Test 2 Pharm Flashcards by Mark Henderson

beta 1 agonist/Beta 1 stimulated increase in HR pacemaker, Tx: TdP (torsades de pointe), bradycardia/tx for TdP

isoproterenol

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beta blockers

olol

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Antacid - moderate/short duration of action can cause gas, and acid rebound, Tx for GERD, Ulcers, dyspepsia/SE: Gas, acid rebound

Calcium Carbonate

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NCCI (thiazide and sulfonamides)/Via: inhibit the Na+ and Cl- reabsorption (causes more to stay in urine), ++Ca2+ reabsorption, vasorelaxation. Tx: htn, CHF, hypercalciuria, nephrolithiasis, nephrogenic Diabetes insipidus/chlorthalidone is the best thiazide HTN

Chlorthalidone (hydrochlorothiazide, metolazone, indapamide)

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alpha 1 blocker

azosin

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phosphodiesterase 3 inhibitors

none

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opioid agonist antidiarrheal/tx diarrhea, SE: CNS, atropine effects/

Diphenoxylate

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Statin - Antilipidemics/Tx: familial combined hyperlipoprotenemia, fam. hypercholesterolemia, fam. ligand-defective apoB, Via –HMG-CoA reductase. SE: GI effects, myopathy, rhabdomyolysis-release cytoskeletal proteins-harm kidney/continued use = ++receptors

Lovastatin Simvastatin Pravastatin Atorvastatin

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Prokinetics AchE Inhibitor/tx: non obstructive urinary retention and abdominal distension. SE: DUMBBELSS/

neostigmine

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H2 blocker/Tx for GERD, ulcers, dyspepsia and gastritis, is absorbed into blood,. Can cause headache, bradycardia, hypotension/CNS effects, endrocrine effects (prolactin Release), and inhibit CYP metabolism

Cimetidine

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Somatostatin agonist antidiarrheal/tx: secretory diarrhea, SE: –pancreatic secretion/

octreotide

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Class Ic antiarrhythmic = —Na+ = slow phase 0/also see little Beta blocker activity. Tx arrhythmias in pts with preserved ventricular function/

Propafenone

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5HT antagonist/tx: IBS diarrhea in women via –Ach=–motility/do not give to MEN, LAST RESORT DRUG

alosetron

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Class Ic antiarrhythmic = —Na+ = slow phase 0/no Beta activity, Slows intraventricular conduction. Tx refractory ectopic foci, not first line drug due to SE: of proarrhythmic/

Flecainide

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mucosal Protective/very safe, tx dyspepsia, H.pylori ulcers, travelers diarrhea/SE: black tongue and stool

Bismuth subsalicylate

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Osmotic diuretics/via: thin loop of henle TX: acute renal failure prophylaxis, cerebral edema, dialysis disequilibrium syndrome, acute glaucoma. SE: pulmonary edema, hyponatremia, hypernatremia. CI: anuria, –liver, cranial bleeding/

Mannitol (Glycerin, isosorbide, urea)

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NKCCI (loop diuretics)/via: inhibition of NaCl reabsoption (Na/K/2Cl transporter), ++Ca2+ and Mg2++ secretion. Tx: pulmonary edema, CHF, Acute renal failure, Hypercalcemia (Give loop diuretics with saline), SE: hypokalemia/some of the best diuretics used in Congestive Heart Failure SE: Hypokalemia

Furosemide (Lasix) (bumetanide, ethacrynic acid)

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Class III antiarrhythmic = –K+ > –alpha, beta, Ach > –Ca++, Na+/Prolong phase 3 repolarization = ++QT interval. Tx wide range of arrhythmias, acute V. Tach and V. Fib. Metabolized to DEA (desethyl amiodarone) has better antiarrhythmics than amiodarone, very large volume of distribution. SE: hypotension, lethal interstitial pneumonitis, hyper/hypothyroidism/T1/2 up to 100 days Very effective

Amiodarone (Dronedarone, Sotalol, Ibutilide, Dofetilide)

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PPI

prazole

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NK1 (neurokinin 1) antagonist direct antiemetic/tx: antiemetic, SE: CYP3A4 itneractions/Last Choice Drug

aprepitant

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central alpha 2 agonist/Tx: HTN via –NE/TX: very safe gestational HTN in PREGNANCY

alpha-methyldopa

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IBD Monoclonal antibody/tx: Moderate to severe IBD via –TNFalpha mediated response = –inflammation/also works on RA

Infliximab

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block renal epithelial Na+ channels on principal cells/tx: hypokalemic alkalosis (spare K+), often given with loop diuretics (amiloride spares K+ loss)/lowerd BP a ton when given with hydrochlorothiazide

Amiloride (Triamterene)

