Test 4: Arrhythmias, Immune, GI Flashcards

1
Q

What is the MOA of H2 Blockers?

A

Reversibly block Histamine H2 receptors, decreasing basal secretion of H+ by parietal cells

Take H2 blockers before you “dine”. Think: “table for 2” to remember H2

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2
Q

What is the suffix of H2 Blockers?

A

–tidine

Cimetidine

Ranitidine

Famotidine

Take H2 blockers before you “-dine”. Think: “table for 2” to remember H2

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3
Q

What are the therapeutic uses of H2 Blockers?

A
  1. Ulcers
  2. GERD

**Not as effective as proton pump inhibitors

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4
Q

What side effects are associated with H2 Blockers?

A

All:

  • Tolerance in 3 days
    • Loss of effectiveness
    • May cause hypergastrinemia

Very High Doses (OTC)

  • (-) Testosterone
    • gynecomastia
  • Thrombocytopenia

Cimetidine

  • Inhibits CYP enzymes of liver
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5
Q

What side effect is unique to Cimetidine within the H2 Blocker family?

A

It inhibits CYP liver enzymes

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6
Q

What is the MOA of proton pump inhibitors?

A
  • Reacts covalently and irreversibly with the H+/K+ ATPase
    • Long-acting
  • Most potent suppressors of gastric acid secretion
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7
Q

What is the suffix of proton pump inhibitors?

A

-prazole

(Think pretzel)

Ex: Omeprazole

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8
Q

How does food affect bioavailability of proton pump inhibitors?

A

It decreases it by 50%

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9
Q

What are the therapeutic uses of proton pump inhibitors?

A
  1. Ulcers
  2. GERD
  3. erosive esophagitis
  4. Zollinger-Ellison syndrome (hypergastrinemia)
  5. NSAID-associated gastric ulcers
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10
Q

Which proton pump inhibitor is indicated for use in children?

A

Omeprazole

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11
Q

What side effects are associated with proton pump inhibitors?

A
  1. Hip fracture
    • inhibit osteoclastic activity
    • Bone loss
  2. Magnesium depletion
  3. Hypergastrinemia
    • rebound hyperacidity and tumors
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12
Q

What is the MOA of Sucralfate?

A
  • It is an aluminum polysaccharide
  • At pH<4, undergoes cross-linking, creates polymer that sticks to epithelial cells and ulcerations
    • provide physical protection
  • (Don’t take w/antiacids or things that increase stomach pH)
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13
Q

What are the therapeutic uses of sucralfate?

A
  • Mucosal inflammation and ulceration
    • oral mucositis/proctitis from radiation
    • bile reflux
  • Not used for peptic acid disease
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14
Q

What side effects are associated with sucralfate?

A
  • Constipation
    • can also be used to treat traveller’s diarrhea (FA)
  • CON: Renal failure
    • aluminum overload
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15
Q

WHat is the MOA of Misoprostol?

A
  • Prostaglandin analog (PGE1)
  • stimulates mucin production
  • inhibits cAMP in parietal cells => inhibits H+ secretion and acid formation
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16
Q

What side effects are associated with Misoprostol?

A
  • abortifacient
    • CON: pregnant women
  • Diarrhea
    • CON: IBS (irritable bowel syndrome)
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17
Q

What are the therapeutic uses of Misoprostol?

A

NSAID-induced mucosal injury

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18
Q

Mg2+ antacids

  • Benefit
  • Side effects
A
  • Rapidly acting
  • SE:
    • Diarrhea
      • Mg = Must Go to the bathroom
    • Chelates drugs
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19
Q

Al3+ antacids

  • Benefit
  • Side Effects
A
  • Slowly-reacting (long-term relief but not immediate)
  • SE:
    • Constipation
      • Aluminimum amount of feces
    • Chelates drugs
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20
Q

What are the negative effects associated with CaCO3 antacids?

