Pharmacology Flashcards
Alpha-1
Gq
* Vascular smooth muscle, pupillary dilator contraction, intestinal and bladder sphincter contraction
Alpha-2
Gi
* Decrease insulin, lipolysis, sympathetic outflow, increase platelet aggregation
Beta-1
Gs
* HR, contractility, renin, lipolysis
Beta-2
Gs
* Vasodilation, bronchodilation, increased HR, contractility, lipolysis, insulin; decreased uterus tone, increased aq. humor, ciliary muscle relaxation
M1
Gq
* CNS, enteric
M2
Gi
* HR/atria
M3
Gq
* Exocrine, miosis, accommodation (ciliary muscle contraction)
D1
Gs
* Relaxes renal vascular smooth muscle
D2
Gi
* Modulate transmitter release (brain)
H1
Gq
* Nasal and bronchial mucus production, contraction bronchioles, pruritis, pain
H2
Gs
* Gastric acid
V1
Gq
* Vascular smooth muscle contraction
V2
Gs
* Collecting tubules (2 kidneys)
- Match
DAG/PKC
IP3/Ca
DAG = PKC IP3 = Ca2+
Protein kinase A –>
Myosin light chain kinase (smooth muscle)
MOA Amphetamine
Releases stored catecholamines
Indirect sympathomimetics (3)
- Amphetamine
- Ephedrine
- Cocaine
MOA Ephedrine
Releases stored catecholamines
Uses Amphetamine
Narcolepsy, obesity, ADHD
Uses Ephedrine
Nasal decongestion, urinary incontinence, hypotension
MOA Cocaine
Reuptake inhibitor
Uses cocaine
Vasoconstriction/local anesthesia
You should never give beta-blockers with cocaine intoxication because…
Can lead to unopposed alpha-1 activation and extreme hypertension
Antidote to acetaminophen toxicity
N-acetylcysteine (replenishes glutathione)
Antidote to salcylates toxicity
NaHCO3 (alkalinize urine), dialysis
Antidote to amphetamine toxicity
Nh4Cl (acidify the urine)
Antidote to AchE inhibitor (OP) toxicity
Atropine, pralidoxime
Antidote to anti-muscarinic toxicity
Physostigmine salicylate, control hyperthermia
Antidote to beta-blocker toxicity
Glucagon
Antidote to digitalis toxicity
KLAM
- Normalize K
- Lidocaine
- Anti-dig Fab
- Mg2+
Antidote to Fe toxicity
Deferoxamine, deferasirox
Antidote to lead poisioning
EDTA, dimercaprol, succimer, penicillamine
Antidote to mercury, arsenic, gold
Dimercaprol, succimer
Antidote to Cu, arsenic, gold
Penicillamine
Antidote to CN toxicity
Nitrate + thiosulfate; hydroxocobalamin
Antidote to Methemeglobin
Methylene blue, vitamin C
Antidote to CO toxicity
O2
Antidote to methanol, ethylene glycol toxicity
Fomepizole > ETOH, dialysis (alcohol DH)
Antidote to opioid toxicity
Naloxone, Naltrexone
Antidote to benzo toxicity
Flumazenil
Antidote to TCA toxicity
NaHCO2 (plasma alk)
Antidote to heparin toxicity
Protamine
Antidote to warfarin toxicity
Vitamin K, FFP
Antidote to TPA/streptokinase/urokinase toxicity
Aminocaproic acid
Antidote to theophylline toxicity
Beta-blocker
Sulfa drugs
Popular FACTSSS
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazide, Sulfonamide, Sulfasalazine, Sulfonurea
Patients with sulfa allergy may develop…
Fever, UTI, pruritic rash, SJ, hemolytic anemia, TBO, agranulocytosis, hives
P450 Inducers
APPCR (Chronic ETOH, phenytoin, phenobarbital, carbamazepine, rifampin)
Modafinil
St. John’s Wort
Griseofulvin
P450 Inhibitors
MAGIC RACKS GQ
Macrolides, Amiodarone, Grapefruit juice, INH, Cimetidine, Ritonavir, acute ETOH, Cipro, Azoles, Sulfonamides, Gemfibrozil, Quinidine
ADR: Coronary vasospasm (3)
Cocaine, sumatriptan, ergot alkaloids
ADR: Cutaneous flushing (4)
VANC
Vancomycine, Adenosine, Niacin, CCB
ADR: Dilated cardiomyopathy (2)
Doxorubicin (Adriamycin), Daunorubicin
ADR: TDP (2)
Class IA: Quinidine
Class 3: Sotalol
ADR: Agranulocytosis (6)
Clozapine, Carbamazepine, Colchicine, Dapsone, PTU, Methimazole
