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Pharm > Pharm 1 - Test 2 > Flashcards

Pharm 1 - Test 2 Flashcards

1
Q

Quinidine/quinidex drug class, mechanism, and indications?

A

Class 1a Na channel blocker decreases inward flow of Na at phase 0 resulting in lengthened refractory period

Used to treat A-flutter, A fib, And AV/ventricular arrhythmias

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2
Q

Qunidine/quinidex side effects?

A

Cinchonism - blurred vision, tinnitus, N/V, HA, disorientation, psychotic states
Torsade de pointes (turning on point) - arrhythmia of abnormal v-tach

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3
Q

Mexiletine/mexitil drug class, mechanism, and indications?

A

Class 1b Na channel blocker shortens phase 3 (repolarization)

Used to treat ventricular arrythmias - particularly Vtach after an MI

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4
Q

Mexiletine/mexitil side effects?

A

Drowiness, confusion, pro-arrhythmic

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5
Q

Flecainide/tambocor drug class, mechanism, and indications?

A

Class 1c Na channel blocker slows phase 0 depolarization

Used to treat tupraventricular tachycardia - wolff parkinson white syndrome, v-tach, and paroxysmal supraventricular tachycardia

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6
Q

Flecainide/tambocor side effects?

A

Pro-arrythmic
C/I with history of MI or acute ischemic event
NARROW THERAPEUTIC INDEX

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7
Q

Atenolol/tenormin drug class, mechanism, and indications?

A

Class II beta blocker (cardio-selective)
Reduces sympathetic effects on heart muscle - diminishes phase 4 depolarization and blunts sympathetic influence on AV/SA nodes

Used to treat tachyarrythmias (A flutter, A-fib,HTN, angina, and post MI

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8
Q

Atenolol side effects?

A

Bradycardia, hypotension, dizziness, depression, fatigue, impotence
*can influence bronchoconstriction - caution with asthma/COPD pts

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9
Q

Amiodarone/cordarone drug class, mechanism, and indications?

A

Class III K channel blocker prolongs phase 3 - also blocks sympathetic and Na/Ca channels

Used to treat ventricular arrythmias following MI - used before pacemaker

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10
Q

Amiodarone/cordarone side effects?

A

High iodine content can cause blue-gray skin discoloaration (C/I in pts with goiter, graves, or hypothyroid)

Can also cause dizziness, light-headedness, and pulmonary fibrosis

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11
Q

Verapamil/Calan drug class, mechanism, and indications?

A

Class IV Ca channel blocker
Slows phase 4 depolarization resulting in slowed AV conduction

Used to treat A flutter, A fib (risk of embolism), PVST, HTN, and angina

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12
Q

Verapamil/calan side effects?

A

Dizziness, flushing, HA, hypotension

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13
Q

Adenosine/adenocard drug class, mechanism, and indications?

A

Endogenous nucleoside prolongs refractory period and decreases automaticity in AV node - acts for 15sec

Used for PVST - drug of choice, but only available IV

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14
Q

Adenosine/adenocard side effects?

A

Flushing, HA, light-headedness, hypotension, chest pain

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15
Q

Atropine/belladona drug class, mechanism, and indications?

A 
Tropane alkaloid (from belladonna)
Anticholinergic - competitive inhibitor of muscarinic acetylcholine receptors (parasympatholytic)

Used for emergent treatment of bradycardia with hypotension

Also used for…

  • cycloplegic - temporarily paralyzing pupillary muscles
  • Mydriatic - dilation of pupils
  • small doses orally for diarrhea
  • decrease bronchial/salivary secretions
  • Organophosphate poisoning (Salvation, lacrimation, urination, diarrhea, GI distress, emesis)
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16
Q

Atropine/belladona side effects? Antidote?

A

blurred vision, dilated pupils, dry mouth, increased HR

Toxicitiy - “dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter”

Antidote = physostigmine?

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17
Q

Digoxin/lanoxin drug class, mechanism, and indications?

A

Cardiac glycoside (found in foxglove) inhibits Na/K ATPase to create greater influx of calcium into heart cells to slow rate and increase contractility

Used to treat CHF, A-fib, A-flutter

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18
Q

Digoxin/lanoxin side effects?

