Pharm Flashcards
(190 cards)
0
Q
Blocks ACh-H+ antiporter (STORAGE of ACh) into vesicles
A
Vesamicol
1
Q
Prevents UPTAKE of CHOLINE for ACh synthesis
A
Hemicholinium-3
2
Q
Degrades synaptobrevin (snap-25), thus preventing the vesicle fusion with presynaptic membrane/inhibiting RELEASE of ACh
A
Botulinum Toxin
3
Q
Botulinum Toxin tx:
A
Dystonias, torticollis, achalasia, strabismus, blepharospasm, pain syndromes, wrinkles, hyperhidrosis
4
Q
Agent used for diagnosis of MG, eaton-lambert, muscle weakness
A
Edrophonium
5
Q
Agents used for urinary or G.I. motility, glaucoma, or NMJ diseases (I.e. MG)
A
Neostigmine, pyridostigmine, ambenonium
6
Q
It’s nonpolar/lipophilic structure makes this agent the DOC for tx of CNS anticholinergic toxicity
A
Physostigmine
7
Q
These inhibitors of ACh degradation are used to tx Alzheimer’s and Dementia
A
Tacrine, donepezil, rivastigmine (“pseudo irreversible”), galantamine
8
Q
Agent used for diagnosis of asthma
A
Methacholine
9
Q
Muscarinic receptor agonist for tx of glaucoma
A
Carbachol
10
Q
Muscarinic receptor agonist as urinary tract motility agent
A
Bethanechol
11
Q
Muscarinic receptor agonists used for Xerostomia in Sjögren’s syndrome
A
Cevimeline, pilocarpine
12
Q
Nicotinic receptor agonist used for DEPOLARIZING nm blockade and intubation
A
Succinylcholine
13
Q
Muscarinic receptor antagonist used for anticholinesterase overdose, acute bradycardia, mushroom poisoning antidote, mydriasis/opth exam,excessive salivation/mucus during surgery
A
Atropine
14
Q
Muscarinic receptor antagonist for N&V and MOTION SICKNESS
A
Scopolamine
15
Q
Muscarinic receptor antagonists used for PUD
A
Pirenzepine, methscopolamine, glycopyrrolate
16
Q
Muscarinic receptor antagonist used to surgically/vagally induce bradycardia
A
Glycopyrrolate
17
Q
Muscarinic receptor antagonists for COPD and asthma
A
Ipratropium and tiotropium
18
Q
Muscarinic receptor antagonists used for hyperreflexic/overactive bladder and urge incontinence
A
Oxybutynin, propantheline, terodiline, tolterodine, fesoterodine, darifenacin, solifenacin, trospium
19
Q
Nicotinic receptor antagonists for NONDEPOLARIZING nm blockade and intubation: long acting? Intermediate acting? Short acting?
A
Pancuronium, tubocurarine. Vecuronium, rocuronium. Mivacurium
20
Q
These Nicotinic receptor antagonists tx HTN in pts with acute aortic dissection
A
Trimethaphan, mecamylamine
21
Q
Tx of Pheochromocytoma-assoc. HTN by inhibiting tyrosine hydroxylase, thus inhibiting catecholamine synthesis
A
Alpha-Methyltyrosine
22
Q
This agent inhibits catecholamine storage in vesicles by inhibiting VMAT. Used for HTN, common SE is psychotic depression.
A
Reserpine
23
Q
These agents inhibit catecholamine storage by concentrating in vesicles and displacing NE. Used to tx HTN.
A
Guanethidine, guanadrel
24
Amphetamine and methylphenidate displace catecholamines from storage vesicles, inhibit MAO, and block catecholamine reuptake by NET and DAT. What are their clinical applications?
ADHD, narcolepsy (amphetamine only)
25
Inhibitor of catecholamine storage, for tx of allergic rhinitis and nasal congestion
Pseudoephedrine
26
Agent for local anesthesia and Dx of Horners syndrome pupil. Causes marked vasoconstriction and is cardiotoxic
Cocaine
27
Clinical applications of amitryptiline and imipramine?
OCD, depression, nocturnal enuresis (imipramine)
28
These MAO inhibitors block catecholamine degradation, tx Depression, and have common SE of tyramine toxicity
Phenelzine, iproniazid, tranylcypromine, clorgyline, selegiline, brofaromine, befloxatone, moclobemide
29
Alpha1 adrenergic antagonists increase what?
Peripheral vascular resistance, BP
30
Alpha1 agonist to tx hypotension and shock
Methoxamine
31
Phenylephrine, oxymetazoline, and tetrahydrozoline are alpha1 agonists that tx??
