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Pharmacology Flashcards

1
Q

acetaminophen

A

扑热息痛,对乙酰氨基酚 reversibly inhibits COX, mostly in CNS (inactivated in peripheral) clinical use: antipyretic (扑热）， analgestic （熄痛）， NOT anti-inflammatory! used instead of Aspirin to avoid Reye’s syn in children with viral infection toxicity: 肝毒性（deplete glutathione in liver) antitode: N-acetylcystine (to regenerate glutathione)

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2
Q

Atropine

A

competitive antagonist at M2 (post-junctional muscarinic receptor in the heart) increase HR by blocking vagal firing

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2
Q

ALL (acute lymphoblastic leukemia) drugs: activated by? inhibited by?

A

6-mercaptopurine, 6-thioguanine purine analogs to inhibit de novo purine synthesis activated by HGPRT (hypoxanthine-guanine phosphoribosyl transferase) degraded by XO (xanthine oxidase) and thiopurine methyltransferase (TPMT) in the liver

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2
Q

Antidepressents的分类？机制？各自代表药物？

A
  1. ↑ 【NE] in the synapse: 1) ↑ its release (Bupropion） 2）↓ its re-uptake (SNRIs, TCAs) 3) inhibit metabolism (MAOI) 4) 去抑制：mirtazapine 2. ↑ 【5-HT] in the synapse: 1) ↑ its release (Bupropion） 2）↓ its re-uptake (SSRIs, SSNIs, TCAs, trazodone 三唑酮) 3) inhibit metabolism (MAOI)
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3
Q

atypical antipsychotics包括哪些？

A

“It’s atypical for Old Closets to Quietly riser from A to Z” Olanzapine 奥兰氮平 (significant weigt gain) Clozapine: 氯氮平 1. agranulocytosis - requires weekly WBC monitoring!!! (must watch clozapine closely!!!) 2. seizure 3.significant weigt gain Quetiapine 喹硫平 risperidone: ↑ prolactin (lactation + gynecomastia) ⟹ ↓ GnRH, LH, FSH ziprasidone 齐拉西酮 prolong QT interval

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4
Q

Benzodiazepines: 机制？用途？side effects? tolerance和什么相关? 分类？

A

机制: bind and enhance the inhibitory effects of GABAa 用途: 1. hypnotics 2. anxiolytics (for panic attacks, anxiety disorders) 3. anticonvulsants (seizures with alcohol withdrawal) 4. general anesthesia side effects: daytime drowsiness tolerance： the shorter the duration of action of a drug, the more likely withdrawal sym occur 分类

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5
Q

Benzodiazepines有2种用于epilepsy: which 2? for what kind of epilepsy? clinical use？ mechanism? side effects? notes?

A

diazepam, 地西泮; 安定 lorazepam 劳拉西泮 for what kind of epilepsy: status (DOC: lorazepam) mechanism: ↑ GABAa action side effects: sedation, tolerance, dependence, respiratory depression notes: also for for eclampsia seizure (子痫; DOC: MgSO4)

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6
Q

Bethanechol: 什么药？用途？ 同种药物还有哪些？

A

氨基甲酰甲基胆硷(胆硷能药) “Bethany, call me if you want to activate your bowel and bladder” - work on SMCs in the intestine and bladder; used to treat o.p. ileus, neurogenic ileus, urinary retention

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6
Q

benztropine

A

苯甲托品,苄托品 muscarinic antagonist, treat PD (Park my Benz)

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7
Q

bretylium

A

溴苄胺 inhibit NE release

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9
Q

Bupropion

A

antidepresant, has no side effect on sexual performance (while sexual dysfunction is seen in 50% patients treated with SSRIs) side effects: agitation, insomnia,

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10
Q

Buspirone

A

抗焦虑药， “I am always anxious if the “bus” will be “on time” with minimal to no hypnotic, sedative or euphoria effects; selective 5-HT1A R; safe and effective

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11
Q

carbachol

A

卡巴胆碱, 拟胆碱药 在青光眼和缩瞳中使用，降低球内压

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11
Q

buspirone: 什么药？机制？

A

抗焦虑

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12
Q

celecoxib

A

考塞来西，抗关节炎药 COX2 specific inhibitor spare COX-1, which helps maintain the gastric lining (NSAIDs and Aspirin: inhibits both COX1/2, decrease PG , which protects gastric lining) spares platelet function

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13
Q

cholinesterase inhibitor poisoning : syn, antidote?

