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Pharmacology II-Final > Pharmacology 1 > Flashcards

Pharmacology 1 Flashcards

1
Q

what is a virus?

A

is an intracellular parasite that consists of DNA or RNA core surrounded by a protein coat and sometimes an outer covering of lipoprotein

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2
Q

How does a virus work?

A

the virus attaches itself to the host’s cell repleasing viral genetic material which takes control of the host cell machinery for replication. The host cell eventually dies releasing replicated viruses that proliferate and attack more and more host cells

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3
Q

are antivirals virustatic?

A

yes, they work bes when the host has a healthy immune system; so that when the rate of virus proliferation is slowed, the immune system releases appropriate cells to overcome virus’s attack and overcome the infection.

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4
Q

what are the factors that determine the effective treatment of viral infections?

A

host factors, virus factors and antiviral agent factors

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5
Q

what factors influence the outcome of antiviral therapy?

A

-stage of illness at the time of initation of therapy
-antiviral dose
-ability of the virus to penetrate the central nervous system
-ability of the virus to remain latent within its host
-development of antiviral resistance

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6
Q

Treatment of influenza?

A

Amantanes
neuraminidase inhibitors

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7
Q

What is the treatment for Amantanes?

A

treatment of influenza A
They are not effective against influenza B

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8
Q

MOA amantanes?

A

interfere with the uncoating of the influenza A virus, a necessary step in the viral replication process

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9
Q

what does neuraminidase inhibitors treat?

A

influenza A and B
The h1n1 and h3n3 strains of influenza A are susceptible to the effects of oseltamivir ad zanamivir.

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10
Q

MOA of neuraminidase inhibitors?

A

inhibit viral release and inhibit virus prolieration

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11
Q

Oseltamivir is formulated for? zanamivir if formulated for?

A

oral use
powder for oral inhalation

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12
Q

what drug is not recommended with pulmonary disease?

A

Zanamivir

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13
Q

Oseltamivir brand name?

A

Tamiflu

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14
Q

Zanamivir brand name?

A

Relenza

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15
Q

Treatment of hepatitis B and C?

A

Interferones
Nucleoside/neucleotide analogues
Direct acting antivirals

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16
Q

MOA of interferons?

A

they protect uninfected cells by promoting resistance to virus infection
inhibit viral transcription by activating enxymes that cleave single-stranded viral RNA

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17
Q

What is Nucleoside/Neucleotide analogue used for?

A

treatment of HBV
only Ribavirin is indicated for HBC (when combined with peginterferone alfa) and RSV

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18
Q

what is direct acting antivirals used for?

A

treatment of hepatitis C
most are marketed as combination products or taken in combination to improve effectiveness

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19
Q

what is the treatment of herpes simplex, herpes Zoster and cytomegalovirus?

A

Acyclocir, valacyclocir, foscarnet, ganciclovir, famciclovir, penciclovir, trifluridine

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20
Q

what does Acyclovir do?

A

inhibits viral DNA synthesis. it is used for the treatment of herpes simplex virus, herpes genitalis and varicella zoster virus.
Higher doses are reqiured for the treatment of chickenpox and shingles

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21
Q

what does valacyclocir do? moa

A

is an ester of acyclovir. it has greater oral absorption
it treats the same as acyclovir but reiuqres less frequent dosing

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22
Q

what does Foscarnet do? moa

A

Indicated for the treatment of CMV, HSV-1, HSV-2, herpes labialis (sold sores)

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23
Q

What does Ganciclovir do?

A

used in the treatment of CMV.

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24
Q

What 4 aux labels should be on Ganciclovir?

A

-swallow whole
-do not crush or chew
-avoid pregnacy
-take with food

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25
Q

what is famciclovir used for?

A

indicated for the treatment of HSV-1, HSV-2 and acute herpes zoster infections
has a longer duration of action than acyclovir

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26
Q

Acyclovir brand name?

A

Zovirax

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27
Q

Famciclovir brand name?

A

Famvir

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28
Q

Ganciclovir brand name?

A

Cytovene

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29
Q

Trifluridine brand name?

A

Viroptic

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30
Q

HIV attacks?

A

CD4 T lymphocytes and weakens the immune system

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31
Q

The steps of the HIV life cycle?

A

9 steps
-Binding
-Fusion
-Uncoating
-reverse transcription
-Integration
-Genome replication
-protein synthesis
-protein cleavage and viral assembly
-virus release

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32
Q

what are antiretrovirals?

A

medicines that interfere with the replication of retroviruses. HIV is a retrovirus

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33
Q

why are antiretrovirals are administered?

A

reduce viral load
increase CD4 counts
delay the development of AIDS-related conditions
imporve survival

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34
Q

Antiretrovirals 6 classes?

