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Pharm_spring > Spring Exam 2 > Flashcards

Spring Exam 2 Flashcards

1
Q

lysergic and diethylamide (LSD)

A

hallucinogen - indole

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2
Q

psilocybin, psilocin

A

hallucinogen - indole

found in mushrooms

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3
Q

bufotenin

A

hallucinogen - indole

found in mushrooms, skin of some amphibians

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4
Q

ibogaine

A

hallucinogen - indole

suppress craving for heroin, cocaine

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5
Q

mescaline

A

hallucinogen - phenylethylamine
found in peyote cactus
more pronounced somatic autonomic changes

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6
Q

MDMA

A

hallucinogen - phenylethylamine

hallucinogenic + stimulant effects

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7
Q

rivastigmine

A

aceytlcholinesterase inhibitor

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8
Q

donepezil

A

aceytlcholinesterase inhibitor

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9
Q

memantine

A

NMDA receptor antagonist

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10
Q

vitamin E (alpha-tocophenol)

A

antioxidant

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11
Q

seligiline/deprenyl

A

MAO inhibitor/??

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12
Q

riluzole

A

for ALS

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13
Q

methylphenidate

A

stimulant

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14
Q

atomoxatine

A

non-stimulating

inhibit NE reuptake

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15
Q

ethinyl estradiol

A

estrogen

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16
Q

estradiol valerate

A

estrogen

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17
Q

levonorgestrel

A

progestin

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18
Q

desogestrel

A

progestin

little to no androgenic activity

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19
Q

norgestimate

A

progestin

little to no androgenic activity

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20
Q

drospirenone

A

progestin
spironolactone derivative
progestin activity
aldosterone antagonist activity

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21
Q

norethindrone

A

progestin

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22
Q

Micronor (R)

A

norethindrone

progestin only contraceptive

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23
Q

Depo-Provera (R)

A

medroxyprogesterone acetate
progestin only contraceptive
IM injection every 3 months
*SE: bone loss

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24
Q

Implanon (R)

A

etonogestrel

progestin only contraceptive

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25
Q

ParaGuard (R)

A

Copper
intrauterine device
risk of PID

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26
Q

Mirena, Skyla (R)

A

levonorgestrel
intrauterine device
risk of PID

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27
Q

raloxifene hydrochloride

A

selective estrogen receptor modulator (SERM)
estrogen agonist in bone - anti-resorptive effect
*prevent osteoporosis in postmenopausal
**SE: hot flashes, thromboembolism risk x3

not assoc with endometrial prolif, no estrogenic effects on lipid metab

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28
Q

clomiphene

A

anti-estrogen (trans); weak estrogenic (cis)
inhibit negative feedback of estrogen at hypothalamus
promote release of FSH and LH – promote maturation of ovarian follicle, ovulation, generation corpus luteum
*tx female infertility (induce ovulation in anovulatory women)
*SE: hot flashes, ovarian enlargement/cyst formation, incr risk ovarian cancer (prolonged use)
*Cx: preexisting ovarian cyst, pregnancy

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29
Q

leuprolide acetate

A

GnRH agonist
*tx: androgen-dependent prostate cancer, endometriosis, precocious puberty
SE: hot flashes, night sweats, decr bone density (women for endometriosis), impotence, decreased libido

30
Q

menotropins

A

gonadotropins; use with hCG
LH and FSH isolated from urine of postmenopausal women
given IM
F - induce ovulation in infertile anovulatory women
M - stimulate spermatogenesis
*SE: ovarian enlargement (abdominal distension), plural gestations d/t multiple ovulations

31
Q

chorionic gonadotropin

A

gonadotropin
from urine of pregnant women
tx: prepubertal cryptochidism (promote testicular descent), promote spermatogenesis, promote ovulation
SE: precocious puberty, *ovarian hyperstimulation, *multiple pregnancies

32
Q

AndroGel (R)

A

topical testosterone - gel
more stable testosterone levels
for: male hypogonadism or testosterone deficiency, andropause (male senescence), athletic enhancement
SE: risk of exposure to women and children if touch applicator or skin, testicular atrophy, erythrocytosis

33
Q

Androderm (R)

A

topical testosterone - transdermal
more stable testosterone levels
for: male hypogonadism or testosterone deficiency, andropause (male senescence), athletic enhancement
SE: risk of exposure to women and children if touch applicator or skin, testicular atrophy, erythrocytosis

34
Q

finasteride

A 
5a-reductase inhibitor (type 1)
block conversion of testosterone to DHT
**treat BPH - decr prostate size, incr urine flow rates**
*tx male pattern baldness*
**SE: impotence**
35
Q

dutasteride

A

5a-reductase inhibitor (type 1 and type 2)
block conversion of testosterone to DHT
treat BPH - decr prostate size, incr urine flow rates
SE: impotence