A

Sym: DUMBBELSS (diarrhea , Urination Miosis, bronchospasm , bradycardia , lacrimation , sweating, salivation) Antidote : atropine + pralidoxime (解磷定Regenerate active AchE)

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14
Q

CNS stimulants: 包括哪些？机制？用途？

A

MMDP ↑ Catecholamines at synapes ADHD, narcolepsy, appetite control

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14
Q

clomiphene 同类药物还包括？ Mx Use Toxicity

A

SERMs

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15
Q

diaphoresis

A

发汗

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16
Q

Dimercaprol

A

二硫基丙醇 chelator of arsenic, treat arsenic posioning

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17
Q

Diphenhydramine: 什么药？机制？ 副作用？

A

苯海拉明， 1st generation anti-histamine (H-1 blocker) anti-allgery drug, 第一代抗组胺药（Diphenhydramine， chlorphe’niramine 扑尔敏)副作用很多： 1) anti-muscarinic (pupillary dilation, dry mouth, urinary retention, constipation) 2) anti- alpha adrengenic 3) anti-serotonergic

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17
Q

DOC for absence seizure?

A

1st line: ethosuximide 2nd line: valproate

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18
Q

DOC for complex partial?

A

carbamazepine

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19
Q

DOC for eclampsia seizure?

A

子痫 DOC: MgSO4 can also use benzodiazepines (diazepam, lorazepam)

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19
Q

DOC for myoclonic seizures?

A

Valproic acid (sodium valprote)

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19
Q

DOC for myoclonic?

A

valproic acid

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20
Q

DOC for simple seizures?

A

carbamazepine

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21
Q

DOC of trigeminal neuralgia? mechanism? toxicity? 对P450影响？

A

carbamazepine inhibit Na+ channel toxicity: aplastic aneima, agranulocytosis (have to check CBC regularly) P450 inducer to ↑ metabolism of many drugs, so ↓ the drugs’ effectiveness

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21
Q

DOC for tonic-clonic?

A

phenytoin, carbamazepine, valproate

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22
Q

donepezil

A

多奈哌齐 (益智药） anticholinesterase, 增强胆碱能药物，treat AD

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23
Q

drug choice for HTN and BPH (benign prostatic hyperplasia)?

A

“osin” a1 blockers: relax VSMCs in arteries, also relax muscles around bladder neck and prostate

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24
Q

edrophonium

A

腾喜龙 [氯化腾喜龙试验诊断重症肌无力] Cholineasterase inhibitors

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25
Q

Epinephrin: receptor?

A

a1, a2, b1, b2 a1: constrict VSMCs in skin and viseral - increase BP b1: in heart, increase HR b2: dilate VSMCs in skeletal muscles - decrease diastolic BP (和a1作用正相反） Epi at low dose: b2 > a1 - decrease in diastolic BP Epi at high dose: a1 > b2 - increase in both systolic and diatolic BP

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27
Q

eplerenone: what drug is this? side effect?

A

newer generation of aldosterone inhibitor, most common side effect: gynecomastia (男子女性型乳房）

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28
Q

metyrosine

A

甲基酪氨酸，美替罗星 (降压药） 抑制tyrosine代谢为DOPA

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28
Q

flunisolide

A

氟尼缩松，9-去氟肤轻松 for asthma

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29
Q

flunisolide

A

9-去氟肤轻松[糖皮质激素] 用于inhalar for persistent bronchial asthema

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31
Q

Fluoxetine [flu:’oksetine]

A

氟西汀,百忧解 serotonin reuptake inhibitor, elongate the effect of serotonin, treat depression

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32
Q

Scopolamine [skou’polemin]

A

东莨菪碱; 天仙子碱 selective muscarinic R antagonist 治疗MG药物， pyridostigmine对GI的副作用

32
Q

Furosemide

A

“速尿“ loop diuretics,作用在亨利管 利尿mechanisms: 1) inhibit Na/K-2CL co-transporter in the ascending limp of the loop of Henle 2) stimulate PG release for vasodilation

