drugs Flashcards

(34 cards)

1
Q

-setron drugs (type of drug and used to treat)

A
  • competitive inhibitors for serotonin 5HT-3 channels.

- used to treat nausea and vomiting

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2
Q

benodiazepines (diazepam / zolpidem)

A
  • positive allosteric activators/modulators.
  • Desensitize slowly
  • bind at GABAa
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3
Q

strychnine

A

glycine competitive inhibitor
highly toxic
cause excess excitation

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4
Q

antibiotics - amikasin, gentamicin and tobramycin

A

block VG Ca2+ channels in motor nerve endings

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5
Q

Botulinum Toxin

A
  • Cleaves a very restricted area of the secretory apparatus in nerve endings SNARE protein
  • SNARE protein SNAP-25. It is used to treat spasticity at the skeletal neuromuscular junction.
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6
Q

-curonium (Rocuronium or Vecuronium)

A

non-depolarizing blockers/competitive inhibitors used in surgical procedures

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7
Q

Succinylcholine

A
  • neuromuscular block for intubation

- looks like 2 ACh molecules causing depolarization and activation before blocking

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8
Q

Neostigmine

A
  • reversible cholinesterase inhibitor (increases ACh by inhibiting degradation)
  • used to improve cholinergic transmission
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9
Q

-tropiums (atropine, ipratropium, tiotropium)

A
  • ANS parasympathetic cholinergic muscarinic receptor antagonist
  • block parasympathetic ACh activation of K+ channels (ByG-protein usually would open K+ after ACh bind) -> increases HR
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10
Q

phenylephrine (selective), E and NE (nonselective)

A
  • ANS sympathetic a-1 receptor agonists
  • PLC pathway and Ca2+ liberatoin -> vasoconstriction
  • phenylephrine used to increase BP and relieve nasal congestion
  • NE used to treat hypotension last resort
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11
Q

-terols (albuterol)

A
  • ANS sympathetic B2 receptor agonist
  • delivered to airway by inhalation
  • Increase cAMP in smooth muscle -> bronchodilation
  • B2 relax smooth muscle to reduce Ca2+ contractions
  • albuterol used for asthma maintenance
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12
Q

-olol (propranolol and metoprolol)

A
  • ANS sympathetic B receptor antagonists
  • propranolol non-selective B1 and B2 blocker
  • metoprolol blocks B1: selective blocker of cardiac SNS
  • NE and E bind to B1 -> increase cAMP -> increase PKA -> increase Ca2+ -> increase heart contractility
  • B-blockers
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13
Q

cyp metabolism of -azolam / midazolam

A
  • metabolized by CYP3A4. Hydroxylized
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14
Q

cimetidine and other -tidines

function and metabolism

A
  • competitive H2 receptor blocker
  • suppress acid secretion
  • cimetidine also inhibits lots of CYPS except 2E1
  • metabolized through S oxidation
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15
Q

methylxanthines (caffeine, theophylline)

function and metabolism

A
  • competitive inhibitors of adenosine at low doses
  • inhibit phosphodiesterases and increase cAMP at higher doses
  • complimentary shape -> tighter fit
  • metabolized through N-dealkylation
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16
Q

ethanol metabolism

A
  • role in acetaminophen toxicity

- metabolized by dehydrogenases

17
Q

acetaminophen

A
  • analgesic and antipyretic

- inhibits COX

18
Q

acetaminophen metabolism

A
  • doesn’t have phase I bc already have -OH
    PHASE II
  • sulfation -> inactivated non-toxic
  • glucuronide (via UDP glucuronyl transferases in smooth ER) -> inactivated non-toxic
  • glutathione (GSH) -> use GST to rescue from toxic metabolites -> rescue acetaminophen from toxicity
19
Q

acetaminophen toxicity

A
  • CYP3A4 and CYP2E1 -> NAPQI -> not enough GSH-> toxic protein-SH -> liver cell death
  • use NAC to conjugate with toxic site and replace GSH stores
20
Q

ethanol and acetaminophen toxicity

A
  • high levels of EtOH -> use CYP2E1 -> make toxic acetaminophen intermediate NAPQI -> EtOH reduce GSH concentrations -> can’t rescue NAPQI -> liver cell death
21
Q

CYP3A4

A
  • most common CYP in drug phase I metabolism
  • -azolam and -azepams metabolized by
  • toxic in acetaminophen
22
Q

grapefruit juice flavonoids
St. John’s wort
Echinacea
Ginko

A

flavonoids inhibit CYP3A4
St. John’s wort induces CYP3A4, CYP2C19, CYP2C9, CYP2E1, and p-glycoprotein
echinacea induces CYP3A4
ginko induces CYP2C19 and CYP2C9

23
Q

-conazoles and erythromycin

A

inhibit CYP3A4

24
Q

CYP2D6

A
  • responsible for most CYP polymorphisms

- multimodal distribution on enzyme activity population

25
drugs metabolized by CYP2D6
- metoprolol - opioids - CNS drugs
26
CYP2C19 drugs
- responsible for many polymorphisms - -azepams (benzo) and -prazoles (proton-pump inhibitor) - clopidogrel - prodrug for anti-platelet. polymophism role
27
CYP2C9
- polymorphisms interfere with warfarin | - warfarin and NSAIDs metabolized
28
CYP2E1
- toxic acetaminophen and high dose ethanol metabolism -> toxicity
29
tetrodotoxin (TTX)
- Blocks voltage gated Na+ channels in nerve and muscle. | acts like a plug at the voltage-gated sodium channel doesn't allow Na+ into cell
30
Local Anesthetics
- Blocks the voltage-gated Na+ channel associated with the action potential - different than TTX bc bind to inactive state of Na+ channel
31
tetanus toxin
- inhibits the release of glycine -> can't inhibit postsynaptic neuron
32
CYP2D6 allele polymorphisms
* 2 - normal function * 1XN or *2XN - increased function (copy number variants) * 3-*6 - nonfunctioning * 9, *10, *17 - partial functioning
33
CYP2C19 allele polymorphisms
* 2 - non-functioning * 3 - partial function * 17 - increased function
34
penicillin
- toxic to GABA receptors | - blocks Cl- channel once opened