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Fifth Term > PHARM > Flashcards

PHARM Flashcards

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1
Q

Acetylcholine

A

Direct Acting Cholinergic Agonist
Choline Ester

Rapidly Hydrolized

Rapid miosis after cataract surgery

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2
Q

Cromolyn

A

Autacoid
Mast stabilizer

Reduces immunologic degranulation of mast cells

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3
Q

Nedocromil

A

Autacoid
Mast stabilizer

Reduces immunologic degranulation of mast cells

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4
Q

Bethanechol Receptor

A

Muscarinic Only

Direct Cholinergic Action

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5
Q

Bethanechol Structure

A

Ester of choline, not hydrolized by AChE, inactivated by other esterases

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6
Q

Bethanecol Uses

A

GI-Post-op distension, atony, retention, ileus, megacolon, refulx

Neurogenic Atonic Bladder

Xerostomia

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7
Q

Bethanecol Adverse Effects

A

Exaggeration of PSNS (DUBMBELLS)

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8
Q

Carbachol Receptor

A

Muscarinic, Nicotinic

Direct Cholinergic Action

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9
Q

Carbachol Structure

A

Ester of choline, pore substrate for AChE, slow biotransformation

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10
Q

Carbachol Effects

A

Miosis

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11
Q

Carbachol Use

A

Glaucoma-reduces intraocular pressure

Miosis during surgery or post-op

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12
Q

Carbachol AE

A

External only: high potency and long duration

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13
Q

Methacholine Receptor

A

Muscarinic mostly, some nicotinic

Direct Cholinergic Action

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14
Q

Methacholine Structure

A

Ester of Choline, slow hydrolysis by AChE

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15
Q

Methacholine Use

A

Diagnose asthma by bronchial agitation (not commonly used)

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16
Q

Pilopcarpine Receptor

A

Partial Muscarinic

Direct Cholinergic Action

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17
Q

Pilocarpine Structure

A

Natrual Alkaloid-Tertiary Amine, stable to hydrolysis by AChE

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18
Q

Pilocarpine Effects

A

Sweat, salivary, lacrimal, and bronchial gland secretions.

Contracts Iris

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19
Q

Pilocarpine Uses

A

DOC for acute angle glaucoma
2nd choice for open angle (timolol is DOC)

Xerostima/Sjorgen’s Syndrome

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20
Q

Pilocarpine AE

A

CNS Disturbances

Sweating, salivation

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21
Q

Nicotine Receptor

A

Nn, some Nm

Direct Cholinergic Action

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22
Q

Nicotine Structure

A

Natural Alkaloid-Tertiary amine

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23
Q

Nicotine MOA, Low dose

A

ganglion stimulation by depolarization (SNS and PSNS)

