Drugs Flashcards
(195 cards)
1
Q
Heparin affects what clotting factors
A
II (Prothrombin) and X (Stuart-Factor)
2
Q
It binds to antithrombin III to increase activity
A
Heparin
3
Q
Antidote for Heparin
A
Protamine sulfate
4
Q
What clotting factors does warfarin affect?
A
Vit K-dependent: II (prothrombin), VII (Stable factor), IX (Christmas factor, X (Stuart factor)
5
Q
Antidote for warfarin
A
Vitamin K
6
Q
Treatment for tic douloureux
A
Carbamazepine (Tegretol)
7
Q
Antiepileptic drugs (2)
A
Benzodiazepine - diazepam
Diphenylhydantoin - phenytoin
8
Q
Drug contraindicated for hyperthyroidism
A
Epinephrine. May cause thyroid storm
9
Q
Drugs for hyperthyroidism
A
Propythiouracil (PTU)
Methimazole
10
Q
Drug for hypothyroidism
A
Levothyroxine (synthethic thyroxine)
11
Q
tx for anaphylaxis
A
epi
adult dose: 0.5mL of 1:1000 or 0.5mg of epi
pedia dose: 0.01mg/kg (max dose 0.3mg)
12
Q
Vancomycin side effect
A
Red man syndrome
13
Q
Tx for TB
A
RIPES / StRIPE
Rifampicin
Isoniazid (1st line, most hepatotoxic)
Pyrizinamide
Ethambutol
Streptomycin (ototoxic)
14
Q
Tx for hansen’s disease
A
Aka leprosy (Mycobacterium leprae)
Rifampin + dapsone (sulfone/sulfonamide)
15
Q
content of artificial tears and artificial saliva
A
artificial tears - hydroxypropyl cellulose
artificial saliva - hydroxymethyl cellulose
16
Q
tx for sjogren’s syndrome
A
- immunosuppressant drugs such as
-cyclosporine,
-corticosteroids (also an anti-inflammatory) - cholinergic drugs (parasympathomimetic agents) - pilocarpine
17
Q
tx for toxicities
A
activated charcoal
syrup of ipecac
gastric lavage (deposit then aspirate)
cathartics (laxative)
18
Q
most important liver microsomal enzyme because it metabolizes most drugs
A
cytochrome p450
19
Q
plasma enzyme important for metabolizing drugs
A
plasma pseudocholinesterase metabolizes esters and succinylcholine
20
Q
bypasses metabolism stage of pharmacokinetics? bypass absorption?
A
bypass absorption - IV route
bypass metabolism - nitrous oxide
21
Q
double i na anes but ester?
amide na sa both sa liver and plasma namemetabolize?
A
piperocaine - ester
articaine - amide but sa both metabolized
22
Q
Tx for amoebiasis
A
Antiprotozoal and antibiotics
Co-trimoxazole (bactrim) - trimethoprim + sulfamethoxazole
Or
Metronidazole (anaerobes only)
23
Q
Tx for malaria
A
Doxycycline
Quinine analog (mefloquine)
Primaquine
Chloroquine
“#1clean queen”
24
Q
Tx for angina pectoris
A
Nitrates.
Nitroglycerin (sublingual)
Amyl nitrate (inhalation drug)
25
antibiotic prophylaxis (recommended dose)
30-60mins before invasive procedure
Amoxicillin (oral and parenteral) - 2g (Adult), 50mg/kg (child)
ampicillin (parenteral) - 2g (A), 50mg/kg (C)
cefalexin (oral and parenteral) - 2g (A), 50mg/kg (C)
azithromycin and clarithromycin (oral and parenteral) - 500mg (A), 15mg/kg (C)
*clindamycin (oral and parenteral) - 600mg (A), 20mg/kg (C)
*not recommended according to ADA 2021
26
Time required for a drug to reduce half of its initial value
Half-life
27
Rate at which the active drug is removed from the body
Clearance rate
28
Differentiate zero-order kinetics and first-order kinetics
Zero-order = clearance rate is constant and is **not** dependent on concentration of drug in plasma fluid
First-order = clearance rate is dependent on the concentration of drug. Half life ang constant
**Drugs that follow zero-order have higher chance to accumulate in the body**
29
Amount of drug eliminated is dependent on the concentration of drug in the plasma fluid
First-order kinetics
30
Amount of drug eliminated is constant and not dependent on the concentration of drug in the plasma fluid
Zero-order kinetics
31
Free-floating drugs in the plasma fluid?
