Other One-Liners Flashcards
1
Q
The selective agents lose their selectivity at
A
high doses
2
Q
Another pneumonic for anticholinergic toxicity
A
“dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat”
3
Q
These beta blockers are less lipid soluble
A
Acebutolol and atenolol
4
Q
This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis
A
Acetazolamide
5
Q
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis
A
Albuterol
6
Q
Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction
A
Amphetamines
7
Q
Toxicity of anticholinergics
A
Anti-DUMBBELSS
8
Q
Selective alpha agonists that decreases aqueous secretion
A
Apraclonidine, brimonidine
9
Q
Treatment of muscarinic symptoms in organophosphate overdose
A
Atropine
10
Q
Clinical uses of these agents include treatment of HTN, angina, arrhythmias, and chronic CHF
A
Beta blockers
11
Q
Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF, signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)
A
Beta blockers
12
Q
These agents increase blood flow and may be beneficial in treatment of acute heart failure and some types of shock
A
Beta1 agonists
13
Q
Reversal of blockade by neuromuscular blockers
A
Cholinesterase inhibitors
14
Q
Reduce transient hyper GI motility
A
Dicyclomine, methscopolamine
15
Q
Antiglaucoma organophosphate, indicated but not used much clinically anymore due to long duration of action
A
Echothiophate
16
Q
Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis
A
Edrophonium
17
Q
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis
A
Ephedrine
18
Q
This is the drug of choice for anaphylactic shock
A
Epinephrine
19
Q
Nonselective alpha agonists that decrease aqueous production and increase aqueous outflow
A
Epinephrine, dipivefrin
20
Q
This parenteral beta blocker is a short acting
A
Esmolol
21
Q
Epinephrine and dipivefrin are used for
A
Glaucoma
22
Q
Ganglion blockers that were indicated (but not anymore) for severe hypertension
A
Hexamethonium, trimethaphan
23
Q
Shock due to septicemia or myocardial infarction is made worse by
A
Increasing afterload and tissue perfusion declines
24
Q
Atropine fever is the most dangerous effect and can be lethal in this population group
A
Infants
25
Contraindications to use of atropine
Infants, closed angle glaucoma, prostatic hypertrophy
26
Combined alpha and beta blocking agents that may have application in treatment of CHF
Labetalol and carvedilol
27
Insecticide organophosphate
Malathion, parathion
28
Chronic orthostatic hypotension can be treated with
Midodrine
29
This beta blocker is the longest acting
Nadolol
30
Carbamate with intermediate action and used as off-label for postoperative paralytic ileus and urinary retention
Neostigmine
31
Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis
Nondepolarizing Neuromuscular Blockers
32
Prototypical drug is atropine
Nonselective Muscarinic Antagonists
33
Cystitis, postoperative bladder spasms, or incontinence
Oxybutynin, dicyclomine
34
Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis
Phenoxybenzamine
35
Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud's phenomena
Phentolamine
36
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia
Phenylephrine
37
Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions
Physostigmine
38
Muscarinic that is very lipid soluble and used in glaucoma
Pilocarpine
39
Muscarinic used to treat dry mouth in Sjˆgren's syndrome
Pilocarpine or Cevimeline
40
Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction
Pilocarpine, carbachol, physostigmine
41
Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
Pindolol and acebutolol
42
This agent competes for phosphorylated cholinesterase enzyme and regenerates enzyme if organophosphate-enzymes complex has not "aged"
Pralidoxime
43
This beta blocker is highly lipid soluble and may account for side effects such as nightmares
Propranolol
44
This agent cause increased aqueous outflow
Prostaglandin PGF2a (latanoprost, travoprost, unoprostone)
45
Treatment of myasthenia gravis and sometimes used prophylactically for organophosphate poisoning in chemical warfare
Pyridostigmine
46
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma
Reduce aqueous synthesis
47
Often mixed with local anesthetic to
Reduce the loss from area of injection
48
The most important cause of acute deaths in cholinesterase inhibitor toxicity
Respiratory failure
49
Longer acting Beta 2 agonists is recommended for prophylaxis of asthma
Salmeterol
50
Beta 1 agonist toxicity
Sinus tachycardia and serious arrhythmias
51
Beta 2 agonist toxicity
Skeletal muscle tremor
52
Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use
Succinylcholine
53
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus
Terbutaline
54
Selective Alpha 2 blocker used for impotence (controversial effectiveness)
Yohimbine
55
NSAID avoided in gout because low doses increases uric acid levels
Aspirin
56
