Pharmacology One-Liners 2 Flashcards
1
Q
First-line drugs for acute gout
A
Indomethacin, naproxen
2
Q
NSAID avoided in gout because low doses increase uric acid levels
A
Aspirin
3
Q
Mechanism of action of colchicine
A
Inhibits microtubules assembly, decreases leukocyte migration, and phagocytosis
4
Q
Side effects of colchicine
A
Diarhhea, liver toxicity, myelosuppression
5
Q
Agents that inhibit xanthine oxidases and used to treat chronic gout
A
Allopurinol, febuxostat
6
Q
Recombinant uricase that enhances uric acid metabolism and indicated for gout refractory to conventional therapy
A
Pegloticase
7
Q
DMARDs are slow-acting drugs for this indication
A
Rheumatic diseases
8
Q
1st line for rheumatic arthritis for most patients
A
Low-dose methotrexate
9
Q
Dose-limiting toxicity of methotrexate
A
Myelosuppression
10
Q
A mixture of two agents with one agent active for rheumatic disease and the other for inflammatory bowel disease
A
Sulfasalzine
11
Q
Agent used to treat chronic gout by increasing uric acid excretion through inhibition of URAT1 anion transporter
A
Probenecid
12
Q
Alternative to methotrexate as 1st line for rheumatoid arthritis through inhibition of dihydroorotate dehydrogenase, which leads to decreased pyrimidine synthesis
A
Leflunomide
13
Q
Side effect of penicillamine
A
Hypersensitivity (rash), nephrotoxicity, myopathy, myelosuppression
14
Q
Anti-malarial drug used in rheumatoid arthritis
A
Hydroxychloroquine
15
Q
Side effect of hydroxychloroquine
A
Retinopathy
16
Q
Two drugs that bind and prevent action of tumor necrosis factor alpha (TNF-alpha)
A
Infliximab and etanercept
17
Q
Neuromuscular blocking drugs
A
Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artificial ventilation. Full doses lead to respiratory paralysis and require ventilation
18
Q
Class of agents that block acetylcholine receptors at motor endplates and its effects can be reversed by cholinesterase inhibitors
A
Nondepolarizing blockers
19
Q
Tubocurarine
A
Non-depolarizing neuromuscular blocker with long duration of action and is most likely to cause histamine release
20
Q
Two non-depolarizing blockers that undergo Hofmann elimination, which is useful for patients with renal and hepatic deficiency
A
Atracurium, cisatracurium
21
Q
Pancuronium
A
Non-depolarizing neuromuscular blocker with long duration of action that can block muscarinic receptor in the heart
22
Q
These drugs strongly potentiate and prolong effect of neuromuscular blockers
A
Inhalation anesthetics (isoflurane), antibiotics (aminoglycosides, tetracyclines)
23
Q
Succinylcholine
A
Depolarizing blocker that causes muscle relaxation and paralysis and can cause postoperative muscle pain
24
Q
Two life-threatening side effects of succinylcholine
A
Hyperkalemia, malignant hyperthermia
25
Dantrolene
Drug for treating malignant hyperthermia associated with drug-drug interaction between halogenated anesthetics and depolarizing blocker
26
During Phase I depolarizing block this class of agents enhance muscle paralysis, but during Phase II block they may reverse muscle paralysis
Cholinesterase inhibitors
27
Neostigmine
Drug of choice for reversal of non-depolarizing neuromuscular blockade
28
Mechanism of action of cromolyn
Prevent mast cell degranulation (by blocking opening of Cl- channels)
29
Which enzyme does theophylline inhibit?