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24
Q

Nicotine MOA, High dose

A

Ganglion and neuromuscular blockade

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25
Nicotine Effects
CVS: SNS due to catecholamine from andrenergic nerves and adrenal medulla GI and Urinary: PSNS and initial stimulation of salivary and bronchial secretions
26
Areocoline Structure
Natural Alkaloid (muscarinic), less important clinically Direct Cholinergic Action
27
Varenicline Receptor
Nn (partial)
28
Vernicline MOA
Ganglion Stimulant
29
Verincline Use
Smoking cessation, orally or transdermally applied
30
Phenobarbital PK
Induces P450 PXR and CAR
31
Pheyntoin PK
Induces P450 CAR Shows saturation kinetics (zero order) for clearance
32
Rifampin PK
Induces P450 PXR
33
Carbamazepine PK
Induces P450 PXR
34
Cimetidine PK
Inhibits P450
35
Ketoconazole PK
Inhibits P450
36
Erythromycin PK
Inhibits P450
37
Chloramphenicol PK
Inhibits P450
38
Warfarin PK
Induces P450
39
Acetominophen PK
Metablized by CYP2E1 In presence of alcohol, Acetominophen is metabolized into Nacteylcysteine. Antidoe is NAPQ and cysteine
40
Endrophonium Receptor
Anti-AChE-Amplification of endogenous ACh Won't work on epithelial M3
41
Endrophonium Structure
Simple alcohol with quaternary ammonium group-can't enter CNS
42
Endrophonium MOA
Inhibits AChE and ButylcholinesteEst to increase ACh Binds reversibly to active site on AChE Competetive antagonist, short lived
43
Endrophonium Effects
NMJ: Increased contraction in weak muscles Can reverse blockade after surgery
44
Endrophonium Indications
Diagnosis of Myasthenia-gravis Reverse Neuromuscular block from non-polarizing muscular blockers
45
Endrophonium PK
Hydrolized by receptor, short duration, not meant for treatment
46
Neostigmine Receptor
Anti-AChE, Amplifies endogenous ACh action Won't work on epithelial M3
47
Neostigmine Structure
Carbamate ester of alcohol, quaternary ammonium, no CNS effect
48
Neostigmine MOA
Inhibits AChE and butyrlcholineE to increase ACh Binds covalenty to active site, longer duration
49
Neostigmine Effects
CNS: EEG Activation Eye, Respiratory, GI and urinary: PSNS CVS: negative chronotrope, hypotension and decrease cardiac output NMJ: Increased contraction in weak muscles Can reverse blockade after surgery
50
Neostigmine Indications
Stimulates GI, bladder Antidote for tubocararine, other competitive NMJ blockers Treats myasthenia gravis More effect on NMJ than physostigmine
51
Neostigmine PK
Hydrolized by receptor
52
Neostigmine AE
Salivation, flushing, low bp, nausea, abdominal pain, diarrhea, bronchospasm
53
Phsyostigmine Receptor
Anti-AChE, amplifies action of endogenous ACh Won't work on epithelial M3
54
Physostigmine Structure
Carbamate Ester of Alcohol, tertiary ammonium, enters CNS
55
Phsyostigmine MOA
Inhibits AChE and butyrlcholineE Binds covalently to active site, long duration
56
Physostigmine Effects
CNS: EEG Activation Eye, Respiratory, GI and urinary: PSNS CVS: negative chronotrope, hypotension and decrease cardiac output NMJ: Increased contraction in weak muscles Can reverse blockade after surgery
57
Physostigmine Indications
Intestinal, bladder atony Treat anticholinergic drug overdose (ie-Atropine overdose)
58
Physostigmine PK
Hydrolized by receptor
59
Physostigmine AE
Convulsions, Flushing, Bradycardia, Accumulation of ACh leading to skeletal muscle paralysis
60
Physostigmine Contraindications
Patients with TCA overdose (aggrevates block and AV node)
61
Pyridostigmine Receptor
Anti-AChE, amplification of endogenous ACh. Won't work on epithelial M3
62
Pyridostigmine Strucutre
Carbamate ester of alcohol, quaternary ammonium, won't enter CNS
63
Pyridostigmine MOA
Inhibits AChE and ButyrlcholineE Covalenty binds to active site, long mechanism of action
64
Pyridostigmine Effects
CNS: EEG Activation Eye, Respiratory, GI and urinary: PSNS CVS: negative chronotrope, hypotension and decrease cardiac output NMJ: Increased contraction in weak muscles Can reverse blockade after surgery
65
Pyridostigmine Indications
Most common drug for Myasthenia Gravis
66
Pyridostigmine AE
CNS toxicity
67
Echothiophate Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
68
Malathion Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
69
Parathion Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
70
Tabun Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3 Nerve Agent
71
Sarin Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3 Nerve Agent
72
Soman Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3 Nerve Agent
73
Tacrine Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
74
Donepezil Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
75
Rivastigmine Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
76
Galantamine Receptor
AChE, amplifies endogneous ACh Won't work on epithelial M3
77
Echothiophate Structure
Organophosphate (not lipid soluble)
78
Echothiophate MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
79
Echothiophate Indications
Gluacoma | -Chronic open angle, subacute or chronic angle closure after surgery or if surgery is not chosen
80
Echothiophate PK
All organophosphates are distributed throughout the entire body, inlcuding CNS
81
Echothiophate AE
Organophosphate overdose or exposure is treated with atropine and pralidoxime
82
Malathion Structure
Organophosphate (Thiophosphate)
83
Malathion MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
84
Malathion Indications
Insecticide
85
Malathion PK
Acitvated by conversion to oxygen analogs Rapidly metabolized to inactive products by birds and humans but not in insects. Less toxic to humans than parathion
86
Malathion AE
CNS toxicity, treated with atropine or pralidozime
87
Parathion Structure
Organosphosphate (Thiophosphate)
88
Parathion MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
89
Parathion Indications
Insecticide
90
Parathion PK
Activated in body by conversion to oxygen analogs Not detoxed in vertebrates, very toxic to humans
91
Parathion AE
CNS Toxcity, treated by atropine or pralidoxime
92
Tabun Structure
Organophosphate
