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Rapid Review Notecards > Pharm (Pages 225-248) > Flashcards

Pharm (Pages 225-248) Flashcards

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1
Q

α1

G-Protein Class/Major Functions

A

q

Increase vascular smooth muscle contraction, Increase pupillary dilator muscle contraction (mydriasis), Increase intestinal and bladder sphincter muscle contraction

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2
Q

α2

G-Protein Class/Major Functions

A

i

Decreases sympathetic outflow, Decreases insulin release, Decreases, lipolysis, Decreases platelet aggregation

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3
Q

β1

G-Protein Class/Major Functions

A

s

Increase heart rate, Increase contractility, Increase renin release, Increase lipolysis

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4
Q

β2

G-Protein Class/Major Functions

A

s

Vasodilation, bronchodilation, Increase heart rate, Increase contractility, Increase lipolysis, Increase insulin release, DECREASED uterine tone (tocolysis), ciliary muscle relaxation, q aqueous humor production

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5
Q

M1

G-Protein Class/Major Functions

A

q

CNS, enteric nervous system

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6
Q

M2

G-Protein Class/Major Functions

A

i

Decreased heart rate and contractility of atria

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7
Q

M3

G-Protein Class/Major Functions

A

q

Increased exocrine gland secretions (e.g., lacrimal, salivary, gastric acid), increased gut peristalsis, increased bladder contraction, bronchoconstriction, decreased pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accommodation)

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8
Q

D1

G-Protein Class/Major Functions

A

s

Relaxes renal vascular smooth muscle

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9
Q

D2

G-Protein Class/Major Functions

A

i

Modulates transmitter release, especially in brain

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10
Q

H1

G-Protein Class/Major Functions

A

q

Increases nasal and bronchial mucus production, Increases vascular permeability, contraction of bronchioles, pruritus, and pain

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11
Q

H2

G-Protein Class/Major Functions

A

s

Increases gastric acid secretion

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12
Q

V1

G-Protein Class/Major Functions

A

q

Increases vascular smooth muscle contraction

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13
Q

V2

G-Protein Class/Major Functions

A

s

Increases H2O permeability and reabsorption in the collecting tubules of the kidney (V2 is found in the 2 kidneys)

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14
Q

Bethanechol

Clinical applications/action

A

Postoperative ileus, neurogenic ileus, and
urinary retention

Activates bowel and bladder smooth
muscle; resistant to AChE. “Bethany, call
(bethanechol) me, maybe, if you want to
activate your bowels and bladder.”

Direct agonist

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15
Q

Carbachol

Clinical applications/action

A

Glaucoma, pupillary constriction, and relief of
intraocular pressure

Carbon copy of acetylcholine.

Direct agonist

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16
Q

Pilocarpine

Clinical applications/action

A

Potent stimulator of sweat, tears, and saliva
Open-angle and closed-angle glaucoma

Contracts ciliary muscle of eye (open-angle glaucoma), pupillary sphincter (closed-angle glaucoma); resistant to AChE. “You cry, drool, and sweat on your ‘pilow.’ ”

Direct agonist

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17
Q

Methacholine

Clinical applications/action

A

Challenge test for diagnosis of asthma

Stimulates muscarinic receptors in airway when inhaled.

Direct agonist

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18
Q

Neostigmine

Clinical applications/action

A

Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative)

Increases endogenous ACh.
Neo CNS = No CNS penetration.

Indirect agonist

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19
Q

Pyridostigmine

Clinical applications/action

A 
Myasthenia gravis (long acting); does not 
penetrate CNS

Increases endogenous ACh; increases strength. Pyridostigmine gets rid of myasthenia gravis.

Indirect agonist

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20
Q

Physostigmine

Clinical applications/action

A 
Anticholinergic toxicity (crosses blood-brain 
barrier to CNS)

Increases endogenous ACh. Physostigmine “phyxes”
atropine overdose.

Indirect agonist

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21
Q

Donepezil,
rivastigmine,
galantamine

Clinical applications/action

A

Alzheimer disease

Increases endogenous ACh.