Phosphodiesterase
30
Somatropin
Growth hormone analog used in growth hormone deficiency
31
Octreotide
Somatostatin analog used for acromegaly, carcinoid, glucagonoma, and other growth hormone-producing pituitary tumors
32
Leuprolide
Gonadotropin-releasing hormone analog used for infertility (pulsatile administration) or suppression of gonadotropin production (continuous administration)
33
Ganirelix
Competitive antagonists at gonadotropin releasing hormone receptors used to prevent LH surger during controlled ovarian hyperstimulation
34
Bromocriptine
Ergot dopamine agonist used to suppress prolactin release
35
Cosyntropin
Synthetic human corticotropin used for diagnosis of adrenal insufficiency
36
Oxytocin
Agent used to stimulate uterine contraction and labor, milk letdowns, and control postpartum bleeding
37
Levothyroxine (T4)
Agent of choice for the treatment of hypothyroidism
38
Liothyronine (T3)
An isomer of T3 which may be used in myxedema coma
39
Thioamide agents used in hyperthyroidism
Methimazole and propylthiouracil (PTU)
40
Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and indicated for pregnant women in 1st trimester
Propylthiouracil (PTU)
41
Propylthiouracil mechanism of action
Inhibits thyroid peroxidase
42
Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism
Iodide salts (potassium iodide)
43
Radioactive iodine
Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy
44
Used for symptomatic treatment of thyrotoxicosis by blocking cardiac adverse effects
Beta-blockers such as propranolol and esmolol
45
Glucocorticoids
Used for Addison's disease, congenital adrenal hyperplasia inflammation, immune suppresion, and asthma
46
Two short-acting glucocorticoids
Hydrocortisone (cortisol), cortisone
47
Four intermediate-acting glucocorticoids
Prednisone, prednisolone, methylprednisolone, and triamcinolone
48
Two long-acting glucocorticoids
Betamethasone, dexamethasone
49
Two glucocorticoids with mineralocorticoid action
Fludrocortisone and deoxycorticosterone
50
Side effects of corticosteroids
Iatrogenic Cushing's syndrome, hyperglycemia, impaired wound healing, osteoporosis, peptic ulcers, myopathy, adrenal suppression (>2 week treatment)
51
Aminoglutethimide
Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis
52
Ketoconazole
Antifungal agent used to inhibit adrenal and gonadal steroid synthesis
53
Metyrapone
Seelctive inhibitor of 11-hydroxylation and interferes with cortisol and corticosterone synthesis; used for adrenal function tests and is the only adrenal-inhibiting medication that can be administered to pregnant women with Cushing's syndrome
54
Mifepristone (RU486)
Glucocorticoid receptor antagonist that is used as an abortifacient due to its strong antiprogestin activity
55
Three rapid-acting insulin used for postprandial glycemia
Aspart, lispro, glulisine
56
Short-acting insulin used intravenously for ketoacidosis
Regular insulin
57
Intermediate-acting insulin with variable pharmacokinetics; use is mostly replaced by long-acting insulin
Neutral protamine Hagedorn (NPH) insulin
58
Two long-acting insulin preparations that provide basal glycemia control
Glargine, detemir
59
Major side-effect of insulin
Hypoglycemia
60
Tolbutamide
First generation sulfonylurea that is safest for elderly diabetics due to its short half-life
61
Chlorpropamide
First generation sulfonylurea contraindicated in elderly diabetics because of very long half-life
62
Three second generation sulfonylureas
Glyburide, glipizide, glimepride
63
Mechanism of action of sulfonylureas
Close K+ channels, depolarize cell, open voltage-gated Ca2+ channels, release insulin
64
Common side effect of first-generation sulfonylureas
Disulfiram-like reactions with alcohol use
65
Common side effect of second-generation sulofnylureas
Hypoglycemia
66
Repaglinide
A meglitinide insulin secretagogue that has no sulfur in its structure and may be used in type 2 diabetics with sulfonylurea allergy
67
Nateglinide
A D-phenylalanine derivative insulin secretagogue that is useful for type 2 diabetics with very reduced renal function
68
Mechanism of action of repaglinide and nateglinide
Close K+ channels, depolarize cell, open voltage-gated Ca2+ channels, release insulin
69
First line drug used for treatment of Type 2 diabetes
Metformin
70
Mechanism of action of metformin
decreased gluconeogeesnis, increased peripheral glucose uptake; increase insulin sensitivity
71
Most serious side effect of metformin
Lactic acidosis
72
Two thiazolidinediones
Pioglitazone, rosiglitazone
73
Mechanism of action of thiazolidinediones
