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pharm Flashcards

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1
Q

bethanicol

A

cholinergic: direct agonist.Tx: ileus, urinary retention. activates bowel and bladder smooth muscle. resistant to AChE

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2
Q

carbachol

A

cholinergic: direct agonist. Tx: constricts pupil and relieves intraocular pressure in glaucoma. = carbon copy of ACh

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3
Q

methacholine

A

cholinergic: direct agonist. Tx: challenge test for Dx of asthma. stimulates muscarinic receptors in airway when inhaled.

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4
Q

pilocarpine

A

cholinergic: direct agonist. Tx: potent stimulator of sweat, tears, and saliva. open-angle and closed-angle glaucoma. contracts ciliary muscle of eye (open-angle), pupillary sphincter (close-angle). resistant to AChE.

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5
Q

donepezil, galantamine, rivastigmine

A

cholinergic: indirect agonist (anticholinesterase). Tx: AD.

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6
Q

edrophonium

A

cholinergic: indirect agonist. Tx: historical Dx for MG. extremely short-acting

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7
Q

neostigmine

A

cholinergic: indirect agonist. Tx: ileus, urinary retention, MG, reversal of NMJ blockade. neo (no) CNS penetration

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8
Q

physostigmine

A

cholinergic: indirect agonist. Tx: ACh toxicity. crosses BBB. phyxes overdose

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9
Q

pyridostigmine

A

cholinergic: indirect agonist. Tx: MG. long acting. no CNS penetration.

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10
Q

w/cholinomimetics, watch out for…

A

COPD, asthma, PUD flairs

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11
Q

Sx of cholinesterase inhibitor poisoning

A

DUMBBELSS: Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation (skeletal muscle and CNS), Lacrimation, Sweating, Salivation.

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12
Q

cause of cholinesterase inhibitor poisoning

A

organophosphates (parathion)

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13
Q

atropine, homatropine, tropicamide

A

muscarinic antagonists. target: eyes. -> mydriasis + cycloplegia. also used to Tx bradycardia.

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14
Q

benztropine

A

muscarinic antagonist. target: CNS. Tx: PD, acute distonia

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15
Q

glycopurrolate

A

muscarinic antagonist. target: GI, respiratory. Tx: parenteral: preop -> dec. airway secretions. oral: drooling, PUD.

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16
Q

hyoscyamine, dicyclomine

A

muscarinic antagonist. target: GI. Tx: antispasmodics for IBS

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17
Q

ipratropium, tiotropium

A

muscarinic antagonist. target: respiratory. Tx: COPD, asthma

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18
Q

oxybutynin, solifenacin, tolterodine

A

muscarinic antagonist. target: GU. Tx: reduce bladder spasms and urge incontinence

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19
Q

scopalamine

A

muscarinic antagonist. target: CNS. Tx: motion sickness

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20
Q

effects of muscarinic antagonists:

A

inc. pupil dilation, dec. secretions, dec. acid secretion, dec. motility, dev. urge in cystitis

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21
Q

muscarinic antagonist toxicity

A

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter. can cause acute angle glaucoma.

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22
Q

tetrodotoxin

A

in fugu. binds fast V-gates Na channels -> N/D, paresthesias, weakness, dizziness, loss of DTRs. Tx: supportive

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23
Q

ciguatoxin

A

reef fish (baracuda, snapper, moray eel). opens Na channels -> depolarization. Sx: confused w/cholinergic poisoning. temperature dysesthesia. Tx: supportive

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24
Q

scombroid poisoning

A

dark-meat fish. bacterial histidine decarboxylase converts histidine -> histamine. mimics fish allergy. -> mouth burning, face flushing, erythema, urticaria, pruritus, h/a. can look like anaphylaxis (bronchospasm, angioedema, hypotension. Tx: supportive, antihistamines, antianaphylactics if needed).