93
Tabun MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
94
Tabun Effects
Extremely potent CNS Toxin
95
Tabun Indications
Terrorism
96
Tabun AE
CNS Toxicity, treated with atropine and pralidozime
97
Sarin Structure
Organophosphate
98
Sarin MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
99
Sarin Effects
Extremely potent CNS toxin
100
Sarin Indications
Terrorism
101
Sarin AE
CNS Toxicity, treated with atropine and pralidoxime
102
Soman Structure
Organophosphate
103
Soman MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
104
Soman Effects
Extremely potent CNS toxin
105
Soman Indications
Terrorism
106
Soman AE
CNS toxicity, treated with atropine and pralidoxime
107
Tacrine MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
108
Tacrine Use
Alzheimer's
109
Donepezil MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
110
Donepezil Use
Alzheimer's
111
Rivastigmine MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
112
Rivastigmine Use
Alzheimer's
113
Galantamine MOA
Inhibits AChE and butrylcholineE Binds to and hydrolized by enzyme, active site is phosphorylated-extremely stable covalent bond Phosphorylated enzyme may undergo aging, which strengthens bond.
114
Galantamine Use
Alzheimer's
115
Pralidoxime Receptor
AChE Regenerator
116
Pralidoxime MOA
AChE reactivator outside CNS will split the phosphate-enzyme bond if aging has not occured-needs early administration
117
Pralidoxime Uses
Early ogranophosphate poisoning
118
Muscarine Structure
Natural Alkaloid Direct Cholinergic Action
119
Atropine Receptor
Muscarinic Antagonist
120
Atropine MOA
Bines competitively to muscarinic Receptors, central and peripheral
121
Atropine Effects
Eye: Myrdriasis, cyclopegia, unresponsiveness to light GI: Antispasmodic, HCl not effected Urinary: Decreased hypermobility of bladder eneuresis CVS: High dose: Blockade of atrial M2 with tachycardia Low dose: initial bradycardia (M2 blockade on vagal Post-gang fibers), blocks vasodilation of skeletal muscle and coronary vascular beds Secretions: inhibition of salivary, sweat, and lacrimal glands, increases body temp
122
Atropine Indications
AChE inhibotor or organosphophate poisoning treatment Mydriasis with cyclopegia Antispadmotic for atonic bladder Reverses sinus bradycardia Given with neostigmine to counter NMJ blockade Atropine flush at high doses: cutaneous vasodilation
123
Atropine PK
Readily absorbed, partially metabolized by liver, eliminated in urine half life: 4 hours
124
Muscarinic Antagonist AE
May raise intraocular pressure colose angle glaucoma Cutaneous vasodilation in upper body High body temp (no sweat) Dry mouth, blurred vision, sandy eyes, tachycardia, constipation, urinary retention Bradycardia (low dose) and tachycardia and CNS effects (high doses) Tertiary only: confusion, hallucinations, delerium, leading to depression, circulatory and respiratory collapse, leading to death
125
Muscarinic Antagonist Contraindications
Patients with: Peptic ulcers, old age, close angle glaucoma, prostratic hypertrophy/BPH (risk of decreased detrussor contraction), Fever, Elderly patients
126
Scopalamine Receptor
Muscarinic Antagonist
127
Scopalamine Structure
Belladona alkaloid Tertiary amine Greater effects on CNS and longer action than atropine
128
Atropine Structure
Belladonna alkaloid Tertiary amine
129
Scopalamine Effects
DOC for motion sickness-transdermal Blocks short term memory, sedation, excitment at high doses
130
Scopalamine Indications
DOC for motion sickness-transdermal Mydriasis and cyclopegia in diagnostic procedures and treatment of irdocyclitis
131
Ipratropium Receptor
Muscarinic Antagonist | Blocks M3
132
Ipratropium Structure
Quaternary Ammonium, no CNS
133
Ipratropium MOA
Blocks M3, causes bronchodialtaion
134
Ipratropium Indications
COPD for patients unable to take andrenergic agonists Off label: Asthma Inhaled
135
Tiotropium Receptor
Muscarinic Antagonist
136
Tiotropium Structure
Quaternary ammonium, no CNS
137
Tiotropium Effects
Bronchodilation
138
Tiotropium Indications
COPD only
139
Homatropine Structure
Tertiary Amine, topical
140
Homatropine Effects
Mydriasis with cyclopegia Short duration
141
Homatropine Uses
Opthamology
142
Cyclopentaloate Receptor
Muscarinic Antagonist
143
Cyclopentaloate Structure
Tertiary amine, topical
144
Cyclopentaloate Effects
Mydriasis with cyclopegia Short duration
145
Cyclopentaloate Uses
Opthamology
146
Tropicamide Receptor
Muscarinic Antagonist
147
Tropicamide Structure
Tertiary Amine, topical
148
Tropicamide Effects
Mydriasis with cyclopegia short duration
149
Tropicamide Indications
Opthamology
150
Benztropine Receptor
Muscarinic Antagonist
151
Bextropine Structure
Tertiary amine
152
Benztropine Indications
Parkinsoniism and extrapyrimidal effects of anti-psychotic drugs
153
Trihexyphenidyl Receptor
Muscarinic Antagonist
154
Trihenxyphenidyl Structure
Tertiary amine
155
Trihenxyphenidyl Use
Parkinsoniism and extrapyrimidal effects of anti-psychotic drugs
156
Glycopyrrolate Receptor
Muscarinic antagonist
157
Glycopyrrolate Structure
Quaternary Ammonium (no CNS)
158
Glycopyrrolate Uses
Oral: Inhibits GI motility Parental: Prevents bradycardia during surgery
159
Tolterodine Receptor
Muscarinic Antagonist
160
Tolterodine Structure
Tertiary amine
161
Tolterodine Use
Overactive bladder
162
Tetraethylammonium (TEA) Receptor
Nn Ganglion Blocker
163
Tetraethylammonium (TEA) Structure
Quaternary ammonium
164
Ganglion Blocker MOA
Blocks ACh at nicotinic receptors of both PSNS and SNS ganglia by prolonging depolaraization after stimulation of antagonising receptors. Can also block ion channel gated by the Nn
165
Tetraethylammonium (TEA) Indications
First ganglion blocker, little use
166
Tetraethylammonium (TEA) PK
Very short duration
167
Ganglion Blocker AE
Vaso/venodilation, hypotension, tachycardia, mydriasis, reduced GI/urinary motlilty, xerostima, anyhydrosis. No longer used for HTN
168
Hexamethonium Receptor
Nn Ganglion Blocker
169
Hexamethonium Structure
Quaternary Ammonium
170
Hexamethonium Indications
Hypertension
171
