Pharmacology Flashcards
1
Q
What drugs end in “litazone”?
A
Thiazolidinedione-type, also called “glitazones”
2
Q
What drugs end in “ronates”?
A
Bisphosphonates
3
Q
What smokinc cessation medication is lethal in children and CI in pregnancy?
A
Nicotin gum and patches
4
Q
What is a sign of nicotine toxicity?
A
Nightmares
5
Q
What substances/medication induce CYP1A2?
A
Caffeine, theophylline, TCA’s, Warfarin, and Nicotine
6
Q
What medications are indicated for glaucoma? What class are they?
A
Pilocarpine - cholinergic agonist
Physostigmine - cholinesterase inhibitor
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
8
Q
What are symptoms of neuroleptic malignant syndrome?
A
catatonia, fluctuating BP, dysarthria, fever, death
Counteract with dopamine agonist (Bromocriptine)
9
Q
What is the MOA of the phenothiazines (antipsychotics)? What about haloperidol?
A
Dopamine blockade
Dop block + H1 blockade
10
Q
What are important AE with antipsychotics?
A
Extrapyramidal reactions
11
Q
What drugs are contraindicated in depressed patients?
A
Antipsychotics
12
Q
What other hormone is released as a result of dopamine blockade?
A
Prolactin
13
Q
What two neurotransmitters are blocked with Respiradone?
A
Serotonin and Dopamine
14
Q
What is a serious AE of Clozapine?
A
Agranulocytosis
15
Q
How does Buproprion lowers seizure threshold?
A
Spares catecholamines
16
Q
What vitamin is required by MAO to operate properly?
A
B6
17
Q
What cofactors are required by COMT?
A
Mg and SAMe
18
Q
What amino acid become serotonin?
A
Tryptophan
19
Q
Induce or inhibit CYP450 3A4: barbituates, glucocorticoids, phenytoin, hypericum
A
Induce
20
Q
Induce or inhibit CYP460 3A4: ciprofloxacin, clarithromycin, erythromycin, fluconazole, fluoxetine, grapefruit juice, Itraconazole, ranitidine, miconazole, ketoconazole, metronidazole
A
Inhibit
21
Q
Which drugs block reuptake of MAO and inc NE and serotonin?
A
TCAs - Amitriptyline, Imipramine, Doxepin, etc.
22
Q
Which drugs are modified serotonin effectors?
A
Venlafaxine
Mirtazapine
23
Q
How do MSE’s work?
A
SSRI + Inc Serotonin prod + NE receptor effects
24
Q
What case class of drug is Duloxetine?
A
SSNRI
25
Which medication is used for neuropathic pain, post-herpetic neuralgia, and fibromyalgia? I
Pregabalin - block alpha2delta subunit and reduces Ca dependent release of neurotransmitters
26
Name two serotonin transporter inhibiting medications.
Desyrel and Serzone
27
What neurosteroid enhances GABA in the brain?
The degradation of progesterone
28
High dose vitex inc what hormone?
Progesterone
29
Which drug is an anxiolytic without sedation or euphoria and modulates Serotonin/Dopamine/NE activity?
Buspirone
30
What medications are given acutely for seizure?
Diazepam and Ca Gluconate IV
31
What is the action of Hydroxyzine and indication?
H1 Blocker
| Anxiolytic
32
How does glycine work in the brain?
Cl channel blocker
| Calming
33
What herbs should you not administer within two weeks of an MAO inhibitor?
Rauwolfia or Reserpine
34
What two drugs for bipolar drugs require regular blood levels due to potential toxicity?
Lithium and Valproic Acid
35
What neuropathic pain medication is also used in bipolar?
Gabapentin
36
What is Lithium's action?
Interferes with Na ions in the brain.
37
What dietary recommendation should you NOT make with pt taking lithium?
Low Na diets!!!
38
What drugs end in "tidine"?
H2 Blockers
Lower Acid in the stomach
H1 is for snotty noses
39
What drugs end in "prazoles"?
PPIs
40
What mineral deficiency is a problem in PPI usage?
Magnesium
41
What is Sucralfate?
GI Demulcent
42
What is Metoclopramide?
Stimulates upper GI motility, can affect CNS (extrapyramidal effects)
43
What are two Belladonna alkaloids? And what action do they have?
Hyoscyamine, Dicyclomine
Anticholinergic
44
Dephenoxlylate w/ Atropine as well as Loperamide are what type of drug?
Anti-diarrheal
45
How does Docusate (Colace) work?
Reduce surface tension of the oil-water interface of stool to soften it.