Drugs attached to plasma protein?
Free-ionized drug
Bound drug (reservoir of free-ionized)
32
Phenomenon of drug metabolism whereby the concentration of orally taken drugs is reduced before reaching the systemic circulation
First-pass effect
33
Branch of pharmacology concerned with effects of drugs and the mechanism of their action
Pharmacodynamics
34
Branch of pharmacology concerned with movements of drugs within the body
Pharmacokinetics (ADME)
35
It is the accumulation of drug because it cannot be excreted by the body
Cumulation
36
Drugs contraindicated for glaucoma
Diazepam and anticholinergic drugs
37
Study of damage to fetus during development?
Study of drug dosage?
Teratology - damage
Posology - dosage
38
Common teratogenic drugs and their effects
1. Phenytoin (anti seizure)
2. Thalidomide (anti cancer) - shortened limbs
3. Tetracycline (antibiotic) - teeth stain (intrinsic), altered bone growth
39
Amount of drug that reaches the circulatory system after administration
Bioavailability
40
Drug pH that influence absorption
Drug must be weak acids (pH 6) or weak bases (pH 8) = more lipid soluble
41
Influences bioavailability
Drug solubility
Route
First-pass effect
42
dosage of drug needed to produce an effect
potency
43
refers to the effect of a drug
efficacy
*a drug can be more potent but less efficacious (fentanyl is more potent that morphine)
44
maximum effect of a drug where no effect is added even though drug dose is increased
maximal effect
45
a ratio that measures the relative safety of a drug
therapeutic index
TI = LD50/ED50 or TI = TD50/ED50
LD50 - median lethal dose (kill 50% of population)
TD50 - median toxic dose
ED50 - median effective dose (dose that is effective to 50% of population)
*higher TI means safer drug*
46
targets of drug action
1. receptors
ex. narcotics ➡️ opioid receptors (mu, kappa, delta)
pilocarpine ➡️ muscarinic receptors
epinephrine ➡️ adrenergic receptors
2. enzymes
ex. MAO inhibitor ➡️ monoamine oxidase
anti-cholinesterase ➡️ acetyl-cholinesterase
47
ability of drug to bind to its target site
affinity
48
Ability of drug to procude an effect after binding to its target site
intrinsic activity
*all drugs have affinity but NOT all drugs gave intrinsic activity
49
full agonist vs antagonist vs partial agonist
FA - elicits maximal response by activating all or a portion of the receptors (ex. Pilocarpine)
antagonist - with affinity but no intrinsic activity (belladona alkaloids - atropine and scopolamine aka hyoscine butylbromide)
partial agonist - with affinity but lesser intrinsic activity; produces less maximal response even all the receptors are occupied (acts as agonist and antagonist)
50
clark’s occupational theory vs paton’s rate theory
clark - drug effect is proportional to the number of receptors occupied
paton - drug effect is proportional to the rate at which drug and receptor combine
51
types of sedation
1. minimal (conscious) - relieves anxiety
2. moderate (depressed consciousness) - can still respond to external stimuli
3. deep (depressed consciousness) - only responds to painful and repeated stimuli
52
Ultra-short acting barbiturates
Methohexital and Thiopental
53
Short-acting barbiturates
secobarbital and pentobarbital
used for insomnia
54
intermediate acting barbiturates
amobarbital and butabarbital
used for insomnia
55
long acting barbiturates
phenobarbital, mephobarbital and primidone
56
used for induction of general anesthesia
Sedative
**ultra-short acting barbiturates **(thiopental, methohexital)
anticonvulsants/antiseizures
**Benzodiazepines (non-barbiturate sedative) ex. Midazolam (most common), diazepam, lorazepam (short-acting)**
57
barbiturates vs non-barbiturates
barbs - more potent, with barbaric acid
non - barbs - less potent, without barbaric acid
58
common sedative drug used in pediatric patients
Chloral hydrate (non-barbiturates)
59
non-barbiturate drug that is an anxiolytic but also an antihistamine and anti-cholinergic
diphenhydramine
60
mechanism of action of sedatives (barbiturates and non-barbiturates)
1. affects reticular activating system (RAS)
2. activates GABA receptors (gamma amino butyric acid) - inhibition of the different parts of CNS
61
most common inhibitory neurotransmitter
gamma amino butyric acid
Other inhibitory: glycine, serotonin, dopamine
62
Sedative-hypnotics drug uses
sedation
induction of G.A.