A

-Nucleoside/nucleotide reverse transcriptase inhibitors
-Non-nucleoside reverse transcriptase inhibitors
-protease inhibitors
-fusion inhibitors
-chemokine receptor antagonists
-hiv integrase strand inhibitor

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35
Q

therapy of antiretrovirals are based on what?

A

CD4 counts and patients are symptomatic or asymptomatic

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36
Q

what is HAART? AND WHY is it used?

A

Highly active antiretrovial therapy
used to reduce antiviral resistance and is a regimen of 3 or more medications from two or more antiretroviral classes is prescribed

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37
Q

what is done prior to antiretroviral?

A

agent resistance testing is recommended

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38
Q

Used in the catagory of Nucleoside and Nucleotide reverse transcriptase inhibitors?

A

Lamivudine, Zidovudine, Emtricitabine + Tenofovir, Efavirenz + Emtricitabine + Tenofovir

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39
Q

what is lamivudine used for?

A

effective aginst HIV and also inhibits replication of HBV. good choice of therapy for those who have HIV and HBV coninfections

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40
Q

what drug causes nail discoloration?

A

Zidovudine

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41
Q

Lamicudine brand name?

A

epivir

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42
Q

Zidovudine brand name?

A

Retrovir

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43
Q

what is Zidovudine?

A

first availble antiretroviral and is formulated for oral and parenteral administration
may be administered to pregnanct women and intravenously during delivery and as a suspesion

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44
Q

how does NNRTI’s and NRTIs differ?

A

-NNRTI’s are noncompetitive inhibitors of reverse transcriptase
-they do not need to be activated by host enxymes
-they are not effective against HIV-2

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45
Q

why are NNRTI’s only used in combination with NRTIs and PIs?

A

due to resistance except for Nevirapine

46
Q

do NNRTIs have drug interactions?

A

yes they are metabolized by cytochrome P-450
interact with benzodiazepines, HMG-CoA inhibitors (statins) and proton pump inhibitors when coadministered

47
Q

What is Efavirenz used for?

A

used for treatment of HIV-1 infection. also available as single entity but monotherapy is not recommended because of development of resistance.

48
Q

when is Efavirenz not allowed?

A

the drug should not be taken in first trimester of pregnancy and women taking the drug should be advised to avoid pregnacy

49
Q

Can Mevirapine be administered as monotherapy for the perinatal mother to child transmission of HIV?

A

yes it is the only NNRTI to do so

50
Q

MOA of Protease inhibitors?

A

interfere with step 8 of the HIV life cycle.

51
Q

what is administered together with protease inhibitors?

A

PIs

52
Q

MOA of Ritonavir?

A

competitive inhibitor of HIV protease

53
Q

what does Ritonavir do?

A

effective against HIV-1 and HIV-2 proteases
boost the effects of other PI by inhiting their metabolism
Resistance to ritonavir appears to occur more slowly than with other PIs.

54
Q

Fusion inhibitors MOA?

A

interfere with step 2 in the HIV life cycle.

55
Q

The only drug in Fusion inhibitors?

A

Enfuvirtide

56
Q

Chemokine receptor type 5 antagonists MOA?

A

inhibits HIV entry into host cells

57
Q

what drug is in chemokine receptor type 5 antagonist?

A

Maravrioc

58
Q

HIV integrase Strand inhibitors MOA?

A

block the final step in the process of human host cell infection by HIV

59
Q

what is asthma?

A

is a chronic disease that affects the airways, producing irritation, inflammation and difficutly breathing

60
Q

what factors increase the risk of asthma?

A

positive family history of asthma, exposure to tobacco smoke, chronic exposure to other sources of air pollution and exposure to some allergens and infections early in life.

61
Q

asthma symptoms?

A

airway constriction, inflammation and mucus
coughing, wheezing, shortness of breath and chest tightness
feeling they they cannot get enough air into the lungs

62
Q

What happens in noctural asthma?

A

lung function and anti-inflammatory formones decrease and the release of proinflammatory mediators increases in the middle of the night.

63
Q

allergens examples?

A

animal dander, environmental pollutants, cleaning fluid, mold, tobacco smoke and cold air

64
Q

how can risks for exercise-induced be minimized?

A

by taking prescribed medicines prior to excerise

65
Q

how can asthma symtoms be managed?

A

with combination of medication
lifestyle modification
home monitoring of breathing using a peak flow meter and medication

66
Q

what are the two components of asthma?

A

airway inflammation
acute bronchoconstriction (constriction of the airways)

67
Q

drugs used in the treatment of acute symtoms of asthma?

A

Relievers
short-acting beta2-adrenergic agonist

68
Q

what do relievers do?

A

provide rapid and short-term relief of asthma symptoms
they reverse bronchospasm and open airways

69
Q

what is Albuterol (salbutamol)?

A

short-acting beta2-adrenergic agonist

70
Q

Terbutaline is a?

