Pharmacology Flashcards
Aspirin:
Indications, MOA, Side effects, Poisoning
Antiinflamm, analgesic, anti-pyretic, antiplatelet
MOA - inhibits cycloxygenase (Cox) inhibits prostaglandin synthesis. Irreversible and predictable mechanism
SE - GI upset, N & V, bleeding, ulcers, Methotrexate toxicity ( aspirin decreases methotrexate excretion)
Salicylate poisoning: Tinnitus, N&V, lethargy/excitability, hyperventilation –> Resp alkalosis. Severe toxicity may lead to metabolic acidosis, seizures.
Methotrexate:
Chemotherapy, autoimmune disease, RA
SE: Anaemia, leukopenia, thrombocytopenia, dizziness, weakness, fatigue, reduced ex tolerance, HA, Nausea, Joint pain, swelling
NSAIDS: Non-selective
Ibuprofen, advil, molvin - inhibit both Cox-1 and Cox 2 eliminating the good prostaglandins (Cox1) and the inflammatory ones (Cox2) nonselectively.
SE: fluid retention, edema, CHD, GI irritation, lithium toxicity - N&V diarrhea, weakness
NSAIDS: Selective
Celebrex/celecoxib - acts only on the Cox II and spares the Cox I
Glucocorticosteroids
MOA: inhibit capillary dilation, edema, migration of leuokocytes and macrophages
indications: RA, DJD
SE: Fragile bone, poor growth, increased appetite, diabetes, hypokalemia –> muscle cramp/spasm
Peripheal edema, glaucoma, reduced WBC, emotional changes, hirsuitism, cushings
Withdrawal: opposite - hypotension, addisons disease
Disease Modifying Antirheumatic Drugs (DMARDs)
- anticytokines
Demyelinating, lymphoma, infections, lupus like rash
Disease Modifying Antirheumatic Drugs (DMARDs)
- Cyclosporine
SE: HTN Nephrotoxicity
Biphosphonates
Anti-osteoporotic - Reduced osteoclast, increased BMD, SE: stomach and esophagus lesions, arrhythmia, muscle pain
Calcitonin
Antiosteoporotic - inhibit osteoclasts - increased BMD used in padgets disease
SE: pain, myalgia, HA, Nasal complications
Teriparatide (forteo)
Selective antiestrogen, parathyroid hormone - not for padgets disease.
Etidrenate diphosphonate
Inhibition of Osteoclasts - Padgets
Alendronate (fosamax)
Side effects: myalgia, esophageal lesions - standing for 30 mins after taking, take 30 mins before breakfast
Diazepam
Works on the spinal interneruons
Side effects - drowsiness, muscle spasm
Tizanidine
Muscle relaxant
Indications: spasticity
acts on the spinal cord
SE: hypotension
Flexeril
Muscle relaxant
Local, acute muscle spasm
Acts on the brain and spinal cord
possible hypertensive crisis, tachycardia, blurry vision, dry mouth
Baclofen
Spasticity, painful F/E spasm
SE: drowsiness, Seizures
MOA: inhibits neurotransmitter release in brain and spinal cord
Reduces inflammation and pain
Dantroline
Acts locally on muscle fibers to block calcium release
Side effects - drowsy, diarrhea, dizziness, photosensitivity
Indications: Chronic muscle spasm
Tricyclic Antidepressants
Amitryptyline, Nortryptoline, doxepine, lmipramine
Monoamine Oxidase Inhibitors
MOA: Inhibits breakdown of neutrotransmitters leading to more availability
Nordil, Pornate, Morplan
Indicated for Hysteria
SE: sweating, tremor, increased BP, Increased temp
SSRIs
Zoloft - OCD
SE: HA Nausea, lethargy, fatigue, insomnia
Opiods
Morphine, codine, hydrocodone, oxycodone
Indications: analgesia, dyspnea, antidiarrheal, antitussive
SE: N&V, drowsiness, withdrawal, resp depression, addiction
Oxycodone - constipation
Mepiridine - tremor, twitch, seizures
Non-opioid narcotics
Acetaminophen - mild-mod pain
Antipyretic
325-650mg TID 4g daily max
Large doses lead to liver damage
Digoxin toxicity leads to
Distraction, indiscretion, grandiocity, increased activity, sleep deficit, talkativeness, blurry yellow vision, tachycardia, heart block
Thiazide, hydrochlorthiazide
Diuretic - first line HTN
Inhibits the resorption of sodium in the kidney which inhibits water resorption = increased urine volume and decreased vascular resistance
SE: Hyperglycemia, hyperurecemia, HYPERcalcemia, hypokalemia, increased LDL
Loop diuretics
affect the Loop of henle
Hyperurecemia, hyperglycemia, hypokalemia increased LDL and HYPOCALCEMIA
Potassium sparing diuretics
Weak diuretics prevent hypokalemia - hyperkalemia.
Alphaadrenergic blockers: alpha receptors cause:
Vasoconstricution - increased hypertension
Alphaadrenergic blockers: beta receptors cause:
vasodilation - relaxation
Glycerol trinitrate (GTN) Nitroglycerin
Angina
SE: orthostatic hypotension, dizziness, HA, tachycardia
MOA: peripheral vasodilation, blood pooling, reduced oxygen demand of the heart
3 times with no relief - Call for assistance likely MI
Hydralazine, minoxidil
Vasodilators
used with ACE inhibitors in CHF
used with betablockers for HTN
SE: GI disturbances, HA, flushing (lupus like symptoms), congestion, reflex tachycardia
Anticoagulants: Warfarin considerations
CI in pregnancy
Consider purple to syndrome - microemboli
Anticoagulants: Heparin
CI in renal failure
Antiretroviral treatment
SE Neuralgia and myopathy, lots of water to prevent dehydration
Beta blockers - Lols
Reduce cardiac output by slowing the heart Beta 1 act on heart Beta 2 act on lungs Selective beta blockers - Beta 1 only Non-selective - Beta and and 2 SE: Bradycardia Lethargy GIT disturbance Low BP Depression
Calcium channel blockers (pines)
Inhibit calcium ions into heart and muscle cells = decreased peripheral resistance - coronary artery dilation
- decreased contractility and conductivity of the heart, reduced oxygen demand
SE: Bradycardia, peripheral vasodilation, flushing, headache, ankle swelling, reflex tachy,
ACE Inhibitors (Prils)
CHF - reduced peripheral vascular resistance without increasing CO, HR or Contractility
SE: dizzy, OH, GI distress, Cough, HA, Hyperkalemia