insomnia
anti-seizure and anti-anxiety
**does not produce analgesia**
63
adverse effects of sedatives
drug dependence
stimulates prophyrin production (porphyrism)
respiratory depression - death
coma
64
drug interaction of sedatives
increases activity of Liver microsomal enzymes (cp450 = faster metabolism)
increase activity of Coumarin-related agents
*precaution to combine with other CNS depressants
65
drug interaction of sedatives
increases activity of Liver microsomal enzymes (cp450 = faster metabolism)
increase activity of Coumarin-related agents
*precaution to combine with other CNS depressants
66
common anti-convulsant/anti-seizure drugs
benzodiazepines
**phenytoin/ diphenylhydantoin / dilantin**
carbamazepine / tegretol
valproic acid
barbiturates
67
anti seizure drug that is also anti-arrhythmic
phenytoin/ diphenyldantoin / dilantin
68
anti-seizure drug that is also a treatment of tic douloureux
carbamazepine
69
mechanism of action of anti-convulsants/anti-seizures
activates GABA receptors
**like the sedatives**
70
mechanism of action of anti-convulsants/anti-seizures
activates GABA receptors
**like the sedatives**
71
drug uses of anti-seizures
anti-convulsant/anti-seizure or anti-epileptic
anti-anxiety (benzos)
induction of anes (benzos)
insomnia
72
adverse effects of anti-seizures/anti-epileptic
severe sedation
**paradoxical excitement (benzos, nitrous oxide)**
drug dependence
respiratory depression
gingival hyperplasia (phenytoin / diphenylhydantoin/ dilantin)
73
drug interaction: anti-seizures
precaution to combine with other CNS depressants
74
diazepam is slowly and poorly absorbed in what route of admin?
intramuscular route
75
drugs with anticholinergic effects but are not generally anticholinergics?? secondary effect lang nila yun
DiTriBeAM
Diphenhydramine
Tricyclic antidepressants
benzodiazepines
antipsychotic agents
meperidine (narcotic)
76
drug interaction types
1. synergistic 1 +1 > 2 (CNS depressants - SNAB)
2. additive 1 + 1 = 2 (nsaids and corticosteroids)
3. antagonistic 1 + 1 = 0 (narcotic and naloxone)
4. potentiation 1 +0 = 2 (paracet and caffeine)
77
CNS depressants
sedative -hypnotics
narcotics
alcohol
benzodiazepine
78
Tx for herpes zoster
Aka shingles from VZV
**Acyclovir**
79
Mechanism of action of narcotics
Acts on opioid receptors (mu kappa delta) in:
-limbic system: emotion
-area postrema: n/v (medulla)
-solitary nuclei: gag reflex etc (medulla)
-substantia gelatinosa of rolando: "gate"
80
Endogenous opioids produced by our body
Enkephalins and endorphines
81
What is lomotil a combination of?
