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Flashcards in Pharmacology Deck (230):
1

What does the PNS innervate?

cardiac and smooth muscle, gland cells, nerve terminals. The nerves come from the medulla and use Ach at pre and postganglionic receptors

2

What receptors does the SNS use to innverate sweat glands?

Ach for pregang
Ach for postgangiolinic M receptor

3

What receptors does the SNS use to innervate cardiac and smooth muscle, gland cells, and nerve terminals?

ACh for pregang
NE for alpha and beta receptors

4

What receptors does the SNS use to innervate renal vasculature, and smooth muscle

Ach for pregang
Dopamine for D1 receptors

5

What receptors does the Somatic system use to innervate skeletal muscle?

The voluntary motor nerve uses ACH at N receptors

6

What aspects of SNS are innervated by cholinergic fibers?

1. adrenal medulla
2. sweat glands

7

What does botulinum toxin do?

prevents release of neurotransmitters at all cholinergic terminals

8

How do Nicotinic Ach receptors work?

ligand gated NaK channels. Nn found in autonomic ganglia and Nm found in neuromuscular

9

How do Muscarinic Ach receptors work?

GPCR that act via 2nd messengers. 5 subtypes M1-M5

10

What does alpha one receptor do?

VC - increases vascular SM contraction; increases pupillary dilator muscle contraction (mydriasis); increases intestinal and bladder sphincter muscle contraction

11

What does alpha 2 receptor do?

VD - decreases sympathetic outflow, decreases insulin release, decreases lipolysis, and increases platelet aggregation

12

What does beta 1 receptor do

increases heart rate, increases contractility, increases renin release, and increases lipolysis

13

What does beta 2 receptor do?

VD, BD, and decreases uterine tone
increases heart rate, increases contractility, increases lipolysis, increases insulin release, ciliary muscle relaxation, increases aqueous humor production

14

What does M1 receptor do?

CNS and ENS

15

What are the sympathetic receptors?

Alpha 1 and 2; Beta 1 and 2. They use NE

16

What are the Parasympathetic receptors?

M1-M3 using Ach

17

What does the M2 receptor do?

decreases heart rate and contractility or atria at SA node

18

What does M3 receptor do?

increase exocrine gland secretions, increases gut peristalsis, increases bladder contraction, bronchoconstriction, increased pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accommodation)

19

What does the D1 receptor do?

relaxes renal vascular SM to improve renal blood flow

20

What does the D2 receptor do?

modulates transmitter release especially in the brain

21

What does the H1 receptor do?

increases nasal and bronchial mucus production, contraction of bronchioles, pruritus, pain

22

What does the H2 receptor do?

increases gastric acid secretion

23

What does V1 receptor do?

increases vascular CM contraction

24

What does V2 receptor do?

increases H20 permeability and reabsorption in the collecting tubules of kidney

25

What 2nd messengers are used for the autonomic drug receptors?

Alpha 1 - q
Alpha 2 - i
Beta 1 - s
Beta 2 - s
M1 - q
M2 - i
M2 - q
D1 - s
D2 - i
H1 - q
H2 - s
V1 - q
V2 - s

* HAVe 1M & M for Gq (H1,A1,V1,M1, and M3)
* MAD 2's for Gi (M2, A2, D2)

26

How does the Gq receptor work?

PLC breaks down lipids to PIP2
PIP2 broken down into IP3 and DAG
IP3 increases Ca from Sr, Ca activates CAM kinase
DAG activates PKC

27

How does the G2 receptor work?

AC increases cAMP
cAMP activates PKA
PKA increases Ca in heart, and inhibits myosin light chain kinase in smooth muscle

28

How does Gi receptor work?

inhibits AC so no increase in cAMP

29

What are all the steps that take place at the cholinergic nerve terminal?

1. Choline enters the axon w/ Na coupled transport
2. Choline + AcetylCoA combine via ChAT to form Ach
3. Ach is packaged into vesicles
4. Ca stimulates release of ACh from vesicles into NMJ
5. Ach has 4 fates: AchE degradation, Diffuse away, bind to postsynaptic receptor, and bind to autorecepto

30

What step does hemicholinium inhibit?

The entry of Choline and Na coupled transport into the axon

31

What step does Vesamicol inhibit?

The packaging of Ach into vesicles

32

What does black widow spider toxin do at the cholinergic nerve terminal?

activates releases of Ach

33

What are the steps that take place at the noradrenergic nerve terminal?

1. Tyr is coupled to Na to enter axon
2. Tyr to NE synthesis pathway
3. NE is packaged into vesicles
4. NE is releases via Ca stimulation
5. NE has 5 fates: binds to the postsynpatic receptor, reuptake, binds to Alpha 2 autoreceptor

34

How do you make NE from Tyr?

1. Tyr to dopa via Try hydroxylase
2. Dopa to dopamine via Dopa decarboxylase
3. Dopamine to NE via Dopamine Beta Hydroxylase

35

What does metyrosine inhibit at the adrenergic terminal?

Tyr hydroxylase

36

How does reserpine inhibit at the adrenergic terminal?