A
  • CO2
    • cause belching, nausea, flatulence
  • Ca2+
    • rebound acid secretion
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21
Q

Simethicone

  • MOA
A

Surfactant that may decrease foaming and esophageal reflux

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22
Q

Bismuth

  • MOA
  • Indication
  • SE
A
  • MOA
    • physical protection by binding ulcer
    • promote mucin and HCO3- secretion
    • Antibacterial against H. pylori
  • Indication (not as important)
    • H. pylori ulcers
    • nausea
    • diarrhea
    • gastroenteritis
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23
Q

Neostigmine methylsulfate

  • MOA
  • IND
  • SE
A

Last ditch effort

  • MOA
    • AChE inhibitor
  • IND (off label)
    • Colonic pseudo obstruction
    • Paralytic ileus
  • SE
    • Severe Bradycardia
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24
Q

Metoclopramide

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • D2 receptor antagonist
    • stimulate ACh release from myenteric motor neurons
    • acts on upper digestive tract
  • Indications
    • Gastroparesis
    • anti-emetic (dismotility or chemo)
  • Side effects
    • Extrapyramidal symptoms
      • parkinson-like
      • dystonia
      • tardive dyskinesia
    • Galactorrhea
      • increased Prolactin
      • Pituitary hypertrophy possible
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25
Q

What side effects are associated with Metoclopramide?

A
  • Extrapyramidal symptoms
    • parkinson-like
    • dystonia
    • tardive dyskinesia
  • Galactorrhea
    • increased Prolactin
    • Pituitary hypertrophy possible
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26
Q

What is the MOA of metoclopramide?

A
  • D2 receptor antagonist
  • increases ACh release from myenteric motor neurons
  • acts on upper digestive tract
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27
Q

What are the therapeutic uses of metoclopramide?

A
  1. gastroparesis
  2. anti-emetic (w/dismotility or chemo)
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28
Q

What is the MOA of serotonin receptor agonists on the GI tract?

A
  • stimulate nausea, vomiting, abdominal pain
  • Peristaltic reflex
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29
Q

Tegaserod

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • Serotonin receptor agonist
    • Stimulates motility
  • Indications
    • constipation-predominant irritable bowel syndrome
  • Side effects
    • Diarrhea
    • Headache
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30
Q

What is the MOA of Cisapride? Why is it no longer used?

A
  • MOA:
    • serotonin receptor agonist
    • stimulate gastric motility
  • IND:
    • GERD
    • Gastroparesis
  • SE: arrhythmias
    • V-tach
    • V-Fib
    • torsade de pointes
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31
Q

Macrolides

  • MOA
  • Indications
A
  • Ex: erythromycin and other -mycins
  • MOA
    • motilin mimetic
    • used to stimulate motility of upper GI and “sweep the bowel clean”
    • Increased LES presure
  • Indications
    • Diabetic gastroparesis
    • Dumping effect (ultrastrong contractions to clear undigestible residue)
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32
Q

What is the effect of botulinum toxin in the GI tract?

A

paralyzes LES and improves esophageal clearance

Used for esophageal spasms

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33
Q

Which types of laxatives are the mildest with regard to symptoms and used for mild discomfort?

A
  1. Bulk-forming laxatives
    • ex: dietary fiber and supplements
  2. Surfactant laxatives
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34
Q

Which type of laxatives are of intermediate action, turning stools soft/semi-fluid and work in 6-8 hours?

A

Stimulant laxatives

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35
Q

Which types of laxatives are used for watery evacuation in 1-3 hours?

A

Osmotic laxatives (high dose)

(low dose used for laxative effect)

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36
Q

Which type of laxative is used when non-pharmacological measures are unrealistic (elderly, infirmity)?

A
  1. Bulk-forming
  2. Osmotic (low dose)
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37
Q

What are the effects of long-term use of stimulant laxatives?

A
  1. habit
  2. loss of excess water and electrolytes
  3. possible secondary aldosteronism
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38
Q

What are contraindications for bulk-forming laxatives?

A
  1. Megacolon
  2. Obstruction
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39
Q

What is the MOA of osmotic laxatives?

A

osmotically-mediated water retention, which stimulates peristalsis

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40
Q

What are the therapeutic uses of Bile Acid Sequestrants in GI dysfunction?

