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Flashcards in Exam 2 Deck (90):
1

What is the nature of inhibition of CP450?

Competitive inhibition

2

What is special about Grapefruit Juice?

Inhibits cytochrome P450 and therefore inhibits the metabolism of many drugs/herbs.

3

Chloral hydrate can potentiate alcohol and be used as a

sedative

4

what is the mechanism of Chloral hydrate which as been used to inebriate victims of sexual assault?

- Synergism with alcohol
- Metabolised into trichloroethanol
- Absorbed quickly in the GI tract

5

"Mickey Finn"

Chloral hydrate

6

Fast acting, short term drug used for quickly initiating heavy sedation

Triazolam (Halcion)

7

which drugs would have been useful in Bedlam?

Triazolam (Halcion)

8

Cessation of Triazolam can cause

rebound insomnia

9

Short acting drug
used for insomnia, anxiety, and alcohol withdrawal

Oxazepam (Serax)

10

Can cause paranoid or suicidal ideation and impair memory, judgment, and coordination

Oxazepam (Serax) and Alprazolam (Xanax)

11

Used for short and long term treatment of panic attacks

Alprazolam (Xanax)

12

Because females metabolize Zolpidem (Ambien) slower than males, they tend to have more side effects, which include?

○ Hallucinations
○ Sleep walking
○ Nightmares/night-terrors
○ Daytime drowsiness
○ Headache
○ GI distress
○ Dizziness

13

An Inhibitory neurotransmitter that activates/opens chloride channels

GABA

14

GABA agonists have what affect?

increases inhibition --> Calms/sedates

15

Selectively increases the frequency of chloride channel opening (induces hyperpolarization)

Benzodiazepines

16

Benzodiazepines have ______ binding sites

allosteric

17

Used for anesthetic, seizure disorders and anxiety/nervous tension

Barbiturates

18

Barbiturates enhance _____ receptors

GABA

19

Diazepam, Oxazepam, and Lorazepam are examples of

benzodiazepines

20

A Non-benzo sedative that is a good first line therapy for anxiety

Buspirone

21

Buspirone has a slow onset and binds to

serotonin and D-2 receptors

22

Side Effects of Buspirone include

increased prolactin and Galactorrhea

23

Ritalin or Adderall is the amphetamine?

Adderall

24

Mixed amphetamine salts with 4-6 hour duration (short-acting)

Adderall

25

A methylphenidate with a 3-5 hour duration and rapid onset

Ritalin

26

Most common med for ADHD in adults?

ritalin

27

Both Ritalin and Adderall increase the concentrations of

Epinephrine, Norepinephrine, and dopamine

28

a sedative and antihypertensive drug that is given if patients are
unresponsive to stimulants (Mostly to calm the patient)

Clonidine

29

Therapeutic strategy for ADHD?

frontal lobe stimulation

30

First line therapy for ADHD?

stimulants

31

non-stimulant options for ADHD?

atomoxetine (strattera)

32

A Norepinephrine reuptake inhibitor with potentially dangerous interactions with MAO inhibitors

Atomoxetine (Strattera)

33

Atomoxetine (Strattera) may increase

BP and heart rate

34

What medicine for COPD has Salmeterol and Fluticasone in it?

Advair

35

Bronchial spasm due to irritation from Exercise, Emotions, Infection, or Extreme temperatures

Intrinsic Asthma

36

Extrinsic Asthma is caused by

Immune mediated hypersensitivity (Allergy etc)

37

Both Beta 2 agonists and Anticholinergic act on

smooth muscle and and autonomics

38

Side effects of Anticholinergics

Reduce parasympathetic secretion of mucus -->
○ Dry mouth
○ Blurred vision
○ Urinary retention

39

An Anticholinergic useful in treating acute symptoms

Ipratropium bromide (Atrovent)

40

An Anticholinergic with a longer duration of activity

Tiotropium

41

Contraindications for Anticholinergics

- Narrow angle glaucoma
- BPH
- Pregnancy

42

Relaxes smooth muscle and bronchodilates

Beta 2 agonists (short acting)

43

Albuterol (Proventil/Ventolin), pirbuterol (maxair), terbutaline (Brethine) are examples of

Beta 2 agonists

44

Rank priorities for Asthma treatment in order of therapeutic importance

Anti-inflammation (MOST IMPORTANT) --> Bronchodilation --> mucolysis

45

MOST IMPORTANT treatment for asthma?

Anti-inflammation

46

Prevents mast cells from releasing chemical mediators by Inhibiting calcium transport into mast cells

Cromolyn sodium

47

why is Cromolyn sodium prefered for children over corticosteroids?