Activate PPAR-gamma, increased transcription of insulin-responsive genes, increased GLUT4 glucose transporter, increased insulin sensitivity
74
Side effect of thiazolidinediones
Weight gain, edema, heart failure, hepatotoxicity
75
Two alpha-glucosidase inhibitors
Acarbose, miglitol
76
Mechanism of action of alpha-glucosidase inhibitors
Act on intestine, delay digestion and absorption of glucose
77
Side effect of alpha-glucosidase inhibitors
Flatulence, diarrhea, abdominal cramps
78
Pramlintide
Amylin analog that delays gastric emptying and suppresses glucagon release
79
Two glucagon-like polypeptide-1 (GLP-1) analogs that increase insulin secretion and suppress postprandial glucagon release
Exenatide, liraglutide
80
Three dipeptidyl peptidase-4 (DPP-4) inhibitors that reduce breakdown of glucagon-like polypeptide-1, resulting in increased insulin secretion and suppress postprandial glucagon release
Sitagliptin, saxagliptin, linagliptin
81
Bisphosphonates
Alendronate and -dronates
82
Mechanism of action of bisphosphonates
Inhibits osteoclast activity and prevent bone resorption
83
Uses of bisphosphonates
Osteoporosis, Paget's disease, hypercalcemia
84
Major side effects of bisphosphonates
Corrosive esophagitis, osteonecrosis of the jaw
85
Etidronate
First generation bisphosphonate when used long-term causes osteomalacia
86
May be used intranasally to decrease bone resorption
Calcitonin (salmon prep)
87
Vitamin given with calcium to ensure proper absorption
Vitamin D
88
Its use can increase risk of endometrial and breast cancer, cause postmenopausal uterine bleeding, but can stabilize bone mineral loss
Estrogen
89
Antiestrogen drug used for treatment of infertility in anovulatory women
Clomiphene
90
Tamoxifen
Selective estrogen receptor modulator most commonly used for treatment of breast cancer
91
Raloxifine
Selective estrogen receptor modulator used for prevention of osteoporosis and invasive breast cancer
92
Common side effect of tamoxifen and clomiphene
Hot flushes
93
Two estradiol derivatives with higher oral bioavailability and longer half-lives that are primarily used as oral contraceptives
Ethinyl estradiol and mestranol
94
Testosterone
Androgen receptor agonist used to treat hypogonadism and promote secondary sex characteristics
95
Finasteride
5 alpha-reductase inhibitor used for benign prostatic hyperplasia and male patter baldness
96
Danazol
Partial androgen agonist used for endometriosis and hereditary angioedema
97
Flutamide
Androgen receptor antagonist used to treat prostate cancer
98
Cyproterone
Androgen receptor antagonist used for hirsutism in females
99
Autacoids
A class of endogenous substances that include histamine, serotonin, prostaglandins, vasoactive peptides that work in autocrine or paracrine manner
100
Two peptides that increase capillary permeability and edema
Bradykinin and histamine
101
Distribution of H1 histamine receptors
Smooth muscle and mast cells
102
Distribution of H2 histamine receptors
Stomach, heart, and mast cells
103
Distribution of H3 histamine receptors
Nerve endings, CNS
104
Most common side effect of 1st generation antihistamines
Sedation, anticholinergic
105
Dephenhydramine
1st generation antihistamine that is highly sedating
106
Chlorpheniramine
1st generation antihistamine that is least sedating
107
Major indication for H1 antihistamines
IgE mediated allergic reaction (allergic rhinitis, urticaria)
108
Antihistamine that is indicated for allergies, motion sickness, and insomnia
Diphenhydramine
109
Antihistamine with motion sickness as the only indication
Dimenhydrinate
110
Three 2nd generation antihistamines
Fexofenadine, loratadine, and cetirizine
111
H2 antagonist that causes the most interactions with other drugs
Cimetidine
112
Indication for H2 antagonists
Acid reflux disease, duodenal ulcer and peptic ulcer disease
113
Location of serotonin type-1 (5HT-1) receptors
Mostly in the brain
114
Buspirone
5HT-1A receptor partial agonist indicated for generalized anxiety disorder; due to longer onset of action, is less effective for acute anxiety
115
5HT-1D/1B agonist used for migraine headaches
Sumatriptan and -triptans
116
Ergotaimne
Ergot alkaloid indicated for migraine headaches
117
Reason ergot alkaloids are contraindicated in pregnancy
Uterine contractions
118
Two side effects of ergot alkaloids
Prolonged vasospasm and hallucinations resembling psychosis
119
Two drugs that may be used off-label for ischemia and gangrene caused by ergot alkaloids overuse
Nitroprusside, nitroglycerin
120
Serotonin receptor responsible for serotonin syndrome
5HT2
121
H1 antihistamine with 5HT2 antagonist activity that is mostly used for carcinoid tumor but may be used to treat serotonin syndrome
