Exam 4 Flashcards

Question

Lepirudin

Answer 1

Thrombin inhibitor Yeast polypeptide IV injected, very short halflife. Used as an anticoagulant in patients with heparin-induced thrombocytopenia. Side effects include hypersensitivities, bleeding, may affect fetus. No antidote for OD.

Answer 2

tPA Serine protease Activates fibrin bound plasminogen to plasmin. Can be reversed with Aminocaproic acid

Answer 3

Reverses alteplase (tPA)

Answer 4

Antihemophilic factor | Treats hemophilia A, which is a factor VIII deficiency

Answer 5

Oral antiplatelet Inhibits platelet aggregation Inhibits the irreversible binding of ADP to the ADP receptor Platelets exposed to clopidogrel are thus effected for their entire lifespan. Used to prevent MI, stroke in high risk patients

Answer 6

Blocks platelet adhesion to the subendothelium by inhibiting phosphodiesterase, increasing cAMP

Answer 7

Antagonist of the platelet glycopritein IIb/IIIa receptor. | Inhibits platelet aggregation.

Answer 8

Treatment for megaloblastic anemia Pernicious anemia is an example Megaloblastic because cells lack the nutrients that allow them to divide. They just get larger.

Answer 9

Chelation agent used to treat iron toxicity

Answer 10

Required for DNA synthesis Deficiency is a cause if megaloblastic anemia Metabolized to THF in order to be used Less than 5ng/ml is deficiency Increased requirement in pregnancy Make sure that your diagnosis is right, because if the patient's anemia is due to B12 deficiency and you treat with only folate, you'll have CNS damage.

Answer 11

Cofactors for enzyme... Look them up. | Microgram requirement as opposed to nanogram requirement for folate

Answer 12

``` Increases the production of erythrocytes Released by kidney cells These cells respond to oxygen levels. Cloned product from recombinant DNA Used to treat anemia associated with AIDS and with chemotherapy May worsen hypertension May increase chance of clotting. ```

Answer 13

Stimulates neutrophil production

Answer 14

Stimulates production of granulocytes and macrophages

Answer 15

Classic antacid. Neutralizes HCl, producing NaCl, H2O, and CO2. CO2 can cause distention Works fast, but doesnt last long. Can cause metabolic alkalosis. Can cause problems associated with high Na intake. Used in tx of heartburn and mild gastritis. NOT useful for peptic ulcer disease.

Answer 16

Antacid. Neutralizes HCl, producing CaCl2, H2O, and CO2. Can cause metabolic alkalosis, especially in patients with high Ca intake or poor renal fxn. Can cause rebound acid excretion. NOT good for long term management of peptic ulcers. Can form complexes with some other drugs, decreasing their bioavailability.

Answer 17

Antacid. Neutralizes HCl, producing MgCl2 and H2O. (No CO2 production). Not well absorbed so it doesnt cause metabolic alkalosis like the other antacids. Can have diarrhetic effect. Poor renal function can cause Mg build-up (hypermagnesemia). Like Calcium Carbonate, can for complexes with many drugs, decreasing their bioavailability.

Answer 18

Aluminum hydroxide plus Magnesium hydroxide. Combination antacid. They are combined to minimize the side effects of each individual agent.

Answer 19

Famotidine Ranitidine Cimetidine Nizatidine Used in the tx of peptic ulcer disease (acute and preventative treatment) Also used to treat Zollinger Ellison and GERD.

Answer 20

Pantoprazole Omeprazole Lanzoprazole Esomeprazole

Answer 21

Proton Pump Inhibitors. Reduce most types of acid secretion. Some activity against H. pylori. Taken as prodrugs, metabolized to agents the covalently interact with proton pumps. Need to be taken on empty stomach. Take 3-4 days to have effect. Very effective tx for ZE, peptic ulcers, GERD. Inhibit hepatic drug metabolizing enzymes (can have drug interactions) May allow overgrowth of upper GI tract bacteria. Maybe increases risk of bone fractures in females???

Answer 22

Polymerizes in stomach to form viscous coating that covers ulcer and forms protective barrier. Needs acidic stomach to work (don't take with antacids) Side effect is constipation. Can form complexes with other drugs. Can cause Al buildup in patients with impaired renal fxn.

Answer 23

PGE 1 Analogue Increases mucus production and decreases acid secretion. Used to prevent NSAID induced GI ulcers. Can induce uterine contractions because it's a prostaglandin. DONE USE IN PREGNANT FEMALES or those who may become pregnant.

Answer 24

Coat the stomach and inhibit actions of pepsin. | Protects against ulceration.

Answer 25

Usually either a PPI or a bismuth compound in addition to 1-2 antibiotics (Clarithromycin, Amoxicillin, metronizadole, tetracycline).

Answer 26

Laxatives are the mildest, form soft stool over a period of hours/days. Cathartics are more intense, produce a prompt, fluid evacuation. Purgatives are super intense, cause pain/cramping, clean you out goooood.

Answer 27

Bulk forming laxative. | Mostly cellulose, indigestible carbs. Helps you poop, decreases risk of colon cancer.

Answer 28

Bulk forming laxative. | Synthetic cellulose, fiber.

Answer 29

Bulk forming laxative. | Fiber from Plantago seeds.

Answer 30

Bulk forming laxative. | Polyacrylic resin.

Answer 31

Laxative Inhibits absorption of water in the bowel. Can have systemic effects. Turns urine red if it's basic. Carcinogenic? Maybe, that's why we don't use it.

Answer 32

Laxative that inhibits water absorption in the bowels.

Answer 33

Laxative with effects similar to bisacodyl. | Plant extract that contains anthraquinone compounds in glycoside linkages.

Answer 34

Laxative. Hydrolyzed in small intestine to ricinoleic acid, the active agent. Acts in small intestine to decrease water absorption and stimulate peristalsis. Can produce intense effects, which is why it's no longer recommended.

Answer 35

Osmotic laxative. Poorly absorbed salt that exerts an osmotic effect, preventing water absorption. Causes fluid evacuation within 1-6 hours.

Answer 36

Osmotic laxative. | Used in combo with other laxatives to prepare bowel for surgical/endoscopic procedures.

Answer 37

Lubricating agent to help you poop. Petroleum product. Aspiration can cause lipid pneumonitis. Can decrease absorption of fat soluble vitamins (ADEK). Can leak from your anus and stain furniture...

Answer 38

Surface active agent (fecal softener) Detergent breaks up fecal mass. May increase solubility/absorption of other drugs.

Answer 39

Treats idiopathic constipation and constipation in IBS. Activates chloride channels in the intestines, increasing fluid secretion. Typical GI side effects. Safe for pregnancy? Who knows.

Answer 40

Treats idiopathic constipation and constipation in IBS. Activates gunnel cyclase, increasing cGMP, which enhances fluid secretion in the GI tract. Side effects include diarrhea, cramping, and dehydration. Don't give it to kids, they're at higher risk of dehydration.

Answer 41

Quaternary opioid antagonists used to treat opioid induced constipation. Methylnaltrexone is given parenterally, which Alvimopan can be given orally. Only appropriate for serious constipation caused by high dose opioid tx. Also used for paralytic ileus.

Answer 42

