Pharm Flashcards
(184 cards)
1
Q
Receptors that work on Gi
A
M2, a2, D2 (MAD2s inhibit)
2
Q
Receptors that work on Gs
A
B1,b2, D1, H2, V2
3
Q
Receptors that work on Gq
A
H1, a1,v1, m1, m3 (cutesies HAV 1 M&M)
4
Q
Alpha 1 effects
A
Increases vascular smooth muscle contraction (increase TPR,increase BP)
pupillary dilation
intestinal and sphincter muscle contraction
5
Q
Alpha 2 effects
A
Inhibits sympathetic outflow, negative feedback on presynaptic nerves
decreases insulin release (found on pancreatic cells)
6
Q
Beta 1 effects
A
Found mainly on heart and kidney: increases heart rate, contractility, increase renin release
7
Q
Beta 2 effects
A
Smooth muscle relaxation (peripheral vasodilation, broncodilation, GI, utuers, bladder), causes decreasedTPR, reflex tachycardia, decrease uterine tone
Increases insulin release, increased glycogenolysis
8
Q
Dopamine 1 effect
A
Relaxes renal vascular smooth muscle
9
Q
Dopamine 2 effect
A
Modualtes transmitter release in the brain
10
Q
Histamine 1 effect
A
Increases nasal and bronchial mucus production, contract bronchioles, pruritis
11
Q
Histamine 2 effect
A
Increases gastric acid secetion
12
Q
Vasopressin 1
A
increases vascular smooth muscle contraction
13
Q
Vasopressin 2
A
Increases H2O permeability and RAB in collecting tubules
14
Q
Definition of Km
A
[S] at which V = 1/2Vmax
15
Q
This value is related to affinity of enzyme for substrate
A
Km
16
Q
Vm is directly proportional to…
A
Enzyme concentration
17
Q
Line-weaver burke plot:
X axis, Y axis, slope
A
X axis: -1/Km
Y axis: 1/Vm
Slope: Km/Vm
18
Q
Origins of Parasympathetic NS
A
CN III, VII, IX, X, S2/S3
19
Q
Which is more selective, PNS or SNS, and why?
A
PNS because longer preganglionic fibers, which allow one nerve-one organ effect. SNS has shorter preganglionic fibers and postganglionic fibers branch and affect multiple targets
20
Q
Equation for Volume of distribution
A
Vd = amount of drug in body/plasma drug concentration
21
Q
Half life equation
A
T1/2 = 0.7xVd/CL
22
Q
Clearance (CL) equation
A
CL = rate of eliminiation of drug/plasma drug concentration = (Vd) * (Ke) = 0.7*Vd/t1/2
23
Q
Loading Dosage equation
A
Dose = Volume of distribution * target plasma concentration / bioavailability
Vd depdendent, not affected by renail/iver disease
24
Q
Maintainance Dose equation
A
Dose = target plasma concentration * clearance / bioavailability
25
which drugs have zero order elimination?
PEA
Phenytoin,Ethanol, Aspirin
26
Phase I of metabolism does what? and done by what system?
Done by CytP450 in liver, yields slightly polar molecules, still somewhat active
ROH - Reduction, oxidation, hydrolysis
27
What phase of metabolism is lost first in elderly patients?
Phase I
28
Phase II of metabolism includes what?