A

Arrythmia, bradycardia, heart block, N/V, diarrhea, drowsiness, fatigue, blurred vision, flickering dots

ANTIDOTE = digoxin immune Fabs (Digibind)

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19
Q

Niacin MOA/indications?

A

Decreases VLDL synthesis in liver and lowers alpha-lipoproteins
Indicated for hyperlipidemia - especially elevated TGs

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20
Q

Niacin side effects?

A

Liver damage, GI distrurbance, skin flushing, myositis

  • Less flushing when taken with ASA/NSAIDs

** C/I in pts with DM, active liver disease, or PUD - follow LFTs!

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21
Q

Safer niacin alternative?

A

Inositol hexanicinate

500-1000mg tid with meals

22
Q

Gemfibrozol/lopid drug class/MOA and indications?

A

Fibric acid derivative

Hyperlipidemia - especially elevated TGs and low HDL

23
Q

Gemfibrozol/lopid side effects?

A

GI disturbance, myositis, liver damage, gall stones

  • C/I in pts with gall bladder or liver disease
24
Q

Atorvastin/lipitor drug class/mechanism?

A

HMG-coA reductase inhibitor (STATIN)
Inhibits rate limiting step in cholesterol synthesis
*Also inhibits production of CoQ10 - important to supplement!

25
Q

Atrovastin/lipitor indications?

A

Hyperlipidemia - most effective at lowering cholesterol

Symptomatic and non-symptomatic CAD

26
Q

Atrovastin/lipitor side effects?

A

Memory/cognitive dysfunction
Myositis and risk of rhabdomyolysis - check SPK levels!
Liver damage - check liver enzymes! (0, 6, and 12 wks)

*CATEGORY X

27
Q

Atrovastin/lipitor rx?

A

Lipitor 20/40/80 mg
1 po qd
disp: 30
refill: 0

28
Q

Cholystyramine/questran drug class/MOA and indications?

A

Bile acid sequestrant
Forms insoluble complex with bile resulting in greater amts of cholesterol oxidized into bile and excreted in stool

Indicated for hyperlipidemia (*CAN be used with liver disease)

Can also be used to prevent diarrhea in crohn’s pts or pts with pseudomembranous colitis from C. diff.

29
Q

Cholestyramine/questran side effects?

A

Bloating, constipation, decreased absorption of fat soluble vitamins and folic acid

Can also decrease efficacy of other meds - take 1 hr before or 4-6 hrs after meals

Category C - caution with use in pregnancy/lactation

30
Q

Ezetimibe/zetia drug class/MOA and indications?

A

Cholesterol absorption inhibitor
Inhibits cholesterol absorption at brush border
Also reduces apoliporotien B

Used for hyperlipidemia - often in conjunction with statins

31
Q

Ezetimibe/zetia side effects?

A

Diarrhea, myalgia, abdominal pain

Category C

32
Q

Sulfamethoxazole/gantanol drug class/MOA and indications?

A

Sulfonamide
Competitive inhibition of enzyme that converts PABA to dihydropteroate - a key step in folate synthesis

Used for UTIs, OM, bronchitis

33
Q

Sulfamethoxazole/gantanol side effects and characteristics?

A

Broad spectrum bacteriostatic against any organism that must make its own folic acid

Distributed in all body tissues (including CSF)

Can cause PHOTOSENSITIZATION

Largely replaced by Trimethoprim sulfa (broader spectrum)

34
Q

Trimethoprim sulfa/bactrim drug class/MOA and indications?

A

Sulfonamide with combination folic acid inhibitor
Interferes with folate synthesis at an additional, successive step to sulfonamides
Used for similar infections as sulfamethoxazole, plus PNEUMOCYSTITIS PROPHYLAXIS and MRSA

35
Q

Trimethoprim sulfa/bactrim side effects and characteristics?

A

Causes nausea, diarrhea, photosensitivity rash, and rarely steven johnson syndrome

36
Q

Trimehoprim sulfa/bactrim Rx?

A

Bactrim DS
1 po bid x 5 days
disp 10
refill 0

37
Q

Penicillin G drug class/mechanism and indications?

A

Beta lactam inhibitor
Binds to PCPs on bacteria to inhibit peptidoglycan cross-linkage

Effective for gram + infecections as well as gram - neisseria (crosses BBB to treat meningitis)

38
Q

Penicillin G side effects and characteristics?

A

Hypersensitivity reaction - most common cause of severe allergic reaction (though rare)

Can be administered with procaine IM to reduce pain and prolong half life

39
Q

Amoxicillin/amoxil class/MOA and indications?

A

Beta lactam inhibitor
Binds to PCPs on bacteria to inhibit peptidoglycan cross-linkage

Used against strep throat, OM, resp infxns, skin infxns - NOT neisseria meningitidis (does NOT cross BBB)

40
Q

Amoxicillin and clavulanate/augmentin drug class/MOA and indications?

A

Same as amoxicillin, but broader spectrum with clavulanate which prevents beta lactamase inhibition - BROADER SPECTRUM

UTI, strep throat, OM, resp infxns and skin infxns

41
Q

Amoxicillin and clavulante/augmentin side effects and characteristics?

A

Causes more GI disturbance, and potentially PSEUDOMEMBRANOUS COLITIS from C diff.

Dose cannot be simply doubled as 250, 500, and 750mg each has same clavulanate which causes gut disturbance

42
Q

Augmentin Rx?

A

Augmentin 500mg tabs
1 po tid x 5 days
disp 15
refill 0

43
Q

Cephalexin/keflex drug class/MOA and indications?

A

Cephalosporin
Similar to beta lactam inhibitors (penicillin), causing disrupted synthesis of peptidoglycan cell wall

Used for patients who have penicillin allergy
Also has better coverage for atypical microbes (mycoplasma, legionella

44
Q

Erythromycin drug class/MOA and indications?

A

Macrolide
inhibitis bacterial protein synthesis at 50s bacterial ribosome
accumulates within leukocytes to be transported to site of infection

Used for pts with penicillin allergy (also wider spectrum)
Covers typical and atypical respiratory infxns
Also chlamydia, syphillis, and gonnorrhea

45
Q

Erythromycin side effects and characteristics?

A

GI upset common - tabs are coated to help prevent upset stomach
steven johnson syndrom rare

Mainly bacteriostatic but bactericidal at high enough concentration

46
Q

Azithromyzin/zithromax drug class/MOA and indications?

A

Macrolide
inhibitis bacterial protein synthesis at 50s bacterial ribosome
accumulates within leukocytes to be transported to site of infection

Covers atypical resp infxns, chlamydia, mycoplasma, mycobacteria, reckettsia

47
Q

Zitrhromax side effects and characteristics?

A

Similar to erythromycin - less GI disturbance

Has long half life (68hrs)

Dosed in “Zpack”

48
Q

Zitrhomax Rx?

A

Zithromax 250mg tabs
2 tabs po on day 1 followed by 1 tab po qd x 4 days
disp 6
refill 0

49
Q

Tetracyclin/sumycin drug class/MOA and indications?

A

Tetracycline
Inhibits bacterial protein synthesis at 30s ribosomal subunit

Used most commonly to treat acne and rosacea
Also used against resp infxns, chlamydia, lyme, rocky mtn spotted fever

50
Q

Tetracyclin/sumycin side effects and characteristics?

A

GI disturbance, Photosensitivity, STAINED TEETH (in younger than 15yrs)

Potent calcium chelator - dont take with dairy or Ca supplement

Reduced efficacy with BACTERIAL RESISTANCE

51
Q

Gentamicin/garamycin drug class/MOA and indications?

A

Aminoglycoside
Inhibits bacterial protein synthesis at 30s AND 50s bacterial ribosomal subunit

Used against gm - microbes
Emperic treatment for sepsis
Meningitis, endocarditis, TB
Topically fin drops for conjunctivitis

52
Q

Gentamicin/garamycin side effects and characteristics?

A

Nephrotoxicity and ototoxicity

Administered IV and topically only

Should d/c for less toxic microbe after empiric treatment

MAinly used for life threatening situations!

Pharm (2 decks)

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