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Pharmacology > Quiz 12 > Flashcards

Quiz 12 Flashcards

1
Q

H. Pylori treatment options

A

A: x 7 days
1. PPI or H2 antagonist
2. Amoxicillin
3. Clarithromycin or Metronidazole

B: x 7 days
1. PPI
2. Tetracycline
3. Bismuth
4. Metronidazole

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2
Q

Domperidone

A

Prokinetic - enhance GI motility

  • Dopamine antagonist, enhances Ach release
  • inhibit emesis via CTZ (chemoreceptor trigger zone)
  • no extrapyramidal effects, but can increase prolactin release
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3
Q

Metoclopramide

A

Prokinetic AND Antiemetic

  • Dopamine antagonist
  • doesn’t affect lower GI motility
  • also a 5-HT3 antagonist/5-HT4 agonist (increase ACh)
  • extrapyramidal effects –> tardive dyskinesia
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4
Q

Dicyclomine

A

Antispasmodic - decrease GI motility

  • block M2 cholinergic receptor in enteric plexus to inhibit motility
  • limited side effects at low dose
  • high doses cause dry mouth, visual disturbance, constipation, urinary retention
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5
Q

Hycosamine

A

Antispasmodic - inhibits GI motility

  • block M2 cholinergic receptor in enteric plexus to inhibit motility
  • limited side effects at low dose
  • high doses cause dry mouth, visual disturbance, constipation, urinary retention
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6
Q

Meclizine

A

Antiemetic - Antihistamine (H1R Antagonist)

  • depress labyrinth excitability in ear
  • can cause CNS depression
  • good for motion sickness
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7
Q

Doxylamine (+ pyridoxine)

A

Antiemetic - Antihistamine (H1R Antagonist)

  • depress labyrinth excitability in ear
  • can cause CNS depression
  • good for motion sickness
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8
Q

Diphenhydramine

A

Antiemetic - Antihistamine (H1R Antagonist)

  • depress labyrinth excitability in ear
  • can cause CNS depression
  • good for motion sickness
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9
Q

Promethazine

A

Antiemetic - Antihistamine (H1R Antagonist)

  • ALSO BLOCKS D2 RECEPTORS
  • depress labyrinth excitability in ear
  • can cause CNS depression
  • good for motion sickness
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10
Q

Scopolamine

A

Antimuscarinic Antiemetic

  • block M2 receptors in CTZ
  • anti-muscarinic side effects (dry mouth, constipation, hallucination, fever)
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11
Q

Prochlorperazine

A

Antimuscarinic Antiemetic

  • block M2 receptors in CTZ
  • anti-muscarinic side effects (dry mouth, constipation, hallucination, fever)
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12
Q

Ondansetron

A

5-HT Receptor Antagonist (Antiemetic)

  • treats N/V post-op or in chemo
  • selective 5-HT3 antagonist
  • itch, rash, constipation, fever
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13
Q

Bismuth

A

Antidiarrheal

  • forms salicylic acid and a bismuth clay in stomach acid to absorb water and protect stomach
  • treats Traveler’s diarrhea
  • blackens stool and may darken tongue
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14
Q

Loperamide

A

Antidiarrheal

  • Mu opioid receptor agonist (decrease intestinal motility and increase absorption)
  • low abuse potential, low CNS penetration
  • use for less than 48 hrs, can cause CNS depression
  • don’t use with inflammatory bowel disease
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15
Q

Anthraquinone

A

Laxative

  • causes cramping and inflammation
  • can get into breast milk
  • can cause “Lazy Bowel Syndrome” with abuse
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16
Q

Diphenylmethane

A

Laxative

  • can cause bowel inflammation
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17
Q

Aspirin

A

NSAID (Anti-inflammatory)

  • irreversible COX1 and COX2 inhibitor
  • inhibits COX1 at low dose, both at high dose
  • platelet inhibition and vasodilation at low doses
  • causes gastric ulcers, bleeding, Reyes syndrome, hepatotoxicity
  • no for kids with viral infections (Reyes / CNS)
  • no in pregnancy (decrease placental volume) or gout
  • no tolerance
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18
Q

