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Pharamcology > Week 8 > Flashcards

Week 8 Flashcards

1
Q

What enzyme is involved in the synthesis of cholestrol?

A

GMG-CoA

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2
Q

Initial response of statin drugs is ____ week and full response normally takes ____

A

1 week

1 month

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3
Q

Very low levels of cholestrol can be associated with increased risk of ______ and increased overall ______

A

cancer

mortality

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4
Q

A correlation between the use of statin drugs and reduced risk of ____. also there is some evidence that statin drugs may lower the risk of ______ cancer in women and ______ cancer in men

A

Alzheimers
breast
prostate

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5
Q

Stain drugs are _____ thus must not be taken while pregant

A

teratogenic

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6
Q

_______ the original statin drug which came on the market in 1985. also in generic

A

Lovastatin

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7
Q

what is another statin drug

A

Pravastatin

avaible in generic

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8
Q

_______ is the most commonly prescribed generic statin drug.

A

Simvastin

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9
Q

______ typically produces greater reduction in LDL than previous statin drugs and its #1 selling drug in the US in 2008 with 5.9 billion in sales and 58 million prescriptions written in 2008. Went off patent in 11-30-11

A

atorvastatin

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10
Q

_______ is probably the most potent reducer of LDL cholestrol, but also has the highest incidence of myopathy

A

Rosuvastatin

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11
Q

_____ is claimed to increase HDL more than other statin drugs and is being marketed particully for type II diabetics as having fewer adverse effects

A

Pitavastatin

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12
Q

_______ is a dietary supplement made from Manascus purpureus (______ _____) fermentation of rice. It is a natural yeast that makes a naturally occuring _____-_ reductase inhibitor molecule very similar to Mevacor.

A

Cholestin
red yeast
HMGCo-A

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13
Q

A chinease study showed that taking _______ lowers LDL by 25% when taking 13.5 mg/day

A

Cholestin

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14
Q

Many studies confirme statin drugs reduce _______ in patients with high cholestrol, but no confirmed cardiovascular disease as well as preventing a second heart attack in those who have had a first MI

A

mortality

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15
Q

_______ a new drug that inhibits absorption of cholesterol through intestinal wall. thus it works to lower dietary input of cholesterol into the body. It can be combined with _____ drugs to produce greater reductions in blood cholesterol.

A

Zetia

statin

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16
Q

______ high doses of this drug are required and they work by lowering triglycerides thus raising HDL, and lowers LDL.

A

Niacin

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17
Q

Adverse effects of Niacin are _____ flushing and i_______ and ____ upset. They can also casue ______ damage. Niacin is aviable as a time release form, which reduces flushing and itiching and this form of drug is known as ______

A 
cutaneous
itiching
GI
Liver
Niaspan
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18
Q

_______ activates LIPOPROTEIN LIPASE which lowers high blood triglycerides as well as LDL. It increases HDL up to 25% by an unkown mechanism

A

Tricor

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19
Q

Adverse effects of Tricor are increased risk of ______ formation, _______ (heart burn 20%), abdominal pain (10%), and diarrhea (7%). Tricor should not be combined with the ____ family because increased risk of myopathy.

A

gallstone
dyspepsia
statin

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20
Q

_____ was a drug which caused elevation of HDL. However during phase 3 trials showed that although it raised HDl, it actually increased mortality rate. This is a case of a positive _______ outcome (increased HDL) but a negative ________ outcome (increased mortality)

A

Torcetrapib
surrogate
clinical

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21
Q

what is another HDL elevating drug and what phase is it in

A

Anacetripib

phase 2

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22
Q

________ is a naturally occuring glycoprotein made in the _____ _____ which stimulates production of red blood cells. It is used primarily in chronic _____ disease patients with anemia to stimualte increased levels of red blood cells. It has also been used to ________ red blood cell growth in anemic cancer patients undergoing chemo. It is a protein and must be given IV or injection

A

Erythropoietin
adrenal cortex
kidney
promote

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23
Q

__________ is a synthetic form of a naturally occurring Levothyroxine (T4) hormone made in the ______ gland. Low natural levels of thyroxine can lead to f_____, col intolerance, d_____, Muscle cramps, weight gain, and b______

A 
Levothyroxine
thyroid
fatigue
depression
bradycardia
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24
Q

Levothyroxine should be taken a half hour before food and once a day. Soy should may hinder the efficacy of this drug. Levothyroxine is one of the few drugs that is given an _____ rating on the teratogenicity scale

A

A

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25
Q

NSAIDS work by inhibiting ______ ______ the enzyme responsible for synthesizing _____ from fatty acids, primarily arachidonic acid.

