Pharm II - Test 1 Flashcards
(138 cards)
1
Q
Class: Morphine (MS Contin)
A
Opioid analgesic
2
Q
MOA: Morphine (MS Contin)
A
Opioid receptor agonist
3
Q
Indication: Morphine (MS Contin)
A
Pain relief
Acute MI
4
Q
Properties: Morphine (MS Contin)
A
Analgesic
Anxiolytic
Vasodilator
5
Q
Side effects: Morphine (MS Contin)
A
Respiratory depression Miosis Itching (dt histamine release) N/V Constipation (paralytic ileus)
6
Q
Class: Fentanyl/Duragesic
A
Opioid analgesic
7
Q
Indication: Fentanyl/Duragesic
A
Pain relief, anesthesia
8
Q
MOA: Fentanyl/Duragesic
A
Opioid receptor agonist
80x the analgesic property of morphine
9
Q
Route: Fentanyl/Duragesic
A
IV, transdermal patch, buccal lozenge/film, SL spray, lollypop
10
Q
Contraindications: Fentanyl/Duragesic
A
Direct use with heating pads (inc. dose)
11
Q
Class: Codeine
A
Opioid analgesic
12
Q
MOA: Codeine
A
Opioid agonist, converted to morphine, much weaker analgesic than morphine
13
Q
Contraindications: Codeine
A
CYP2D6 polymorphism, which causes ultra-rapid metabolism of codeine
14
Q
Side effects: Codeine
A
Sedation
Constipation
Itching
15
Q
Indication: Tramadol/Ultram
A
Withdrawal of heroin and morphine
16
Q
Class: Naloxone (Narcan)
A
Opioid antagonist
17
Q
Indication: Naloxone (Narcan)
A
Opioid overdose
Reverses coma/respiratory depression
18
Q
MOA: Naloxone (Narcan)
A
Opioid antagonist (bind w/ high affinity, but do not activate response)
19
Q
Class: Aspirin / Acetylsalicyclic acid (ASA)
A
NSAID (COX 1/2 inhibitor)
20
Q
MOA: Aspirin / Acetylsalicyclic acid (ASA)
A
Irreversible inhibition of COX-1 and COX-2 enzymes -> blockade of prostaglandin synthesis
21
Q
Why is aspirin not indicated for post-surgery?
A
Irreversibly affects platelets
22
Q
Side effects: Aspirin / Acetylsalicyclic acid (ASA)
A
Inc. risk of Reye’s syndrome
23
Q
Salicylism
A
dizziness, tinnitus, hyperventilation, mental status changes, potential for coma/death
24
Q
Tx: Salicylism
A
IV hydration, alkalinization of urine, dialysis if necessary
25
Class: Ibuprofen (Motrin, Advil)
NSAID (COX 1/2 inhibitor)
26
MOA: Ibuprofen (Motrin, Advil)
Reversible inhibition of COX-1 and COX-2 enzymes
27
Class: Celecoxib (Celebrex)
NSAID (selective COX-2 inhibitor)
28
Indication: Celecoxib (Celebrex)
adenomatous polyps
29
MOA: Celecoxib (Celebrex)
Reversible, selective COX-2 inhibition
30
Class: Acetaminophen (Tylenol)
NSAID
31
Acetaminophen (Tylenol) is pregnancy category __.
B
32
Stage 1 - Acetominophen toxicity
12-24 hrs - N/V
33
Stage 2 - Acetominophen toxicity
24-48 hrs - mb clinically improved, but rising AST, ALT, bilirubin levels
34
Stage 3 - Acetominophen toxicity
72-96 hrs - peak hepatotoxicity, AST mb > 20,000
35
Stage 4 - Acetominophen toxicity
>96 hrs - recovery, LV transplant or death
36
Antidote - Acetominophen toxicity
N-acetylcysteine within 8 hours of OD
37
What serotonin receptor elicits vasoconstriction?
Serotonin 1 (5 HT-1)
38
What serotonin receptor elicits vasodilation?
