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NPLEX 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What drugs end in “litazone”?

A

Thiazolidinedione-type, also called “glitazones”

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2
Q

What drugs end in “ronates”?

A

Bisphosphonates

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3
Q

What smokinc cessation medication is lethal in children and CI in pregnancy?

A

Nicotin gum and patches

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4
Q

What is a sign of nicotine toxicity?

A

Nightmares

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5
Q

What substances/medication induce CYP1A2?

A

Caffeine, theophylline, TCA’s, Warfarin, and Nicotine

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6
Q

What medications are indicated for glaucoma? What class are they?

A

Pilocarpine - cholinergic agonist

Physostigmine - cholinesterase inhibitor

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7
Q

What are common AE observed with neuroleptics?

A

Tremors/parkinsonian effects, tardive dyskinesia, postural hypotension, blurred vision, dry mouth, constipation, urinary retention, sexual dysfunction, drowsiness

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8
Q

What are symptoms of neuroleptic malignant syndrome?

A

catatonia, fluctuating BP, dysarthria, fever, death

Counteract with dopamine agonist (Bromocriptine)

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9
Q

What is the MOA of the phenothiazines (antipsychotics)? What about haloperidol?

A

Dopamine blockade

Dop block + H1 blockade

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10
Q

What are important AE with antipsychotics?

A

Extrapyramidal reactions

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11
Q

What drugs are contraindicated in depressed patients?

A

Antipsychotics

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12
Q

What other hormone is released as a result of dopamine blockade?

A

Prolactin

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13
Q

What two neurotransmitters are blocked with Respiradone?

A

Serotonin and Dopamine

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14
Q

What is a serious AE of Clozapine?

A

Agranulocytosis

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15
Q

How does Buproprion lowers seizure threshold?

A

Spares catecholamines

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16
Q

What vitamin is required by MAO to operate properly?

A

B6

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17
Q

What cofactors are required by COMT?

A

Mg and SAMe

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18
Q

What amino acid become serotonin?

A

Tryptophan

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19
Q

Induce or inhibit CYP450 3A4: barbituates, glucocorticoids, phenytoin, hypericum

A

Induce

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20
Q

Induce or inhibit CYP460 3A4: ciprofloxacin, clarithromycin, erythromycin, fluconazole, fluoxetine, grapefruit juice, Itraconazole, ranitidine, miconazole, ketoconazole, metronidazole

A

Inhibit

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21
Q

Which drugs block reuptake of MAO and inc NE and serotonin?

A

TCAs - Amitriptyline, Imipramine, Doxepin, etc.

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22
Q

Which drugs are modified serotonin effectors?

A

Venlafaxine

Mirtazapine

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23
Q

How do MSE’s work?

A

SSRI + Inc Serotonin prod + NE receptor effects

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24
Q

What case class of drug is Duloxetine?

A

SSNRI

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25
Q

Which medication is used for neuropathic pain, post-herpetic neuralgia, and fibromyalgia? I

A

Pregabalin - block alpha2delta subunit and reduces Ca dependent release of neurotransmitters

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26
Q

Name two serotonin transporter inhibiting medications.

A

Desyrel and Serzone

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27
Q

What neurosteroid enhances GABA in the brain?

A

The degradation of progesterone

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28
Q

High dose vitex inc what hormone?

A

Progesterone

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29
Q

Which drug is an anxiolytic without sedation or euphoria and modulates Serotonin/Dopamine/NE activity?

A

Buspirone

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30
Q

What medications are given acutely for seizure?

A

Diazepam and Ca Gluconate IV

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31
Q

What is the action of Hydroxyzine and indication?

A

H1 Blocker

Anxiolytic

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32
Q

How does glycine work in the brain?

A

Cl channel blocker

Calming

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33
Q

What herbs should you not administer within two weeks of an MAO inhibitor?

A

Rauwolfia or Reserpine

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34
Q

What two drugs for bipolar drugs require regular blood levels due to potential toxicity?