Indirect agonist

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22
Q

Edrophonium

Clinical applications/action

A

Diagnosis of MG (extremely short acting)
MG is now diagnosed by anti-AChR Ab test

Increases endogenous ACh.

Indirect agonist

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23
Q

With all cholinomimetic agents, watch for:

A

With all cholinomimetic agents, watch for exacerbation of COPD, asthma, and peptic ulcers when giving to susceptible patients.

Indirect agonist

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24
Q

Cholinesterase inhibitor poisoning

Antidote:

A

Often due to organophosphates, such as
parathion, that irreversibly inhibit AChE.
Causes Diarrhea, Urination, Miosis,
Bronchospasm, Bradycardia, Excitation
of skeletal muscle and CNS, Lacrimation,
Sweating, and Salivation.

DUMBBELSS.
Organophosphates are components of
insecticides; poisoning usually seen in farmers.

Antidote—atropine (competitive inhibitor) +
pralidoxime (regenerates AChE if given early).

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25
Atropine, homatropine, tropicamide Clinical organ system/applications
Eye Produce mydriasis and cycloplegia. Muscarinic antagonist
26
Benztropine Clinical organ system/applications
CNS Parkinson disease—“Park my Benz.” Muscarinic antagonist
27
Scopolamine Clinical organ system/applications
CNS Motion sickness. Muscarinic antagonist
28
Ipratropium, tiotropium Clinical organ system/applications
Respiratory COPD, asthma (“I pray I can breathe soon!”). Muscarinic antagonist
29
Oxybutynin, darifenacin, and solifenacin Clinical organ system/applications
Genitourinary Reduce urgency in mild cystitis and reduce bladder spasms. Other agents: tolterodine, fesoterodine, trospium. Muscarinic antagonist
30
Glycopyrrolate Clinical organ system/applications
Gastrointestinal, respiratory Parenteral: preoperative use to reduce airway secretions. Oral: drooling, peptic ulcer. Muscarinic antagonist
31
Atropine toxicity Side effects
Increased body temperature (due to decreased sweating); rapid pulse; dry mouth; dry, flushed skin; cycloplegia; constipation; disorientation Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with prostatic hyperplasia, and hyperthermia in infants ``` Side effects: Hot as a hare Dry as a bone Red as a beet Blind as a bat Mad as a hatter ``` ``` Jimson weed (Datura) p gardeners pupil (mydriasis due to plant alkaloids) ```
32
Epinephrine Effect/application
β > α Anaphylaxis, open angle glaucoma, asthma, hypotension; α effects predominate at high doses Sympathomimetics
33
Norepinephrine Effect/application
α1 > α2 > β1 Hypotension (but r renal perfusion) Sympathomimetics
34
Isoproterenol Effect/application
β1 = β2 Electrophysiologic evaluation of tachyarrhythmias. Can worsen ischemia. Sympathomimetics
35
Dopamine Effect/application
D1 = D2 > β > α Unstable bradycardia, heart failure, shock; inotropic and chronotropic α effects predominate at high doses Sympathomimetics
36
Dobutamine Effect/application
β1 > β2, α Heart failure (inotropic > chronotropic), cardiac stress testing Sympathomimetics
37
Phenylephrine Effect/application
α1 > α2 Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant) Sympathomimetics
38
Albuterol, salmeterol, terbutaline Effect/application
β2 > β Albuterol for acute asthma; salmeterol for long-term asthma or COPD control; terbutaline to reduce premature uterine contractions Sympathomimetics
39
Amphetamine Effect/application
Indirect general agonist, reuptake inhibitor, also releases stored catecholamines Narcolepsy, obesity, attention deficit disorder Indirect sympathomimetics