Ophthalmic hyperemia, nasal congestion, and hypotension(phenylephrine only)
32
Alpha2 adrenergic agonists inhibit what?
Inhibit sympathetic outflow from CNS, which decreases BP
33
DOC for tx of HTN during pregnancy
Methyldopa
34
Alpha2 agonist that txs opioid withdrawal and CA pain?
Clonidine
35
Alpha2 agonist that's used for sedation of surgical/ICU pts
Dexmedetomidine
36
Common SE's of methyldopa
Hepatotoxicity and hemolytic anemia
37
Alpha2 agonists that tx HTN
Clonidine, methyldopa, dexmedetomidine, guanabenz, guanfacine
38
These Beta-adrenergic agonists are BRONCHODILATORS used to tx COPD/asthma
Isoproterenol, dobutamine, metaproterenol, terbutaline, albuterol, salmeterol
39
Alpha ANTAGONISTS cause
Vasodilation, decreased BP and peripheral resistance
40
Alpha antagonists that tx Pheochromocytoma-assoc. HTN and sweating
Phenoxybenzamine, phentolamine
41
Alpha antagonists that tx HTN & BPH. SE is first dose orthostatic hypotension and reflex tachycardia.
Prazosin, terazosin, doxazosin
42
Alpha1A selective antagonist to tx BPH
Tamsulosin
43
Alpha2 selective antagonist to tx organic/psychogenic impotence
Yohimbine
44
Beta-adrenergic antagonists (BETA BLOCKERS) tx
HTN, angina, heart failure
45
Beta blocker with SE of sedation and decreased libido
Propranolol
46
Beta blocker to tx glaucoma
Timolol
47
Beta blocker that requires LFTs bc SE is hepatotoxicity
Labetalol
48
Beta blocker that is preferred in hypertensive pts who have bradycardia or decreased cardiac reserve
Pindolol
49
Beta blocker to tx thyroid storm
Esmolol
50
Nitrate txment of diffuse esophageal spasm
Isosorbide dinitrate
51
Nitrate for angina prophylaxis and chronic IHD. Not susceptible to first pass metabolism in liver. Less rebound angina SE.
Isosorbide 5-mononitrate
52
IV tx of unstable angina or acute heart failure
nitroglycerin
53
Avoid co-administration with phosphodiesterase V inhibitors (sildenafil, etc)
Nitrates
54
Nitrate for hypertensive emergencies, severe cardiac failure, and ergot alkaloid toxicity. SE's are cyanide toxicity, methemoglobinemia, increase ICP, etc.
Sodium nitroprusside
55
Tx for neonatal respiratory failure, perinatal hypoxia, and pulmonary hypertension
Inhaled NO gas
56
Phosphodiesterase type V inhibitors cause an increase in what?
cGMP
57
PDE5 inhibitors for erectile dysfunction
Sildenafil (also tx pulmonary HTN), vardenafil, tadalafil (longer elimination half life)
58
CCB that tx exertional angina,unstable angina,coronary spasm, hypertension,hypertrophic cardiomyopathy, Reynauds phenomenon, pre-eclampsia
Nifedipine, amlodipine, felodipine, clevidipine
59
CCB that can cause a brisk fall in BP, triggering sever reflex tachycardia
Nifedipine
60
CCB administered IV for hypertensive urgency/emergency
Clevidipine
61
CCBs for tx of prinzmetal angina, chronic stable angina, HTN, atrial fibrillation or flutter, PSVT
Diltiazem, Verapamil
62
K+ channel openers for tx of severe/refractory HTN
Minoxidil, pinacidil, nicorandil, cromakalim
63
K+ channel opener for male pattern alopecia
Minoxidil
64
Endothelin receptor antagonists for sever pulmonary HTN. Must monitor LFTs. Pregnancy is contraindication.
Bosentan, ambrisentan
65
ET receptor with greater selectivity for ETa
Ambrisentan
66
Arteriolar vasodilator to tx severe HTN/heart failure. SE's are agranulocytosis, hepatotoxicity, lupus like syndrome
Hydralazine
67
ACE inhibitors
Captopril, enalapril, lisinopril
68
ACE inhibitor SE's??