Hexamethonium PK
Longer duration than other ganglion blockers
172
Mecamylamine Receptor
Nn Ganglion Blocker Only ganglion blocker in US
173
Mecamylamine Indications
Severe/essential and uncomplicated/malignant HTN
174
Trimethephan Receptor
Nn Ganglion Blocker One of two ganglion blockers in clinical use
175
Tubocurarine Receptor
Nn Antagonist, NMJ blocker
176
Tubocurarine Structure
From curare, prototype of NMJ blockers
177
Tubocurarine MOA
Nondepolarizing antagonist blocker Binds Nn to prevent ACh from binding, prevents depolarization of the cell membrane, inhibiting contraction Competitive Antagonist
178
Tubocurarine Effects
Small, rapidly contracting muscle paralyzed firs (face and eyes), followed by finger, arms, neck and trunk, eventually diaphragm
179
Tubocurarine Indications
Anasthesia adjuvant during surgery to relax skeletal muscle
180
Tuborcurarine PK
needs to be given IV due to poor oral absorption Poor membrane/BBB permeability
181
Tubocurarine AE
Autonomic: Some agents are moderate blockers of Muscarinic receptors May cause histamine release Overcome by increased ACh with AChE inhibitors
182
Succinylcholine Receptor
Nn Antagonist, NMJ blocker
183
Succinylcholine MOA
Depolarizing agonistic blocker Binds Nn to act like ACh-end plate depolarization Genearlized disorganized contraction of motor units leading to flaccid paralysis Receptor desensitizes
184
Succinylcholine Effects
Muscle Paralysis Repsiratory muscles paralyzed last Ganglion block at High Doses Weak Histamine Release
185
Syccinylcholine Uses
Endotracheal intubation Electroconvulsive therapy
186
Succinylcholine PK
IV by continous infusion Poorly metabolized at synapse, rapidly hyrdolyzed by plasma cholinesterase Rapid onset (1-15 min) brief duration (5-10 min)
187
Succinylcholine AE
Malignant Hyperthermia-Massive release of Calcium from SR. Tx: Dantrolene
188
Dantrolene Uses
Tx for Malignant Hyperthermia Blocks Calcium release from SR
189
Hemicholonium Receptor
Presynaptic-ACh Transporter
190
Hemicholonium MOA
Blocks choline transporter, prevents choline uptake, and therefore ACh synthesis
191
Hemicholonium Uses
Research
192
Vesamicol Receptor
Presynaptic, ACh-H+ Transporter
193
Vesamicol MOA
Blocks ACh-H+ Transporter used to transport ACh into vesicles, preventing ACh storage
194
Vesamicol Uses
Research
195
Botulinum Toxin Receptor
Presynaptic, synaptobrevin
196
Botulinum Toxin Structure
Bacterial protein from anaerobic C. botulinum
197
Botulinum Toxin MOA
Degrades synaptobrevin, preventing release as ACh containing vesicles into synaptic cleft
198
Botulinum Toxin Uses
Disease with increased muscle tone: torticollis, achalasia, staismus, blepharopsams, etc Facial wrinkles Headache and pain syndromes
199
Epinephrine Receptors
a and B Direct Andrenergic agonist
200
Epinephrine Structure
Made from tyrosine in adrenal glange Polar, doesn't enter CNS Similar to hormone
201
Epinephrine MOA
Low dose: B effects High dose: a effects
202
Epinephrine Effects
Blood pressure: Low dose-increases systolic due to increased heart contractility and decreases diastolic due to vasodilation, little change in mean BP High dose-increase BP through increase ventricular contraction, vasoconstriction through a (which my cause bradycardia from sinus reflex) CV: Positive ionotrope, chronotrope, dromotropc, increases O2 demands of heart and CO Resp: Bronchodilation Metabolic: Hyperglycemia, insulin inhibition, lypolysis GI: smooth muscle relaxation, detrusor relaxation, contracts trigone and sphincter
203
Norepinephrine Receptor
a and B1 Direct Andrenergic Agonist
204
Norepinephrine MOA
Mostly a actions at therapeutic doses
205
Norepinephrine Effects
Vasoconstriction, causing reflex bradycardia-doesn't act as positive ionotrope Renal-Vasoconstricion of kidneys
206
Norepinephrine Indications
Tx for shock, dopamine is usualy better to maintain renal profusion
207
Norepinephrine PK
Rapid onset, IV admin in emergencies, can also be administered subcutaneously, inhaled, through ET tube, topicalled Oral admin ineffective metabolized by COMT and MAO, excreted in urine as VMA
208
Epinephrine PK
Rapid onset, IV admin in emergencies, can also be administered subcutaneously, inhaled, through ET tube, topicalled Oral admin ineffective metabolized by COMT and MAO, excreted in urine as VMA
209
Epinephrine AE
CNS: Anxiety, fear, tension, headache, tremor, cerebral hemorrhage, cardia arrythmias (especially if combined with digitalis), pulmonary edema
210
Enpinephrine Contraindications
Enhanced CV actions with hyperthyroidism (increased receptors) and cocaine (inhibited reuptake)
211
Norepinephrine AE
Shut down of kidneys
212
Norepinephrine Contraindications
Cause tachycardia with atropine
213
Dopamine Receptor
D, a, and B Direct andrenergic antagonist
214
Dopamine MOA
D1-Gs
215
Dopamine Effects
Real vasodilation (D1), increases GFR Positive ionotrope Release of NE from nerve termina
216
Dopamine Indications
DOC for shock
217
Dopamine PK
Ineffective Orally
218
Dopamine AE
Nausea, HTN, arrhythmias
219
Feneldopam Receptors
D1 Direct Andrenergic Agonist
220
Feneldopam MOA
Vasodilation of selective vascular beds D1, 5 (Gs)
221
Feneldopam Indications
In hospital, short-term management of severe HTN
222
Feneldopam PK
Given by continuous IV only
223
Isoproterenol Receptor
B1 and B2, singnificant a effect, Andrenergic Agonist
224
Isoproterenol MOA
Stimulates B1 and B2 Generally stimulates rate and force of heart, vasodilation, bronchodilation
225
Isoproterenol Effects
Bronchodilation-B2 Increases systolic BO slightly, greatly decreases mean arterial and diastolic press Inhibits GI, insulin not blocked so no hyperglycemia, lipolysis
226
Isoproterenol Indications
Stimulates Heart in Emergency situations
227
Isoproterenol AE
Anxiety, fear, tensions, headache, tremor, cerebral hemorrhage, cardiac arrhythmia, pulmonary edema (Same as Epinephrine)
228
Dobutamine Receptor
B Andrenergic Agonist
229
Dobutamine Structure
Racemic mixutre of a1/B1 agonist and a1 antagonist/potent B1 agonist. Mixture cancels each other out to get a clinical B1 agonist