40
Ephedrine Effect/application
Indirect general agonist, releases stored catecholamines Nasal decongestion, urinary incontinence, hypotension Indirect sympathomimetics
41
Cocaine Effect/application
Indirect general agonist, reuptake inhibitor Causes vasoconstriction and local anesthesia; never give β-blockers if cocaine intoxication is suspected (can lead to unopposed α1 activation and extreme hypertension) Indirect sympathomimetics
42
Clonidine Application/toxicity
``` Hypertensive urgency (limited situations); does not decrease renal blood flow ADHD, severe pain, and a variety of off-label indications. ``` CNS depression, bradycardia, hypotension, respiratory depression, and small pupil size Sympatholytics (α2-agonists)
43
α-methyldopa Application/toxicity
Hypertension in pregnancy Safe in pregnancy Direct Coombs + hemolytic anemia, SLE-like syndrome Sympatholytics (α2-agonists)
44
Phenoxybenzamine (irreversible) Application/toxicity
``` Pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis ``` Orthostatic hypotension, reflex tachycardia Nonselective α-blockers
45
Phentolamine (reversible) Application
Give to patients on MAO inhibitors who eat tyramine-containing foods Nonselective α-blockers
46
Prazosin, terazosin, doxazosin, tamsulosin Application/toxicity
α1 selective blockers Urinary symptoms of BPH; PTSD (prazosin); hypertension (except tamsulosin) 1st-dose orthostatic hypotension, dizziness, headache
47
Mirtazapine Application/toxicity
α2 selective blockers Depression Sedation, increased serum cholesterol, increased appetite
48
β-blocker toxicity
Impotence, cardiovascular adverse effects (bradycardia, AV block, CHF), CNS adverse effects (seizures, sedation, sleep alterations), dyslipidemia (metoprolol), and asthmatics/COPDers (may cause exacerbation) Avoid in cocaine users due to risk of unopposed α-adrenergic receptor agonist activityDespite theoretical concern of masking hypoglycemia in diabetics, benefits likely outweigh risks; not contraindicated
49
β1-selective antagonists
(β1 > β2)—acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol Selective antagonists mostly go from A to M (β1 with 1st half of alphabet)
50
β Nonselective antagonists
(β1 = β2)—nadolol, pindolol (partial agonist), propranolol, timolol Nonselective antagonists mostly go from N to Z (β2 with 2nd half of alphabet)
51
Nonselective α- and β-antagonists
Nonselective α- and β-antagonists—carvedilol, labetalol Nonselectives α- and β-antagonists have modified suffixes (instead of “-olol”)
52
Nebivolol
Nebivolol combines cardiac-selective β1-adrenergic blockade with stimulation of β3-receptors, which activate nitric oxide synthase in the vasculature
53
Acetaminophen Antidote/treatment
N-acetylcysteine (replenishes glutathione)
54
AChE inhibitors, organophosphates Antidote/treatment
Atropine followed by pralidoxime
55
Amphetamines (basic) Antidote/treatment
NH4Cl (acidify urine)
56
Antimuscarinic, anticholinergic agents Antidote/treatment
Physostigmine salicylate, control hyperthermia
57
Benzodiazepines Antidote/treatment
Flumazenil
58
β-blockers Antidote/treatment
Glucagon
59
Carbon monoxide Antidote/treatment
100% O2, hyperbaric O2
60
Copper, arsenic, gold Antidote/treatment
Penicillamine
61
Cyanide Antidote/treatment
Nitrite + thiosulfate, hydroxocobalamin
62
Digitalis Antidote/treatment
Anti-dig Fab fragments
63
Heparin Antidote/treatment
Protamine sulfate
64
Iron Antidote/treatment
Deferoxamine, deferasirox
65
Lead Antidote/treatment
EDTA, dimercaprol, succimer, penicillamine
66
Mercury, arsenic, gold Antidote/treatment
