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Pharmacology drew > test 4 > Flashcards

test 4 Flashcards

1
Q

hydrocortisone

A

corticosteroid, short to medium acting

2+ mineralcorticoid activity

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2
Q

prednisone

A

corticosteroid, short to medium acting
1+ mineralcorticoid activity
use in treatment of allergic disorders, cerebral edema (vasogenic and abcess edema), Collagen disorders

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3
Q

methylprednisolone

A

corticosteroid, short to medium acting
use in treatment of allergic disorders,Collagen disorders
pediatric renal disease

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4
Q

triamcinolone

A

corticosteroid, intermediate acting
0 mineralcorticoid activity
use in treatment of allergic disorders, Collagen disorders
SE: myopathy

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5
Q

ketoconazole

A

glucocorticoid synthesis inhibitor and antagonist
anti fungal
inhibits 17a Hydroxylase and stops all steroid biosynthesis, best treatment for bushings disease

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6
Q

fludrocortisone

A 
mineralcorticoid agonist( most widely used)
both mineral and glucocorticoid activity
used in adrenocortical insufficiency with mineral corticoid deficiency
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7
Q

spironolactone

A

glucocorticoid and mineralocorticoid antagonist

used to normalize K concentration sin HYPER aldosteronis

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8
Q

Cosyntropin

A

Glucocorticoid, mineralocorticoid, androgen, progesterone and estrogen agonist

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9
Q

dexamehazone

A

long acting corticosteroid
0 mineralcorticoid activity
use in treatment of allergic disorders, acute nonTB bacterial meningitis
stopping TNFa and IL-1B and cytokines production, Collagen disorders

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10
Q

metyrapoine

A

glucocorticoid synthesis inhibitor and antagonist

inhibits 11 B hydroxylase in cushings patients

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11
Q

zona glomerulosa secretes

A

mineralocorticoids, aldosterone

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12
Q

zona fasciculata secretes

A

glucocorticoids, cortisol

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13
Q

zona reticularis

A

androgens, progesterone, estrogens

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14
Q

Aspirin

A

anti platelet
irreversibly acetylates COX
inhibiting TXA2 synthesis
low dose (1-2mg/kg) preserves PGI2 production with still inhibiting TXA2
USE: prevent MI, ischemic attack,ischemic stroke, arterial thrombotic event, prevent vein graft occlusion
Adverse RXN: adbominal discomfort, GI bleed, ab discomfort, inpaired surgical hemostasis, risks in pregnancy

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15
Q

dipyridamole

A

anti platelet
inhibits Phosphodiesterase thus increasing [cAMP]
increased [cAMP] (via adenylate cyclase) blocks TXA2 production

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16
Q

clopidiigrel

A

anti platelet, inhibits platelet aggregation
inhibits ADP binding to P2Y12 componenet of ADP receptor
preventing activation of GPIIb/IIIa
works for life of the platelet

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17
Q

tirofiban

A

anti platelet
reversible antagonist of fibrinogen binging to the GPIIb/IIIa receptor
a non peptide antagonist

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18
Q

heparin

A

anti coagulant
MOA: binds to lysine on AT-III accelerating inactivation of Thrombin and factor Xa, also interacts with platelets to inhibit function/ induce aggregation causing thrombocytopenia
use: when rapid effects are needed, pregnancy instead of other teratogens ( oral anticoag like warfarin)
antidote :protamine sulfate
interact; SUPRESSES aldosterone, interacts with insulin

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19
Q

enoxaparin Na

A

anti coagulant

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20
Q

protamine sulfate

A

anti coagulant
rich in arginine and strongly basic
bind and inactivates Heparin( instantaneous effect for 2 hours), careful monitoring b/c it has anti coat effect by itself
SE: transient HypoTN, anaphylaxis in fish allergies, less effective against LMW HEPARIN

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21
Q

warfarin Na

A

anti coagulant
blocks vitamin K required for post translation modification of essential clot factors
Vitamin K epoxide reductase inhibition, inhibiting gamma corboxylationof N-terminal Glu acid
DONT USE in PREG- crosses placenta and teratogenic
reversal is Fresh frozen plasma and VIT K1