Cyproheptadine
122
Location of serotonin type-3 (5HT-3) receptors
GI tract, vomiting center of medulla
123
5HT-3 antagonist used for the prevention of chemotherapy-induced nausea and vomiting
Ondansetron and -setrons
124
Ganglion blockers that were indicated (but not anymore) for severe hypertension
Hexamethonium, trimethaphan
125
Two direct-acting cholinomimetics that increase aqueous outflow through ciliary muscle contraction and opening of trabecular meshwork
Pilocarpine, carbachol
126
Two indirect-acting cholinomimetics that increase aqueous outflow through ciliary muscle contraction and opening of trabecular meshwork
Physostigmine, echothiophate
127
Nonselective alpha agonist that decreases aqueous production
Epinephrine
128
Selective alpha 2 agonits that decreases aqueous production
Brimonidine
129
Three beta blockers that decrease aqueous production
Timolol (nonselective)
Betaxolol (selective)
Carteolol (nonselective)
130
Carbonic anhydrase inhibitor used to decrease aqueous humor production
Acetazolamide
131
Prostaglandin 2 alpha analog used to increase aqueous humor outflow
Latanoprost
132
Common side effect of sedative hypnotics
CNS depression
133
Occurs when sedative hypnotics are used long-term
Tolerance and physical dependence
134
Mechanism of action of benzodiazepines
Increase frequency of GABA-mediated chloride ion channel (GABAa) opening
135
Main route of metabolism for benzodiazepines
Hepatic
136
Useful side effect of benzodiazepines in patients undergoing stressful procedures or surgery
Anterograde amnesia
137
Three benzodiazepines that are metabolized only by Phase II conjugation and therefor is useful in elderly patients
Lorazepam, oxazepam, temazepam
138
Two benzodiazepines that have active metabolites with long half-lives
Diazepam, chlordiazepoxide
139
Clinical uses of benzodiazepines
Anxiety, insomnia, alcohol detoxification, status epilepticus, spasticity
140
Reason why benzodiazepines are safer than barbiturates
Benzodiazepines work only in presence of GABA
141
Mechanism of action of barbiturates
Increased duration of GABAa chloride channel opening
142
Most serious side effect of barbiturates
Respiratory and cardiovascular depression
143
Barbiturates may precipitate this hematologic condition
Porphyria
144
Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetic property
Induce CYP450
145
Effect of benzodiazepines and barbiturates on sleep architecture
Suppress REM
146
Three nonbenzodiazepine hypnotics that lack suppressive effect on REM and are preferred over benzodiazepines for the treatment of insomnia
Zolpidem, zaleplon, eszopiclone
147
Mechanism of action of zolpidem
Activates BZ1 subtype of GABAa receptor
148
Drug of choice for treatment of acute status epilepticus
Diazepam, lorazepam
149
Drug of choice for partial seizures
Carbamazepine
150
Antiepileptic drug used as first line for trigeminal neuralgia
Carbamazepine
151
Antiepileptic drug that can induce CYP450, is teratogenic, and can cause diplopia, ataxia, and blood dyscrasias; follows first order kinetics of eliminations
Carbamazepine
152
Drug of choice for generalized tonic-clonic seizures
Carbamazepine, phenytoin, valproic acid
153
Mechanism of action of phenytoin, carbamazepine, lamotrigine
Blocks sodium channels
154
Antiepileptic agent that exhibits zero-order kinetics, causes fetal hydantoin syndrome, and induces CYP450
Phenytoin
155
Side effects of phenytoin
Gingival hyperplasia, nystagmus, diplopia, and ataxia
156
Mechanism of valproic acid
Blocks sodium channels, T-type calcium channels, and increase GABA concentration
157
Drug of choice for myoclonic seizures that may also be used for absence seizures
Valproic acid
158
Antiepileptic drug that can cause fatal hepatotoxicity and neural tube defects
Valproic acid
159
Drug of choice for absence seizures
Ethosuximide
160
Mechanism of action of Ethosuximide
Blocks T-type calcium channels
161
Antiepileptic drugs that may also be used for bipolar disorder
Valproic acid, carbamazepine, gabapentin
162
Antiepileptic drug used also for pain of neuropathic origin
Gabapentin
163
Serious side effect of lamotrigine that makes it require slow titration
Stevens-Johnson Syndrome
164
Mechanism of action of opioids on analgesia
Activate mu receptors to 1) close presynaptic Ca2+ channels to inhibit neurotransmitter release and 2) open postsynaptic K+ channels to hyperpolarize cell membrane
165
Side effects of these drugs include nausea and vomiting, euphoria, dependence, sedation, respiratory depression, constipation
Opioids
166
Tolerance to all effects of opioid agonists can develop except...