Serotonin 2 (5 HT-2)
39
Indication: Propranolol (Inderal)
HTN, angina, AMI, panic attacks, migraines (prophylaxis), hyperthyroidism
40
Contraindications: Amitriptyline (Elavil)
Do not use with monoamine oxidase (MAO) inhibitors
41
Class: Topiramate (Topamax)
Anticonvulsant
42
Inidication: Topiramate (Topamax)
Epilepsy, migraines (prophylaxis), weight loss, bipolar d/o (off-label)
43
MOA: Topiramate (Topamax)
Block voltage-dependent Na channels in CNS -> affects GABA activity
44
Class: Methysergide (Sansert)
Ergot derivative (serotonin 2 antagonist)
45
Indication: Methysergide (Sansert)
Migraine (prophylaxis) and cluster HA
46
MOA: Methysergide (Sansert)
Serotonin 2 receptor antagonist
47
Contraindications: Methysergide (Sansert)
Should not be used longer than 6 months
Do not use within 24 hrs of a triptan bc of inc. risk of vasoconstrictive spasm
Category X
48
Prodromal phase of migraines medications (1)
Sumatriptan (Imitrex)
49
Prophylaxis of migraines medications (4)
Propranolol (Inderal)
Amitryptyline (Elavil)
Methysergide (Sansert)
Topiramate (Topamax)
50
Indication: Sumatriptan (Imitrex)
Migraine and cluster HA
51
MOA: Sumatriptan (Imitrex)
Serotonin agonist at 5-HR 1D/1B receptors
52
Side effects: Sumatriptan (Imitrex)
Serotonin syndrome
53
Contraindications: Sumatriptan (Imitrex)
Use w/ caution in pts with HTN or angina
Category C
54
Serotonin syndrome
agitation, tremor, ataxia, fever, chills, diarrhea
55
Class: Butorphanol (Stadol)
Opioid analgesic
56
Indication: Butorphanol (Stadol)
Migraine HA refractory to triptans
57
MOA: Butorphanol (Stadol)
Mixed agonist-antagonist of opioid receptors
58
Anti-emetic for migraines medications (1)
Prochlorperazine (Compazine)
59
Category: Ondansetron (Zofran)
Antiemetic
60
MOA: Ondansetron (Zofran)
Blockade of serotonin (5HT3) receptor sites
61
If a patient is taking Aspirin and you add an NSAID, ___
you reduce the cardioprotective effects of aspirin
62
Treatment of acute gouty attack includes:
NSAIDs
Steroids
Colchicine
63
Prophylactic tx of gout includes:
Colchicine
Allopurinol
Probenecid
64
Category: Indomethacin (Indocin)
NSAID
65
Indication: Indomethacin (Indocin)
Gout, arthritis, bursitis, migraine, hemicrania, pain, swelling
66
MOA: Indomethacin (Indocin)
COX-I and COX-II inhibition
67
Category: Colchicine
Mitotic inhibitor
68
Indication: Colchicine
Gout (acute and prophylaxis)
69
MOA: Colchicine
Inhibits microtubule polymerization via tubulin binding -> Tubulin essential for mitosis
Inhibits neutrophil motility/activity -> anti-inflammatory
70
Side effects: Colchicine
PERIPHERAL NEUROPATHY, GI upset, anemia, neutropenia, hair loss
71
Category: Allopurinol (Zyloprim)
Purine analog
72
Indication: Allopurinol (Zyloprim)
Hyperuricemia, gout, prophylaxis against tumor lysis syndrome
73
MOA: Allopurinol (Zyloprim)
Xanthine oxidase inhibitor
74
Category: Probenecid (Probalan)
Uricosuric
75
Indication: Probenecid (Probalan)
Hyperuricemia, gout
76
MOA: Probenecid (Probalan)
Interferes w/ kidneys' organic anion transporter (OAT), which normally retains uric acid from urine
77
Contraindications: Probenecid (Probalan)
Pts with G6PD deficiency (hemolytic anemia)
Pts w/ renal insufficiency (formation of uric acid stones)
Use w/ salicylates
78
PARQ: Probenecid (Probalan)
Drink water, stay hydrated to prevent stone formation
79
Side effects: corticosteroids
Inc susceptibility to infx, poor wound healing, hyperglycemia, inc. risk for osteoporosis, Cushing's syndrome, potential adrenal suppression
80
First-line drug for juvenile arthritis
Methotrexate
81
Class: Methotrexate (MTX)
Anti-metabolite and anti-folate immunosuppressant and chemotherapeutic
82
MOA: Methotrexate (MTX)
Anti-metabolite, anti-folate drug
83
For cancer patients on Methotrexate (MTX), never give ___
folic acid
84
Class: Azathioprine (Imuran)
Purine anti-metabolite immunosuppressant
85
Indication: Azathioprine (Imuran)
Prevention of transplant rejection, IBD, SLE, RA
86
MOA: Azathioprine (Imuran)
Metabolic breakdown products of Azathioprine inhibit purine synthesis -> block protein synthesis
87
Class: Cyclosporine (Sandimmune)
Immunosuppressant (derived from soil fungus)
88
Indication: Cyclosporine (Sandimmune)
Prevent rejection of KD, LV, and heart transplants, RA, severe psoriasis
89
MOA: Cyclosporine (Sandimmune)
T-cell inhibition -> inhibition of IL-1, IL-2, IL-3, IL-4, IFN-gamma
90
Class: Tacrolimus (Prograf)
Immunosupressant (derived from soil microorganism)
91
Indication: Tacrolimus (Prograf)
Protection against rejection of organ transplantation
Topical for severe eczema
92
MOA: Tacrolimus (Prograf)
T-cell inhibition
100x more potent than Cyclosporine
93
Contraindications: Tacrolimus (Prograf), Cyclosporine (Sandimmune)
Use w/ grapefruit juice
94
Which immunosuppressant can be used in the eye to stimulate tear production?
