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Flashcards in Multidiscipline pharm Deck (90):
1

alpha-agonist that decreases aqueous humor synthesis via vasoconstriction
Use: glaucoma

epinephrine
Adv: mydriasis -> remember fight or flight -> open wide to see

2

alpha2-agonist decreases aqueous humor synthesis
Use: glaucoma

brimonidine

3

beta blockers used to decrease aqueous humor synthesis
Use: glaucoma

Timolol
Betaxolol
Carteolol

4

diuretic that decreases aqueous humor synthesis by inhibition of carbonic anhydrase
Use: glaucoma

acetazolamide

5

contracts the ciliary muscle and opens the trabecular meshwork to increase outflow of aqueous humor
direct cholinomimetics (2)
indirect cholinomimetics (2)
Use: glaucoma

Direct: pilocarpine, carbachol
Indirect: physostigmine, echothiophate
Adv: miosis & cyclospasm (contraction of ciliary muscle)

6

prostaglandin that increases outflow of aqueous humor
Use: glaucoma

Latanoprost
Adv: brown iris

7

-opioid receptor agonists that modulate (decrease) synaptic transmission by opening potassium channels & closing Ca2+ channels
-inhibit release of ACh, NE, 5-HT, glutamate & substance P

morphine
fentanyl
codeine
loperamide
methadone
meperidine
dextromethorphan
diphenoxylate
Adv: addiction, resp depression, constipation, miosis
(no tolerance to miosis & constipation)

8

opioid receptor antagonists

naloxone
naltrexone

9

mu receptor partial agonist
kappa receptor agonist
Use: severe pain tx with less resp depression side effect

butorphanol

10

very weak opioid agonist
inhibits serotonin & NE reuptake
Use: chronic pain
Adverse: lowers seizure threshold; serotonin syndrome

tramadol

11

drug that induces hepatic enzymes and can result in decreased plasma levels of other medications

RIFAMPIN
others: Phenobarbitol, carbamazepine, phenytoin, nevirapine, griseofulvin, St. John's wart, chronic alcohol use, modafinil

12

cause coronary vasospasm drug rxn

cocaine
sumatriptan
ergot alkaloids

13

cause cutaneous flushing drug rxn

Vancomycin
Adenosine
Niacin
Calcium channel blocker

14

cause dilated cardiomyopathy drug rxn

doxorubicin
daunorubicin

15

cause Torsades de pointes

Class III antiarrhythmics (sotalol)
Class IA antiarrhythmics (quinidine)
macrolides
antipsychotics
TCAs

16

cause adrenocortical insufficiency

glucocorticoid withdrawal

17

cause hot flash drug rxn

tamoxifen
clomiphene

18

cause hyperglycemia

tacrolimus
protease inhibitors
Niacin
HCTZ
beta blockers
corticosteroids

19

cause hypothyroidism

Lithium
amiodarone
sulfonamides

20

cause acute cholestatic hepatitis, jaundice drug rxn

erythromycin

21

cause diarrhea drug rxn

metformin
erythromycin
colchicine
orlistat
acarbose
"might excite colon on accident"

22

cause focal to massive hepatic necrosis drug rxn

halothane
amanita phalloides (death cap mushroom)
Valproic acid
acetaminophen
"liver Havac"

23

cause hepatitis drug rxn

INH

24

cause pancreatitis drug rxn

Didanosine
corticosteroids
alcohol
valproic acid
azathioprine
diuretics (furosemide, HCTZ)
"Drugs Causing A Violent Abdominal Distress"

25

cause pseudomembranous colitis (C diff) drug rxn

Clindamycin
ampicillin
cephalosporins

26

drugs that cause cinchonism
(temporary deafness, ringing in ears, headache)

quinidine
quinine

27

drugs that cause Parkinson-like syndrome

Antipsychotics
Reserpine
Metoclopramide

28

drugs that cause seizures

INH (Vit B6 deficiency)
Buproprion
Imipenem/cilastatin
tramadol
enflurane
metaclopramide

29

Causes tardive dyskinesia drug rxn

Antipsychotics
Metoclopramide

30

Causes hemorrhagic cystitis

cyclophosphamide
ifosfamide

31

Causes interstitial nephritis drug rxn

methicillin
NSAIDs
furosemide

32

Causes pulmonary fibrosis drug rxn

Bleomycin
Amiodarone
Busulfan
Methotrexate
"breathing air badly from medications"