36
Q

oxytocin

A

stimulate uterine activity (oxytocic)
release from PP stimulated by stretching of cervix, vag, breast
contract myometrial smooth muscles –> induce labor contractions
contract myoepithelial cells in breast –> force milk letdown
reduce postpartum hemorrhage
SE: decr bp, incr HR, arrhythmia, antidiuretic + hyponatremia (d/t water retention), sustained uterine contractions/uterine hyperstimulation
Cx: abnormal fetal position, fetal distress, previous uterine surgery

37
Q

dinoprostone

A

PGE2
stimulate uterine activity (oxytocic)
stimulate uterine contraction and cervical ripening
SE: n/v, uterine hyperstimulation
Cx: abnormal fetal position, fetal distress, previous uterine surgery

38
Q

carboprost tromethamine

A

15-methyl PGF2a

stimulate uterine activity (oxytocic)

39
Q

misoprostol

A

PGE1 analog
stimulate uterine activity (oxytocic)
use with mifepristone - antiprogestin
early termination of pregnancy (up to 49d from LMP)
induce uterine contractions and expulsion of products of conception
SE: vaginal bleeding, abdominal cramps

40
Q

ergonovine maleate

A

ergot alkaloid
stimulate uterine activity (oxytocic)
activate a1 adrenergic receptors –> contractions
DO NOT use for induction of labor
*tx postpartum or postabortion hemorrhage
*SE: HTN, n/v/d, gangrene
*Cx: HTN, CVD, hepatic and renal disease

41
Q

methylergonovine maleate

A

ergot alkaloid
stimulate uterine activity (oxytocic)
activate a1 adrenergic receptors –> contractions
DO NOT use for induction of labor
*tx postpartum or postabortion hemorrhage
*SE: HTN, n/v/d, gangrene
preferred over ergonovine because less HTN
*Cx: HTN, CVD, hepatic and renal disease

42
Q

mifepristone

A

stimulate uterine activity (oxytocic); antiprogestin
cause detachment of products of conception from uterus
use with PGE1 analog misoprostol
early termination of pregnancy (up to 49d from LMP)
SE: vaginal bleeding, abdominal cramps

43
Q

indomethacin

A

prostaglandin-synthetase inhibitor
inhibit uterine activity (tocolytic)
for women 24-32wk gestation
inhibit production of F2a and E2 - important for cervical ripening and myometrial contraction
SE: premature closure of ductus arteriosis, oligohydramnios [more likely to occur after 32wk]

44
Q

nifedipine

A

Ca channel blocker
inhibit uterine activity (tocolytic)
for women 32-34wk gestation
decr Ca influx –> inhibit contractions

45
Q

activated charcoal

A

non-specific antidote
limit drug absorption
(not as efficacious if drug is rapidly absorbed)

46
Q

polyethylene glycol

A

non-specific antidote
whole-bowel irrigation
useful for ingestion of drug that’s poorly absorbed by activated charcoal ex. lithium

47
Q

fomepizole

A

specific antidote
for non-opiates; alcohols
alcohol dehydrogenase inhibitor

48
Q

hydroxocobalamin

A

specific antidote

for cyanide poisoning

49
Q

pralidoxime (2-PAM)

A

specific antidote
for non-carbamate organophosphate insecticides, nerve agents
reactivate cholinesterase enzymes

50
Q

calcium EDTA

A

metal chelator 2nd line
IV or IM for severe lead poisoning
toxic to kidney at high dose
**SE: chills, fever, n/v

51
Q

succimer

A

metal chelator 1st line

*first orally effective metal chelator**

52
Q

organophosphates (ex. methyl parathion)

A

toxic insecticide
acetylecholinesterase inhibitor
irreversible - “reversible” by pralidoxime
S&S: miosis, headache (with low level exposure), loss muscle control, cholinergic complaints (SLUDGE); resp failure d/t diaphragm muscle paralysis
Tx: atropine, pralidoxime

53
Q

methanol

A

wood alcohol
source: windshield washer solvent
s&s: CNS depression, blindness, metabolic acidosis
metabolized to formaldehyde
Tx: NaHCO3 IV (for metabolic acidosis), fomepizole (alcohol dehydrogenase inhibitor)

54
Q

ethylene glycol

A

source: antifreeze
s&s: CNS depression
metabolized to oxalic acid –> high affinity for Ca –> hypocalcemic tetany –> crystal formation –> oxaliaciduria + renal injury
Tx: Ca IV (for hypocalcemia), fomepizole

