Flashcards in Exam 2 Deck (90):
What is the nature of inhibition of CP450?
What is special about Grapefruit Juice?
Inhibits cytochrome P450 and therefore inhibits the metabolism of many drugs/herbs.
Chloral hydrate can potentiate alcohol and be used as a
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
Fast acting, short term drug used for quickly initiating heavy sedation
which drugs would have been useful in Bedlam?
Cessation of Triazolam can cause
Short acting drug
used for insomnia, anxiety, and alcohol withdrawal
Can cause paranoid or suicidal ideation and impair memory, judgment, and coordination
Oxazepam (Serax) and Alprazolam (Xanax)
Used for short and long term treatment of panic attacks
Because females metabolize Zolpidem (Ambien) slower than males, they tend to have more side effects, which include?
○ Sleep walking
○ Daytime drowsiness
○ GI distress
An Inhibitory neurotransmitter that activates/opens chloride channels
GABA agonists have what affect?
increases inhibition --> Calms/sedates
Selectively increases the frequency of chloride channel opening (induces hyperpolarization)
Benzodiazepines have ______ binding sites
Used for anesthetic, seizure disorders and anxiety/nervous tension
Barbiturates enhance _____ receptors
Diazepam, Oxazepam, and Lorazepam are examples of
A Non-benzo sedative that is a good first line therapy for anxiety
Buspirone has a slow onset and binds to
serotonin and D-2 receptors
Side Effects of Buspirone include
increased prolactin and Galactorrhea
Ritalin or Adderall is the amphetamine?
Mixed amphetamine salts with 4-6 hour duration (short-acting)
A methylphenidate with a 3-5 hour duration and rapid onset
Most common med for ADHD in adults?
Both Ritalin and Adderall increase the concentrations of
Epinephrine, Norepinephrine, and dopamine
a sedative and antihypertensive drug that is given if patients are
unresponsive to stimulants (Mostly to calm the patient)
Therapeutic strategy for ADHD?
frontal lobe stimulation
First line therapy for ADHD?
non-stimulant options for ADHD?
A Norepinephrine reuptake inhibitor with potentially dangerous interactions with MAO inhibitors
Atomoxetine (Strattera) may increase
BP and heart rate
What medicine for COPD has Salmeterol and Fluticasone in it?
Bronchial spasm due to irritation from Exercise, Emotions, Infection, or Extreme temperatures
Extrinsic Asthma is caused by
Immune mediated hypersensitivity (Allergy etc)
Both Beta 2 agonists and Anticholinergic act on
smooth muscle and and autonomics
Side effects of Anticholinergics
Reduce parasympathetic secretion of mucus -->
○ Dry mouth
○ Blurred vision
○ Urinary retention
An Anticholinergic useful in treating acute symptoms
Ipratropium bromide (Atrovent)
An Anticholinergic with a longer duration of activity
Contraindications for Anticholinergics
- Narrow angle glaucoma
Relaxes smooth muscle and bronchodilates
Beta 2 agonists (short acting)
Albuterol (Proventil/Ventolin), pirbuterol (maxair), terbutaline (Brethine) are examples of
Beta 2 agonists
Rank priorities for Asthma treatment in order of therapeutic importance
Anti-inflammation (MOST IMPORTANT) --> Bronchodilation --> mucolysis
MOST IMPORTANT treatment for asthma?
Prevents mast cells from releasing chemical mediators by Inhibiting calcium transport into mast cells
why is Cromolyn sodium prefered for children over corticosteroids?
Cromolyn sodium doesn't inhibit the immune system or disrupt linear growth.
beta 2 agonists have what effect on the heart?
Positive chronotropic (Speeds up)
What are the side effects of corticosteroids, such as Methylpredn isolone (Medrol) and Prednisone (Deltasone), for asthma?
Immune suppression, Gastric lining damage, and Osteoporosis
Selectively inhibit angiotensin II receptors and prevents vasoconstriction and the effects of aldosterone secretion
benefit of Losartan over ACE inhibitors
lower risk for cough and hyperkalemia
Side effects of losartan
- URT infections
- Viral infections
Doxazosin (Cardura), Prazosin (Minipress), Terazosin (Hytrin) are examples of
Alpha-1 receptor blockers
Induces vasodilation and used for treating BPH
Alpha-1 receptor blockers
Side effects of Alpha-1 receptor blockers
- “First dose phenomenon”, vivid dreams, and depression
“First dose phenomenon” from alpha-1 blockers includes
Dizziness, faintness, palpitations, and syncope
Which drug class would not mix with alpha blockers?
- Alpha-1 receptor blockers
Viagra + Alpha-1 receptor blockers can cause dangerous
Blood pressure drug that reduces peripheral resistance?
Depletes/leeches catecholamines out of the CNS
Side effects of reserpine
Suicidal ideation and depression, Impotence, Bradycardia, Drowsines, and Nasal congestion
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 has a long or short half-life?
Digitalis Toxicity/side effects
- Small therapeutic index
- Blue/green visual changes
- Cardiac arrhythmias
Digitalis Interacts with spironolactone to cause
Used in the treatment of patients with progressive heart failure due to left ventricular systolic dysfunction
Digitalis is contraindicated by
AV node blockage
Selectively inhibits the absorption of dietary and biliary cholesterol
MOA for Ezetimibe (Zetia)
Prevents cholesterol uptake by liver and Reduces hepatic cholesterol storage
lowers TG as well as some lowering of LDL and raising of HDL
Niacin (Vitamin B3)
Most effective agent for increasing HDLs and Decreases LDLs 10-20%
Niacin (Vitamin B3)
Side effects of Niacin (Vitamin B3)
- Flushing and histamine release (take aspirin before to reduce)
- Increased risk of hyperuricemia and gout
- Nausea and abdominal pain
cholesterol binding resins decreases the absorption of what other drugs?
Anti-seizure meds and oral conrtraception
Is COPD treatment palliative or curative?
Induces bronchodilation and Inhibits release of histamine and leukotrienes
Theophylline, which is a Methylxanthine
Methylxanthines are used to treat
- Liver disease
- Congestive heart failure
Methylxanthines like thephylline will interact with larges amounts of
Prevents sodium/chloride reabsorption in the Proximal/Distal tubule and Loop of henle
1st line therapy for Hypertension
Increases urinary output of
sodium and chloride
Calcium Channel blockers that reduce heart rate and conduction at AV node
Diltiazem hydrochloride and Verapamil HCL
4th line therapy for HTN and used to treat ischemic heart disease
Calcium Channel blockers
Ramipril (Altace), Benazepril (Lotensin), Captopril (Capoten) are examples of
Prevents the conversion of angiotensin 1 to angiotensin 2 which results in vasodilation
First choice for hypertensive diabetic patients
Side effects of ACE inhibitors
- Chronic dry cough
Contraindications to ACE inhibitors
Renal artery stenosis