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Pharmacology > recitation 6.21 > Flashcards

recitation 6.21 Flashcards

1
Q

Ziconotide

A

indicated for intrathecal admin for severe chronic pain

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2
Q

Ziconotide MOA

A

N-type calcium channel blocker in primary nociceptors in the dorsal horn

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3
Q

Ziconotide Warnings

A

neuropyschosis

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4
Q

Ziconotide ADR

A

dizziness, ataxia, somnolence, nausea

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5
Q

intrathecal baclofen

A

severe spasticity

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6
Q

Intrathecal Baclofen ADR

A

hypotonia, somnolence, dizziness,

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7
Q

Topical analgesics

A

methyl salicylate, Trolamaine salicylate

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8
Q

Counter irritants

A

menthol, camphor, capsaicin

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9
Q

Counter irritants ADR

A

creates irritation/inflammation locally to relieve inflammation in underlying or adjacent tissues and local anesthetic action

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10
Q

Menthol indications

A

orally for GI complaints and topically for pain, inflammation

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11
Q

Menthol ADR

A

oral: heartburn, NV. Topical: dermatitis, irritation

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12
Q

Camphor

A

topical anti-tussive, analgesic

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13
Q

Camphor toxicity

A

NV, burning of mouth, and throat. can lead to seizure and respiratory depression

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14
Q

Capsaicin MOA

A

TRPV 1 channel agonist. enhances TRPV1 stimulation and relieves pain when these receptors are desensitized.

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15
Q

Capsaicin indications

A

post herpetic neuralgia

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16
Q

Capsaicin ADR

A

oral- GI discomfort, sweating, flushing, anitcoag

Topical- burning, stinging, erythema

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17
Q

Iontophoresis

A

ion current to deliver charged drugs through the skin

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18
Q

Gout

A

allopurinol, colchicine, febuxostat, probenacid, Rasburicase, pegloticase

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19
Q

Allopurinol MOA

A

Xanthine oxidase inhibitor and purine analog. Reduces production of uric acid

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20
Q

Allopurinol indications

A

Chronic treatment of rimary or secondary gout, tumor lysis syndrome in chemo patients, hyperuricemia with recurrent calcium oxalate stones

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21
Q

Allopurinol Drug interactions

A

Azothioprine, warfarin, increases theophylline

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22
Q

Allopurinol ADR

A

rash, ND, increased LFT, acute gout attack

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23
Q

Probenacid

A

chronic treatment for hyperuricemia associated with gout and boosts PSN levels

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24
Q

Probenacid MOA

A

blocks renal tubular reabsorption of urate

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25
Q

Probenacid ADR

A

HA, nausea, worsening gout flares, dizziness, uric acid, kidney stones, blood dyscrasias

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26
Q

Febuxostat

A

chronic treatment for gout

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27
Q

Febuxostat MOA

A

Xanthine oxidase inhibitor

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28
Q

Febuxostat ADR

A

higher CV events and hepatic failure

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29
Q

Lesinurad

A

use with an XOI when target uric acid levels are not acheived

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30
Q

Lesinurad MOA

A

blocks uric acid resborption

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31
Q

Lesinurad interactions

A

metabolized at CYP2C9- amlodipine, soldenafil

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32
Q

Lesinurad ADR

A

increased SCr, renal failure, kidney stones, HA, flu, GERD

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33
Q

Colchicine

A

prophylaxis and treatment of gout flare and familial mediterranean fever

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34
Q

Colchicine MOA

A

inhibits microtubule formation in bone cells and prevents neutrophil activation

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35
Q

Colchicine warnings

A

blood dyscrasias, neuromuscular toxicity, rhabdo, contraindicated with strong 3A4 inhibitors

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36
Q

Colchicine ADR

A

DIARRHEA, throat pain

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37
Q

Pegloticase

A

refractory chronic gout

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38
Q

Pegloticase MOA

A

PEGylated uricase enzyme catalyzies oxidation of uric acid to allantoin

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39
Q

Pegloticase ADR

A

gout flare, infusion reaction, nausea, ecchymosis, nasopharyngitis, constipation, chest pain, vomiting, CHF exacerbation

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40
Q

Rasburicase

A

hyperuricemia due to tumor lysis syndrome

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41
Q

Rasburicase MOA

A

urate-oxidase, catalyzes oxidation of uric acid to allantoin

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42
Q

Rasburicase ADR

A

anaphylaxis, hemolysis, methemoglobinemia

43
Q

Systemic Corticosteroids

A

prednisone, methylprednisone, prednisolone

44
Q

Systemic corticosteroid MOA

A

inhibit cytokine production, adhesion, protein activation, inflammatory cell migration, and activation (anti-inflammatory)

45
Q

Systemic Corticosteroids short term ADR

A

hyperglycemia, increased appetite, fluid retention, wt gain, mood alteration, HTN, peptic ulcer

46
Q

Systemic Corticosteroids Long term ADR

A

adrenal axis suppression

47
Q

Systemic corticosteroid indications

A

Rheumatoid arthritis

48
Q

DMARDS (disease modifying rheumatic drugs)

A

Methotrexate, leflunomide, hydroxychloroquine, Sulfasalazine, Minocycline

49
Q

DMARDs biologics

A

humira, enbrel, Remicade, Cimzia, Simponia, orencia, Rituxan, Actemra, Stelara

50
Q

Methotrexate MOA

A

folate analog, relieves inflammation, swelling and pain

51
Q

Methotrexate

A

rheumatoid arthritis. psoriasis, some cancers

52
Q

Methotrexate contraindications

A

pregnancy and lactation, liver disease, alcoholism, blood dyscrasias

53
Q

Methotrexate ADR

A

NV, hair loss, rash, abnormal liver enzymes, fatigue, mouth sores, diarrhea, low blood counts

