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Flashcards in Final - Content Deck (113):
1

Which drug only activates alpha 1 receptors?

Phenyleprine

2

Which drug activates alpha 1 & beta 1 receptors?

Dopamine

3

Which drug activates only beta 1 receptors?

Dobutamine

4

Which drug activates beta 1 & 2 receptors?

Isoprotenerol

5

Which drug only activates beta 2 receptors?

Terbutaline

6

What receptors does dopamine activate?

Alpha 1 and beta 1

7

What receptors does norepinephrine activate?

Alpha 1 & 2, Beta 1

8

What do alpha 1 blockers end in?

End in: -sin

Ex: Alfusosin

9

How are alpha 1 & 2 start and end with what?

Start with: Phen

End in: mine

Ex: Phentolamine

 

10

Beta 1 blockers start and in what?

  • Start with: B,E,A, or M
  • End in: -lol
  • Ex: Atenolol

 

11

Beta 1 & 2 blockers end in?

End in: -lol

Ex: Carteolol

 

12

What do most cholinergic drugs end in?

End with: -chol

Ex: Bethanechol, carbachol, acetylcholine

 

13

What do most anticholinergic drugs have in there name?

Have: -trop-

Ex: Atropine, Ipratropium,Tiotropium

14

What occurs when the alpha 1 receptors are activated?

  1. Pupil dialation
  2. Arterioles constrict
  3. Venous constrict
  4. Male ejaculation
  5. Contraction of prostate
  6. Contraction of tigone & sphincter muscle in bladder

15

What occurs when the beta 1 receptor is activated?

  1. ↑ HR, ↑ contraction
  2. Activation of renin

16

What occurs when the beta 2 receptor is activated?

  1. Arterioles of the heart, lung, and skeletal muscle are dialated
  2. Bronchi of the lungs dilate
  3. Uterus relaxes
  4. Glycogenolysis in the liver
  5. Enhanced contraction of skeletal muscle & glycogenolysis

17

What are some characteristics of catecholamines and what are some examples?

Characteristics:

  • Too big to cross BBB
  • Short duration of action
  • You can't give this by mouth

Example:

  • Norepinephrine
  • Epinephrine
  • Dobutamine
  • Isoprotenerol

18

What are some characteristics of Non-catecholamines and what are some examples?

Characteristics

  • Long duration
  • Cross BBB / placenta
  • Can be given by mouth

Examples:

  • Phenylephrine
  • Ephedrine
  • Terbutaline

19

How should oral Penicillin be taken?

Take with full glass of water 1 hour before meals or 2 hours after meals

20

What is the DOC for MRSA?

Vancomycin

21

What are the AE of Vancomycin?


 

  • Nephrotoxicity 
  • Ototoxicity (may be permanent if exceed 30mcg/mL)

  • Thrombophlebitis

22

What drugs are contraindicated with an immunosuppresed pt.?

  • Tetracycline
  • Steroids
  • Live vaccinations

23

What are some adverse effects of tetracycline?


 

  • Renal toxicity  
  • Hepatotoxicity 

  • Phototoxicity

  • Chelation - don't combine w/ other stuff

  •  

     

    Causes C. difficile

     

     

     

24

How should tetracycline be taken?


 

  • Should be taken on an empty stomach: give 2 hours before or 2 hours after chelating agents. 
  • Council pts to avoid calcium (milk, antacids), iron, magnesium (laxatives), aluminum & zinc for 2 hours before/after taking Tetracyclines.

25

Can you mix aminoglycosides with penicillins?


 

Never mix PCN and Aminoglycosides in the same IV solution; Mixing increases bacterial kill capability of Aminoglycosides (can use together, but do not mix) 

26

What are some adverse effects of AMINOGLYCOSIDEs? 

  • Reversible  nephrotoxicity
  • Irreversible ototoxicity

27

What is the MOA of sulfonamides?

Suppress bacterial growth & replication by inhibiting synthesis of folic acid; folic acid required by all cells to synthesize DNA, RNA & proteins

28

What are the AE of sulfonamides?


 

  • Renal damage (crystal formation) - take with a lot of water 
  • Hemolytic anemia (esp. African Americans)

     

29

What do Fluoroquinolones end in?

  • End in: oxacin
  • Ex: Ciprofloxacin

30

What are the adverse effects of Amphotericin B?

  • Nephrotoxicity
  • Infusion reaction

31

What is the MOA for penicillins, cephalosporins, carbapenems, vancomycin?

