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Flashcards in all pharm Deck (499):
1

Decrease angiotensin II (potent vascoconstrictor) and have SE of angioedema (severe), acute RF, and persistent dry cough

Ace-Inhibitors (Lisinopril and Ramipril)

2

Lisinopril depletes

zinc

3

Alpha-2-agonist that decreases vasoconstriction and CO

Clonidine (AntiHTN)

4

Alpha-1-antagonist: decease NE; used to tx HTN and BPH

Doxazosin
Terazosin

5

Do not use these AntiHTN drugs with African Americans

ARBs (Losartan, Irbesartan, Valsartan)

6

Major ADR of ARBs

HYPERkalemia

7

Selective (B1) Antagonists

Atenolol
Metoprolol

8

Nonselective (B1 and B2) Antagonists

Carvedilol
Propanolol
Timolol

9

_______ BB crosses the BBB and has more SE

Propanolol

10

Which BB is commonly used in CHF?

Carvedilol

11

Which antihypertensive drugs are NOT 1st line for CHF?

CCB

12

CCB

Amlodipine
Diltiazem
Verapamil

13

Amlodipine depletes

Potassium

14

Verapamil depletes

Vitamin E

15

Potassium wasting diuretic that inhibits Na+ and Cl- at the ascending loop

Furosemide (Loop diuretic)

16

Furosemide SE

hypokalemia, ototoxicity, and nutrient depletion

17

Furosemide is CI in

allergy to sulfonamides

18

Potassium wasting diuretic that inhibits NaCl transporter in distal tubule

Hydrochlorothiazide (Thiazide diuretic)

19

Hydrochlorothiazide SE

hypokalemia and hyperglycemia

20

Hydrochlorothiazide is CI in

allergy to sulfonamides

21

Potassium sparing diuretics

Spironolactone Triamterene

22

Spironolactone and Triamterene are weak diuretics with SE of ______

HYPERkalemia

23

Aldosterone antagonist that works at the distal convoluted tubule

Sprionolactone

24

What does hydralazine do?

Antihypertensive (unknown MOA, peripheral vasodilation)

25

Major SE of NTG

HA

26

NTG C/I

Sildenafil (w/in 24 hrs)

27

Prophylactic vasodilator w/ a slower action than NTG

Isosorbide mononitrate

28

sympathomimetic with vasoconstriction via alpha-1 and bronchodilation via beta-2

Epinephrine (increases HR and contractility)

29

This antiarrhythmic has a narrow therapeutic window

Potassium chloride

30

Potassium chloride SE

Hyperkalemia

31

Sodium channel blockers

Class I anti-arrhythmics: Lidocaine and Flecainide

32

BBW for Class I anti-arrhythmics: Lidocaine and Flecainide

increased mortality*use as a last resort in hospital setting

33

Class II anti-arrhythmics

BB (-olol)

34

Potassium channel blockers

Class III anti-arrhythmics: Amiodarone

35

70% of pt on amiodarone have ADR, including:

pulmonary fibrosis, heart block, hypotension, hypo/hyperthyroidism, hepatotoxicity, coronary/skin deposits

36

Class IV anti-arrhythmics

CCB: Amlodipine, Diltiazem, Verapamil

37

anti-arrhythmics that inhibits N/K/ATPase

Digoxin (Class V)

38

Which anti-arrhythmics can be used for LHF (palliative) and A flutter, but must be monitored d/t narrow therapeutic window

Digoxin

39

Combining digoxin w/ diuretics increases the risk of

hypokalemia

40

fatigue, mm. weakness, agitation, anorexia, and yellow halos around vision are sx of _______ toxicity

Digoxin

41

Bile acid sequestrant used to tx T2DM, familial hypercholesterolemia and hyperlipidemia

Colesevelam

42

Colesevelam SE

wastes nutrients when bile is sequestered

43

Colesevelam C/I

bowel obstruction or TG > 500

44

Cholesterol absorption inhibitor

Ezetimibe

45

Ezetimibe C/I

active liver dz

46

fibrate drug used to tx triad of low HDL, high LDL, high TG (Type IV and V)

Gemfibrozil

47

Gemfibrozil interacts with

Warfarin and statins

48

Gemfibrozil SE

gallstones, elevated liver enzymes, enhances anticoagulants, myositis/rhabdomyolysis

49

HMG-CoA reductase inhibitors

Atorvastatin and Simvastatin

50

Statins interact with

fibrates and niacin

51

Statin SE

elevated LFT, myositis, rhabdomyolysis - d/c if pt has muscle pain

52

______ should always be given with statins

75-100 mg CoQ10

53

Best drug in anaphylaxis

Epinephrine

54

antitussive that suppresses cough reflex at source (i.e. anesthetizes respiratory passage)

Benzonatate (it's actually an ester local anesthetic)

55

antitussive that works at cough center in medulla

Dextromethorphan

56

Which antitussive can cause serotonin syndrome?