A

Lithium and Valproic Acid

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35
Q

What neuropathic pain medication is also used in bipolar?

A

Gabapentin

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36
Q

What is Lithium’s action?

A

Interferes with Na ions in the brain.

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37
Q

What dietary recommendation should you NOT make with pt taking lithium?

A

Low Na diets!!!

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38
Q

What drugs end in “tidine”?

A

H2 Blockers
Lower Acid in the stomach
H1 is for snotty noses

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39
Q

What drugs end in “prazoles”?

A

PPIs

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40
Q

What mineral deficiency is a problem in PPI usage?

A

Magnesium

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41
Q

What is Sucralfate?

A

GI Demulcent

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42
Q

What is Metoclopramide?

A

Stimulates upper GI motility, can affect CNS (extrapyramidal effects)

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43
Q

What are two Belladonna alkaloids? And what action do they have?

A

Hyoscyamine, Dicyclomine

Anticholinergic

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44
Q

Dephenoxlylate w/ Atropine as well as Loperamide are what type of drug?

A

Anti-diarrheal

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45
Q

How does Docusate (Colace) work?

A

Reduce surface tension of the oil-water interface of stool to soften it.

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46
Q

What is the MOA of “triptans”? What condition do you NOT want to use triptans?

A

agonist for a vascular 5-HTP1 receptor subtype - resulting in vasoconstriction

DO NOT USE in basilar artery disease, HTN, w/ MAO inhibitors.

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47
Q

What is the combo drug of carbi-levodopa?

A

Sinemet - can use lower dose initially

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48
Q

Bromocriptine and Pergolide are _____ derivative dopamine agonists.

Pramipexole and Ropinirole are _____ dopamine agonists.

A

Ergot

Non-ergot

49
Q

In end-stage Parkinson’s, what previously CI drug is used to keep dopamine from being broken down in the brain?

A

MAO inhibitors

50
Q

What type of drugs are often used in Alzheimer’s dz?

A

Acetylcholine sparing: Donepezil, Tacrine hydrochloride, galantamine, rivastigmine

NMDA/Glutamate blocker: Namenda

51
Q

T/F: Schedule 1 drugs have accepted use.

52
Q

What type of medications are cyclobenzaprine carisoprodol? What is important to remember about cyclobenzaprine?

A

Muscle relaxants

It is a tricyclic derivative - therefore do NOT use with MAO inhibitors.

53
Q

Describe the symptoms of cinchonism.

A

Tinnitus, HA, nausea, dizziness, vertigo, visual changes

54
Q

What do each of the pregnancy categories A-D mean?

A

A - The safest drugs to take during pregnancy. No known adverse reactions.
B - No risks have been found in humans.
C - Not enough research has been done to determine if these drugs are safe.
D - Adverse reactions have been found in humans.

55
Q

What two drugs are opiate receptor blockers used for opiate overdose, CA, and AI?

A

Naloxone and Naltrexone

56
Q

What is the MAX safety dose for acetaminophen? What is the toxic single dose?

A

3-4g

7-10g (140mg/kg)

NAPQI - toxic metabolite

57
Q

What is the antidote to acetaminophen toxicity?

58
Q

What is a major concern of Tramadol HCl (Ultram)?

A

Lowers seizure threshold.

59
Q

How can NSAIDs affect asthmatics?

A

Can shunt toward leukotrienes - worsening asthma

60
Q

What are drugs ending in “sone,” “zone” or “onide”?

61
Q

What is the ratio of Prednisone to Cortisone?

A

4:1
5mg Pred = 20 mg Cortisone

Cortisone is basically to what we make naturally.

62
Q

What are two gout medications that are also toxic to the liver and often cause GI upset?

A

Allopurinol and colchicine

Can used prednisone or naproxen which are less toxic.

63
Q

Which hormone has a gaba-like effect as a neurosteroid?

A

Progesterone

64
Q

Which neurotransmitters are blocked in cocaine use?

A

Dopamine, NE, Serotonin

Euphoria, energy, confidence

65
Q

T/F: MDMA or Ecstasy has a very weak affinity for serotonin transporters.

