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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
factor VIII
defecit is Hemophilia a | x linked recessive
26
Factor IX
defecit is hemophilia b | x linked recessive
27
Phytonadione
vitamin K1
28
anticoagulants
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
29
- adverse rxn to Heparin | - inactivation
bleeding thrombocytopenia hypersensativity local capillary rupture in SC and IM dose suppression of Aldosterone REVERSAL: protamine sulfate IV administration
30
Urokinase
directly activates plasminogen by proteolytic cleavage to produce plasmin non antigenic
31
anemia definition and values
males HCT less than 41% (Hb
32
Iron deficiency anemia
smaller cells microcytic hypochromic ( B/c less Hb)
33
Megaloblastic anemia
usually folate or B12 deficiency
34
Calcium carbonate
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
Al hydroxide | Mg hydroxide
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
Cimetidine
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
Ranitidine
H2 histamine antagonist,competitive Antagonist reduces acid in response to vagal, histamine, and gastrin stimulation USE: GERD, Peptic ulcer disease
38
Omeprazole
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
Pantoprazole
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
Sucralfate
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
Misoprostal
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
Bismuth subsalicylate
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
Famotidine
H2 histamine antagonist, competitive Antagonist reduces acid in response to vagal, histamine, and gastrin stimulation USE: GERD, Peptic ulcer disease
44
Nizatidine
H2 histamine antagonist, competitive Antagonist reduces acid in response to vagal, histamine, and gastrin stimulation USE: GERD, Peptic ulcer disease
45
dietary fiber
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
docusate
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
Mg Hydroxide
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
Polyethylene glycol
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
bisacodyl
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
anthraquinone deravitives
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
general mechanisms of laxatives
increse motility prevent absorption of h20 enhance secretions dissolve or lubricate fecal mass
52
1. glycerine supossotory | 2. mineral oil
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
Na PO4( sodium phosphate)
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
Stimulant Laxatives and cathartics
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
bethanechol
cholinergic agonist | increases gastric motility
56
neostigmine
acetylcholinesterase inhibitor | increases gastrin motility and gastric and intestinal emptying
57
Metoclopramide
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
erythromycin
prokinetic agent stimulates motolin and increases gastric emptying sometimes used as pro kinetic agent to treat gastroparesis
59
Methylnaltrexone
opioid receptor antagonist, prokinetic agent used to treat opioid induced constipation don't cross BBB
60
alvimopan
opioid receptor antagonist, prokinetic agent used to treat post operative ileus short term use due to CV effects don't cross BBB
61
Loperamide
opioid analogue that decreases peristalsis | dose not produce CNS effects at therapeutic doses (available OTC)
62
Dicyclomine
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
Hyoscyamine
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
other antispasmodic drugs
``` glycopyrrolate propantheline atropine homatropine belladonna extracts isopropamide ```
65
Lubiprostone
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
aminosalicylates
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
Sulfasalazine
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
Mesalamine
5-ASA | formulated to deliver to diffrent parts of GI
69
Budesonide
glucocorticoid inhibits production of inflammatory cytokns and chemokns used for acute attacks of IBD moderate to severe
70
Azathiaprine
anti metabolite, thiopurine disrupts neucleotide synthesis and thus RNA/DNA synthesis and cell proliferation used in chronic severe or steroid resistant IBD
71
methotrexate
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
infliximib
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
Natalizumab
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
bile acid therapy
can help dissolve small gall stones-ursodiol no serious SE Monoctanoin- injected into bile duct to dissolve stones
75
simethicone
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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