Dextromethorphan (it is C/I to use MAO-I w/in 14 days of dextromethorphan)

57

Opioid antitussive(s)

Codeine
Hydrocodone

58

Mucolytic, expectorant

Guaifenesin

59

1st generation anti-histamines that cross BBB and cause sedation

Diphenhydramine
Hydroxyzine
Promethazine

60

2nd generation anti-histamines that do not cross BBB (thus do not cz sedation)

Cetirizine
Fexofenadine
Loratadine

61

Dose of diphenhydramine during anaphylaxis

50 mg IM

62

The anti-histamine _____ is used as an anxiolytic

Hydroxyzine

63

The anti-histamine _______ is used as an antipsychotic

Promethazine

64

Antihistamines that are used for allergies/asthma are ____ antagonists

H1

65

Loratadine SE

QT prolongation

66

sympathomimetic nasal spray (mostly alpha-adrenergic)

Phenylephrine (decongestant)

67

sympathomimetic decongestant (alpha and beta)

Pseudoephedrine

68

Pseudoephedrine C/I

MAO-I (HTN crisis)

69

Decongestants

Phenylephrine (nasal spray), Pseudoephedrine, Epinephrine

70

mast cell stabilizer that inhibits histamine release

Cromolyn sodium

71

Albuterol onset is ___ and lasts ____

onset: 15 min lasts: 3-4 hrs

72

Albuterol C/I

MAO-I, TCA, sympathomimetic

73

Long-acting B2 agonist that lasts 12-24 hr

Salmeterol (usu. used in combo w/ glucocorticoids)

74

Salmeterol C/I ______ and ADR _____

C/I: acute asthmaADR: prolonged QT

75

Salmeterol BBW

may increase asthma-related death

76

Inhaled steroids

Fluticasone, Mometasone, Beclomethasone, Budesonide

77

leukotriene antagonist used for prophylaxis and maintenance of persistent asthma, aspirin-induced asthma, and exercise-induced asthma

Montelukast

78

Montelukast SE

Churg-strauss syndrome, hypereosinophilia

79

antimuscarinic bronchodilator that inhibits ACh in smooth muscle of respiratory tract and is used for maintenance therapy in COPD

Tiotropium bromide

80

antimuscarinic bronchodilator that is shorter acting

Ipratropium bromide

81

Procoagulant that stimulates factors II, VII, IX, X

Vitamin K1

82

drug that inhibits ADP-induced platelet aggregation and is often used in pt that are aspirin intolerant

Clopidogrel

83

drugs that inhibits COX and inhibits platelet aggregation

Aspirin

84

Aspirin increases which drug?

Phenytoin (seizure drug)

85

Aspirin C/I

kids < 12 y/o (Reye's syndrome) and G6PD deficiency

86

inhibits synthesis of vitamin K-dependent factors but has no effect on established thrombus

Warfarin

87

has a narrow therapeutic window and requires monitoring of PT/INR

Warfarin

88

Drugs that can increase effects of Warfarin

Acetaminophen, Androgens, BB, Corticosteroids, Omeprazole, Phenytoin

89

xanthine derivative that reduces blood viscosity and is used in intermittent claudication and peripheral vascular dz

Pentoxifylline

90

Factor X inactivator that binds anti-thrombin III to prevent conversion of fibrinogen to fibrin (intrinsic pathway)

Heparin

91

Low molecular weight heparin (factor X inactivator)

Enoxaparin

92

Factor Xa inactivator that inhibits platelet activation and fibrin clot formation

Rivaroxaban

93

direct thrombin inhibitor that inhibits free and fibrin-bound thrombin

Dabigatran

94

Iron chelator used to tx chronic iron overload, hemochromatosis, routine transfusions

Deferoxamine

95

chelator of mercury, gold, arsenic

DMPS

96

chelator of mercury, lead, antimony, and arsenic

DMSA (oral version of DMPS so it has less severe ADR)

97

chelator of lead, mercury, iron; also acts as anti-coagulant in blood tubes

Edetate calcium disodium (EDTA)

98

chelator of copper and other heavy metals; used to tx Wilson's dz

Penicillamine

99

drug used in anemia of chronic dz because it stimulates erythropoiesis

Epoetin alfa

100

Antibacterial classes that inhibit cell wall synthesis

Penicillins, Glycopeptides, Cephalosporins

101

Antibacterial classes that inhibit protein synthesis

Tetracyclines, Macrolides, Lincosamides, Aminoglycosides

102

Antibacterial classes that inhibit DNA synthesis

Fluoroquinolones

103

Antibacterial classes that inhibit RNA synthesis

Synthetase inhibitors (Mupirocin), Monoxycarbolic acid agents (Rifaximin, Nitrofurantoin)

104

Antibacterial classes that act as PABA analogue/dihydrofolate reductase inhibitors

Sulfamethoxazole-trimethorpim

105

B-lactam drug used to tx dental abscesses, recurrent rheumatic fever, recurrent strep cellulitis in lymphedema but has SE of anaphylaxis and black hairy tongue

Penicillin G/VK (i.e. natural penicillin)

106

synthetic B-lactam drugs that are 1st choice for uncomplicated ENT infx

Ampicillin, Amoxicillin, Amoxicillin + clavulanate

107

What is clavulanate?

B-lactamase inhibitor (added to B-lactam drug Ampicillin)

108

Are the synthetic penicillin drugs (ampicillin, amoxicillin, and amox + clavulanate) safe in Pg?

Yes

109

glycopeptide drugs that is IV only and used to tx MRSA

Vancomycin

110

Cephalosporins

Cefdinir CefuroximeCeftriaxoneCephalexin

111

10-15% of pt that are hypersensitive to penicillins will also reach to ________

Cephalosporins (cefdinir, cefuroxime, ceftriaxone, cephalexin)

112

Cephalosporins (cefdinir, cefuroxime, ceftriaxone, cephalexin) tx

cellulitis

113

broad-spectrum antibiotics that can have ADR of photosensitivity and tooth discoloration/bone effects in kids < 8

Tetracyclines (minocycline, doxycycline)

114

_________ antibiotics should be taken on an empty stomach, where as ______ antibiotics should be taken with food

Empty = tetracyclinesFood = macrolides

115

Are macrolides safe in pregnancy?