ADR: Aplastic anemia (5)
Chloramphenicol, benzene, NSAIDS, PTU, Methimazole
ADR: AIHA (Direct Coombs positive)
Methyldopa, penicillin
ADR: Gray baby syndrome (1)
Chloramphenicol
ADR: Hemolysis in G6PD patients (5)
IS PAIN
INH, Sulfonamides, Primaquine, ASA, Ibuprofen, Nitrofurantoin
ADR: Megaloblastic anemia (3)
Phenytoin, MTX, Sulfa drugs
ADR: Thrombotic complications
OCP’s (estrogens)
ADR: Cough
ACE inhibitors (not ARB’s)
ADR: Pulmonary fibrosis (3)
Amiodarone, Bleomycin, Busulfan
ADR: Acute cholestatic hepatitis, jaundice (1)
Erythromycin
ADR: Focal to massive hepatic necrosis (4)
HAVAc
Halothane, Amantia phalloides, Valproate, Acetaminophen
ADR: Hepatitis
INH
ADR: C. diff (2)
Clindamycin, ampicillin
ADR: Adrenocortical insufficiency (1)
GC withdrawal
ADR: Gynecomastia (6)
Some Drugs Create Awkward Knockers
Spironolactone, Digitalis, Cimetidine, ETOH (chronic), Estrogens, Ketoconazole
ADR: Hot flashes (2)
Tamoxifen, clomiphene
ADR: Hyperglycemia (5)
Niacin, Tacrolimus, Protease inhibitor, HCTZ, CS
ADR: Hypothyroidism (3)
Lithium, amiodarone, sulfonamides
ADR: Fat redistribution (2)
PI, GC
ADR: Gingival hyperplasia (2)
Phenytoin, Verapamil
ADR: Gout
Furosemide, Thiazides, Niacin, Cyclosporin
ADR: Osteoporosis
Heparin, CS
ADR: Anti-muscarinic (4)
Atropine, TCA, H1 blocker, neuroleptics
ADR: Disulfram-like reaction
Metronidazole, CS, Procarbazine, 1st generation sulfonureas
ADR: Nephro/ototoxicity
AG, Vanco, Loop diurectics, cisplatin
ADR: Tardive dyskinesia
Antipsychotics
ADR: Seizures
I BITE My tongue
INH, Bupropion, Imipenim/cilastatin, Tramadol, Enflurane, Metoclopramide
ADR: Parkinson’s
Antipsychotics, reserpine, metoclopramide
ADR: Cinconism
Quinidine, quinine
ADR: SIADH
Carbamazepine, Cyclophosphamide
ADR: I/S nephritis
Methicillin, NSAIDS, Ferosemide
ADR: Hemorrhagic cystitis
Cyclo/Ifosfamide (mesna)
ADR: Fanconi’s syndrome
Expired tetracycline
ADR: DI
Lithium, democlocycline
ADR: Tendonitis, tendon rupture, cartilage damage
FQ’s
ADR: Teeth kids
Tetracyclines
ADR: SLE-like syndrome
HIPP
Hydralazine, INH, Procainamide, Phenytoin
ADR: Myopathy
Fibrates, Niacin, Colchicine, Hydroxychloroquine, IFN-alpha, Penicillamine, Statins, GC
ADR: Osteoporosis (2)
CS, heparin
ADR: Photosensitivity (3)
Sulfonamides, Tetracycline, Amiodarone
ADR: SJ/Rash
PEC SLAPP
Penicillin, Ethosuximide, Carbamazepine, Sulfa, Lamotrigine, Allopurinol, Phenytoin, Phenobarbital
Platelet aggregation inhibitors (4 classes)
- COX inhibitors: ASA
- PDE inhibitors: Dipyramidole, Cilastazol
- ADP R blockers: Clopidogrel, Ticlopidine,
- Gp2b/3a blockers: Abciximab, Eptifibratide, Tirofiban
ADP receptor blockers (4)
Clopidogrel, Ticlopidine, Ticagrelor, Prasugrel
Clopidogral and Omeprazole interaction
Omeprazole inhibits CYP and clopidogrel requires CPY2C19 to be activated
Four classes of anti-coagulants
- Indirect thrombin (UFH) & 10 ( LMWH = Fondaparinaux, Enoxaparin/Dalteparin/Tiazaparin)
- DTI (Lepirudin, Bivalirudin, Argatroban PO = dabigatrin etexilate)
- D10I (Rivaroxiban, Apixiban)
- Courmarin (Warfarin)
Thrombolytics
SK, UK, Alteplase, Reteplase, Tenecleplase
Chemical antagonist of heparin
Protamine sulfate
TPAi drug
Aminocaproic acid
Describe HIT
Heparin complexes with platelet factor 4; anti-IgG Ab attack and deposit on platelets; more Factor 4 released.
d/c heparin; DTI/Fondaparinaux & protamine sulfate
Part of nephron: CAI
Uses
AE’s
PCT: Acetazolamide
Use: metabolic alkalosis, mountain sickness, glaucoma, pseudotumor cerebri
AE: metabolic acidosis
Drug used in treatment of pseudotumor cerebri
Acetazolamide