Ibuprofen

A

NSAID (Anti-inflammatory)

  • nonselective COX1 and COX2 reversible inhibitor
  • causes gastric ulcers, MI, stroke, HF, bleeding, renal impairment
  • no in pregnancy or gout
  • no tolerance
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19
Q

Naproxen

A

NSAID (Anti-inflammatory)

  • nonselective COX1 and COX2 reversible inhibitor
  • longer duration of action
  • causes gastric ulcers, MI, stroke, HF, bleeding, renal impairment
  • no in pregnancy or gout
  • no tolerance
20
Q

Diclofenac

A

NSAID (Anti-inflammatory)

  • nonselective COX1 and COX2 reversible inhibitor
  • causes gastric ulcers, MI, stroke, HF, bleeding, renal impairment
  • no in pregnancy or gout
  • no tolerance
21
Q

Meloxicam

A

NSAID (Anti-inflammatory)

  • predominant COX2 reversible inhibitor
  • causes gastric ulcers, MI, stroke, HF, bleeding, renal impairment
  • no in pregnancy or gout
  • no tolerance
22
Q

Celecoxib

A

NSAID (Anti-inflammatory)

  • selective COX2 reversible inhibitor
  • more CV risks due to platelet aggregation and vasoconstriction via TXA2
  • little GI or renal effects
  • no in pregnancy or gout
  • no tolerance
23
Q

Acetaminophen

A

Anti-inflammatory

  • treats pain and fever but NOT inflammation
  • little platelet effects, little GI effects
  • overdose causes fatal hepatic necrosis
24
Q

N-Acetylcysteine

A

antidote to acetaminophen poisoning

25
Q

Azathioprine

A

Antimetabolite (Anti-Inflammatory and Immunosuppressant)

  • purine analog inhibits gene translation of immune cells
  • bone marrow suppression, increased infection risk
  • contraindicated in pregnancy
  • targets inflammation and its destructive process
26
Q

Methotrexate

A

Antimetabolite (Anti-Inflammatory and Immunosuppressant)

  • folate analog inhibits gene translation of immune cells via dihydrofolate reductase inhibition
  • cytotoxic
  • contraindicated in pregnancy
  • targets inflammation and its destructive process
27
Q

Infliximab

A

DMARD - TNF-alpha Inhibitor

  • can cause anaphylaxis or lupus like syndrome
  • increased risk for malignancies and infection
  • used for RA or Crohns
28
Q

Etanercept

A

DMARD - TNF-alpha Inhibitor

  • increased risk for malignancies and infection
29
Q

Abatacept

A

DMARD - T-Cell Modulation

  • increased risk for malignancies and infection
30
Q

Rituximab

A

DMARD - B-Cell Cytotoxic Agent

  • increased risk for malignancies and infection
31
Q

Colchicine

A

Gout (Anti-Inflammatory)

  • mitotic inhibitor
  • used when NSAIDs ineffective
  • not uricosuric
  • GI distress, myopathy, neuropathy
32
Q

Anakinra

A

DMARD - IL-1 Inhibition

  • increased risk for malignancies and infection
33
Q

Probenecid

A

Gout (Anti-Inflammatory)

  • uricosuric
  • precipitate uric acid crystals in renal tubules
  • GI irritation with peptic ulcers, hypersensitivity
34
Q

Allopurinol

A

Gout (Anti-Inflammatory)

  • inhibit xanthine oxidase
  • decrease uric acid production
  • fever, malaise, muscle aches
35
Q

Sumatriptan

A

Migraine - 5HT1 Agonist

  • acute migraine treatment
  • direct vasoconstriction intracranially, inhibits sensory neurons presynaptically
  • serious CV complications
  • contraindicated in heart disease, MAOi, or SSRI/SNRI
36
Q

Rimegepant

A

Migraine - CGRP Antagonist

  • inhibit the CGRP receptor
  • acute migraine treatment

(CGRP are small molecules tied directly to migraine activity)