Yes (Cat. B)

116

Macrolides

"-romycin"
Azithromycin
Clarithromycin
Erythromycin

117

alternative antibiotic for people w/ penicillin allergy

Clindamycin

118

antibiotic that is used topically for acne

Clindamycin

119

Clindamycin ADR

C. diff super infx (pseudomembranous colitis)

120

topical aminoglycoside antibiotic used for ocular infx

Gentamicin

121

1st line drug for UTIs

Ciprofloxacin and Levofloxacin (Fluoroquinolones)

122

Ciprofloxacin and Levofloxacin BBW

tendon rupture

123

Ciprofloxacin and Levofloxacin C/I

< 18 y/o (can arrest growth plate)

124

topical antibiotic for MRSA and impetigo

Mupirocin

125

Monoxycarbolic acid agent used to tx SIBO, traveler's diarrhea, IBS, hepatic encephalopathy

Rifaximin

126

"everything inhibitor" used to tx acute uncomplicated UTIs

Nitrofurantoin

127

Nitrofurantoin C/I

G6PD deficiency, lactation, and 3rd trimester of Pg (can cz hemolysis of newborn)

128

Give _____ with Sulfamethoxazole-trimethorpim

Folate

129

Sulfamethoxazole-trimethorpim SE

photosensitivity and megaloblastic anemia

130

Sulfamethoxazole-trimethorpim interactions

OCPs

131

Triple Antibiotic Ointment

Bacitracin + Neomycin + Polymyxin B B: inhibits cell wall synthN: aminoglycosidePB: cell wall permeability

132

Triple Antibiotic Ointment SE

allergic contact derm and SNHL (neomycin)

133

Neomycin SE

permanent SNHL (aminoglycoside drug)

134

Anti-tuberculosis drugs

Isoniazid and Rifampin Note: use both drugs together for active infx

135

can be used to tx latent and active TB but is also hepatotoxic

Isoniazid

136

Rifampin SE

red tears/saliva/urine, hepatotoxic

137

anti-fungals that penetrate into all body fluids

Fluconazole and Ketoconazole (Triazoles)

138

Fluconazole and Ketoconazole interactions

Warfarin, phenytoin, others

139

Anti-fungal used for onychomycosis

Terbinafine

140

Terbinafine SE

hepatotoxic, SJS, neutropenia

141

anti-fungal that disrupts cell wall formation and only works topically (even in GI it works as topical agent)

Nystatin

142

Malaria prophylaxis

Hydroxychloroquine

143

anti-helminthic drugs that destroy microtubules and block glucose uptake

Albendazole and Mebendazole

144

topical application for lice, ticks, mites; 1st line tx scabies

Permethrins

145

anti-parasitic for roundworms, lice, scabies

Ivermectin

146

anti-protozoel for anaerobic infx, C. diff, H. pylori ulcers, BV, trichomonas, and giardia

Metronidazole

147

Metronidazole C/I

EtOH (disulfiram rxn)

148

guanosine analogue that inhibits viral DNA polymerase and tx actively replicating HSV

Acyclovir and Valacyclovir

149

reverse transcriptase inhibitor; drug accumulates in all dividing cells

Zidovudine

150

Parkinson's drugs that can also tx Influenza A

Amantadine (no longer recommended for influenza A)

151

tx influenza A and B; prevents release of virus

Oseltamivir

152

tx chronic HBV and HCV

interferon-a-2

153

alkylating agent used to tx metastatic testicular and ovarian tumors and adv bladder CA

Cisplatin

154

Cisplatin BBW

renal toxicity, myelosuppression, ototoxicity

155

alkylating agent used to tx leukemia, lymphoma, and many other CA

Cyclophosphamide

156

anthracycline drug used to tx Kaposi's sarcoma, ovarian CA, multiple myeloma

Doxorubicin

157

Doxorubicin SE

life-threatening heart damage

158

Doxorubicin C/I

cardiac dz

159

drug used to tx Her-2+ breast CA

Trastuzumab

160

Trastuzumab BBW

fatal heart/lung problems and fetal harm

161

folic acid antagonist used to tx many CA and to induce abortion

Methotrexate

162

anti-microtuble drug used to tx Hodgkin's, testicular CA, and Kaposi's sarcoma

Vinblastine (IV only)

163

Vinblastine is derived from

Vinca rosea (periwinkle)

164

aromatase inhibitor used reduce serum estradiol in breast CA pt post-surgery and for METS

Anastrozole

165

GnRH analogue; testosterone antagonist used to tx metastatic prostate CA

Bicalutamide

166

Bicalutamide C/I

women, pregnancy (X)

167

GnRH analogue; suppression of ovarian/testicular steroidogenesis for prostate CA, endometriosis, uterine fibroids

Leuprolide

168

mitotic inhibitor that binds tubulin and affects rapidly dividing cells

Paclitaxel

169

drug used to tx advanced ovarian CA, non-small cell lung CA, ovarian/breast CA METS unresponsive to 1st line drugs

Paclitaxel

170

pyrimidine analogue use to tx many CA

5-Fluorouracil

171

5-Fluorouracil is used topically to tx

BCC

172

SERM used prophylactically for postmenopausal osteoporosis

Raloxifine

173

SERM that competes with E2 for E-receptor proteins and is used to tx E+ CA

Tamoxifen

174

Tamoxifen BBW

uterine malignancies, stroke, PE

175

cytokine inhibitor; circulating receptor fusion protein used to tx RA, jRA, PsA, AS, plaque psoriasis

Etanercept

176

Etanercept BBW

incr risk of serious infx and CA

177

TNF-a inhibitor used to tx inflammatory dz (RA, PsA, IBD)

Adalimumab

178

Adalimumab BBW

incr risk of serious infx and CA

179

Infliximab BBW

incr risk of serious infx and CA *can also cz HF, pancytopenia, and demyelinating dz