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M1 antagonist direct antiemetic/tx: mostion sickness, SE: Dry… opposite of DUMBBELSS/tx Motion sickness

scopolamine

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Arterial Vasodilators/Via: donation of NO = cGMP Ca2+ sequestration = --preload and afterload, TX HTN. SE: methemoglobinemia/

Sodium Nitroprusside

Niacin - antilipidemics/Tx all hypercholesterol and triglyceridemias, via --VLDL synthesis and secretion (by liver). SE: cutaneous Flush/by --VLDL=\>=\>--LDL cutaneous flush

Nicotinic acid (Vit. B3)

Mucosal Protective/SE: cramping, diarrhea tx for NSAID ulcers/not if pregnant - abortificient via uterine contraction

Misoprostol

inhibit PG synthesis (intestines) antidiarrheal/absorbs toxins, tx diarrhea, very safe with little SE/

Bismuth subsalicylate

antacid - slow/short duration of action, can cause constipation, Tx for GERD, Ulcers, dyspepsia/SE: constipation

Aluminum Hydroxide

GABA agonist indirect antiemtic/tx: antiemtic for anxiety and chemotherapy/

Lorazepam

Fibrates - antitriglyceridemia/Tx all hypertriglyceridemias (chylomicronemia, hypertriglyceridemia, hyperlipoproteinemia, dysbetalipoprotenemia). SE ++ HDL, GI effects/activation of PPAR receptor (++LPL=\> ++HDL, --VLDL

Gemfibrozil Fenofibrate

PANS activation/tx sinus tachycardia, PSVT/

valsalva maneuver/carotid massage

osmotic laxatives/oral or rectal, increase stretch receptors causing ++peristalsis. tx constipation and given pre surgery/

lactulose

ARB

sartan

cannabinoid agonsit indirect anatiemetic/tx: chemotherpay induced nasuea/

Nabilone

add bulk, absorb toxins antidiarrheal/tx: diarrhea, SE: constipation/

kaolin and pectin

Ulcer/PPI + clarithromycin + amoxicillin/metronidazole + bismuth subsalicylate/

quadruple therapy

ARB/via: blocker of receptor of Angiotensin. TX: first line for uncomplicated HTN, Diabetes, CKF, CAD, LV dysfunction. CI Hyperkalemia, volume depletion,/More expensive than ACEI avoid in pregnancy

Losartan, Valsartan, Candesartan

IBD Antimetabolites/Tx.Maintain remission of Crohn's dis. via --DHFR = --cellular proliferation (immune cells)/Maintain remission of Crohn's dis.

Methotrexate

Class Ia antiarrhythmic= --K+ \> --Na+ /small effect on phase 0, larger effect on phase 3. Tx: life threatening Ventricular arrhythmias within 20 minutes, Reentrant SVT, atrial fribrillations and flutters associated with Wolff-Parkinson-White Syndrome. Contraindicated in Tosades de Pointes (long QT already), hypokalemia. SE: SLE-like syndrome, N/V/TX: WPW syndome

Procainamide (Disopyramide)

Organic Nitrates VIA: denitrification via mitochondrial aldehyde reductase -\> NO -\> cGMP-\>++cGK-1 = ++mitochondrial Ca2+, --Ca2+ influx, phosphorylation of MLCK = vasorelaxation = --preload and afterload = --O2 demand of heart. No effect on peripheral resistance, no coronary steal (thats a good thing) TX: ischemia, angina, CHF SE: headache, hyptension (titrate ISDN) PO dosing, QD dosiing, T 1/2 = 4 hours

ISDN Isosorbide dinitrate

H2 inhibitors

tidine

Class Ib antiarrhythmic= --Na+, faster Phase 3 repolarization/Tx: digitalis and MI induced arrhythmias, 2nd choice after amiodarone for Immediate arrhythmias/Heart failure and Ventricular tachycardia = Give Lidocain Give via IV with large loading doses. tx for digitalis toxicity

Lidocaine (Phenytoin, Mexiletine, Tocainide)

DHP CCB/Peripheral vascular effects/

Nifedipine

IBD Glucocorticoids/tx: moderate to severe active IBD. Via: suppresion of inflammatory cytokines/

Prednisone (Prednisolone, hydrocortisone, budesonide)

GTN Nitroglycerin

Ulcer/PPI + clarithromycin + amoxicillin/metronidazole/

triple therapy

NDHP CCB/First line for uncomplicated HTN, Diabetes, CAD, Migraine, arrhythmias, tachycardic pt's. CI: LV dysfunction, bradycardic Pt's/

Verapamil Diltiazem

5HT antagonist

tron

++ A1 (in SA node), and ++A2 (vasculature)/opens cAMP independent K+ channels, causes SA node hyperpolarization, -- Firing rate, --AP duration in atria, --conduction velocity. Vasculature = ++NO -\>vasodilation. Tx for paroxysmal supraventricular tachcardia, use as IV to central vein/1st line drug for Paroxysmal Supraventricular tachycardia extremely short half life (T 1/2 = 15 secs) often given acutely in ER