Cough, angioedema, hyperkalemia
69
ACE Inhibitor administered as active drug and processed to active metabolite
Captopril
70
ACE inhibitor that's an ester prodrug converted to active metabolite in plasma
Enalapril
71
ACE inhibitor administered as active drug and excreted unchanged
Lisinopril
72
AT1 receptor antagonists for tx of HTN, diabetic nephropathy, heart failure, MI, stroke
Losartan, valsartan
73
NA channel inhibitor for tx of status epilepticus, seizures related to eclampsia, arrhythmias
Phenytoin
74
NA channel inhibitor for tx of bipolar disorder, trigeminal neuralgia
Carbamezine
75
NA channel inhibitor for tx of bipolar disorder, atypical absence seizures
Lamotrigine
76
Adjunct therapy for focal seizures
Lacosamide
77
CCI's that inhibit the low threshold T-type calcium channels
Ethosuximide, valproic acid
78
CCI's at inhibit high voltage activated calcium channels
Gabapentin, pregabalin
79
Absence seizure agents
Ethosuximide, valproic acid
80
Valproic acid clinical applications and common SE's ?
Tonic-clonic, absence, atypical absence, and focal seizures. Hepatotoxicity, pancreatitis, thrombocytopenia, hyperammonemia.
81
Gabapentin clinical applications. Common SE?
Focal seizures, diabetic peripheral neuropathy, migraine prophylaxis. Stevens-Johnson syndrome
82
Pregabalin clinical applications. Common SE?
Diabetic peripheral neuropathy, fibromyalgia, postherpetic neuralgia. Angioedema.
83
Benzodiazepines for focal and tonic-clonic seizures??? Benzo for absence seizure??
Diazepam, lorazepam, midazolam. Clonazepam ("don't clone me in my absence").
84
BenzodiaZEPAMs also tx?
Status epilepticus, anxiety, alcohol withdrawal
85
Phenobarbital (barbiturate) clinical applications
Focal and tonic-clonic seizures, insomnia, preop sedation
86
This agent inhibits GABA metabolism and txs focal epilepsy and infantile spasms
Vigabatrin
87
Glutamate receptor inhibitor for refractory epilepsy. Common SE is aplastic anemia and hepatic failure
Felbamate
88
This glutamate receptor inhibitor inhibits the glycine binding site of NMDA receptor
Felbamate
89
This glutamate receptor inhibitor prolongs sodium channel inactivation. Txs focal seizures and drop attacks assoc with Lennox-Gestaut syndrome. Also a modest P450 inducer.
Rufinamide
90
This adjunct to focal and tonic-clonic seizures enhances GABA activity by blocking GABA reuptake into presynaptic neurons. SE's are unexplained sudden death and GI irritation.
Tiagabine
91
This anti epileptic adjunct inhibits burst firing without affecting normal neuronal excitability
Levetiracetam
92
Cyclooxygenase inhibitors prevent platelet aggregation by blocking ?
Thromboxane A2 generation
93
This agent inhibits COX1 and COX2 non selectively to Tx arthritis, fever, pain, and for prophylaxis against TIA, MI, or thromboembolism.
Aspirin
94
Aspirin common SE's
GI bleeding, Tinnitus
95
Phosphodiesterase inhibitors inhibit degradation of ?
Inhibit degradation of platelet cAMP and thereby decrease platelet aggregability
96
This PDI may paradoxically induce angina by causing coronary steal
Dipyridamole
97
ADP receptor pathway inhibitors inhibit platelet ?
Inhibit platelet activation
98
For pts intolerant of Aspirin, this ADPr inhibitor can prevent thrombotic strokes
Ticlopidine
99
This ADPr inhibitor txs acute coronary syndromes and prevents atherosclerotic events. Requires a loading dose to achieve immediate anti platelet effect. SE is atrial fibrillation
Clopidogrel
100
This ADPr inhibitor has more efficient platelet inhibition, but increased risk of bleeding
Prasugrel
101
These GPIIb-IIIa antagonists prevent binding of platelet to fibrinogen. Inhibiting platelet aggregation and decreases cross-linking.
Eptifibatide, Abciximab, tirofiban
102
Chimeric mouse-human monoclonal antibody
Abciximab
103
Warfarin inhibits hepatic epoxide reductase that catalyzes the regeneration of Vit. K, which is required for synthesis of coag factors ???? and anticoagulant proteins ??
Factors 2, 7, 9, 10. Proteins C and S
104
This anticoagulant is contraindicated in pregnant woman and requires monitoring with PT/ INR.
Warfarin
105
This agent combines with antithrombin III and inhibits secondary hemostasis via nonselective inactivation of activated factors II (thrombin), IX, X, XI, XII
Unfractionated heparin
106
This agent combines with antithrombin III and inhibits secondary hemostasis via selective inactivation of factor Xa
LMW heparins
107
LMW Heparins
Enoxaparin, dalteparin, tinzaparin
108
With this unfractionated heparin, discourage concomitant use of ?
dong quai, garlic, ginger, ginkgo, motherwort, and red clover
109
This anticoagulant is a selective factor Xa inhibitor
Fondaparinux
110
Recombinant polypeptides based on the medicinal leech protein hirudin?
Lepirudin, desirudin, bivalirudin
111
Direct thrombin inhibitor for tx of heparin induced thrombocytopenia
Lepirudin
112
Direct thrombin inhibitor for prophylaxis of DVT
Desirudin
113
Direct thrombin inhibitor for anticoagulation in pts receiving coronary angiography/angioplasty
Bivalirudin
114
Recombinant activated protein C inactivated factors?
Va and VIIIa
115
r-APC clinical application? r-APC prolongs activated ?
Sepsis with organ dysfunction. PTT
116
Prior administration of this thrombolytic agent/bacterial protein is a contraindication to use due to the risk of anaphylaxis. Indicated for ST elevation MI
Streptokinase
117
This recombinant t-PA binds to newly formed thrombi, causing fibrinolysis
Alteplase
118
This recombinant t-PA is administered as a single weight bolus
Tenecteplase
119
This recombinant t-PA is administered as a double bolus
Reteplase
120
Heparin overdose agent
Protamine
121
This serine-protease reduces perioperative bleeding during CABG surgery
Aprotinin
122
These losing analogues tx disorders involving the fibrinolytic system and hemorrhage from increased fibrinolysis(antidote to streptokinase and t-PAs)
Aminocaproic acid, tranexamic acid
123
Class I antiarrythmics block?
Na channels
124
Class IA antiarrythmics
Quinidine, procainamide, disopyramide
125
Quinidine SE's
Prolongs QT interval, torsades de pointes
126
Procainamide SE
Lupus like syndrome
127
Class IB antiarrythmics
Lidocaine, mexiletine, phenytoin
128
Class IC antiarrythmics
Encainide, flecainide, moricizine, propafenone
129
Class II antiarrythmics block?
They are beta blockers
130
Class III antiarrythmics block?
K channels
131
Class III antiarrythmics
Ibutilide, dofetilide, sotalol, bretylium, amiodarone, dronedarone
132
Must monitor QT interval during administration of this class III antiarrythmic.
Ibutilide
133
This mixed class II & III antiarrhythmic is used frequently in pts who cannot tolerate SE's of amiodarone
Sotalol
134
This is both a class III antiarrhythmic and anti hypertensive agent. SE is marked orthostatic hypotension
Bretylium
135
Mixed class I, II, III, IV antiarrhythmic agent with many SE's (pulmonary toxicity, thyroid dysfunction, hepatic failure, blue-gray skin pigmentation, etc)
Amiodarone
136
Class IV antiarrhythmics block
Ca channels (agents are verapamil and diltiazem)
137
This antiarrhythmic agent converts a PSVT into a normal sinus rhythm by inhibiting the SA nodal, atrial, and AV nodal conduction
Adenosine
138
Tx for chronic angina pectoris
Ranolazine
139
These cardiac glycosides tx systolic heart failure and atrial fib/flutter/tachycardia
Digoxin, digitoxin
140
This agent txs digitalis and digoxin toxicities
Digoxin Immune Fab
141
Beta-adrenergic agonists increase ?
CO & BP
142
Beta agonists for cardiogenic shock
Dopamine, dobutamine
143
Dopamine at low doses causes ? At high doses?
Low doses cause vasodilation, high doses cause vasoconstriction
144
Beta agonist for tx of bronchospasm, hypersensitivity/anaphylactic shock, cardiac resuscitation, open angle glaucoma, nasal congestion
Epinephrine
145
This beta agonist is used for BP support in acute hypotensive states (shock)
Norepinephrine
146
PDE inhibitor for asthma/COPD
Theophylline
147
This beta agonist is given IV to tx heart block/shock, atropine-resistant bradycardia, and emergency tx of arrhythmias
Isoproterenol
148
These PDE inhibitors are used as short term tx of severely falling circulation in pts refractory to conventional tx
Inamrinone, milrinone, vesnarinone
149
GnRH agonists to Dx hypogonadism and stimulate ovulation(pulsatile form)
Gonadorelin
150
These GnRH agonists tx breast CA, prostate CA, endometriosis, precocious puberty, and acute intermittent porphyria
Goserelin, histrelin, leuprolide, nafarelin
151
GnRH agonists with SE's of DVT.