180

Cytokine/TNF inhibitors

Etanercept, Adalimumab, Infliximab

181

DMARD used to tx SLE and RA

Hydroxychloroquine

182

DMARD used to tx CA, RA, severe psoriasis, ectopic pg (abortifacient)

Methotrexate

183

DMARD used RA (also a copper chelating agent)

Penicillamine

184

DMARD used to tx IBD and RA that is C/I in people with sulfonamide/salicylate allergy

Sulfasalazine

185

JAK inhibitor used to tx RA when it's refractive to methotrexate

Tofacitinib*new on NPLEX

186

Tofacitinib BBW

incr risk of serious infx and CA

187

used for prophylaxis during organ transplant and for dry eyes

Cyclosporine

188

transplant drug that has BBW of incr risk of serious infx and CA

Tacrolimus

189

drug used to tx leprosy and multiple myeloma

Thalidomide

190

Thalidomide C/I

pregnancy (X)

191

4x stronger than cortisol and longer acting than hydrocortisone

Prednisone

192

non-selective COX inhibitor used to tx fever, pain, inflamm, and platelet agg

Aspirin

193

Salicylism

dose-dependen reversible vertigo, vomiting, tinnitus, hearing loss (aspirin toxicity - max dose = 4g)

194

Diclofenac gel

non-selective COX inhibitor for inflammation; NSAID

195

non-selective COX inhibitor that decreases cartilage synthesis

Ibuprofen

196

Ibuprofen interacts with

Aspirindo not combine

197

Indomethacin

non-selective COX inhibitor for inflammation

198

non-selective COX inhibitor use for moderate-severe pain only; IV or IM

Ketorolac

199

Ketorolac C/I

use > 5 days and in peds

200

Naproxen

non-selective COX inhibitor for inflammation

201

Naproxen sodium

greater absorption and faster onset than Naproxen (NSAID)

202

non-selective COX inhibitor used for post-cataract surgery

Nepafenac

203

Selective Cox-2 inhibitor

Celecoxib

204

Celecoxib has less ______ than aspirin, but increased risk of _______

less: GI distressincr: risk of serious thrombosis

205

Celecoxib C/I

perioperative pain from CABG

206

Muscle relaxants for acute use (1-2 wks)

Carisoprodol
Cyclobenzaprine
Diazepam (benzo)
Methocarbamol

207

muscle relaxants C/I

CNS depressants

208

Methocarbamol SE

black/blue/green urine

209

you need to taper this drug that is used to tx mm. spasticity, spinal cord injury, and rheumatic d/o

Baclofen

210

alpha-2 agonist used for mm. spasticity

Tizanidine

211

inhibits ACh release and causes flaccid paralysis

Botulinum toxin

212

bisphosphonate drug that inhibits osteoclasts

Alendronate

213

_______ must be taken on an empty stomach with 6-9 oz water and remain upright for 30 min

Alendronate

214

Alendronte SE

esophageal erosion, osteonecrosis of jaw

215

Alendronte C/I

hypocalcemia

216

hormone used to inhibit osteoclasts and tx osteoporosis (not prevention)

Calcitonin

217

monoclonal antibody use to tx osteoporosis

Denosumab SQ q 6 mo

218

SERM used for postmenopausal osteoporosis prophylaxis

Raloxifene

219

Raloxifene C/I

past VTE, pregnancy (X)

220

centrally acting analgesic that inhibits prostaglandin synthesis for pain and fever; not anti-inflammatory

Acetaminophen

221

Acetaminophen interactions

EtOH3 drinks/day + 3 g can shut down the liver

222

Acetaminophen max dose

4 g in 24 hours #1 drug to OD on

223

xanthine oxidase inhibitor used in prevention of further gouty attacks (decreases uric acid production)

Allopurinol

224

drug used in acute gouty attacks; microtubule inhibitor that prevents neutrophils causing gout sx

Colchicine

225

______ is used to tx acute gout, whereas ______ is used to prevent further gout attacks

Acute = colchicine
Prevention = allopurinol

226

rubefacient used as a counter-irritant for pain, vasodilation, and blocks substance P

capsaicin

227

kappa and mu receptor activities

Codeine
Fentanyl
Morphine
Tramadol
Oxycodone
Hydrocodone*

*all are class II except hydrocodone, which is class III

228

strongest non-synthetic opiate

morphine

229

Tramadol SE

seizure risk

230

synthetic opioid agonist for addiction and detox

Methadone

231

partial opioid agonist/antagonist for addiction

Buprenorphine

232

competitive opioid antagonist for addiction that is C/I in pt taking opiates

Naltrexone

233

competitive opioid antagonist for acute OD

Naloxone

234

immunosuppressant and ocular emulsant; used to tx keratoconjunctivitis sicca (Sjogrens, scleroderma)

Cyclosporine

235

aminoglycoside, bacteriocidal eye drops

Gentamicin

236

bacteriostatic drug used for conjunctivitis, superficial ocular infx

Sulfacetamide

237

macrolide used for superficial ocular infx that has a SE of eye irritation

Erythromycin

238

BB for ocular HTN and open-angle glaucoma

Timolol

239

prostaglandin analog that reduces IOP by increasing outflow of aqueous humor

Latanoprost

240

Latanoprost SE

iris darkening

241

cholinergic agonist causing miosis (constriction) and decreased pressure in open-angle glaucoma or ocular HTN; also used in acute-open angle glaucoma

Pilocarpine

242

anticholinergic drug used to dilate eyes for exam (mydriatic agent)

Atropine

243

NSAID for cataract surgery to decrease pain and inflammation

Nepafenac

244

Nepafenac SE

increased bleeding time, delayed healing, corneal ulcers

245

ophthalmic antihistamine used in tx allergies

Olopatadine

246

sympathomimetic decongestants that cause rebound congestion (aka rhinitis medicamentosa)

