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First Aid Step 1 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

sympathetic alpha-1 R (Gp-q): fxns

A
  • vascular sm muscle contraction
  • pupil dilation
  • intestine and bladder sphincter contraction
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2
Q

sympathetic alpha-2 R (Gp-i): fxns

A
  • decreases sympathetic outflow
  • decreases insulin release and lipolysis
  • incr plt aggregation
  • decr aqueous humor production (eye)
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3
Q

sympathetic beta-1 R (Gp-s): fxns

A
  • incr HR
  • incr heart contractility (inotropy)
  • incr renin release (to incr BP via incr ADH, thirst, and vasoconstriction)
  • incr lipolysis
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4
Q

sympathetic beta-2 R (Gp-s): fxns

A
  • vasodilation
  • bronchodilation
  • incr insulin release and lipolysis
  • decr uterine tone (tocolysis)
  • ciliary muscle relaxation (opp of accommodation), incr aqueous humor production
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5
Q

parasympathetic M1 R (Gp-q): fxns

A

Works on CNS and enteric nervous system

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6
Q

parasympathetic M2 R (Gp-i): fxns

A
  • Decreases HR

- Decr atrial contractility

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7
Q

parasympathetic M3 R (Gp-q): fxns

A
  • incr exocrine gland secretions (lacrimal, salivary, gastric acid)
  • incr gut peristalsis
  • incr bladder contraction
  • bronchoconstriction
  • pupil constriction
  • ciliary muscle contraction (Accommodation)
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8
Q

Dopamine D1 R (Gp-s): fxns

A
  • relaxes renal vascular smooth muscle
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9
Q

Dopamine D2 R (Gp-i): fxns

A
  • modulates NT release
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10
Q

Histamine H1 R (Gp-q): fxns

A
  • incr nasal and bronchial mucus production
  • incr vascular permeability
  • bronchiole contraction
  • pruritis
  • pain
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11
Q

Histamine H2 R (Gp-s): fxns

A
  • incr gastric acid secretions
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12
Q

Vasopressin V1 R (Gp-q): fxns

A
  • contracts vascular smooth muscle
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13
Q

Vasopressin V2 R (Gp-s): fxns

A
  • incr H2O permeability and reabsorption in collecting tubules
  • V”2” for H”2”O reabsorption in collecting “TU”bule
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14
Q

Gq pathway (for H1, Alpha1, V1, M1, M3 = HAVe 1 M&M)

A

R –Gq-> PLC –> breaks lipids into DAG (-> PK3) and IP3 -> increase Ca2+ –> incr smooth muscle contraction

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15
Q

Gs and Gi pathway

A

R –Gs/i-> Adenylyl cyclase –> turns ATP to cAMP –> PKA –> incr Ca in heart –> incr heart contractility

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16
Q

MOA of botulinum

A

blocks ACh release from presynaptic cholinergic neuron at NMJ

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17
Q

MOA of physostigmine, rivastigmine, galantamine, donepezil, edrophonium, neostigmine (and caffeine!)

A

AchEI

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18
Q

MOA and use of: Bethanechol

A

Cholinomimetic (Ach)

- activates bowel, bladder: for post-op or neurogenic ileus, urinary retention

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19
Q

MOA and use of: Carbachol

A

Ach copy

- constricts pupil, relieves intraocular P: for glaucoma

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20
Q

MOA and use of: Methacholine

A

Stimulates Musc Ach Rs in airway (constricts)

- challenge test for asthma dx

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21
Q

MOA and use of: pilocarpine

A

Contracts ciliary muscle of eye (for open-angle glaucoma), pupillary sphincter (for closed-angle glaucoma)
- potent stimulatory of sweat, tears, saliva (“cry, sweat, and drool on your PILOow”)

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22
Q

Use of donepezil/galantamine/rivastigmine

A

incr Ach for Alzeheimer Disease

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23
Q

Use of edrophonium

A

Old dx for MG (now test for Anti-AChR Ab)

