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Pharmacology Step 1 > Pharm Basics > Flashcards

Pharm Basics Flashcards

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1
Q

Cholinomimetic agents: direct agonists

A

Bethanechol, carbachol, methacholine, pilocarpine

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2
Q

Cholinomimetic agents: indirect agonists (acetylcholinesterase inhibitors)

A

galantamine, donepezil, rivastigmine, edrophonium, neostigmine, physostigmine, pyridostigmine, echothiophate

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3
Q

Bethanechol

A

direct cholinergic agonist
activates bowel and bladder smooth muscle
used for post-op ileum, neurogenic ileum, urinary retention
resistant to AChE

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4
Q

Carbachol

A 
direct cholinergic agonist
mimics ACh (but is resistant to AChE)
constricts pupil and relieves intraocular pressure in open-angle glaucoma
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5
Q

Methacholine

A

direct cholinergic agonist
stimulates muscarinic receptors in airway when inhaled
Challenge test for diagnosis of asthma (causes bronchospasm)

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6
Q

Pilocarpine

A

direct cholinergic agonist
contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (close-angle glaucoma), resistant to AChE, can cross BBB

Potent stimulator of sweat, tears, and saliva
Open-angle and closed-angle glaucoma, xerostomia (Sjogren syndrome)

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7
Q

Galantamine, donepezil, rivastigmine

A

indirect cholinergic agonist (antiAChE)
increase ACh
used in Alzheimer disease (GDR -> Grandma Doesn’t Remember)

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8
Q

Edrophonium

A

indirect cholinergic agonist (antiAChE)
increases ACh
historically used to dx myasthenia gravis

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9
Q

Neostigmine

A

indirect cholinergic agonist (antiAChE)
increases ACh
No CNS penetration
used for post-op and neurogenic ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade (post-op)

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10
Q

Physostigmine

A

indirect cholinergic agonist (antiAChE)
increases ACh
Antidote for anticholinergic toxicity
Crosses BBB

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11
Q

Pyridostigmine

A

indirect cholinergic agonist (antiAChE)
increases Ach, increases muscle strength
Used for Tx of myasthenia gravis (long acting)
does not cross BBB

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12
Q

Echothiophate

A

indirect cholinergic agonist (antiAChE)

glaucoma

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13
Q

What are potential complications of all ACh agonists to look out for?

A

exacerbation of COPD, asthma, and peptic ulcers when given to susceptible patients

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14
Q

Muscarinic antagonists

A

atropine, homatropine, tropicamide, cyclopentolate, benztropine, glycopyrrolate, hyoscyamine, dicyclomine, ipratropium, tiotropium, oxybutynin, scopolamine

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15
Q

Atropine, homatropine, tropicamide, cyclopentolate

A

muscarinic antagonists
target: eye
applications: produce mydriasis and cycloplegia (paralysis of the ciliary muscles)
homatropine, tropicamide, and cyclopentolate have a shorter duration of action than atropine, so used more often to dilate eyes

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16
Q

benztropine

A

muscarinic antagonist

target: CNS
uses: decreases side effects of antipsychotics, Parkinson disease, acute dystonia

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17
Q

glycopyrrolate

A

muscarinic antagonist

target: GI, respiratory
uses: parenteral: pre-op use to decrease airway secretions
oral: drooling, peptic ulcer

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18
Q

hyoscyamine, dicyclomine

A

muscarinic antagonist

target: GI
uses: antispasmodics for IBS

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19
Q

Ipratropium, tiotropium

A

muscarinic antagonist (inhaled)

target: respiratory
uses: decreases bronchoconstriction, COPD, asthma

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20
Q

oxybutinin

A

muscarinic antagonist

target: GU
uses: reduce bladder spasms and urge urinary incontinence (overactive bladder)

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21
Q

scopolamine

A

muscarinic antagonist (patch)

target: CNS
uses: motion sickness, decreases oral secretions in mechanically ventilated patients

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22
Q

What are adverse effects of atropine use?

