Final Exam Review Flashcards
(113 cards)
1
Q
What are schedule I substances?
A
Drugs, substances, or chemicals that are defined as drugs with no currently accepted medical use and high potential for abuse
2
Q
What drugs are schedule I?
A
-Heroin
-LSD
-Marijuana
-MDMA
3
Q
What are schedule II drugs?
A
Drugs, substances, or chemicals that are defined as drugs with high abuse potential with use potentially leading to severe psychological or physical dependence but have an accepted medical use
4
Q
What drugs are schedule II?
A
-Methamphetamine
-Oxycodone
-Morphine
-Fetanyl
-Cocaine
5
Q
What are schedule III drugs?
A
Moderate or lower abuse potential compared to schedule II drugs
6
Q
What drugs are schedule III?
A
-Anabolic steroids
-Testosterone
-Codeine
-Ketamine
7
Q
What are schedule IV drugs?
A
Lower abuse potential compared to schedule III drugs
8
Q
What drugs are schedule IV?
A
-Diazepam
-Lorazepam
-Tramadol
9
Q
What are schedule V drugs?
A
Lowest abuse potential
10
Q
What drugs are schedule V?
A
-Low dose opioids in cough medicine
-Lamotil
-Pregabalin
11
Q
What is the main enzyme in the liver that is responsible for drug metabolism?
A
Cytochrome P450 (CYP450)
12
Q
What increases CYP activity and drug metabolism?
A
-Rifampin
-Carbamazepine
13
Q
What inhibits CYP and drug metabolism?
A
-Valproic acid
-Fluoxetine
14
Q
What drugs are reabsorbed by the kidneys?
A
Lipid soluble drugs
15
Q
How many half-lives does it usually take to eliminate a drug from the body?
A
5-7
16
Q
What is the median effective dose (ED50)?
A
Dose at which 50% of the population responds to the drug in a specific manner
17
Q
What is the median toxic dose (TD50)?
A
Dose at which 50% of the group exhibits adverse effects
18
Q
What is the median lethal dose (LD50)?
A
Dose that causes death in 50% of the group (animal studies)
19
Q
What is the therapeutic index? What does a higher therapeutic index (TI) indicate?
A
-TI= TD50/ED50
-The higher the TI, the safer the drug
-A large TI indicates that it takes a much larger dose to evoke a toxic response than it does to produce the desired effect
20
Q
What are additive effects?
A
The effect of two chemicals is equal to the sum of the effect of two chemicals taken separately
21
Q
What are synergistic effects?
A
The effect of two chemicals taken together is greater than the sum of their separate effects at the same doses
22
Q
What are antagonistic effects?
A
The effect of the two chemicals taken together is less than the sum of their separate effects at the same doses
23
Q
What is the opioid toxicity triad?
A
-CNS depression (coma)
-Respiratory depression (cyanosis)
-Pupillary miosis
24
Q
What are the adverse effects of opioids with chronic use?
A
-Hypogonadism
-Immunosuppression
-Increased feeding
-Increased growth hormone secretion
-Withdrawal effects
-Tolerance and dependence
-Abuse
-Hyperalgesia
-Impairment while driving
25
What disease should acetaminophen not be used in? What is this condition and who is most at risk?
-Reyes syndrome: a rare but serious condition that causes confusion, swelling in the brain, and liver damage
-Children recovering from a viral infection who have a metabolic condition are most at risk
26
How does acetaminophen cause liver toxicity?
-Metabolized to a toxic intermediate (NAPQI) in the liver, which is quickly detoxified and eliminated via the urine
-High doses can result in an accumulation of the toxic intermediate with subsequent toxicity to liver proteins
27
What are the acetaminophen & opioid combination drugs?
-Loratb, lorcet: hydrocodone + acetaminophen
-Darvocet: propoxyphene
-Percocet: oxycodone
28
What glucocorticoid (SAID) is used for anaphylaxis?
Dexamethasone
29
How does glucocorticoids breakdown tissue?
-Inhibits the genes responsible for production of collagen and other tissue components by increasing the expression of substances that promote breakdown of bone, muscle, etc.
-Interfere with muscle protein synthesis
30
What are the symptoms of drug induced Cushing's syndrome?
-Roundness and puffiness in the face
-Fat deposition and obesity in the trunk
-Muscle wasting in the extremities
-Hypertension
-Osteoporosis
-Increased body hair
-Glucose intolerance
31
What are the signs and symptoms of adrenal crisis/shock?
-Pain in legs, low back, abdomen
-Low BP, syncope
-Vomiting and diarrhea
-Hyperkalemia
-Hyponatremia
32
What are the traditional DMARDs for the treatment of RA?
-Hydroxychloroquine
-Methotrexate
-Leflunomide
-Sulfasalazine
33
What is the MOA of hydroxycholorquine?