46
What is the MOA of "triptans"? What condition do you NOT want to use triptans?
agonist for a vascular 5-HTP1 receptor subtype - resulting in vasoconstriction
DO NOT USE in basilar artery disease, HTN, w/ MAO inhibitors.
47
What is the combo drug of carbi-levodopa?
Sinemet - can use lower dose initially
48
Bromocriptine and Pergolide are _____ derivative dopamine agonists.
Pramipexole and Ropinirole are _____ dopamine agonists.
Ergot
Non-ergot
49
In end-stage Parkinson's, what previously CI drug is used to keep dopamine from being broken down in the brain?
MAO inhibitors
50
What type of drugs are often used in Alzheimer's dz?
Acetylcholine sparing: Donepezil, Tacrine hydrochloride, galantamine, rivastigmine
NMDA/Glutamate blocker: Namenda
51
T/F: Schedule 1 drugs have accepted use.
F
52
What type of medications are cyclobenzaprine carisoprodol? What is important to remember about cyclobenzaprine?
Muscle relaxants
It is a tricyclic derivative - therefore do NOT use with MAO inhibitors.
53
Describe the symptoms of cinchonism.
Tinnitus, HA, nausea, dizziness, vertigo, visual changes
54
What do each of the pregnancy categories A-D mean?
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
What two drugs are opiate receptor blockers used for opiate overdose, CA, and AI?
Naloxone and Naltrexone
56
What is the MAX safety dose for acetaminophen? What is the toxic single dose?
3-4g
7-10g (140mg/kg)
NAPQI - toxic metabolite
57
What is the antidote to acetaminophen toxicity?
NAC
58
What is a major concern of Tramadol HCl (Ultram)?
Lowers seizure threshold.
59
How can NSAIDs affect asthmatics?
Can shunt toward leukotrienes - worsening asthma
60
What are drugs ending in "sone," "zone" or "onide"?
Steroids
61
What is the ratio of Prednisone to Cortisone?
4:1
5mg Pred = 20 mg Cortisone
Cortisone is basically to what we make naturally.
62
What are two gout medications that are also toxic to the liver and often cause GI upset?
Allopurinol and colchicine
Can used prednisone or naproxen which are less toxic.
63
Which hormone has a gaba-like effect as a neurosteroid?
Progesterone
64
Which neurotransmitters are blocked in cocaine use?
Dopamine, NE, Serotonin
Euphoria, energy, confidence
65
T/F: MDMA or Ecstasy has a very weak affinity for serotonin transporters.
F, STRONG affinity for serotonin
66
For what condition is Tolterodine indicated? What is it's MOA?
Urinary incontinence or overactive bladder
| Anticholinergic
67
What is a finding on ECG of Amitriptyline overdose?
Wide QRS complex ventricular tachycardia
68
indication(s), side effect(s), and interaction(s)/contraindication(s).
Ind:
SE:
Intxn:
CI:
69
What drugs end in "cyclovir or vir”?
Antiviral
70
What drugs end in "azole”?
Antifungal
71
What drugs end in "cycline”?
Antibiotic
72
What drugs end in "penicillin”?
Antibiotic
73
What drugs end in "olol”?
Beta blocker
74
What drugs end in "pril”?
ACE Inhibitor
75
What drugs end in "sartan”?
ARB
76
What drugs end in "amlodipine or pine”?
Ca Channel Blocker
77
What are the side effects of alendronate?
Esophageal irritation. Avascular necrosis of the jaw.
78
What are the adverse events related to atorvostatin?
Increased CK, mild upper GI disturbance, sleep issues, HA, rash, myopathy, Coq10 depletion
Rare: periph neuro, impotence
79
What is important to check every 3 months when taking a statin?
ALT liver function
80
What cholesterol marker is most affected by a statin medication?
LDL
81
What cholesterol marker is most affected by fibrate medication?
Triglycerides
82
What drugs/supplements require ionization (requiring stomach acid)?
Antifungals, Mineral
Problem with PPIs
83
How does substances that increase albumin binding affect drug availability? Decrease albumin binding?
Decreased availability
| Increased availability
84
Describe phase 1 and phase 2 detox.
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
What consideration is made for pt w/ kidney dz or dec GFR when dosing renally cleared medication?
Might need to have a lower dose due to higher conc in the blood.
86
Term: time required for half of that substance to be removed from an organism.
Half-life
87
How many half-lives does sit take for a drug's serum conc to reach steady state?