A

can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with BPH, and hyperthermia in infants

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23
Q

direct sympathomimetics

A

albuterol, almeterol, dobutamine, dopamine, epinephrine, isoproterenol, norepinephrine, phenylephrine, terbutaline, clonidine

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24
Q

indirect sympathomimetics

A

amphetamine, cocaine, ephedrine

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25
albuterol, salmeterol
direct sympathomimetic B2>B1 (inhaled) use: albuterol for acute asthma or COPD Salmeterol for long-term asthma or COPD control
26
adverse effect of albuterol
tachycardia
27
dobutamine
direct sympathomimetic B1>B2, alpha uses: HF, cardiac stress testing effect: increases HR and contractility
28
dopamine
``` direct sympathomimetics Low doses = D1/D2 Medium doses = B1/B2 High doses = alpha1/alpha2 Uses: unstable bradycardia, HF, shock ```
29
epinephrine
direct sympathomimetics B>alpha (alpha1, alpha2, B1, B2) uses: anaphylaxis, asthma, croup, hypotension
30
isoproterenol
direct sympathomimetic B1=B2 use: electrophysiologic evaluation of tachyarrhythmias can worsen ischemia
31
norepinephrine
direct sympathomimetic alpha1>alpha2>beta1 use: hypotension, septics shock, cariogenic shock
32
phenylephrine
direct sympathomimetic alpha1>alpha2 uses: hypotension, ocular procedures (mydriasis), rhinitis (decongestant)
33
terbutaline
direct sympathomimetic B2>B1 uses: bronchospasm, tocolysis
34
clonidine
direct sympathomimetic alpha2 uses: decrease BP (can see significant rebound HTN)
35
ampethamine
indirect sympathomimetic MOA: indirect agonist, reuptake inhibitor, releases stored catecholamines uses: narcolepsy, obesity, ADHD
36
cocaine
indirect agonist, reuptake inhibitor uses: causes vasoconstriction and local anesthesia never give beta blockers if cocaine intoxication is suspected
37
ephedrine
indirect agonist, releases stored catecholamines | uses: nasal decongestion, urinary incontinence, hypotension
38
alpha2-agonists
clonidine, alpha-methyldopa
39
alpha-methyldopa
alpha2-agonist; Tx HTN in pregnancy
40
Nonselective alpha blockers
phenoxybenzamine, phentolamine
41
alpha 1 selection alpha blockers
prazosin, terazosin, doxazosin, tamsulosin
42
phenoxybenzamine
nonselective alpha blocker uses: irreversible; pheochromocytoma to prevent catecholamine (HTN) crisis AE: orthostatic hypotension, reflex tachycardia
43
Phentolamine
nonselective alpha blocker uses: reversible; given to patients on MAO inhibitors who eat tyramine-containing food AE: orthostatic hypotension, reflex tachycardia
44
Prazosin, terazosin, doxazosin, tamsulosin
alpha 1 selective blocker uses: urinary symptoms of BPH, PTSD (prazosin), HTN (except tamsulosin - prostate specific) AE: orthostatic hypotension, dizziness, headache, reflex tachycardia, rebound HTN with abrupt withdrawl
45
Nonselective beta blockers
nadolol, propranolol, timolol
46
B1 selectieve beta blockers
atenolol, esmolol, metoprolol, nebivolol
47
Weak B1/B2 agonists
acebutolol, pindolol
48
Nonselective alpha/beta blockers
carvedilol, labetalol
49
uses of beta blockers
HTN, CAD, CHF (slows), hyperthyroidism, migraine prophylaxis, anxiety, SVT, glaucoma, aortic dissection
50
what are the adverse effects of beta blockers?
bronchoconstriction, hypoglycemia, increased BP in cocaine user, rebound tachycardia, rebound HTN, arrhythmia Avoid beta blocker use in patients with lung problems
51
What drug class has the suffix -afil?
phosphodiesterase inhibitors | ex: sildenafil, tadalafil
52
What drug class has the suffix -azepam?
benzodiazepines | ex: lorazepam, diazepam
53
What drug class has the suffix -azine?
phenothiazine | ex: chlorpromazine, thioridazine (neuroleptics), promethazine (antiemetic)
54
What drug class has the suffix -azolam?
benzodiazepines | ex: alprazolam, midazolam, triazolam
55
What drug class has the suffix -barbital?
