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HLTH 2511 > Pharmacopoeia > Flashcards

Pharmacopoeia Flashcards

1
Q

Heparin (unfractionated)

A
  • Anticoagulant
  • promotes antithrombin III (ATIII) activity, inactivating factor Xa and thrombin.
  • Only given parenterally (IV, SC)
  • Requires ongoing aPTT monitoring
  • Used acutely (PE, DVT, DIC) and prophylactically in surgery or in patients at high risk for clotting disorders
  • Antidote is Protamine if excessive bleeding is present
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2
Q

Cocaine

A
  • Ester-type local anaesthetic
  • Sodium channel blocker
  • causes local vasoconstriction, prolonging duration of action
  • relatively weak anaesthetic effect and high risk of abuse, so rarely used
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3
Q

Esbriet (Perfenidone)

A
  • Anti-fibrotic, anti-inflammatory
  • Used in management of IPF
  • thought to interfere with production of inflammatory proteins like TGF-Beta and TNF
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4
Q

Claritin (Loratadine)

A
  • Second-generation antihistamine, H1 receptor antagonist
  • Blocks peripheral H1 receptors, does not closs blood-brain barrier
  • Alleviates allergy symptoms without causing significant sedation/hypnosis
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5
Q

Decadron (Dexamethasone)

A
  • Long-acting, high-potency corticosteroid
  • Causes broad anti-inflammatory effects
    • Decreases eicosanoid production
    • Decreases inflammatory cytokine production
    • Decreases inflammatory cell produciton and recruitment
    • Reduces histamine production and release
  • Used in dexamethasone suppression test and in long-term anti-inflammation, anti-immune treatment
  • Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
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6
Q

Apo-Hydro (Hydrochlorothiazide)

A
  • thiazide diuretic
  • Acts on NaCl symporter in DCT, causing natriuresis, kaliuresis, and Calcium retention
  • First line diuretic for treatment of hypertension and edematous states.
  • Also used in treatment of nephrolithiasis, diabetes insipidus, and renal disorders
  • Common side effects: hypokalemia, hyperglycemia, hyperlipidemia, hyperuricemia
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7
Q

Levophed (Norepinephrine)

A
  • Direct-acting adrenergic agonist, endogenous catecholamine
  • Has high α1 specificity, so minimal cardiac effects with signigicant peripheral vasoconstriction
  • incr. BP due to incr. SVR. high potential for reflex bradycardia (no beta effect)
  • used in treatment of shock and hypotension
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8
Q

Diprivan (Propofol)

A
  • Parenteral, non-opioid anaesthetic
  • Cause GABA potentiation (similar to BZs) to produce sedation and anaesthesia
  • generally used to induce anaesthesia which is maintained by an inhalational anaesthetic, except in short, minor procedures. (20s onset, 5-10 min duration)
  • Reduces ICP and BP, so near ideal for head injury management
  • prolonged use potentiates cardiovascular depression
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9
Q

Spiriva (Tiotropium bromide)

A
  • Muscarinic-selective receptor antagonist (synthetic atropine analog)
  • used for bronchodilation and reduced mucus secretion in asthma/COPD
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10
Q

Atrovent (Ipratropium bromide)

A
  • Muscarinic-selective receptor antagonist (synthetic atropine analog)
  • used for bronchodilation and reduced mucus secretion in asthma/COPD
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11
Q

QVAR (Beclomethasone dipropionate)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • MDI only given BID
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12
Q

Pulmicort (Budesonide)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • Turbuhaler DPI only, given BID
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13
Q

Viagra (sildenafil)

A
  • Type 5 phosphodiesterase inhibitor (PDE5 inhibitor)
  • PNS innervation of vascular smooth muscle causes vasodilation and cGMP release (causing further smooth muscle relaxation). PDE5 inhibitors slow the breakdown of cGMP leading to increased/prolonged vasodilation.
  • As Viagra, sildenafil is used to treat erectile dysfunction
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14
Q

Ativan (Lorazepam)

A
  • Benzodiazepine, sedative-hypnotic
  • Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization
  • Fast onset with medium duration of action and no active metabolites
  • Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia
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15
Q