Adenosine

ACEI

opril

ISMN Isosorbide mononitrate

IBD Aminosalicylates/Tx: ulcerative colitis /very safe

Mesalamine-(pentasa, asacol, rowasa and canasa)

CAI Carbonic Anhydrase Inhibitors/Via: metabolic acidosis, diuresis, --GFR, Tx: glaucoma, Mtn sickness, urinary alkalinization, edema (when given a NKCC or NCC inhibitor). SE: metabolic acidosis, kidney stones. CI: cirrhosis/

Acetazolamide (dichlorphenamide, methazolamide)

chloride channel activator - prostoglandin derivative laxative/tx chronic constipation. SE: NVD/

lubiprostone

alpha 1 blocker/via: alpha 1\>\>\>2, NE is not effected, Tx: lowers LDL TG and total Cholesterol as well as --HTN. SE: --sexual function/Doxazosin great for Resistant HTN

Prazosin, doxazosin, terazosin

Rauwolfia Alkaloids/via: depletion of NE and Catecholamines. TX: HTN when given a thiazide combo. SE: PANS activity/Last line of defense

Reserpine

Mucosal Protective/creates barrier on lulcers and stimulate mucus secretion (increase stomach PG, and decrease intestinal PG)/not in pts with CKD, prevent stress ulcers

Sucralfate

Class IV antiarrhythmic , Non Dihydropyridine (NDHP)= --Ca2+ = --SA , AV nodes and --Ventricular Contractility/-- L and T type Ca++ channels mainly in Heart, Tx: HTN, angina, Supraventricular tachycardia, post infarct protection. SE: could worsten CHF, constipation/no effect on ventricular arrhythmia, CI: WPW (wolf parkinson white syndrom - A. fib)

Verapamil Diltiazem

/Tx first line for uncomplicated HTN and LV dysfunction and Previous ischemic stroke, osteoporosis, high K+. CI: Gout, hypnatremia/kalemia, prediabetes/dont give if diabetic

Chlorthalidone (hydrochlorothiazide, metolazone, indapamide)

Resins - antilipidemics/Tx familial hypercholesterolemia. via - binding bile acids. SE: constipation/continued use = ++receptors

Cholestyramine Colestipol

central alpha 2 agonist/Tx: HTN via --NE. SE: rebound htn, /given with a diuretic to --fluid retention

Clonidine

glucocorticoid agonist indirect antiemetic/tx: chemotherapy induced nausea via ++5HT antagonist/SE Weight gain and via water retention

dexamethasone

opioid agonist antidiarrheal/tx IBS diarrhea/Very Safe

loperamide (imodium)

5HT antagonist direct antiemetic/antiemetic. SE: constipation (--5HT=--Motility)/Zofran

Ondansetron

sequester bile acids antidiarrheal/tx: antidiarrheal via impaired bile salt absorption/Also tx: for digoxin od

cholestyramine

Prokinetics M3 agonist/Tx GERD and gastroparesis, SE: cholinergic side effects (DUMBBELSS)/

bethanechol

Prokinetic Motilin Receptor Agonist/tx non obstructive gastroparesis/

erythromycin

anti muscarinic/produces a vagal block to increase HR Tx brady cardia/

Atropine

stimulant laxatives/oral or rectal; stimulate the ENS, cause a leaky mucosa, --Na absorption, /

Senna

Phosphodiesterase 3 Inhibitors/ ++CO, T 1/2 = 2 hours TX: Short term circulation in CHF/given via IV

Amrinone, Milrinone

Beta blockers/Tx: first line for CAD, LV Dysfunction, add on for uncomplicated htn. CI: migraine, tachyarrhythmia, /labetalol is preferred due to alpha and beta blocking

Propranolol, metoprolol, pindolol, labetalol

Class II antiarrhythmic = --SA, --AV, --Ventricular contractility/tx supraventricular arrhythmias/tx patients with previous MI

Beta blockers

Antacid - Fast/short duration of action, and cause gas, metabolic alkalosis. Tx for GERD, Ulcers, dyspepsia/SE: Gas, acid rebound

Sodium Bicarbonate

Prokinetics D2 antagonist/Tx Gerd, impaired gastric emptying (--D2=++Ach=++motility), antiemetic. SE: parkinsonian like sx's (from drop in D2 in CNS)/SE: parkinsonsian like symptoms

Metoclopramide

Direct renin inhibitor/Via: blocks the renin mediated cleavage of angiotensinogen. TX: HTN esp. with thiazide, ADEI, ARB, CCB. SE: hyperkalemia if pt has CKD/Never use in pregnancy