Miosis, constipation
167
Strong opioid agonists
Morphine and fentanyl
168
Opioid that can be given PO, IV, IM, and intrathecal to relieve anxiety associated with pulmonary edema
Morphine
169
Opioid available transdermally
Fentanyl
170
Opioid with antimuscarinic activity
Meperidine
171
Long-acting opioids used in the management of withdrawal states
Methadone, buprenorphine
172
Opioid that can cause hyperpyrexic coma with MAOI and serotonin syndrome with SSRI
Meperidine
173
Moderate opioid agonists
Codeine, hydrocodone, and oxycodone
174
Partial opioid agonist that has a long duration of action and is resistant to naloxone reversal
Buprenorphine
175
Opioid antagonist that is given IV
Naloxone
176
Opioid antagonist that is given orally
Naltrexone
177
Opioids indicated for use as antitussive
Dextromethorphan, Codeine
178
Opioids indicated for use as antidiarrheal
Diphenoxylate, Loperamide
179
Directly proportional to the potency of inhalation anesthetics
Lipid solubility
180
Inversely proportional to the potency of inhalation anesthetics
Minimal alveolar concentration (MAC)
181
Inversely proportional to the rate of induction and recovery of inhalation anesthetics
Blood:gas partition coefficient
182
Mechanism of action of inhalation anesthetics
Potentiation of GABA at GABAa receptors; also reduce Na+ and Ca2+ influx
183
Currently the only non-halogenated inhalation anesthetic
Nitrous oxide
184
Inhalation anesthetic with the most analgesic activity
Nitrous oxide
185
Inhalation anesthetic with the least respiratory and cardiovascular depression and therefore is used frequently as a component of balanced anesthesia
Nitrous oxide
186
Inhalation anesthetic that can cause fatal hepatotoxicity and cardiac arrhythmia and is no longer used in the US
Halothane
187
Inhalation anesthetic that is withdrawn from that market due to fatal nephrotoxicity
Methoxyflurane
188
Inhalation anesthetic that at high concentrations can produce CNS excitation, leading to seizures
Enflurane
189
Rare, but fatal side effect associated with combination of halogenated inhalation anesthetic and depolarizing blocker
Malingant hyperthermia
190
Close to ideal inhalation anesthetic that exhibits rapid and smooth induration and recovery, with little organ system toxicity
Sevoflurane
191
Barbituate used for the induction of anesthesia
Thiopental
192
A short-acting benzodiazepine commonly used adjunctively with inhalation anesthetics and opioid analgesics for a balanced anesthesia
Midazolam
193
Opioid safe for use of analgesia and anesthesia during cardiac surgery
Fentanyl
194
Produces both rapid anesthesia and recovery, has antiemetic activity, but may cause marked hypotension
Propofol
195
Marked dissociative anesthesia but has significant analgesic activity
Ketamine
196
Mechanism of action of the intravenous anesthetic that causes dissociative anesthesia
Block NMDA receptor
197
Side effects of dissociative anesthetic
Cardiovascular stimulation, increased cerebral blood flow, vivid dreams, hallucinations
198
Neuroleptanesthesia can be produced by a combination of these two agents
Fentanyl and droperidol
199
Mechanism of action of local anesthetics
Block voltage-gated sodium channels
200
This condition may necessitate larger doses of local anesthetics because the drugs become ionized and cannot penetrate the neuronal membranes
Low pH
201
Almost all local anesthetics have this property and sometimes requires the administration of vasoconstrictors to prolong activity
Vasodilation
202
The only local anesthetic with vasoconstrictive property, but due to abuse potential, only occasionally used for nasal surgery
Cocaine
203
This type of local anesthetic is more likely to cause hypersensitivity reactions
Ester-type (local anesthetic with one "l" in name)