37
Q

Fremanezumab

A

Migraine - CGRP Antibody

  • monoclonal Ab to the CGRP receptor
  • MIGRAINE PROPHYLAXIS
  • no current contraindications
  • causes URIs and injection site reactions
38
Q

Cortisone

A

Glucocorticoid (Immunosuppressant)

  • must be activated by IIB-hydroxysteroid dehydrogenase I
  • toxic in long term use
  • reduce cytokine release, decrease inflammation
  • increase blood glucose, increase muscle catabolism (amino acids in blood), increase lipolysis (Trigs in blood)
  • major side effect profile: Cushing disease, osteoporosis/bone growth suppression, myopathy
39
Q

Prednisone

A

Glucocorticoid (Immunosuppressant)

  • must be activated by IIB-hydroxysteroid dehydrogenase I
  • toxic in long term use
  • reduce cytokine release, decrease inflammation
  • increase blood glucose, increase muscle catabolism (amino acids in blood), increase lipolysis (Trigs in blood)
  • major side effect profile: Cushing disease, osteoporosis/bone growth suppression, myopathy
40
Q

Dexamethasone

A

Glucocorticoid (Immunosuppressant)

  • no mineralocorticoid activity, about 18x more potent than cortisol
  • toxic in long term use
  • reduce cytokine release, decrease inflammation
  • increase blood glucose, increase muscle catabolism (amino acids in blood), increase lipolysis (Trigs in blood)
  • major side effect profile: Cushing disease, osteoporosis/bone growth suppression, myopathy
41
Q

Cyclosporine A

A

IL-2 Synthesis Inhibition (Immunosuppressant)

  • binds to cyclophilin and then to calcineurin to inhibit IL-2 production via NFAT inactivation
  • metabolized by CYP3A
  • NEPHROTOXIC, hepatotoxic, neurotoxic
  • for severe RA or organ transplants
42
Q

Tacrolimus

A

IL-2 Synthesis Inhibition (Immunosuppressant)

  • binds FK Binding Protein (FKBP) and then to calcineurin to inhibit IL-2 production via NFAT inactivation
  • metabolized by CYP3A
  • NEPHROTOXIC, neurotoxic
  • for sever RA or organ transplants
43
Q

Sirolimus (Rapamycin)

A

IL-2 Signaling Inhibition (Immunosuppressant)

  • binds FK Binding Protein (FKBP) and then blocks IL-2 receptor signaling by blocking mTOR
  • metabolized by CYP3A
  • USED FOR PT AT RISK FOR NEPHROTOXICITY
  • leukopenia, thrombocytopenia
44
Q

Mycophenolic Acid

A

Antimetabolite (Immunosuppressant)

  • inhibits IMPDH, the rate limiting enzyme for guanosine formation
  • preferentially affects lymphocytes because of their high IMPDH expression
  • can’t use with Azathioprine
  • causes vomiting, diarrhea, leukopenia
45
Q

Anti-Thymocyte Globulin (ATG)

A

Antibodies (Immunosuppressant)

  • polyclonal Ab from rabbits injected with thymocytes
  • Ab to T-cell antigens (CDs), depletes circulating lymphocytes
  • causes cytokine release syndrome (fever, HA, tremor, N/V, weakness)
  • used for renal rejection and transplants
46
Q

Muronomab-CD3 (OKT3)

A

Antibodies (Immunosuppressant)

  • mouse monoclonal Ab against human CD3
  • depletes available T cells
  • causes cytokine release syndrome (fever, HA, tremor, N/V, weakness)
  • potentially fatal pulmonary edema, CV collapse, or arrhythmias
  • used for organ rejection
47
Q

Basiliximab

A

Antibodies (Immunosuppressant)

  • humanized anti-CD25 mouse monoclonal Ab
  • bind to IL-2 on activated T cells
  • causes anaphylaxis
  • PROPHYLAXIS FOR RENAL TRANSPLANT

Pharmacology (3 decks)

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