barbiturates | ex: phenobarbital, secobarbital
56
What drug class has the suffix -bendazole?
benzimidazoles | ex: mebendazole, albendazole
57
What drug class has the suffix -caine?
local anesthetics | ex: lidocaine, tetracaine
58
What drug class has the suffix -chol?
muscarinic agonist | ex: bethanechol, carbachol
59
What drug class has the suffix -cillin?
penicillin | ex: amoxicillin, methicillin
60
What drug class has the suffix -conazole?
imidazole (anti fungal) | ex: fluconazole, ketoconazole
61
What drug class has the suffix -curium?
non-depolarizing neuromuscular blocker | ex: atracurium, mivacurium
62
What drug class has the suffix -curonium?
non-depolarizing neuromuscular blocker | ex: vecuronium, rocuronium
63
What drug class has the suffix cycline?
protein synthesis inhibitor | Ex: tetracycline, doxycycline
64
What drug class has the suffix -dipine?
dihydropyridine calcium channel blocker | ex: nifedipine, amlodipine
65
What drug class has the suffix -dronate?
bisphosphonate | ex: alendronate, risedronate
66
What drug class has the suffix -etine?
SSRI | Ex: fluoxetine, paroxetine, sertraline
67
What drug class has the suffix -flurane?
inhaled anesthetics | Ex: isoflurane, sevoflurane
68
What drug class has the suffix -gliptin?
DPP-IV inhibitor (T2DM Tx) | Ex: sitagliptin, saxagliptin
69
What drug class has the suffix -glitazone?
Thiazolidinedione (T2DM Tx) | Ex: pioglitazone, rosiglitazone
70
What drug class has the suffix -ipramine?
TCA | Ex: clomipramine, imipramine
71
What drug class has the suffix -mab?
monoclonal antibody | Ex: infliximab, rituximab
72
What drug class has the suffix -mustine?
nitrosourea (cancer Tx) | ex: lomustine
73
What drug class has the suffix -navir?
protease inhibitor (HIV Tx) ex: ritonavir, saquinavir (CYP450 inhibitors)
74
What drug class has the suffix -olol?
beta blockers | Ex: atenolol, metoprolol
75
What drug class has the suffix -operidol?
neuroleptic | Ex: haloperidol, droperidol
76
What drug class has the suffix -phylline?
methylxanthine Ex: theophylline, aminophylline (asthma, COPD Tx?)
77
What drug class has the suffix -pril?
ACE inhibitor | Ex: enalapril, lisinopril
78
What drug class has the suffix -prost?
``` prostaglandin analog (glaucoma treatment) Ex: latanoprost, travoprost ```
79
What drug class has the suffix -sartan?
angiotensin receptor blocker | Ex: losartan, valsartan
80
What drug class has the suffix -statin?
HMG-CoA reductase inhibitors | Ex: atorvastatin, simvastatin
81
What drug class has the suffix -stigmine?
Acetylcholinesterase inhibitors | Ex: neostigmine, physostigmine, rivastigmine
82
What drug class has the suffix -terol?
beta 2 agonist | Ex: albuterol, salmeterol
83
What drug class has the suffix -tidine?
H2 histamine antagonist | Ex: cimetidine, ranitidine
84
What drug class has the suffix -triptan?
5-HT 1B/1D agonist (migraine Tx) | Ex: sumatriptan, rizatriptan
85
What drug class has the suffix -triptyline?
TCA | Ex: amitriptyline, nortriptyline
86
What drug class has the suffix -tropin?
pituitary hormone | Ex: somatotropin, thyrotropin (TSH)
87
What drug class has the suffix -zosin?
alpha1-antagonist | ex: prazosin, doxazosin
88
What drugs have the side effect of flushing?
Vancomycin (red man syndrome) (slow infusion, pretreat with anti H2) Niacin Adenosine Dihydropyridine CCB (via smooth m. relaxation)
89
What drugs have the side effect of coronary vasospasm?
``` cocaine amphetamines triptans (C/I w/ CAD) ergotamine (last 2 are migraine Tx drugs) ```
90
What drugs have the side effect of dilated cardiomyopathy?
doxorubicin | daunorubicin
91
What drugs have the side effect of TdP?
``` Potassium channel blockers (class III) Sodium channel blockers (class IA) Macrolides Haloperidol (antipsychotic) chloroquine (malaria Tx) protease inhibitors (HIV Tx) ```
92
What drugs have the side effect of thrombocytopenia?
heparin (HIT) | Cimetidine (H2 blocker)
93
What drugs have the side effect of agranulocytosis?