Weaken cell wall which causes cell wall to take up water & burst (osmotic lysis) = bactericidal

32

What is the MOA for tetracyclines, macrolides, lincosamide, choloramphinicol?

Inhibiting protein synthesis = bacteriostatic

33

What is the MOA for aminoglycosides?



 


Rapid bactericidal action through disruption of protein synthesis (dose dependent)
 

 

 

34

What is the MOA for sulfonamides?


 

Suppress bacterial growth & replication by inhibiting synthesis of folic acid; folic acid required by all cells to synthesize DNA, RNA & proteins

 

 

35

What is the MOA for Fluoroquinolones?

Inhibits bacterial DNA gyrase—enzyme that converts closed circular DNA into a super coiled configuration (for DNA replication)

 

 

36

What are the AE of Fluoroquinolones?

  • Can cause C. difficle
  • Possible tendon rupture with systemic use -- Affects achilles tendon
  • Photosensitivity

37

What is the DOC to treat C. Diff?

Metronidazole

38

What are some AE of Metronidazole?

Nephrotoxicity

39

If a pt. is allergic to penicillins what drug could you give them instead?

Macrolides

40

How is COPD diagnosed?

Diagnosed based on a decrease in FEV1 and forced vital capacity (FVC) ratio to below 75% on spirometry

41

What is the 1st line agent for pts. w/ COPD?

Anticholinergics medications

 

Ex: Ipratropium/Atrovent, Tiotropium/Spiriva, Atropine

42

What is the 1st choice medication for acute exacerbations in a pt. w/ COPD?

Beta2 Agonists

Ex: Albuterol, Levalbuterol, Salbutamol

43

When taking a steroid for asthma, what medication should the pt. take before taking the steroid?

Albuterol (beta 2 agonist) to dialate the lungs to make the steroid more effective

44

What is the 1st line treatment for pts w/ moderate-severe asthma?

Inhaled Glucocorticoids

 

Ex:

Beclomethasone, Mometasone, Fluticasone

45

What do inhaled glucocorticoids end with?

 

 

 

End with: -asone

Ex:

  • Beclomethasone
  • Mometasone
  • Fluticasone

46

What do PO glucocorticoids end with?

End with: -isone / -isolone

Ex:

  • Prednisone

  • Prednisolone

  • Fludrocortisone

47

Why do you taper off oral glucocorticoids?

To prevent adrenal suppression & bone loss

48

How should you take all glucocorticoids?

In the morning w/ food

49

What is the MOA for leukotriene modifiers?

Suppress effects of leukotriene and decreases bronchoconstriction, inflammation, edema, mucus secretion and recruitment of eosinophils

50

What do most leukotriene modifiers end with?

End with: -lukast

Ex:

  • Zafirlukast
  • Montelukast

51

What is the only leukotriene modifier approved for pts. over 1 years old?

Montelukast (Singulair)

52

What are the 1st line drugs for tuberculosis?

  1. Isoniazid
  2. Rifampin
  3. Pyrazinamide
  4. Ethambutol / Streptomycin

53

What are the AE of Isoniazid and how do you take this med?

AE:

  • peripheral neuropathy

  • Hepatotoxicity

  • Burning dark urine, jaundice, tingling

Take:

  • Take on empty stomach

     

54

What are the AE of Rifampin and how do you take this med?

AE:

  • Discoloration of body fluids
  • pruritus, rash, chills

Take:

  • Give w/ water and no food

 

55

What are the AE of Pyrazinamide?

AE:

  • Urination difficulties
  • photosensitivity

56

What are the AE of Ethambutol and how do you take this med?

AE:

  • Optic neuritis: blurred vision, loss of red/green

  • Renal impairment

  • Chills, joint pain/swellin

Take:

  • w/ food

57

What is the MOA for H2 receptor antagonists?

Suppress acid secretion by blocking H2 receptors on parietal cells

58

What do H2 receptor antagonists end with?

End with: -tidine

Ex:

  • Cimetidine [Tagamet]  BEST TAKEN WITH FOOD

  • Famotidine [Pepcid]

  • Nizatidine [Axid]

  • Ranitidine [Zantac]

59

What is the MOA for Proton Pump Inhibitors?


 

Suppress acid secretion by irreversible inhibiting H+/K+-ATPase, the enzyme that makes gastric acid aka: BLOCKS final step of acid production

 

 

60

What do Proton Pump Inhibitors end with?