Cyclosporine (Sandimmune) as Restasis
95
Class: Etanercept (Enbrel)
DMARD, recombinant-DNA drug
96
Indication: Etanercept (Enbrel)
Mod-sev RA, mod-sev. polyarticular juvenile arthritis, psoriatic arthritis, ankylosing spondylitis, mod-sev. plaque psoriasis
97
MOA: Etanercept (Enbrel)
Reduction of inflammation via anti-TNFalpha action
98
Class: Infliximab (Remicade)
DMARD, recombinant-DNA drug
99
Indication: Infliximab (Remicade)
RA, Crohn's, UC
100
MOA: Infliximab (Remicade)
prevents binding of TNF-a with its receptors by binding to free TNF-a
101
MOA: Infliximab (Remicade) vs Etanercept (Enbrel)
Infliximab causes apoptosis of TNFa-expressing activated T-cells
Why infliximab has been used with success in Crohn's and UC, while Etanercept has not
102
Which of the drugs used for RA or lupus is also used to treat malaria?
Hydroxychloroquine (Plaquenil)
103
MOA: Hydroxychloroquine (Plaquenil)
Blocks activation of TLRs on plamacytoid dendritic cells
Increases lysosomal pH
104
Class: Hydroxychloroquine (Plaquenil)
Immunosuppressant and anti-malarial
105
Indication: Hydroxychloroquine (Plaquenil)
RA, SLE, Sjogren's, malaria
106
Side effects: Hydroxychloroquine (Plaquenil)
Corneal/macular damage, D, HA, N/V, hives, itching rash, loss of hair
Pts with G6PD deficiency: severe anemia
OD: drowsiness, HA, vision problems, SOB, convulsions
107
Which immunosuppressant requires regular ophthalmologic exams dt the possibility of corneal and macular damage?
Hydroxychloroquine (Plaquenil)
108
What is a last-option drug for RA?
Gold salts - Auranofin (Ridaura)
109
What is tachyphylaxis?
rapid decrease in the response to a drug over a relatively short period of time
110
Corticosteroids: Short-acting (8-12 hrs)
Hydrocortisone
111
Corticosteroids: Intermediate-acting (18-36 hrs)
Prednisone
112
Corticosteroids: Long-acting (24-72+ hrs)
Dexamathasone
| Betamethasone
113
If hydrocortisone is considered a "1" for its anti-inflammatory effect, prednisone is a ___.
4
114
If hydrocortisone is considered a "1" for its anti-inflammatory effect, dexamethasone is a ___.
30
115
If hydrocortisone is considered a "1" for its anti-inflammatory effect, betamethasone is a ___.
35
116
Abrupt discontinuation of a glucocorticoid can result in ___, which can be lethal.
Acute adrenal insufficiency syndrome (Addisonian crisis)
117
SSx: Addisonian Crisis
```
Severe lethargy
Severe V/D (dehydration)
Low blood pressure
Confusion
Hyponatremia, hypoglycemia
LOC
Convulsions
```
118
Class: Prednisone (Deltasone)
Glucocorticoid (corticosteroid)
119
MOA: Prednisone (Deltasone)
Alters gene transcription
120
Class: Dexamethasone (Decadron)
Fluorinated corticosteroid
121
Indications: Dexamethasone (Decadron)
IV (intracranial pressure)
122
MOA: Dexamethasone (Decadron)
Affects gene transcription
123
Class: Triamcinolone inhaler (Azmacort)
Corticosteroid
124
Indications: Triamcinolone inhaler (Azmacort)
Asthma (not acute attack), COPD
125
MOA: Triamcinolone inhaler (Azmacort)
Dec. inflammation of bronchial wall
Affects gene transcription
126
Aldosterone is reduced in __ and increased in __.
Addison's dz
Conn's syndrome
127
Class: Fludrocortisone (Florinef)
Halogenated glucocorticoid (mineralcorticoid agonist)
128
Indications: Fludrocortisone (Florinef)
Mineralcorticoid replacement for pts w/ Addison's dz and other cases of hyponatremia
129
MOA: Fludrocortisone (Florinef)
Na retention at renal tubular cells
130
Contraindications: Fludrocortisone (Florinef)
Not indicated as an anti-inflammatory agent
131
High potency corticosteroids (2)
Betamethasone
Dexamethasone
132
Medium potency corticosteroids (4)
Methylprednisolone
Triamcinolone
Prednisolone
Prednisone
133
Low potency corticosteroids (2)
Hydrocortisone
Cortisone
134
Mineralcorticoid activity (2)
Cortisone
Hydrocortisone
135
More Corticosteroid effect than Mineralcorticoid effect (2)
Prednisolone
Prednisone
136
No Mineralcorticoid activity (4)
Betamethasone
Dexamethasone
Methylprednisolone
Triamcinolone
137
DEA - Schedule I
No currently accepted medical use, high potential for abuse
138
DEA - Schedule II
High potential for abuse (less than schedule I)