A

F, STRONG affinity for serotonin

66
Q

For what condition is Tolterodine indicated? What is it’s MOA?

A

Urinary incontinence or overactive bladder

Anticholinergic

67
Q

What is a finding on ECG of Amitriptyline overdose?

A

Wide QRS complex ventricular tachycardia

68
Q

indication(s), side effect(s), and interaction(s)/contraindication(s).

A

Ind:
SE:
Intxn:
CI:

69
Q

What drugs end in “cyclovir or vir”?

70
Q

What drugs end in “azole”?

A

Antifungal

71
Q

What drugs end in “cycline”?

A

Antibiotic

72
Q

What drugs end in “penicillin”?

A

Antibiotic

73
Q

What drugs end in “olol”?

A

Beta blocker

74
Q

What drugs end in “pril”?

A

ACE Inhibitor

75
Q

What drugs end in “sartan”?

76
Q

What drugs end in “amlodipine or pine”?

A

Ca Channel Blocker

77
Q

What are the side effects of alendronate?

A

Esophageal irritation. Avascular necrosis of the jaw.

78
Q

What are the adverse events related to atorvostatin?

A

Increased CK, mild upper GI disturbance, sleep issues, HA, rash, myopathy, Coq10 depletion

Rare: periph neuro, impotence

79
Q

What is important to check every 3 months when taking a statin?

A

ALT liver function

80
Q

What cholesterol marker is most affected by a statin medication?

81
Q

What cholesterol marker is most affected by fibrate medication?

A

Triglycerides

82
Q

What drugs/supplements require ionization (requiring stomach acid)?

A

Antifungals, Mineral

Problem with PPIs

83
Q

How does substances that increase albumin binding affect drug availability? Decrease albumin binding?

A

Decreased availability

Increased availability

84
Q

Describe phase 1 and phase 2 detox.

A

Phase 1 - CYP450, render non-polar substance polar through oxidation, reduction, hydrolysis, and hydration. Cofactors: B2, 3, 4, 12, folate, GSH, AA’s

Phase 2 - Conjugation, tak more polar P450 metabolites and conjugate them with amino acids

85
Q

What consideration is made for pt w/ kidney dz or dec GFR when dosing renally cleared medication?

A

Might need to have a lower dose due to higher conc in the blood.

86
Q

Term: time required for half of that substance to be removed from an organism.

87
Q

How many half-lives does sit take for a drug’s serum conc to reach steady state?

A

4.7 (5X rule)

88
Q

Drugs that are easily displaced from album, therefore inc plasma drug level

A

Sulfonamides
Phenylbutazone
Tolbutamide
Coumarin

89
Q

Drugs that induce P450, therefore dec plasma drug levels

A

Alcohol
Barbiturates
Phenytoin
Rifampicin

90
Q

Drugs that inhibit P450, inc plasma drug level

A

Chloramphenicol
Sulfonamides
Phenylbutazone

91
Q

Drugs that compete for renal transporters, inc plasma drug levels

A 
Uric acid
Probenecid
Penicillins
Sulfonamides
Salicylates
Thiazides 
NSAIDs
92
Q

Which antibiotics are famous for their ototoxicity side effects?

A

Aminoglycosides

93
Q

Name the antidote:

1) Acetaminophen
2) Opiates
3) Benzodiazepines
4) Methanol/Ethylene glycol
5) CO
6) Cyanide
7) Organophosphates
8) Iron
9) Lead
10) Coumarins
11) Heparin

A

1) NAC
2) Naloxone
3) Flumazenil
4) Ethanol
5) 100% O2
6) Amyl nitrate
7) Atropine
8) Deferoxamine
9) EDTA
10) Vit K
11) Protamine

94
Q

Name the acetylcholine receptor:
1) found at postsynaptic parasympathetic locations

2) autonomic ganglia, adrenal medulla, neuromuscular junction

A

1) Muscarinic

2) Nicotinic

95
Q

Classic:

1) sympathomimetic drug
2) sympatholytic drug
3) parasympathomimetic drug
4) parasympatholytic

A

1) Epi
2) Rauwolfia/Reserpine
3) Pilocarpine (used in ophthalmology)
4) Atropine

96
Q

How does digitalis act to improve atrial dysfunction?

A

Increases intracellular Ca elongating plateau of cardiac AP (by blocking Na/K ATPase pump)

97
Q

What drugs end in “sone,” “zone,” or “onide”?

A

Glucocorticoid

98
Q

What medication for allergic rxn is CI w/ CNS depressants and MAO inhibitors?

A

Diphenhydramine (Benadryl)

99
Q

What nasal spray (or rx eye drops) stimulate a1 receptors causing vasoconstriction? What is it CI in? What interaction is important to remember

A

Oxymetazoline
CI in severe HTN
DO NOT USE w/ MAO inhibitors

100
Q

Which drugs require therapeutic monitoring?

A

Digoxin, phenytoin, lithium, carbamazepine, theophylline.

101
Q

What drugs end in “afil”?

A

erectile dysfunction meds

102
Q

What drugs end in “romycin”?

A

MacROlides

103
Q

T/F: Macrolides are CI in pregnancy.

104
Q

What is the concern with tetracyclines in children < 9yo?

A

Permanent discoloration of teeth

ALSO interferes with OCPs

105
Q

What drugs can cause a hemolytic crisis in g6p deficiency

A

Sulfonamides

106
Q

What side effect is a hallmark of Fluoroquinolones? What pt population should you NOT prescribe fluoroquinolones?

A

Achilles Tendon Rupture (BBW)

Children <18yo
Can arrest growth plates

107
Q

What is the biggest problem/adverse event with aminoglycosides?

A

Severe ototoxicity

108
Q

What are the three TB drugs?

A

Isoniazid
Rifampin
Pyrazinamide

Depletes B6 - give w/ B6

109
Q

Three type of HIV tx.

A

Nucleoside Reverse-transcriptase Inhibitors
Non Nucleoside Reverse-transcriptase Inhibitors
Protease inhibitors

110
Q

What is the indication for Adalimumab? Action?

A

RA, psoriatic arthritis, ankylosing spondylitis, Crohn’s dz, mod-sev chronic psoriasis, and juvenile RA

TNF - blocker

111
Q

Adverse events with interferon tx.

A 
Flu-like zx 
Depression/suicide
Hypothyroidism
Fatigue
Diarrhea
Etc.
112
Q

What is the indication for Tacrolimus? Action?

A

Organ transplant
Chronic tx of mod-sev atopic derm

Suppresses cell-mediated immune reaction

113
Q

What is the indication for Anastrozole? Action?

A

Breast CA after surgery and for METS

Aromatase inhibitor - block conversion of testosterone to estrogen

114
Q

What is the indication for Doxorubicin? Action? Most serious AE?

A

Hematologic malignancy, Carcinomas, soft tissue Sarcoma

Antibiotic (Anti-DNA) - administered IV

Life-threatening heart damage

115
Q

What is the indication for Paclitaxel? Action? Common SE?

A

Lung, ovarian, breast, head/neck CA and advanced Kaposi’s sarcoma

Mitotic inhibitor (from Pacific yew tree)

SE: Neuropathy

116
Q

What is the indication for Vinblastine? Action?

A

Hodgkin’s lymphoma, non-small cell lung CA, breast, head/neck, testicular CA

Binds tubulin

117
Q

What is the indication for Methotrexate? Action? What would you NOT give with methotrexate?

A

Chemo, Preg termination, Autoimmune disorders

Dihydrofolate reductase inhibitor

Folic acid

118
Q

Drugs that end in “sone,” “zone,” or “onide”?

119
Q

What is the indication for DMPS/DMSA? Adverse events?

A

Mercury/Lead poisoning/heavy metals

DMPS (IV)
DMSA (oral)

AE: Hypomagnesemia, hypotension

NPLEX 2 (22 decks)

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