Diphenoxylate (opioid)
Atrophine (anti-cholinergic/decreases GI motility)
82
Drug effects of narcotics
Analgesia
Sedation
Euphoria
Dysphoria
**Anti-tussive**
Drug dependence
Nausea
Respiratory depression
83
Morphine Triad (overdose)
Myosis (pin point pupils)
Coma
Respiratory depression
84
Drugs combined to induce neuroleptic analgesia
Neuroleptic analgesia (amnestic and analgesic state)
Butyrophenone (Droperidol) and Fentanyl
(Forget BUTY DROgs)
*Neuroleptic agents are your hallucinogens, major tranquilizers, or anti-psychotics.
85
Non-scheduled narcotic agent
Tramadol
86
Aka heroin
Diacetylmorphine (narcotic)
87
Antagonist of narcotics
**Naloxone**
Naltrexone
88
Antagonist of benzodiazepines
Flumazenil
89
Which narcotic agents are converted by the body into CNS stimulant
Meperidine -normeperidine
Propoxyphene -norpropoxyphene
90
Acute tolerance to drugs
Tachyphylaxis
91
Drugs used for general anesthesia
Ketamine
Propofol
Etomidate
(Eto Protulugin Keta)
Induction: ultrashort acting barbiturates and benzos (**midazolam**, diazepam, lorazepam)
Inhalation drugs: halothane, desflurane
92
Used for dissociative anesthesia
Ketamine
93
Most commonly used sedative drug in dentistry
Midazolam (benzodiazepines)
94
Differentiate target of narcotic analgesic and non-narcotic analgesics
Narcotic - blocks pain in CNS
Non-narcotic - blocks pain *primarily* in the PNS
95
Mechanism of action of non-narcotic analgesics
Inhibit activity of cyclooxygenase
96
Explain prostaglandin production
Phospholipid --(phospholipase)> arachidonic acid --(lipooxygenase)> leukotrienes bind to bronchial tree--> bronchoconstriction
-----
Arachidonic acid --cox1(pns)> **thromboxane A2** (platelet aggregation) and **prostaglandin** (gastric protection)
----
Arachidonic acid --cox2(cns)> prostaglandins (fever, pain, headache)
----
Arachidonic acid --cox2(pns)> **prostaglandins** (pain, inflammation), **prostacyclin** (inflammation) *both are vasodilators which increase renal blood flow*
97
Acetaminophen action
Centrally acting cox2 inhibitor
Weak peripherally acting cox1 and cox2 inhibitor
98
NSAIDS mechanism of action
Inhibits cox1 and cox2 (peripheral and central)
99
Drug interactions of nsaids
Enhance effects of warfarin
Nsaid + nsaid = exacerbated effects
Nsaid + paracetamol = synergistic
100
Other name for paracetamol
Acetaminophen
APAP (a-pam aminophenol)
101
Nsaids drug examples
Ibuprofen, mefenamic acid, naproxen, aspirin, diclofenac, piroxicam, indomethacin, sulindac, nabumetone, ketorolac, tolmetin, oxaprozin, flurbiprofen, ketoprofen, diflunisal, etodolac, cox2 inhibitors
102
Selective cox 2 inhibitors
Etoricoxib
Celecoxib
Lumiracoxib
Valdecoxib and rofecoxib (banned)
High cardiovascular risk
No or lessened GI irritation
103
Mechanism of action of aspirin
**Irreversibly** inhibits platelet COX1
*Blood thinner
*Acetyl salicylic acid (ASA)
*Aspirin and ibuprofen are least toxic than other nsaids
104
An NSAID safest for patients at high risk for GI bleeding but higher risk for cardiovascular toxicity
Celecoxib (+omeprazole)
105
Nsaids for patients with renal insufficiency
**Nonacetylated salicylates**
Magnesium choline salicylate
Sodium salicylate
Salicyl salicylate
106
Drug used to treat salicylism
**sodium bicarbonate**
Salicylism is associated with aspirin toxicity w/ sweating, drowsiness, hallucinations, convulsions, coma
107
Toxic prodrug that is coverted to acetaminophen
Phenacetin
108
Mechanism of action of synthetic glucocorticoids (corticosteroids)
Inhibits phospholipase a2
(No arachidonic acid)
109
effects of corticosteroid drugs
Bronchodilators
Immunosuppressant
Anti-inflammatory
Antagonize vit D absorption (dec Calcium - bone resorption)