``` clozapine carbamazepine colchicine PTU/methimazole (anti-thyroid) dapsone ```
94
What drugs have the side effect of aplastic anemia?
chloramphenicol benzene NSAIDs PTU/methimazole
95
What drugs have the side effect of gray baby syndrome?
chloramphenicol because UDP glucuronyltransferase enzyme is immature buildup of substrates
96
What drugs have the side effect of hemolysis in G6PD deficiency?
``` Isoniazid sulfonamides primaquine (malaria Tx) aspirine (high dose) ibuprofen nitrofurantoin dapsone fava beans naphthalene ```
97
What drugs have the side effect of thrombosis?
oral contraceptives
98
What drugs have the side effect of pulmonary fibrosis?
amiodarone (a-fib Tx) bleomycin busulfan (last two are anti-cancer)
99
What drugs have the side effect of cough?
ACE inhibitors (via increased bradykinin; try ARBs)
100
What drugs have the side effect of pseudomembranous colitis?
clindamycin | amoxicillin/ampicillin
101
What drugs have the side effect of hepatic necrosis?
halothane acetaminophen valproic acid amanita phalloides (mushroom toxin)
102
What drugs have the side effect of hepatitis?
isoniazid
103
What drugs have the side effect of tertiary adrenal insufficiency?
corticosteroid withdrawal
104
What drugs have the side effect of gynecomastia?
``` STACKED sprinolactone (CHF Tx) THC alcohol (chronic use) cimetidine ketoconazole estrogens digoxin ```
105
What drugs have the side effect of hot flashes?
tamoxifen clomiphene (SEMRs)
106
What drugs have the side effect of hypothyroidism?
amiodarone lithium sulfonamides
107
What drugs have the side effect of gout?
diuretics (loop and thiazide) niacin (for decreased HDL) cyclosporine pyrazinamide
108
What drugs have the side effect of gingival hyperplasia?
phenytoin | verapamil
109
What drugs have the side effect of osteoporosis?
corticosteroids | heparin
110
What drugs have the side effect of photosensitivity?
sulfonamides amiodarone tetracycline (SAT for photo)
111
What drugs have the side effect of Stevens-Johnson syndrome?
``` Flu-like Sx then erythema multiforme CLAPPPERS Carbamazepine Lamotrigine Allopurinol Phenytoin Phenobarbital Penicillin Ethosuximide RASH Sulfa drugs ```
112
What drugs have the side effect of drug-induced lupus?
``` SHIPP Sulfonamides Hydralazine Isoniazid Procainamide Phenytoin ```
113
What drugs have the side effect of tendinitis/cartilage damage?
Fluoroquinolones
114
What drugs have the side effect of interstitial nephritis?
NSAIDs Furosemide (loop) Antibiotics
115
What drugs have the side effect of diabetes insipidus?
lithium | demeclocycline
116
What drugs have the side effect of fanconi syndrome?
(proximal tube defect) Tetracycline Heavy metals & Wilson Dz
117
What drugs have the side effect of hemorrhagic cystitis?
cyclophosphamide | ifosfamide
118
What drugs have the side effect of Parkinson-like syndrome?
metoclopramide (gastric paresis Tx) antipsychotics reserpine
119
What drugs have the side effect of cinchonism
(dizziness with HA, vision changes, tinnitus) Quinidine Quinine
120
What drugs have the side effect of seizures?
``` buproprion imipenem/cilastatin isoniazid tramadol metoclopramide benzodiazepine/alcohol withdrawal ```
121
What drugs have the side effect of tardive dyskinesia?
antipsychotics | metoclopramide
122
What drugs have the side effect of disulfiram-like reaction?
``` metronidazole certain cephalosporins procarbazine (alkylating agent - anti-cancer) first-generation sulfonylureas disulfiram ```
123
What drugs have the side effect of nephrotoxicity + neurotoxicity?
aminoglycosides cisplatin polymixins
124
What drugs have the side effect of nephrotoxicity + ototoxicity?
ahminoglycosides vancomysin loop diruetics cisplatin
125
What drugs have the side effect of anticholinergic effect? (dry you up)
atropine TCAs H1 blockers (diphenhydramine) Low-potency neuroleptics (thioridazine, chlorpromazine)

Pharmacology Step 1 (8 decks)

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