Conjugation reactions - methylation, glucordination, aceylation, sulfation
yields polar, inacative metabolites
29
Therapeutic index =
LD50/ED50
30
Hemicholinum
Blocks choline entry into nerves
31
Vasamicol
blocks packaging of Ach into vesicles
32
Botulinum fxn
Decreases ACh release into synapse
33
Black Widow Spider Toxin
Causes release of Ach into synapse, causing paralysis
34
Metyrsoine fxn
blocks conversion of Tyrosine to Dopa by blocking tyrosine hydroxylase
35
Reserpine
Inhibits NE packaging into vesicles
36
Amphetamine
Stimulates release of NE into synapse
37
Guanethidine, bretylium
Blocks NE release into synapse
38
Ephedrine, Tyramine
Stimulates release of NE into synapse
39
Cocaine, TCA
blocks NE reuptake by pre-synaptic neuron
40
Feedback on pre-synaptic neuron via 3 signals
M2: inhibits NE release
A2: inhibits NE release
AII: promotes NE release
41
MOA, Clinical indications for Bethanechol
Direct Cholinergic Agonist
Activates bowel and bladder smooth muscle
Used for post op ileus, neurogenic ileus and urinary retention
42
MOA, Clinical indications for carbhachol
Direct cholinergic agonist, used for glaucoma and relief of IOP
43
MOA, Clinical indications for Pilocarpine
Contracts ciliary muscle of eye, pupillary sphincter, resistant to AChE
Used for stimulatoin of sweat, tears, and saliva
Used for open/closed angle Glaucoma
44
MOA, Clinical indications for Methacholine
Challenge test for asthma dx, direct cholinergic agonist, stimulates muscarinic receptors in airway when inhaled
45
MOA, Clinical indications for Neostigmine
Acetylcholinesterase Inhibitors
| Post op and neurogenic ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade
46
MOA, Clinical indications for pyridostigmine
Increases endogeneous ACh bc acetylcholineesterase inhibtor
| myasthenia gravis
47
MOA, Clinical indications for edrophonium
Cholinergic that blocks acetylcholinesterase
| used for dx of MG
48
MOA, Clinical indications for physostigmine
Blocks acetylcholineesterase fxn, increases ACh
Used for Atropine overdose and anticholingeric toxicity
49
MOA, Clinical indications for Donepeil,
Block acetylcholine function, causing increased ACh, used for Alzhemiers
50
MOA, Clinical indications for Rivastigmine, Gamantine
Block acetylcholine function, causing increased Ach, used for Alzhemiers
51
Cholinesterase Inhibitor Poisoning Sx
DUMBBELSS
| Diarrhea, urination, miosis, bradycardia, bronchospasm, exciation of skeletal muscle, lacrimation, sweating, salivation
52
Cause and tx for cholinesterase inhibitor poisoning
Insectasides (Organophosphates)
| Tx: atropine, pralidoxime
53
MOA, Clinical indications for Atropine
muscarinic antagonist
54
MOA, Clinical indications for benztropine
muscarininc antagonisns, used for parkinsons
55
MOA, Clinical indications for scopolamine
muscarininc antagonist, used formotion sickness and to decreased oral secretions (eg ICU pt)
56
MOA, Clinical indications for ipratropium, tiatropium
Muscarninc antagonist at level of lungs for COPD and asthma pts, by decreasing bronchoconstriction
57
MOA, Clinical indications for oxybutynin, tolteridine, trospium
Muscarininc antagonist at GU system to reduce urgency and decrease ladder spasms
58
Sx of atrophine toxicity
Caused by excessive anticholnergic sx bc its an antimuscarinic
Hot as a hare, dry as a bone, red as a bat, blind as a bat, mad as a hatter
increased body temp,dry flushed skin, cyclooplegia, constipated, disoriented
59
MOA, Clinical indications for epinephrine
sympathomimetic, beta and alpha agonist
Anaphylaxis, asthma, hypotension
60
MOA, Clinical indications for norepinephrine
sympathomimetic, primarily alpha effects, some B1 effect
hypotension (but decreases renal perfusion), septic shock
61
MOA, Clinical indications for isoproternol
sympathomimetic, Beta effects only
Used for torsade de pointes,bradyarrythmias
62
MOA, Clinical indications for Dopamine
sympathomimetic, low dose: dopamine
Med dose: beta receptors
high dose: alpha receptors
Used for shock, heart failure
63
MOA, Clinical indications for dobutamine
sympathomimetic, primarily B1 effects
increases Hr and contractility, heart failure, cardiac stess test
64
MOA, Clinical indications for phenylephrine
sympathomimetic, Increases alpha effects
causes vasoconstiction and ocular mydriasis,decongestant for rhinitis
65
MOA, Clinical indications for albuterol, salmeterol, terbutaline
sympathomimetic, Primarily B2,some B1 effect. Acute asthma (metaproternol, albuterol), salmetrol for long term asthma or COPD control
terbutaline helps with uterine relaxation
66
MOA, Clinical indications for amphetamine
indirect sympathetomemimetc, releases stored catecholamines, used for narcolepsy, ADD
67
MOA, Clinical indications for ephedrine
releases stored catecholamines, used for nasal decongestion
68
MOA, Clinical indications for cocaine
blocks reputake of NE at cleft
| Used for vasoconstriction and local anesthesia
69
MOA, Clinical indications for clonidine
alpha 2 agonist, used to decrease BP, acts centrally
70
MOA, Clinical indications for methyldopa
central alpha 2 agonist, decreases BP, especially pregnancy induced BP
71
MOA, Clinical indications for phenoxybenzamine
irreversible nonselective alpha blocker, used for phenochromacytoma
72
MOA, Clinical indications for phentolamine
reversible nonselective alpha blocker, used for pts on MAO inhibitors who have eaten tyramine containing foods
73
MOA, Clinical indications, and toxicity for prazosin, terazosin, doxazosin
alpha1 blocker, used for HTN and urinary retension in BPH, can cause 1st dose orthostaiss, reflex tachy, and rebound HTN
74
MOA, Clinical indications for tamusolosin
alpha1 blocker that decreases urinary retention but does not affect BP
75
MOA, Clinical indications for mirtazapine
central alpha2 drug, used for depression
76
Cardiac use for B Blockers (6)
Angina, MI, SVT, HTN, CHF, aortic dissection
77
Noncardiac use for B blockers (4)
glaucoma,anxiety,migraine ppx, hyperthyrooidism
78
Beta blocker toxicity
exacerbate asthma (by bronchoconstriction), bradycardia, AV block, CHF, seizures, sedation
79
In which groups must you be careful with B blockers?