Oxymetazoline
Phenylephrine

247

Oxymetazoline and Phenylephrine C/I

use > 3 days, glaucoma, MAO-I

248

topical antibacterial and steroid for swimmer's ear, superficial bacterial infx of external auditory canal

Neomycin/
Polymyxin B/
Hydrocortisone

249

cholinesterase inhibitors used to tx dementia

Donepezil
Rivastigmine

250

drug that blocks NMDA-R and decreases excitotoxicity for moderate to severe Alzheimers

Memantine

251

GABA analogue used as adjunct in epilepsy tx

Gabapentin
Pregabalin

252

sodium channel blocker used to tx partial seizures, bipolar mania, and trigeminal neuralgia

Carbamazepine

253

Carbamazepine SE

ataxia

254

sodium channel blocker seizure drug that has SE of gingival hyperplasia and suicidal ideation

Phenytoin

255

Phenytoin SE

-P: peripheral neuropathy-H: hyperplasia of gingiva, hirsutism, hypersensitivity -E: enlarged LN -N: nystagmus -y-T: teratogenicity -O: osteomalacia-I: inhibition of insulin -N: nausea

256

benzodiazepine use in seizure tx

Diazepam

257

Diazepam C/I

CNS depressants

258

seizure drugs with SE of sudden unexplained death and suicidal ideation

Lamotrigene
Topiramate
Valproate

259

PD drugs that is a dopamine precursor

Levodopa/carbidopa

260

inhibits peripheral degradation of levodopa but has no effect if used alone

carbidopa

261

Levodopa/carbidopa SE

tolerance over time

262

Levodopa/carbidopa interaction

B5 (increases peripheral DA catabolism)

263

dopamine agonist used to tx PD, acromegaly, and hyperprolactinemia

Bromocriptine

264

Bromocriptine SE

pulmonary fibrosis

265

dopamine agonist for tx PD that is s/t used to delay starting Levodopa

Pramipexole

266

anticholinergics for dyskinesia (in PD)

Benztropine
Scopolamine
Diphenhydramine

267

drug used to levodopa-induced dyskinesia

Amantadine

268

sphingosine-1-phosphate-R modulator used to tx MS; it decreases inflammation

Fingolimod

269

immune modulator used to tx MS, that activates suppressor T-cells to decrease inflammation

Glatiramer acetate

270

interferon used to reduce MS exacerbations

Interferon-beta-1

271

drugs used to spasticity related to MS

Tizanidine (mm. relaxant)
Baclofen (unknown MOA)
Botulinum toxin

272

drug used for postherpetic neuralgia, epilepsy, and bipolar mania

Gabapentin

273

drug used for neuropathic pain, fibromyalgia, and postherpetic neuralgia

Pregabalin

274

5HT-1 agonist, potent vasoconstriction of cranial aa., take at onset of migraine or cluster HA

Sumatriptan

275

Sumatriptan CI

ischemic heart dz, history of MI or stroke

276

tx for chronic migraines that blocks ACh release

Botulinum toxin

277

Topiramate and Valproate can both be used to tx

migraines and seizures

278

Amides are metabolized

by the liver

279

Esters are metabolized

in peripheral plasma to PABA

280

Lidocaine is an

amide (liver)

281

Bupivacaine is an

amide (liver)

282

Procaine is an

ester (peripheral plasma)

283

Lidocaine onset and duration

onset: 1-10 min duration: 30-60 min

284

Bupivacaine

onset: 8-12 min duration: 3-4 hr

285

Which type of nerve block agent is more likely to cause allergic rxn?

Esters (i.e. procaine)

286

the nerve block agent _______ acts topically, and ______ does not act topically

Lidocaine
Procaine

287

Procaines has a _____ onset, and ______ duration as Lidocaine

slower onset same duration (30-60 min)

288

NMDA receptor antagonist used in pain/procedures

Ketamine

289

Ketamine C/I

psychosis

290

1st generation antihistamines that are somnorific

Diphenhydramine
Hydroxyzine
Promethazine

291

non-benzo GABA potentiator - strong sedative, minor anxiolytic, rapid onset but short duration of hypnotic action

Zolpidem

292

Zolpidem SE

rebound insomnia (must taper)

293

anti-convulsant drugs used to tx mania in bipolar d/o

Lamotrigine
Valproate
Carbamazepine

294

Carbamazepine blocks ____ channels

sodium

295

drugs that block 5HT and DA

Atypical anti-psychotics:
Risperidone
Aripiprazole
Quetiapine

296

The atypical anti-psychotic ______ is used to tx irritability in autism

Risperidone

297

Aripiprazole SE

dysglycemia (caution with DM)

298

drug used to tx mania that has a narrow therapeutic window and must be monitored

Lithium

299

Lithium SE

hypothyroidism, hyponatremia

300

_____ are first line anxiolytic for MDD, OCD, GAD, and eating d/o

SSRIs:
Escitalopram
Fluoxetine
Paroxitine

301

SSRIs (Escitalopram, Fluoxetine, Paroxitine) C/I

MAO-I (serotonin syndrome)

302

Benzodiazepines

Alprazolam
Diazepam

303

Benzodiazepine (Alprazolam, Diazepam) SE

anterograde amnesia, must taper

304

Benzodiazepine (Alprazolam, Diazepam) C/I

CNS depressants

305

long-acting benzo used to tx epilepsy, EtOH w/drawal, and mania

Diazepam

306

antipsychotic that blocks D2, some H1, some cholinergic, some alpha-adrenergic and has LOTS of SE

Haloperidol

307

Haloperidol C/I

severe CNS depression, dementia-related psychosis

308

anti-psychotic used to tx psychosis and vomiting

Phenothiazines:
Prochlorperazine
Promethazine

309

Phenothiazines (Prochlorperazine, Promethazine) SE

tardive dyskinesia

310

Phenothiazines (Prochlorperazine, Promethazine) C/I

CNS or bone marrow depression

311

atypical antipsychotic used in treatment-resistant schizophrenia and suicide risk reduction

Clozapine

312

Clozapine BBW

severe neutropenia

313

Quetiapine

atypical antipsychotic used to tx mania

314

amphetamine agents used to tx narcolepsy

Dextroamphetamine
Methylphenidate

315

non-amphetamine CNS stimulation used to tx narcolepsy

Modafinil

316

Modafinil SE

SJS

317

Anorexiants (used to suppress appetite)

Phentermine
Dextroamphetamine

318

Is Phentermine safe in pregnancy?