A

Treat bile salt-induced diarrhea from resection of the distal ileum

(normal site of bile acid reabsorption)

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41
Q

Loperamide

  • MOA
  • Indications
  • Side effects
A
  • aka imodium
  • MOA
    • binds to opioid receptors in the GI tract
  • Indications
    • traveller’s diarrhea
  • Side effects
    • mild, cannot penetrate CNS
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42
Q

Ondansetron

  • MOA
  • Indications
A
  • MOA
    • serotonin receptor antagonist
  • Indications
    • chemo-induced emesis
      • most powerful and safe
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43
Q

Diphenhydramine

  • MOA
  • Indications
A
  • MOA
    • Histamine H1 receptor antagonist
  • Indications
    • Motion sickness
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44
Q

Aprepitant

  • MOA
  • Indications
A
  • MOA
    • Neurokinin receptor antagonist
  • Indications
    • chemo-induced emesis
    • delayed vomiting, often associated with Cisplatin
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45
Q

Dronabinol

  • MOA
  • Indications
A
  • MOA
    • Cannabinoid receptor agonist
  • Indications
    • chemo-induced emesis
46
Q

Azathioprine

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • Prodrug of purine analog 6-mercaptopurine
    • inhibits DNA replication
    • Inhibits B and T cell proliferation
  • Indications
    • Organ rejection, RA, SLE (FA 215/403)
  • Side effects
    • Bone marrow suppression
47
Q

Hyoscine

  • MOA
  • Indications
A
  • MOA
    • Muscarinic receptor antagonist
  • Indications
    • motion sickness
48
Q

Glucocorticoids

  • MOA (in immunosuppression)
  • Indications
A
  • MOA
    • NF-KB inhibitor, triggering apoptosis (FA 215/406)
  • Indications
    • Transplate rejection
    • Graft vs Host disease
    • Autoimmune
49
Q

Methylprednisolone

  • Belongs to which Drug class?
  • Indications
A
  • Glucocorticoids
  • Acute transplant rejection
50
Q

Antithymocyte Globulin (ATG)

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • Ab to T-cell ag
    • depletes circulating lymphocytes
  • Indications
    • Acute renal rejection
    • Immunosuppression
    • Withdrawal of calcineurin inhibitors
  • Side effects
    • Cytokine release syndrome
      • T cells are active before being destroyed
51
Q

Cyclosporin

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • binds cyclophilin
    • blocks dephosphorylation of NFAT by calcineurin, can’t enter nucleus
    • Blocks IL-2 production
  • Indications
    • Organ transplants
    • RA
  • Side effects
    • Nephrotoxicity
    • HTN
    • Hirsutism
    • gum hyperplasia
52
Q

What is the MOA of cyclosporine?

A

binds cyclophilin
blocks dephosphorylation of NFAT by calcineurin, can’t enter nucleus
Blocks IL-2 production

53
Q

What are the therapeutic uses of cyclosporine?

A
  1. Organ transplants
  2. RA
54
Q

What side effects are associated with cyclosporine?

A
  1. Nephrotoxicity
  2. HTN
  3. Hirsutism
  4. Gum hyperplasia

Both calcineurin inhibitors are highly nephrotoxic. (tacrolimus and cyclosporine)

55
Q

Tacrolimus

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • binds FKBP
    • Prevents dephosphorylation of NFAT by calcineurin
    • inhibits IL-2 production
  • Indications
    • Transplantation and rescue w/rejection
  • Side effects
    • Nephrotoxicity
    • Neurotoxicity
56
Q

What is the MOA of Tacrolimus?

A
  • binds FKBP
  • Prevents dephosphorylation of NFAT by calcineurin
  • inhibits IL-2 production
57
Q

What are the therapeutic uses of tacrolimus?

A
  1. Transplantation
  2. rescue therapy w/ rejection
58
Q

What side effects are associated with Tacrolimus?

A
  1. Nephrotoxicity
  2. Neurotoxicity

Both calcineurin inhibitors are highly nephrotoxic. (tacrolimus and cyclosporine)

59
Q

Sirolimus (Rapamycin)

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • Binds FKBP (like tacolimus)
    • blocks mTOR to inhibit intracellular IL-2 receptor signaling
  • Indications
    • Prophylaxis in organ transplants
  • Side effects
    • Hyperlipidemia
    • Leukopenia
    • Thrombocytopenia
    • The kidney “Sir-vives”
60
Q

What is the MOA of Sirolimus (Rapamycin)?