Immunomodulation
34
What is the MOA of methotrexate?
Inhibits DNA synthesis which can lead to the reduction of antibodies
35
What is the MOA of leflunomide?
Inhibits AA synthesis (pyrimidine)
36
What is the MOA of sulfasalazine?
Not well understood
37
What are the side effects of hydroxycholorquine?
-Retinal damage
-Rash
38
What are the side effects of methotrexate?
-Hepatic fibrosis
-Rash
-Thrombocytopenia
-Leukopenia
39
What are the side effects of leflunomide?
-Hepatitis
-Alopexia
-HTN
40
What are the side effects of sulfasalazine?
-Rash
-Photosensitivity
-Alopecia
41
What are the TNF-⍺ blockers?
-Etanercept
-Infliximab
-Adalimumab
-Certolizumab
-Golimumab
42
What are the side effects of TNF-⍺ blockers?
-Local injection site reactions
-Infection
-Malignancy
43
What are the non TNF-⍺ blockers?
-Rituximab
-Abatacept
-Tocilizumab
-Baricitinib
-Anakinra
44
What are indirect acting cholinergic agonists that are used to treat Alzheimer's?
-Donepezil
-Rivastigmine
-Galantamine
45
What are indirect acting cholinergic agonists that are used to treat Myasthenia Gravis?
-Neostigmine
-Pyridostigmine
-Edrophonium
-Ambenonium
46
What are indirect acting cholinergic agonists that are used to treat Glaucoma?
-Physostigmine
-Echothiopate
47
What are common anticholinergic drugs?
-Atropine
-Scopolamine
-Ipratropium bromide
-Tiotropium bromide
-Oxybutynin
-Tolterodine
-Benztropine
-Tropicamide
-Dicyclomine
-Hyoscyamine
48
What are the major side effects of organic nitrates?
-Headache
-Reflex tachycardia
-Orthostatic hypotension
-Facial flushing
-Nitroglycerin specifically has significant interactions with sildenafil (Viagra) and can cause fatal hypotension
49
What are the major side effects of β-blockers?
-Fatigue
-Bradycardia
-Hypotension
-Bronchoconstriction (only with non-selective β-blockers)
50
What are the major side effects of calcium-channel blockers?
-Constipation (especially Verapamil)
-Headache
-Dizziness
-Flushing
-Non-dihydropyridines can cause heart failure to worsen due to negative intotropic effects
51
What are the major side effects of sodium-channel blockers?
-Dizziness
-Headache
-Constipation
-QT interval prolongation
52
What is the generic name of the sodium channel blocker?
Ranolazine
53
What are the generic names of the K+ sparing diuretics?
-Spironolactone
-Triamterene
54
What are the side effects of diuretics?
-Orthostatic hypotension
-Weakness
-Cardiac arrhythmias
-Fatigue
-Hyponatremia
-Hypokalemia
55
What is the mechanism of action of sprionolactone?
Direct antagonist of aldosterone, which prevents salt retention, myocardial hypertrophy, and hypokalemia
56
What is the mechanism of action of eplerenone?
Antagonist of aldosterone but with lower incidence of endocrine-related side effects
57
What are the two aldosterone antagonists?
-Spironolactone
-Eplerenone
58
What are the common side effects of aldosterone antagonists?
Hyperkalemia
59
What is a common arterial dilator used for chronic heart failure?
Hydralazine
60
What are the common side effects of hydralazine and isosorbide dinitrate?
-Headache
-Hypotension
-Tachycardia
61
What patient population is the combination of hydralazine and isosorbide dinitrate for the treatment of heart failure used in? Why?
-Used in black patients
-Used because ACE inhibitors is not recommended in this group as there are excessive side effects
62
What are common positive inotropic drugs used for the treatment of heart failure?
-Digoxin
-Dobutamine
-Milrinone
63
What is a major downside of positive inotropic drugs?
All positive inotropic drugs have been associated with reduced survival in patients with HF, so they are only used for a short period of time with the exception of Digoxin
64
Which coagulation factors are involved in the extrinsic pathway?
-Factor III
-Factor VII
65
Which coagulation factors are involved in the intrinsic pathway?
-Factor XII
-Factor XI
-Factor IX
-Factor VIII
66
Which coagulation factors are involved in the rest of the coagulation pathway?
-Factor X
-Prothrombin (Factor II)
-Prothrombin activator
-Thrombin
-Fibrinogen (Factor I)
-Fibrin
67
Which coagulation factor is responsible for the conversion from factor X to prothrombin activator?
-Factor III
-Factor V
68
What is the role of thrombin in the coagulation cascade?
Converts fibrinogen to fibrin
69
What is the role of factor V in the coagulation cascade?
Converts prothrombin activator to thrombin
70
What is the role of factor VIII in the coagulation cascade?