No (Cat. X)

319

ADD/ADHD meds

Dextroamphetamine
Methylphenidate
Clonidine

320

Clonidine MOA

alpha-2 agonist

321

methylxanthine, phosphodiesterase inhibitor

caffeine

322

CNS stimulant and local anesthetic that works by reducing Na+ permeability

cocaine

323

Nicotinic ACh-R partial agonist

Varenicline

324

Varenicline BBW

suicidal ideation

325

Nicotine interactions

BB

326

Bupropion is used to tx

smoking cessation

327

Bupropion C/I

seizure d/o, eating d/o

328

hallucinogen that affects 5HT release, increases catecholamines, inhibits parasympathetics

Cannabis

329

hallucinogen that is an NMDA receptor antagonist

Ketamine

330

anticholinergic used to tx bradycardia, organophosphate poisoning, and PD

Atropine

331

Atropine C/I

acute glaucoma

332

MOA inhibitor that increases NE, DA, 5HT - used in depression

Phenelzine

333

Phenelzine C/I

all antidepressants and any meds that affect catecholamines

334

tricyclic that increases NE and 5HT - used in depression

Amitriptyline

335

Amitriptyline C/I

MAO-I or SSRI

336

tetracycline drug used for MDD

Mirtazapine

337

the smoking cessation drug ______ can also be used to tx depression

Buproprion (although takes several wk for antidepressant effects)

338

which anti-depressant has the fewest sexual SE

Buproprion

339

5HT antagonist and reuptake inhibitor (SARI) used off label to tx insomnia

Trazodone

340

SSRI used to tx MDD, OCD, GAD, eating d/o, panic attack

SSRI:
Escitalopraim,
Fluoxetine,
Paroxetine

341

1st line tx for depression and panic d/o

Fluoxetine (SSRI)

342

drug used to social anxiety, MDD, OCD, panic d/o, GAD

Paroxetine

343

SNRI used to tx depression, GAD and diabetic neuropathy

Duloxetine

344

SNRI used to tx MDD

Venlafaxine

345

ADHD med, NE reuptake inhibitor

Atomoxetine

346

antibacterial used topically for acne that has SE of photosensitivity

Benzoyl peroxide

347

synthetic retinoid that reduces sebaceous gland size and sebum production

Isoretinoin

348

Isoretinoin SE and C/I

SE: chelitis, increased LFTsC/I: pregnancy (X)

349

synthetic retinoid cream used for acne - reduces sebaceous gland size and sebum production

Tretinoin

350

blocks ACh release and can tx hyperhydrosis

Botulinum toxin

351

Topical steroids for eczema

Clobetasol propionate
Fluocinonide
Mometasone
Fluticasone
Triamcinolone
Hydrocortisone

352

RNA synthesis blocker that tx staph infx

Mupirocin

353

synthetic calcitriol to aid in proliferation and differentiation of various cell types; used to tx psoriasis

Calcipotriol

354

Calcipotriol SE

hypercalcemia

355

tx tinea versicolor, seborrheic derm, and dandruff

selenium disulfide

356

used to tx actinic keratosis and external genital warts

Imiquimod

357

Imiquimod C/I

immunocompromised and kids with molluscum (ineffective)

358

tx diarrhea and ulcers; coats stomach; cytoprotective against H. pylori

Bismuth subsalicylate

359

Bismuth subsalicylate SE

black tongue, tarry stool

360

mast cell stabilizer that inhibits histamine release and can tx diarrhea

Cromolyn sodium

361

anti-diarrheal effect on circular smooth muscle of bowel; may prolong transit time

Diphenoxylate/atropine

362

Diphenoxylate/atropine C/I

pseudomembranous colitis, enterotoxin-producing bacteria

363

opioid analogue that inhibits peristalsis and prolongs transit time; tx diarrhea

Loperamide

364

Loperamide C/I

bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis

365

somatostatin analog for vasoactive intestinal peptide tumors (flushing and watery diarrhea)

Octreotide

366

detergent agent that pulls more water into fecal matter

Docusate

367

Docusate interactions

mineral oil

368

Docusate C/I

obstruction

369

increase water into lumen and increase peristalsis; between softener and laxative

Oral osmotic agents: LactuloseMilk of magnesium PEG 3350

370

stimulant laxative that evacuates bowels 8 hr after taking

Bisacodyl

371

phosphoric acid salt that exerts osmotic effect and acts as a laxative/bowel evacuant

Sodium phosphate enema

372

binds prostaglandin R or parietal cells increasing HCO3-, decreasing pepsin, protecting tight jn, and thickening mucous layer; used for prevention of NSAID-induced ulcers

Misoprostal

373

Misoprostal C/I

pregnancy (X; abortifacient)

374

enhances mucosal barrier, adheres to "roughed up" gastric mucosa, little systemic absorption/no toxicity; powerful demulcent

Sucralfate

375

H2 blockers that inhibit gastric acid secretion by binding reversibly to H2-R in parietal cells, for short-term use

Cimetidine
Ranitidine

376

suppress gastric acid secretion by irreversible blocking H/K/ATPase at parietal cells

PPI:
Esomeprazole
Lansoprazole
Omeprazole

377

Are H2 blockers safe in Pg?