33
Q

treatment for MG (myasthenia gravis)

A
  1. cholinesterase inhibitor (pyridostigmine 吡斯的明，美定隆）: has GI side-effect by stimulating the gut muscarinic cholinergic R. 胃肠道副作用用Scopolamine (selective muscarinic R antagonist)治疗， which won’t affect the act of pyridostigmine on nicotinic cholinergic R in muscle Note: 和Pilocarpine对比：pilocarpine is a non-selective muscarinic R antagonist, which will worsen the MG sym 2. immunosuppresent 3. thymectomy
33
Q

gemfibrozil

A

吉非贝齐, 调血脂药, 用于降TG one of the “fibrates”, to increase the cholesterol content of bile, can precipitate for gallstone formation similar risk for gallstone formation as the bile acid-binding resins (cholestyramine, colestipol, colesevelam)

34
Q

guanethidine

A

胍乙啶（一种降血压药） inhibit NE release

35
Q

haloperidol

A

氟派啶醇 抗精神病药 commonly used in agitation; the drug most commonly associated with NMS (neuroleptic malignant syn) 过度抑制dopamingergic （尤其是D2 receptor)引起 NMS4大特征：高温（dopaminergic系统调控体温，muscle tone/movement), 全身僵硬，autonomic instability, altered mental status 无法预防NMS， 出现症状后用bromocriptine （dopamine agonist) or dantrolene （肌松剂）治疗

36
Q

haloperidol

A

氟派啶醇 commonly used in agitation; the drug most commonly associated with NMS (neuroleptic malignant syn) 过度抑制dopamingergic （尤其是D2 receptor)引起 NMS4大特征：高温（dopaminergic系统调控体温，muscle tone/movement), 全身僵硬，autonomic instability, altered mental status

37
Q

If a pt with history of seizure and mental illness presents with gingival hyperplasia, which drug causes it? Mechanism of this drug? Use? toxicity?

A

Phenytoin Mechanism: inhibit Na+ channel Use: for partial seizures, tonic-clonic (grand mal) seizures, and status epilepticus toxicity: 1. very narrow therapeutic window 2. major CNS sym: ataxia + nystagmus 3. megablostic anemia 4. ↑ P450 activity, to decrease the blood level of many drugs (因为加快了其代谢） 5. 如果用于孕妇，fetal hydantoin syn 胎儿乙内酰脲综合征

38
Q

ipratropium

A

异丙托铵(支气管扩张药) muscarinic antagonist, 作用于呼吸系统。胆碱能系统激活时，支气管痉挛，所以拮抗剂会使气道扩张。 Dx: COPD, asthma

40
Q

isoproterenol

A

activate b1 and b2 - increase HR and decrease BP (dilate vessels)

41
Q

Lithium: 用途？副作用？

A

用途： mood stabilizer for bipolar; also SIADH side effects: “LMNOP”

42
Q

lorazepam clinical use？ mechanism? side effects? notes?

A

劳拉西泮,氯羟安定 DOC in status epilepticus （持续性癫痫） mechanism: ↑ GABAa action side effects: sedation, tolerance, dependence, respiratory depression notes: also for for eclampsia seizure (子痫; DOC: MgSO4)

44
Q

MAO

A

monoamino oxidase, degrade NE, DA and serotinin MAO inhibitors are used for depression

45
Q

MAOI: 包括哪些药（口诀）？ 机制？ Rx? toxicity? contradiction?

A

“MAO Takes Pride In Shanghai” Tranylcypromine: 反苯环丙胺 ‘phenelzine Isocarboxazid 异卡波肼 selegiline: 司来吉兰 (selective for MAO-B) 机制: non-selective inhibition of MAO - ↑ amine neurotransmitters (NE, 5-HT, DA) Rx: 1) atypical depression 2) anxiety 3) hypochondriasis 疑病[症] toxicity: 1) hypertensive crisis (if digest tyramine from wine and cheese) 2) CNS stimulation contradiction: SSRIs, TCAs, meperidine (哌替啶; 度冷丁), and dextramethorphan 右甲吗南, (鸦片类镇咳药)