Dimercaprol (BAL), succimer
67
Methanol, ethylene glycol (antifreeze) Antidote/treatment
Fomepizole > ethanol, dialysis
68
Methemoglobin Antidote/treatment
Methylene blue, vitamin C
69
Opioids Antidote/treatment
Naloxone
70
Salicylates Antidote/treatment
NaHCO3 (alkalinize urine), dialysis
71
TCAs Antidote/treatment
NaHCO3 (plasma alkalinization)
72
tPA, streptokinase, urokinase Antidote/treatment
Aminocaproic acid
73
Warfarin Antidote/treatment
Vitamin K, plasma (if active bleeding)
74
Coronary vasospasm Causal agents
Cocaine, sumatriptan, ergot alkaloids
75
Cutaneous flushing Causal agents
Vancomycin, Adenosine, Niacin, Ca2+ channel blockers VANC
76
Dilated cardiomyopathy Causal agents
Doxorubicin, daunorubicin
77
Torsades de pointes Causal agents
Class III (e.g., sotalol) and class IA (e.g., quinidine) antiarrhythmics, macrolide antibiotics, antipsychotics, TCAs
78
Adrenocortical insufficiency Causal agents
HPA suppression 2° to glucocorticoid withdrawal
79
Hot flashes Causal agents
Tamoxifen, clomiphene
80
Hyperglycemia Causal agents
Tacrolimus, Protease inhibitors, Niacin, HCTZ, β-blockers, Corticosteroids Taking Pills Necessitates Having Blood Checked
81
Hypothyroidism Causal agents
Lithium, amiodarone, sulfonamides
82
Acute cholestatic hepatitis, jaundice Causal agents
Erythromycin
83
Diarrhea Causal agents
Metformin, Erythromycin, Colchicine, Orlistat, Acarbose Might Excite Colon On Accident
84
Focal to massive hepatic necrosis Causal agents
Halothane, Amanita phalloides (death cap mushroom), Valproic acid, Acetaminophen Liver “HAVAc”
85
Hepatitis Causal agents
INH
86
Pancreatitis Causal agents
Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (furosemide, HCTZ) Drugs Causing A Violent Abdominal Distress
87
Pseudomembranous colitis Causal agents
Clindamycin, ampicillin, cephalosporins Antibiotics predispose to superinfection by resistant C. difficile
88
Agranulocytosis Causal agents
Dapsone, Clozapine, Carbamazepine, Colchicine, Methimazole, Propylthiouracil Drugs CCCrush Myeloblasts and Promyelocytes
89
Aplastic anemia Causal agents
Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil Can’t Make New Blood Cells Properly
90
Direct coombs-positive hemolytic anemia Causal agents
Methyldopa, penicillin
91
Gray baby syndrome Causal agents
Chloramphenicol
92
Hemolysis in G6PD deficiency Causal agents
INH, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin Hemolysis IS D PAIN
93
Megaloblastic anemia Causal agents
Phenytoin, Methotrexate, Sulfa drugs Having a blast with PMS
94
Thrombocytopenia Causal agents
Heparin, cimetidine
95
Thrombotic complications Causal agents
OCPs (e.g., estrogens)
96
Fat redistribution Causal agents
Protease inhibitors, Glucocorticoids Fat PiG
97
Gingival hyperplasia Causal agents
Phenytoin, verapamil, cyclosporine, nifedipine
98
Hyperuricemia (gout) Causal agents
Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine Painful Tophi and Feet Need Care
99
Myopathy Causal agents
Fibrates, niacin, colchicine, hydroxychloroquine, interferon-α, penicillamine, statins, glucocorticoids
100
Osteoporosis Causal agents
Corticosteroids, heparin
101
Photosensitivity Causal agents
Sulfonamides, Amiodarone, Tetracyclines, 5-FU SAT For Photo
102
Rash (Stevens-Johnson Syndrome) Causal agents
Anti-epileptic drugs (ethosuximide, carbamazepine, lamotrigine, phenytoin, phenobarbital), Allopurinol, Sulfa drugs, Penicillin Steven Johnson has epileptic Allergy to Sulfa drugs and Penicillin
103
SLE-like syndrome Causal agents
Sulfa drugs, Hydralazine, INH,Procainamide, Phenytoin, Etanercept Having lupus is “SHIPP-E”
104