Period of time of therapy after which GC therapy will need to be tapered
5-7 days
57
Four main actions of NSAIDS
Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
58
Irreversible, nonselective COX inhibitor
Aspirin (or other salicylates)
59
Difference between aspirin and other NSAIDS
Aspirin irreversibly inhibits cyclooxygenase
60
Long acting GC's
Betamethasone, dexamethasone, and paramethasone
61
Drug that selectively inhibits COX 2
Celecoxib
62
Newer NSAIDs that selectively inhibit COX-2
Celecoxib
63
Short acting GC's
Cortisone and hydrocortisone (equivalent to cortisol)
64
Difference between COX 1 and COX 2
COX 1 is constitutive while COX 2 may be induced during inflammation, although COX 2 is constitutive in some tissues
65
Mineralocorticoids
Fludrocortisone and deoxycorticosterone
66
COX 2 inhibitors may have reduced risk of
Gastric ulcers and GI Bleeding
67
Used for Addison's disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)
Glucocorticoids
68
SE of acetaminophen
Hepatotoxicity
69
NSAID used in gout
Indomethacin, ibuprofen
70
MOA of corticosteroids
Induce lipocortins to 1. inhibit phospholipase A2, 2. repress COX-2 gene and enzyme expression, 3. repress cytokines that activate COX-2
71
MOA of NSAIDS
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
72
NSAID available orally, IM, IV, nasally, and ophthalmically
Ketoralac
73
NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
Ketoralac
74
Major SE of zileuton
Liver toxicity
75
Class of drugs that reversibly inhibit COX
NSAIDS
76
Approved for use in severe pulmonary HTN
PGI2 (epoprostenol)
77
The reason why aspirin is contraindicated in children with viral infection
Potential for development of Reye's syndrome
78
COX 2 inhibitors should be used cautiously in pts with
Pre-existing cardiac or renal disease
79
Intermediate acting GC's
Prednisone, methylprednisolone, prednisolone, oaramethasone, fluprednisone and triamcinolone
80
SE of salicylates
Tinnitus, GI bleeding
81
Inhibitor of leukotrienes (LTD4) receptors and used in asthma
Zafirlukast and montelukast
82
Inhibit angiotensin-converting enzyme (ACE)
ACE inhibitors
83
Carbonic anhydrase inhibitor
Acetazolamide
84
Nitroprusside vasodilates
Arteries and veins
85
Drugs used in the management of angina
Aspirin, Nitrates, CCB, and Beta blockers
86
Beta-blockers should be used cautiously in
Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease
87
Block L-type calcium channel
Calcium channel blockers
88
Beta blockers are used for which type of anginal attack
Classic
89
Presynaptic Alpha 2 agonist used in HTN
Clonidine, and methyldopa
90
Toxicity caused by nitroprusside and treatment
Cyanide toxicity treated with sodium thiosulfate
91
Direct vasodilator of arteriolar smooth muscle
Hydralazine
92
SE of minoxidil
Hypertrichosis
93
Mechanism of action of spironolactone
Inhibit mineralocorticoid receptor and inhibit Na/K-ATPase and ENaC synthesis
94
Mechanism of action of thiazide diuretics
Inhibit Na+/Cl- cotransport
95
Mechanism of action of loop diuretics
inhibits Na+/K+/2Cl- cotransporter
96
Diuretic used in hypertensive patients with renal failure
Loop diuretics (furosemide, ethacrynic acid, butmetanide)
97
Arterial vasodilator that works by opening K+ channels
Minoxidil
98
CCB with predominate effect on arteriole dilation
Nifedipine
99
Nitrate used for acute anginal attacks
Nitroglycerin sublingual tablets
100
IV Drug used Hypertensive Crisis
Nitroprusside
101
Nitrate used to prevent further attacks
Oral and transdermal forms of nitroglycerin
102
Aminoglycosides used with loop diuretics potentiate this adverse effect
Ototoxicity
103
Non-selective Alpha1blockers use to treat pheochromocytoma
Phenoxybenzamine
104
For rebound HTN from rapid clonidine withdrawal
Phentolamine
105
Aspirin reduces mortality in unstable angina by
Platelet aggregation inhibition
106
SE of methyldopa
Positive Comb's test, depression
107
SE of nitrates
Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation
108
CCB are DOC for
Prinzmetal's angina
109
Non-selective Beta-blocker also used for migraine prophylaxis
Propranolol
110
SE of clonidine
Rebound HTN, sedation, dry mouth
111
Class of drugs that may cause cross-sensitivity with thiazide diuretics
Sulfonamides
112
Diuretic used as first line for treatment of hypertension
Thiazides
113
Nitrate free intervals are needed due to
Tolerance
114
Alpha-glucosidase inhibitor associated with elevation of LFT's
Acarbose
115
Examples of alpha-glucosidase inhibitors (AGI)
Acarbose, miglitol
116
Drugs available in combination with metformin
Acroplus Met progutazone and metformin, Janumet and Janumet XR Sitagliptin and Metformin, Glyburide, glipizide, and rosiglitazone
117
MOA of AGI's
Act on intestine, delay absorption of glucose
118
Sulfonylurea NOT recommended for elderly because of very long half life
Chlorpropamide
119
First generation sulfonylurea
Chlorpropamide, tolbutamide, tolazamide, etc.
