General Flashcards
(130 cards)
1
Q
These weak acids (3) get trapped in a basic urine. (Bonus- how tx overdose?)
A
phenobarbital, methotrexate, aspirin (tx OD w/ bicarb)
2
Q
These weak bases (1) get trapped in an acidic urine. (Bonus- how tx overdose?)
A
amphetamines (tx OD w/ ammonium chloride)
3
Q
Zero order elimination (3)
A
Phenytoin, EtOH, Aspirin (PEA- round like 0 order)
4
Q
What are the Phase 2 metabolism mechanisms?
A
GAS- Glucuronidation, Acetylation, Sulfation (Old people have GAS [they still have phase 2])
5
Q
What is a competitive antagonist of Diazepam at the GABA receptor?
A
Flumazenil
6
Q
What is a noncompetitive antagonist of Glutamate at the NMDA receptor?
A
Ketamine
7
Q
What is a irreversible competitive antagonist of NorEpi at the alpha receptor?
A
Phenoxybenzamine
8
Q
Partial agonist of morphine? (@ Mu receptor)
A
Buprenorphine
9
Q
What type of receptors are nicotinic ACh receptors?
A
Na+/K+ channels (found at autonomic ganglia and neuromuscular junction)
10
Q
What type of receptors are muscarinic ACh receptors?
A
G-protein coupled receptor that uses 2nd messengers (5 subtypes M1-5)
11
Q
Bethanechol
A
Cholinomimetic direct agonist- bowels and bladder [post-op ileus, neurogenic ileus, urinary retention]
12
Q
Carbachol
A
Cholinomimetic direct agonist [constrict pupil and decrease IOP]
13
Q
Methacholine
A
Cholinomimetic direct agonist [challenge test to dx asthma]
14
Q
Pilocarpine
A
Cholinomimetic direct agonist [sweat, tears, and saliva– both open and closed angle Glaucoma]
15
Q
Donepezil
A
Cholinomimetic INdirect agonist increase ACh
[Alzheimers]
16
Q
Galantamine
A
Cholinomimetic INdirect agonist increase ACh
[Alzheimers]
17
Q
Rivastigmine
A
Cholinomimetic INdirect agonist increase ACh
[Alzheimers]
18
Q
Edrophonium
A
Cholinomimetic INdirect agonist increase ACh
[short acting; DX myasthenia gravis]
19
Q
Neostigmine
A
Cholinomimetic INdirect agonist increase ACh
[Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative)]
20
Q
Physostigmine
A
Cholinomimetic INdirect agonist increase ACh
[Anticholinergic toxicity; crosses blood-brain barrier –> CNS]
21
Q
Pyridostigmine
A
Cholinomimetic INdirect agonist increase ACh
[Myasthenia gravis (long acting); does not penetrate CNS]
22
Q
Antidote for organophosphate poisoning?
A
Atropine (competitive inhib) + pralidoxime (regenerate AChE – give early!)
23
Q
Atropine
A
Muscarinic ANTagonist
[eye- mydriasis & cycloplegia]
24
Q
Homatropine
A
Muscarinic ANTagonist
[eye- mydriasis & cycloplegia]
25
Tropicamide
Muscarinic ANTagonist
| [eye- mydriasis & cycloplegia]
26
Benztropine
Muscarinic ANTagonist
| [CNS- Parkinsons & Acute dystonia]
27
Glycopyrrolate
Muscarinic ANTagonist
[Parenteral: preoperative use to reduce airway secretions.
Oral: drooling, peptic ulcer]
28
Hyoscyamine
Muscarinic ANTagonist
| [GI- Antispasmodics for irritable bowel syndrome]
29
Dicyclomine
Muscarinic ANTagonist
| [GI- Antispasmodics for irritable bowel syndrome]
30
Ipratropium
Muscarinic ANTagonist
| [Resp- COPD & asthma]
31
Tiotropium
Muscarinic ANTagonist
| [Resp- COPD & asthma]
32
Oxybutynin
Muscarinic ANTagonist
| [GU- decrease urgency and bladder spasms]
33
Solifenacin
Muscarinic ANTagonist
| [GU- decrease urgency and bladder spasms]
34
Tolterodine
Muscarinic ANTagonist
| [GU- decrease urgency and bladder spasms]
35
Scopolamine
Muscarinic ANTagonist
| [CNS - motion sickness]
36
Tetrodotoxin
Poison from poorly prepared pufferfish
- Binds fast voltage-gated Na+ channels in cardiac and nerve tissue--> prevent depolarization
- Sx- nausea, diarrhea, paresthesia, weakness, loss of reflexes
37
Ciguatoxin
Poison from eating reef fish (barracuda, snapper...)