Atropine (atropine)

A
  • muscarinic receptor antagonist (belladonna alkaloid, tertiary amine)
  • toxixicity is dose dependent, remember; dry as a bone, red as beet, mad as a hatter, blind as a bat
  • causes dilatation, positive chronotropy, decreased secretions, decreased GI motility, bronchodilation, etc.
  • used to reverse cholinesterase overdose and as a positive chronotrope
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16
Q

Tagamet (Cimetidine)

A
  • H2-receptor antagonist
  • reduces gastric acid secretion to reduce dyspepsia/gastroenteritis in GERD
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17
Q

Allegra (Fexofenadine)

A
  • Second-generation antihistamine, H1 receptor antagonist
  • Blocks peripheral H1 receptors, does not closs blood-brain barrier
  • Alleviates allergy symptoms without causing significant sedation/hypnosis
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18
Q

TNKase (Tenecteplase)

A
  • fibrinolytic, thrombolytic, recombinant tPA
  • causes plasmin activation from plasminogen, with high specificity for fibrin-bound plasminogen
  • longer duration of action than alteplase
  • used in resolution of STEMI
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19
Q

Alvesco (Ciclesonide)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • MDI only, given QD
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20
Q

Haldol (Haloperidol)

A
  • first generation, typical antipsychotic
  • blocks D2 receptors in the mesocortical, mesolimbic and other pathways
  • high potency, very high risks of extrapyramidal side effects
  • generally only useful in treatment of positive symptoms of schizophrenia.
  • prolonged use may lead to tardive dyskinesia or neuroleptic malignant syndrome
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21
Q

Accolate (Zafirlukast)

A
  • Leukotriene Receptor Antagonist (LTRA)
  • second-line asthma controller
  • given as adjunct with ICS or as second-line monotherapy where ICS not tolerated
  • not useful in severe exacerbations of asthma
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22
Q

Sublimaze (Fentanyl)

A
  • Strong, synthetic opioid, full opioid agonist
  • 100x potency relative to morphine with fewer CV effects, faster onset, and less hangover than morphine
  • powerful analgesic for acute and chronic pain
  • adverse effects include sedation, respiratory depression, constipation, miosis, N/V
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23
Q

Lovenox (Enoxaparin)

A
  • Anticoagulant, fractionated heparin / LMWH
  • promotes antithrombin III (ATIII) activity, inactivating factor Xa
  • Only given parenterally (IV, SC)
  • Does not require ongoing aPTT monitoring
  • Used acutely (PE, DVT, DIC) and mainly prophylactically in surgery or in patients at high risk for clotting disorders
  • Antidote is Protamine if excessive bleeding is present
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24
Q

Bricanyl (Terbutaline)

A
  • Non-catecholamine direct-acting adrenergic
  • selective, short-acting β2 agonis (SABA). May activate β1 reeptors at higher doses.
  • used to promote bronchodilation in COPD and asthma as a rescue medication
  • adverse effects include tachycardia, tremor, and nervousness
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25
Q

Deltasone (Prednisone)

A
  • Intermediate acting corticosteroid
  • Causes broad anti-inflammatory effects
    • Decreases eicosanoid production
    • Decreases inflammatory cytokine production
    • Decreases inflammatory cell produciton and recruitment
    • Reduces histamine production and release
  • Used to treat cancer, inflammation, allergy, and autoimmune disorders
  • Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
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26
Q

Sotacor (Zaleplon)

A
  • non-BZ sedative-hypnotic
  • used in management of sleep disorders
  • increases GABA activity in CNS
  • less tolerance and dependence forming than the BZ drugs
  • preserves sleep architecture
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27
Q

Pravachol (Pravastatin)

A
  • Statin, antihyperlipidemic
  • HMG-CoA inhibitor, reduces LDL by 20-50%
  • Shown to reduce mortality due to atherosclerosis
  • adverse effects include muscle damage, GI issues, memory impairment, and NIDDM
  • Pravachol has the lowest rate of adverse effects and drug interactions of any statin
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28
Q