Adrenal insufficiency
Cushing's syndrome
110
Example corticosteroid drugs
Hydrocortisone
Prednisone
Prednisolone
**If with adrenal insufficiency, supplement before minor (x2) or major (x10) surgery.
111
Mechanism of action of antipsychotic drugs/neuroleptic /hallucinogens/ major tranquilizers
Dopamine receptor antagonist
112
Side effect seen in typical antipsychotic (first gen) not in atypical antipsychotics
**Extra-pyramidal syndrome**
-Tardive dyskinesia -involuntary repeated body movements usually involves the jaw, lips and tongue
-akathisia -uncontrollablr restlessness
-parkinson's syndrome
-acute dystonic reaction -spastic retrocollis or torticollis
113
1st antipsychotic drug:
Typical?
Atypical?
Typical: Chlorpromazine (phenothiazine derivative)
Atypical: clozapine
114
Example of antipsychotic drugs
**typical** "people talking backwards"
1. Phenothiazine (chlorpromazine, fluphenazine)
2. Thioxanthene (thiothixene)
3. Butyrophenone (haloperidol, droperidol)
4. New (pimozide, molindone)
**Atypical**
1. Clozapine
2. Asenapine
3. Olanzapine
4. Quetiapine
115
Used for acute phase and prevention of bipolar disorder
Lithium - 1st agent useful for bipolar disorder
Other drugs for bipolar:
Carbamazepine and valproic acid
Lamotrigine -prevent recurrence
Chlorpromazine, olanzapine, quietiapine
Olanzapine + fluoxetine
Tricyclic antidepressants
116
Tricyclic antidepressants
Imipramine -prototype
Desipramine
Amitriptyline
117
Examples of Antidepressants
Selective serotonin reuptake inhibitors (SSRI)
Serotonin-norepinephrine reuptake inhibitors (SNRI)
Tricyclic antidepressants (TCA)
Monoamine oxidase (MAO) inhibitors
118
Antabuse agent used for patients with alcoholism
Disulfiram
119
tx to accelerate closure of patent ductus arteriosus
Indomethacin (NSAID) -IV
Ibuprofen
*ductus arteriosus to bypass lungs. connects aorta and pulmonary artery*
120
only nonacid NSAID available
Nabumetone
121
Prodrug of salicylates? morphine? dopamine?
Aspirin
Remember:
Codeine to morphine
Levodopa to dopamine
122
What receptors do dopamine, isoproterenol, norepi, epi adrenergic drugs act on?