- Opens Na+ channels causing depolarization
- Sx- similar to cholinergic poisoning ** Temperature dysesthesia (cold feels hot/ hot feels cold)
38
Scombroid poisoning
Poison from eating dark meat fish (tuna, bonito, mackarel...) not properly stored
- Bacterial histidine decarboxylase converts histidine --> histamine (not degraded by cooking)
- Sx- similar to anaphylaxis
39
Albuterol/ Salmeterol
Sympathomimetic beta2>beta1
| acute asthma; COPD
40
Dobutamine
```
Sympathomimetic beta1> beta2; alpha
Heart failure (ionotopic> chronotropic)
```
41
Dopamine
Sympathomimetic D1=D2>beta>alpha
| Unstable bradycardia, HF, shock; inotropic and chronotropic α effects predominate at high doses.
42
Epinephrine
Sympathomimetic beta>alpha
Anaphylaxis, asthma, open-angle glaucoma;
α effects predominate at high doses. Significantly stronger effect at β2-receptor than norepinephrine
43
Isoproterenol
Sympathomimetic beta1=beta2
| Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia
44
Norepinephrine
Sympathomimetic alpha1>alpha2>beta1
| Hypotension (but dec. renal perfusion). Significantly weaker effect at β2-receptor than epinephrine.
45
Phenylephrine
Sympathomimetic alpha1>alpha2
| Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)
46
Amphetamine
Indirect sympathetic agonist
- Reuptake inhibitor & releases stored catecholamines
- Narcolepsy, obesity, ADHD
47
Cocaine
Indirect sympathetic agonist
- Reuptake inhibitor
- Causes vasoconstriction and local anesthesia
[Never give β-blockers if cocaine intoxication is
suspected (can lead to unopposed α1 activation and extreme hypertension)]
48
Ephedrine
Indirect sympathetic agonist
- Releases stored catecholamines
- Nasal decongestion, urinary incontinence, hypotension
49
Clonidine
Alpha2- agonist
-Use: Hypertensive urgency (limited situations); does not decrease renal blood flow,
ADHD, Tourette syndrome
- Tox: CNS depression, bradycardia, low BP, resp. depression, miosis
50
a-methyldopa
Alpha2- agonist
-Use: HTN in pregnancy
Tox: Direct Coombs + hemolysis; SLE-like syndrome
51
Phenoxybenzamine
Irreversible a-blocker
| - Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis
52
Phentolamine
Reversible a-blocker
| - Give to patients on MAO inhibitors who eat tyramine-containing foods
53
Prazosin, terazosin, doxazosin, tamsulosin
Selective alpha1 blocker
| - Use: Urinary symptoms of BPH; PTSD (prazosin); hypertension (except tamsulosin)
54
Mirtazapine
Selective alpha2 blocker
Use: Depression
Tox: Sedation, inc. serum cholesterol, inc. appetite
55
Beta 1 selective blockers
acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol
56
Nonselective beta blockers
nadolol, pindolol (partial agonist), propranolol, timolol
57
Nonselective alpha & beta antagonists
carvedilol, labetalol
58
Nebivolol
Beta1 blocker and Beta3 stimulation
59
Acetaminophen overdose antidote?
N-acetylcysteine (replenishes glutathione)
60
AChE inhibitors, organophosphates overdose antidote?
Atropine > pralidoxime
61
Amphetamines overdose antidote?
NH4Cl (acidify urine)
62
Antimuscarinic, anticholinergic agents overdose antidote?
Physostigmine salicylate, control hyperthermia
63
Benzodiazepines overdose antidote?
Flumazenil
64
β-blockers overdose antidote?
Glucagon
65
Carbon monoxide overdose antidote?
100% O2, hyperbaric O2
66
Copper, arsenic, gold overdose antidote?
Penicillamine
67
Cyanide overdose antidote?
Nitrite + thiosulfate, hydroxocobalamin
68
Digitalis (digoxin) overdose antidote?
Anti-dig Fab fragments
69
Heparin overdose antidote?
Protamine sulfate
70
Iron overdose antidote?
Deferoxamine, deferasirox
71
Lead overdose antidote?
EDTA, dimercaprol, succimer, penicillamine
72
Mercury, arsenic, gold overdose antidote?
Dimercaprol (BAL), succimer
73
Methanol, ethylene glycol (antifreeze) overdose antidote?
Fomepizole > ethanol, dialysis
74
Methemoglobin overdose antidote?
Methylene blue, vitamin C
75
Opioids overdose antidote?
Naloxone, naltrexone
76
Salicylates overdose antidote?
NaHCO3 (alkalinize urine), dialysis
77
TCAs overdose antidote?
NaHCO3 (plasma alkalinization)
78
tPA, streptokinase, urokinase overdose antidote?
Aminocaproic acid
79
Warfarin overdose antidote?
Vitamin K (delayed effect), fresh frozen plasma (immediate)
80
What drugs cause coronary vasospasm?
Cocaine, sumatriptan, ergot alkaloids
81
What drugs cause cutaneous flushing?
Vancomycin, Adenosine, Niacin, Ca2+ channel blockers (VANC)
82
What drugs cause dilated cardiomyopathy?