A
  • Binds FKBP (like tacolimus)
  • blocks mTOR to inhibit intracellular IL-2 receptor signaling
61
Q

What are the therapeutic uses of Sirolimus?

A

Prophylaxis in organ transplantation

esp in patients with liver disease

62
Q

What side effects are associated with Sirolimus?

A
  1. Hyperlipidemia
  2. Leukopenia
  3. Thrombocytopenia
63
Q

Mycophenolic Acid and Mycophenolate Mofetil

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • inhibits inosine monophosphate dehydrogenase (IMPDH)
      • rate-limiting in guanosine formation
    • Preferentially affects lymphocytes
      • depend solely on IMPDH for purine synthesis
      • Drug prefers Type II IMPDH, highly expressed in lymphocytes
  • Indications
    • Transplant rejection
  • Side effects
    • leukopenia
64
Q

What is the MOA for Mycophenolic Acid and Mycophenolate Mofentil?

A
  • inhibits inosine monophosphate dehydorgenase (IMPDH)
  • rate-limiting in guanosine formation
  • Preferentially affects lymphocytes
    • depend solely on IMPDH for purine synthesis
    • Drug prefers Type II IMPDH, highly expressed in lymphocytes
65
Q

Muromonab - CD-3

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • Ab against CD3
    • depletes T-cells
  • Indications
    • organ transplant rejection
  • Side effects
    • Cytokine release syndrome
    • pulm edema
    • CV collapse and arrythmia
66
Q

Daclizumab

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • anti-CD25
    • binds IL-2 receptor on activated T cells
  • Indications
    • Renal transplants (prophylactic)
  • Side effects
    • Anaphylaxis
67
Q

Lenalidomide

  • MOA
  • Side effects
A
  • MOA
    • tumor cell apoptosis
  • Side effects
    • teratogen (related to thalidomide)
68
Q

Thalidomide

  • Indications
  • Side effects
A
  • Indications
    • ​multiple myeloma
    • leprosy
  • Side effects
    • teratogen
69
Q

Rh0(D) Immune Globulin

  • MOA
  • Indications
A
  • MOA
    • IgG Ab
  • Indications
    • Rhesus disease
    • defend Rh (+) baby against Rh (-) mom’s immune system
70
Q

Mitotane

  • Action
  • Indication
A
  • Action
    • Toxic to adrenocortical cells
    • Inhibits P450
  • Indication
    • Adrenal tumor
71
Q

Aminoglutethimide

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • blocks cholesterol side-chain cleavage
    • (No pregnenolone)
    • inhibits P450
  • Indications
    • breast cancer
    • prostate cancer
  • Side effects
    • Adrenal insufficiency (not enough hormone produced)
    • GI/Neuro issues
    • rash
72
Q

Ketoconazole

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • inhibits 17-alpha-hydroxylase
      • excess mineralocorticoids
      • decreased glucocorticoids
    • inhibits P450
  • Indications
    • Antifungal
    • Cushing’s (second line)
  • Side effects
    • hepatotoxicity
73
Q

Metyrapone

  • MOA
  • Indications
A
  • MOA
    • inhibits 11ß-hydroxylase
  • Indications
    • hypercorticism (cushing’s) resulting from neoplasm
74
Q

What is the MOA of glucocorticoid use and the effects?

A
  • MOA
    • binds type II glucocorticoid receptor
    • Binds GRE (response elements) which change gene expression
  • Physiology
    • increased glucose (SE=diabetes)
    • Increased aa (muscle catabolism)
    • Increased triglycerides
    • decrease inflammation
75
Q

What are the therapeutic uses of glucocorticoids?

A
  1. Adrenal insufficiency (ex; Addison’s disease)
  2. Anti-inflammatory/ immune suppression
    • asthma
    • RA
    • Crohn’s
    • Psoriasis
    • dermatitis
    • arthritis
76
Q

What are the side effects associated with glucocorticoids?

