent hx

199
Q

Cefepime

A

C: Antibiotic

A: B-lactam

I: infx, pneumonia, UTIs

SE: increase LFT, leukopenia, eosinophilia

CI: antibiotic associated colitis recent hx

200
Q

Carvedilol

A

C: beta blocker

I: HTN, HF with decreased EF, left ventricular dysfunction

SE: CHF, asthma, decreased HR and heart issues

CI: HF, bradycardia, cardiogenic shock, sinus sick syndrome, AV blocks

201
Q

Atezolizumab

A

A: binds PDL1 on cancer-immune cells to decrease tumor growth

I: urothelial carcinoma, non small cell lung carcinoma, melanoma, breast cancer

Jessica: NPLEX 2 Pharmacology (11 decks)

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