Aliskiren

5HT agonist laxative/tx constipation, IBS constipation (++Ach=++motility)/SE: GI, CV, not for general use - LAST RESORT DRUG TX: IBS

Tegaserod

Arterial Vasodilators/Via: Katp channel = relax arteriolar VSMC's (no effect on veins), TX: --BP, ++skin blood, sever refractory HTN if given with Beta blcoker and diuretics. SE: reflex ++inotropy/

Minoxidil

antacid - slow/short duration of action, can casue osmotic diarrhea, Tx for GERD, Ulcers, dyspepsia/SE: diarrhea

Magnesium hydroxide

stool softener laxitives/provide stool with oil - easily movable tx constipation, given prior to surgery. SE: malabsorption/nutrient malabsorption

glycerin

ACEI/TX: first line for Uncomplicated HTN and Diabetes, CKF, CAD, LV dsyfunction, post ischemic stroke. CI: High plasma renin levels, CKF - use a reduced dose, hyperkalemia, volume depletion/ do not give pregnant women SE: coughing - consider ARB Good in caucasions, less in African Americans

Captopril, Lisinopril, Fosinopril

Class Ia antiarrhythmic= --K+ \> --Na+ /small effect on phase 0, larger effect on phase 3. SE: hypotension, diarrhea, proarrhythmic/Only used in refractory pt's

Quinidine

M1,D2, H1 antagonist direct antiemetic/Tx: antiemetic, SE: D2-parkisnonian like sxs(extrapyramidal), H1-drowsiness, M1-anticholinergic effects/not first line of defense

prochlorperazine

H1 antagonist direct antiemetic/tx Motion sickness, SE drowsiness/Dramamine

dimenhydrinate

Cardiac Glycosides (++inotropic)/ ++inotropic effect, (=--EDV and ESV, --SANS, ++Vagal tone --QT interval, ++coronary flow, ST Depression. T1/2 2days, excreted by kidney, SE: Low TI arrhythmias, anorexia, N/V TX: HF, CHF with AF Antidote to Digoxin: cholestyramine, des-IgG (via IV)/do not give to pt if hypokalemic CHF with atrial fib.

Digoxin

IBD Aminosalicylates/tx: ulcerative colitis, SE: malaise in 1/2 of pt's. Inhibits COX/Only given topically, N-N (triple bond Azo) linking

sulfasalazine 5-ASA (balsalazide, olsalazine)

D2 antagonist direct antiemetic/tx antiemetic, SE: parkinsonian sx's/

Metoclopramide

DHP CCB (dihydropyridine calcium channel blockers)/TX: first line for uncomplicated hypertension, diabetes, CAD, elderly with isolated systolic htn. CI: LV dysfunction, tachycardia/

Nifedipine, Amlodipine, Felodipine

Absorption inhibitors - antilipidemics/Tx: Fam. compined hyperlipoproteinemia, hypercholesterolemia, ligand-defective apoB. Via: inhibition of cholesterol absorption, SE not many/

ezetimibe

/Add on for refractory/resistant HTN, low k+ (when also given with thiazide). CI: high K+/

Spironolactone (eplerenone)

Bulk forming laxatives (fiber)/increase stretch receptors and cause peristalsis. tx constipation, given prior to surgery./

methylcellulose

DHP CCB

dipine

Aldosterone Antagonist/Via: --Na+ reabsorption =--total body water, --K+ loss. TX: LV remodeling, edema, htn, primary hyperaldesteronism, refractory edema. SE: hyperkalemia, binds steroid receptors (gynecomastia, hirsutism, impotence)./TX refractory HTN well SE: hyperkalemia

Spironolactone (eplerenone)

H2 blocker/Tx for GERD, ulcers, dyspepsia and gastritis, is absorbed into blood,. Can cause headache, bradycardia, hypotension/

ranitidine nizatidine famotidine

IBD Antimetabolites/tx. Maintain remission of IBD via --Immune cell proliferation (purine analog)/Maintain remission of IBD

Azathioprine

PPI/tx for GERD, ulcers, dyspepsia, gastritis, hypersecretory, NSAID ulcers, H.Pylori ulcers. Takes 3 days to max effect, very safe, need acidic to be activated. Long term use causes B12, Fe, Ca,Zn deficiencies/very safe, minus long term use

omeprazole Lansoprazole Rabeprazole Esomeprazole Pantoprazole

Arterial Vasodilators/Via --IP3 = --contraction, opens Ca2+ activated K+ channels = ++relaxtion. TX: add on to REsistant HTN in CKD. SE: drug induced Lupus, tachycardia and Na+ retention, (alway give a diuretic/Beta blocker, NDHP CCB to mitigate this)/TX: gestational HTN in PREGNANCY, but be careful, acutely administerd = abortion

Hydralazine