Yes

378

Are PPI safe in Pg?

Yes(-"prazole")

379

PPI ("-prazole") SE

rebound hypersecretion (must taper)

380

spasmolytic drugs (dicyclomine, hyoscyamine, and scopolamine) C/I

glaucoma

381

spasmolytic, anticholinergic, tx diarrhea, IBS, spasms, PUD

Hyoscyamine
Dicyclomine

382

anticholinergic, parasympatholytic drug used for motion sickness prevention

Scopolamine

383

DMARD used to tx IBD and RA

Sulfasalazine

384

Sulfasalazine C/I

sulfa allergy

385

active metabolite of sulfasalazine (tx IBD)

Mesalazine

386

1st generation antihistamines used to prevent vestibular stimulation of vomiting center, prophylaxis for motion sickness

Diphenhydramine
Meclizine

387

blocks 5HT3-R, inhibits activation of vomiting reflex pathway; used for N/V with chemotherapy or surgery

Ondansetron

388

antipsychotics with anti-DA and anti-emetic effects

ProchlorperazinePromethazine

389

Prochlorperazine and Promethazine SE and C/I

SE: extrapyramidal C/I: kids <2 (fatal respiratory depression)

390

solubilizing agent for primary biliary cirrhosis; tx gallstonres

Ursodeoxycholic acid

391

Ursodeoxycholic acid C/I

biliary obstruction

392

progestin for anorexia/cachexia of AIDS

Megestrol acetate

393

Megestrol acetate C/I

pregnancy (X)

394

cholinergic, increased SLUDGE for dry mouth of Sjogren's or chemotherapy

Pilocarpine

395

Pilocarpine C/I

glaucoma

396

dopamine R antagonist that tx N/V associated with chemo or radiation, GERD (2nd line), diabetic gastroparesis

Metoclopramide

397

Metoclopramide SE and C/I

SE: extrapyramidalC/I: used > 12 wk

398

5-alpha reductase inhibitor, decreases serum DHT for BPH and male pattern baldness

Finasteride

399

Finasteride C/I

Pregnancy (X)

400

BPH drugs that block alpha-1 R around bladder neck

Doxazosin
Terazosin
Tamsulosin (alpha-1-antagonists)

401

androgen that tx ED

Testosterone

402

Testosterone C/I

Pregnancy (X)

403

cGMP-PDE V Inhibitor, smooth muscle relaxation and inflow of blood to tx ED

Sildenafil

404

Sildenafil SE

HA (MC), sudden cardiac death

405

Sildenafil C/I

Nitrate use

406

prostaglandin analogue (PGE-1) that leads to vasodilation and platelet inhibition and tx ED; IM into corpus cavernosum or used as urethral suppository

Alprostadil

407

Alprostadil SE

curving of penis, priapism, testicular swelling/pain

408

Alprostadil C/I

pregnancy (X)

409

antimuscarinic drugs used to tx urinary incontinence

Oxybutynin
Solifenacin
Tolteridine

410

Antimuscarinic (Oxybutynin, Solifenacin, Tolteridine) C/I

glaucoma, gastric/urinary retention

411

block ACh release and tx urinary incontinence

Botulinum toxin

412

muscarinic agonist (structurally related to ACh) that acts as a parasympathomimetic and is used for acute post-op and postpartum urinary retention

Bethanechol

413

1st line tx for interstitial cystitis; also used to tx pain of UTI but does not tx infx

Phenazopyridine

414

Phenazopyridine SE

body fluids turn deep orange (will interfere with urinalysis results)

415

antibiotic that has high concentration in urine, for cystitis, uncomplicated UTIs, 1st line tx for E. coli UTI

Nitrofurantoin

416

Nitrofurantoin C/I

3rd trimester of pregnancy (can cz hemolysis of newborn)

417

HBV tx that inhibits reverse transcriptase and incorporates into viral DNA

Entecavir

418

Entecavir BBW

hepatitis B exacerbation if tx is d/c, HIV resistance (don't use in pt w/ coinfx)

419

NSAID used to tx OA and RA

Meloxicam

420

precursor of progestogens, mineralcorticoids, glucocorticoids, androgens, and estrogens

Pregnenolone

421

used in Addison's to replace mineralcorticoids

Fludrocortisone

422

Oral glucocorticoids

Hydrocortisone
Prednisone
Prednisolone
Methyprednisolone
Dexamethasone

423

Prednisone is ___ X stronger than hydrocortisone

4

424

Dexamethasone is ___ X stronger than hydrocortisone

30

425

Inhaled glucocorticoids

Fluticasone
Momentasone
Budesonide
Beclomethasone

426

Glucocorticoid topical creams/gels

Fluocinonide
Triamcinolone
Hydrocortisone
Clobetasol propionate
Dexamethasone

427

Glucocorticoid nasal sprays

Beclomethasone
Budesonide
Fluticasone
Mometasone

428

estrogen that is used for HT, prophylaxis of osteoporosis, naturally highest in postmenopausal F, and

Estrone

429

Estrone SE and C/I

SE: carcinogenicC/I: pregnancy (X)

430

estrogen that is used for atrophic vaginitis, BrCA, osteoporosis, DUB/AUB

Estradiol

431

Estradiol SE and C/I

SE: clot formation C/I: E+ tumor, pregnancy(X)

432

estrogen that is used for HT, atrophic vaginitis, and is highest during pregnancy