230
Dobutamine MOA
Stimulates B1, generally generating more force and rate in heart
231
Dobutamine Effects
Increase CO with little change in HR. Does not raise O2 demands of myocardium.
232
Dobutamine Indications
Acute management of CHF
233
Dobutamine AE
Same as Epinephrine: anxiety, fear, tensions, headache, tremor, cerebral hemorrhage, cardiac arrhythmias
234
Terbutaline Receptor
B2 Andrenergic Agonist
235
Terbutaline Structure
Contains Resorcinol Ring
236
Terbutaline MOA
Stimulates B2 effects, causes bronchodilation
237
Terbutaline Effects
Bronchodilation, reduces uterine contractions
238
Terbutaline Indications
Acute asthma attacks (status athmaticus) Premature Labor
239
Terbutaline PK
Oral inhalation or subcutaneous administration Not a substrate for COMT
240
Isoprotenerol PK
Absorbed sublingually, parenterally, or inhaled Not a substrate for MAO
241
Albuterol (Salbutamol) Receptor
B2 andrenergic agonist
242
Albuterol (Salbutamol) MOA
B2 activation stimulates bronchodilation
243
Albuterol (Salbuterol) Effects
Fast acting bronchodilator
244
Albuterol (Salbutamol) Uses
Acute asthma attacks
245
Albuterol (Salbutamol) PK
Oral, inhalation, or SC
246
Salmeterol Receptor
B2 andrenergic agonist
247
Salmeterol Structure
Long hydrocarbon chain-liposoluble
248
Salmeterol MOA
Stimulates B2, bronchodilates
249
Salmeterol Effects
B2 stimulation and bronchodilation, long acting
250
Salmeterol Uses
Management of Asthma
251
Salmeterol Contraindications
Not for prompt releif of asthma
252
Dobutamine Contraindications
Increases AV conduction, use in cautino in AF
253
Formoterol Receptor
B2 Andrenergic Agonist
254
Formoterol MOA
Stimulates B2 for bronchodilation
255
Formoterol Effects
Long acting bronchodilator (about 12 hrs.)
256
Formoterol Uses
Management of asthma, not acute treatment
257
Phenylephrine Receptor
a1 Andrenergic Agonist
258
Phenylephrine Chemical Structure
Not a catechol derivative
259
Phenylephrine MOA
Peripheral Vasoconstriction
260
Phenylephrine Effects
No direct effect on heart | Causes vasoconstriction, induces reflex bradycardia
261
Phenylephrine Indications
Nasal decongestant (topical) Mydriasis without cyclopegia Supraventricular tachycardia, shock (increases bp)
262
Phenylephrine PK
Not a substrate for COMT Combined with H1-histamine for oral nasal decongestant
263
Phenylephrine AE
Hypertensive headaches Cardiac Irregulataries
264
Clonidine Receptor
Partial a2 Andrenergic Agonist, centrally acting
265
Clonidine MOA
Activation of a2 in the CV control centers in the CNS
266
Clonidine Effects
Centrally acting anti-hypertensive Suppresses sympathetic outflow from brain
267
Clonidine Indications
Hypertension
268
Clonidine AE
Transient vasoconstriction leading to prolonged hypotensive response (seen only with IV administration) Sedation, mental lassitude, impaired concentration, lethargyy, zerostima
269
Clonidine Contraindications
Not to be taken with yohimbine (a2 antagonist), will reverse HTN effects
270
Methyldopa Receptor
a2 Andrenergic agonist
271
Methyldopa MOA
Taken up by norandrenergic neurons and metabolized to a-methylnorepinephrine, activates a2
272
Methyldopa Effects
Reduces sympathetic outflow, decreases, bp
273
Methyldopa Indications
DOC for hypertension during pregnancy
274
Methyldopa AE
Sedation, mental lassitude, impaired concentration
275
Bromidine Receptor
Highly selective a2 Andrenergic Agonist
276
Bromidine MOA
Vasoconstriction of ciliary body blood vessels
277
Bromidine Effects
Reduces aqueous humor production (not through canal of schlemm) to lower intraocular pressure
278
Bromidine Uses
Glaucoma
279
Amphetamine MOA
Releases Exogenous Catecholamines from vesicles, weak inhibitor of MAO
280
Amphetamine Effects
Increase alertness, decrease fatigue, appetite suppression, insomnia, increase bp by a action on vasculature, B stimulatory effects on heart
281
Amphetamine Indications
Narcolepsy, depression, appetite suppression
282
Amphetamine AE
Fatigue and depression following central stimulation, withdrawl
283
Methylphenidate Structure
Analogue of amphetamine
284
Methylphenadate MOA
Releases NE from vesicles, weak inhibitor of MAO (same as amphetamine)
285
Methylphenidate Indications
ADHD in Children
286
Tyramine Structure
Product of Tyrosine metabolism Not clinically useful
287
Tyramine MOA
Acts on storage vesicles Displaces, releases stored NE
288
Tyramine PK
Found in fermented foods such as cheese and wine, normally oidized by MAO
289
Tyramine Contraindications
Persons taking MAO Inhibitors
290
Ephedrine Receptor
a and B Andrenergic Agonist, also works on storage vesicles
291
Ephedrine Structure
Plant alkaloid, not a catecholamine, poor substrate for MAO and COMT, long duration
292
Ephedrine MOA
Induces release of NE and activates andrenergic receptors
293
Ephedrine Effects
Increases systolic and diastolic bp, bronchodilation, mild stimulation of CNS (alertness and decreases fatigue, therefore increases athletic performance)
294
Ephedrine Indications
Chronic asthma prohylaxis, nasal decongestant, performance improving
295
Ephedrine PK
Excellent absorption orally, Penetrates CNS, Long Duration, eliminated unchanged in urine
296
Ephedrine AE
Life threatening CV reactions Banned by FDA for supplements
297
Pseudoephedrine Receptor
a, B andrenergic agonist, also acts on vesicles
298
Psuedoephedrine Structure
One of 4 enantiomers
299
Pseudoephedrine MOA
Induces release of NE and activates adnrenergic receptors
300
Psuedoephedrine Indications
Nasal decongestant
301
Pseudoephedrine PK
Combined with H1-histamine as oral nasal decongestant
302
Phenoxybenzamine Receptor
a1 Andrenergic antagonist Also H1, M, Serotonin-R, NE reuptake
303
Phenoxybenzamine Structure
Haloalkylamine
304
Phenoxybenzamine MOA
Alyklates-> Irreversibly blocks a receptors by forming covalent bonds
305
Phenoxybenzamine Effects
Prevents vasoconstriction of peripheral blood vessels and causes reflex tachycardia a2 blockage in the heart can increase CO
306
Phenoxybenzamine Indications
Pheochromocytoma, 14 days prior to tumor removal or as long term treatment if surgery isn't an option