Catecholamines (direct-acting)
Dopamine: A1, B1, B2 agonist
Isoprotetenol: B1, B2 agonist (primarily bronchodilation)
Norepinephrine: mainly A1, A2 agonist, weak B1 agonist, very weak B2 agonist or none
Epinephrine: most potent alpha agonist; B1, B2 agonist
123
Drug of choice for severe allergies (anaphylactic shock)
Epinephrine
124
Example of selective alpha-1 agonist
Phenylephrine (inc BP)
-a decongestant
125
Example of alpha 2 agonist
Clonidine (Catapres)
Methyldopa
Tx for hypertension, decrease BP
126
Selective alpha-1 and Beta-1 agonists
Dobutamine "**DOB**le **U**no"
Increase BP, increase ♥️ contraction, and ♥️rate
127
Example of selective beta-2 agonist
Albuterol (Salbutamol) Sabu2mol/Albu2rol
Terbutaline 2rbutaline
Ideal for asthma
128
Indirect acting adrenergic drugs
*stimulates release of norepinephrine from adrenergic neuron
1. Tyramine
2. Mephentermine
3. Amphetamine (derived from methamphetamine)
4. Methylphenidate- (Ritalin) used as study drug
3 and 4 are classified as stimulants and used for ADHD pt
Ty MeMe Amp
129
Example of mixed acting adrenergic drug
Ephedrine (used for obesity)
130
Example of selective alpha 1-adrenergic antagonist
Prazosin - decrease BP
131
Example of non-selective beta blocker
Propanolol (prototype of B blockers)
132
interferes with the release and storage of norepinephrine in adrenergic neurons
adrenergic neuron blockers
affects both alpha and beta receptors but predominantly alpha receptors
133
example of adrenergic neuron blocker and effect
guanethidine
reserpine (anti-hypertensive and anti psychotic)
*produced transient hypertension **(increase BP)**before lowering down the blood pressure **(decrease BP)**
134
it is both an anti-hypertensive and anti-psychotic drug
reserpine - adrenergic neuron blocker
135
drugs that promote functions of acetylcholine by activating directly the cholinergic receptors or by increasing Ach in synapse? **classification?**
CHOLINERGIC DRUGS
acetylcholine-like type - mimic Ach to activate receptor
anticholinesterase - binds to acetylcholinesterase to inhibit function
136
example of acetylcholine -like type of cholinergic drugs
Pilocarpine - muscarinic agonist
muscarine - stimulates muscarinic receptors (mushroom)
nicotine - stimulates nicotinic receptors (nicotine plant)
carbachol - muscarinic and nicotinic agonist
bethanechol chloride - muscarinic agonist
BETH Punched Me Not CARmen
137
example of anticholinesterase type of cholinergic drugs
neostigmine - for myasthenia gravis
pyridostigmine - for myasthenia gravis
physostigmine - for glaucoma, reversal agent of atropine
anti-enzyme = --stigmine aka carbamates
138
reversal agent of atropine (muscarinic antagonist)
Physostigmine (anticholinesterase cholinergic drug)
139
drugs that opposes the action of acetylcholine and their classification
Anticholinergics
**A. MUSCARINIC ANTAGONIST** (belladonna alkaloids: atropine, scopolamine *hyoscine butylbromide*/buscopan) - no intrinsic activity
**B. NEUROMUSCULAR BLOCKERS** (muscle paralysis/muscle relaxation)
b.1. Non-depolarizing type (Tubocurare: Pancuronium, mivocurium) blocks nicotinic receptors….can be reversed by anti-cholinesterase neostigmine and pyridostigmine
b.2. depolarizing type (Succinylcholine or *suxamethonium*) - *contracts but no repolarization*
140
Drugs that inhibit the transmission of signals from preganglionic neurons to the postganglionic neurons of ANS
ganglionic blocking drugs (used for malignant hypertension)
141
example of ganglionic blocking drugs
Hexamethonium (prototype)
Mecamylamine (for bloodless surgical field)
*lowers BP significantly, xerostomia, constipation, blurred vision
142
example of selective beta 1 adrenergic blocker
(-olol)
metoprolol
143
antiarrhythmic drugs - suppress abnormal rhythms of heart
quinidine
procainamide
propanolol -B blocker
lidocaine
phenytoin
amiodarone
verapamil -Ca channel blocker
adenosine
144
cardiac glycosides
increase the force contraction of the heart
for patients with heart failure
DIGoxin
DIGitoxin
145
Diuretics - drugs that increase urine output