SE: hemorrhage and HTN

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22
Q

Lepirudin

A

anti coagulant, naturally occurring in leeches,
directly inhibits thrombin, 1:1 binding
use: heparin puts with thrombocytopenia
Adverse RXN: hyper sensativity, bleeding, crosses placenta in rats only use in pre if absolute needed, NO ANTIDOTE available

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23
Q

alteplase

A

thrombolytic, recombinant form of tPA
activates fibrin bound plasminogen to plasmin
reversal with aminocaprotic acid

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24
Q

aminocaprotic acid

A

fibrinolysis inhibitor

selectively inhibits plasminogen activation

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25
Q

factor VIII

A

defecit is Hemophilia a

x linked recessive

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26
Q

Factor IX

A

defecit is hemophilia b

x linked recessive

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27
Q

Phytonadione

A

vitamin K1

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28
Q

anticoagulants

A

interfere with fibrin formation, and used to prevent thrombus formation
major use in venus thromboembolic disorders b/c of stasis and not vessel damage
bleeding is main complication of therapy

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29
Q
  • adverse rxn to Heparin

- inactivation

A

bleeding
thrombocytopenia
hypersensativity
local capillary rupture in SC and IM dose
suppression of Aldosterone
REVERSAL: protamine sulfate IV administration

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30
Q

Urokinase

A

directly activates plasminogen by proteolytic cleavage to produce plasmin
non antigenic

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31
Q

anemia definition and values

A

males HCT less than 41% (Hb

32
Q

Iron deficiency anemia

A

smaller cells
microcytic
hypochromic ( B/c less Hb)

33
Q

Megaloblastic anemia

A

usually folate or B12 deficiency

34
Q

Calcium carbonate

A

Neutralizing agent, Antacid, CO2 produced
about 10% absorbed so some alkalosis
high Ca intake or poor renal function pts–>Milk alkali syn
Milk alkali–> Hyper Ca, Alkalosis, Kidney stone, renal damage
causes acid rebound, ok for low dose usage, not good for long term management
Drug interactions- forms Ca complex with digitalis glycosides, tetracycline, phenytoin to decrease bioavailability

35
Q

Al hydroxide

Mg hydroxide

A

neutralizing agent, antacid,No CO2 produced
poorly absorbed so alkalosis
used in combination to minimize SE
both Al and Mg can for insoluble complex to decrease bioavailability of drugs

36
Q

Cimetidine

A

H2 histamine antagonist, competitive Antagonist
blocks basal acid secretion
reduces acid in response to vagal, histamine, and gastrin stimulation
USE: GERD, Peptic ulcer disease
SE: antagonize androgen receptors, inhibit estriadol metabolism, increase prolactin level–>gynecomastia in men
interferes with CYP450- prolongs action of theophylline, warfarin, and phenytoin

37
Q

Ranitidine

A

H2 histamine antagonist,competitive Antagonist
reduces acid in response to vagal, histamine, and gastrin stimulation
USE: GERD, Peptic ulcer disease

38
Q

Omeprazole

A

PPI-( proton pump inhibitor), USE: GERD, PEPTIC ulcers
Irreversibly inhibits H+/K+ ATPase, given as prodrugs
rapid activation by protonation
suppresses basal and meal stimed gastric acid secretion
adverse effect: altered nutrition, increased enteric/resp infections, transient rebound acid secretion
may alter some drug bioavailability that require acidity

39
Q

Pantoprazole

A

PPI-( proton pump inhibitor)USE: GERD, PEPTIC ulcers
Irreversibly inhibits H+/K+ ATPase, given as prodrugs
rapid activation by protonation
suppresses basal and meal stimed gastric acid secretion
adverse effect: altered nutrition, increased enteric/resp infections, transient rebound acid secretion
may alter some drug bioavailability that require acidity