End with: -Prazole

Ex:

  • Dexlansoprazole [Dexilant]

  • Esomeprazole [Nexium]

  • Lansoprazole [Prevacid]

  • Omeprazole [Prilosec, Zegerid, Losec]

  • Pantoprazole [Protonix]

61

What is the MOA of Sucralfate [Carafate, Sulcrate]?


Forms a barrier over the ulcer crater that protects against acid and pepsin
 

 

 

62

What is the MOA of misoprostol?

Protects against NSAID-induced ulcers by stimulating secretion of mucus and bicarbonate, maintain submucosal blood flow, and suppressing secretion of gastric acid

63

What are some Antacids?

Magnesium hydroxide -- Causes diarrhea

Aluminum hydroxide -- Causes constipation

64

When is the best time to take PPI's?

In the morning 30min before meals

65

How should H2 Receptor Antagonist be taken?

With food

66

What drugs have a delayed response in treating constipation?

  • Methylcellulose
  • Psyllium
  • Polycarbophil
  • Docusate sodium/calcium
  • Lactulose

67

What is the MOA for bulk forming laxatives and how should you take it?

MOA:

  • Softens stool by pulling water into small intestine and ↑ of colonic bacteria à ↑ fecal volume à promotes peristalsis

 

 

Take:

  • Take w/ full glass of water

 

 

 

68

What is the MOA for docustate sodium and how should you take it?

MOA:

  • ↓ surface tension à water penetrates SI & colon à softening stool

 

 

Take:

  • Take w. full glass of water

 

 

69

What is the MOA for lactulose?


 

MOA:

  • ↓ water absorption, ↑ water in lumen
  • ↑ excretion of NH3 ß helps pts w/ hepatic disease

 

 

70

Which drugs will cause a bowel movement quickly?

  • Castor oil (15-60min)
  • Mineral oil (5-30min)
  • Glycerin supplements (5-30min)

71

What drugs are used to treat diarrhea?

Opiods:

  • Diphenoxylate HCL [Lomotil]

72

What do Serotonin Rec Antagonist end with?

End with: -estron

Ex:

  • Ondansetron [Zofran]

  • Granisetron

  • Dolasetron

  • Palonosetron

73

What is the MOA for Serotonin Rec Antagonists?

Blocks 5HT3 receptor on vagal afferents in the CTZ --->  Prevents nausea and vomiting

74

What do short acting steroids end with?

End with: -isone

Ex:

  • Cortisone

  • Hydrocortisone

75

What do long acting steroids end with?

End with: -asone

Ex:

  • Betamethasone

  • Dexamethasone

     

76

What type of insulin must you roll in your hands before administering?

NPH insulin

 

Ex: Humulin N, Novolin N

77

What are the fasting plasma glucose values?

Normal is < 100

Diabetes is > 126

78

What are the casual plasma glucose values?

Normal is < 200

Diabetes is > 200

79

What are the oral glucose tolerance test values?

 

Glucose load of 75g & measure 2 hours later:

 

normal is <140

Diabetes > 200

 

 

80

What is HgA1?

Reflects average BS past 2-3 months;

 

diabetes is > 6.5%

81

How does excercise affect people with type 2 diabetes?


 

Exercise increases insulin receptivity

82

What doe sulfonylureas end in?

End in: -amide

Ex:

  • Tolbutamide

  • Acetohexamide

  • Tolazamide

  • Chlorpropamide

83

What is the MOA for sulfonylureas?

 


  • Glucose dependent: ↑ insulin release from pancreas dependent on glucose concentration
  • Only for type 2

 

84

What is the DOC for type 2 diabetes?

metformin

85

What is the MOA for metformin?


  • ↓ glucose production by liver
  • ↑ glucose uptake by muscle

86

What are the AE of metfrmin and how should it be taken?

AE:

  • Weight loss

  • ↓ appetite

  • Nausea/diarrhea
  • Lactic acidosis

Taken:

  • W/ food
  • Can be combined with sulfonylureas or Exenatide

87

What is the MOA for Glitazones and AE?

MOA:

  • ↓ insulin resistance by ↑ insulin sensitivity of skeletal muscles, liver & tissues

  • *Insulin must be present*

AE:

  • Fluid retention

88

What is the MOA for Levothyroxine and how do you take it?