33

Causes SIADH drug rxn

carbamazepine
cyclophosphamide
SSRIs
"can't concentrate serum sodium"

34

causes diabetes insipidus drug rxn

lithium
demeclocycline

35

causes Fanconi syndrome drug rxn

expired tetracycline

36

Causes SLE-like syndrome drug rxn

Sulfa drugs
Hydralazine
INH
Procainamide
Phenytoin
Etanercept
"having lupus is SHIPP-E"

37

Causes fat redistribution drug rxn

protease inhibitors
glucocorticoids

38

Causes myopathy drug rxn

Fibrates
Niacin
Colchicine
hydroxychloroquine
IFN-alpha
penicillamine
statins
glucocorticoids

39

Causes hemolysis in G6PD deficiency

INH
Sulfonamides
Dapsone
Primaquine
Aspirin
Ibuprofen
Nitrofurantoin

40

nonlinear pharmacokinetics
extensive binding to plasma proteins
Used for tonic-clonic & partial seizures
MOA: blocks voltage-gated sodium channels

phenytoin
Adverse: diplopia, ataxia, gingival hyperplasia, hirsutism, neuropathy

41

drugs for absence seizures

clonazepam
ethosuximide
valproic acid

42

drugs for myoclonic seizures

clonazepam
lamotrigine
valproic acid

43

for absence seizures
MOA: decreases Ca2+ currents (T-type)

ethosuximide

44

voltage-gated sodium channel blockers used for seizures
prolong the refractory period for a neuron

Phenytoin
Carbamazepine
Lamotrigine
Zonisamide
Note: lamotrigine blocks both sodium & calcium channels & decreases glutamate

45

increase the frequency of GABA-mediated chloride channel opening

benodiazepines

46

increase the duration of the GABA-mediated chloride channel opening
also block glutamic acid
At high concentration: block sodium channels
These depress neuronal activity in the midbrain reticular formation, prolonging the inhibitory effects of GABA & glycine.
Use: anxiety, seizures, insomnia, anesthesia

barbiturates:
Phenobarbital
Pentobarbital
Thiopental
Secobarbital

47

hypnotic drug that activates melatonin receptors in the suprachiasmatic nuclei
decreases latency of sleep onset with minimal rebound insomnia or withdrawal

ramelteon

48

Given before niacin to prevent flush

Aspirin
Flush is thought to be mediated by prostaglandin

49

increases blood flow to muscle during exercise

epinephrine
can decrease diastolic bp

50

NTs thought to be deficient in ADHD

DA and NE in the prefrontal cortex

51

growth factor that influences neuron growth and survival

brain-derived neurotrophic factor (BDNF)
Note: the two week delay in efficacy of anti-depressants is thought to be due to production of of BDNF

52

amino acid precursor of serotonin

tryptophan

53

if have symptoms of depression, check for?

levels of thyroid hormone, estrogen & testosterone

54

Mechanism of action of antidepressants

Increase availability of NTs

55

bind to SERT and NET to prevent reuptake

SNRIs:
Venlafaxine
Desvenlafasine
Duloxetine

56

MOA: inhibition of SERT

SSRIs
Fluoxetine
certroline
Citalopram
drugs are highly lipophilic

57

TCA antidepressant with anticholinergic properties

imipramine
MOA: prevention of NT reuptake by NET and SERT

58

found primarily in the brain, gut, placenta and liver
breaks down epi, NE, DA and 5-HT

MAO-A

59

associated with the EPS of antipsychotic medications

blockade of D2 receptors in nigrostriatal pathway
schizophrenia is thought to involve increased density of D2 receptors
5-HT2A and 5-HT2C receptors modulate the release of dopamine, NE, glutamate, GABA and acetylcholine, as well as other NTs of the cortex, limbic region and striatum

60

unpleasant senstations of inner restlessness

akathisia
Note: the most unwanted effect of antipsychotics is tardive dyskinesia
It's caused by the relative deficiency of ACh because of supersensivity of DA receptors of caudate & putaman

61

enhance effects of GABA allosterically and increase the frequency of chloride channel opening

benzodiazepines
Effects on sleep:
○ Decreases latency of sleep onset
○ Increases duration of stage 2 nonREM sleep
○ Duration of REM sleep is decreased
○ Duration of stage 4 nonREM slow-wave sleep is decreased
Tolerance: downregulation of BZ receptors

62

reflects the concentration of anesthetic soluble in the blood

blood:gas partition coefficient

63

concentration required to prevent a response to a surgical incision in 50% of population (evidenced by immobility which is mediated by neural inhibition within the spinal cord)

Minimal Alveolar Concentration (MAC)
MAC is dependent upon cerebral blood flow and can be reduced by inhaled anesthetics

64

what circumstance would NO be a poor choice for anesthetic

fetal manipulation
NO has little effect on uterine smooth muscle.