Anthracyclines (e.g., doxorubicin, daunorubicin); prevent with dexrazoxane
83
What drugs cause Torsades de Pointes?
Class III (e.g., sotalol) and class IA (e.g., quinidine) antiarrhythmics, macrolide antibiotics, antipsychotics, TCAs
84
What drugs cause adrenocortical insufficiency?
HPA suppression 2° to glucocorticoid withdrawal
85
What drugs cause hot flashes?
Tamoxifen, clomiphene
86
What drugs cause hyperglycemia?
Tacrolimus, Protease inhibitors, Niacin, HCTZ,
| Corticosteroids
87
What drugs cause hypothyroidism?
Lithium, amiodarone, sulfonamides
88
What drugs cause acute cholestatic hepatitis, jaundice?
Erythromycin
89
What drugs cause diarrhea?
Metformin, Erythromycin, Colchicine, Orlistat,
| Acarbose
90
What drugs cause focal to massive hepatic necrosis?
Halothane, Amanita phalloides (death cap
| mushroom), Valproic acid, Acetaminophen
91
What drugs cause hepatitis?
Rifampin, isoniazid, pyrazinamide, statins, fibrates
92
What drugs cause pancreatitis?
Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (furosemide, HCTZ)
93
What drugs cause pseudomembranous colitis?
Clindamycin, ampicillin, cephalosporins
94
What drugs cause agranulocytosis?
Ganciclovir, Clozapine, Carbamazepine, Colchicine, Methimazole, Propylthiouracil
95
What drugs cause aplastic anemia?
Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil
96
What drugs cause Direct Coombs + hemolytic anemia?
Methyldopa, penicillin
97
What drugs cause gray baby syndrome?
Chloramphenicol
98
What drugs cause hemolysis in G6PD?
Isoniazid, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin
99
What drugs cause megaloblastic anemia?
Phenytoin, Methotrexate, Sulfa drugs
100
What drugs cause thrombocytopenia?
Heparin
101
What drugs cause thrombotic complications?
OCPs, hormone replacement therapy
102
What drugs cause fat redistribution?
Protease inhibitors, Glucocorticoids
103
What drugs cause gingival hyperplasia?
Phenytoin, Ca2+ channel blockers, cyclosporine
104
What drugs cause hyperuricemia (gout)?
Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine
105
What drugs cause myopathy?
Fibrates, niacin, colchicine, hydroxychloroquine, interferon-α, penicillamine, statins, glucocorticoids
106
What drugs cause osteoporosis?
Corticosteroids, heparin
107
What drugs cause photosensitivity?
Sulfonamides, Amiodarone, Tetracyclines,
| 5-FU
108
What drugs cause rash (stevens-johnson)?
Anti-epileptic drugs (especially lamotrigine),
| allopurinol, sulfa drugs, penicillin
109
What drugs cause SLE-like syndrome?
Sulfa drugs, Hydralazine, Isoniazid,
| Procainamide, Phenytoin, Etanercept
110
What drugs cause teeth discoloration?
Tetracyclines
111
What drugs cause tendonitis, tendon rupture, and cartilage damage?
Fluoroquinolones
112
What drugs cause Cinchonism?
Quinidine, quinine
113
What drugs cause Parkinson-like syndrome?
Antipsychotics, Reserpine, Metoclopramide
114
What drugs cause seizures?
Isoniazid (vitamin B6 deficiency), Bupropion, Imipenem/cilastatin, Enflurane
115
What drugs cause tardive dyskinesia?
Antipsychotics, metoclopramide
116
What drugs cause diabetes insipidus?
Lithium, demeclocycline
117
What drugs cause Fanconi syndrome?
Expired tetracycline
118
What drugs cause hemorrhagic cystitis?
Cyclophosphamide, ifosfamide
119
What drugs cause interstitial nephritis?
Methicillin, NSAIDs, furosemide
120
What drugs cause SIADH?
Carbamazepine, Cyclophosphamide, SSRIs
121
What drugs cause dry cough?
ACEi
122
What drugs cause pulmonary fibrosis?
Bleomycin, Amiodarone, Busulfan, Methotrexate
123
What drugs cause antimuscarinic reaction?
Atropine, TCAs, H1-blockers, antipsychotics
124
What drugs cause disulfram-like rxn?
Metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st-generation sulfonylureas
125
What drugs cause nephrotoxicity/ototoxicity?
Aminoglycosides, vancomycin, loop diuretics, cisplatin
126
Cisplatin toxicity; tx?
Amifostine
127
p450 substrates? (4)
Antiepileptics, Theophylline, Warfarin, OCPs
128
p450 inducers? (8)
Chronic alcohol use St. John’s wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine
129
p450 inhibitors? (10)
Acute alcohol abuse Ritonavir Amiodarone Cimetidine Ketoconazole Sulfonamides Isoniazid (INH) Grapefruit juice Quinidine Macrolides (except
azithromycin)
130
What are the sulfa drugs? (8)
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas
