Lecom Pharm One Liners 2015

Front 1

Basic Pharmacokinetics

Back 1

...

Front 2

Time it takes for amount of drug to fall to half of its value; this is a constant in first order kinetics (majority of drugs)

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Half-life (T1/2)

Front 3

Relates the amount of drug in the body to the plasma concentration

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Volume of distribution (VD)

Front 4

Plasma concentration of a drug at a given time

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Cp

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The ratio of the rate of elimination of a drug to its plasma concentration

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Clearance (CL)

Front 6

The elimination of drug that occurs before it reaches the systemic circulation

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First pass effect

Front 7

The fraction of administered dose of a drug that reaches systemic circulation

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Bioavailability (F)

Front 8

When the rate of drug input equals the rate of drug elimination

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Steady state

Front 9

Metabolism

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...

Front 10

This step of metabolism makes a drug more hydrophilic and hence augments elimination

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Phase I

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Different steps of Phase I

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Oxidation, reduction, hydrolysis

Front 12

Inducers of Cytochrome P450 (CYP450)

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Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort

Front 13

Inhibitors of CYP450

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Amiodarone, Diltiazem, Verapamil, Cimetidine, ketoconazole, erythromycin, isoniazid and grapefruit

Front 14

Products of Phase II conjugation

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Glucuronate, acetic acid, and glutathione sulfate

Front 15

Type of kinetics when a constant percentage of substrate is metabolized per unit time

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First order kinetics

Front 16

Drug elimination with a constant amount metabolized regardless of drug concentration

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Zero order kinetics

Front 17

Target plasma concentration times (volume of distribution divided by bioavailability)

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Loading dose (Cp*(Vd/F))

Front 18

Concentration in the plasma times (clearance divided by bioavailability)

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Maintenance dose (Cp*(CL/F))

Front 19

Pharmacodynamics

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...

Front 20

Strength of interaction between drug and its receptor

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Affinity

Front 21

Selectivity of a drug for its receptor

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Specificity

Front 22

Amount of drug necessary to elicit a biologic effect; refers to the drug's strength

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Potency

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Maximum response achieveable from a drug

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Efficacy

Front 24

Ability of a drug to produce 100% of the maximum response regardless of the potency

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Full agonist

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Ability to produce less than 100% of the response

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Partial agonist

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Ability to bind reversibly to the same site as the drug and without activating the effector system

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Competitive antagonist

Front 27

Class of drugs with ability to decrease the maximal response to an agonist

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Noncompetitive antagonist

Front 28

A hormone whose mechanism of action (MOA) utilizes intracellular receptors

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Thyroid and steroid hormones

Front 29

A hormone whose MOA utilizes transmembrane receptors

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Insulin

Front 30

Class of drugs whose MOA utilizes ligand gated ion channels

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Benzodiazepines and calcium channel blockers

Front 31

Median effective dose required for an effect in 50% of the population

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ED50

Front 32

Median toxic dose required for a toxic effect in 50% of the population

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TD50

Front 33

Dose which is lethal to 50% of the population

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LD50

Front 34

Window between therapeutic effect and toxic effect

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Therapeutic index

Front 35

Term for a high margin of safety

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High therapeutic index

Front 36

Term for a narrow margin of safety

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Low therapeutic index

Front 37

Antidotes and agents used in drug overdose

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...

Front 38

Antidote used for lead poisoning

Back 38

Dimercaprol, EDTA

Front 39

Antidote used for cyanide poisoning

Back 39

Nitrites

Front 40

Antidote used for anticholinergic poisoning

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Physostigmine

Front 41

Antidote used for organophosphate/anticholinesterase poisoning

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Atropine, pralidoxime (2-PAM)

Front 42

Antidote used for iron salt toxicity

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Deferoxamine

Front 43

Antidote used for acetaminophen (APAP) toxicity

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N-acetylcysteine (Mucomyst)

Front 44

Antidote for arsenic, mercury, lead, and gold poisoning

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Dimercaprol

Front 45

Antidote used in poisonings: copper (Wilson's disease), lead, mercury, and arsenic

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Penicillamine

Front 46

Antidote used for heparin overdose

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Protamine

Front 47

Antidote used for warfarin toxicity

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Vitamin K and Fresh frozen plasma (FFP)

Front 48

Antidote for tissue plasminogen activator (t-PA), streptokinase

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Aminocaproic acid

Front 49

Antidote used for methanol and ethylene glycol

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Ethanol or fomepizole

Front 50

Antidote used for opioid toxicity

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Naloxone (IV), naltrexone (PO)

Front 51

Antidote used for benzodiazepine toxicity

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Flumazenil

Front 52

Antidote used for tricyclic antidepressants (TCA)

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Sodium bicarbonate

Front 53

Antidote used for carbon monoxide poisoning

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100% O2 and hyperbaric O2

Front 54

Antidote used for digitalis toxicity

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Digibind (also need to d/c digoxin, normalize K+, and lidocaine if pt. Is arrhythmic)

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Antidote used for beta agonist toxicity (eg. Metaproterenol)

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Esmolol

Front 56

Antidote for methotrexate toxicity

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Leucovorin

Front 57

Antidote for beta-blockers and hypoglycemia

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Glucagon

Front 58

Antidote useful for some drug induced Torsade de pointes

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Magnesium sulfate

Front 59

Antidote for hyperkalemia

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sodium polystyrene sulfonate (Kayexalate)

Front 60

Antidote for salicylate intoxication

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Alkalinize urine, dialysis

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Cancer Chemotherapy

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...

Front 62

Relationship of tumor cell number to time of diagnosis, symptoms, treatment and survival

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Log-kill hypothesis

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Pyrimidine analog that causes "thymineless death" given with leucovorin rescue

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5-fluorouracil (5-FU)

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Drug used in cancer therapy causes Cushing-like symptoms

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Prednisone

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Side effect of Mitomycin

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SEVERE myelosuppression

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MOA of cisplatin

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Alkylating agent

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Common toxicities of cisplatin

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Nephro and ototoxicity, peripheral neuropathy

Front 68

Analog of hypoxanthine, needs HGPRTase for activation

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6-mercaptopurine (6-MP)

Front 69

Interaction with this drug requires dose reduction of 6-MP

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Allopurinol

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Iron-chelating agent, protects against doxorubicin toxicity by scavenging free radicals

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Dexrazoxane

Front 71

Blows DNA (breaks DNA strands), limiting SE is pulmonary toxicity

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Bleomycin

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Platinum-based combination therapy for testicular cancer

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Bleomycin+etoposide+cisplatin

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ABVD regimen used for Hodgkin's, but appears less likely to cause sterility and secondary malignancies than MOPP

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Adriamycin (doxorubicin) +bleomycin, vinblastine +dacarbazine

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Regimen used for non-Hodgkin's lymphoma

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CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus rituximab

Front 75

Regimen used for breast cancer

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CMF (cyclophosphamide, methotrexate, and fluorouracil) and tamoxifen if ER+

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Alkylating agent, vesicant that causes tissue damage with extravasation

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Mechlorethamine

Front 77

Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis

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Cyclophosphamide

Front 78

Microtubule inhibitor that causes peripheral sensory neuropathy, foot drop (eg. ataxia), and SIADH

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Vincristine

Front 79

Interact with microtubules (but unlike vinca which prevent disassembly of tubules), it stabilizes tubulin and cells remain frozen in metaphase

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Paclitaxel (taxol)

Front 80

Agent similar to cisplatin, less nephrotoxic, greater myelosuppression, used to treat refractory hematologic malignancies

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Carboplatin

Front 81

Anti-androgen used for prostate cancer

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Flutamide, bicalutamide, nilutamide

Front 82

Anti-estrogen used for estrogen receptor + breast cancer

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Tamoxifen

Front 83

Aromatase inhibitor used in breast cancer

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anastrozole

Front 84

Newer biologic agent approved for metastatic melanoma, enhances T-cell immune responses

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Ipilimumab

Front 85

Some cell cycle specific anti-cancer drugs

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Bleomycin, vinca alkaloids, antimetabolites (eg., 5-FU, 6-MP, methotrexate, etoposide)

Front 86

Some cell cycle non-specific drugs

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Alkylating agents (eg., mechlorethamine, cyclophosphamide), antibiotics (doxorubicin, daunorubicin), cisplatin

Front 87

Regimen used for advanced colorectal cancer, stage II and III colon cancer

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FOLFOX (oxaliplatin, 5-FU and leucovorin)

Front 88

Nitrosoureas with high lipophilicity, used for brain tumors

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lomustine

Front 89

Anti-cancer agents that affect the VEGF-signaling pathway

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Bevacizumab, Ziv-aflibercept, Sorafenib, Sunitinib, Pazopanib

Front 90

Endocrine drugs: hypothalamic and pituitary hormones

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...

Front 91

Somatostatin (SRIF) analog used for acromegaly, carcinoid, glucagonoma and other GH producing pituitary tumors

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Octreotide

Front 92

Somatotropin (GH) analog used in GH deficiency (dwarfism)

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Somatrem

Front 93

GHRH analog used as diagnostic agent

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Sermorelin

Front 94

GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively

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Leuprolide

Front 95

GnRH antagonist with more immediate effects, used for infertility

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Ganirelix

Front 96

Dopamine (DA) agonist (for Parkinson's disease), used also for hyperprolactinemia

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Bromocriptine

Front 97

Hormone inhibiting prolactin release

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Dopamine

Front 98

ACTH analog used for diagnosis of patients with corticosteroid abnormality

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Cosyntropin

Front 99

Synthetic analog of ADH hormone used for diabetes insipidus and nocturnal enuresis

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Desmopressin (DDAVP)

Front 100

SE of OCs

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Increased thromboembolic events

Front 101

Thyroid and anti-thyroid drugs

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...