Goserelin and Leuprolide (also pituitary apoplexy)
152
These GnRH antagonists are used for inhibition of premature LH surges in women undergoing controlled ovarian hyperstimulation
Ganirelix, cetrorelix
153
GnRHr antagonist with SE's of ectopic pregnancy, thrombotic disorder, and spontaneous abortion
Ganirelix
154
GnRHr antagonist with SE of anaphylaxis
Cetrorelix
155
These agents inhibit 5alpha reductase conversion of testosterone to DHT to tx BPH
Dutasteride, finasteride (androgenic alopecia too)
156
Competitive inhibitors of aromatase to decrease estrogen levels, tx ER+ breast CA
Anastrozole and letrozole
157
Irreversible/covalent inhibitors of aromatase to decrease estrogen levels, tx ER+ breast CA
Exemestane and formestane
158
This SERM is an ER antagonist in breast and partial agonist in endometrium. Breast CA tx that's Administered for no more than 5 years to minimize risk of iatrogenic endometrial CA.
Tamoxifen
159
This SERM txs female infertility due to an ovulatory disorder
Clomiphene
160
This SERM txs osteoporosis and decreases breast CA incidence. Contraindicated during pregnancy
Raloxifene
161
This SERM txs vulvovaginal atrophy and vaginal dryness
Ospemifene
162
This ER antagonist is used for the tx of ER+ metastatic breast CA in postmenop. women with disease progression following anti-estrogen therapy
Fulvestrant
163
This androgen receptor antagonist txs metastatic prostate CA and BPH. SE is hepatotoxicity
Flutamide
164
This androgen receptor antagonist txs hirsutism, acne vulgaris, HTN, primary aldosteronism, edema, hypokalemia. Common SE's are gynecomastia, hyperkalemia, and impotence.
Spironolactone
165
Progesterone receptor antagonist for abortion
Mifepristone (RU-486)
166
Investigational agent for tx of endometriosis and uterine fibroids
Asoprisnil
167
Emergency/morning-after contraception agent
Levonorgestrel
168
Estrogens of estrogen-progestin contraceptives
Ethinyl estradiol, mestranol
169
Progestin only contraceptive that's a silastic implant effective for 3 years
Etonogestrel
170
This progestin only contraceptive is injectable/given parenterally every 3 months
Medroxyprogesterone acetate
171
Other progestin only contraceptives
Norgestrel, norethindrone
172
Androgens used for hypogonadism. SE's are BPH and prostate CA
Testosterone enanthate, testosterone cypionate
173
Alpha-glucosidase inhibitors for tx of DM type 2. Should monitor serum aminotransferase levels during therapy
Acarbose, miglitol, voglibose
174
Alpha-glucosidase inhibitor SE's
Ab pain, diarrhea, flatulence, elevated plasma TGs and serum aminotransferase
175
Prandial bolus insulins administered subQ 30 minutes before meal
Insulin lispro, insulin aspart, insulin glulisine
176
Intermediate acting insulin administered twice per day. Contains protamine to prolong absorption.
NPH insulin
177
Long acting insulins injected once per day
Insulin glargine, insulin detemir
178
Insulin secretagogues (sulfonylureas and meglitinides) inhibit the pancreatic beta cell ? channel at the ? subunit, stimulating insulin release
K/ATP channel. SUR1 subunit
179
First generation sulfonylureas
Acetohexamide, chlorpropamide, tolazamide, tolbutamide
180
Second generation sulfonylureas (*all begin with G)
Glimepiride, glipizide, glyburide, gliclazide, gliquidone
181
Meglitinides. Also contraindicated for type 1 DM
Nateglinide, repaglinide
182
This insulin sensitizer also lowers serum lipids and decreases weight. Used in type 2 DM and PCOS.
Metformin
183
This amylin analogue slows gastric emptying, reduces post prandial glucagon/glucose release, and promotes satiety. Txs type 1 & 2 DM.
Pramlintide
184
GLP-1 analogues for type 2 DM
Exenatide, liraglutide
185
These DPP-4 inhibitors prolong GLP-1 activity and tx type 2 DM
Sitagliptin, saxagliptin
186
These thiazolidinediones (TZDs) bind and stimulate PPARgamma, increasing insulin sensitivity. (**TZDs don't increase insulin levels so do not induce hypoglycemia)
Pioglitazone, rosiglitazone
187
Agent for tx of hypoglycemia due to hyperinsulinism and malignant HTN (off label). Binds to SUR1 and stabilizes open state of K/ATP channels, beta cells remain hyper polarized and decrease insulin secretion.
Diazoxide
188
This somatostatin analogue inhibits GH release. Txs acromegaly, flushing/diarrhea from carcinoid syndrome, carcinoid crisis, TSH producing adenomas, diarrhea from VIP-secreting rumors
Octreotide
189
This agent txs hypoglycemia and as an intestinal relaxant before radiography of GI tract
Glucagon