40
Q

Sucralfate

A

Mucosal protective Agent
aluminum salt of sulfated sucrose
polymerizes in acid stomach and binds to ulcer crater to protect it
most effective if taken before meals, dont take antacid within 1/2 hour, SE: Al complexes and pts w/ renal disease

41
Q

Misoprostal

A

Mucosal protective Agent, Analogue of PGE1
increases mucus production, may reduce acid secretion
to prevent NSAID induced ulceration
PG that can cause uterine contraction and abortions
SE: diarrhea, ab distress, dizziness, headache,aggravate IBS

42
Q

Bismuth subsalicylate

A

Mucosal protective Agent
coating effect to protect the stomach, inhibit pepsin action
some H.pylori antibacterial action
some with salicylates lead to REYEs in kids

43
Q

Famotidine

A

H2 histamine antagonist, competitive Antagonist
reduces acid in response to vagal, histamine, and gastrin stimulation
USE: GERD, Peptic ulcer disease

44
Q

Nizatidine

A

H2 histamine antagonist, competitive Antagonist
reduces acid in response to vagal, histamine, and gastrin stimulation
USE: GERD, Peptic ulcer disease

45
Q

dietary fiber

A

bulk forming laxative
portion of food that is not digested, bran or psyllium
SE:celluose derivatives ( methyl cellulose, psyllium or polycarbophil) bloating and flatulence
can bind some drugs and decrease bioavailability

46
Q

docusate

A

stool surfactant agent(softener)
exerts a detergent effect to break and soften the fecal mass, may stimulate secretion
may increase the solubility and absorption of other drugs
hepatotoxic in some lab animals

47
Q

Mg Hydroxide

A

Osmotic laxative and cathartic
poorly absorbed salt exerts a osmotic effect to hold water in the GI tract to produce fluid evacuation in 1-6 hrs
-Mg SO4 and Mg literate as well
Hyper Mg in pts with renal insufficiency

48
Q

Polyethylene glycol

A

inert non absorbed sugar
balanced with Electrolytes-Na SO4, NaCl, NaHCO3, KCl
used for complete colonic cleansing before diagnostic procedures or surgery
safe for all pts
NO FLATULENCE or CRAMPING

49
Q

bisacodyl

A

stimulant laxative and cathartic, Diphenylmethane derivative
acts on bowel to inhibit H2O abs ( like phenolphthalein)
use: acute and chronic constipation, w/ PEG for colonic cleansing prior to colonoscopy
minimal abs

50
Q

anthraquinone deravitives

A

plant extracts containing anthraquinone compounds
poor abs, hydrolyzed in colon
source -ALOE, Senna/sennosides, Cascara sagrada
acts on bowel to inhibit H2O abs ( like phenolphthalein and bisacodyl)
SE: chronic use->melanosis coliI(brown colon), some concern with colorectal cancer

51
Q

general mechanisms of laxatives

A

increse motility
prevent absorption of h20
enhance secretions
dissolve or lubricate fecal mass

52
Q
  1. glycerine supossotory

2. mineral oil

A

1.dissolve and lub the distal bowel
irritatino also increases perastalsis
2. mix of long chain hydrocarbons
poorly absorbed,coats and lubes fecal mass
prevent and treat fecal impaction in young and debilitated
decrease abs of Fat soluble Vits(a,e,k,d), cause oil leak

53
Q

Na PO4( sodium phosphate)

A

poorly absorbed salt exerts a osmotic effect to hold water in the GI tract to produce fluid evacuation in 1-6 hrs
pts must maintain adequate hydration
SE: electrolyte disturbance, Hyper PO4, HypoCa, HyperNa, hyperK—> arrthymias, acute renal failure
don’t use in elderly, renal insufficient, cardiac disease or dehydrated pts

54
Q

Stimulant Laxatives and cathartics

A

act on intestinal mocosa to enhance secretions, inhibit H2o absorptions, or induce peristalsis,
moderate dose work in 2-8 hrs, high dose is faster
ex: bisacodyl, anthraquinone derivatives