A
  1. Diabetes
  2. Cushing’s
  3. Osteoporosis
  4. Impaired vertical bone growth in children
  5. Secondary hyperparathyroidism
  6. Steroid psychosis
77
Q

Fludrocortisone

  • Indications
A

Hypoaldosteronism

Presents with dehydration, hypotension, possibly hyperkalemia

78
Q

Spironolactone

  • MOA
  • Indications
A
  • MOA
    • minerolocorticoid receptor antagonist
  • Indications
    • hyperaldosteronism
      • edema, HTN, hypokalemia
79
Q

Eplerenone

  • MOA
  • Indications
A
  • MOA
    • minerolocorticoid receptor antagonist
  • Indications
    • hyperaldosteronism
      • edema, HTN, hypokalemia
80
Q

ß2 agonists

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • increase cAMP
    • relax bronchial smooth mm
  • Indications
    • asthma
  • Side effects
    • tachycardia
    • hypotension

Albuterol, terbutaline, pirbuterol, salmeterol

81
Q

Ipratropium

  • MOA
  • Indications
A
  • MOA
    • muscarinic receptor antagonist
  • Indications
    • asthma and COPD in patients who can’t take ß2 agonists
      • taking MAOI
      • arrhythmia or angina
82
Q

Tiotropium

  • MOA
  • Indications
A
  • MOA
    • muscarinic receptor antagonist
  • Indications
    • asthma and COPD in patients who can’t take ß2 agonists
      • taking MAOIs
      • arrhythmia or angina
83
Q

Beclomethasone

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • glucocorticoid
    • suppresses inflammation
  • Indications
    • severe asthma attacks
  • Side effects
    • hoarse voice
    • oral candidiasis
84
Q

Fluticasone

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • glucocorticoid
  • Indications
    • severe asthma attacks
  • Side effects
    • hoarse voice
    • oral candidiasis
85
Q

Cromolyn

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • inhibits mast cell degranulation
    • reduce airway reactivity
  • Indications
    • moderate/severe asthma
  • Side effects = mild
    • cough
    • wheezing
    • bronchospasm
    • bad taste
86
Q

Montelukast

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • Leudotriene receptor antagonist (C4, D4, E4)
    • same with zafirlukast
  • Indications
    • prophylactic, mild asthma
  • Side effects = rare
    • pulm. inflitrates
    • neuropathy
    • skin rash
    • vasculitis

-Lukast = Leukotriene receptor antagonist

87
Q

Zileuton

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • 5-lipoxygenase inhibitor
  • Indications
    • prophylactic for mild asthma
  • Side effects
    • (slight elevation of liver enzymes)
88
Q

Omalizumab

  • MOA
  • Indications
A
  • MOA
    • IgG Ab that binds free IgE
    • blocks release of histamine and leukotrienes
    • decreased airway responsiveness
  • Indications
    • asthma
89
Q

Combivent (Ipratropium/Albuterol)

  • Indication
  • Contraindication
A
  • Indication: COPD
  • CON: soy allergy
90
Q

First Generation H1 receptor antagonists

  • Indications
  • Side effects
A

Diphenhydramine, Promethazine, Hydroxaline

  • en/ine or -en/ate
  • Enter CNS
  • Indications
    • Allergic reaction
  • Side effects
    • Sedation
    • Anti-muscarinic effects
91
Q

Second Generation H1 Receptor Antagonists

  • Indications
  • Side effects
A

Loratadine, Fexofenadine

-adine

  • MOA
    • does not cross into CNS
  • Indications
    • ​Allergic reaction
  • Side effects
    • minimal
92
Q

Diphenhydramine

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • first gen H1 histamine receptor blocker
  • Indications
    • allergies
    • motion sickness
    • reduces early Parkinson’s symptoms
  • Side effects
    • Sedation
    • anti-cholinergic effects
93
Q

Promethazine

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • first gen H1 histamine receptor blocker
  • Indications
    • allergies
    • motion sickness
  • Side effects
    • Sedation
    • anti-cholinergic effects
94
Q

Triptans

  • MOA
  • Indications
  • Side Effects
A
  • Types: Sumatriptan, Zolmitriptan
  • MOA
    • 5HT1 receptor agonist
      • 1B and 1D (vasoconstriction)
  • Indications
    • Acute migraine
  • Side Effects
    • Dry mouth
    • Paresthesia
    • Coronary artery spasm
    • arrythmia
95
Q