46
Q

mestranol [`mestrənɔl] 同类药物还包括？ Mx Use Toxicity

A

美雌醇，为口服激素避孕药中的雌激素成分

47
Q

methacholine

A

muscarinic chonlinergic agonist induce bronchial SMC contraction - induce asthma mechacholine challenge test: Dx for asthma

48
Q

drug selection for isolated HTN? for HTN + DM? list side effects: 1. doxazosin 2. propranolol 3. ramipril 4. hydrochlorothiazide 5. elephenone 6. verapamil 7. amlodipine 8. isosorbide dinitrate

A

for isolated HTN: thiazide diuretics + DHP CCB (dihydropyridine CCB, such as Amlodipine) for HTN + DM: ACE I or ARB side effects: 1. a1 selective blocker: 1st dose hypotension 2. non-selective b blocker: asthma, bradycardia, worsen peripheral vascular disease 3. ACE I: angioedema (swollen of lips, 舌, - 与peripheral edema 如flushing + ankle swelling区别）， cough, 1st-dose hypotension 4. 1st line anti-HTN drug? 5. aldosterone inhibitor: gynecomastia 男性乳房女性型化 6. CCB more selective to heart: constipation, gingival hyperplasia 7. CCB selective for vessels: flushing, peripheral edema 8. nitrates: headache, contraindicated for drugs for ED (the PDE inhibitors “fil”s

49
Q

methotrexate

A

甲氨喋呤 (MTX), DOC for early (< 6wks gestational age) ectopic pregnancies irreversibly inhibits DHF reductase

51
Q

Prazosin

A

哌唑嗪,降压新 alpha-1 adrenergic antaognist

52
Q

mirtazapine

A

米尔塔扎平(抗抑郁症) de-inhibit the a2 R

53
Q

finasteride [fi’nasteride]

A

非那司提(治疗良性前列腺增生) 5 a-reductase inhibitor 同类药有dutasteride

54
Q

niacin: use, side effect and drug interacitons

A

used to decrease LDL side effect: when niacin is initiated, most patients experience warmth, flushing, itchiness of the skin - caused by prostaglandins - can be relieved by giving aspirin 30 min before administration interact with anti-HTN drugs: niacin is a vasodilator interact with anti-DM drugs: increase insulin resistance

56
Q

niacin: use, side effect and drug interacitons

A

used to decrease LDL side effect: when niacin is initiated, most patients experience warmth, flushing, itchiness of the skin - caused by prostaglandins - can be relieved by giving aspirin 30 min before administration interact with anti-HTN drugs: niacin is a vasodilator interact with anti-DM drugs: increase insulin resistance can increase uric acid - watch out for gout patient!

58
Q

nitroprusside: use, toxicity, antitode

A

硝普盐，rapid-onset visodilator (within 30 sec), used in emergency to control BP; metabolized to NO and cyanide； cyanide metabolized by the liver (adding a sulfur) to form thiocyanate; major risk is cyanide toxicity; give sulfur to enhance conversion of cyanide to thiocynate

59
Q

NMS: Cx? Rx?

A

neuroleptic malignant syndrome: 抗精神病药的恶性综合征:一种罕见的有时是致死的反应,特点为高烧、强直及昏迷 Cx: “FEVER”: Fever, Encephalopathy Vitals unstable Enzyme ↑ (myoglobinuria) Rigidity of muscles Rx: dantrolene 肌松药 + D2 agonists (bromocriptine)

61
Q

NSAID

A

diclofenac: 双氯芬酸, 双氯灭痛 indomethacin : 吲哚美辛. 消炎痛 piroxicam: 吡罗昔康,吡氧噻嗪,炎痛喜康 reversibly inhibit COX1 and COX2

62
Q

Reserpine

A

利血平 利舍平对NE神经末梢中的囊泡膜具有很高的亲和力，能与囊泡膜上胺泵（依赖于Mg2+-ATP的胺类主动转运机制）呈难逆性结合，使囊泡膜失去摄取和贮存去甲肾上腺素和多巴胺的能力，从而使囊泡内递质的合成与贮存逐渐减少，以至耗竭，使去甲肾上腺素能神经冲动传递受阻，从而产生降压作用并伴有心率减慢。

63
Q

pen’tazocine: 什么药？ Mechanism? side effect?