Cromolyn sodium doesn't inhibit the immune system or disrupt linear growth.

48

beta 2 agonists have what effect on the heart?

Positive chronotropic (Speeds up)

49

What are the side effects of corticosteroids, such as Methylpredn isolone (Medrol) and Prednisone (Deltasone), for asthma?

Immune suppression, Gastric lining damage, and Osteoporosis

50

Selectively inhibit angiotensin II receptors and prevents vasoconstriction and the effects of aldosterone secretion

Losartan

51

benefit of Losartan over ACE inhibitors

lower risk for cough and hyperkalemia

52

Side effects of losartan

- URT infections
- Viral infections
- Dizziness
- Fatigue

53

Doxazosin (Cardura), Prazosin (Minipress), Terazosin (Hytrin) are examples of

Alpha-1 receptor blockers

54

Induces vasodilation and used for treating BPH

Alpha-1 receptor blockers

55

Side effects of Alpha-1 receptor blockers

- “First dose phenomenon”, vivid dreams, and depression

56

“First dose phenomenon” from alpha-1 blockers includes

Dizziness, faintness, palpitations, and syncope

57

Which drug class would not mix with alpha blockers?

- Alpha-1 receptor blockers
- Viagra
- Paxil

58

Viagra + Alpha-1 receptor blockers can cause dangerous

hypotension

59

Blood pressure drug that reduces peripheral resistance?

reserpine

60

Depletes/leeches catecholamines out of the CNS

reserpine

61

Side effects of reserpine

Suicidal ideation and depression, Impotence, Bradycardia, Drowsines, and Nasal congestion

62

Sodium/potassium pump inhibitor (NA+/K+ ATPase) which causes Less Ca2+ ejected from the cell and drives more powerful contractions of the myocardium (Increased ejection fraction)

digitalis

63

digitalis has a long or short half-life?

long

64

Digitalis Toxicity/side effects

- Small therapeutic index
- Blue/green visual changes
- Cardiac arrhythmias
- Seizures
- Delirium
- Fatigue/malaise

65

Digitalis Interacts with spironolactone to cause

menstrual irregularities

66

Used in the treatment of patients with progressive heart failure due to left ventricular systolic dysfunction

Digitalis

67

Digitalis is contraindicated by

AV node blockage

68

Statins deplete

COQ10

69

Selectively inhibits the absorption of dietary and biliary cholesterol

Ezetimibe (Zetia)

70

MOA for Ezetimibe (Zetia)

Prevents cholesterol uptake by liver and Reduces hepatic cholesterol storage

71

lowers TG as well as some lowering of LDL and raising of HDL

Niacin (Vitamin B3)

72

Most effective agent for increasing HDLs and Decreases LDLs 10-20%

Niacin (Vitamin B3)

73

Side effects of Niacin (Vitamin B3)

- Hepatotoxicity
- Flushing and histamine release (take aspirin before to reduce)
- Increased risk of hyperuricemia and gout
- Nausea and abdominal pain

74

cholesterol binding resins decreases the absorption of what other drugs?

Anti-seizure meds and oral conrtraception

75

Is COPD treatment palliative or curative?

Palliative

76

Induces bronchodilation and Inhibits release of histamine and leukotrienes

Theophylline, which is a Methylxanthine

77

Methylxanthines are used to treat

COPD

78

Methylxanthine contraindications

- Ulcers
- Seizures
- Arrhythmias
- Liver disease
- Congestive heart failure

79

Methylxanthines like thephylline will interact with larges amounts of

caffeine

80

Prevents sodium/chloride reabsorption in the Proximal/Distal tubule and Loop of henle

Furosemide (Lasix)

81

1st line therapy for Hypertension

Thiazide diuretics

82

Hydrochlorothiazide (Hydrodiuril/Microzide)
Increases urinary output of

sodium and chloride

83

Calcium Channel blockers that reduce heart rate and conduction at AV node

Diltiazem hydrochloride and Verapamil HCL

84

4th line therapy for HTN and used to treat ischemic heart disease

Calcium Channel blockers

85

Ramipril (Altace), Benazepril (Lotensin), Captopril (Capoten) are examples of

ACE inhibitors

86

Prevents the conversion of angiotensin 1 to angiotensin 2 which results in vasodilation

ACE inhibitors

87

First choice for hypertensive diabetic patients

ACE inhibitors

88

Side effects of ACE inhibitors

- Chronic dry cough
- Rashes
- Dizziness
- Hyperkalemia
- Angioedema

89

Contraindications to ACE inhibitors

Renal artery stenosis

90

slow HR and reduce BP by blocking norepinephrine and renin

beta blockers