Ergot Alkaloids

  • MOA
  • Indications
  • Side Effects/CON
A
  • Types: Methysergide, Ergotamine
  • MOA
    • 5HT agonists
  • Indications
    • migraine
  • Side Effects/CON
    • CON: Pregnancy
      • stimulates uterus, decrease blood flow
    • CON: coronary or peripheral artery disease
    • CONLiver or renal disease
96
Q

Methylsergide

  • MOA
  • Indications
  • Side Effects
A
  • MOA
    • 5HT receptor agonist
  • Indications
    • migraine prophylaxis
  • Side Effects
    • Same as ergot alkaloids
    • develop lung/heart fibrosis
      • shouldn’t be administered more than 6 mo.
97
Q

What is the difference in the MOA between acetylsalicylic acid and acetaminophen?

A
  • acetylsalicylic acid
    • irreversible inhibition of COX 1 & 2
    • Acts peripherally so anti-inflammatory
  • Acetaminophen
    • reversible
    • only acts on CNS (inactivated peripherally)
98
Q

What are side effects of acetylsalicylic acid?

A
  1. Ulcers
  2. Increased bleeding
  3. Reyes (children with viral infection)
  4. Hep tox
  5. Tinnitis with toxicity
99
Q

When is acetaminophen preferred over acetylsalicylic acid?

A

Patients with:

  1. ulcers
  2. anticoag meds/clotting disorder
  3. gout
  4. children with viral infection
100
Q

Celecoxib

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • irreversibly inhibits COX-2
      • thought to be upregulated at sites of inflammation only, protecting normal PG function
  • Indications
    • Rheumatoid arthritis
    • Osteoarthritis
  • Side effects
    • Allergic rxn to Sulfa
101
Q

What drugs are used for the treatment of Rheumatoid arthritis?

A
  1. Anti-neoplastic drugs
  2. Etanercept (false TNF-alpha receptor)
  3. TNF-alpha Ab
    • Infliximab
    • Adalimumab
  4. Gold compounds
  5. Celecoxib (inhibits COX-2 only)
102
Q

Etanercept

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • false receptor for TNF-alpha
    • anti-inflammatory
  • Indications
    • Rheumatoid arthritis
    • autoimmune disease
  • Side effects
    • Injection site rxn
103
Q

Infliximab

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • TNF-alpha Ab
    • inhibit inflammation
  • Indications
    • Autoimmune disease
    • RA
    • Inflammatory bowel disease
  • Side effects
    • Infection
    • Anaphylaxis/hypotension (rare)
    • Lupus-like syndrome (rare)
104
Q

Gold compounds in treatment of RA

  • Action
  • Indication
  • Side effects
A
  • Action
    • relieve pain/stiffness
    • may prevent further joint degeneration
  • Indication
    • progressive RA
  • Side Effects
    • metallic taste
    • GI problems
    • dermatitis
    • blood component disorders
105
Q

What agents are used to treat gout?

A
  1. NSAIDS
  2. Glucocorticoids
  3. Colchicine
  4. Probenecid
  5. Allopurinol
  6. Rasburicase
106
Q

Colchicine

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • inhibits migration of granulocytes to inflammed area (MT depolarization)
  • Indications
    • Acute attacks of gout
  • Side effects
    • Diarrhea
    • Blood dyscrasia
107
Q

Probenecid

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • decrease reabsorption of uric acid (increased excretion)
  • Indications
    • prevent further attacks of gout
  • Side effects
    • decreased renal function
108
Q

Allopurinol

  • MOA
  • Indications
A
  • MOA
    • decreased production of uric acid
    • inhibit xanthine oxidase (purine metabolism)
  • Indications
    • Prevent attacks of gout
109
Q

Rasburicase

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • recombinant version of urate oxidase
      • catalyze conversion of uric acid to allantoin
      • increased excretion
  • Indications
    • Gout
110
Q

Febuxostat

  • MOA
  • Indications
  • Side effects
A
  • MOA
    • decreased production of uric acid
    • inhibit xanthine oxidase (purine metabolism)
  • Indications
    • Prevent attacks of gout
111
Q

MOA of drugs in treatment of Gout:

  1. Allopurinol
  2. Febuxostat
  3. Probenacid
  4. Diuretics
A