Front 102

Most widely used thyroid drugs such as Synthroid and Levoxyl contain

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L-thyroxine (T4)

Front 103

T3 compound less widely used

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Cytomel

Front 104

Anti-thyroid drugs

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Thioamides, iodides, radioactive iodine, and ipodate

Front 105

Thioamide agents used in hyperthyroidism

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Methimazole and propylthiouracil (PTU)

Front 106

Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and should be used with extreme caution in pregnancy

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PTU

Front 107

PTU (propylthiouracil) MOA

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Inhibits thyroid hormone synthesis by blocking iodination of the tyrosine residues of thyroglobulin

Front 108

Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism

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Iodide salts

Front 109

Dose may need to be increased during pregnancy or with Ocs due to increased TBG in plasma

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Thyroxine

Front 110

Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy

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Radioactive iodine

Front 111

Radio contrast media that inhibits the conversion of T4 to T3

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Ipodate

Front 112

Block cardiac adverse effects of thyrotoxicosis such as tachycardia, inhibits the conversion of T4 to T3

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Beta-blockers such as propranolol

Front 113

Vitamins containing iron should NOT be taken simultaneously with levothyroxine because

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Iron deiodinates thyroxine

Front 114

Thyroxine dose may need to be increased in hypothyroid patient during pregnancy because

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Estogens increase maternal TBG

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Adrenocorticosteroid and adrenocortical antagonists

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...

Front 116

3 zones of adrenal cortex and their products

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Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)

Front 117

Mnemonic for 3 zones of adrenal cortex

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GFR

Front 118

Used for Addison's disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)

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Glucocorticoids

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Short-medium acting glucocorticoids

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Cortisone, Hydrocortisone, Prednisone, Prednisolone, Methylprednisolone

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Intermediate acting glucocorticoids

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Triamcinolone, Fluprednisolone

Front 121

Long acting glucocorticoids

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Betamethasone and dexamethasone

Front 122

Mineralocorticoids

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Fludrocortisone and deoxycorticosterone

Front 123

Some side effects of corticosteroids

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Osteopenia, impaired wound healing, inc. risk of infection, inc. appetite, HTN, edema, PUD, euphoria, psychosis, stria, thinning of skin

Front 124

Inhibitors of corticosteroids biosynthesis

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...

Front 125

Used for Cushing's syndrome (increased corticosteroid)

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Dexamethasone suppression test

Front 126

Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis

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Aminoglutethimide

Front 127

Antifungal agent used for inhibition of all gonadal and adrenal steroids

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Ketoconazole

Front 128

Antiprogestin used as potent antagonist of GC receptor

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Mifepristone

Front 129

Diuretic used to antagonize aldosterone receptors

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Spironolactone

Front 130

Common SE of spironolactone

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Gynecomastia and hyperkalemia

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Gonadal hormones and inhibitors

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...

Front 132

Slightly increased risk of breast cancer, endometrial cancer, heart disease (questionable), has beneficial effects on bone loss

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Estrogen

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Antiestrogen drugs used for fertility and breast cancer respectively

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Clomiphene and tamoxifen

Front 134

Common SE of tamoxifen and raloxifene

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Hot flashes

Front 135

Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and prophylaxis in women with risk factors for breast cancer

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Raloxifene

Front 136

Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy

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Diethylstilbestrol (DES)

Front 137

Estrogen mostly used in oral contraceptives (OC)

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Ethinyl estradiol and mestranol

Front 138

Anti-progesterone used as abortifacient

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Mifepristone (RU-486)

Front 139

Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)

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Combination oral contraceptives (OC)

Front 140

Oral contraceptive available in a transdermal patch

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Ortho-Evra

Front 141

Converted to more active form DHT by 5 alpha-reductase

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Testosterone

Front 142

5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness

Back 142

Finasteride (Proscar and Propecia respectively)

Front 143

Anabolic steroid that has potential for abuse

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Nandrolone, oxymetholone, and oxandrolone

Front 144

Anti-androgen used for hirsutism in females

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Cyproterone acetate

Front 145

Drug is used with testosterone for male fertility

Back 145

Leuprolide

Front 146

Pancreatic hormones, antidiabetics, and hyperglycemics

Back 146

...

Front 147

What do alpha cells in the pancreas produce?

Back 147

Glucagon

Front 148

What do beta cells in the pancreas produce?

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Insulin

Front 149

Where are beta cells found in the pancreas?

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Islets of Langerhans

Front 150

What do delta cells in the pancreas produce?

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Somatostatin

Front 151

Product of proinsulin cleavage used to assess insulin production

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C-peptide

Front 152

Exogenous insulin contains

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No C-peptide

Front 153

Endogenous insulin contains

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Normal C-peptide

Front 154

Very rapid acting insulin, having fastest onset and shortest duration of action

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Lispro (Humalog), aspart (Novolog), glulisine (Apidra)

Front 155

Short acting, crystalline zinc insulin used to reverse acute hyperglycemia

Back 155

Regular (Humulin/Novolin R)

Front 156

Long acting insulins

Back 156

Glargine, detemir

Front 157

Major SE of insulin

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Hypoglycemia

Front 158

Important in synthesis of glucose to glycogen in the liver

Back 158

GLUT 2

Front 159

Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation

Back 159

GLUT 4

Front 160

Examples of alpha-glucosidase inhibitors (AGI)

Back 160

Acarbose, miglitol

Front 161

MOA of AGI's

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Act on intestine, delay digestion and absorption of glucose formed from digestion of starch and disacchrides

Front 162

SE of AGI's

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Flatulence (do not use beano to tx), diarrhea, abdominal cramps

Front 163

Alpha-glucosidase inhibitor associated with elevation of LFT's

Back 163

Acarbose

Front 164

Amino acid derivative, active as an insulin secretagogue

Back 164

Nateglinide

Front 165

MOA of nateglinide

Back 165

Insulin secretagogue - closes ATP-sensitive K+ channel

Front 166

Biguanide

Back 166

Metformin

Front 167

Drugs available in combination with metformin

Back 167

Glyburide, glipizide, sitagliptin, saxagliptin, pioglitazone

Front 168

MOA of metformin

Back 168

Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity

Front 169

Vascular effects of metformin

Back 169

Decreased micro and macro vascular disease

Front 170

Most important potential SE of metformin

Back 170

Lactic acidosis

Front 171

Incidence of hyoglycemia with metformin

Back 171

None

Front 172

Meglitinide class of drugs

Back 172

Repaglinide

Front 173

MOA of repaglinide

Back 173

Insulin release from pancreas; faster and shorter acting than sulfonylurea

Front 174

First generation sulfonylurea

Back 174

Chlorpropamide, tolbutamide, tolazamide, etc.

Front 175

Second generation sulfonylurea

Back 175

Glyburide, glipizide, glimepiride, etc.

Front 176

MOA of both generations

Back 176

Insulin release from pancreas by modifying K+ channels

Front 177

Common SE of sulfonylureas, repaglinide, and nateglinide

Back 177

Hypoglycemia, weight gain

Front 178

Sulfonylurea NOT recommended for elderly because of very long half life

Back 178

Chlorpropamide

Front 179

Thiazolidinediones

Back 179

Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)

Front 180

Reason troglitazone was withdrawn from market

Back 180

Hepatic toxicity

Front 181

MOA of thiazolidinediones

Back 181

Decrease insulin resistance, stimulate PPAR-gamma receptors

Front 182

SE of Thiazolindinediones

Back 182

Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism, risk for angina/MI

Front 183

Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation

Back 183

Glucagon

Front 184

Drugs used in bone homeostasis

Back 184

...

Front 185

Available bisphosphonates

Back 185

Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid

Front 186

MOA of Bisphosphonates

Back 186

Inhibits osteoclast bone resorption

Front 187

Names of three bisphosphonates available IV

Back 187

Pamidronate, zoledronate, ibandronate

Front 188

Uses of bisphosphonates

Back 188

Osteoporosis, Paget's disease, and osteolytic bone lesions, and hypercalcemia from malignancy

Front 189

Major SE of bisphosphonates

Back 189

Chemical esophagitis

Front 190

Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia

Back 190

Etidronate

Front 191

Used for prevention of postmenopausal osteoporosis in women

Back 191

Estrogen (HRT-Hormone replacement therapy)

Front 192

Increase bone density, also being tested for breast CA prophylaxis

Back 192

Raloxifene (SERM-selective estrogen receptor modulator)

Front 193

Used intranasally and decreases bone resorption

Back 193

Calcitonin (salmon prep)

Front 194

Used especially in postmenopausal women, dosage should be 1500 mg

Back 194

Calcium

Front 195

Vitamin given with calcium to ensure proper absorption

Back 195

Vitamin D

Front 196

Drugs with important actions on smooth muscle

Back 196

...

Front 197

Disease caused by excess ergot alkaloids

Back 197

St. Anthony's Fire

Front 198

Endogenous substances commonly interpreted as histamine, serotonin, prostaglandins, and vasoactive peptides

Back 198

Autocoids

Front 199

Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea

Back 199

Zollinger-Ellison Syndrome

Front 200

Drug that causes contraction of the uterus

Back 200

Oxytocin

Front 201

Distribution of histamine receptors H1, H2, and H3

Back 201

Smooth muscle; stomach, heart, and mast cells; nerve endings, CNS respectively

Front 202

Prototype antagonist of H1 and H2 receptors

Back 202

Diphenhydramine and cimetidine, respectively

Front 203

1st generation antihistamine that is highly sedating

Back 203

Diphendydramine

Front 204

1st generation antihistamine that is least sedating

Back 204

Chlorpheniramine or cyclizine

Front 205

2nd generation antihistamines

Back 205

Fexofenadine, loratadine, and cetirizine

Front 206

Generation of antihistamine that has the most CNS effects

Back 206

First generation due to being more lipid-soluble

Front 207

Major indication for H1 receptor antagonist

Back 207

Use in IgE mediated allergic reaction

Front 208

Antihistamine that can be used for anxiety and insomnia and is not addictive

Back 208

hydroxyzine (Atarax)

Front 209

H1 antagonist used in motion sickness

Back 209

Dimenhydrinate, meclizine, and other 1st generation

Front 210

Most common side effect of 1st generation antihistamines

Back 210

Sedation

Front 211

Lethal arrhythmias resulting from concurrent therapy with azole fungals (metabolized by CYP 3A4) and these antihistamines which inhibit the 3A4 iso-enzyme.