Estriol

433

Estriol C/I

pregnancy, thrombosis

434

estrogen used to tx atrophic vaginitis, F hypogonadism, osteoporosis, AUB

Conjugated Estrogen (from pregnant mare)

435

Conjugated Estrogen C/I

pregnancy (X)

436

strong E, only E used in OCP

Ethinyl Estradiol (EE)

437

prevents endometrial hyperplasia in females with uterus with postmenopausal estrogen therapy

Progesterone

438

hormones used to tx amenorrhea, DUB, PMS, fibroids, insomnia (dose at night), and is used in OCP

Progesterone

439

IUD

Levonorgestrel

440

Levonorgestrel C/I

pregnancy (X)

441

contraception, endometriosis, IM q 3 months

Medroxyprogesterone acetate

442

Medroxyprogesterone acetate C/I

pregnancy (X)

443

progestin used in OCP - alone or in combo with ethinyl estradiol (EE); also used in menopause

Norethindrone

444

only OC that are safe in nursing moms

Progestin OC (Norethindrone)
(they also have highest rate of unintended Pg)

445

Norethindrone C/I

pregnancy (X)

446

Combo OCP

Drospirenone/Ethinyl Estradiol
Norelgestromin/Ethinyl Estradiol
Norgestimate/Ethinyl Estradiol

447

ovulatory stimulant used in ovulatory dysfn in F trying to become pregnant, PCOS, post-OCP amenorrhea, some 2' amenorrhea

Clomiphene

448

Clomiphene SE

ovarian hyperstimulation syndrome, hepatic dysfn

449

Clomiphene C/I

pregnancy (X)

450

increases production of E and T, decreases cortisol

DHEA

451

DHEA C/I

breast/uterine CA, endometriosis, fibroids

452

hormone for tx male hypogonadism

Testosterone (only give if AM plasma T is < 3 ng/mL)

453

Testosterone SE (males)

gynecomastia, transfer to partner, liver CA, BPH, prostate CA

454

Testosterone SE (female)

clitoral hypertrophy, hirsuitism, acne, amenorrhea

455

Testosterone C/I

pregnancy (X)

456

competitive antagonist at androgen R, decreases T and tx hirsuitism d/t PCOS

Spironolactone

457

Insulin interactions

BB (can mask sx of hypoglycemia and prolong recovery)

458

very rapid onset insulin (1 hr), very short-acting (3-4 hr), bolus dosing with meals

Lispro

459

rapid onset insulin (2-3 hr), short-acting (5-7 hr)

Regular

460

slow onset insulin (12 hr), long-acting (24 hr)

Glargine

461

rescue of hypoglycemia; given IV, IM, SQ

Glucagon

462

Glucagon C/I

pheochromocytoma

463

synthetic ADH, tx diabetes insipidus, limits H2O eliminated in urine

Desmopressin

464

Desmopressin SE

seizures, hyponatremia

465

labor/let down/love

Oxytocin

466

IV or nasal spray, postpartum hemorrhage, labor induction, incomplete abortion

Oxytocin

467

Oxytocin C/I

pregnancy (X)

468

prolactin blocker, dopamine agonist; tx hyperprolactinemia or prolactin-secreting adenoma

Bromocriptine

469

GH agonist used to tx dwarfism, growth failure (peds), HIV cachexia

Somatropin

470

stimulates chondrocytes, protein synthesis, EPO

Somatropin

471

given with Octreotide for acromegaly

Bromocriptine

472

somatostatin analogue that tx acromegaly, VIP tumor, carcinoid tumor

Octreotide

473

Octreotide SE

hyper/hypoglycemia, cardiac conduction d/o

474

iodine replenisher, radiation protection, inhibits release of thyroid hormone (ST); can be used in tx of both hyper and hypothyroidism

Lugol's sol'n

475

inhibits thyroid hormone synthesis, blocks TPO, safer than PTU

Methimazole

476

inhibits TPO, inhibits conversion of T4 to T3, preferred agent in thyroid storm

Propylthiouracil (PTU)

477

Propylthiouracil (PTU) SE

agranulocytosis, life-threatening hepatotoxicity

478

T4

Levothyroxine

479

Levothyroxine C/I

uncorrected adrenal deficiency

480

T3

Liothyronine

481

T4/T3 blend from desiccated pig thyroid

Thyroid USP

482

from C-cells, opposes PTH, decreases serum Ca++; tx Paget's disease of bone, hypercalcemia, postmenopausal osteoporosis

Calcitonin

483

induces ovulation and tx infertility in F; increases sperm count in M and helps testes descend

hCG

484

hCG SE

ovarian hyperstimulation syndrome

485

hCG C/I

pregnancy (X)

486

powerful antioxidant that tx disturbed biorhythms and sleep d/o

Melatonin

487

increases # and affinity of insulin R in periphery, decreases hepatic glucose output

Metformin(Biguanide)

488

Metformin SE

lactic acidosis, diarrhea, B12 deficiency

489

Metformin C/I

metabolic acidosis, T1DM

490

sulfonyluria that stimulates insulin release

Glyburide

491

Glyburide SE

hypoglycemia

492

Glyburide C/I

DKA, sulfa allergy

493

insulin sensitizer in periphery

Pioglitazone

494

Pioglitazone BBW

cause/worsen heart failure

495

Pioglitazone C/I

CHF and liver disease

496

GLP1 agonist; incretin mimetic to increase insulin secreted in elevated blood glucose, slows gastric emptying

Liraglutide

497

SGLT2 antagonist that lowers renal glucose threshold, leading to increase urinary glucose excretion

Canaglifozin

498

Canaglifozin SE

increased urination, vag/penis stuff

499

DPP-4 inhibitor that increases/prolongs incretin increasing insulin release and decreasing serum glucose

Sitagliptin