4.7 (5X rule)
88
Drugs that are easily displaced from album, therefore inc plasma drug level
Sulfonamides
Phenylbutazone
Tolbutamide
Coumarin
89
Drugs that induce P450, therefore dec plasma drug levels
Alcohol
Barbiturates
Phenytoin
Rifampicin
90
Drugs that inhibit P450, inc plasma drug level
Chloramphenicol
Sulfonamides
Phenylbutazone
91
Drugs that compete for renal transporters, inc plasma drug levels
```
Uric acid
Probenecid
Penicillins
Sulfonamides
Salicylates
Thiazides
NSAIDs
```
92
Which antibiotics are famous for their ototoxicity side effects?
Aminoglycosides
93
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
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
Name the acetylcholine receptor:
1) found at postsynaptic parasympathetic locations
2) autonomic ganglia, adrenal medulla, neuromuscular junction
1) Muscarinic
| 2) Nicotinic
95
Classic:
1) sympathomimetic drug
2) sympatholytic drug
3) parasympathomimetic drug
4) parasympatholytic
1) Epi
2) Rauwolfia/Reserpine
3) Pilocarpine (used in ophthalmology)
4) Atropine
96
How does digitalis act to improve atrial dysfunction?
Increases intracellular Ca elongating plateau of cardiac AP (by blocking Na/K ATPase pump)
97
What drugs end in "sone," "zone," or "onide"?
Glucocorticoid
98
What medication for allergic rxn is CI w/ CNS depressants and MAO inhibitors?
Diphenhydramine (Benadryl)
99
What nasal spray (or rx eye drops) stimulate a1 receptors causing vasoconstriction? What is it CI in? What interaction is important to remember
Oxymetazoline
CI in severe HTN
DO NOT USE w/ MAO inhibitors
100
Which drugs require therapeutic monitoring?
Digoxin, phenytoin, lithium, carbamazepine, theophylline.
101
What drugs end in "afil"?
erectile dysfunction meds
102
What drugs end in "romycin"?
MacROlides
103
T/F: Macrolides are CI in pregnancy.
T
104
What is the concern with tetracyclines in children < 9yo?
Permanent discoloration of teeth
ALSO interferes with OCPs
105
What drugs can cause a hemolytic crisis in g6p deficiency
Sulfonamides
106
What side effect is a hallmark of Fluoroquinolones? What pt population should you NOT prescribe fluoroquinolones?
Achilles Tendon Rupture (BBW)
Children <18yo
Can arrest growth plates
107
What is the biggest problem/adverse event with aminoglycosides?
Severe ototoxicity
108
What are the three TB drugs?
Isoniazid
Rifampin
Pyrazinamide
Depletes B6 - give w/ B6
109
Three type of HIV tx.
Nucleoside Reverse-transcriptase Inhibitors
Non Nucleoside Reverse-transcriptase Inhibitors
Protease inhibitors
110
What is the indication for Adalimumab? Action?
RA, psoriatic arthritis, ankylosing spondylitis, Crohn's dz, mod-sev chronic psoriasis, and juvenile RA
TNF - blocker
111
Adverse events with interferon tx.
```
Flu-like zx
Depression/suicide
Hypothyroidism
Fatigue
Diarrhea
Etc.
```
112
What is the indication for Tacrolimus? Action?
Organ transplant
Chronic tx of mod-sev atopic derm
Suppresses cell-mediated immune reaction
113
What is the indication for Anastrozole? Action?
Breast CA after surgery and for METS
Aromatase inhibitor - block conversion of testosterone to estrogen
114
What is the indication for Doxorubicin? Action? Most serious AE?
Hematologic malignancy, Carcinomas, soft tissue Sarcoma
Antibiotic (Anti-DNA) - administered IV
Life-threatening heart damage
115
What is the indication for Paclitaxel? Action? Common SE?
Lung, ovarian, breast, head/neck CA and advanced Kaposi's sarcoma
Mitotic inhibitor (from Pacific yew tree)
SE: Neuropathy
116
What is the indication for Vinblastine? Action?
Hodgkin's lymphoma, non-small cell lung CA, breast, head/neck, testicular CA
Binds tubulin
117
What is the indication for Methotrexate? Action? What would you NOT give with methotrexate?
Chemo, Preg termination, Autoimmune disorders
Dihydrofolate reductase inhibitor
Folic acid
118
Drugs that end in "sone," "zone," or "onide"?
Steroid
119
What is the indication for DMPS/DMSA? Adverse events?
Mercury/Lead poisoning/heavy metals
DMPS (IV)
DMSA (oral)
AE: Hypomagnesemia, hypotension