Asthma/COPD and Diabetics
For diabetics B blockers causes decreased glcogenolysis and glucagon release, which causes hypoglycemia. Also, Bblockers can mask sx of hypoglycemia
80
B1 selective B bockers
betaxolol, esmolol, atenolol, metoprolol (BEAM)
81
nonselective B blockers
propranolol, timlol, nadolol
82
nonselective alpha and beta blockers
carvedilol, labetalol
83
Partial B agonists (fxn essentially as B blockers)
pindolol, acebutlol
84
Cant use what drug in cocaine or phenochromocytoma HTN and why
B blockers bc unopposed alpha effect causes worsening HTN due to vasoconstriction
85
acetaminphen OD tx and MOA
N-acetylglutathione, which replenishes glutathione,which is needed to decrease the toxic NAPQI (metabolite of acetaminophen)
86
Salicylates tx and sx
n,V, dizziness, tinnitus
Dialysis, alkanize urine with NaHCO3
87
-bendazole
Helminth infections, like mebendazole
88
-azole
antifungals
89
-cillin
penicillin
90
-cycline
abx, protein synthesis inhibitor
91
-navir
protease inhibitor
92
-triptan
5HT1b/1D agonists - migraines
93
-ane
inhaled general anesthetic (halothane)
94
-caine
local anesthetic
95
-operidol
neuroleptic
96
-azine
neuroleptic, antiemetic (chlropromazine)
97
-etine
SSRI (fluoxetine)
98
-ipramine
TCA
99
-triptyline
TCA
100
-olol
B antagonist
101
-terol
B2 agonist
102
-zosin
alpha 1 antagonist
103
-pril
ACE inhibitor
104
-afil
phosphodiseterase inhibitor for erectyle dysfunction
105
-tropin
pituitary hormone (somatotropin)
106
-tidine
H2 antagonist (cimetidine)
107
-phylline
methylxanthine drug
108
-prost
prostaglandin analog
109
-sartan
angiotensin II receptor blocker
110
-stigmine
anticholinesterase drug
111
-chol
muscarinic agonist (carbachol, bethanechl)
112
-curium/curonium
non depolarizing NM blocker
113
-dipine
DHP CCB
114
-dronate
-bisphosphonate
115
-gliptin
DPP-IV inhibitors, like sitagliptin
116
-glitazone
TZDs like pioglitazone
117
Acetylcholinesterase inhibitors, organophosphates toxicity tx
Atropine, pralidoxime
118
Antimuscarinic, anticholinergic agents, atropine OD
Physostigmine salicylate, control hyperthermia
119
B blockers, verapimil toxicity
Glucagon, atropine, Ca2+
120
Digitalis toxicity tx
fragments, Mg2+ (KLAM), Normalize K+, Lidocaine, Anti-dig Fab
121
Iron toxicity tx
Deferoxamine, deferasirox
122
Lead toxicity tx
CaEDTA, dimercaprol, succimer, penicillamine
123
Mercury, arsenic, gold toxicity tx
Dimercaprol ( BAL), succimer
124
Copper, arsenic, gold toxicity tx
Penicillamine
125
Cyanide toxicity tx
Nitrite + thiosulfate, hydroxocobalamin. Can occur via Na nitroprosude tx in hospitals
126
Methemoglobin toxicity tx
Methylene blue, vitamin C
127
Carbon monoxide toxicity
10 0 % 02, hyperbaric 02 –think >of CO toxicity with spaceheaters, kerosone gas lamps, ovens, etc.. Can present with “cherry red lips”
128
Methanol, ethylene glycol (antifreeze) toxicity tx
Fomepizole >ethanol, dialysis
129
Opioids toxicity tx
Naloxone/naltrexone
130
Benzodiazepines toxicity tx
Flumazenil
131
TCAs toxicity tx
NaHC03 (plasma alkalinization)
132
Heparin toxicity tx
Protamine
133
Warfarin toxicity tx
Vitamin K, fresh frozen plasma
134
toxicity txt PA, streptokinase, urokinase
Aminocaproic acid
135
Theophylline toxicity tx
Bblocker
136
Coronary vasospasm
Cocaine, sumatriptan, ergot alkaloids
137
Cutaneous flushing
Vancomycin, Adenosine, Niacin, Ca2+ channel blockers - VANC
138
Dilated cardiomyopathy
Doxorubicin (Adriamycin), daunorubicin
139
Torsades de pointes
Class III, class Ia antiarrythmics, macrolides,haloperidol, chloroquine, protease inhibitors
140
Agranulocytosis
clozapine,carbamazepine, colchicine, propylthioruacil, methimaziole,dapsone
141
Aplastic anemia
Chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole
142
Direct Coombs + hemolytic anemia
Methyldopa, penicillin
143
Grey baby syndrome
Chloramphenicol
144
hemolysis in G6PD deficient pts
Isoniazid (INH), Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin
145
megaloblastic anemia caused by drugs?