Lopressor (Metoprolol)

A
  • Selective β1-antagonist (beta-blocker)
  • oral or parenteral
  • good antihypertensive, antianginal, antiarrhythmic
  • relatively short half-life (3-4hr)
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29
Q

Aldactone (Spironolactone)

A
  • Potassium-sparing diuretic, aldosterone receptor antagonist
  • inhibits binding of aldosterone in the late DCT and collecting duct, which prevents expression of sodium channels.
  • Used in combination with other diuretics to prevent hyperkalemia, in treatment of primary hyperaldosteronism, and in PCOS as an anti-androgenic
  • Adverse effects; gynecomastia and infertility in men, hyperkalemia.
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30
Q

Anexate (Flumazenil)

A
  • Benzodiazepine antagonist, reversal agent
  • Competitive BZ receptor antagonist
  • used to reverse BZ overdose and BZ sedation
  • short half-life (7-15 minutes) with unpredictable effects that may potentiate seizures. Rarely indicated due to low mortality with benzo overdose
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31
Q

Singulair (Montelukast)

A
  • Leukotriene Receptor Antagonist (LTRA)
  • second-line asthma controller
  • given as adjunct with ICS or as second-line monotherapy where ICS not tolerated
  • not useful in severe exacerbations of asthma
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32
Q

Persantine (Dipyridamole)

A
  • antiplatelet
  • relatively weak antiplatelet effect, but also acts as a coronary vasodilator by causing adenosine release
  • Often combined with aspirin for post-CVA therapy
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33
Q

Protamine (Protamine sulphate)

A
  • heparin antidote
  • used to treat uncontrollable bleeding in the context of heparin administration
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34
Q

BLES (Bovine Lipid Extracted Surfactant)

A
  • Natural surfactant extracted from bovine lungs
  • First choice treatment for managment of RDS
  • Reduces pulmonary gas-liquid interface surface tension and work of breathing
  • Instilled through endotracheal tube
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35
Q

Celebrex (Celecoxib)

A
  • NSAID, selectie COX-2 inhibitor
  • Reduces PG production associated with inflammation without causing gastric irritation
  • used in management of pain and inflammation
  • increased risk of cardiovascular events (MI, CVA)
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36
Q

Oxeze (Formoterol)

A
  • Long-acting Beta Agonist (LABA), Fast-acting Beta Agonist (FABA)
  • 12hr duration of action with relatively fast onset
  • Used always as combination therapy with an ICS for asthma control
  • causes bronchodilation and potentiates anti-inflammatory effects of ICS
  • may be used for asthma control or relief
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37
Q

Flovent (Fluticasone propionate)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • MDI or Diskus DPI given BID
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38
Q

Xylocaine (Lidocaine)

A
  • Class 1B antiarrhythmic
  • Preferentially binds to sodium channels in the inactivated state
  • Has fast, rate-dependant kinetics. Slows conduction in rapidly depolarizing tissue and limits reentry
  • Used in the management of refractory Ventricular arrhythmias, esp. VTach and VFib
  • Second-line choice if amiodarone is unsuccessful
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39
Q

Xylocaine (Lidocaine)

A
  • Amide-type local anaesthetic
  • sodium channel blocker that produces use-dpendent and size-dependent blockade
  • may be given with epi to induce vasoconstriction and prolong duration of action
  • relatively strong local anaesthetic effect
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40
Q

Prozac (fluoxetine)

A
  • SSRI antidepressent
  • selectively blocks reuptake of serotonin, increasing serotonin concentration in the synaptic cleft
  • highly effective with a low rate of adverse effects (e.g. sedation, anticholinergic effects, ortho hypo, dysrhythmia)
  • most common and first line drug in treatment of depression
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41
Q

Imovane (Zopiclone)

A
  • non-BZ sedative-hypnotic
  • used in management of sleep disorders
  • increases GABA activity in CNS
  • less tolerance and dependence forming than the BZ drugs
  • preserves sleep architecture
42
Q

Xolair (Omalizumab)