54
Q

Leflunomide MOA

A

pyrimidine synthesis inhibitor

55
Q

Leflunomide

A

reduces signs and symptoms, inhibit structural damage in RA

56
Q

Leflunomide contraindications

A

pregnancy

57
Q

Leflunomide warnings

A

hepatotoxicity

58
Q

Leflunomide ADR

A

Diarrgea, N, stomach pain, indigestion, rash, hair loss, cough, SOB, lung injury

59
Q

Hydroxychloroquine

A

antimalarial, RA, discoid and systemic lupus

60
Q

Hydroxychloroquine contraindications

A

retinal or visual field changes, long term use in kids

61
Q

Hydroxychloroquine ADR

A

bulls eye maculopathy, nausea, diarrhea, skin and hair changes

62
Q

sulfasalazine

A

ulcerative colitis, RA, ankylosing spondilitis. psoriatic arthritis

63
Q

Sulfasalazine MOA

A

anti-inflammatory and immunomodulatory

64
Q

Sulfasalazine ADR

A

Nausea, abd discomfort, photosensitivity

65
Q

Minocycline

A

mild RA

66
Q

Minocycline ADR

A

dizziness, rash, photosensitivity

67
Q

Anti-TNF drugs MOA

A

genetically engineered proteins that block proinflammatory cytokines

68
Q

Anti-TNF indications

A

used when DMARDs fail in RA, psoriatic arthritis, peds crohns and UC, anylosing spondylitis and psoriasis

69
Q

Anti-TNF contraindications

A

infection, HF, MS, cancer

70
Q

Anti-TNF ADR

A

infection, injection site reactions (local rash, burning, itching), infusion reaction (headache and abdominal pain)

71
Q

Anti-TNF

A

Humira, Enbrel, remicade, cimzia, Simponi

72
Q

Abatacept (Orencia)

A

second line for RA, juvenile arthritis after MTX and biologics

73
Q

Orencia MOA

A

selective T cell costimulation modulator. prevents T cell activation

74
Q

Orencia contraindications

A

Concomitant use with other biologics

75
Q

Orencia ADR

A

HA, URI, nasopharyngitis, nausea

76
Q

Ritixumab (Rituxan) MOA

A

chemo drug- targets and removes abnormal B cells decreasing autoimmune response

77
Q

Rituxan

A

Non-hogdkins lymphoma, Chronic lymphocytic Leukemia, Second line RA, wegeners granulomatosis, Microscopic polyangitis

78
Q

Rituxan Warnings

A

tumor lysis syndrome, SJS, TEN, Hep b reactivation, cardiac arrhythmias, renal toxicity, bowel obstruction

79
Q

Rituxan ADR

A

infusion reaction, hypotension

80
Q

Tocilizumab (Actemra)

A

RA, JA

81
Q

Actemra MOA

A

IL-6 receptor agonist- binds and inhibits signaling

82
Q

Actemra warnings

A

serious infections, GI perforation, neutropenia, live vaccines

83
Q

Actemra ADR

A

HA, HTN, increased cholesterol, increased ALT, URI

84
Q

Stelara

A

psoriasis, psoriatic Arthritis

85
Q

Stelara MOA

A

selectively targets IL-12 and IL-23

86
Q

Stelara ADR

A

nasopharyngitis, URI, HA, fatigue, arthralgia, nausea

87
Q

Calcium

A

Osteoporosis

88
Q

Difference in Ca carbonate and Ca citrate

A

Citrate absorbs better, Carbonate must take with food.

89
Q

Biphosphonates

A

Alendronate, Risedronate, Ibandronate, Zoledronic acid

90
Q

Biphosphonates MOA

A

block osteoclasts activity

91
Q

Biphosphonates warning

A

GI side effects, infusion reactions, osteonecrosis of the jaw, arrhythmias, bone quality, Uveitus/scleritis, esophagitis, not for women of child bearing age

92
Q

Alendronate ADR

A

dyspepsia, abd pain, acid reflux, constipation, diarrhea, musculoskeletal pain, nausea

93
Q

Zolendronate indications

A

osteoporosis (Reclast), hypercalcemia of malignancy, multiple myeloma (Zometa)

94
Q

Raloxifene (Evista)

A

increases BMD without breast Cancer or endometrial hyperplasia

95
Q

Raloxifene ADR

A

increased risk of DVT

96
Q

Teriparatide (Forteo)

A

synthetic PTH that builds bone by stimulating osteoblast activity

97
Q

Teriparatide warnings

A

osteosarcoma

98
Q

Teriparatide contraindications

A

Pagets disease, preg/nursing, peds, prior radiation therapy, bone mets, skeletal malignancies, hypercalcemia

99
Q

Teriparatide ADR

A

hypercalcemia, HA, myalgia, arthralgia

100
Q

Denosumab MOA

A

monoclonal antibody that blocks RANK ligand which stimulates osteoclasts

101
Q

Denosumab indications

A

postmenopausal women with osteoporosis (Prolia) unresectable giant cell tumor, increase bone mass in high risk for fracture (Xgeva)

102
Q

Denosumab ADR

A

cellulitis, eczema, flatulence, fatigue, asthenia, hypophosphatemia, nausea, dyspnea, arthralgia, HA

103
Q

AACE guidelines first line for osteoporosis

A

alendronate, risedronate, zoledronic acid or denosumab

Pharmacology (33 decks)

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