``` Nausea/vomiting Abdominal cramps Undiagnosed abdominal pain Appendicitis Intestinal Obstruction ```

Answer 43

Anti-diarrhetic Opioid analog that decreases peristalsis without having CNS effects. Now available OTC. If P-gp is inhibited, loperamide can better cross the BBB and may have CNS effects.

Answer 44

Anticholinergics used to treat irritable bowel syndrome.

Answer 45

``` General anti diarrhetic. Absorbs excess water. May inhibit some bacterial toxins. Darkens stool. Dont give to kids because you may cause Reye's. ```

Answer 46

Converted in bowel to sulfapyridine and aminosalicyclic acid. Aminosalicyclic acid has an anti-inflammatory effect (effective in UC) and sulfapyridine has antimicrobial activity. Don't give it to people allergic to sulfa...

Answer 47

mab that binds and inactivated TNFalpha and suppresses immune fxn. Tx for Crohn's disease. Given via IV. Works for some, not for others. Can cause hypersensitivity reactions and make patients more prone to infections.

Answer 48

Cholinergic agonist that increases GI tone and motility.

Answer 49

Antimicrobial agent that also stimulates motion and promotes gastric emptying. Sometimes used to treat gastroparesis.

Answer 50

Antiflatulant Surface active agent that prevents formation of large gas bubbles. Does it work? ¯\_(ツ)_/¯

Answer 51

Digests lactose in people who can't. | Keeps you from farting.

Answer 52

Digests galactose in people who can't. | Keeps you from farting.

Answer 53

``` Morphine Codeine Fentanyl Heroin Hydrocodone Hydromorphone Meperidine Methadone Oxycodone Oxymorphone ```

Answer 54

``` Pentazocine Buprenorphine Butorphanol Tramadol Tapentadol ```

Answer 55

``` Naloxone Naltrexone Methylnaltrexone Alvimopan Naloxegol ```

Answer 56

Opiate means derived from opium. Opioid means having properties similar to drugs derived from opium. Narcotic means sleep inducing, but more commonly is used to mean "opioid."

Answer 57

Morphine is mostly Mu, but also agonist at kappa and delta. Hydromorphone is the same as morphine. Pentazocine is a kappa agonist. Nalbuphine is a mu antagonist and a kappa agonist. Buprenorphine is the opposite of nalbuphine (mu agonist and kappa antagonist). Naloxone is an antagonist at mu, kappa, and delta.