A

Short-acting beta2 adrenergic agonist

71
Q

What is ipratropium bromide?

A

short-acting beta2-adrenergic agonist
given with a beta2-adrenergic agonist for the relief for acute symptoms.

72
Q

what happens when short-acting beta-2 adrenergic sgonists bind to beta2 receptors?

A

bronchial smooth muscle relaxes and bronchospasm is revered causing airways to dilate

73
Q

how are short-acting beta2-adrenergic agonists administered?

A

oral inhalation using a metered-dose inhaler (MDI) or nebuilzer

74
Q

short-acting beta2 adrenergic agonists rapid onset?

A

rapid onset of action and short duration of action

75
Q

Terbutaline brand name?

A

Bricanyl inhaler

76
Q

Salbutamol + ipratropium bromide brand name?

A

Combivent/ combivent respimat

77
Q

what drugs are used for flare-ups?

A

controllers (long term use)

78
Q

what guidelines are used when prescribing long-acting beta2 adrenergic agonists?

A

-contraindicated without the use of an inhaled corticosteroid
-use should be limited to the shotest duration of time reqiured to achieve control of asthma symtoms and then discountiuned
-combination inhaled corticosteroid and an LABA are recommended for pediatric and adolescent patients

79
Q

Formoterol brand name?

A

Oxeze turbuhaler

80
Q

salmeterol brand name?

A

serevent

81
Q

anticholinergic drugs?

A

Ipratropium bromide
Tiotropium bromide

82
Q

ipratropium brand name?

A

Atrovent

83
Q

Tiotropium bromide brand name?

A

Spiriva/spiriva respimat

84
Q

Glucocorticoids are what typeof drug?

A

anti-inflammatory drugs
they reduce the inflammatory response in airway cells
decreasing the muscus and swelling that makes breathing difficult

85
Q

Beclomethasone brand name?

A

Qvar

86
Q

Budesonide brand name?

A

Pulmicort turbuhaler

87
Q

Ciclesonide brand name?

A

Alvesco

88
Q

Fluticasone brand name?

A

Flovent

89
Q

Mometasone brand name?

A

Asmanex

90
Q

Formoterol + budesonide brand name?

A

Symbicort

91
Q

Salmeterol + fluticasone brand name?

A

Advair

92
Q

when are leukotriene modifiers administered?

A

mild asthma to reduce inflammation

93
Q

Leukotriene modifers drugs?

A

Montelukast and zafirlukast

94
Q

MOA of leukotriene modifiers?

A

interfere with the binding of leukotrienes on airway smooth muscle, reducing allergen-induced airway inflammation, airway relaxation and edema

95
Q

when should montelukast and zafirlukast be taken?

A

Montelukast can be taken on food
Zafirlukast should not be taken with food

96
Q

Do leukotriene modifiers interfere with drugs?

A

yes they are metabolized in the liver

97
Q

Monetlukast brand name?

A

Singulair

98
Q

Zafirlukast brand name?

A

Accolate

99
Q

MOA of mast cell stabilizers?

A

reduce the release of inflammatory subtances responsible for producing the symptoms of asthma by making mast cells less reactive to antigens
they inhibit the degranulation of mast cells and prevent the release of histamine the slow-reacting substance of anaphylaxis.

100
Q

when and what is cromolyn sodium used for?

A

administered for prophylaxis and does not control acute symtoms
several weeks of therapy are reqiured before max response to the drug is achieved
given using a meteted-dose inhaler or nebuilzer

101
Q

Tiotropium brand name?

A

Spiriva

102
Q

what properties does xanthine derivatives have?

A

bronchodilator and anti-inflammatory properties

103
Q

what is theophylline drived from?

A

caffeine

104
Q

what is the difference between theopylline and aminophylline?

A

the half-life and varies with patient age, liver function, smoking status and use of concurrent drugs

105
Q

Theophylline brand name?

A

Uniphy/Theo ER

106
Q

What is monoclonal antibodies used for?

A

treatment of moderate to severe allergic asthma
indicated as addon therapy for patients whose asthma is not controlled with inhaled corticosteroids and beta2-adrenergic agonists

107
Q

what drug is monoclonal antibodies?

A

Omalizumab

108
Q

treatment of COPD?

A

bronchodilators
glucocorticosteroids
antibiotics (when infections are present)
anticholinergics (tiotropium)
antimucolutics (acetylcysteine)

109
Q

Nonpharm treatments of COPD?

A

oxygen therapy and mechanical ventialtion

110
Q

What is the first line treatment of COPD?

A

Inhaled anticholinergics with persistent symtoms

111
Q

what is the most common side effect of?

A

dry mouth

112
Q

Drug delivery devices?

A

MDI, dry powder inhaler, nebulizer, spacer

Pharmacology II-Final (14 decks)

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