204
Local anesthetic most widely used for obstetric anesthesia but causes the most cardiac depression
Bupivacaine
205
Side effect of most local anesthetics
CNS excitation
206
Common side effect of antipsychotics, MPTP (contaminant in illicit meperidine analog), and cholinergic excess
Drug-induced parkinsonism
207
Precursor of dopamine that can cross the blood-brain-barrier and used to alleviate motor dysfunction in Parkinson's disease
Levodopa (L-dopa)
208
Inhibits peripheral DOPA decarboxylase, reduces peripheral side effects of dopamine precursor and enhances delivery to brain
Carbidopa
209
Two fluctuations in clinical response associated with long-term use of dopamine precursor
"Wearing off" and "on-off phenomenon"
210
Inhibits monoamine oxidase type B (MAO-B), used as monotherapy for early or mild Parkinson's disease or adjunct to improve motor function in patients with fluctuations in clinical response
selegiline
211
Inhibits of catechol-O-methyltransferase (COMT), used as adjunct to improve motor function in Parkinson's patients with fluctuations in clinical response
Entacapone, tolcapone
212
Ergot type 2 dopamine receptor (D2) agonist, used for Parkinson's and restless legs syndrome
Bromocriptine
213
Non ergot type 2 dopamine receptors (D2) agonist, used for Parkinson's and restless legs syndrome
Pramipexole and ropinirole
214
An antiviral that enhances dopamine release for nigrostriatal neurons
Amantadine
215
A centrally-acting anticholinergic used for tremor and rigidity but have little effect on bradykinesia in patients with Parkinson's
Benztropine
216
Drug of choice indicated for familial or essential tremors
Propranolol
217
Two drugs that inhibit vesicle monoamine transporter used for Huntington's
Tetrabenazine, reserpine
218
An antipsychotic with dopamine receptor activity used for Huntington's
Haloperidol
219
Three centrally-acting cholinesterase inhibitors used for Alzheimer's
Donepezil, rivastigmine, galantamine
220
Noncompetitive antagonist of NMDA receptors used for Alzheimer's
Memantine
221
Three main classes of CNS depressant drugs of abuse
Alcohol, opioid, barbiturate/benzodiazepine
222
Agent that is metabolized by alcohol dehydrogenase or microsomal ethanol-oxidizing system (MEOS) to acetaldehyde; displays zero-order kinetics of elimination
Ethanol
223
Enzyme that is induced through chronic exposure to alcohol, may contribute to tolerance
Microsomal ethanol oxidizing system (MEOS)
224
Complications of the gastrointestinal system associated with chronic alcohol use
Mallory-Weiss syndrome, hepatitis, cirrhosis, pancreatitis
225
Neurological abnormality caused by chronic alcohol abuse and thiamine deficiency
Neurological deficits (Peripheral neuropathy)
226
Life-threatening alcohol withdrawal syndrome that peaks at 5 days after the last drink
Delirium tremens
227
Inhibits aldehyde dehydrogenase and used as deterrent for alcohol use
Disulfiram
228
Opioid receptor antagonist used to prevent alcohol abuse
Naltrexone
229
Competes for alcohol dehydrogenase and used in methanol or ethylene glycol poisoning
Fomepizole, ethanol
230
Most commonly abused opioids
Heroin, morphine, oxycodone
231
Respiratory and CNS depression, pinpoint pupils, seizures, and needle track marks are symptoms of this intoxication
Opioid
232
Opioid receptor antagonist that is used to treat opioid intoxication, may cause more rapid and intense symptoms of withdrawal
Naloxone
233
Sweating, dilated pupils, piloerection, and flu-like symptoms are symptoms of withdrawal from this class of drugs
Opioid
234
Opioids used for long-term maintenance from opioid withdrawal
Methadone, buprenorphine
235
Most widely abused sedative hypnotics
Short-acting barbiturates (pentobarbital)
236