307
Phenoxybenzamine AE
Postural Hypotension, nasal stiffness, nausea, vomiting, inhibits ejaculation
308
Phenoxybenzamine Contraindications
Patients with decreased perfusion B blockers should not be given before as they could cause bp elevation to due increased vasoconstricion
309
Phentolamine Receptors
a andrenergic antagonist Serotonin, M, H1, H2
310
Phentolamine MOA
Reversibly blocks a1 and a2
311
Phentolamine Indications
Diagnosis of pheochromocytoma though phentolamine blocking test Hypertensive crisis die to stimulant overdose, or sympathetic anti-HTN withdrawl Prevent dermal necrosis after NE extravasation
312
Phentolamine AE
Postural hypotension, reflex cardiac stimulation, arrhythmias, anginal pain
313
Phentolamine Contraindications
Patients with decreased coronary perfusion
314
Prazosin Receptors
a1 Andrenergic Antagonist
315
Prazosin MOA
Lowers arterial bp-no reflex tachycardia Suppresses SNS from CNS Decreases LDL and Tag, increases HDL Inmproves urinary flow
316
Prazosin Indications
Hypertension BPH
317
Prazosin PK
1st dose must be small to avoid rapid hypotension or syncope (1/3 to 1/4)
318
Prazosin AE
Dizziness, lack of energy, nasal decongestion, headache, drowsiness, orthostatic hypotension, sodium and fluid retention
319
Terazosin Receptor
a1 andrenergic antagoinst
320
Terazosin Structure
Prazosin analog with longer half life
321
Terazosin Indications
HTN BPH Symptom Releif
322
Terazosin and Doxasin AE
Dizziness, lack of energy, nasal decongestion, headache, drowsiness, orthostatic hypotension, sodium and fluid retention
323
Doxazosin Receptor
a1 andrenergic antagonist
324
Doxazosin Structure
Prazosin analog with longer half life
325
Doxazosin Indications
HTN BPH Symtpom Releif
326
Tamsulosin Structure
a1A (Genitourinary) Andrenergic antagonist
327
Tamsulosin Effects
Relexes genitourinary smooth muscle
328
Tamsulosin Indications
Only approved for symptomatic relief of BPH Little effect on blood pressure
329
Tamsulosin AE
Less likely to cause hypotension than other a1 antagonists
330
Yohimbine Receptor
a2 andrenergic antagonist
331
Yohimbine MOA
Blocks a2, acts as indirect andrenergic agonist
332
Yohimbine Effects
Increase NE Release
333
Yohimbine Indications
Increases BP
334
Yohimbine PK
Treats erectile dysfunction, replaced by P5 inhibitors (sildenifil)
335
Yohimbine AE
Not to be taken with Clonidine!
336
Yohimbine Contraindications
Can reverse antihypertensice effects of a2 agonist actions of clonidine
337
Labetalol Receptor
mixed a1 and B Antagonist
338
Labetalol MOA
Competetive antagonist More potent at B antagonism, antioxidant
339
Labetalol Effects
Decreases HTN
340
Labetalol Indications
HTN for pheochromocytoma and HTN emergencies Stimulant drug overdose
341
Labetalol AE
Orthostatic hypotension, dizziness, hepatic injury
342
Labetalol Contraindications
For HTN with bradycardia, use pure a blocker to maintain B2 vasodilation
343
Carvedilol Receptor
a1 and B antagonist
344
Carvedilol Indications
HTN, Congestive Heart Failure
345
Pindolol Receptor
Partial B antagonist
346
Pindolol MOA
Smaller reductions in resting HR and BP Less metabolic effects
347
Pindolol Effects
B-antagonist with intrinsic SNS activity
348
Pindolol Indications
HTN with diminished cardiac reserve or propensity to bradycardia (diabetics)
349
Pindolol Contraindications
Clinical significance of ISA uncertain
350
Propanolol Receptor
non-selective B Blocker
351
Propanolol Structure
Lipophillic
352
Propanolol MOA
Inhibits cardiac B1 and CNS Sympathetics, decreases myocardial contractility
353
Propanolol Effects
Lowers HTN by decreasing CO Increases glucagon release, lowers glycogenolysis
354
Propanolol Indications
Hypertension Prophylaxis for Migraine Post MI Prophylaxis for Performance Anxiety
355
B Blocker AE
Bronchconstriction, masks hyperglycemic tachycardia associated with diabetes
356
B Blocker Contraindications
Asthmatics, Variental Angina Diabetics use with caution
357
Timolol Receptor
Non-selective B blocker
358
Timolol Uses
HTN Open Angle Glaucoma Migraine Prophylaxis
359
Nadolol Receptor
Non-selective B blocker
360
Nadolol Uses
Long term management of angina Management of HTN
361
Atenolol Receptor
B1 cardioselective antagonist
362
Atenolol Effects
Decreases HTN Increases exercise tolerance in angina
363
Atenolol Indications
HTN in patients with impaired pulmonary funcion Diabetic HTN recieving oral treatment
364
Metoprolol Receptor
B1 Cardioselective Antagonist
365
Metoprolol Effects
Decreases HTN Increases exercise tolerance in angina
366
Metorpolol Uses
HTN in patients with pulmonary impairment or diabetes
367
Esmolol Receptor
B1 cardioselective Antagonist
368
Esmolol Structure
Ester Bond
369
Esmolol MOA
Ultra short acting, half life about 10 minutes Anti-emetic
370
Esmolol Effects
Decreases HTN Increases exercise tolerance in angina
371
Esmolol Indications
Supraventricular Arrhythmias
372
Esmolol PK
Rapidly broken down by esterases in RBCs
373
Metyrosine Receptor
Tyrosine Hydroxylase Indirect Andrenergic Antagonist
374
Metyrosine MOA
Competitive Inhibitor of tyrosine hydroxylase, interferes with DA synthesis, decrease NE and Epinephrine secretion
375
Metyrosine Effects
Inhibits NE Synthesis
376
Metyrosine Indications
Given with phenoxybenzamine to manage malignant pheochormocytoma and preop
377
Reserpine Receptor
Irreversible VMAT damage Indirect Andrenergic Antagonist
378
Reserpine MOA
Irreversibly damages VMAT, vesicles lose ability to concentrate and store NE and DA, NE broken down by MAO in cytoplasm and depleted
379
Resperpine Effects
Depletes NE stores
380
Resperpine Indications
Slow, gradual decrease in bp, previously used for HTN
381
Reserpine PK
long duration of action
382
Guanethidine Structure
Transported into SNS nerve by NET, no CNS actions
383
Guanethidine MOA
Displaces NE from vesicles, disrupts process by which action potentials release stored NE from terminals
384
Guanethidine Effects
Depletes NE stores and prevents NE release
385
Guanethidine Indicatinos