Converts fibrin to fibrin polymer
71
What is the role of vitamin K in the coagulation pathway?
-Involved in the synthesis of vitamin K dependent clotting factors in the liver
-Factor II (prothrombin)
-Factor VII
-Factor IX
-Factor X
72
What are the side effects of warfarin (Coumadin)?
-Hemorrhage
-Fetotoxic
-Many drugs interactions
73
What are the side effects of heparins?
-Hemorrhage
-Thrombocytopenia
-Osteoporosis with long term use
-Hypersensitivity reactions
74
What is the MOA of aspirin for anticoagulation?
Inhibits COX enzyme which converts arachidonic acid to thromboxane A2, which activates platelets and causes them to clump together
75
What is the MOA of Clopidogrel for anticoagulation?
Prevents platelets from sticking together by inhibiting a receptor on the platelet called P2Y12
76
What is the MOA of Ticagrelor and Prasugrel for anticoagulation?
Same mechanism as Clopidogrel but has different pharmacokinetics and dynamics
77
What is the MOA of Dipyridamole for anticoagulation?
-Used in combination with aspirin
-Inhibits phosphodiesterase enzyme which leads to the increase of cAMP in platelets which inhibits their aggregation
78
What is a rare but serious side effect of Clopidogrel?
Thrombotic thrombocytopenic purpura (TTP): rare but severe condition where small blood clots form throughout the body
79
What are the antithrombotic/antiplatelet drugs?
-Aspirin
-Clopidogrel
-Ticagrelor
-Prasugrel
-Dipyridamole
80
What are the thrombolytic drugs?
-Alteplase (tPA)
-Reteplase
-Tenecteplase
-Streptokinase
-Urokinase
81
What are the suffixes for thrombolytic drugs?
-"plase"
-"kinase"
82
What are the suffixes for direct thrombin inhibitors?
-"tran"
-"ban"
-"udin"
83
What are the suffixes for anti-thrombotics?
-"grel"
-Aspirin
-Dipyridamole
84
What are the suffixes for factor Xa inhibitors?
"xaban"
85
What is the MOA of statins?
Inhibits the HMG-CoA reductase enzyme which plays a role in production of cholesterol
86
What are the major side effects of statins?
-Muscle pain and weakness
-Fatigue
-Rhabdomyolysis
87
What is the mechanism of action of bile acid sequestrants?
-Bind to bile acid in the intestines, forming a complex that is excreted in the feces
-Bile acids are made in the liver from cholesterol
-By binding these acids and promoting excretion, the liver compensates by converting
88
What is the only cholesterol absorption inhibitor?
Ezetimibe
89
What are the rapid acting insulin?
-Lispro
-Aspart
-Glulisine
90
What are the short acting insulin?
Crystalline
91
What are the intermediate acting insulin?
-NPH
-Lente
92
What are the long acting insulin?
-Detemir
-Glargine
93
What are the suffixes of sulfonylureas?
-First generation: "amide"
-Second generation: "ide"
-Third generation: "piride"
94
What are the adverse effects of sulfonylureas?
-Hypoglycemia
-Cholestatic jaundice
-Weight gain
-Fetal hypoglycemia
95
What are the suffixes of meglitinides?
"glinide"
96
What are the common adverse effects of meglitinides?
Hypoglycemia
97
What is the only biguanide?
Metformin
98
What are the adverse effects of metformin?
-GI side effects
-Lactic acidosis
99
What is the suffix for thiazolidinediones?
"glitazone"
100
What are the adverse effects of thiazolidinediones?
Edema
101
What are the alpha-glucosidase inhibitors?
-Acarbose
-Miglitol
102
What are the adverse effects of alpha-glucosidase inhibitors?
-Flatulence
-Diarrhea
103
What is the suffix for GLP-1 analogs?
"tide"
104
What are the adverse effects of GLP-1 analogs?
-GI issues
-Injection site reactions
-Pancreatitis
105
What is the suffix for DPP-4 inhibitors?
"gliptin"
106
What are the adverse effects of DPP-4 inhibitors?
-Nasopharyngitis
-Headache
-Pancreatitis
107
What is the suffix for SGLT-2 inhibitors?
"gliflozin"
108
What are the adverse effects of SGLT-2 inhibitors?
-Genital yeast infections
-Urinary tract infections
-Bone fracture risk
-Ketoacidosis
109
What are the short acting β-2 agonists?
-Albuterol
-Levalbuterol
110
What are the long acting β-2 agonists?
-Salmeterol
-Formoterol
111
What are the injectable disease modifying drugs for MS?
-Avonex
-Betaseron
-Copaxone
112
What are the oral disease modifying drugs for MS?
-Gilenya
-Tecfidera
113
What are the infused disease modifying drugs for MS?
-Novantrone
-Ocrevus
-Tysabri