120
MOA of metformin
Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
121
SE of Thiazolindinediones
Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism; if used over one year, bladder Cancer; with CHF, may cause new or worsening CHF
122
SE of AGI's
Flatulence (do not use beano to tx), diarrhea, abdominal cramps
123
Ultra long acting insulin, has over a day duration of action
Glargine (Lantus)
124
Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation
Glucagon
125
Important in synthesis of glucose to glycogen in the liver
GLUT 2
126
Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation
GLUT 4
127
Second generation sulfonylurea
Glyburide, glipizide, glimepiride, etc.
128
Reason troglitazone was withdrawn from market
Hepatic toxicity
129
Major side effect of insulin
Hypoglycemia
130
Common SE of sulfonylureas, repaglinide, and nateglinide
Hypoglycemia
131
MOA of both generations
Insulin release from pancreas by modifying K+ channels
132
MOA of repaglinide
Insulin release from pancreas; faster and shorter acting than sulfonylurea
133
Beta cells are found
Islets of Langerhans
134
Most important potential SE of metformin
Lactic acidosis
135
Very rapid acting insulin, having fastest onset and shortest duration of action
Lispro (Humalog)/Apidra (glulisine)
136
Biguanide
Metformin
137
Endogenous insulin
Normal C-peptide
138
Thiazolidinediones
Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)
139
Alpha cells in the pancreas
Produce glucagon
140
Beta cells in the pancreas
Produce insulin
141
Delta cells in the pancreas
Produce Somatostatin
142
Rapid acting, crystalline zinc insulin used to reverse acute hyperglycemia
Regular (Humulin R)
143
Meglitinide
Repaglinide
144
MOA of thiazolindinediones
Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
145
MOA of nateglinide
Stimulates rapid and transient release of of insulin through closure of the ATP-sensitive K+ channel
146
Anti-seizure medication also used in the prevention of migraines
Valproic acid
147
Adenosine's MOA
Activates acetylcholine sensitive K+ channels in SA and AV node
148
DOC for paroxysmal supraventricular tachycardia (PSVT)
Adenosine
149
Anti-arrhythmic with <10 second duration of action
Adenosine
150
MOA for Valproic acid at high doses
Affect calcium, potassium, and sodium channels
151
Carbamazepine may cause
Agranulocytosis
152
Class III antiarrhythmic that exhibits properties of all 4 classes
Amiodarone
153
Antiarrhythmic effective in most types of arrhythmia
Amiodarone
154
SE for Felbamate
Aplastic anemia and acute hepatic failure
155
Class II antiarrhythmics are
B-blockers
156
Anti-arrhythmics that decrease mortality
B-blockers
157
MOA of class IV antiarrhythmics
Calcium channel blockers
158
MOA for Ethosuximide
Calcium channels
159
Anti-seizure drugs used also for Trigeminal neuralgia
Carbamazepine
160
Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida
Carbamazepine
161
Anti-seizure drugs used as alternative drugs for mood stabilization
Carbamazepine, gabapentin, lamotrigine, and valproic acid
162
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents
Class IC (flecainide, propafenone, moricizine)
163
Drugs that can be used for infantile spasms
Corticosteroids
164
Drug used supraventricular arrhythmias
Digoxin
165
Used intravenously for acute arrhythmias during surgery
Esmolol
166
MOA for benzodiazepines and barbiturates
GABA-related targets
167
SE of phenytoin
Gingival hyperplasia
168
Most frequent route of metabolism
Hepatic enzymes
169
Major drug interaction with Quinidine
Increases concentration of Digoxin
170
Drugs of choice for status epilepticus
IV diazepam (or lorazapam) followed by phenytoin
171
Agent to treat torsades de pointes
Magnesium sulfate
172
DOC for febrile seizures
Phenobarbital
173
DOC for digoxin induced arrhythmias
Phenytoin
174
Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism
Phenytoin
175
MOA of class III antiarrhythmics
Potassium channel blockers
176
Specific pharmacokinetic characteristic of amiodarone
Prolonged half-life, up to six weeks
177
Side effect of sotalol
prolongs QT and PR interval
178
Laboratory value required to be monitored for patients on valproic acid
Serum ammonia and LFT's
179
Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine
Sodium blockade
180
Antiarrhythmic that exhibits Class II and III properties
Sotalol
181
SE for Lamotrigine
Stevens-Johnson syndrome
182
Other side effects of Quinidine
Thrombocytopenic purpura, and CINCHONISM
183
SE of Amiodarone
Thyroid dysfunction, photosensitivity, skin (blue smurf syndrome), corneal deposits, liver damage and pulmonary fibrosis
184
Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress
Valproic acid
185
Anti-seizure drugs used also for bipolar affective disorder (BAD)
Valproic acid, carbamazepine, phenytoin and gabapentin