A
  • Anti-IgE antibody
  • inhibits inflammatory mediator release from mast cells
  • used to treat asthma that is not controlled by med/high ICS/LABA combination therapy
  • given SQ every 2-4 weeks for 3-4 months
43
Q

Spiriva (Tiotropium)

A
  • Long-Acting Anti-Muscarinic
  • Used as combination therapy with ICS for “ultra” long-acting control of asthma symptoms
  • also used in COPD management
  • most useful where there is parasympathetic/vagal mediated bronchoconstriction and mucus production
44
Q

Neosynephrine (Phenylephrine)

A
  • Non-catecholamine direct-acting adrenergic
  • relatively pure α1-agonist
  • Used to promote mydriasis
  • Used as a nasal decongestant
  • Used in the emergency or surgical setting as a vasopressor (prominent push-dose vasopressor)
45
Q

Prolastin

A
  • Alpha1 Proteinase Inhibitor
  • Used in patients with alpha1 antitrypsin deficiency to reduce alveolar damage due to elastin degradation
  • alpha1 antitrypsin usually inhibits elastase and protease, preventing damage from these endogenous enzymes.
  • Used in management of alpha1 antitrypsin-associated emphysema
46
Q

Noctec (Chloral hydrate)

A
  • Non-BZ sedative hypnotic
  • given as a prodrug
  • generally only given as preanesthetic sedation in pediatric patients
47
Q

Normodyne (Labetalol)

A
  • α and β blocker
  • used in the treatment of hypertension and for its potent anti-oxidant effects
  • non-selctive beta effect, so should not be used in persons with asthma
48
Q

Aspirin (Acetylsalicylic acid)

A
  • NSAID, antiplatelet
  • non-competitive cyclooxygenase inhibitor. At low doses selectively inhibits thromboxane A2 production without affecting prostacyclins
  • prevents platelet aggregation
  • given prophylactically or acutely for MI and stroke
49
Q

Diamox (Acetazolamide)

A
  • Carbonic anhydrase inhibitor, diuretic
  • Inhibits Carbonic anhydrase at the PCT, which causes increased bicarbonate excretion and a weak diuretic effect
  • may cause a secondary metabolic acidosis
  • used in treatment of glaucoma, acute mountain sickness, and epilepsy
50
Q

Amidate (Etomidate)

A
  • Parenteral anaesthetic
  • Acts on GABA receptors to produce anaesthesia/sedation
  • Rapid onset and very few cardiovascular side effects, so ideal for hyperacute situations
  • used in RSI and conscious sedation
  • Prolonged use inhibits steroid synthesis
51
Q

Lipitor (Atorvastatin)

A
  • Statin, antihyperlipidemic
  • HMG-CoA inhibitor, reduces LDL by 20-50%
  • Shown to reduce mortality due to atherosclerosis
  • adverse effects include muscle damage, GI issues, memory impairment, and NIDDM
  • Lipitor has a long half life and can be taken at any time of day
52
Q

Dobutrex (Dobutamine)

A
  • Direct-acting adrenergic agonist, exogenous catecholamine
  • Has only β affinity, so produces positive cardiac effects and vasodilation
  • Positive inotrope and dromotrope without significant chronotropic effects! Increases SBP and stroke volume without increasing HR while dropping SVR
  • preferred drug for treating cradiogenic shock or heart failure
53
Q

Symbicort (Budesonide+ Formoterol)

A
  • Combination ICS and LABA
  • used to control asthma that is not adequately controlled with low-dose ICS alone
  • ICS and LABA potentiate each others’ effects, improving both anti-inflammatory and bronchodilatory actions
  • May be used as a reliever for brief exacerbations of asthma
54
Q

describe the function of Zyban (bupropion) in smoking cessation therapy

A
  • antidepressant (atypical, norep and dopamine reuptake inhibitor)
  • increases dopamine concentration when ceasing smoking
  • more effective when combined with NRT
55
Q

Elavil (amitryptiline)

A
  • tricycylic antidepressent (TCA)
  • inhibits reuptake of serotonin and norepinephrine, increasing synaptic concentration
  • highly effective in treatment of depression, but with many adverse effects
  • onset of 2-4 weeks
  • adverse effects include; sedation, anticholinergic effects, orthostatic hypotension, and cardiac dysrhythmia. OD may cause wide-QRS tachy. Prolonged use may lead to serotonin syndrome
56
Q

Cinquair (Rexlizumab)

A
  • Anti-IL-5 agent
  • Inactivates interleukin-5 (IL-5) which is involved in recruitment, activation, differentiation, and growth of eosinophils. Cinquair reduces number of activated eosinophils in blood and sputum
  • used in management of refractory asthma, reduces inflammation and airway remodelling
57
Q

Dilaudid (Hydromorphone)

A
  • Strong, semi-synthetic opioid, full opioid agonist
  • 10x potency relative to morphine with fewer CNS, GI, and CV effects than morphine
  • powerful analgesic for acute and chronic pain
  • adverse effects include sedation, respiratory depression, constipation, miosis, N/V
58
Q

Ventolin (Salbutamol)

A
  • Non-catecholamine direct-acting adrenergic
  • selective, short-acting β2 agonis (SABA). May activate β1 reeptors at higher doses.
  • used to promote bronchodilation in COPD and asthma as a rescue medication
  • adverse effects include tachycardia, tremor, and nervousness
59
Q

Coumadin (Warfarin)

A
  • anticoagulant
  • Inhibits production of clotting factors II, VII, IX, and X, thereby inhibiting both intrinsic and extrinsic pathways, but especially extrinsic
  • Delayed onset of action (3-5 days), initially given with LMWH
  • effectiveness is assessed by INR (should be 2-3 for warfarin. 1.1 or less is normal)
  • Used in long term PO prophylactic treatment for DVT, with artificial heart valves, and AFib
60
Q

Cymbalta (duloxetine)

A
  • SNRI antidepressant
  • Inhibits reuptake of Serotonin and Norep with few other NT interactions
  • Used in treatment of affective and anxiety disorders
  • Fewer adverse effects than TCAs
61
Q

Provocholine (Methacoline)

A
  • Direct-acting cholinergic with greater M3 muscarinic specificity
  • Broad systemic effects, but mainly respiratory (SLUDGE), decreased heart rate, increased PR-interval, increased gastric secretions and GI motility
  • Used in the methacholine challenge test (MCT) for asthma. Small doses of methacholine may induce bronchospasm and excessive mucus production in those with reactive airways
62
Q

Versed (Midazolam)

A
  • Benzodiazepine, sedative-hypnotic
  • Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization
  • Fast onset with short duration of action, generally only given IV (or IM)
  • Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia
  • used in acute settings for induction of anaesthesia, termination of seizures, and delirium
63
Q

Aspirin (ASA)

A
  • NSAID, non-specific COX inhibitor
  • causes irreversible inhibition of platelet COX enzymes. Reduces PG and TXA2 production in a dose-dependent fashion
  • used for anti-inflammation, anti-inflammatory, analgesic, and anti-platelet effects
  • Has an anti-platlet effect which is longer-acting than analgesia
  • Increased risk of GI bleeding, ulcers, can cause tinnitus, respiratory alkalosis, and asthma
  • may potentiate Reye’s syndrome in children with viral infection
64
Q

Serevent (Salmeterol)

A
  • Long-acting Beta Agonist (LABA)
  • 12hr duration of action with relatively slow onset
  • Used always as combination therapy with an ICS for asthma control
  • causes bronchodilation and potentiates anti-inflammatory effects of ICS
  • never to be used as monotherapy or as a rescue inhaler
65
Q

Coreg (Carvedilol)

A
  • α and β blocker
  • used in the treatment of hypertension and for its potent anti-oxidant effects
  • non-selctive beta effect, so should not be used in persons with asthma
66
Q

Nucala (Mepolizumab)

A
  • Anti-IL-5 agent
  • Inactivates interleukin-5 (IL-5) which is involved in recruitment, activation, differentiation, and growth of eosinophils. Nucala reduces number of activated eosinophils in blood and sputum
  • used in management of refractory asthma, reduces inflammation and airway remodelling
67
Q

Cordarone (Amiodarone)

A
  • Class 3 antiarrhythmic, potassium channel blocker, thyroxine analog
  • also blocks sodium and potassium channels and beta-adrenoceptors
  • Decreases SA automaticity, prolongs AV nodal and ventricular refractory periods. Increases PR and QT intervals and may widen QRS.
  • Orally given to suppress both supraventricular and ventricular dysrhytmias
  • Given IV to terminate VT and VF
  • Many adverse effects; bradycardia, torsades de pointes, thyrotoxicity, photosensitivity, pulmonary fibrosis
68
Q

Mannitol

A
  • osmotic diuretic
  • increases filtrate osmolarity, drawing additional fluid into urine and causing diuresis
  • Used in treatment of cerebral edema, increased intraocular pressure (glaucoma), and to icrease urine volume
69
Q

Sufenta (Sufentanil)

A
  • Strong, synthetic opioid, full opioid agonist
  • 1000x potency relative to morphine with fewer CV effects, faster onset, and less hangover than morphine
  • powerful analgesic for acute and chronic pain
  • adverse effects include sedation, respiratory depression, constipation, miosis, N/V
70
Q

Robinul (Glycopyrrolate)

A
  • Quaternary amine muscarinic receptor antagonist
  • not absorbed by CNS
  • used in the setting of surgery to dry secretions and inhibit muscarinic effects of neuromuscular blocking agents (rocuronium, succinylcholine)
71
Q

Adenocard (Adenosine)

A
  • Antiarrhythmic, endogenous nucleoside, non-Vaughan-Williams class
  • Binds to A1 receptors to cause AV Nodal Blockade (may cause complete heart block and brief asystole). Causes increased potassium efflux and membrane hyperpolarization.
  • Used to terminate PSVT, including in WPW
  • Extremely short T1/2 (~10s)
  • May cause bronchoconstriction and reduces epinephrine sensitivity
72
Q

Valium (Diazepam)

A
  • Benzodiazepine, sedative-hypnotic
  • Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization
  • Fast onset with long duration of action
  • Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia
73
Q

Tylenol (Acetaminophen)

A
  • Not strictly an NSAID; non-opioid analgesic/antipyretic
  • MOA not udnerstood, but may involve COX-3. Does not affect COX-1 or COX-2
  • reduces pain and fever associated with inflammation
  • No associated GI effects or Reye’s syndrome
  • causes hepatic toxicity in overdose that rapidly escalates with higher doses as toxic metabolites accumulate
74
Q

TXA (Tranexamic Acid)

A
  • procoagulant, antiplasmin
  • inhibits activation of plasmin from plasminogen
  • used in management of heavy menstrual bleeding, hemophilia, and traumatic hemorrhage
75
Q

Cortef / Solu-Cortef (Hydrocortisone)

A
  • Short-acting corticosteroid
  • Causes broad anti-inflammatory effects
    • Decreases eicosanoid production
    • Decreases inflammatory cytokine production
    • Decreases inflammatory cell produciton and recruitment
    • Reduces histamine production and release
  • Short-acting CS mainly used in CS-replacement therapy (addison’s) or as topical anti-inflammatory
  • Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
76
Q

Benadryl (Diphenhydramine)

A
  • First-generation antihistamine, H1 receptor antagonist
  • Blocks H1 receptors systemically, including the CNS
  • Used to manage symptoms of allergy, but may cause unwanted sedation/hypnosis
77
Q

Activase (Alteplase-Recombinant)

A
  • fibrinolytic, thrombolytic, recombinant tPA
  • causes plasmin activation from plasminogen, with moderate-to-high specificity for fibrin-bound plasminogen
  • only thrombolytic recommended for acute PE
  • also used in stroke and MI management (tenecteplase preferred for STEMI)
78
Q

Isuprel (Isoproterenol)