Back 211

Terfenadine and astemizole (have been removed from the market)

Front 212

H2 blocker that causes the most interactions with other drugs

Back 212

Cimetidine

Front 213

Clinical use for H2 blockers

Back 213

Acid reflux disease, duodenal ulcer and peptic ulcer disease

Front 214

Receptors for serotonin (5HT-1) are located

Back 214

Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance

Front 215

"

Back 215

...

Front 216

5HT-1d agonist used for migraine headaches "

Back 216

Sumatriptan, naratriptan, and rizatriptan

Front 217

Triptan available in parenteral and nasal formulation

Back 217

Sumatriptan

Front 218

H1 blocker that is also a serotonin antagonist

Back 218

Cyproheptadine

Front 219

Agents for reduction of postpartum bleeding

Back 219

Oxytocin, ergonovine and ergotamine

Front 220

Agents used in treatment of carcinoid tumor

Back 220

Ketanserin cyproheptadine, and phenoxybenzamine

Front 221

5HT-3 antagonist used in chemotherapeutic induced emesis

Back 221

"Ondansetron, granisetron,

Front 222

dolasetron and alosetron "

Back 222

...

Front 223

5HT-3 antagonist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease

Back 223

Dolasetron

Front 224

DOC to treat chemo-induced nausea and vomiting

Back 224

Odansetron

Front 225

Drug used in ergot alkaloids overdose, ischemia and gangrene

Back 225

Nitroprusside

Front 226

Reason ergot alkaloids are contraindicated in pregnancy

Back 226

Uterine contractions

Front 227

SE of ergot alkaloids

Back 227

Hallucinations resembling psychosis

Front 228

Ergot alkaloid used as an illicit drug

Back 228

LSD

Front 229

Dopamine agonist used in hyperprolactinemia

Back 229

Bromocriptine

Front 230

Peptide causing increased capillary permeability and edema

Back 230

Bradykinin and histamine

Front 231

Mediator of tissue pain, edema, inactivated by ACE, and may be a contributing factor to the development of angioedema

Back 231

Bradykinin

Front 232

Drug causing depletion of substance P (vasodilator)

Back 232

Capsaicin

Front 233

Prostaglandins that cause abortions

Back 233

Prostaglandin E1 (misoprostol) PGE2, and PGF2alpha

Front 234

"

Back 234

...

Front 235

Difference between COX 1 and COX 2 "

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"COX 1 is found throughout

Front 236

the body and COX 2 is only

Back 236

...

Front 237

in inflammatory tissue"

Back 237

...

Front 238

Drug that selectively inhibits COX 2

Back 238

Celecoxib and rofecoxib

Front 239

Inhibitor of lipoxygenase

Back 239

Zileuton

Front 240

Major SE of zileuton

Back 240

Liver toxicity

Front 241

Inhibitor of leukotrienes (LTD4) receptors and used in asthma

Back 241

Zafirlukast and montelukast

Front 242

Used in pediatrics to maintain patency of ductus arteriosis

Back 242

PGE1

Front 243

Approved for use in severe pulmonary HTN

Back 243

PGI2 (epoprostenol)

Front 244

Prostaglandin used in the treatment of impotence

Back 244

Alprostadil

Front 245

Irreversible, nonselective COX inhibitor

Back 245

Aspirin

Front 246

Class of drugs that reversibly inhibit COX

Back 246

NSAIDS

Front 247

Primary endogenous substrate for Nitric Oxidase Synthase

Back 247

Arginine

Front 248

MOA and effect of nitric oxide

Back 248

Stimulates cGMP which leads to vascular smooth muscle relaxation

Front 249

Long acting beta 2 agonist used in asthma

Back 249

Salmeterol, formoterol

Front 250

Muscarinic antagonist used in asthma

Back 250

Ipratropium

Front 251

MOA action of cromolyn

Back 251

Mast cell stabilizer

Front 252

Methylxanthine derivative used as a remedy for intermittent claudication

Back 252

Pentoxifylline

Front 253

"

Back 253

...

Front 254

MOA of corticosteroids"

Back 254

inhibit phospholipase A2

Front 255

SE of long term corticosteroid therapy and remedy

Back 255

Adrenal suppression and weaning slowly, respectively

Front 256

Antimicrobials

Back 256

...

Front 257

MOA of quinolones

Back 257

Inhibit DNA gyrase

Front 258

MOA of penicillin

Back 258

Block cell wall synthesis by inhibiting peptidoglycan cross-linkage

Front 259

Drug used for MRSA

Back 259

Vancomycin

Front 260

Vancomycin MOA

Back 260

Blocks cell wall synthesis by sequestration

Front 261

Genetic basis of low level resistance found with vancomycin

Back 261

Point mutation

Front 262

Meningitis prophylaxis for persons in contact with patients

Back 262

Ciprofloxacin or Rifampin (for children less than 4 yrs old)

Front 263

Technique used to diagnose perianal itching, and the drug used to treat it

Back 263

"Scotch tape technique

Front 264

and mebendazole"

Back 264

...

Front 265

Two toxicities of aminoglycosides

Back 265

nephro and ototoxicity

Front 266

DOC for Legionnaires' disease

Back 266

Moxifloxacin

Front 267

MOA of sulfonamides

Back 267

Inhibit dihydropteroate synthase

Front 268

Penicillins active against penicillinase secreting bacteria

Back 268

Methicillin, nafcillin, and dicloxacillin

Front 269

Cheap wide spectrum antibiotic DOC for otitis media

Back 269

Amoxicillin

Front 270

Class of antibiotics that have 10% cross sensitivity with penicillins

Back 270

Cephalosporins

Front 271

PCN active against pseudomonas

Back 271

ceftazidime, imipenem, piperacillin and ticarcillin

Front 272

Antibiotic causing red-man syndrome, and prevention

Back 272

"Vancomycin, infusion

Front 273

at a slow rate and antihistamines"

Back 273

...

Front 274

Drug causes teeth discoloration

Back 274

Tetracycline

Front 275

MOA of tetracycline

Back 275

Decreases protein synthesis by inhibiting 30S ribosome

Front 276

Drug that causes gray baby syndrome and aplastic anemia

Back 276

Chloramphenicol

Front 277

Drug notorious for causing pseudomembranous colitis

Back 277

Clindamycin, metronidazole

Front 278

DOC for tx of pseudomembranous colitis (mild)

Back 278

Metronidazole

Front 279

Treatment of severe/relapsing pseudomembranous colitis

Back 279

ORAL vancomycin

Front 280

Anemia caused by trimethoprim

Back 280

Megaloblastic anemia

Front 281

Reason fluoroquinolones are contraindicated in children and pregnancy

Back 281

Cartilage damage

Front 282

DOC for giardia, bacterial vaginosis, and trichomonas

Back 282

Metronidazole

Front 283

Treatment for TB patients (think RIPE)

Back 283

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Front 284

Metronidazole SE if given with alcohol

Back 284

Disulfiram-like reaction

Front 285

Common side effect of Rifampin

Back 285

Red urine discoloration

Front 286

MOA of nystatin

Back 286

Bind ergosterol in fungal cell membrane

Front 287

Neurotoxicity with isoniazid (INH) prevented by

Back 287

Administration of Vit. B6 (pyridoxine)

Front 288

Toxicity of amphotericin

Back 288

Nephrotoxicity

Front 289

SE seen only in men with administration of ketoconazole

Back 289

Gynecomastia

Front 290

Topical DOC in impetigo

Back 290

Topical mupirocin (Bactroban)

Front 291

Drug used for African sleeping sickness

Back 291

Suramin

Front 292

Drug used in Chagas disease

Back 292

Nifurtimox

Front 293

Cephalosporins able to cross the BBB

Back 293

Ceftazidime, Ceftriaxone or Cefotaxime

Front 294

Oral 3rd generation cephalosporins NOT able to cross the BBB

Back 294

Cefixime

Front 295

Drug used for N. gonorrhea in females

Back 295

Ceftriaxone

Front 296

Cephalosporin causes kernicterus in neonates

Back 296

Ceftriaxone or cefuroxime

Front 297

SE of INH

Back 297

Peripheral neuritis and hepatitis

Front 298

Aminoglycoside that is least ototoxic

Back 298

Streptomycin

Front 299

Drug used in exoerythrocytic cycle of malaria

Back 299

Primaquine

Front 300

Oral antibiotic of choice for moderate inflammatory acne

Back 300

Minocycline

Front 301

Drug of choice for leprosy

Back 301

Dapsone, rifampin and clofazimine combination

Front 302

DOC for herpes and its MOA

Back 302

Acyclovir; phosphorylation, incorporation into viral DNA, and chain termination

Front 303

Anti-bacterials that cause hemolysis in G6PD-deficient patients

Back 303

Sulfonamides

Front 304

MOA of erythromycin

Back 304

Inhibition of protein synthesis at the 50s subunit of ribosome

Front 305

Anti-biotic frequently used for chronic UTI prophylaxis

Back 305

sulfamethoxazole/ trimethoprim

Front 306

Lactams that can be used in PCN allergic patients

Back 306

Aztreonam/carbapenems

Front 307

SE of imipenem

Back 307

Seizures

Front 308

Antiviral Agents

Back 308

...