MOA:

  • Increases the levels of T4 in the body

Take with:

  • Give 30 min before breakfast
  • ↓ absorption of thyroid hormone - must give 1 hour apart

89

What is the MOA of Propylthiouracil (PTU) and how do you take it?

MOA:

  • Blocks conversion of T4 into T3 (peripheral tissue), does nothing for circulating thyroid hormones

Take with:

  • Take w/ food. If missed, take dose ASAP

90

What is the MOA for Bisphosphonate, what are the AE, and how do you take?

MOA:

  • Prevent the loss of bone mass

AE:


  • Esophagitis – if pt lie down/eat w/i 30 min 

Take it:


 

  • TAKE in AM  on empty stomach w/ full glass of water.  
  • Do NOT lie down OR take any other food or beverages for 30 minutes after taking med 

     

 

91

What is asprin used for?

  • ↓ mild-moderate pain 
  • DOC: ↓fever in adults 
  • Thrombotic disorders 
  • ↓ risk of MI/stroke 

 

Nonselective and irreversible COX inhibitor

 

 

92

What are the AE of Asprin?

  • ↑ bleeding by inhibiting plt aggregation (lasts 8 days) 
  • GI distress, heartburn, nausea, edema 
  • Longterm use: GI ulcer, perforation, bleeding  

93

What is the MOA of Ibuprofen?


 


 

Nonselective and reversible inhibition of COX (1&2)

  • Anti-inflammatory 
  • Analgesic 

  • Antipyretic 

  • RA and OA 

94

What are the AE of ibuprofen?


 

  • GI ulceration 

 

 

 

  • Bleeding 
  • Renal impairment 
  • ↑ risk of thrombolytic even

 

 

95

What is Acetaminophen (Tylenol) used for?


 

  • Analgesic (anti-pain) 
  • Antipyretic (anti-fever

     

96

What are some AE of Acetaminophen (Tylenol)?

↑ risk of warfarin bleeding by ↓ warfarin metabolism in body

97

What is the 1st line agent for HTN?

Hydrochlorothiazide 

98

What are some examples of ACE inhibitors?





 

Lisinopril 

 

Captopril

 

 

99

What are some AE of ACE inhibitors?

  • ↑ K+ lvls

  •  

    Persistent cough (give ARBs instead?) 

  • 1st dose hypotension (vascular dilation) 

     

100

What are some examples of ARBS?

 

Losartan 

Ibersartan

 

 

NO COUGH

 

 

101

What are some AE of ARBS?

  • Angioedema (less than ACEI though) 
  • RBF (↓GFR) pts

102

What is the MOA of Spironolactone?

 

 


 

  • Blocks actions of aldosterone in distal nephron  
  • ↑K+ lvls
  • ↓Na+ lvls 

103

What is the fastest acting diuretic?

Mannitol

104

What is the MOA of Mannitol and what are some AE?

MOA:


  •  

    ↑ osmotic pressure in tubule & ↓H2O reabsorption 

AE:


  •  

    Can leave vascular and cause edema 

     

105

What do high ceiling loop diuretics end in?

End with: -ide, -mide

Ex:

  • Furosemide (Lasix) 
  • Torsemide (Demadex)  
  • Bumetanide (Bumex)

106

What are the AE of Furosemide (Lasix)?

  • Hypokalemia:  K < 3.5, give K or use K-sparing diuretics - monitor electrolytes
  • Ototoxicity 
  •  

107

What is the MOA of Clonidine & Methyldopa and AE of these drugs?

MOA:

  • Blocks vasoconstriction

AE:


 

  • Dry mouth sedation 
  • Severe rebound HTN 

    Methyldopa: hemolytic anemia, liver dz

     

108

What is the MOA for Hydralazine?


 

Dilate arterioles = ↓cardiac afterload  = ↓cardiac work = ↑CO/perfusion

109

What is the MOA for Nitroglycerin?


 

Dilate veins = ↓cardiac preload  = ↓blood return = ↓ventricular filling = ↓cardiac work = ↓CO/perfusion

110

What is the MOA for Sodium nitroprusside?

Dilates arterioles & veins

111

What do CALCIUM CHANNEL BLOCKERS (CCBS) end with?

End with: -ipine

Ex: 

  • Nifedipine (fast-acting) 
  • Amlodipine
  • Isradipine
  • Felodipine

 

112

What is the MOA of Verapamil & Diltiazem? 


 

  • Acts on arterioles and the heart 
  • Block at peripheral arterioles: ↓ arterial pressure

  •  

113