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Flashcards in pharm Deck (151):
1

bethanicol

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

2

carbachol

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

3

methacholine

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

4

pilocarpine

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.

5

donepezil, galantamine, rivastigmine

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

6

edrophonium

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

7

neostigmine

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

8

physostigmine

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

9

pyridostigmine

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

10

w/cholinomimetics, watch out for...

COPD, asthma, PUD flairs

11

Sx of cholinesterase inhibitor poisoning

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

12

cause of cholinesterase inhibitor poisoning

organophosphates (parathion)

13

atropine, homatropine, tropicamide

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

14

benztropine

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

15

glycopurrolate

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

16

hyoscyamine, dicyclomine

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

17

ipratropium, tiotropium

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

18

oxybutynin, solifenacin, tolterodine

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

19

scopalamine

muscarinic antagonist. target: CNS. Tx: motion sickness

20

effects of muscarinic antagonists:

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

21

muscarinic antagonist toxicity

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.

22

tetrodotoxin

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

23

ciguatoxin

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

24

scombroid poisoning

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).

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