Teeth discoloration Causal agents
Tetracyclines
105
Tendonitis, tendon rupture, and cartilage damage Causal agents
Fluoroquinolones
106
Cinchonism Causal agents
Quinidine, quinine
107
Parkinson-like syndrome Causal agents
Antipsychotics, Reserpine, Metoclopramide Cogwheel rigidity of ARM
108
Seizures Causal agents
INH (vitamin B6 deficiency), Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide With seizures, I BITE My tongue
109
Tardive dyskinesia Causal agents
Antipsychotics, metoclopramide
110
Diabetes insipidus Causal agents
Lithium, demeclocycline
111
Fanconi syndrome Causal agents
Expired tetracycline
112
Hemorrhagic cystitis Causal agents
Cyclophosphamide, ifosfamide Prevent by coadministering with mesna
113
Interstitial nephritis Causal agents
Methicillin, NSAIDs, furosemide
114
SIADH Causal agents
Carbamazepine, Cyclophosphamide, SSRIs Can’t Concentrate Serum Sodium
115
Causal agents Dry cough
ACE inhibitors
116
Pulmonary fibrosis Causal agents
Bleomycin, Amiodarone, Busulfan, Methotrexate Breathing Air Badly from Medications
117
Antimuscarinic Causal agents
Atropine, TCAs, H1-blockers, antipsychotics
118
Disulfiram-like reaction Causal agents
Metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st-generation sulfonylureas
119
Nephrotoxicity/ototoxicity Causal agents
Aminoglycosides, vancomycin, loop diuretics, cisplatin
120
Sulfa drugs
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas Popular FACTSSS
121
-ovir Category/example
DNA polymerase inhibitor Acyclovir
122
-cycline Category/example
Protein synthesis inhibitor Tetracycline
123
-ivir Category/example
Neuraminidase inhibitor Oseltamivir
124
-navir Category/example
Protease inhibitor Ritonavir
125
-thromycin Category/example
Macrolide antibiotic Azithromycin
126
-cillin Category/example
Peptidoglycan synthesis inhibitor Ampicillin
127
-ane Category/example
Inhalational general anesthetic Halothane
128
-azine Category/example
Typical antipsychotic Thioridazine
129
-barbital Category/example
Barbiturate Phenobarbital
130
-caine Category/example
Local anesthetic Lidocaine
131
-etine Category/example
SSRI Fluoxetine
132
-ipramine Category/example
TCA Imipramine
133
-triptan Category/example
5-HT1B/1D agonists Sumatriptan
134
-triptyline Category/example
TCA Amitriptyline
135
-zepam Category/example
Benzodiazepine Diazepam
136
-zolam Category/example
Benzodiazepine Alprazolam
137
-chol Category/example
Cholinergic agonist Bethanechol/carbachol
138
-curium or -curonium Category/example
Non-depolarizing paralytic Atracurium or vecuronium
139
-olol Category/example
β-blocker Propranolol
140
-stigmine Category/example
AChE inhibitor Neostigmine
141
-terol Category/example
β2-agonist Albuterol
142
-zosin Category/example
α1-antagonist Prazosin
143
-afil Category/example
PDE-5 inhibitor Sildenafil
144
-dipine Category/example
Dihydropyridine CCB Amlodipine
145
-pril Category/example
ACE inhibitor Captopril
146
-sartan Category/example
Angiotensin-II receptor blocker Losartan
147
-statin Category/example
HMG-CoA reductase inhibitor Atorvastatin
148
-dronate Category/example
Bisphosphonate Alendronate
149
-glitazone Category/example
PPAR-γ activator Rosiglitazone
150
-prazole Category/example
Proton pump inhibitor Omeprazole
151
-prost Category/example
Prostaglandin analog Latanoprost
152
-tidine Category/example
H2-antagonist Cimetidine
153
-tropin Category/example
Pituitary hormone Somatotropin
154
-ximab Category/example
Chimeric monoclonal Ab Basiliximab
155
-zumab Category/example
Humanized monoclonal Ab Daclizumab

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