PSNS no altered (Distinguished from ganglion blockers)
386
Guanethidine AE
Orthostatic Hypotension, Male Sexual dysfunction, Supersensitivity to NE
387
Cocaine Receptor
DAT, SET, NET, Sodium Channels Indirect Andrenergic Antagonist
388
Cocaine MOA
Blcoks monoamine reuptake, monoamines accumulate in synaptic space
389
Cocaine Effects
Increase/prolonged monoamine singaling, especially dopamine in the limbic pleasure centers
390
Cocaine Uses
Local anesthetic
391
Epinephrine H1 effect
Physiological Antagonist
392
Choloremphenicol
First Generation H1 Antagonist
393
Diphenhydramine (Benadryl) Receptor
H1 Antagonist, First Generation
394
Dimenhydrinate Receptor
First Generation H1 Antagonist
395
Doxylamine Receptor
First Generation H1 Antagonist
396
Hydroxyzine Receptor
First Generation H1 Antagonist
397
Meclizine Receptor
First Generation H1 Receptor Antagonist
398
Promethazine Receptor
First Generation H1 Antagonist
399
First Generation H1 Antagonist Effects
Sedative (penetrates BBB), more likely to block ANS receptors
400
First Generation H1 antagonist MOA
Actually inverse agonist of H1 Also block cholinergic, a andrenergic, and Na receptors (Local anesthetic)
401
H1 Antagonist Uses
First and Second Generation: Allergic Rhinitis, Motion Sickness and nausea, First generation only: insomnia
402
First Generation H1 Antagonist AE
``` Sedation Dry Mouth (especially in elderly patients) ```
403
Fecofenadine Receptor
Second Generation H1 Receptor Antagonist
404
Loratadine (Claritin) Receptor
Second Generation H1 Receptor Antagonist
405
Cetirizine Receptor
Second Generation H1 Receptor Antagonist
406
Second Generation H1 Receptor Effects
Less sedating than first generation, less liposoluble Substrate of P-glycoprotein, so they are pumped out of the brain
407
Second Generation H1 Antagonist PK
Ventricular arrhythmias in patients taking CYP3A4 inhibitors, blocks cardiac K channels
408
Second Generation H1 Antagonist AE
Dry Mouth
409
Cimitidine Receptor
H2 Receptor Antagonist
410
Ranitidine (Zantac) Receptor
H2 Receptor Antagonist
411
Famotidine (Pepcid) Receptor
H2 Receptor Antagonist
412
Nizatidine (Axid) Receptor
H2 Receptor Antagonist
413
H2 Receptor Antagonist Use
Inhibits gastric acid secretion
414
H2 Receptor Antagonist MOA
Competitively blocks H2 receptors and decreases gastric acid
415
H2 Receptor Antagonist Indications
Peptic Ulcers, acute stress ulcers, GERD
416
H2 Receptor Antagonist AE
Very safe drugs Cimitidine inhibits Cytochrome P450, will slow metabolism of drugs (WARFARIN!!!) Binds androgen receptors and has antiandrogenic effect-gynecomastia, decreased sperm count, galactorrhea in women
418
Sumatriptan Uses
DOC for acute severe migraine attacks
419
Metoclopramide Receptor
5-HT4 Receptor Agonist
420
Cisapride Receptor
5-HT4 Receptor Agonist
421
Metoclopramide MOA
Prokinetic Agent, promotes and organizes peristalsis of the gut
422
Metoclopramide USes
Lazy Gut and anti-emetic
423
Cisapride AE
Serious cardiac side effects-no longer used
424
Cyproheptadine Receptor
5-HT2 Receptor Antagonist Also blocks H1
425
Cyproheptadine Uses
Allergic/vasomotor rhinitis Cold urticaria, dermatographism, treatment of smooth muscle effects of carcinoid tumor, serotonin syndrome (too much antidepressants)
426
Ondasetron Receptor
5-HT3 Antagonist Most powerful anti-emetic
427
Ondasetron MOA
Blocks ligand gated ion channel
428
Ondasteron Indications
Severe nauseau and vomiting with cancer therapyq
429
Ergotamine Receptor
5-HT Antagonist Ergot Alkaloid
430
Dihydroergotamine Receptor
5-HT antagonist Ergot Alkaloid
431
Bromocriptine Receptor
5-HT Antagonist Ergot Alkaloid
432
Cabergoline Receptor
5-HT Antagonist Ergot Alkaloid
433
Methylergonovine Receptor
5-HT Receptor Ergot Alkaloid
434
Ergonovine Receptor
5-HT Antagonist Ergot Alkaloid
435
Ergot Alkaloid MOA
Non selective agonst/antagonists for a adrenergic, 5-HT, and CNS dopamine
436
Ergotamine/Dihydroergotamine USes
Migraines (Triptans preferred)
437
Bromocriptine/Cabergoline Uses
Hyperprolactinemia (pituiatary tumor)
438
Methylergonovine/Ergovine Uses
Post-partum hemorrhage (oxytocin 1st line) Ergovine IV used to provoke variant angina
449
Sumatriptan Receptor
5-HT (1D/1B) Agonist
450
Dinosprostone Class
Eicosanoid-PGE2
451
Eiconsanoid MOA
Act in autocrine and paracrine fashion, binds G protein receptor on cell surface. Gs-activates adenylyl cyclase Gi-inhibits adenylyl cyclase Gq-activates PLC Contractile effects on smooth muscle by releasing Calcium, relaxing effects by cAMP
452
Dinosprostone Indicationss
Ripens cervix at term prior to induction of labor with oxytocin
453
Carboprost tromethamine Class
Eicosanoid, 15-methyl-PGFa
454
Carboporst tomethamine Indications
Induces abortion
455
Misoprostol Drug Class
Eiconsanoid, Derivative of PGE1
456
Misoprostol Use
Ripens cervix to induce labor before oxytocin administration
457
Alprostadil Class
Eicosanoid, PEG1
458
Alprostadil Use
Maintains patent ductus arteriosus
459
Prostacyclin/Epoprostenol CCClass
Eicosanoid, PGI2
460
Prostacyclin/Epoprostenol Use
Severe Pulmonary HTN Prevents platelet aggregation in dialysis machine
461
Latanoprost Class
Eicosanoid, PGF2a derivative
462
Latanoprost Use
Glaucoma-GOLD standard
463
Zileuton Class
Eicosanoid Inhbitor
464
Zileuton MOA
Inhibits 5-LOX
465
Zileuton Uses
Asthma attack
466
Zafrilukast Class
Eicosanoid Antagonist
467
Mantelukast Class
Eicosanoid Antagonist
468
Zafrilukast MOA
Inhibits binding of LTD4 to receptoor
469
Montelukast MOA
Inhibits binding of LTD4 to receptor
470
Eicosanoid Antagonist Use
Asthma attacks
471
Hydrochlorothiazide Class
Thiazide Diuretic
472
Chlorthalidone Class
Thiazide Diuretic
473
Metoalazone Class
Thiazide Diuretic
474
Thiazide Diuretics Effects
Decrease peripheral vascular resistance, decrease BP even after vloume recovery
475
Thiazide Diuretic MOA
Blocks Na/Cl transport in distal convoluted tubule "ceiling" diuretic, saturates at low dose
476
Thiazide Diuretics Indications
HTN Heart Failure Hypercalcuria Diabetes Insipidus
477
Thiazide Diuretics effect on Urine Composition
Increases Na, K, Cl, Increases Mg Decrease Ca
