pharmacy foundations 1 Flashcards
muscarinic action & agonist/antagonist
ACh
SLUDD - pilocarpine
anti SLUDD - atropine, oxybutynin
nicotinic action & agonist/antagonist
ACh
increase BP, HR - nicotine
NM blockade - NM blockers (rocuronium)
alpha 1 action & agonist/antagonist
Epi/NE - peripheral
increase BP/ smooth muscle vasoconstriction - PE, dopamine
decrease BP/ vasodilation - doxazosin, carvedilol, phentolamine
alpha 2 action & agonist/antagonist
Epi/NE - central
decrease BP, HR - clonidine, brimonidine
increase BP, HR - ergot alkaloids, yohimbe
beta 1 action & agonist/antagonist
Epi/NE - heart
increase contractility, HR, CO - dobutamine, isoproterenol, dopamine
decrease CO, HR - AMEBBA, propranolol, carvedilol
beta 2 action & agonist/antagonist
Epi - lungs
bronchodilation - albuterol, isoproterenol, terbutaline
bronchoconstriction - non selective BB
dopamine action & agonist/antagonist
renal, cardiac, CNS - levodopa, pramiprexole
renal, cardiac, CNS - FGA, metoclopramide
serotonin action & agonist/antagonist
platelet, GI, psych - triptans
platelet, GI, pysch - ondansetron, SGA
AChesterase drugs
donepezil, rivastigmine, galantamine
MAO inhibitors
phenelzine, tranylcypromine, isocarboxazid, selegiline, rasagiline, methylene blue, linezolid
what drugs should be separated from polyvalent ions
levothyroxine, tetracyclines, quinolones, bisphosphonates
which drugs are polyvalent cations and should be separated from certain drugs
antacids, MVI, sucralfate, bile acid resins, Al, Ca, Fe, Mg, Zn, phosphate binders
where do most PK drug interactions occur
liver
list of prodrugs and their active metabolites
colistimethate - colistin
cortisone - cortisol
famciclovir - penciclovir
isavuconazonium sulfate - isavuconazole
prednisone - prednisolone
primidone - phenobarbital
tramadol - active
CYP inhibitors
G <3 PACMAN
Grapefruit juice
Protease inhibitors (-avir)
Amiodarone
Cyclosporine, cobicistat
Macrolides (not azithromycin)
Azoles
Non DHP CCB
CYP inducers
PS PORCS
Phenytoin
Smoking
Phenobarbital/Primidone
Oxcarbazepine
Rifampin
Carbamazepine (auto inducer)
St john’s wort
Pgp substrates
anticoagulants
digoxin
non dhp ccb
cyclosporine/tacrolimus
colchicine
HCV drugs
Pgp inhibitors
PACMAN
Protease inhibitor (AND HCV drugs)
Azoles (itraconazole/posaconazole)
Cyclosporine/Cobicistat
Macrolides (clarithromycin)
Amiodarone
Nonn DHP CCB
Pgp inducers
P PRCS
Phenytoin
Phenobarbital
Rifampin
Carbamazepine
St John’s wort
common CV drug interactions
amiodarone (2C9 inhibitor) + warfarin - decrease warfarin 50%
amiodarone (Pgp inhibitor) + digoxin - decrease digoxin 50%
digoxin + loop - decreases K, Mg, Ca, Na (digoxin increases Ca)
statin (3A4 substrate) + inhibitor - use pitastatin, pravastatin, rosuvastatin
warfarin + 2C9 inhibitor/inducer - increase/decrease warfarin level AND INR
common inhibitor/substrate drug interactions
valproate + lamotrigine - increase lamictal (use lower starter kit)
MAO + antidepressants, antipsychotics, opioids, analgesics, ADHD drugs, lithium, st john’s wort, tyramine food
3A4, pgp inhibitors + CNI or mTOR - increases drug concentration
common inducer/substrate drug interactions
AED + contraceptives, other AEDs (use higher lamictal kit)
smoking + antipsychotics, antidepressants, hypnotics, caffeine, theophylline, warfarin
drugs with additive serotonergic activity
antidepressants
MAO inhibitors
opioids
triptans
St. john’s wort, L tryptophan
buspirone, lithium, dextromethorphan
drugs with additive bleeding risk
anticoagulants
antiplatelets
NSAID
5 Gs, vitamin E, dong quai, willow bark, fish oil
SSRI/SNRI
drugs with additive hyperkalemia risk & hypokalemia
RAAS inhibitors (ACEi, ARB, ARNI, aliskiren, aldosterone antagonists)
potassium sparing (triamterene, amiloride)
KCl
CNI
SMX/TMP
canagliflozin
drosperinone
hypokalemia - diuretics, beta2 agonists, insulin
drugs with additive QT prolongation risk
antipsychotics
antidepressants
antiarrhythmics
anti-infectives - macrolides, quinolones, azoles, antimalarials
antiemetics
ADT
TKI
oxaliplatin
methadone
loperamide
hydroxyzine
drugs with additive ototoxicity risk
vancomycin
aminoglycosides
cisplatin
salicylates
loops
drugs with additive nephrotoxicity
ampB
vancomycin
cisplatin
aminoglycosides
CNI
loop
NSAIDs
contrast dye
drugs with anticholinergic toxicity
antidepressants/antipsychotics
sedating antihistamines
muscle relaxants - baclofen, carisoprodol, cyclobenzaprine
antimuscarinics
atropine, dicyclomine
drugs with additive hypotension risk
PDE5 inhibitors +
3A4 inhibitors OR nitrates OR alpha 1 blockers
CYP3A4 substrates
opioids (fentanyl, hydrocodone, oxy, methadone, tramadol)
statins
warfarin, Xa inhibitors
amiodarone
amlodipine
Non DHP CCB
CNI, sirolimus
NNRTIs
PDE5 inhibitors
EE
CYP1A2 substrates
theophylline
R-warfarin
CYP1A2 inhibitors
ciprofloxacin
fluvoxamine
CYP2C9 subtrate
S-warfarin