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25
albuterol, salmeterol
sympathomimetic. beta2>beta1. salmeterol = LABA.
26
dobutamine
sympathomimetic. beta1>beta2, alpha. Tx: HF, inotropic > chronotropic. cardiac stress-test.
27
dopamine
sympathomimetic. D1 = D2>beta>alpha. Tx: unstable bradycardia, HF, inotropic + chronotropic alpha effects predominate at high doses.
28
epinephrine
sympathomimetic. beta>alpha. Tx: anaphylaxis, asthma, open-angle glaucoma, alpha effects predominate at high doses. stronger beta2 than NE
29
isoproterenol
sympathomimetic. beta1=beta2. Tx: electrophysiologic eval of tachyarrhythmias. can worsen ischemia.
30
NE
sympathomimetic. alpha1>alpha2>beta1. Tx: hypotension (but decreases renal perf), significantly weaker effect at beta2 than NE
31
phenylephrine
sympathomimetic. alpha1>alpha2. Tx: hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant).
32
amphetamine
indirect sympathomimetic: agonist, reuptake inhibitor, releases stores catecholamines. Tx: narcolepsy, obesity, ADHD
33
cocaine
indirect adrenergic agonist, reuptake inhibitor. -> vasoconstriction and local anesthesia. never give beta-blockers if cocaine intoxication is suspected (-> unopposed alpha1 activation -> extreme HTN)
34
ephedrine
indirect adrenergic agonist, releases stored catecholamines. Tx: nasal decongestion, urinary incontinence, hypotension
35
NE vs. isoproterenol: NE
inc. BP via alpha1 vasocontriction -> inc. MAP -> reflex bradycardia
36
NE vs. isoproterenol: isoproterenol
little alpha effect. causes beta2-mediated vasodilation -> dec. MAP + inc. HR via beta1 and reflex activity
37
clonidine
Tx: hypertensive urgency. does not decrease renal blood flow. ADHD, tourettes. toxicity: CNS depression, bradycardia, hypotension, respiratory depression, meiosis
38
alpha-methydopa
Tx: HTN in pregnancy. toxicity: direct coombs + hemolysis, SLE-like syndrome
39
phenoxybenzamine
irreversible alpha-blocker. Tx: pheo (preop). side effects: orthostatic hypotension, reflex tachycardia
40
phentolamine
reversible alpha-blocker. Tx: give to pts on MAO inhibitors who eat tyramine-containing foods. side effects: orthostatic hypotension, reflex tachycardia
41
prazosin, terazosin, doxazosin, tamsulosin
selective alpha1 blocker. Tx: urinary Sx of BPH, PTSD (prazosin), HTN (except tamsulosin). side effects: 1st dose orthostatic hypotension, dizziness, h/a
42
mirtazepine
selective alpha2 blocker. Tx: depression. side effects: desation, inc. serum cholesterol, inc. appetite
43
timolol
beta blocker used to dec. secretion of aqueous humor to treat glaucoma
44
beta blocker toxicity
impotence, CV (bradycardia, AV block, HF), CNS (seizures, sedation. sleep alterations), dyslipidemia (metop), and asthma/COPD. avoid after cocaine use!
45
selective beta1 blockers
acebutolol (partial), atenolol, betaxolol, esmolol, metoprolol (A-M = 1st 1/2 of alphabet)
46
nonselective beta blockers
nadolol, pindolol (partial), propranolol, timolol. (N-Z = 2nd 1/2 of alphabet)
47
nonselective alpha and beta blockers
carvedilol, labetalol (don't quite end in olol)
48
nibivolol
combines cardiac-selective beta1 blockade w/stimulation of beta3-receptors, which activate NO synthase in the vasculature
49
acetaminophen antidote
n-acetylcysteine (replenishes glutathione)
50
AchE inhibitor/organophosphate antidote
atropine > pralidozime
51
amphetamine (basic) antidote
NH4Cl (acidify urine)
52
antimuscarinic anticholinergic antidote
physostigmine salicylate: control hyperthermia
53
benzo antidote
flumazenil
54
beta-blocker antidote
glucagon
55
Cu, As, Au antidote
penicillamine
56
cyanide antidote
nitrite + thiosulfate, hydroxocobalamin
57
digitalis antidote
anti-dig Fab fragments
58
heparin antidote
protamine sulfate
59
iron antidote
deferoxamine, deferasirox
60
lead antidote
EDTA, dimercaprol, succimer, penicillamine
61
mercury, As, Au antidote
dimercaprol (BAL), succimer
62
methanol, ethylene glycol antidote
fomepizole > ethanol, dialysis
63
methemoglobic antidote
methylene blue, vit C
64
opiod antidote
naloxone
65
salicylate antidote
NaHCO3 (alkalinize urine), dialysis
66
TCA antidote
NaHCO3 (plasma alkalinization)
67
tPA etc. antidote
aminocaproic acid
68
causes coronary vasospasm
cocaine, sumatriptan, ergot alkaloids
69
causes cutaneous flushing
vanc, adenosine, niacin, CCBs
70
causes dilaed cardiomyopathy
anthracyclines (doxorubicin, daunorubicin), prevent w/dexrazoxane
71
causes torsades
class III (sotalol) and class IA (quinidine) antiarrhythmics, macrolide antibiotics, antipsychotics, TCAs
72
causes adrenocortical insufficiency
glucocorticoid withdrawal
73