65

○ Muscle rigidity, hyperthermia, rapid onset of tachycardia and hypercapnia, hyperkalemia and metabolic acidosis
-may occur with use of succinylcholine

Malignant hyperthermia
Tx: dantrolene
MOA: decreases Ca2+ release from the SR

66

-produce analgesia by binding with G protein-coupled receptors located in the brain and spinal cord
1. Close voltage-gated Ca2+ channels on presynaptic nerve terminals, reducing NT release
2. Hyperpolarize postsynaptic neurons by opening K+ channels → inhibition

opioid agonists

67

GI effects of opioids

§ Decreased motility
§ Decreased HCl release
§ Tone increased with periodic spasms of intestine while peristaltic waves are diminished: delays passage of fecal mass

68

what medication class enhances the analgesic effects of opioids

amphetamines

69

○ Selective 5-HT1 agonists that decrease nausea and vomiting of migraine

triptans
Sumatriptan

70

activation requires release of glutamate onto a receiving neuron that is depolarized

NMDA receptor
blocked by magnesium at negative potentials

71

○ Shape and color distortion, depersonalization, hallucinations, distorted time perception, dizziness, nausea, paresthesias, blurred vision
○ Do not induce dependence or addiction
○ Increase glutamate release at the cortex
○ Main target 5-HT2a receptor

LSD, mescaline & psilocybin

72

block the magnesium binding site in the NMDA channel, preventing excessive excitability, reducing the rate of clinical deterioration

memantine

73

NMDA, AMPA, or kainic acid

glutamate receptors

74

decrease sympathetic outflow by activation of alpha2 receptors to reduce blood pressure by reducing cardiac output &/or vascular resistance.

Methyldopa -> hemolysis
Clonidine -> rebound HTN if dced
Adverse of both: sedation

75

alpha1 blockers used for HTN

prazosin, doxazosin, terzosin
Adverse: orthostatic hypotension
Bonus: relax prostate smooth muscle (BPH tx)

76

how do beta blockers help with HTN?

initially, they decrease cardiac output
After a few days they reduce vascular resistance by decreasing ANG II
Note: nebivolol has direct vasodilator action

77

dihydropyridine CCB used to tx HTN
MOA: blocks L-type Ca channels

nifedipine**
-dipine drugs
Adverse: excessive cardiac depression; constipation
vasodilator effects are > than cardiac depressor effects

78

drug to treat HTN by opening K+ channels and vasodilation of arterioles
Causes hirsutism so can be used to tx male-pattern baldness

minoxidil

79

Used to tx HTN
MOA: causes release of NO from endothelial cells

hydralazine
Adverse: lupus-like syndrome
Can be used in combo with isosorbide dinitrate to treat heart failure

80

D1 receptor agonist used for hypertensive emergencies
MOA: marked arteriolar vasodilation

fenoldopam

81

Used for prophylaxis in those definitely exposed to N meningitidis, as well as the carrier state

Rifampin

82

Antibiotic of choice for lung abscess in alcoholic (most likely due to aspiration)

Clindamycin

83

Used in tx of hypoglycemia to inhibit insulin release
Relaxes vascular smooth muscle ( hypertensive crisis)

Diazoxide

84

GnRH analog with agonist activity when used in pulsatile fashion; antagonist when used continuously
Used for prostate cancer, uterine fibroids, precocious puberty, infertility (pulsatile for infert)

Leuprolide

85

Increases LH and FSH release from ant pituitary
Used to stimulate ovulation

Clomiphene

86

Antagonist at breast tissue
Agonist at uterus and bone
Tx: breast cancer

Tamoxifen
Raloxifene does not affect uterus and can be used to tx osteoporosis

87

Aromatase inhibitors

Anastrozole
Exemestane

88

5 alpha reductase inhibitor

Finesteride

89

Nonsteroidal competitive inhibitor of androgens at testosterone receptor

Flutamide

90

Alpha 1 antagonist used to treat BPH by inhibiting smooth muscle contraction

Tamsulosin