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24
Q

Use of neostigmine

A

No CNS penetration, so use for postop/neurogenic ileus and urinary retention, postop reversal of NMJ blockade, and MG tx

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25
Use of Physostigmine
Crosses BBB, used to "phy"x atropine OD: incr Ach for anticholinergic toxicity antidote
26
Use of Pyridostigmine
Incr Ach and muscle strength, long acting MG tx (no CNS penetration) "pyRIDostiGMine gets RID of MG"
27
S/E of cholinomimetic drugs
Exacerbation of COPD, asthma, peptic ulcers
28
Cholinergic toxicity
``` 2/2 AchEi toxicity or organophosphates (irreversibly inhibit AChE): DUMBBELSS Diarrhea Urination Miosis (big pupils) Bronchospasm Bradycardia Excitation of muscle and CNS Lacrimation Sweating Salivation ```
29
cholinergic toxicity antidote (2)
atropine (competitively inhibits) | pralidoxime (regenerates AChE if given early)
30
MOA and use of: Atropine
MOA: muscarinic Ach antagonist | - dilate pupil, and antidote for cholinergic toxicity
31
MOA and use of: Benztropine
MOA: musc Ach antagonist (CNS) | -for PD-acute dystonia ("park my Benz")
32
MOA and use of: Glycopyrrolate
MOA: musc Ach antagonist (GI, resp) - oral: for drooling, peptic ulcer - parenteral: preop to reduce airway secretions
33
MOA and use of: Ipratropium, tiotropium
MOA: musc Ach antag (resp) - for COPD, asthma "I PRAy I can breathe soon"
34
MOA and use of: Oxybutynin, tolteridone
MOA: Musc Ach antagonist (GU) | - reduce bladder spasms and urge incontinence
35
MOA and use of: Scopolamine
Musc Ach antagonist (CNS) | - for motion sickness
36
Anticholinergic toxicity
2/2 Atropine, Jimson weed (Datura) "Can't pee, can't see, can't spit, can't shit" - hyperthermia, tachycardia, dry mouth, dry/flushed skin, no sweating, mydriasis (big pupils), constipation, AMS
37
R action and use of: Albuterol, Salmeterol
Sympathomimetic: B2 > B1 - Albuterol: acute asthma - Salmeterol: chronic asthma or COPD control
38
R action and use of: Dobutamine
Sympathomimetic: B1 > B2, a | - for HF (inotropic > chronotropic), cardiac stress testing
39
R action and use of: Dopamine
Sympathomimetic: D1 = D2 > B > a - for unstable bradycardia, HF, shock - inotropic and chronotropic (alpha effects) at high doses
40
R action and use of: Epi
Sympathomimetic: Beta > alpha - for anaphylaxis, asthma, open-angle glaucoma - alpha effects at high doses - B2 effects much stronger than NE * alpha blockage causes BP depression b/c of B2 action (vs phenylephrine which is only effect-suppressed)
41
R action and use of: Isoproterenol
Sympathomimetic: B1=B2 | - EP eval of tachyarrhythmias
42
R action and use of: NE
Sympathomimetic: a1 > a2 > B1 | - for hypotension (but will decr renal perfusion)
43
R action and use of: Phenylephrine
Sympatomimetic: a1 > a2 - vasoconstriction (for hypotension) - dilates pupils for eye procedures - decongestant * not as susceptible to alpha blockage as Epi (get suppression of pressor effect, but no net BP depression b/c has no B2 action)
44
action of alpha-1 adrenergic receptors (NE > Epi)
- smooth muscle contraction - pupil dilation (mydriasis) - skin, mucosa and GI/GU vasoconstriction/sphincter constriction
45
action of alpha-2 adrenergic receptors (Epi > NE)
- smooth muscle mixed effects | - platelet activation
46
action of beta-1 adrenergic receptors (Epi=NE)
+ chronotropy + incr intropy + incr amylase secretion
47
action of beta-2 adrenergic receptors (Epi)
smooth muscle relaxation (ex bronchodilation)
48
MOA and use of: amphetamine
indirect sympathetic general agonist, reuptake inhibitor, releases stored catecholamines - for: narcolepsy, obesity, ADHD
49
MOA and effects of: cocaine
indirect sympathetic general agonist and reuptake inhibitor - causes: vasoconstriction and local anesthesia - don't give BB w/cocaine CP b/c can cause unopposed alpha1 action -> extreme HTN
50
MOA and use of: ephedrine
indirect sympathetic general agonist, releases stored catecholamines - for: nasal decongestant, urinary incontinence, hypotension
51
NE effect on BP and HR
NE increases SBP and DBP (from alpha1 vasoconstriction) --> incr MAP --> reflex bradycardia
52
Isoproterenol effect on BP and HR
Isoproterenol causes B2 vasodilation --> decr MAP --> incr HR via B1 and reflex activity
53
MOA and use of: Clonidine
``` a2 agonist (sympatholytic) - for HTN urgency, ADHD, Tourette syndrome ```
54
sympatholytic toxicity
Clonidine: CNS depression, bradycardia, hypotension, resp depression, miosis alpha-methyldopa: direct coombs+ hemolysis, SLE_like syndrome
55
MOA and use of: Phenoxybenzamine
MOA: irreversible nonselective alpha blocker | - for pheos (to prevent catecholamine-HTN crisis)
56
MOA and use of: Phentolamine
MOA: reversible nonselective alpha blocker | - for pts on MAOIs who eat tyrosine foods
57
alpha blocker S/Es (2)
``` orthostatic hypotension (w/a1 specific, only w/1st dose) reflex tachycardia ```
58
MOA and use of: Prazosin, Terazosin, Doxazosin, Tamsulosin (and S/E's)
MOA: alpha1-selective blockers (-osin endings) - for BPH, PTSD (prazosin), HTN (except tamsulosin) S/E: can get HA and orthostasis (1st use), dizziness
59
MOA and use of: Mirtazepine (and S/E's)
MOA: alpha2-selective blocker - for: depression - S/E: sedation, incr appetite/wt gain (and incr chol)
60
MOA of Bb effects on: angina
decr heart rate and contractility --> decr O2 consumption
61
Bb effects on: MI (metoprolol, carvedilol, bisoprolol) and chronic HF
decrease mortality
62
MOA of Bb effects on: SVT (metop, esmolol)
decr AV conduction velocity (class II antiarrhythmic)
63
MOA of Bb effects on: HTN
decr CO, decr renin secretion (due to B1-blockade on JGA cells)
64
MOA of Bb effects on glaucoma (timolol)
decr secretion of aqueous humor
65
Bb toxicity
impotence, bradycardia, AV block, Sz, sedtion, asthma/COPD exacerbation
66
B1 selective blockers (B1 > B2): in 1st half of alphabet (A to M)
acebutolol (partial ag), atenolol, betaxolol, esmolol metoprolol
67
Nonselective Bbs (B1=B2): in 2nd half (N to Z)
nadolol, pindolol (partial ag), propranalol, timolol
68
nonselective alpha and beta antagonists (modified "olol" to -ilol or -alol)
carvedilol, labetalol
69
Antidote to acetaminophen toxicity
N-acetylcysteine (NAC) - replenishes glutathione
70
Antidote to cholinergic toxicity (2/2 AchEi toxicity or organophosphates)
Atropine > Pralidoxime
71
Antidote to amphetamine toxicity
NH4Cl (ammonium chloride) to acidify urine and let the basic amphetaines be excreted
72
Antidote to anticholinergic (antimuscarinic) toxicity
physostigmine salicylate + control hyperthermia
73
Antidote to benzo toxicity
flumazenil
74
Antidote to BB toxicity
Glucagon
75
Antidote to CO poisoning
100% O2, hyperbaric O2
76
Antidote to Cu, Arsenic, gold toxicity
Penicillamine (chelator)
77
Antidote to cyanide poisoning
Nitrite + thiosulfate, hydroxocobalamin
78
Antidote to Digitalis/Digoxin toxicity
Anti-dig Fab fragments
79
Antidote to heparin toxicity
protamine sulfate
80
Antidote to Iron toxicity
Deferoxamine, Deferasirox
81
Antidote to lead poisoning
EDTA, dimercaprol succimer (combines w/lead in the body), penicillamine
82
Antidote to mercury poisoning (also works for arsenic and gold)
Dimercaprol (BAL), succimer
83
Antidote to Methanol, Ethylene Glycol (antifreeze) poisoning
Fomepizole > ethanol, dialysis
84
Antidote to methemoglobinemia
Methylene blue, Vit C
85
Antidote to Opioid toxicity
Naloxone, Naltrexone
86
Antidote to salicylate (ASA) toxicity
NaHCO3 (to alkalinize urine), dialysis
87
Antidote to TCA toxicity
NaHCO3 (to alkalinize plasma)
88
Reversal of tPA, streptokinase, urokinase
aminocaproic acid
89
Antidote to warfarin toxicity
Vit K (delayed effect) + FFP (immediate)
90
What drugs can cause coronary vasospasm (drug rxn)?
cocaine, sumitriptan and ergot alkaloids (for migraines)
91
What drugs can cause cutaneous flushing (drug rxn)?
Vancomycin, Adenosine, Niacin, CCBs ("VANC")
92
What drugs can cause dilated cardiomyopathy (drug rxn)? - and how to prevent it?
anthracyclines (doxorubicin, daunorubicin) - prevent w/dexrazoxane
93
What drugs can cause TdP (drug rxn)?
Class III (sotalol, amiodarone) and class IA (quinidine, procainamide) antiarrhythmics, macrolide abx (erythromycin, azithro), APs, TCAs
94
What drugs can cause adrenal insufficiency (drug rxn)?
glucocorticoids, on withdrawal (HPA suppression)
95
What drugs can cause hot flashes (drug rxn)?
tamoxifen, clomiphene
96
What drugs can cause hyperglycemia (drug rxn)?
tacrolimus, protease inhibitors, niacin, HCTZ, corticosteroids
97
What drugs can cause hypothyroidism (drug rxn)?
Li, amiodarone, sulfonamides
98
What drugs can cause acute cholestatic hepatitis w/jaundice (drug rxn)?
erythromycin
99
What drugs can cause diarrhea (drug rxn)? | - ("May Excite Colon On Accident")
Metformin, Erythromycin, Colchicine, Orlistat, Acarbose
100
What drugs can cause focal to massive hepatic necrosis (drug rxn)? - (liver "HAVAc")
Halothane, Amanita phalloides (death cap mushrooms), VPA, Acetaminophen
101
What drugs can cause hepatitis (drug rxn)?
TB drugs (rifampin, isoniazid, pyrazinaminde), statins, fibrates
102
What drugs can cause pancreatitis (drug rxn)? | - "Drugs Causing A Violent Abdominal Distress"
Didanosine (ART), Corticosteroids, Alcohol, VPA, Azathioprine, Diuretics (furosemide, HCTZ)
103
What drugs predispose to C diff?
Clindamycin, ampicillin, cephalosporins
104
What drugs can cause agranulocytosis (drug rxn)? | - "Gangs CCCrush Myeloblasts and Promyelocytes"
Ganciclovir, Clozapine, Carbamazepine, Colchicine, Methimazole, Propylthiouracil
105
What drugs can cause aplastic anemia (drug rxn)? | - "Cant Make New Blood Cells Properly"
Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol Propylthiouracil
106
What drugs can cause direct coombs+ hemolytic anemia (drug rxn)?
methyldopa, PCN
107
What drug causes gray baby syndrome (drug rxn)?
chloramphenicol
108
What drugs can cause hemolysis in G6PD? | - "hemolysis IS D PAIN"
Isoniazid, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprifen, Nitrofurantoin
109
What drugs can cause megaloblastic anemia (drug rxn)? | - "having a --blast-- with PMS"
Phenytoin, Methotrexate, Sulfa drugs
110
What drugs can cause thrombocytopenia (drug rxn)?
heparin (HIT)
111
What drugs are pro-thrombotic (not intended effect)?
OCPs, HRT
112
What drugs can cause fat redistribution (drug rxn)?
PIs, glucocorticoids
113
What drugs can cause gingival hyperplasia (drug rxn)?
phenytoin, CCBs, cyclosporine
114
What drugs can cause gout/hyperuricemia (drug rxn)? | - "Painful Tophi and Feet Need Care"
Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine
115
What drugs can cause myopathy (drug rxn)?
Fibrates, niacin, colchicine, hydroxychloroquine, IFN-a, penicillamine, statins, GCs
116
What drugs can cause osteoporosis (drug rxn)?
steroids, heparin
117
What drugs can cause photosensitivity (drug rxn)? | -"SAT For photo"
Sulfonamides, Amiodarone, Tetracyclines, 5-FU
118
What drugs can cause SJS (drug rxn)? | - "Steven Johnson has EPILEPTIC ALLergy to SULFA DRUGS and PCN"
AEDs (lamotrigine), allopurinol, sulfa drugs, PCN
119
What drugs can cause SLE-like syndrome (drug rxn)? | - "having lupus is SHIPP-E"
Sulfa drugs, Hydralazine, Isoniazid, Procainamide, Phenytoin, Etanercept
120
What drugs can cause childhood teeth discoloration (drug rxn)?
tetracyclines
121
What drugs can cause tendonitits/tendon rupture/cartilage damage (drug rxn)?
fluoroquinolones (ciprofloxacin, levo, moxi, etc.)
122
What drugs can cause PDisms (drug rxn)? | - "cogwheel rigidity of ARM"
APs (1st gen), Reserpine, Metoclopromide (Reglan)
123
What drugs can cause seizures (drug rxn)? | -" I BItE my tongue"
Isoniazid (from B6 deficiency), Buproprion, Imipenem/cilastatin, Enflurane (anesthetic)
124
What drugs can cause TD (drug rxn)?
APs, metoclopromide (Reglan)
125
What drugs can cause DI (drug rxn)?
Li (and demeclocycine = tetracycline Abx)
126
What drugs can cause Fanconi syndrome (drug rxn)?
Tetracyclines (expired) | NB: Fanconi syndrome is proximal tubule dysfxn causing loss of glucose, aa's, PO4 and bicarb --> RTA and rickets
127
What drugs can cause hemorrhagic cystitis (drug rxn)? and prevented by coadministering what chemo adjuvant?
cyclophosphamide (prevent by coadministering with mesna - organosulfur chemo adjuvant)
128
What drugs can cause interstitial nephritis (drug rxn)?
methicillin, NSAIDs, furosemide
129
What drugs can cause SIADH (drug rxn)? | -"Cant Concentrate Serum Sodium"
Carbamazepine, Cyclophosphamide, SSRIs
130
What drugs can cause dry cough (drug rxn)?
ACEi
131
What drugs can cause pulmonary fibrosis (drug rxn)? | -"Breathing Air Badly from Meds"
Bleomycin, Amiodarone, Busulfan, MTX
132
What drugs can cause anticholinergic (antimuscarinic) toxicity?
Atropine, TCAs, H1 blockers, APs
133
What drugs can cause disulfuram-like rxn (drug rxn)? | =flushing, tachycardia, hypotension
metronidazole, some cephalosporins, griseofulvin, procarbazine, 1st gen sulfonylureas
134
What drugs are nephro- and oto-toxic?
Aminoglycosides (gentamycin, streptomycin, tobramycin, amikacin), vancomycin, loop diuretics (furosemide), cisplatin (cisplatin toxicity may respond to amifostine)
135
What drugs induce CYP 450? | - "chronic alcoholics St-eal Phen-Phen and Never Refuse Gr-easy Carbs"
``` Chronic alcohol use St. John's wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine ```
136
What drugs inhibit CYP 450? | - "AAA RACKS IN GQ Magazine"
``` Acute Alcohol Abuse Ritonavir Amiodarone Cimetidine Ketoconazole Sulfonamides INh (isoniazid) Grapefruit juice Quinidine Macrolides (except azithromycin) ```
137
What 4 drugs are common substrates of CYP 450 and thus influenced by the inducers/inhibitors? -"Always Think When Outdoors"
AEDs Theophylline Warfarin OCPs
138
What are the sulfa drugs? | - "Popular FACTSSS
``` Probenecid Furosemide Acetazolamide Celecoxib Thiazides Sulfa abx Sulfasalazine Sulfonylureas ```
139
What can a sulfa allergy rxn look like?
fever, UTI, SJS, hemolytic anemia, tcp, agranulocytosis, hives
140
what are -azoles?
antifungals: ergosterol (lipid) synthesis inhibitors
141
what are -bendazoles?
antiparasitic/antihelminthic
142
what are -cillins?
abx: peptidoglycan synthesis inhibitor
143
what are -cyclines?
abx: ribosomal 30S protein synthesis inhibitors
144
what are -ivir drugs?
anti-flu: neuraminidase inhibitors (ex. oseltamivir)
145
what are -navirs?
HAART: PIs (ex. ritonavir)
146
what are -ovirs?
antiviral: DNA polymerase inhibitor (Acyclovir)
147
what are -thromycins?
macrolide abx (azithromycin, erythromycin)
148
what are -anes?
inhaled general anesthetic
149
what are -azines?
typical (1st gen) APs (ex thioridazine)
150
what are -barbitals?
barbiturates (ex phenobarbital)
151
what are -caines?
local anesthetics
152
what are -etines?
SSRIs (ex fluoxetine)
153
what are -ipramines and -triptylines?
TCAs (ex imipramine, amitriptyline)
154
what are -triptans?
anti-migraine: 5-HT 1b/1d agonist
155
what are -zepams and -zolams?
benzos
156
what are -chols?
cholinergic agonist (ex bethanechoo, carbachol)
157
what are -curiums and -curoniums?
nondepolarizing paralytics
158
what are -olols?
BBs
159
what are -stigmines?
AChE inhibitors (incr cholinergic effects)
160
what are -terols?
B2 agonists (ex albuterol)
161
what are -zosins?
a1 antagonists
162
what are -afils?
PDE-5 inhibitors (ex sildenafil)
163
what are -dipines?
dihydropyridine CCBs (ex amlodipine)
164
what are -prils?
ACEi
165
what are -sartans?
ARBs (angiotensin-II R blockers)
166
what are -statins?
Statins: HMG-CoA reductase inhibitors
167
what are -dronates?
bisphosphonates (ex aledronate)
168
what are -glitazones?
PPAR-gamma activators (oral DM med)
169
what are -prazoles?
PPI
170
what are -prosts or -prostols?
prostaglandin analogs (ex misoprostol - for gastric ulcers and elective abortions)
171
what are -tidines?
H2 antagonists (ex ranitidine, cimetidine)
172
what are -tropins?
pituitary hormines (ex somatotropin)
173
what are -ximabs?
chimeric monoclonal Abs (ex basiliximab)
174
what are -zumabs?
humanized monoclonal Abs (ex daclizumab)

First Aid Step 1 (1 decks)

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