causes hot flashes
tamoxifen, clomiphene
74
causes hyperglycemia
tacrolimus, protease inhibitors, niacin, HCTZ, corticosteroids
75
causes hypothyroidism
lithium, amiodarone, sulfonamides
76
causes acute cholestatic hepatitis, jaundice
erythromycin
77
causes diarrhea
metformin, erythromycin, colchicine, orlistat, acarbose
78
causes focal to massive hepatic necrosis
halothane, amanita phalloides (death cap mushroom), valproic acid, acetaminophen
79
causes hepatitis
rifampin, isoniazid, pyrazinamide, statins, fibrates
80
causes pancreatitis
didanosine, corticosteroids, alcohol, valproic acid, azathioprine, diuretics
81
causes agranulocytosis
ganciclovir, clozapine, carbamazepine, colchicine, methimzaole, propylthiouracil
82
causes aplastic anemia
carbamazepine, methimazole, NSAIDs, benzene, chloramphenicol, proylthiouracil
83
causes direct coombs-+ AIHA
methyldopa, penicillin
84
causes gray baby syndrome
chloramphenicol
85
causes hemolysis in G6PD def.
isoniazid, sulfonamides, dapsone, primaquine, ASA, ibuprofen, nitrofurantoin
86
causes megaloblastic anemia
phenytoin, methotrexate, sulfa drugs
87
causes thrombocytopenia
heparin
88
causes thrombosis
OCPs, HRT
89
causes fat redistribution
protease inhibitors, flucocorticoids
90
causes gingival hyperplasia
phenytoin, CCBs, cyclosporine
91
causes hyperuricemia
pyrazinamide, thiazides, furosemide, niacin, cyclosporine
92
causes myopathy
fibrates, niacin, colchicine, hydroxychloroquine, IFN-alpha, penicillamine, statins, glucocorticoids
93
causes osetoporosis
corticosteroids, heparin
94
causes photosensitivity
sulfonamides, amiodarone, tetracyclines, 5-FU
95
causes stevens-johnson
anti-epileptic drugs, allopurinol, sulfas, PCN
96
causes SLE-like syndrome
sulfas, hydralazine, isoniazid, procainamide, phenytoin, etanercept
97
causes tooth discoloration
tetracyclines
98
causes tendonitis, tendon rupture, cartilage damage
fluoroquinolones
99
causes cinchonism
quinidine, quinine
100
causes parkinson-like syndrome
antipsychotics, reserpine, metoclopramide
101
causes seizures
isoniazid (vit B6 def), bupropion, imipenem/cilastatin, enflurane
102
causes tardive dyskinesia
antipsychotics, metoclopramide
103
causes DI
lithium, demeclocycline
104
causes fanconi syndrome
expired tetracycline
105
causes hemorrhagic cystitis
cyclophosphamide, ifostamide
106
causes interstitial nephritis
methicillin, NSAIDs, furosemide
107
causes SIADH
carbamazepine, cyclophosphamide, SSRIs
108
causes pulmonary fibrosis
bleomycin, amiodarone, busulfan, methotrexate
109
causes antimuscarinic toxidrome
atropine, TCAs, H1-blockers, antipsychotics
110
causes disulfiram-like rxn
netronidazole, some cephs, griseofulvin, procarbazine, 1st gen sulfonylureas
111
causes nephrotox/ototox
aminoglycosides, vanc, loop diuretics, cisplatin (may respond to amifostine)
112
P-450 inducers
chronic alcohol, st. john's wart, phenytoin, phenobarb, nevirapine, rifampin, griseofulvin, carbamazepine: chronic alcoholics steal phen-phen and never refuse greasy carbs
113
P-450 substrates
anti-epileptics, theophylline, warfarin, OCPs
114
P-450 inhibitors
acute alcohol, ritonavir, amiodarone, cimetadine, ketoconazole, sulfonamides, isoniazid, grapefruit juice, quinidine, macrolides (except azithro)
115
sulfa drugs
probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide Abx, sulfasalazine, sulfonylureas
116
effects of sulfa allergies
fever, UTI, stevens-johnson, hemolytic anemia, thrombocytopenia, agranulocytosis, hives.
117
-azole
ergosterol synthesis inhibitor
118
-bendazole
antiparasitic/antihelmintic
119
-cillin
peptidoglycan synthesis inhibitor
120
-cycline
protein synthesis inhibitor
121
-ivir
neuraminidase inhibitor
122
-navir
protease inhibitor
123
-ovir
DNA polymerase inhibitor
124
-thromycin
macrolide
125
-ane
inhalational general anesthetic
126
-azine
typical antipsychotic
127
-barbital
barbiturate
128
-caine
local anesthetic
129
etine
SSRI
130
-ipramine, -triptyline
TCA
131
-triptan
5-HT 1B/1D agonists
132
-zepam, -zolam
benzo
133
-chol
cholinergic agonist
134
-curium, -curonium
nondepolarizing paralytic
135
-olol
beta-blocker
136
-stigmine
AChE inhibitor
137
-terol
beta2 agonist
138
-zosin
alpha1 antagonist
139
-afil
PDE-5 inhibitor
140
-dipine
dihydropyridine CCD
141
pril
ACE-I
142
-sartan
ARB
143
-statin
HMG-CoA reductase inhibitor
144
-dronate
bisphosphonate
145
-glitazone
PPAR-gamma activator
146
-orazole
PPI
147
-prost
prostaglandin analog
148
-tidine
H2 antagonist
149
-tropin
pituitary hormone
150
-ximab
chimeric monoclonal Ab
151
-zumab
humanized monoclonal Ab

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