pharm Flashcards
(122 cards)
1
Q
triptans mechanism
A
serotonin agonists
cause vasoconstriction
modulate neurotransmission in trigeminal nerve
should be taken as soon as the headache starts
2
Q
contraindications to triptans
A
vasoconstricts; do not give in pregnancy or CAD, or prinzmetal angina
3
Q
DUMBBELSS
A
Diarrhea, urination, miosis, bradycardia, bronchospasm, excitation of skeletal muscle (ACh at NMJ), lacrimation, salivation sweating (ACh despite being a SNS function)
4
Q
Endogenous stim at mu receptor
A
beta endorphin
5
Q
endogenous stim at delta receptor
A
enkephalin
6
Q
endogenous stim at kappa receptor
A
dynorphin
7
Q
anticholinergic effects: atropine
A
hot as a hare (hyperpyrexia), red as a beet (flushing), blind as a bat (mydriasis), dry as a bone (no salivation), mad as a hatter (delirium), bloated as a toad (constipation), tachycardia
8
Q
on the darn toilet: drugs that treat urge incontinence
A
oxybutinin, tolterodine, darifenacin and solifenacin, trospium; anticholinergics
9
Q
physostigmine
A
anticholinesterase (indirect cholinergic agonist)
10
Q
pilocarpine
A
direct muscarinic agonist
11
Q
oxybutynin
A
muscarinic antagonist for urge incontinence
12
Q
donepezil
A
anticholinesterase
13
Q
pralidoxime
A
regenerator of AChE
14
Q
bethanecol
A
cholinergic agonist
15
Q
neostigmine
A
anticholinesterase inhibitor
16
Q
darifenacin
A
muscarinic antagonist
17
Q
ipratropium
A
muscarinic antagonist
18
Q
tropicamide
A
muscarinic antagonist
19
Q
benztropine
A
muscarinic antagonist
20
Q
scopolamine
A
muscarinic antagonist for motion sicknesss and decreased salivary secretion in ventilated patients
21
Q
edrophonium
A
anticholinesterase
22
Q
tolteridine
A
muscarinic antagonist
23
Q
trospium
A
muscarinic antagonist
24
Q
rivastigmine
A
anticholinesterase, used in AD
25
homatropine
muscarinic antagonist
26
pyridostigmine
anticholinesterase
27
carbachol
cholinergic agonist
28
nonselective beta blockers
propanolol, timolol, nadolol
29
selective beta1 blockers
metoprolol, atenolol
30
partial agonists
acebutol (beta-1 only), pindolol (alpha and beta)
31
alpha and beta blockers
carvedilol, labetalol
32
glaucoma drugs
timolol, nadolol
33
opioid cough suppressant commonly used with the expectorant guaifenesin
dextromethorphan (DM)
34
opioid used in the treatment of diarrhea
loperamide, diphenoxylate
35
opioid receptor antagonist
naloxone, naltrexone
36
non-addictive weak opiod agonist
tramadol
37
partial opioid agonist that causes less respiratory depression
butorphanol
38
hemicholinium
inhibits choline - sodium transport into cholinergic axons for ACh synthesis
39
Vesimacol
inhibits ACh packaging into vesicles
40
Botulinum
inhibits presynaptic ACh vesicle release for flaccid paralysis
41
Black widow spider toxin
promotes ACh release from presynaptic terminal for spastic paralysis
42
Metyrosine
tyrozine hydroxylase inhibitor
43
reserpine
inhibits DOPA decarboxylase (conversion of DOPA to DA)
44
Bretylium, guanethidine
inhibit NE release from presynapse
45
Tyramine, amphetamine, ephedrine
promotes NE release from presynapse
46
Cocaine, TCA, amphetamine
inhibits NE reuptake
47
ATII
promotes NE release
48
alpha2 agonists
inhibit NE release from presynapse
49
Disulfiram- like reaction
p. 95, 260
| metronidazole, certain cephalosporins, procarbazine, 1st generation sulfonylureas
50
CYP450 inducers
Guiness, coronas, PBRs induce chronic alcoholism