Front 309

DOC for influenza A

Back 309

Oseltamivir

Front 310

DOC for severe RSV

Back 310

Ribavirin

Front 311

DOC for CMV retinitis

Back 311

Ganciclovir, valganciclovir

Front 312

SE for ganciclovir

Back 312

myelosuppression

Front 313

Anti-viral agent associated with Stephen Johnson syndrome

Back 313

Nevirapine

Front 314

HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism

Back 314

Protease inhibitors

Front 315

Protease inhibitors recommended for pregnant women

Back 315

lopinavir, ritonavir, atazanavir

Front 316

Antivirals that are teratogens

Back 316

Delavirdine, efavirenz, and ribavirin

Front 317

Single dose used to prevent perinatal transmission of HIV

Back 317

Nevirapine

Front 318

Anti-viral with a dose limiting toxicity of pancreatitis

Back 318

Didanosine

Front 319

Anti-HSV/VZV agent that causes thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in high doses

Back 319

Valacyclovir

Front 320

Intravenous drug effective for end-organ CMV disease (retinitis, colitis, esophagitis)

Back 320

Foscarnet

Front 321

Nucleoside reverse transcriptase inhibitor that can cause fatal hypersensitivity reactions linked to HLDB5701

Back 321

Abacavir

Front 322

Polymerase inhibitor used to treat Hepatitis C infections in combination with ribavarin

Back 322

Sofosbuvir

Front 323

Protease inhibitors used to treat Hepatitis C infections

Back 323

Boceprevir, Simeprevir, Telaprevir

Front 324

Sedative Hypnotics

Back 324

...

Front 325

Common side effect of hypnotic agents

Back 325

Sedation

Front 326

Occurs when sedative hypnotics are used chronically or at high doses

Back 326

Tolerance

Front 327

The most common type of drug interaction of sedative hypnotics with other depressant medications

Back 327

Additive CNS depression

Front 328

Benzodiazepines used to promote sleep

Back 328

Temazpam, trizolam, flurazepam

Front 329

Benzodiazepine used for anxiety

Back 329

Alprazolam

Front 330

Non-benzodiazepine used as an anxiolytic

Back 330

Buspirone

Front 331

Non-benzodiazepine used for sleep

Back 331

Zolpidem

Front 332

Major effect of benzodiazepines on sleep at high doses

Back 332

REM is decreased

Front 333

Neurologic SE of benzodiazepines

Back 333

Anterograde amnesia

Front 334

Reason benzos are used cautiously in pregnancy

Back 334

Ability to cross the placenta

Front 335

Main route of metabolism for benzodiazepines

Back 335

Hepatic

Front 336

Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired)

Back 336

Lorazepam, oxazepam, and temazepam

Front 337

"MOA for benzodiazepines

Back 337

...

Front 338

"

Back 338

increase the FREQUENCY of GABA-mediated chloride ion channel opening

Front 339

Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects)

Back 339

Flumazenil

Front 340

Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin

Back 340

Diazepam

Front 341

Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia

Back 341

Clonazepam

Front 342

Benzodiazepines that are the most effective in the treatment of panic disorder

Back 342

Alprazolam and Clonazepam

Front 343

"Benzodiazepine that is used for anesthesia

Back 343

...

Front 344

"

Back 344

Midazolam

Front 345

DOC for status epilepticus

Back 345

Diazepam

Front 346

Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs

Back 346

Chlordiazepoxide and Diazepam

Front 347

Agents having active metabolites, long half lives, and a high incidence of adverse effects

Back 347

Diazepam, Flurazepam, chlordiazepoxide, and clorazepate

Front 348

Barbiturates

Back 348

...

Front 349

Barbiturates may precipitate this hematologic condition

Back 349

Acute intermittent porphyria

Front 350

Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property

Back 350

Liver enzyme INDUCTION

Front 351

Barbiturates MOA

Back 351

Increase the DURATION of GABA-mediated chloride ion channels

Front 352

Barbiturate used for the induction of anesthesia

Back 352

Thiopental

Front 353

Others

Back 353

...

Front 354

Site of action for zaleplon and zolpidem

Back 354

Benzodiazepine receptor BZ1 (although do not have a benzodiazepine ring structure)

Front 355

Good hypnotic activity with less CNS SE than most benzodiazepines

Back 355

Zolpidem, zaleplon

Front 356

Agent that is a partial agonist for the 5-HT1A receptor

Back 356

Buspirone

Front 357

Drug of choice for generalized anxiety disorder, NOT effective in acute anxiety

Back 357

Buspirone

Front 358

Alcohols

Back 358

...

Front 359

Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS)

Back 359

Ethanol

Front 360

Agent with zero-order kinetics

Back 360

Ethanol

Front 361

Rate limiting step of alcohol metabolism

Back 361

Aldehyde dehydrogenase

Front 362

System that increases in activity with chronic ethanol exposure and may contribute to tolerance

Back 362

MEOS

Front 363

Enzyme that metabolizes acetaldehyde to acetate

Back 363

Aldehyde dehydrogenase

Front 364

Agents that inhibit acetaldehyde dehydrogenase

Back 364

Disulfiram, metronidazole, certain sulfonylureas and cephalosporins

Front 365

Agent that inhibits alcohol dyhydrogenase and its clinical use

Back 365

FOMEPIZOLE - used to prevent formation of toxic metabolites from methanol and ethylene glycol ingestion

Front 366

Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension

Back 366

Disulfiram

Front 367

The most common neurologic abnormality in chronic alcoholics

Back 367

Peripheral neuropathy (also excessive alcohol use is associated with HTN, anemia, and MI)

Front 368

Agent that is teratogen and causes a fetal syndrome

Back 368

Ethanol

Front 369

Agent that is the antidote for methanol overdose

Back 369

Ethanol, fomepizole

Front 370

Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure

Back 370

Fomepizole

Front 371

Anti seizure Drugs

Back 371

...

Front 372

Most frequent route of metabolism

Back 372

Hepatic enzymes

Front 373

Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine

Back 373

Sodium channel blockade

Front 374

MOA for benzodiazepines and barbiturates

Back 374

GABA-related targets

Front 375

MOA for Ethosuximide

Back 375

Calcium channels

Front 376

MOA for Valproic acid at high doses

Back 376

Affect calcium, potassium, and sodium channels

Front 377

Drugs of choice for generalized tonic-clonic and partial seizures

Back 377

Valproic acid and Phenytoin

Front 378

DOC for febrile seizures

Back 378

Phenobarbital

Front 379

Drugs of choice for absence seizures

Back 379

Ethosuximide and valproic acid

Front 380

Drug of choice for myoclonic seizures

Back 380

Valproic acid

Front 381

Drugs of choice for status epilepticus

Back 381

IV diazepam for short term (acute) treatment; phenytoin for prolonged therapy

Front 382

Drugs that can be used for infantile spasms

Back 382

Corticosteroids

Front 383

Anti-seizure drugs used also for bipolar affective disorder (BAD)

Back 383

Valproic acid, carbamazepine, phenytoin and gabapentin

Front 384

Anti-seizure drugs used also for Trigeminal neuralgia

Back 384

Carbamazepine

Front 385

Anti-seizure drugs used also for pain of neuropathic orgin

Back 385

Gabapentin

Front 386

Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism

Back 386

Phenytoin

Front 387

SE of phenytoin

Back 387

Gingival hyperplasia, nystagmus, diplopia and ataxia

Front 388

Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida

Back 388

Carbamazepine

Front 389

Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress

Back 389

Valproic acid

Front 390

Laboratory value required to be monitored for patients on valproic acid

Back 390

Serum ammonia and LFT's

Front 391

SE for Lamotrigine

Back 391

Stevens-Johnson syndrome

Front 392

SE for Felbamate

Back 392

Aplastic anemia and acute hepatic failure

Front 393

Anti-seizure medication also used in the prevention of migraines

Back 393

Valproic acid

Front 394

Carbamazepine may cause

Back 394

Agranulocytosis

Front 395

Anti-seizure drugs used as alternative drugs for mood stabilization

Back 395

Carbamazepine, gabapentin, lamotrigine, and valproic acid

Front 396

General Anesthetics

Back 396

...

Front 397

MOA of general anesthetics

Back 397

Most are thought to act at GABA-A receptor - chloride channel

Front 398

Inhaled anesthetic with a low blood/gas partition coefficient

Back 398

Nitrous oxide

Front 399

Inversely related to potency of anesthetics

Back 399

Minimum alveolar anesthetic concentration (MAC)

Front 400

Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents

Back 400

Halothane and methoxyflurane

Front 401

Most inhaled anesthetics SE

Back 401

Decrease arterial blood pressure

Front 402

Inhaled anesthetics are myocardial depressants

Back 402

Enflurane and halothane

Front 403

Inhaled anesthetic causes peripheral vasodilation

Back 403

Isoflurane

Front 404

Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis

Back 404

Halothane

Front 405

Inhaled anesthetic, less likely to lower blood pressure than other agents, and has the smallest effect on respiration

Back 405

Nitrous oxide

Front 406

Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency

Back 406

Methoxyflurane

Front 407

Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia

Back 407

Nitrous oxide

Front 408

Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm

Back 408

Desflurane

Front 409

DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics

Back 409

Dantrolene

Front 410

IV barbiturate used as a pre-op anesthetic

Back 410

Thiopental

Front 411

Benzodiazepine used adjunctively in anesthesia

Back 411

Midazolam

Front 412

Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose

Back 412

Flumazenil

Front 413

This produces "dissociative anesthesia", is a cardiovascular stimulant which may increases intracranial pressure, and hallucinations occur during recovery

Back 413

Ketamine

Front 414

Opioid associated with respiratory depression, but is used in high risk patients who may not survive full general anesthetia

Back 414

Fentanyl

Front 415

State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide

Back 415

Neuroleptanesthesia

Front 416

Produces both rapid anesthesia and recovery, has antiemetic activity and commonly used for outpatient surgery, may cause marked hypotension

Back 416

Propofol

Front 417

Local Anesthetics

Back 417

...

Front 418

MOA of local anesthetics (LA's)

Back 418

Block voltage-dependent sodium channels

Front 419

This may enhance activity of local anesthetics

Back 419

Hyperkalemia

Front 420

This may antagonize activity of local anesthetics

Back 420

Hypercalcemia

Front 421

Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity

Back 421

Vasodilation

Front 422

Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery

Back 422

Cocaine

Front 423

Longer acting local anesthetics which are less dependent on vasoconstrictors

Back 423

Tetracaine and bupivacaine

Front 424

These LA's have surface activity

Back 424

Cocaine and benzocaine

Front 425

Most important toxic effects of most local anesthetics

Back 425

CNS toxicity

Front 426

Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction

Back 426

Cocaine

Front 427

LA causing methemoglobinemia

Back 427

Prilocaine

Front 428

Skeletal Muscle Relaxants

Back 428

...