55
Q

diethylene glycol (DEG)

A

source: substitute for glycerin and propylene glycol

s&s: anuric renal failure, hepatitis, pancreatitis

56
Q

arsenic

A

elemental forms most toxic
source: rural/municipial water supplies, occupational exposure (CPU manufacturing)
**s&s: acute - hemorrhagic gastroenteritis (rice water diarrhea); chornic - hyperkeratosis, exfoliative dermatitis
MOA: high affinity for -SH groups
tx: metal chelator Dimercaprol

57
Q

lead

A

source: contaminated food, ingestion lead paint chips, inhalation lead dust, drinking contaminated water
s&s: hypochromic microcytic anemia, weak wrist or ankle extensor muscles, lead encephalopathy, colic, gout
inhibit hemoglobin synthesis –> anemia
Tx: metal chelators - 1st succimer, 2nd EDTA; dexamethasone for cerebral edema

childhood lead exposure - lower IQ, incr ADHD, aggressive, juvenile deliquency

58
Q

methylmercury

A

organic forms more toxic; inorganic/elemental poorly absorbed
highly absorbed from GI tract, readily pass BBB
source: consumption contaminated fish, grain fungicide, gold mining
**s&s: cerebellar ataxia, movement disorders, loss of balance, sensory deficits, loss of visual field, deafness, dysarthria
**irreversible

59
Q

CO

A

colorless, odorless, tasteless, ubiquitous
source: any burning or combustion process
s&s: headache, dizziness, incr HR
chronic exposure –> possible CV problems
outcompete O2 binding to Hb, reduces ability of O2 to dissociate and be delivered to tissues
Tx: remove from CO, hyperbaric oxygen

60
Q

cyanide

A

source: smoke (burning of plastics, wool)
s&s: “bitter almond” breath, headache, tachypea, apnea, LOC
bind to cytochrome oxidase –> inhibit ETC
Tx: hydroxocobalamin (binds to cyanide –> cyanocobalamin)

61
Q

asbestos

A

filamentous silica
no real s&s;
mesothelioma lung cancer 15-20yrs after exposure, pleural plaques, pleural effusions 5-10yrs after exposure
no antidote! prevent exposure

62
Q

PCBs, dioxin

A

source: flame retardants, placticizers, insulating material

* *s&s: dermal acne-like eruptions – chloracne, n/v, headache

63
Q

bisphenol A (BPA)

A

sources: leach from waterbottles (#7) into water, plastic-lined canned food
“some concern” that exposure in utero results in neural and behavioral effects

64
Q

phencyclidine

A 
hallucinogen, analgesic
most commonly smoked
rapidly absorbed, slowly metabolized
block NMDA receptors
**SE: hyperreflexia, increased muscle tone and HTN, vertical nystagmus, hostility**
to tx: acidify urine
65
Q

progestin only contraceptives

A

**use if
- **have contraindications for use of estrogen-containing,
- **are lactating and want contraception
DO NOT consistently inhibit ovulation

66
Q

emergency contraception

A

high doses of oral contraceptives (levonorgestrel)
must be taken within 120hrs after intercourse
inhibit or delay ovulation

67
Q

unipristal

A

emergency contraceptive
progesterone antagonist and partial agonist
inhibit or delay ovulation

68
Q

COC side effects

A 
*nausea = most common
chloasma (incr in UV light)
hirsutism (if progestin with androgenic activity)
hypertension
incr risk MI, stroke
**thromboembolic disorders - incr clotting factors, decr ATIII
decr glucose tolerance
incr TG, LDL
breakthrough bleeding
incr risk Candida
depression, migraine headaches
worsen myopia/nearsightedness
slight incr risk breast, cervical cancer (if have HPV)
69
Q

COC benefits

A

decr risk endometrial, ovarian cancer
estrogen - tx acne vulgaris (decr sebaceous gland activity, incr sex hormone binding globulin –> decr free testosterone)

70
Q

drug-drug interactions with COCs

A

antibiotics - decr enterohepatic recirculation

anticonvulsants - induce CYP3A4 –> decr ethinyl estradiol levels

71
Q

uterine hyperstimulation definition

A

contractions lasting >2min
or
>5 contractions within 10min

72
Q

carbamates

A

toxic insecticide
reversible with atropine
acetylecholinesterase inhibitor
S&S: miosis, headache (with low level exposure), loss muscle control, cholinergic complaints (SLUDGE); resp failure d/t diaphragm muscle paralysis
Tx: atropine, pyridostigmine, physostigmine

Pharm_spring (3 decks)

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