A

Prostaglandin

prostaglandins

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26
Q

prostaglandins cause cause

A

increased sensitivity of pain receptors
increased body temp
uterine contractions
increased platelet aggregation

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27
Q

primary use of NSAIDs is to reduce risk of ischemic strokes and Mis, decrease inflammation, pain, fever, and primary menstrual cramps

A

___

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28
Q

adverse effects of NSAIDs are stomach ulceration, renal failure, may induce ____ attack, and may reduce efficacy of ____ inhibitor drugs

A

astma

ACE

29
Q

what are the two forms of cyclooxyrgenase enzyme

A 
Cyclooxygenase 1 (COX-1)
Cyclooxygenase 2 (COX-2)
30
Q

COX-1- stimulates-

COX-2 Stimulates-

A

production of mucous lining of the stomach

inflammatory response

31
Q

______ is the oldest NSAID still on the market and has been available since 1899. Its primary adverse effect is ___ _____. It is used for analgesia, reduction of fever, reduction of inflammation but not effective in ___ ____.. Because it is an effective inhibitor of the synthesis of ____ _ it has been promoted for reducing the risk of MI’s due to its ability ti inhibit platelet aggregation

A

aspirin
stomach ulcers
menstural cramps
thromboxane A2

32
Q

Aspirin is common available in two from _____ form and _____ ____. The ____ form is combined with a base such as MgO to speed up the dissolving of the aspirin. People appear to have less stomach pain with this form. The ____ ____ doesn’t dissolve in the stomach and does not dissolve until it reachers the alkaline conditions of small intestine. But inhibitor of prostaglandin still inhibits formation of stomach mucous lining and absorption is often ____

A 
Buffered
enteric coated
buffered
enteric coated
erratic
33
Q

Aspirin side effects include risk of ___ syndrome anaphylaxis, asthma attacks

A

reyes syndrome-in children with influenza or chicken pox-Reyes syndrome presents with nausea, vomiting, fever and could go to coma or death`

34
Q

____ (q 4hrs)is more effective in treatment of primary ______ than aspirin. it causes less gastric bleeding than aspirin. There is risk of kidney problems at high dosage in predisposed patients.

A

Ibuprofen

dysmenorrhea

35
Q

_______ (q 8hrs) It is available OTC and by prescription at high doses for aches and pains, arthritis and primary ____

A

Naproxen

dysmenorrhea

36
Q

____ is a distant fourth place in OTC NSAIDs

A

Orudis

37
Q

______ is available in injectable (IM) and oral forms. it is reputed to be the most ____ NSAID, but there is high incidence of stomach ____. It is used primarily after surgery and recommended for short-term therapy (less than 5 days). Half-life of 6 hours

A

Ketorolac
efficacious
ulceration

38
Q

______ is used primarily for short term treatment of acute gout attack. It has a variety of adverse effects besides the usual problem with ulcers, so its not commonly used for other purposes

A

Indomethacin

39
Q

What are two COX-2 inhibitors that are no longer on the market and what is one that is still on the market

A

Bextra
Vioxx

Celebrex

40
Q

COX-2 inhibitors do not inhibit platelet aggregation like aspirin odes and hence do not provide protection against MI’s. In recent studies showed that the overall mortality rate of patients on COX-2 inhibitors was higher than those on other NSAIDs due to increase in ____ and __ ____. Thats why Bextra and Vioxx were pulled off the shelf. COX-2 and aspirins have been found to be correlated with reduced risk of ____ cancer

A

strokes and heart attacks

colon

41
Q

____ is a sulfa drug with some properties similar to the sulfa antibiotics. It can cause a ____ and _____ sensitivity in people sensitive to sulfa drugs although this is not common

A

celebrex

rash and sun

42
Q

____ is not an NSAID strictly speaking. It is an analgesic and antipyretic but not an anti-inflammatory. It main advantage over NSAIDS is that it doesn’t cause ___ ____. Its action appears to be only in the CNS.

A

acetaminophen

stomach ulceration

43
Q

High doses of acetaminophen can cause ____ ____. typical tablet is 325mg which is converted into toxic free radicals products that are detoxified by _______ a natural molecule found in the liver. Higher doses use up______ thus causing liver damage. Treatment is with _______ a modified amino acid. High doses’s for long periods of time can cause renal damage or failure.

A

hepatic necrosis
glutathione
glutathione
acetylcystenine

44
Q

Acetaminophen is considered safe in pregnant women but a new study shows that it can cause _____ in the children. Tylenol 1,2,3,4 contains APAP+codeine at different doses and require a prescription.

A

ADHD

45
Q

DMARD=

A

Disease modifying anti-rheumatic drugs

46
Q

DMARD drugs are use to slow down the advance of ______ _____ by inhibiting immune response because NSAIDS don’t do use. However DMARD drugs have numerous toxic side effects thus have restricted their use. Some Dr’s advocate their use in earlier treatment to slow progression.

A

rheumatoid arthritis

47
Q

______ is a DMARD and acts as an antagonist of folic acid which is essential for DNA and RNA synthesis. It is used in treatment of other types of autoimmune diseases (_____) and some types of cancer. It frequently causes nausea, vomiting and diarrhea. It is possibly _____ and can cause kidney failure, and _______ fibrosis.