A

喷他佐辛; 镇痛新 opioid narcotic with partial agonist activity + weak antagonist activity at mu receptor; 能有效镇痛，但是很少abuse potential side effect: cause withdrawal sym in pts who are dependent or tolerant to morphine or other opioids

65
Q

phenoxybenzamine

A

苯氧苯扎明, 苯氧苄胺(降压药) non-selective alpha-adrenergic antagonist, treat pheochromocytoma

66
Q

Phentolamine

A

non-selective a1, a2 blockers

68
Q

Phenylephrine

A

selective a-agonist, stimulate both a1, a2

69
Q

Phenytoin: when used for epilepsy, for what kind?？ mechanism? kinetics? side effects? notes?

A

when used for epilepsy, for what kind： all partial (simple, complex) and tonic-clonic [1st line], status epilepticus [1st line + DOC for prophylaxis] mechanism: ↑ Na+ channel inactivation; kinetics: zero order side effects: ↑ P450, Stevens-Johnson syn [(SJS) is a milder form of toxic epidermal necrolysis (TEN)], SLE-like syn, teratogenesis, notes: Fosphenytoin for parenteral use

70
Q

polyethylene glycol

A

聚乙二醇, osmotic laxative

71
Q

G-protein class with receptors for sympathetic, para, etc： 记忆口诀？

A

QISS (kiss) and QIQ (kik) till you are SIQ (sick) of sqs (super kincky sex) QISS = sympathetic Receptors α1, α2,β1, β2 QIQ = parasympathetic Receptors M1, M2, M3 SIQ SQS = dopamine D1, D2, Histamine H1, H2, vasopressin V1, V2

72
Q

downstream signaling for Gq?

A

R → PLC → lipids converted into PIP2 → DAG / PKC, and IP3 (【Ca2+]in

73
Q

Rx: ADHD?

A

methylphenidate 哌醋甲酯,利地林

74
Q

Rx: alcohol withdrawal

A

BZDs

75
Q

Rx: anxiety

A
  1. SSRIs (-etine, ie: flurexine; pa’roxetine, sertraline, citalopram: “flashback paralyzed senior citizens” 2. SNRIs (Venlafaxine 文拉法辛, duloxetine 度洛西汀) 3. busprione
75
Q

Rx: bipolar

A
  1. Mood stabilizers: Lithium, Valproic acid carbamazepine 2. atypical antipsychotics
76
Q

Rx: bulimia

A

神经性贪食症 SSRIs (flurexine; pa’roxetine, sertraline, citalopram: “flashback paralyzed senior citizens”)

77
Q

Rx: depression 如果合并失眠用什么药？

A
  1. SSRIs 2. SNRIs 3. TCAs 4. bupropion 5. mirtazapine 米尔塔扎平(抗抑郁症) - used when depression + insomnia
78
Q

Rx: OCD?

A

obsessive-compulsive disorder SSRIs clomipramine 氯丙咪嗪,海地芬[抗抑郁药, 一种TCA] TCA ends with -ipramine or -iptyline

79
Q

Rx: Panic disorder

A
  1. SSRIs 2. venlafaxine (文拉法辛, 一种SNRI) 3. BZDs
80
Q

Rx: PTSD

A

SSRIs (flurexine; pa’roxetine, sertraline, citalopram: “flashback paralyzed senior citizens”) most effective is therapy!

81
Q

Rx: social phobias?

A
  1. SSRIs (flurexine; pa’roxetine, sertraline, citalopram: “flashback paralyzed senior citizens”) 2. b-blockers
82
Q

Rx: Tourette syn

A

antipsychotics (haloperidol, risperidone)

83
Q

side effect and drug interaction of niacin?

A

gout facial flushing and warmth (can be prevented by aspirin, mediated by prostagladin) can dilate arteries - if combined with anti-HTN drug, have to lower the dose can increase insulin resistance - if combined with anti-DM drugs, have to increase the dose

83
Q

side effect of niacin?

A

gout facial flushing and warmth (can be prevented by aspirin, mediated by prostagladin)

85
Q

side effects of statins?