Two date-rape drugs that work through enhancement of GABA receptors in the brain
Flunitrazepam, GHB (gamma-hydroxybutarate)
237
Benzodiazepine antagonits used to treat benzodiazepine intoxication
Flumazenil
238
Four major CNS stimulant drugs of abuse
Caffeine, nicotine, cocaine, amphetamines
239
Treatments available for nicotine addiction
Patch, gum, lozenge, buproprion, varenicline
240
CNS stimulant that acts by inhibiting reuptake of neurotransmitters; may cause pupil dilation, alter tactile sensation, irregular breathing, and cardiac toxicity
Cocaine
241
Amphetamine derivatives commonly abused
Methamphetamine (crystal meth), MDMA (methylenedioxymethamphetamine, or ecstasy)
242
Drug of abuse that was developed as a dissociative anesthetic; intoxication leads to both horizontal and vertical nystagmus, analgesia, psychosis, delirium, and seizures
PCP (phencyclidine, or angel dust)
243
Synthetic ergot derivative that can produce perceptual hallucinations and used as an illicit drug; pay cause paranoia
LSD (lysergic acid diethylamide)
244
Active ingredietni s tetrahydrocannabinol (THC); side effects include impairment of judgment, altered sense of time, increased appetite, and hallucinations
Marijuana
245
Use of all antipsychotic medication in this group of patients is associated with increased risk of deaths
Elderly with dementia-related psychosis
246
Antipsychotics that repress primarily the positive symptoms of schizophrenia
Typical antipsychotics
247
Primary mechanism of action of typical antipsychotics
Inhibits D2 receptors
248
Common endocrine side effects of all typical antipsychotic drugs
Hyperprolactinemia, galactorrhea
249
Two low potency, typical antipsychotic drugs
Chlorpromazine, thioridazine
250
Typical antipsychotic associated with retinopathy and cardiac toxicity
Thioridazine
251
Common side effects of low potency typical antipsychotic drugs
Dry mouth (anticholinergic), sedation (antihistamine), hypotension (alpha1 block)
252
Three high potency, typical antipsychotic drugs
Haloperidol, fluphenazine, trifluoperazine
253
Typical antipsychotic that can also be used for Tourette syndrome
Haloperidol
254
Side effects more commonly associated with high potency typical antipsychotic drugs
Dystonia, akathisia, bradykinesia, tardive dyskinesia (extrapyramidal symptoms)
255
Life-threatening side effect associated with typical antipsychotic drugs
Neuroleptic malignant syndrome
256
Treatment for drug-induced neuroleptic malignant syndrome
Dantrolene
257
Advantage of atypical over typical antipsychotics
Less extrapyramidal symptoms, more effect against negative symptoms of schizophrenia
258
Primary mechanism of action of atypical antipsychotics
Inhibit 5-HT2 receptors
259
Atypical antipsychotic that can produce potentially fatal agranulocytosis and increase incidence of seizures
Clozapine
260
Two atypical antipsychotics that can cause weight gain
Clozapine, olanzapine
261
Two atypical antipsychotics that can prolong the QT interval
Risperidone, ziprasidone
262
Atypical antipsychotic that can increase prolactin levels and cause gynecomastia and irregular menstruation in men and women, respectively
Risperidone
263
Atypical antipsychotic that can also be used to treat irritability in autistic syndrome
Aripiprazole
264
Tricyclic antidepressants
-iptuline, -ipramine, dozepine, amoxapine
265
Mechanism of tricyclic antidepressants
Block serotonin and norepinephrine reuptake
266
Common side effects of tricyclic antidepressants
Autonomic (block muscarinic and alpha1), sedation
267
Tricyclic secondary amines that produce less sedation and autonomic side effects (compared with tricyclic tertiary amines)
Nortriptyline, desipramine
268
Three life-threatening side effects associated with tricyclic antidepressants