Front 429

Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation

Back 429

Neuromuscular blocking drugs

Front 430

These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)

Back 430

Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic

Front 431

These prevent the action of Ach at the skeletal muscle endplate to produce a "surmountable blockade," effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)

Back 431

Nondepolarizing type antagonists

Front 432

Agent with long duration of action and is most likely to cause histamine release

Back 432

Tubocurarine

Front 433

Non-depolarizing skeletal muscle antagonist that has short duration

Back 433

Mivacurium

Front 434

Skeletal muscle agent that can block muscarinic receptors

Back 434

Pancuronium

Front 435

Skeletal muscle agent that undergoes Hofmann elimination (breaks down spontaneously)

Back 435

Atracurium

Front 436

One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis, causes muscle pain postoperatively and myoglobinuria may occur

Back 436

Succinylcholine

Front 437

During Phase I these agents worsen muscle paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine

Back 437

Cholinesterase inhibitors

Front 438

Spasmolytic drugs

Back 438

...

Front 439

Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease

Back 439

Spasmolytic drugs

Front 440

Facilitates GABA presynaptic inhibition

Back 440

Diazepam

Front 441

GABA agonist in the spinal cord

Back 441

Baclofen

Front 442

Similar to clonidine and may cause hypotension

Back 442

Tizanidine

Front 443

DOC for malignant hyperthermia by acting on the sacroplasmic reticulum or skeletal muscle

Back 443

Dantrolene

Front 444

Agent used for acute muscle spasm

Back 444

Cyclobenzaprine

Front 445

Drugs Used in Parkinsonism & Other Movement Disorders

Back 445

...

Front 446

Irreversible condition resulting from the use of antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog)

Back 446

Drug induced Parkinsonism

Front 447

Agent used in drug therapy of Parkinson's instead of Dopamine which has low bioavailability and does not cross the BBB

Back 447

L-dopa

Front 448

This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE's (GI distress, postural hypotension, and dyskinesias)

Back 448

Carbidopa

Front 449

Clinical response that may fluctuate in tx of Parkinson's dx

Back 449

"On-off-phenomenon"

Front 450

Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma

Back 450

Levodopa

Front 451

Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia

Back 451

Bromocriptine

Front 452

Non ergot agents used as first-line therapy in the initial management of Parkinson's

Back 452

Pramipexole and ropinirole

Front 453

Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis

Back 453

Amantadine

Front 454

Inhibitor of MAO type B which slows down metabolism of dopamine, used adjunct to levodopa or as sole agent in newly diagnosed patients

Back 454

Selegiline

Front 455

Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson's dx and cause acute hepatic failure (monitor LFT's)

Back 455

Tolcapone

Front 456

Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects

Back 456

Benztropine

Front 457

Agent effective in physiologic and essential tremor

Back 457

Propranolol

Front 458

Agents used in Huntington's Disease

Back 458

Tetrabenazine (amine depleting drug), reserpine

Front 459

Agents used in Tourette's dx

Back 459

Haloperidol, pimozide , clonidine

Front 460

Chelating agent used in Wilson's disease

Back 460

Penicillamine

Front 461

...

Back 461

...

Front 462

Antipsychotics

Back 462

...

Front 463

Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor

Back 463

Older antipsychotic agents, D2 receptors

Front 464

MOA of neuroleptics

Back 464

Dopamine blockade

Front 465

Side effects occuring in antipsychotics that block dopamine

Back 465

Hyperprolactinemia, menorrhea, galactorrhea, confusion, mood changes, decreased sexual interest, and weight gain

Front 466

Antipsychotics that reduce positive symptoms only

Back 466

Older antipsychotics

Front 467

Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation

Back 467

Olanzapine, aripiprazole, and sertindole

Front 468

Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia

Back 468

Risperidone

Front 469

Atypical antipsychotic causing high prolactin levels

Back 469

Risperidone

Front 470

Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes

Back 470

Olanzapine

Front 471

Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker

Back 471

Haloperidol

Front 472

Drug used in neuroleptic malignant syndrome

Back 472

Dantrolene

Front 473

Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)

Back 473

Muscarinic blockers

Front 474

Antipsychotic having the strongest autonomic effects

Back 474

Thioridazine

Front 475

Antipsychotic having the weakest autonomic effects

Back 475

Haloperidol

Front 476

Only phenothiazine not exerting antiemetic effects, can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias

Back 476

Thioridazine

Front 477

Agent having no effect on D2 receptors, blocks D4, reserved for resistant schizophrenia, and can cause fatal agranulocytosis

Back 477

Clozapine

Front 478

Anti-psychotic not shown to cause tardive dyskinesia

Back 478

Clozapine

Front 479

Anti-psychotics available in depot preparation

Back 479

Fluphenazine and haloperidol

Front 480

Reduced seizure threshold

Back 480

Low-potency typical antipsychotics and clozapine

Front 481

Orthostatic hypotension and QT prolongation

Back 481

Low potency phenothiazines and ziprasidone

Front 482

Increased risk of developing cataracts

Back 482

Quetiapine

Front 483

Lithium

Back 483

...

Front 484

Major route of elimination for Lithium

Back 484

Kidneys

Front 485

Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop

Back 485

Lithium toxicity

Front 486

Drug increases the renal clearance hence decreases levels of lithium

Back 486

Theophylline

Front 487

Lithium is associated with this congenital defect

Back 487

Cardiac anomalies and is contraindicated in pregnancy or lactation

Front 488

DOC for bipolar affective disorder

Back 488

Lithium

Front 489

Concern using lithium

Back 489

Low therapeutic index

Front 490

SE of lithium

Back 490

Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus

Front 491

Antidepressants

Back 491

...

Front 492

Example of three antidepressants that are indicated for obsessive compulsive disorder

Back 492

Clomipramine, fluoxetine and fluvoxamine

Front 493

Neurotransmitters affected by the action of antidepressants

Back 493

Norepinephrine and serotonin

Front 494

Usual time needed for full effect of antidepressant therapy

Back 494

2 to 6 weeks

Front 495

Population group especially sensitive to side effects of antidepressants

Back 495

Elderly patients

Front 496

All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion

Back 496

Side-effect profile, drug interaction potential and prior pt response

Front 497

Well-tolerated and are first-line antidepressants

Back 497

SSRI's, bupropion, and venlafaxine

Front 498

Monoamine oxidase inhibitors (MAOI)

Back 498

...

Front 499

Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression

Back 499

Monamine oxidase inhibitors

Front 500

Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)

Back 500

Hypertensive crisis

Front 501

MAOI should not be administered with SSRI's or potent TCA's due to development of this condition

Back 501

Serotonin syndrome

Front 502

Tricyclic antidepressants (TCA)

Back 502

...

Front 503

Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly

Back 503

Tricyclic antidepressants (TCA)

Front 504

Three C's associated with TCA toxicity

Back 504

Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)

Front 505

Agents having higher sedation and antimuscarinic effects than other TCA's

Back 505

Tertiary amines

Front 506

TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects

Back 506

Amitriptyline

Front 507

TCA used in chronic pain, enuresis, and ADD

Back 507

Imipramine

Front 508

TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep

Back 508

Doxepin

Front 509

TCA used in obsessive compulsive disorder (OCD), most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms

Back 509

Clomipramine

Front 510

Secondary amines that have less sedation and more excitation effect

Back 510

Nortriptyline, Desipramine

Front 511

Side effects seen with tricyclic antidepressants

Back 511

Muscarinic blockade (dry mouth, constipation); weak alpha-1 block (orthostatic hypotension); weak hisamine block (sedation)

Front 512

Heterocyclics

Back 512

...

Front 513

Antidepressant associated with neuroleptic malignant syndrome

Back 513

Amoxapine

Front 514

Antidepressant associated with seizures and cardiotoxicity

Back 514

Maprotiline

Front 515

Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure

Back 515

Venlafaxine

Front 516

Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake

Back 516

Venlafaxine, duloxetine

Front 517

Antidepressant also used for sleep that causes priapism

Back 517

Trazodone

Front 518

Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure

Back 518

Nefazodone

Front 519

Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures

Back 519

Bupropion

Front 520

Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating

Back 520

Mirtazapine

Front 521

SE of mirtazapine

Back 521

Liver toxicity, increased serum cholesterol

Front 522

Selective serotonin reuptake inhibitors (SSRI)

Back 522

...

Front 523

Except for these agents all SSRI have significant inhibition of CytP450 enzymes

Back 523

Citalopram and its metabolite escitalopram

Front 524

Side effects frequently seen with SSRIs

Back 524

CNS stimulation; GI upset

Front 525

Antidepressants with no effect on BP, no sedation

Back 525

SSRIs

Front 526

SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx

Back 526

Fluoxetine

Front 527

SSRI indicated for premenstrual dysphoric disorder

Back 527

Fluoxetine (Sarafem)

Front 528

Some of SSRIs' therapeutic effects beside depression

Back 528

Panic attacks, social phobias, bulimia nervosa, and PMDD (premenstrual dysphoric disorder), OCD

Front 529

SSRI less likely to cause a withdrawal syndrome

Back 529

Fluoxetine

Front 530

Opioid Analgesics & Antagonists

Back 530

...

Front 531

Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons

Back 531

Ascending pathways

Front 532

Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release

Back 532

Presynaptic mu, delta, and kappa receptors

Front 533

Activation of these receptors open K+ ion channels to cause membrane hyperpolarization

Back 533

Postsynaptic Mu receptors

Front 534

Tolerance to all effects of opioid agonists can develop except

Back 534

Miosis and constipation

Front 535

All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction

Back 535

Meperidine

Front 536

SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone

Back 536

Opioid Analgesics

Front 537

Strong opioid agonists

Back 537

Morphine, methadone, meperidine, and fentanyl

Front 538

Opioids used in anesthesia

Back 538

Morphine and fentanyl

Front 539

Opioid used in the management of withdrawal states

Back 539

Methadone

Front 540

Opioid available trans-dermally

Back 540

Fentanyl

Front 541

Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema

Back 541

Morphine

Front 542

Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome

Back 542

Meperidine

Front 543

Moderate opioid agonists

Back 543

Codeine, hydrocodone, and oxycodone

Front 544

Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

Back 544

Propoxyphene

Front 545

Partial agonist or mixed antagonists

Back 545

...