55
Q

bethanechol

A

cholinergic agonist

increases gastric motility

56
Q

neostigmine

A

acetylcholinesterase inhibitor

increases gastrin motility and gastric and intestinal emptying

57
Q

Metoclopramide

A

Dopamine D2 antagonist, has some 5HT activity
enhances GI motility of upper tract via increasing ach relesae
antiemetic effects on CRTZ zone
SE:cramping diarhhea, can cause some parkinsonism but less than antipsycotics

58
Q

erythromycin

A

prokinetic agent
stimulates motolin and increases gastric emptying
sometimes used as pro kinetic agent to treat gastroparesis

59
Q

Methylnaltrexone

A

opioid receptor antagonist, prokinetic agent
used to treat opioid induced constipation
don’t cross BBB

60
Q

alvimopan

A

opioid receptor antagonist, prokinetic agent
used to treat post operative ileus
short term use due to CV effects
don’t cross BBB

61
Q

Loperamide

A

opioid analogue that decreases peristalsis

dose not produce CNS effects at therapeutic doses (available OTC)

62
Q

Dicyclomine

A

antispasmodic drugs for IBS
primarily acts thru anticholinergic activities
SE: sedation, dry mouth, dry hot skin, constipation, urine retention, loss of visual accommodation ( common for other anti ACH drugs)

63
Q

Hyoscyamine

A

antispasmodic drugs for IBS
primarily acts thru anticholinergic activities
SE: sedation, dry mouth, dry hot skin, constipation, urine retention, loss of visual accommodation ( common for other anti ACH drugs)

64
Q

other antispasmodic drugs

A 
glycopyrrolate
propantheline
atropine
homatropine
belladonna extracts
isopropamide
65
Q

Lubiprostone

A

antispasmodic drug for IBS
newer drug for treatment of chronic idiopathic constipation and IBS w/ constipation in females
activates CIC-2 chloride channels in brush border to promote fluid secretion
not well absed of few systemic effects
SE: nausea, dirrhea,flatulence,bloating, GI distress,headache

66
Q

aminosalicylates

A

5-ASA
work topically not systemically
inhibit COX and lipooxygenase pathways
inhibit nuclear factor KB, inhibit immune cell function
most absorbed in the proximal GI so other formulations to enhance delivery to distal GI tract

67
Q

Sulfasalazine

A

5-ASA bound to an AZO group
converted to sulfapyridine and ASA
ASA is anti inflammatory and helps ulcerative colitis pts
sulfapyridine is antimicrobial
contraindication: allergy to sulfonamides and salicylates
others: olsalazine, balasalazide

68
Q

Mesalamine

A

5-ASA

formulated to deliver to diffrent parts of GI

69
Q

Budesonide

A

glucocorticoid
inhibits production of inflammatory cytokns and chemokns
used for acute attacks of IBD moderate to severe

70
Q

Azathiaprine

A

anti metabolite, thiopurine
disrupts neucleotide synthesis and thus RNA/DNA synthesis and cell proliferation
used in chronic severe or steroid resistant IBD

71
Q

methotrexate

A

anti metabolite, Dihydrofolate reductase inhibitor
disrupts neucleotide synthesis and thus RNA/DNA synthesis and cell proliferation
used in chronic severe or steroid resistant IBD

72
Q

infliximib

A

anti tumor necrosis factor
monoclonal Ab that binds and inactivates TNF-a and suppresses immune response
moderate to severe crohns, must be given IV
Adverse effects:hypersensitivitie and autoimmune disorder, infection and immuno supression

73
Q

Natalizumab

A

anti integrin therapy
blocks intigrins on circulating inflammatory cells preventing binding to adhesion molecules and migration to tissues
treatment of moderate to severe crowns (only in pts where others therapy failed), given IV
restricted due to possible infection of JC virus(and its ddx)

74
Q

bile acid therapy

A

can help dissolve small gall stones-ursodiol
no serious SE

Monoctanoin- injected into bile duct to dissolve stones

75
Q

simethicone

A

Anti flatulence agent

facilitates gas bubble formation in the upper GI to have pt burp instead of fart

Pharmacology drew (9 decks)

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