increase urine output, decrease blood volume, decrease blood pressure
Benzothiazides (-thiazide) -inhibits Na reabsorption in distal tubules of nephron, drug of choice for mild hypertension
Loop diuretics (furosemide) -reabsortion in ascending loop, most potent diuretic agent
146
drug of choice for mild hypertension / mainstay of hypertensive therapy
benzothiazides - inhibit Na reabsorption in distal tubules of nephron
147
most potent diuretic agent
loop diuretics (furosamide) - inhibits ION reabsorption in ascending loop
148
antihypertensive drugs
diuretics
alpha 1 adrenergic blockers (-ozin)
alpha 2 adrenergic agonist (Clonidine)
beta blockers (non selective, selective b1 blocker)
beta blockers with alpha 1 blocker (-ilol and -alol) carvedilol
adrenergic blocking drugs
ACE inhibitors (-pril) captopril, accupril *reduce peripheral resistance and blood volume*
Angiotensin II receptor antagonist (-artan) losartan *reduce peripheral resistance*
calcium channel blockers (-dipine and -pamil) *reduce peripheral resistance*
149
mechanism of action of antianginal drugs and examples
coronary artery dilators
nitroglycerin (sublingual)
amyl nitrate (inhalation)
Isosorbide dinitrate
150
anticoagulants
aspirin
heparin
warfarin (coumadin)
*coumarin - prototype*
151
differentiate bacteriostatic and bactericidal
bacteriostatic - inhibits bacterial growth by inhibiting metabolic pathways and bacterial division
bactericidal - kills bacteria by inhibiting formation of cell wall during cell division
*antagonistic effect*
152
beta-lactam antibiotics and mode of action
penicillin
cephalosporin
monobactams
carbapenems - broadest spectrum
**cell wall synthesis inhibitors / bactericidal** others: glycopeptides (vancomycin), bacitracin, cycloserine (for tb)
153
vancomycin is used for?
pseudomembranous colitis
methicillin-resistant staph areus
side effect: red man syndrome
154
tx for pseudomembranous colitis
vancomycin
metronidazole
155
Protein synthesis inhibitors
*bacteriostatic*
AT30MCC50
blocks 30s/50s ribosomal unit
Aminoglycosides -only one na bactericidal
Tetracycline Family
Macrolides (Azithromycin, Clarithromycin, Erythromycin)
Clindamycin (Lincosamide family with Lincomycin)
Chloramphenicol
156
Adverse effects of chloramphenicol
*one of the last resort Abx due to high toxicity and adverse effects
hemolytic anemia
gray baby syndrome
157
for pt allergic to penicillin
clindamycin (lincosamide)
macrolides (Azithromycin, Clarithromycin, Erythromycin)
158
biosynthetic pathway inhibitors
bacteriostatic
Trimethoprim
sulfonamide - mimic PABA (vit b10)
bactericidal
fluroquinolones (-floxacin) -inhibit DNA gyrase, ciprofloxacin, levofloxacin
159
co-trimoxazole (Bactrim) is a combination of?
trimethoprim + sulfamethoxazole
160
common bacteriostatic drugs
bacterio STTECC tic
sulfonamide
trimethoprim
tetracycline
erythromycin (macrolides)
clindamycin
chloramphenicol
161
Quinolones are derived from?
quinine
162
differentiate penicillin G and penicillin VK
G - benzylpenicillin, parenteral, acid unstable
VK - phenoxymethyl penicillin, oral route, acid stable
163
example of aminopenicillins? differentiate the two
amoxicillin - most common oral prophylactic antibiotics
ampicillin - parenteral
164
*widest* broad spectrum penicillins
piperacillin
ticarcillin
*anti-pseudomonas penicillin*
165
penicillinase-resistant penicillins
methicillin
nafcillin
cloxacillin
oxacillin
dicloxacillin
166
Co-amoxiclav (augmentin) is a combination of?
amoxicillin (500mg) and clavulanic acid (125mg) (beta-lactamase inhibitor)
167
Abx with disulfiram-like effects
cephalosporins
*antabuse agent*
1st gen: against gram +, narrower spectrum
5th gen: againts gram -, broader spectrum
168
antifungals
amphotericin B - given IV
nystatin - for oral candidiasis
-azoles (ketonazole, fluconazole, miconazole)
griseofulvin - most potent anti fungal
flucytosine
169
Adverse effect of tetracycline
Hepatotoxic
Photosensitivity
Resistance and superinfections
Tooth discoloration
Black hairy tongue
170
Mnemonics for cephalosporin generations and exceptions??