Front 546

Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal

Back 546

Buprenorphine

Front 547

Opioid antagonist that is given IV and had short DOA

Back 547

Naloxone

Front 548

Opioid antagonist that is given orally in alcohol dependency programs

Back 548

Naltrexone

Front 549

These agents are used as antitussive

Back 549

Dextromethorphan, Codeine

Front 550

These agents are used as antidiarrheal

Back 550

Diphenoxylate, Loperamide

Front 551

Drugs of Abuse

Back 551

...

Front 552

Inhalant anesthetics

Back 552

NO, chloroform, and diethyl ether

Front 553

Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation

Back 553

Fluorocarbons and Industrial solvents

Front 554

Cause dizziness, tachycardia, hypotension, and flushing

Back 554

Organic nitrites

Front 555

Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression

Back 555

Steroids

Front 556

Readily detected markers that may assist in diagnosis of the cause of a drug overdose include

Back 556

Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses

Front 557

Opioid Analgesics

Back 557

...

Front 558

Most commonly abused in health care professionals

Back 558

Heroin, morphine, oxycodone, meperidine and fentanyl

Front 559

This route is associated with rapid tolerance and psychologic dependence

Back 559

IV administration

Front 560

Leads to respiratory depression progressing to coma and death

Back 560

Overdose of opioids

Front 561

Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome

Back 561

Abstinence syndrome

Front 562

Treatment for opioid addiction

Back 562

Methadone, followed by slow dose reduction

Front 563

This agent may cause more severe, rapid and intense symptoms to a recovering addict

Back 563

Naloxone

Front 564

Sedative-Hypnotics

Back 564

...

Front 565

Sedative-Hypnotics action

Back 565

Reduce inhibition, suppress anxiety, and produce relaxation

Front 566

Additive effects when Sedative-Hypnotics used in combination with these agents

Back 566

CNS depressants

Front 567

Common mechanism by which overdose result in death

Back 567

Depression of medullary and cardiovascular centers

Front 568

"Date rape drug"

Back 568

Flunitrazepam (rohypnol)

Front 569

The most important sign of withdrawal syndrome

Back 569

Excessive CNS stimulation (seizures)

Front 570

Treatment of withdrawal syndrome involves

Back 570

Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol

Front 571

These agents are CNS depressants

Back 571

Ethanol, Barbiturates, and Benzodiazepines

Front 572

Stimulants

Back 572

...

Front 573

Withdrawal from this drug causes lethargy, irritability, and headache

Back 573

Caffeine

Front 574

W/D from this drug causes anxiety and mental discomfort

Back 574

Nicotine

Front 575

Treatments available for nicotine addiction

Back 575

Patches, gum, nasal spray, psychotherapy, and bupropion

Front 576

Chronic high dose abuse of nicotine leads to

Back 576

Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures

Front 577

Tolerance is marked and abstinence syndrome occurs

Back 577

Amphetamines

Front 578

Amphetamine agents

Back 578

Dextroamphetamines and methamphetamine

Front 579

These agents are congeners of Amphetamine

Back 579

DOM, STP, MDA, and MDMA "ecstasy"

Front 580

Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)

Back 580

Cocaine "super-speed"

Front 581

Hallucinogens

Back 581

...

Front 582

Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic

Back 582

PCP

Front 583

Removal of PCP may be aided

Back 583

Urinary acidification and activated charcoal or continual nasogastric suction

Front 584

THC is active ingredient, SE's include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur

Back 584

Marijuana

Front 585

Cholinoreceptor-Activating & Cholinesterase-Inhibiting Drugs

Back 585

...

Front 586

Direct-Acting Cholinomimetic Agonists

Back 586

...

Front 587

Muscarinic agonists or parasympathomimetic

Back 587

...

Front 588

This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention

Back 588

Bethanechol

Front 589

Only direct acting agent that is very lipid soluble and used in glaucoma

Back 589

Pilocarpine

Front 590

This agent used to treat dry mouth in Sjögren's syndrome

Back 590

Cevimeline

Front 591

Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis

Back 591

Edrophonium

Front 592

Carbamate with intermediate action, used for postoperative and neurogenic ileus and urinary retention

Back 592

Neostigmine

Front 593

Treatment of atropine overdose and glaucoma (because lipid soluble). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions

Back 593

Physostigmine

Front 594

Long-term treatment of myasthenia gravis

Back 594

Pyridostigmine

Front 595

Organophosphates

Back 595

...

Front 596

Antiglaucoma organophosphate

Back 596

Echothiophate

Front 597

Associated with an increased incidence of cataracts in patients treated for glaucoma

Back 597

Long acting cholinesterase inhibitors

Front 598

Scabicide organophosphate

Back 598

Malathion

Front 599

Organophosphate anthelmintic agent with long DOA

Back 599

Metrifonate

Front 600

Toxicity of organophosphate:

Back 600

DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)

Front 601

The most frequent cause of acute deaths in cholinesterase inhibitor toxicity

Back 601

Respiratory failure

Front 602

The most toxic organophosphate

Back 602

Parathion

Front 603

Treatment of choice for organophosphate overdose

Back 603

Atropine

Front 604

This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure

Back 604

Pralidoxime

Front 605

Cholinoreceptor Blockers & Cholinesterase Regenerators

Back 605

...

Front 606

Prototypical drug is atropine

Back 606

Nonselective Muscarinic Antagonists

Front 607

Treat manifestations of Parkinson's disease and EPS

Back 607

Benztropine, trihexyphenidyl

Front 608

Treatment of motion sickness

Back 608

Scopolamine, meclizine

Front 609

Produce mydriasis and cycloplegia

Back 609

Atropine, homatropine,C1208 tropicamide

Front 610

Bronchodilation in asthma and COPD

Back 610

Ipratropium

Front 611

Reduce transient hyper GI motility

Back 611

Dicyclomine, methscopolamine

Front 612

Cystitis, postoperative bladder spasms, or incontinence

Back 612

Oxybutynin, dicyclomine

Front 613

Toxicity of anticholinergics

Back 613

block SLUD (salivation, lacrimation, urination, defecation)

Front 614

Another mnemonic for anticholinergic toxicity

Back 614

"dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat"

Front 615

Atropine fever is the most dangerous effect and can be lethal in this population group

Back 615

Infants

Front 616

Contraindications to use of atropine

Back 616

Infants, closed angle glaucoma, prostatic hypertrophy

Front 617

Nicotinic Antagonists

Back 617

...

Front 618

Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate

Back 618

Severe hypertension

Front 619

Reversal of blockade by neuromuscular blockers

Back 619

Cholinesterase inhibitors

Front 620

Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis

Back 620

Nondepolarizing Neuromuscular Blockers

Front 621

Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use; has short duration of action

Back 621

Succinylcholine

Front 622

Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred)

Back 622

Cholinesterase regenerators, pralidoxime

Front 623

Used to treat patients exposed to insecticides such as parathion

Back 623

Pralidoxime, atropine

Front 624

Sympathomimetics

Back 624

...

Front 625

Mnemonic for beta receptors

Back 625

You have 1 heart (Beta 1) and 2 lungs (Beta 2)

Front 626

This is the drug of choice for anaphylactic shock

Back 626

Epinephrine

Front 627

Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction

Back 627

Amphetamines

Front 628

Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia

Back 628

Phenylephrine

Front 629

Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to

Back 629

Reduce aqueous secretion

Front 630

Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis

Back 630

Albuterol

Front 631

Longer acting Beta 2 agonist is recommended for prophylaxis of asthma

Back 631

Salmeterol, formoterol (both in combination with corticosteroid; contraindicated as monotherapy)

Front 632

These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock

Back 632

Beta1 agonists

Front 633

These agents decrease blood flow or increase blood pressure, are local decongestants, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion

Back 633

Alpha1 agonists

Front 634

Shock due to septicemia or myocardial infarction is made worse by

Back 634

Increasing afterload and tissue perfusion declines

Front 635

Epinephrine is often mixed with a local anesthetic to

Back 635

Reduce the loss from area of injection

Front 636

Chronic orthostatic hypotension can be treated with

Back 636

Midodrine

Front 637

Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus

Back 637

Terbutaline

Front 638

Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses

Back 638

Epinephrine

Front 639

Mast cells to reduce release of hisamine and inflammatory mediators

Back 639

Epinephrine

Front 640

Agent used in shock because it dilates coronary arteries and increases renal blood flow

Back 640

Dopamine

Front 641

Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance

Back 641

Dobutamine

Front 642

Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis

Back 642

Ephedrine

Front 643

Alpha 1 agonist toxicity

Back 643

Hypertension

Front 644

Beta 1 agonist toxicity

Back 644

Sinus tachycardia and serious arrhythmias

Front 645

Beta 2 agonist toxicity

Back 645

Skeletal muscle tremor, tachycardia

Front 646

The selective agents loose their selectivity at

Back 646

high doses

Front 647

Adrenoceptor Blocker

Back 647

...

Front 648

Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis

Back 648

Phenoxybenzamine

Front 649

Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud's phenomena

Back 649

Phentolamine

Front 650

Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension

Back 650

Prazosin, terazosin, doxazosin

Front 651

Selective Alpha-1A blocker, used for BPH, but with little effect on HTN

Back 651

Tamsulosin

Front 652

Selective Alpha 2 blocker used for impotence (controversial effectiveness)

Back 652

Yohimbine

Front 653

Beta-Blocking Drugs

Back 653

...

Front 654

SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma

Back 654

Acebutolol, atenolol, esmolol, metoprolol

Front 655

Combined alpha and beta blocking agents that may have application in treatment of CHF

Back 655

Labetalol and carvedilol

Front 656

Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma

Back 656

Pindolol and acebutolol

Front 657

This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma

Back 657

Timolol

Front 658

This parenteral beta blocker is a short acting (minutes)

Back 658

Esmolol

Front 659

This beta blocker is the longest acting

Back 659

Nadolol

Front 660

These beta blockers are less lipid soluble

Back 660

Acebutolol and atenolol

Front 661

This beta blocker is highly lipid soluble and may account for side effects such as nightmares

Back 661

Propranolol

Front 662

Clinical uses of these agents include treatment of HTN, angina, arrhythmias, chronic CHF, and selected post MI patients

Back 662

Beta blockers

Front 663

Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)

Back 663

Beta blockers

Front 664

Glaucoma (all agents topical except for diuretics)

Back 664

...

Front 665

Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction

Back 665

Pilocarpine, carbachol, physostigmine

Front 666

Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins

Back 666

Epinephrine, dipivefrin

Front 667

Selective alpha agonists that decreases aqueous secretion

Back 667

Apraclonidine, brimonidine

Front 668

These Beta blockers decrease aqueous secretion

Back 668

Timolol (nonselective), betaxolol (selective)

Front 669

This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis

Back 669

Acetazolamide

Front 670

This agent cause increased aqueous outflow

Back 670

Prostaglandin PGF2a

Front 671

Antihypertensive Agents

Back 671

...

Front 672

Inhibit peptidyl dipeptidase (plasma kininase)

Back 672

ACE inhibitors

Front 673

SE of ACE inhibitors

Back 673

Cough, hyperkalemia, angioedema

Front 674

ACE inhibitors are contraindicated in

Back 674

pregnancy and with K+

Front 675

Losartan and valsartan block

Back 675

Angiotensin AT1 receptor

Front 676

Angiotensin receptor blockers do NOT effect

Back 676

Bradykinin metabolism

Front 677

Agents that block L-type calcium channel

Back 677

Calcium channel blockers

Front 678

CCB contraindicated in CHF

Back 678

Verapamil

Front 679

CCB with predominant effect on vasodilation

Back 679

Nifedipine

Front 680

SE of CCB

Back 680

atrioventricular block, constipation, edema

Front 681

Agents that reduce heart rate, contractility, and O2 demand

Back 681

Beta-blockers

Front 682

B-blockers that are more cardioselective

Back 682

Beta-1 selective blockers (AMEBBA - atenolol, metoprolol, esmolol, betaxolol, bisoprolol, acebutalol)

Front 683

Beta-blockers should be used cautiously in

Back 683

Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease

Front 684

Non-selective Beta-blocker also used for migraine prophylaxis

Back 684

Propranolol

Front 685

SE of beta blockers

Back 685

Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)

Front 686

Alpha 1selective blockers

Back 686

Prazosin, terazosin and doxazosin (-AZOSIN ending)

Front 687

Non-selective Alpha1blockers use to treat pheochromocytoma

Back 687

Phenoxybenzamine

Front 688

For rebound HTN from rapid clonidine withdrawal

Back 688

Phentolamine

Front 689

SE of alpha blockers

Back 689

Orthostatic hypotension (especially with first dose) and reflex tachycardia

Front 690

Partial Alpha agonist used in HTN, acts centrally

Back 690

Clonidine

Front 691

Used primarily for hypertension during pregnancy, can give positive Coomb's test

Back 691

Methyldopa

Front 692

SE of clonidine

Back 692

sedation, dry mouth, mental depression

Front 693

Direct vasodilator of arteriolar smooth muscle

Back 693

Hydralazine

Front 694

SE of hydralazine with slow acetylators

Back 694

Lupus-like syndrome

Front 695

Arterial vasodilator that works by opening K+ channels

Back 695

Minoxidil

Front 696

SE of minoxidil

Back 696

Hypertrichosis

Front 697

IV Drug used Hypertensive Crisis

Back 697

Nitroprusside, fenoldopam, labetalol

Front 698

Nitroprusside vasodilates

Back 698

Arteries and veins

Front 699

Toxicity caused by nitroprusside and treatment

Back 699

Cyanide toxicity treated with sodium thiosulfate

Front 700

Diuretics

Back 700

...

Front 701

Carbonic anhydrase inhibitor

Back 701

Acetazolamide

Front 702

Diuretic used for mountain sickness and glaucoma

Back 702

Acetazolamide

Front 703

SE of acetazolamide

Back 703

Paresthesias, alkalization of the urine (which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment

Front 704

MOA of loop diuretics

Back 704

inhibits Na+/K+/2Cl- cotransport

Front 705

Site of action of loop diuretics

Back 705

Thick ascending limb

Front 706

SE of loop (furosemide) diuretics

Back 706

Hyperuricemia, hypokalemia and ototoxicity

Front 707

Aminoglycosides used with loop diuretics potentiate adverse effect

Back 707

Ototoxicity

Front 708

Loops lose and thiazide diuretics retain

Back 708

Calcium

Front 709

MOA of thiazide diuretics

Back 709

Inhibit Na+/Cl- cotransport

Front 710

Site of action of thiazide diuretics

Back 710

Work at early distal convoluted tubule

Front 711

Class of drugs that may cause cross-sensitivity with thiazide diuretics

Back 711

Sulfonamides

Front 712

SE of thiazide (HCTZ) diuretics

Back 712

Hyperuricemia, hypokalemia and hyperglycemia

Front 713

Potassium sparing diuretics inhibit

Back 713

Na+/K+ exchange

Front 714

Diuretic used to treat primary aldosteronism

Back 714

Spironolactone

Front 715

SE of spironolactone

Back 715

Gynecomastia, hyperkalemia

Front 716

Osmotic diuretic used to treat increased intracranial pressure

Back 716

Mannitol

Front 717

Antidiuretic hormone (ADH) agonist and antagonist

Back 717

...

Front 718

ADH agonist used for pituitary diabetes insipidus

Back 718

Desmopressin (DDAVP)

Front 719

Used for SIADH

Back 719

Demeclocycline

Front 720

SE of demeclocycline

Back 720

Bone marrow and teeth discoloration for children under 8 years of age

Front 721

Antiarrhythmic agents

Back 721

...

Front 722

MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics

Back 722

Sodium channel blockers

Front 723

SE of procainamide

Back 723

Lupus-like syndrome

Front 724

Limiting side effect of Quinidine

Back 724

Prolongs QT interval

Front 725

Other side effects of Quinidine

Back 725

Thrombocytopenic purpura, and CINCHONISM

Front 726

Major drug interaction with Quinidine

Back 726

Increases concentration of Digoxin

Front 727

DOC for management of acute ventricular arrhythmias

Back 727

Amiodarone

Front 728

DOC for digoxin induced arrhythmias

Back 728

Phenytoin

Front 729

SE of phenytoin

Back 729

Gingival hyperplasia

Front 730

Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents

Back 730

Class IC (flecainide, propafenone, moricizine)

Front 731

Class II antiarrhythmics are

Back 731

B-blockers

Front 732

Antiarrhythmic that exhibits Class II and III properties

Back 732

Sotalol

Front 733

Side effect of sotalol

Back 733

prolongs QT and PR interval

Front 734

Used intravenously for acute arrhythmias during surgery

Back 734

Esmolol

Front 735

Anti-arrhythmics that decrease mortality

Back 735

B-blockers

Front 736

MOA of class III antiarrhythmics

Back 736

Potassium channel blockers

Front 737

Class III antiarrhythmic that exhibits properties of all 4 classes

Back 737

Amiodarone

Front 738

Specific pharmacokinetic characteristic of amiodarone

Back 738

Prolonged half-life, up to six weeks

Front 739

Antiarrhythmic effective in most types of arrhythmia

Back 739

Amiodarone

Front 740

SE of Amiodarone

Back 740

Cardiac dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits

Front 741

MOA of class IV antiarrhythmics

Back 741

Calcium channel blockers

Front 742

Life threatening cardiac event that prolong QT leads to

Back 742

Torsades de pointes

Front 743

Agent to treat torsades de pointes

Back 743

Magnesium sulfate

Front 744

Drug used supraventricular arrhythmias

Back 744

Digoxin

Front 745

DOC for paroxysmal supraventricular tachycardia (PSVT)

Back 745

Adenosine

Front 746

Adenosine's MOA

Back 746

Activattion on an inward K+ current and inhibition of Ca++ current resulting in marked hyperpolarization

Front 747

Anti-arrhythmic with 15 second duration of action

Back 747

Adenosine

Front 748

Vasodilators and treatment of angina

Back 748

...

Front 749

MOA of sildenafil (Viagra)

Back 749

Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP

Front 750

Drugs used in the management of angina

Back 750

Aspirin, Nitrates, CCB, and Beta blockers

Front 751

Aspirin reduces mortality in unstable angina by

Back 751

Platelet aggregation inhibition

Front 752

MOA of nitrates

Back 752

Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles

Front 753

Nitrate used for acute anginal attacks

Back 753

Nitroglycerin sublingual tablets

Front 754

Nitrate used to prevent further attacks

Back 754

Oral and transdermal forms of nitroglycerin

Front 755

Nitrate free intervals are needed due to

Back 755

Tolerance

Front 756

SE of nitrates

Back 756

Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation

Front 757

CCB are DOC for

Back 757

Prinzmetal's angina

Front 758

Beta blockers are used for which type of anginal attack

Back 758

Classic

Front 759

Drugs used to treat CHF

Back 759

...

Front 760

MOA of Cardiac glycosides (eg. digoxin)

Back 760

Indirectly increase intracellular calcium and cardiac contractility by inhibiting Na+/K+ ATPase

Front 761

...

Back 761

...