Phenytoin, Methotrexate, Sulfa drugs
146
Thrombotic complications
OCPs (e.g., estrogens)
147
Thrombocytopenia
Heparin, cimetidine
148
Cough
ACE inhibitors
149
Pulmonary fibrosis
BLeomycin, Amiodarone, Busulfan
150
Acute cholestatic hepatitis
Erythromycin
151
Focal to massive hepatic necrosis
Halothane, Amanita phalloides, Valproic acid, Acetaminophen
152
hepatitis
INH
153
pseudomembranous colitis
Clindamycin, ampicillin, amoxicillin
154
Adrenal insufficinecny
Glucocorticoid withdrawal (HPA suppression)
155
gynecomastia
Spironolactone, Digitalis, Cimetidine, chronic Alcohol use, estrogens, Ketoconazole
156
Hot flashes
Tamoxifen, clomiphene
157
hyperglycemia
Niacin, tacrolimus, protease inhibitors, HCTZ, corticosteroids
158
hypothyroidism
Lithium, amiodarone, sulfonamides
159
fat redistribution
Glucocorticoids, protease inhibitors
160
gingival hyperplasia
Phenytoin, verapamil
161
gout
Furosemide, thiazides, niacin, cyclosporine
162
myopathies
fibrates, niachine,colchicine,hydrocychloroquine, IFNa, statins,glucocorticoids,penicillamine
163
osteporosis
corticosteroids,heparin (if on steroids for more than 3 mos, consider giving bisphosphanates)
164
photosensitivity
Sulfonamides, Amiodarone, tetracycline (SAT for photo)
165
Rash/SJS
Penicillin, ethosuxiide, carbamazepine, Sulfa drugs, lamotrigine, allopurinol, phenytin, phenobarbital
166
SLE like syndrome
Hydralazine, INH,procainamide,sulfonadmies,phenytoine (SHIPP)
167
teeth problems in kids
tetracyclines
168
tendonitis rupture
flouroquinolones
169
Diabes inspidus
lithium, demeclocycline
170
fancoinus syndrome
expired tetracycline, wilsons disease, heavy metal toxicity
171
hemorrhagic cystitis
cyclophosphamide, ifosfamide (prevent with coadmistering mesna)
172
intersitinal nephritis
Methicillin, NSAIDs, furosemide
173
SiADH
Carbamazepine, cyclophosphamide
174
Cinchonism
Quinidine, quinine
175
Parkinson-like symptoms
Antipsychotics, reserpine, metoclopramicle
176
Seizures
Isoniazid, Bupropion, lmipenem/cilastatin, Tramadol, EnAurane, Metoclopramide (with SEIZURES, I BITE My tongue)
177
Tardive dyskinesia
Antipsychotics
178
Antimuscarinic
Atropine, TCAs, H1-blockers, neuroleptics
179
Disulfiram-like rxn
Metronidazole, certain cephalosporins, procarbazine, 1st-generation sulfonylureas
180
Nephrotoxicity/ototoxicity
Aminoglycosides, vancomycin, loop diuretics, cisplatin
181
nephrotoxic/neurotoxic
aminoglycosides, cisplatin,polymxin
182
P450 inducing drugs?
Modafinil, barbiturates,St Johns wort, phenytoin, rifampin, griseofulvin, carbamazepine, CHRONIC alchol use (Guinness, Coronas,and PBRS induce chronic alcoholism)
183
P450 inhibitng drugs?
Macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir/protease inhibitors, acute alcohol abuse
184
Sulfa Drugs
Probenecid, Furosmde, Azetazolamide, celocoxib,thiazides, sulfonamide abx, sulfasalazine, sulfonylureas – Popular FACTSSS
