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Flashcards in Final Final Review Deck (49):
1

AE of Glitazone (TZDs)?

AE - FLUID RETENTION, weight gain, edema, exacerbates CSF, contraindicated in pts with class III and IV heart failure, MONITOR LIVER FUNCTIONING

2

Effect of mercury?

Mercury reacts with -SH groups in vivo inhibiting enzymes and altering cell membranes.

3

Busiprone?

2nd line agent for GAD
-partial 5-HT1a agonist
-gradual onset of 2 weeks
-no abuse potential
-no withdrawal reaciton
-no alcohol potentiation
-no sedative-hypnotic effect

4

AE of amantadine?

Livedo reticularis [purple, mottled skin]

5

How do you treat anorexia in end of life care?

Dronabinol
Dexamethasone

6

Action of acamprosate?

NMDA antagonist

7

AE of tubocurarine?

Hypotension
Bronchospasm
Excessive secretions

**all of this is b/c it is Benzylisoquinolines which causes massive histamine release -- DO NOT GIVE TO PATIENT WITH ASTHMA

8

How are ester anesthetics metabolized?

Via esterases - extrahepatically
Ex. procain

9

What is morphine used for in end of life care?

Pain and dyspnea

10

Other than anesthetic property, what else does propofol provide?

Anti-emetic effect

11

Primidone?

Phenobarbital analog used for ESSENTIAL TREMOR

AE - QT prolongation

12

Fulvestrant?

ER antagonist everywhere in the body used to treat estrogen receptive breast cancer that is unresponsive to other treatment

13

Levothyroxine vs Liothyronine?

Levothyroxine: T4, longer half-life
Liothyronine: T3, 10x more potent

14

What receptor does oxytocin bind to?

Gq (GPCR)

15

Tx theophylline-induced seizures?

Benzos and barbiturates

16

Pt has thyroid storm but has history of asthma?

Give CCB NOT B-blockers -- aka give diltiazem and verapamil

17

Danazol?

Partial agonist at androgen receptors
Tx endometriosis and fibrocystic disease of the breast

AE - acne, weight gain, hepatotoxicity, decrease HDL

18

Tyramine?

Indirect-acting sympathomimetic that enhances catecholamine release from presynaptic neuron

19

Parathion?

Organophosphate that binds ACHE inhibiting it -- reverse with pralidoxime or Atropine

20

Which SSRIs have the lowest potential for drug interactions?

Citalopram, escitalopram and sertraline

*fluoxetine, paroxetine and Fluvoxamine have lots of CYP interactions

21

AE of Clozapine?

Agranulocytosis [continue to do blood draws]
Weight gain
Seizures

22

Which insomnia medication has the least day after drowsiness?

Zaleplon

23

Buprenorphine?

partial mu agonist and kappa antagonist used to treat opioid addiction

24

Acrodynia?

pink discoloration of hands and feet due to exposure to heavy metals such as mercury -- treat with acute (DUS) and chronic (US)

25

Which corticosteroids do not have any mineralocorticoid activity?

Dexamethasone and Triamcinolone

26

Antidote for non-depolarizing ACh blockers?

Endrophonium and Neostigmine

27

Aripiprazole?

Atypical antipsychotic that is a PARTIAL agonist at D2 receptor -- all other atypical antipsychotics are competitive antagonists

28

AE metformin?

-GI irritation
-lactic acidosis
-vit B12 deficiency
-weight loss

29

Which TCAs have less anticholinergic effects?

secondary amines - Desipramine and Nortryptilline

30

Which antidepressants can cause orthostatic hypotension?

TCAs or MAOIs

31

Adverse effects of Mirtazepine?

a2 blocker and 5HT2 agonist

AE - sedation, constipation, dry mouth, weight gain

32

Which atypical antipsychotic causes the least amt of extrapyramidal effects?

Clozapine

33

Oxandrolone?

anabolic-androgen steroid

34

AE of somatropin?

Hyperglycemia
Weight gain
Muscle ache
Headache

35

AE of octreotide?

-hypothyroidism
-cardiac conduction changes
-GI reactions
-GALLSTONES
-hyperglycemia/hypoglycemia

36

What form of vitamin D is found in milk?

cholecalciferol or ergocalciferol

37

Metformin contraindications?

contraindicated in pts with renal disease, hepatic disease, hypoxia, alcoholism

38

Parathion mechanism?

Inhibits AChE increasing amt of ACh in cleft -- pt has pinpoint pupils!

39

What benzo do you use for short term treatment of panic disorders?

Alprazolam

40

Which medications have paradoxical reactions?

-Benzo
-barb
-antipsychotics
-antidepressants
-antibiotics

41

Which anesthetic decreases intracranial pressure?

Propofol

42

Which anesthetics are pungent?

Desoflurane
Isoflurane

43

Which anesthetics are non-pungent?

Halothane
Nitrous oxide
Sevoflurane

44

AE of Thioamides?

nausea, gastrointestinal disturbances, rash, AGRANULOCYTOSIS, hepatitis, HYPOTHYROIDISM

45

Lugol's iodine?

Lugol's solution and Potassium iodide

MOA - large doses of iodide inhibit thyroid hormone synthesis (decrease organification and release) via brief TPO inhibition. There is no long term-use b/c thyroid "escapes" from effects after 10-14 days ["Wolff-Chaikoff effect"]

Lugol's solution - mixture of iodine and potassium iodide
Potassium iodide - saturation solution

Used prior to surgical thyroidectomy to reduce size, fragility and vascularity of thyroid gland. These are used in conjunction with PTU and B-blockers in thyrotoxic crises.

Oral admin -takes 2-7 days for onset of activity

AE - Wolkff-Chaikoff effect or Jod-Basedow phenomenon (hyperthyroidism at the onset of iodine admin?), anaphylactic reaction leading to angioedema, brassy taste, burning of teeth and gums, enlargement of parotid and maxillary glands (with chronic iodide intoxication)

46

Which parkinsons drug may cause livedo reticularis?

Amantadine

47

Stanozolol?

synthetic anabolic steroid derived from dihydrotestosterone

48

Which sulfonyurea causes the worst hypoglycemic episodes?

Glyburide

49

What does physostigmine administration to a pt with TCA toxicity lead to?

heart block and asystole (cardiotoxicity)