Front 762

Digoxin is used in

Back 762

Atrial fibrillation and CHF

Front 763

Digoxin toxicity can be precipitated by

Back 763

Hypokalemia

Front 764

Antidote for digoxin toxicity

Back 764

Digoxin immune fab

Front 765

Drug used for moderate to severe heart failure, reduces mortality, especially for patients taking digitalis to prevent hypokalemia

Back 765

Spironolactone, Eplerenone

Front 766

Combination recommended for only African Americans to reduce preload and afterload in CHF

Back 766

Isosorbide dinitrate/hydralazine

Front 767

Beta 1 agonists used iv in acute decompensated HF

Back 767

Dobutamine and dopamine

Front 768

Diuretics work in CHF by

Back 768

Reducing preload

Front 769

Beta blockers work in CHF by

Back 769

Reducing adverse effects of high catecholamine levels on heart (never use in acute heart failure)

Front 770

Dual ARB and neprilysin inhibitor, early phase 2 trial for heart failure and hypertension

Back 770

LCZ696, sucabitril

Front 771

Select group of beta blockers that reduce heart failure mortality

Back 771

Carvedilol, metoprolol, bisoprolol, nebivolol

Front 772

Vasodilator used in acute CHF resembling brain natriuretic peptide

Back 772

Nesiritide (Natrecor)

Front 773

Drugs used in coagulation disorders

Back 773

...

Front 774

Vitamin K dependent anticoagulant

Back 774

Warfarin (PT)

Front 775

Warfarin is contraindicated in

Back 775

Pregnancy

Front 776

Anticoagulant of choice in pregnancy

Back 776

Heparin

Front 777

Heparin (PTT) increases activity of

Back 777

Antithrombin 3

Front 778

Route of administration of warfarin

Back 778

Oral

Front 779

Routes of administration of heparin

Back 779

IV and IM (only LMW)

Front 780

SE of both warfarin and heparin

Back 780

Bleeding

Front 781

SE of heparin

Back 781

Heparin induced thrombocytopenia (HIT)

Front 782

Alternative anticoagulant used if HIT develops

Back 782

Lepirudin

Front 783

Antidote to reverse actions of warfarin

Back 783

Vitamin K or fresh frozen plasma

Front 784

Antidote to reverse actions of heparin

Back 784

Protamine sulfate

Front 785

MOA of aspirin

Back 785

Irreversibly blocking cyclooxygenase

Front 786

Agent used to treat MI and to reduce incidence of subsequent MI

Back 786

Aspirin, metoprolol

Front 787

SE of Aspirin

Back 787

GI bleeding

Front 788

Antiplatelet drug reserved for patients allergic to aspirin

Back 788

Ticlopidine

Front 789

SE for ticlopidine

Back 789

Neutropenia and agranulocytosis

Front 790

Effective in preventing TIA's

Back 790

Clopidogrel and ticlopidine

Front 791

Prevents thrombosis in patients with artificial heart valve

Back 791

Dipyridamole

Front 792

Block glycoprotein IIb/IIIa involved in platelet cross-linking

Back 792

Abciximab, tirofiban and eptifibatide

Front 793

MOA of thrombolytics

Back 793

Degradation of fibrin clots and are administered IV

Front 794

Thrombolytics are used for

Back 794

Pulmonary embolism and DVT

Front 795

Thrombolytic that can cause allergic reaction

Back 795

Streptokinase

Front 796

Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA

Back 796

Tissue plasmin activator

Front 797

SE of tPA

Back 797

Cerebral hemorrhage

Front 798

Antidote for thrombolytics

Back 798

Aminocaproic acid

Front 799

Agents used in anemias and hematopoietic growth factors

Back 799

...

Front 800

Agent to treat hypochromic microcytic anemias

Back 800

Ferrous sulfate

Front 801

Chelating agent used in acute iron toxicity

Back 801

Deferoxamine

Front 802

Agent for pernicious anemia

Back 802

Cyanocobalamin (Vit B12)

Front 803

Agent used for neurological deficits in megaloblastic anemia

Back 803

Vitamin B12

Front 804

Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy

Back 804

Folic acid

Front 805

Agent used for anemias associated with renal failure

Back 805

Erythropoietin agonists

Front 806

Agent used neutropenia especially after chemotherapy

Back 806

G-CSF (filgrastim) and GM-CSF (sargramostim)

Front 807

Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy

Back 807

Interleukin 11 (oprelvekin)

Front 808

Antihyperlipidemics

Back 808

...

Front 809

Drugs decrease intestinal absorption of cholesterol

Back 809

Bile acid-binding resins

Front 810

Cholestyramine and colestipol are

Back 810

Bile acid-binding resins

Front 811

Major nutritional side effect of bile acid-binding resins

Back 811

Impair absorption of fat soluble vitamin absorption (A,D,E,K)

Front 812

MOA of lovastatin (STATIN)

Back 812

inhibits HMG COA reductase

Front 813

HMG CoA reductase inhibitors are contraindicated in

Back 813

Pregnancy

Front 814

MOA of drug or foods (grapefruit juice) that increase statin effect

Back 814

Inhibit Cytochrome P450 3A4

Front 815

SE of HMG COA reductase inhibitors

Back 815

Rhabdomyolysis and Hepatotoxicity

Front 816

Monitoring parameter to obtain before initiation of STATINS

Back 816

LFT's

Front 817

Decreases liver triglycerol synthesis

Back 817

Niacin

Front 818

SE of niacin

Back 818

Cutaneous flush

Front 819

Cutaneous flush can be reduced by pretreatment with

Back 819

Aspirin

Front 820

Fibrates (gemfibrozil) increase activity of

Back 820

Lipoprotein lipase

Front 821

Most common SE of fibrates

Back 821

Nausea

Front 822

Fibrates are contraindicated in

Back 822

Pregnancy

Front 823

Concurrent use of fibrates (gemfibrozil) and statins (simvastatin, lovastatin) increases risk of

Back 823

Rhabdomyolysis

Front 824

New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins

Back 824

Ezetimibe (Zetia)

Front 825

NSAIDS and DMARDS

Back 825

...

Front 826

MOA of NSAIDS

Back 826

inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)

Front 827

Difference between aspirin and other NSAIDS

Back 827

Aspirin irreversibly inhibits cyclooxygenase

Front 828

Four main actions of NSAIDS

Back 828

Anti-inflammatory, analgesia, antipyretic and antiplatelet activity

Front 829

Agent used for closure of patent ductus arteriosus

Back 829

Indomethacin

Front 830

Aspirin is contraindicated in children with viral infection

Back 830

Potential for development of Reye's syndrome

Front 831

SE of salicylates

Back 831

Tinnitus, GI bleeding

Front 832

NSAID also available as an ophthalmic preparation

Back 832

Diclofenac, ketoralac

Front 833

NSAID available orally, IM and ophthalmically

Back 833

Ketorolac

Front 834

NSAID that is used for acute condition, such as post-surgical pain and has limited duration (<5 days) of use due to nephrotoxicity

Back 834

Ketorolac

Front 835

Newer NSAID that selectively inhibits COX-2

Back 835

Celecoxib

Front 836

COX 2 inhibitors may have reduced risk of

Back 836

Gastric ulcers and GI Bleeding

Front 837

COX 2 inhibitors should be used cautiously in pts with

Back 837

Pre-existing cardiac or renal disease

Front 838

Acetaminophen only has

Back 838

Antipyretic and analgesic activity

Front 839

SE of acetaminophen

Back 839

Hepatotoxicity

Front 840

Antidote for acetaminophen toxicity

Back 840

N-acetylcysteine

Front 841

Drugs-Modifying Anti-Rheumatic Agents (DMARDS)

Back 841

...

Front 842

DMARDs are slow acting drugs for

Back 842

Rheumatic disease

Front 843

Initial DMARD of choice for patients with RA

Back 843

Methotrexate

Front 844

Drug ofter used in combination with TNF - alpha inhitors for RA

Back 844

Methotrexate

Front 845

Causes bone marrow suppression

Back 845

Azathioprine

Front 846

Interferes with activity of T-lymphocytes

Back 846

Hydroxychloroquine

Front 847

Anti-malarial drug used in rheumatoid arthritis (RA)

Back 847

Hydroxychloroquine

Front 848

SE of hydroxychloroquine

Back 848

Retinal destruction and dermatitis

Front 849

MOA of Leflunomide (newer agent)

Back 849

Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis, decreased T cell proliferation and decreased antibody production by B cells

Front 850

Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)

Back 850

Adalimumab, infliximab and etanercept

Front 851

Anti-rheumatic agent also used for ulcerative colitis

Back 851

Sulfasalazine

Front 852

Anti-rheumatic agent also used for Chron's disease

Back 852

Infliximab

Front 853

Drugs used in Gout

Back 853

...

Front 854

NSAID used in gout

Back 854

Indomethacin

Front 855

NSAID contraindicated in gout

Back 855

Aspirin

Front 856

MOA of colchicine (used in acute gout)

Back 856

Selective inhibitor of microtubule assembly

Front 857

SE of colchicine

Back 857

Kidney and liver toxicity, diarrhea

Front 858

Agent used to treat chronic gout by increasing uric acid secretion and excretion

Back 858

Probenecid and sulfinpyrazone

Front 859

Allopurinol treats chronic gout by decreasing uric acid production by inhibiting

Back 859

Xanthine oxidase

Front 860

Insulins

Back 860

...

Front 861

Rapid acting insulins that do not self-aggregate

Back 861

lispro insulin, aspart insulin, glulisine insulin

Front 862

Peakless long acting insulin

Back 862

Insulin glargine

Front 863

Cardiac drugs

Back 863

...

Front 864

DOC for paroxysmal supraventricular tachycardia; has high efficacy and short duration of action

Back 864

Adenosine

Front 865

Miscellaneous Antimicrobial Agents: Disinfectants, Antiseptics, Sterilants

Back 865

...

Front 866

Decontamination of health care worker after caring for patient with C. difficile infection

Back 866

Proper hand-washing with soap and water

Front 867

Used to sterilize endoscopes and dental equipment

Back 867

Formaldehyde, glutaraldehyde, ortho-phthalaldehyde, sterilox, hydrogen peroxide, peracetic acid

Front 868

Disinfection of blood spills

Back 868

1:10 dilution of household bleach

Front 869

Bactericidal, fungicidal, sporicidal disinfectant used to wipe hospital beds

Back 869

1:10 dilution of bleach, phenol