A
  • Direct-acting adrenergic agonist, exogenous catecholamine
  • Has only β affinity, so produces positive cardiac effects and vasodilation (as well as bronchodilation)
  • Strong positive chronotrope! Causes increased HR and SBP, with decreased SVR and diastolic BP
  • Risk of tachyarrhythmias, useful in treatment of heart blocks and bradycardia
79
Q

Clozaril (Clozapine)

A
  • second generation, atypical antipsychotic
  • blocks 5-HT and D2 receptors in the mesocortical, mesolimbic and other pathways
  • high potency, low risk of EPSs, but many other systemic side effects stemming from alpha blockade and anticholinergic effects
  • useful in treating both positive and negative symptoms of schizophrenia
  • prolonged use may lead to tardive dyskinesia or neuroleptic malignant syndrome
80
Q

Zemuron (Rocuronium)

A
  • non-depolarizing neuromuscular blocking agent (ND NMBA)
  • competitive inhibitor of muscle-type nicotinic ACh receptors
  • induction of paralysis during medical procedures (ex: intubation)
  • intermediate acting consider pancuronium for longer duration of action
81
Q

Tracium (Atracurium)

A
  • non-depolarizing neuromuscular blocking agent (ND NMBA)
  • competitive inhibitor of muscle-type nicotinic ACh receptors
  • induction of paralysis during medical procedures (ex: intubation)
  • intermediate acting, may have increased histamine release but lower hepatotoxicity vs. rocuronium
82
Q

Zantac (Ranitidine)

A
  • H2-receptor antagonist
  • reduces gastric acid secretion to reduce dyspepsia/gastroenteritis in GERD
83
Q

Advair (Fluticasone + Salmeterol)

A
  • Combination ICS and LABA
  • used to control asthma that is not adequately controlled with low-dose ICS alone
  • ICS and LABA potentiate each others’ effects, improving both anti-inflammatory and bronchodilatory actions
  • Should NOT be used as a reliever
84
Q

Inderal (Propranolol)

A
  • Non-selective β-antagonist (beta-blocker)
  • Primarily given orally but may be given parenterally
  • One of the first developed and thus has the ridest range of approved clinical uses
    • hypertenion, angina, cardiac dysrhythmias, migraine, AMI, pheochromocytoma
  • Has more CNS side effects than other non-selective beta-blockers
85
Q

Adrenalin (Epinehrine)

A
  • Direct-acting adrenergic agonist, endogenous catecholamine
  • Has equal α and β affinity, so both cardiac and vascular effects
  • effects are highly dose dependent! at lower doses there is greater β activation, so there is MSK vasodilation and positive cardiac effects leading to increased systolic, decreased diastolic. At higher doses there is increased α1 effect and diastolic may increase as well.
  • used in treatment of shock and hypotension
86
Q

Prostigmin (Neostigmine)

A
  • Reversible cholinesterase inhibitor (indirect-acting cholinergics)
  • Relatively long-acting (compared to edrophonium)
  • Used in long-term treatment of myasthenia gravis
87
Q

Tenormin (Atenolol)

A
  • Selective β1-antagonist (beta-blocker)
  • oral or parenteral
  • good antihypertensive, antianginal, antiarrhythmic
  • Low rate of CNS side effects due to poor lipid solubility
88
Q

Lasix (Furosemide)

A
  • Loop diuretic
  • Inhibits the Na/K/2Cl cotransporter in thick ascending limb of loop of henle
  • high-ceiling dose-dependent diuretic
  • Preffered first line diuretic for edematous states
  • Adverse effects: hypokalemia, hypomagnesemia, hypocalcemia, hyperglycemia, hyperuricemia, ototoxicity
89
Q

Tensilon (Edrophonium)

A
  • Short-acting reversible cholinesterase inhibitor (indirect-acting cholinnergic)
  • rapidly increases ACh concentrations
  • may be used to reverse neuromuscular blockade
  • used to diagnose between myasthenic crisis (not enough ACh) and a cholinergic crisis (too much ACh) in myasthenia gravis
90
Q

Motrin/Advil (Ibuprofen)

A
  • NSAID, non-selective COX inhibitor
  • competitively inhibits COX enzymes, reducing PG and TXA2 synthesis in inflammation
  • used to reduce pain, inflammation
  • May cause GI, hepatic, and renal side effects due to COX-1 inhibition
  • does not produce the anti-platelet effects of ASA
91
Q

Zenhale (Mometasone + Formoterol)

A
  • Combination ICS and LABA
  • used to control asthma that is not adequately controlled with low-dose ICS alone
  • ICS and LABA potentiate each others’ effects, improving both anti-inflammatory and bronchodilatory actions
  • May be used as both controller and reliever
92
Q

Pradaxa (dabigatran)

A
  • Anticoagulant, direct thrombin inhibitor
  • Competitively inhibits thrombin protease site, which inhibits fibrin formation
  • no INR monitoring is required
  • is increasingly replacing warfarin for chronic management of DVT, AFib due to lower risk of adverse events, no need for monitoring, and fewer food interactions
  • not for patients with valve replacement!
93
Q

Inotropin (Dopamine)

A
  • Direct-acting adrenergic agonist, endogenous catecholamine
  • Effect is highly dose-dependent. At low doses it is D1 selective and promotes renal perfusion (uncommon). At medium doses it stimulates β1 receptors (incr. inotropy and decr. SVR). At high doses it stimulates α1 receptors, causing vasoconstriction
  • used in treatment of shock and hypotension
94
Q

Describe the function of Champix (verenicline) in smoking cessation therapy

A
  • partial nictone receptor agonist
  • acts as a competitive antagonist in presence of nicotine while maintaining baseline dopamine release
95
Q

Ketamar (Ketamine)

A
  • Non-opioid parenteral anaesthetic, sedative, dissociative
  • Blocks excitatory NTs at NMDA receptors. Produces dissociative anaesthesia
  • Anaesthesia characterized by analgesia, reduced sensory perception, incomplete loss of consciousness, immobility, and amnesia
  • Causes increased BP and no respiratory depression (great for trauma)
  • produces unpleasent emergence including hallucinations and delirium; less common in pediatric patients!
96
Q

Morphine

A
  • Strong, natural opioid, full opioid agonist
  • considered the prototype opioid
  • powerful analgesic for acute and chronic pain
  • adverse effects include sedation, respiratory depression, constipation, miosis, N/V
  • hydromorphone preferred for chronic pain management due to fewer adverse effects
97
Q

Anectine (Succinylcholine)

A
  • depolarizing neuromuscular blocking agent (D NMBA)
  • non-competitive agonist of muscle-type nicotinic ACh receptors causes protracted depolariztion
  • induction of paralysis during medical procedures (ex: intubation)
  • short onset and short-acting
98
Q

Demerol (Meperidine)

A
  • Strong synthetic full opioid analgesic
  • 0.1X potency relative to Morphine
  • Less smooth muscle effects less pronounced than with other opioids. Fewer GI, biliary, and uterine side effects
  • Safer for pregnant patients, or those with cholecystitis
99
Q

Buscopan (Scopolamine)

A
  • muscarinic receptor antagonist (belladonna alkaloid, tertiary amine)
  • toxixicity is dose dependent, remember; dry as a bone, red as beet, mad as a hatter, blind as a bat
  • causes dilatation, positive chronotropy, decreased secretions, decreased GI motility, bronchodilation, etc.
  • greater CNS effect than atropine therefore used to treat motion sickness
100
Q

Precidex (Dexmetetomidine)

A
  • alpha-2 agonist
  • used in treatment of hypertension and for sedation in anaesthetized/intubated patients in an ICU setting
  • used due to lack of respiratory depression
101
Q

Brevibloc (Esmolol)

A
  • Selective β1-antagonist (beta-blocker)
  • IV-only!
  • good antihypertensive, antianginal, antiarrhythmic
  • very short half-life compared to other beta-blockers, used in emergent settings (check out that trade name!)
102
Q

Dolophine (Methadone)

A
  • Long-acting synthetic full opioid agonist
  • Does not tend to produce euphoria or other reinforcing effects
  • Used in management of chronic pain and in opioid addiction treatment

HLTH 2511 (11 decks)

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