A

methotrexate
lupus
carcinogenic
pulmonary

48
Q

_____ eg. ______ may be used during an acute inflammatory attack but side effects discourage long term use. adverse effects include edema (especially _____), delayed wound healing and O_______

A

steroids eg. prednisone
facial
osteoporosis

49
Q

_______ and ______ are DMARD and both are antibodies that bind to and inhibit ____ ____ _____ (TNF) which is involved in the inflammatory and immune response. They may decrease the ability to respond to ____ and are very e_____. GIVEN twice weekly by SQ. Treats a variety of autoimmune diseases.

A

Enbrel and humira
tumor necrosis factor
infections
expensive

50
Q

_____ is an eye drop medication that is a prostaglandin analog that dilates vessels allowing aqueous humor out of the eye thus decreasing internal pressure. Most common drug in treatment of ______

A

latanoprost

glaucoma

51
Q

_____ family of drugs have structures similar to serotonin and may act as serotonin agnostic which bind on serotonin receptors in cranial blood vessels and inhibit release of inflammatory molecules. work best if taken upon noticing first symptoms of. Work better if given ____ rather than oral pill

A

Triptan

SQ

52
Q

What are three triptan drugs

A

Sumatriptan
Zolmitriptan
Rizatriptan

53
Q

Opioids bind to opioid receptors in the brain U, sigma, and K receptors. The _ receptor is the most important pharmacologically. These receptors can be activated by naturally occurring peptides e____, D______, e______

A

endorphins
dynorphin
enkephalin

54
Q

what are the three must useful effects of opioids

A
  1. Analgesia
  2. anti-tussive (cough suppressant)
  3. decrease GI motility (Treatment of diarrhea)
55
Q

______ and ____ (sustained release) is used for serious pain; post-surgical, terminal cancer, post MI. Oral doses are - times IV dosages due to extensive metabolism. regular oral morphine is given q 4h._____ the sustained release has a ____hr half-life

A

morphine and ms-contin
5-10
Ms-contin
12

56
Q

PCA stands for

A

patient controlled analgesia

57
Q

_____ is a semi-synthetic opioids and is more lipophilic than morphine and hence enters the brain faster than morphine. Not scheduled 1 in most of Europe. With draw can induce nausea, intestinal cramping and it can be treating with methadone or clonidine to ease withdraw.

A

Heroin

58
Q

______ has a higher potency than morphine, may have lesser side effects than morphine for some patients. Given PO, SC, IM or IV

A

Hydromorphone

59
Q

_______ is metabolized into morphine, which apparently is responsible for most of its analgesic properties. It is a good ______. It is also a semi-synthetic opioid.

A

Codeine

Antitussive

60
Q

Since codeine is a prodrug it has to be converted by ____ ___ enzyme and about 7% of the population lacks this, thus codeine is not a good treatment. This enzyme is also inhibited by the SSRI’s ___and _____

A

CYP 2D6

Prozac and Paxil

61
Q

If codeine doesn’t work since there is a plateau in efficacy at 60mg/dose move up to oxycodone, hydrocodone, and or morphone

A

______

62
Q

______ is also combined with APAP or with HOMATROPINE as antitussive. This combo was the most commonly prescribed drug in 2005, second most const commonly written prescription in the US in 2008 with 101 million prescriptions. This drug is also converted to morphine. It is also a semi-synthetic opioid.

A

Hydrocodone

63
Q

_____ can also be combined with APAP and has a lower frequency of nausea and vomiting than morphone, but constipation may still be a problem. May be as good as morphine._____ is a long acting BID form. By chewing up this pill resulted in immediate gratification but reformulation stopped this. It is also a semi-synthetic opioid.

A

Oxycodone

Oxycontin

64
Q

____ is a synthetic opioid and good for post-surgical pain control, but long term use builds up toxic liver metabolite causing ____. Short half life, less constipation than morphine.

A

Demerol

convulsions

65
Q

______ is a synthetic opioid and is available in 3-day transdermal patch (______), buccal lozenges (_______) and IV solution. Very short acting when given IV (1-2hrs).Preferred for ______

A

Fentanyl
Duragesic
Actiq Oralet
child birth

66
Q

_______ and or ______ (combo of APAP) very popular for dental pain, but efficacy questioned. Pulled of market due to increased risk of ____ ____

A

Darvon
Darvocet
heart arrhythmias

67
Q

______ and or ____+ APAP pasta as a morphine agonist but also has a non-opioid pain relieving efficacy due to inhibitor of other pain receptors. It has less respiratory depression than opioids

A

tramodol and tramodol

68
Q

______ is a moderate cough suppressant without analgesic effect. Low abuse and OTC. It can produce hallucinations in large doses “____-partying”

A

Robitussin

Robo

Pharamcology (12 decks)

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