1st - cefa
2nd - others
3rd - -one, -ime, -ir
4th - --pi--
Except:
2nd gen - cefuroxime, cefaclor
171
MAO inhibitors should not be combined with?
Meperidine
SSRI
Ephedrine
Epinephrine
Because it can cause hyperpyrexia
172
Relationship of opioiates and nsaids, estrogen TO acid-base balance
Opioiates - depress resp center - dec respi rate - increase pCO2 - resp acidosis
Nsaids/estrogen - stimulate resp center - inc respi rate - dec pCO2 - respi alkalosis
Remember: CO2 + water = carbonic ACID
173
Acidic or basic: barbiturates? Opioiates? Local anes?
Barb - acidic
Op - basic
LA - basic
174
Used as an eye drop to decrease pressure for patients with glaucoma
Pilocarpine (muscarinic agonist)
175
Antiviral medication for hep C, RSV, hemorrhagic fever
Ribavirin aka tribavirin
176
Drug of choice for cardiogenic shock
dobutamine, norepinephrine
177
Proposed the gate control theory of pain
Melzack & Wall
178
drug reaction of oxycodone and acetaminophen
synergistic
179
first atypical antipsychotic drugs
clozapine
180
first typical antipsychotic drugs
Chlorpromazine
181
182
Classes of antiarrhythmic drugs
Class I - sodium blockers (Lidocaine)
Class II - Beta blockers (olol)
Class III - potassium blockers (amiodarone)
Class IV - Ca-channel blocker (Verapamil, Nifedipine)
183
Parent drug of warfarin
Dicoumarol
184
Carbamates Moa
Carbamates are also known as anticholinesterase
"Stigmine"
Inhibits cholinesterase = more Ach in synapse
185
drug that has 100% bioavailability even when given orally
chloramphenicol
186
plasma protein binding of acidic drugs? basic drugs?
acidic - albumin
basic - alpha1 acid glycoprotein
187
Drug metabolism under phase I and phase II?
Phase I: reduction, oxidation, hydroxylation (ex. cytochrome P450 or CYP)
Phase II: conjugation --adding another substance to make the drug more water soluble
(ex. glucuronidation, acetylation, sulfation, transferase enzymes)
remember: it is not in chronologic order kahit termed as phase I and phase II
188
drugs that follow zero-order kinetics
TAPE
theophylline
aspirin
phenytoin
ethanol
189
how to compute for onset when given the half-life?
t1/2 multiply by 4
4-5 na half lives = 94-97% will be eliminated and accumulated already
steady state: rate of accumulation is equal to the rate of elimination
190
muscarinic receptors
M1 - neurons
M2 - cardiac
m3 - visceral organs except cardiac: "glandular"
m4 - neuron
m5 - neuron
191
alpha non-selective agonist examples and uses
oxymetazoline
xylometazoline
--nasal decongestant (nasal spray)
192
Organophosphates examples and action
Echotiopate
Malathion
Parathion
(insect repellants)
increases parasympathetic tone
acetylcholinesterase -->> inc ACh in synapse ->> overstimulation
DOC: IV atropine
193
Irreversible alpha antagonist
Phenoxybenzamine
194
Antifibrinolytic agent used for patients with coagulopathies
Aminocaproic acid
195
Most potent and broad spectrum anti arrhythmic
Amiodarone (potassium channel blocker) class III