A

myopathy; hepatitis

86
Q

SSRIs: (specific serotonin reuptake inhibitors) “Flashbacks Paralyze Senior Citizens”

A

flu’oxetine： 氟西汀,百忧解 pa’roxetine: ,帕罗西丁 ‘sertraline: 舍曲林 citalopram: 西酞普兰

87
Q

summary of side effects of chemo drugs

A

vincristine: 外周神经毒性 neurotoxicity (interfere with microtubule formation in the nerve axons)- finger numbness and tangling cyclophosphamide : 出血性膀胱炎 burning on urination and urgency (cyclophosphamide- or ifosfamide-induced hemorrhagic cystitis) cisplatin： 肾毒性 （生成ROS, 损伤肾小管）， 预防需要1）IV 大剂量生理盐水； 2）amifostine: thiol-based free-radical scavenger methotrexate (MTX) overdose: leucovorin (folinic acid) to treat vomit and nausea: 5-HT3 receptor antagonists (-setrons, such as ondansetron, granisetron, dolasetron) “tumor lysis syn”: 电解质紊乱+急性肾衰， 解毒用aggressive hydration + alkalinization of the urine + allopurinol (别嘌呤醇) Mesna: prevent hemorrhagic cystitis in patients receiving cyclophosphamide or ifosfamide; Mesna binds acrolein, the toxic metabolite formed by these agents.

89
Q

Tardive dyskinesia: 什么药物的副作用？

A

抗精神病药

91
Q

TCA: 词尾？以及2个特例？ 机制？ Rx? toxicity?

A

词尾: - ipramine (imipramine, desipramine, clomipramine) - iptyline (amitriptyline, - 3°TCA; nortriptyline -2°TCA) 2个特例: ‘doxepin 多虑平; amoxapine 阿莫沙平 机制: inhibit both NE and 5-HT re-uptake Rx: 1) major depression 2) OCD (clomipramine 氯丙咪嗪) 3) fibromyalgia 纤维肌痛 toxicity: TCA = Tir-C’s (convulsion, coma, cardiotoxicity)

92
Q

terbinafine

A

特比萘芬, 疗霉舒

93
Q

trazodone

A

曲唑酮,三唑酮 inhibit 5-HT re-uptake: anti-depressent

94
Q

O’meprazole

A

奥美拉唑 proton pump inhibitor, inhibit the H/K ATPase → ↓ of [HCL] in the gastric lumen

95
Q

typical antipsychotics: 包括哪些？其中哪些high potency? 哪些low potency?-各自副作用？ 机制？用途？ 药代动力学特点？ toxicity? 最特别和致命的toxicity?

A

包括哪些： haloperidol + “-azines” high potency: “Try to Fly High” (trifluoperazine, fluphenazine, haloperidol) - neurological side effects low potency: “Cheating Thieves are low) (chlorpromazine 氯丙嗪, thioridazine 硫利达嗪; 机制: block D2 receptor, ↑ [cAMP] 用途: schizophrenia, psychosis, acute mania, Tourette syn 药代动力学特点： high lipid soluble, very slow to clear Toxicity: 1. extrapyramidal system (EPS): dyskinesia 2. endocrine (DA antagonism): hyperprolactinemia, 这些病人常有泌乳；galactorrhea 3. anti muscarinic (dry mouth, constipation) 4. anti-alpha 1 (hypotension) 5. anti-histamine: sedation 最特别和致命的toxicity: NMS, tardive dyskinesia

96
Q

Venlafaxine 什么药？用途？toxicity?

A

文拉法辛 SNRI，inhibit both NE and 5-HT re-uptake 用途：1) depression 2) generalized anxiety disorder 3) panic disorder toxicity: increase BP

97
Q

wafarin drug interaction

A

enhancers for cytochrome P-450 (therefore decrease efficacy of warfarin): rafampicin 利福平, phenobarbital, phenytoin [记忆法：RPP enhance my score】 inhibitors for cytochrome P-450 (therefore enhance efficacy of warfarin): amiodarone, cimentidine, TMP-SMX (trimethoprim-sulfamethoxazole)复方新诺明 【记忆法：ACT]

Step 1 notes (22 decks)

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