Convulsion, cardiotoxicity, coma (3 C's)
269
Tricyclic antidepressent used for enuresis
Imipramine
270
Tricyclic antidepressant used in obsessive compulsive disorder
Clomipramine
271
Tricyclic antidepressant with antihistamine effect and is indicated for insomnia
Doxepin
272
Class of antidepressants that has fewer sedative and autonomic side effects than tricyclic antidepressants and indicated for panic disorder, generalized anxiety disorder, social phobias, bulimia, obsessive compulsive behavior, and post-traumatic stress disorder
Selective serotonin reuptake inhibitors (SSRI)
273
Four selective serotonin reuptake inhibitors
Fluoxetine, paroxetine, sertraline, citalopram
274
Serious side effect of SSRIs when used with other drugs such as MAOIs, SNRIs, or TCAs
Serotonin syndrome
275
Two selective serotonin-norepinephrine reuptake inhibitors (SNRIs)
Duloxetine, venlafaxine
276
Class of drug that is most useful in patients with anxiety, hypochondriasis, and depression that is refractory to other antidepressants
Monoamine oxidase inhibitors
277
Mechanism of action of isocarboxazid, phenelzine, and tranylcypromine
Irreversible inhibition of monoamine oxidase A and B
278
Mechanism of action of selegiline
Selectively inhibits monoamine oxidase B
279
A fatal condition that results from combination of monoamine oxidase inhibitors with tyramine-containing foods
Hypertensive crisis
280
Antidepressant that non-selectively inhibits neuronal reuptake; less likely to cause sedation, autonomic, cardiovascular, or sexual dysfunction; also used for smoking cessation
Buproprion
281
Antidepressant that inhibits serotonin reuptake but also antagonizes 5HT-2 receptors; causes priapism
Trazodone
282
Antidepressant that inhibits alpha 2, 5HT-2, and 5HT-3 receptors to increase release of norepinephrine and serotonin
Mirtazapine
283
First line drug for classic bipolar disorder with euphoric mania
Lithium
284
Major route of elimination for Lithium
Kidneys
285
Side effects of lithium
Tremor, hypothyroidism, nephrogenic diabetes insipidus, fetal cardiac defects
286
Antineoplastic folic acid analogue that inhibits dihydrofolate reductase
Methotrexate
287
Antineoplastic pyrimidine analog that inhibits thymidylate synthetase
5-flurouracil (5-FU)
288
Antineoplastic pyrimidine analog that inhibits DNA polymerase
Cytarabine
289
Serious side effect associated with cytarabine
Pancytopenia
290
Three antineoplastic purine analogs that inhibit purine synthesis
Azathioprine, 6-mercaptopurine, 6-thioguanine
291
Drug used concurrently with antineoplastics to reduce renal precipitation of urates
Allopurinol
292
Two antineoplastics that require dose-reduction in patients who are taking allopurinol
Azathioprine, 6-mercaptopurine
293
Inhibits microtubule formation by binding to beta-tubulin; dose-limiting side effect is bone marrow suppression
Vinblastine
294
Inhibits microtubule formation by binding to beta-tubulin; dose-limiting side effect is neurotoxicty
Paclitaxel, -taxels
295
Two prodrugs, that after liver bioactivation, bind to N7 nitrogen of guanine and cross-link DNA
Cyclophosphamide, ifosfamide
296
Serious side effect of cyclophosphamide and ifosfamide due to generation of acrolein
Hemorrhagic cystitis
297
Agents that is used to bind acrolein and prevent drug-induced hemorrhagic cystitis
Mesna
298
Nitrosureas that spontaneously form active intermediates that cross-link DNA; can cross blood-brain-barrier and is indicated for brain tumors
Carmustine, -mustines
299
Alkylating agent that has greater activity against myeloid cells than lymphoid cells; serious side effects include myelosuppression and pulmonary fibrosis
Busulfan
300
Two anthracyclines that chelate DNA, form free radicals, and cause dose-limiting cardiotoxicity
Daunorubicin, doxorubicin