| griseofulvan, carbamazepine, phenytoin, barbiturates, rifampin, st. john's wart, chronic alcoholism
51
CYP inhibitors
CRACK AMIGOS:
ciprofloxacin, ritonavir, amiodarone, cimetidine, ketoconazole, acute alcohol use, macrolides, isoniazid, grapefruit juice, omeprazole, sulfonamides
52
Flushing
vancomycin, niacin, adenosine, dihydropyridine CCBs
53
Coronary vasospasm
cocaine, amphetamines, triptans (sumatriptan), ergotamine
54
dilated cardiomyopathy
doxorubicin, daunorubicin
55
Torsades de pointes
potassium channel blockers (class III), sodium channel blockers (class IA), macrolides, haloperidol, chloroquine, protease inhibitors
56
thrombocytopenia after heparin
HIT. cimetidine can also cause thrombocytopenia
57
Agranulocytosis
clozapine, carbamazepine, colchicine, PTU, Methimazole, dapsone
58
Aplastic anemia
chloramphenicol, benzene, NSAIDs, PTU, methimazole
59
Gray baby
chloramphenicol 2/2 insufficient UDP- glucaronyl transferase
60
Hemolysis in G6PD deficient patients
isoniazid, sulfonamides, primaquine, high dose asa, ibuprofen, nitrofurantoin, dapsone, fava beans, naphthalene
61
thrombosis
oral contraceptives
62
pulmonary fibrosis
amiodarone, busulfan, bleomycin
63
cough
ACEI 2/2 bradykinins
64
pseudomembranous colitis
clindamycin, amoxacillin, ampicillin
65
hepatic necrosis
halothane, acetaminophen, valproic acid, amanita phalloides
66
hepatitis
INH
67
tertiary adrenal insufficiency
corticosteroid withdrawal
68
gynecomastia
spironolactone, digozin, estrogens, cimetidine, chronic alcohol use, ketoconazole, marijuana (some drugs cause awesome knockers, or stacked where THC)
69
hot flashes
tamoxifen, clomiphene SERMs
70
hypothyroidism
amiodarone, lithium, sulfonamides
71
gout
diuretics (loop and thiazide), niacin, cyclosporine, pyrazinamide
72
gingival hyperplasia
phenytoin, verapamil
73
osteoporosis
corticosteroids, heparin
74
photosensitivity
sulfonamides, amiodarone, tetracycline (SAT for photo)
75
SJS
```
seizure drugs and penicillin
ethosuximide, carbamazepine, lamotragine, phenytoin, phenobarbital, sulfonamides, penicillins, allopurinol
CLAPPPERS
carbamazepine
lamotragine
allopurinol
phenytoin
phenobarbitol
pcn
ethosuximide
RASH
sulfa drugs
```
76
drug- induced lupus
SHIPP
| sulfonamides, hydralazine, INH, phenytoin, procainamide
77
tendinitis, cartilage damage
fluoroquinolones
78
interstitial nephritis
NSAIDs, furosemide, antibiotics
79
DI
lithium, demeclocycline
| treat with HCTZ, amiloride
80
Fanconi
expired tetracycline, heavy metal exposure, wilson
81
hemorrhagic cystitis
cyclophosphamide, ifosfamide
82
Parkinson- like syndrome
metaclopramide, antipsychotics, reserpine
83
cinchonism
dizziness, HA, vision changes, tinnitus
| quinidine, quinine
84
seizures
buproprion, imipenem, cilastatin, INH, tramadol, metaclopramide, benzodiasepines, EtOH w/drawal
85
tardive dyskinesia
antipsychotics, metoclopramide
86
disulfiram- like reaction
metronidazole, cephalosporins, procarbazine, first- generation sulfonylureas, disulfiram
87
nephrotoxic and neurotoxic
aminoglycosides, cisplatin, polymyxins
88
nephrotoxic and ototoxic
aminoglycosides, vancomycin, loop diuretics, cisplatin
89
anticholinergic side effects
atropine, TCAs, H1 blockers (diphenhydramine), low- potency neuroleptics (thioridizine, chlorpromazine)
90
eliminated at a constant rate (zero order)
PEA:phenytoin, ethanol, aspirin
91
low therapeutic index
warfarin, digoxin, lithium, phenobarbital
92
how does sildenafil lead to erection?
inhibits cGMP phosphodiesterase> increase in cGMP> relaxation of smooth muscle in corpus cavernosum> increased bloodflow> erection
93
pseudomonas aeruginosa
```
fluoroquinolones (ciprofloxacin, levofloxacin
ticarcillin
piperacillin
cefepime
ceftazidime
carbapenems (imipenem, meropenem)
```
94
Triple therapy H. Pylori
PPI
Clarithromycin
Amoxicillin or metronidazole (if allergic to PCN)
95
Quadruple therapy H Pylori
PPI
Bismuth
Metronidazole
Tetracycline
96
adenosine
increases outward potassium current, hyperpolarization of cells, decreases intracellular calcium (stops the heart transiently)
97
precursor of 6MP
azathioprine
98
ab that binds CD3 on T cells
muromonab
99
ab that binds IL2 receptor on activated T cells
daclizumab
100
inhibits inosine monophosphate dehydrogenase
mycophenolate mofetil
101
inhibits calcineurin leading to loss of IL2 production and blockage of T cell differentiation and activation
cyclosporing, tacrolimus, pimecrolimus
102
metabolized by xanthine oxidase, thereby increasing allopurinol toxicity
azathioprine, and 6MP
103
ACEI
inhibits angiotensin vasoconstrictor production thereby preventing vasoconstriction.
Dropping angiotensin keeps bradykinin around longer leading to more vasodilation
Used in HTN, CHF to prevent LV remodeling
Post MI
Diabetic kidney disease- reduced proteinuris, reduced progression of nephropathy
overall, well tolerated.
SE:
dry hacking cough
(due to bradykining)
angioedemia (complicated possibly by airway compromise)
cough
angioedema
kyperkalemia, especially if also on a potassium- sparing diuretic.
decreased GFR: renal insufficiency
BL renal artery stenosis is a contraindication
teratogenesis- pregnancy is a contraindication
104
ARB
candesartan, losartan
side effects: teratogenesis, hyperkalemia, renal insufficiency
NO cough (no bradykinin)
but can cause angioedema sometimes
if pt on ACEI gets angioedema then, you can't just sweitch
105
Aliskerin
renin inhibitor
hyperkalemia, renal insufficiency, contraindicated in pregnancy
NOT indicated in CHF or MI.
ONLY FOR HTN
106
Calcium channel blockers- dihydropyridines
amlodipine, felodipine, nicardipine, nifedipine, nisoldipine
act on vascular smooth muscle to cause vasodilation.
indicated to treat HTN, angina, vasospasm (Prinzmetal's angina, Raynaud), esophageal spasm, migraine prophylaxis, cluster HA
adverse effects: peripheral edema, flushing, dizziness, constipation, deflex tachycardia
107
CCB- non-dihydropyridine
acts on heart
diltiazem, verapamil
verapamil acts at calcium channels of pacemaker cells in the heart. no effect on systemic vasodilation
Diltiazem is less specific, acting at calcium channels of heart and vessels. commonly used in patients with angina to slow the heart and decrease o2 demand
also used to control HR in patients with ventricular fibrillation and other tachycardias
adverse effects: cardiac depression, AV block, flushing, dizziness, constipation
108
Hydralazine
increases cGMP inside of smooth muscle cells, dilating arterioles> veins, thereby decreasing afterload.
uses include hypertensive urgency and emergency. HTN in pregnancy
side effects: reflex tachycardia (don't give if coronary disease), may need to give with beta blocker
fluid retention
nausea headache
drug- induced lupus
109
Hypertensive Moms Love Nifedipine (know these HTN drugs that are safe during pregnancy
Hydralazine
Methyldopa
Labetalol
Nifedipine
110
Minoxidil
another arterial vasodilator. Opens potassium channels and hyperpolarizes smooth muscle, resulting in relaxation of vascular smooth muscle
therapeutic for severe HTN
or, apply topically to induce hypertrichosis (hair growth)
adverse effects: hypertrichosis, hypotension, reflex tachycardia, fluid retention/edema
111
Nitrates
nitroglycerin
isosorbide dinitrate
nitroprusside
dilate veins, reducing preload
treats angina, acute pulmonary edema
side effects: reflex tachycardia, flushing, HA, nitroprusside, CN toxicity
112
decreases afterload only
hydralazine
113
decreases preload and afterload
ACEI/ARB
114
decreases nitrates
nitrates
115
lipid- lowering agent with side effect of facial flushing
niacin
116
lipid- lowering agent with SE of elevated LFTs, myositis
statins, fibrates
117
lipid lowering agent with SE of GI discomfort, bad taste
bile acid binding resins
118
Best effect on HDL
niacin
119
Best effect on TGs/ VLDL
fibrates, omega 3 fatty acids
120
best effect on LDL/cholesterol
statins
121
lipid- lowering agent that bind c. diff toxin
cholestyramine
122
lipid- lowering agent that causes rash, vasodilation, diarrhea
niacin
prevent at bedtime, pretreat with ASA or NSAID 30 min in advance, avoid alcohol