478
Thiazide Diuretic PK
Oral half life 40 hrs, takes 1-3 weeks for stable effects
479
Thiaziade AE
``` Hyokalemia Hyponatremia Hyperuricemia Hypersensitivity Hyperglycemia (insulin) Loop effect causing volume depletion ```
480
Furosimide Class
Loop Diuretic, most common
481
Torsemide Class
Loop Diuretic
482
Loop Diuretic Effects
Produces a lot of urine, most effective diuretic
483
Loop Diuretic MOA
Blocks Na/Cl/K transporter in ascending loop of Henle
484
Loop Diuretics Indications
Acute pulmonary edema Heart Failure Hypercalcemia Hyperkalemia
485
Ethacrynic Acid
non-sulfa drug used for sulfa allergies
486
Loop Diuretics Effect on urine Composition
Increase Ca, Na, K, Mg
487
Loop Diuretic PK
Oral, half life 2-4 hours
488
Loop Diuretics AE
``` Ototoxicity Hyperuricemia (competition for transport) Acute hypovolemia K depletion Hypomagnesemia Allergic Reactions-sulfonamides ```
489
Spironolactone Receptor
Potassium sparing, Aldosterone Receptor
490
Eplerenone Receptor
Potassium Sparing, Aldosterone Receptor
491
K Sparing-Aldosterone-R MOA
Antagonist to aldosterone at cytoplasmic receptors (prevents translocation), acting at collecting duct
492
K-Sparing-Aldosterone Receptor Indications
Heart Failure 2' Hyperaldosteronism Hepatic Cirrhosis
493
K-Sparing Diuretics Effect on Urine Composition
Increase Na | Decrease K
494
K-Sparing-Aldosterone-R PK
Oral, strongly protein bound Active metabolite of sprionolactone is canrenone Induces CYP450 half life is 2-3 days
495
K-Sparing-Aldosterone-R AE
GI upset, peptic ulcers Endocrine effects (resemble steroids) Hyperkalemia, lethargy, mental confusion
496
Triamterene Receptor
Potassium Sparing, ENaC
497
Amiloride Receptor
Potassium Sparing, ENaC
498
K-Sparing-ENaC MOA
Blocks Na Transport, lowers Na/K echange Acts on collecting duct
499
K-Sparing-ENaC Indications
Heart Failure 1'Hyperaldosteronism
500
K-Sparing-ENaC AE
Resembles sex steroid-endocrine effects | Increase BUN, uric acid and K retention
501
Acetazolamide Class
Carbonic Anhydrase Inhibitor (Intracellular)
502
Acetazolamide MOA
Acts mainly in the Proximal Tubule Prevents formation of H+ needed for transport of Na reabsorption in PT
503
Acetazolamide Indications
Glaucoma Mountain Sickness/Metabloc Alkalosis (prophylaxis) Epilepsy
504
Acetazolamide Effects on Urine
Increase Na, K, HCO3-
505
Azetazolamide PK
Oral | Increases Urine pH, alters solubulity of other drugs (elminates weak acids)
506
Azetazolamide AE
Metabolic Acidosis K Depletion Crystalluria Don't use with Hepatic cirrhosis-decreased NH4 excretion
507
Mannitol Class
Osmotic Diuretic
508
Mannitol MOA
Freely filters into glomerulus and draws water into tubular fluid. Does not effect Na Secretion Effects everywhere
509
Mannitol Indications
Acute Renal Failure Drug toxicity-excretion Trauma-maintains urine Increases intracranial pressure
510
Mannitol PK
IV only
511
Mannitol AE
Extracellular water expansion Dehydration Hypo- or hypernatremia Osmotic diahrrea if given orally
512
Conivaptan Class
ADH Antagonist
513
Conivaptan Effects
Renders convoluted tubules impermeable to water, dilutes urine
514
Conivaptan MOA
Inhibits effects of ADH by decrasing aquaporins in collecting duct
515
Conivaptan Indications
SAIDH | Elevated ADH
516
Conivaptan Effects on Urine
increases plasma Na | decreases water reabsorption
517
Conivaptan PK
IV only half life 5-10 hrs Metabolized by and inhibits CYP3A4
518
Conivaptan AE
Nephrogenic Diabetes Insipidus Renal Failure Thirst Atrial Fibrillation
519
Conivaptan Contraindications
Renal Failure Hypovolemic hyponatremia
520
Captopril Class
ACE Inhibito
521
Enalapril Class
ACE Inhibito
522
Lisinopril Class
ACE Inhibito
523
ACE Inhibitor Effects
Decrease bp by decreasing peripheral vascular resistance
524
ACE Inhibitor MOA
Decreases Na and water retention via decreased aldosterone action Blocks enzyme, slow effect Increases bradykinin levels Does not refleively decrease CO, hr, or contractility
525
ACE Inhibitors Indications
HTN-first line Chronic Heart Failure Not as effective as older, black-same effectiveness when used with diuretic Spares kidney, spares GFR
526
Captopril Use
DOC treatment 24 hours post MI
527
Enalapril PK
Oral pro-drug, can give IV
528
ACE Inhibitors AE
Dry cough, Angioedema Rash, fever, hypotension, hyperkalemia (from aldosterone), reversible renal failure
529
ACE Inhibitor Contraindications
Pregnancy-Category X
530
Valsartan Class
ARB
531
Losartan Class
ARB
532
ARB Effects
Blocks Angiotensin II Receptor (AT1), lowers blood pressure by lowering peripheral vascular resistance, also spares GFR
533
ARB Indications
HTN Least effective in elderly, black, can be given with diuretic Chronic Heart Failure
534
ARB Uses
DOC in HTN in Diabetics
535
ARB AE
Angioedema No cough, no bradykinin levels Hypotension, hypokalemia
536
Drug Induced Lupus
Butterfuly malar rash, ANA and antihistone antibodies, can be caused by Hydralazine Discontinue drug and symptoms disappear
537
Aliskrien Class
Renin Inhibitor
538
Aliskrien MOA
Inhibits activity of the enzyme Renin, decreases angiotensin I, II, and aldosterone Slow effect
539
Aliskrien Uses
HTN
540
Aliskrien AE
Hyperkalemia, renal impairment, potential teratogenic
541
Amlodipine Class
Dihydropyridine CCB
542
Nifidipine Class
Dihydropyridinne CCB
543
Dihydropyridine CCB MOA
Blocks calcium channels in vascular smooth muscle Not used for cardiac arrhythmias
544
Dihydropyridine Use
First Line for HTN in patients with contraindications or intolerant to ACER, ARBs.
545
Dihydropyridine AE
Dizziness, headache, fatigue, ankle edema, reflex tachycardia
546
Drug Induced SLE caused by;
``` Sulfasulazine Hydralazine Isoniazid Procainimide Phenytoin ```
547
Gingival Hypertrophy Caused by:
Pheyntoin | Nifidipine
548
Pulmonary Fibrosis Caused By:
Amiodarone | Bleomycin
549
Class IA Antiarrhythmics
Quinidine Procainamide Disopyramide
550
Class IB Antiarrhythmics
Lidocaine Mexiletine Tocainide
551
Class IC Antiarrythmice
Flecainide | Propafenone

Fifth Term (1 decks)

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