Dopamine Beta hydroxlase

37

What inhibits reuptake of NE at the terminal?

cocaine, TCAs, and amphetamine

38

What do amphetamines do at the adrenergic terminal?

inhibit reuptake of NE and activate release of NE

39

What do guanethidine and bretylium do at the adrenergic terminal?

inhibit release of NE

40

What are the 2 enzymes that metabolize NE?

1. COMT - methylates NE
2. MAO - oxidizes NE
- both make NE unusable and excrete in urine and increases levels of byproduct in serum

41

How is release of NE from a sympathetic nerve ending modulated?

1. By NE itself acting on presynaptic alpha 2 autoreceptor
2. Ach binds to M2 receptors and inhibits release of NE
3. AII binds to its receptor and activates release of NE

42

What are some direct cholinergic agonists?

Bethanechol, carbachol, pilocarpine, methacholine

43

What does bethanechol do?

- activates bowel and bladder SM
- resistant to AchE
used for post op ileus, neurogenic ileus, and urinary retention

44

What does carbachol do?

-think of it as a carbon copy of Ach
- used in glaucoma, pupillary constriction, and relief of intraocular pressure

45

What does pilocarpine do?

- contracts ciliary muscle of eye (open angled glaucoma), pupillary sphincter
- resistant to AchE
used for potent stimulator of sweat, tears, and saliva. Open and closed angle glaucoma

46

What does methacholine do?

stimulates muscarinic receptors in airway when inhaled
- used for challenge test for Asthma dx

47

What are some indirect agonists or anticholinesterases?

Neostigmine
Pyridostigmine
Edrophonium - Tensilon test
Physostigmine
Donepezil/Galantamine/Rivastigmine

48

What is the function of the indirect cholinergic agonists?

they increases endogenous Ach by inhibiting AchE

49

What is neostigmine used for?

Post op and neurogenic ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade via succinycholine
- has NO CNS penetration

50

What is pyridostigmine used for?

- myasthenia gravis (long acting),
- NO CNS penetration

51

What is edrophonium used for?

for Dx of myasthenia gravis b/c it's short acting

52

What is physostigmine used for?

- Anticholinergic toxicity (crosses BBB)
- fixes atropine overdose

53

What is donepezil/galantamine/rivastigmine used for?

Alzheimer's disease

54

What is a caution you should take w/ all the cholinomimetic agents?

watch for exacerbation of COPD, asthma, and peptic ulcers when giving to susceptible patients

55

What is cholinesterase inhibitor poisoning typically do to and how does it present?

- organophosphates such as parathion that irreverisibly inhibit AchE
- causes DUMBBELSS

56

What is the treatment for organophosphate overdose?

1. antidote = atropine
2. regenerator of active AchE = pralidoxime

57

What does DUMBBELSS stand for

1. Diarrhea
2. Urination
3. Miosis
4. Bronchospasm
5. Bradycardia
6. Excitation of skeletal muscle and CNS
7. Lacrimation
8. Sweating
9. Salivation

58

What are the muscarinic antagonists?

1. atropine, homatropine, tropicamide
2. benztropine
3. scopolamine
4. ipratropium, tiotropium
5. oxybutynin
6. glycopyrrolate

59

What do atropine, homatropine, and tropicamide do?

produce mydriasis and cycloplegia

60

What does benztropine do?

treatment for parkinson's (park my benz)

61

What does scopolamine do?

motion sickness so acts at the CNS

62

What does ipratropium and tiotropium do?

treats COP and asthma

63

What does oxybutynin do?

reduces urgency in mild cystitis and reduces bladder spasms

64

What other drugs can be used to reduce urgency?

tolterodine, darifenacin, solifenacin, trospium

65

What does glycopyrrolate do?

use parenteral for preop to reduce airway secretions
orally to stop drooling and peptic ulcers

66

What is atropine really used for?

to treat bradycardia and for ophthalmic applications

67

What effect does atropine have on eyes, airway, stomach, gut, and bladder?

1. eyes - increase pupil dilation, cycloplegia
2. airways- decreases secretions
3. stomach - decrease acid secretion
4. gut - decrease motility
5. bladder- decrease urgency

68

What happens w/ atropine overdose?

it blocks DUMBBELSS
- increases body temp (due to decreased sweating)
- rapid pulse
- dry mouth
- dry, flushed skin
- cycloplegia
- constipation
- disorientation
- Can cause acute angle-closure glaucoma in elderly, urinary retention in men w/ prostatic hyperplasia and hyperthermia in infants

69

What other meds can cause anticholinergic side effects?

1. 1st gen H blockers - diphenhydramine, doxylamine, chlorpheniramine
2. traditional neuroleptics
3. tricyclic antidepressants
4. amantadine

70

What are the direct sympathomimetics?

1. E
2. NE
3. Isoproterenol
4. Dopamine
5. Dobutamine
6. Phenylephrine
7. Albuterol, salmeterol, terbutaline, levalbuterol
8. Ritodrine

71

What are the indirect sympathomimetics?

1. amphetamine
2. ephedrine
3. cocaine (reuptake inhibitor)
- all of these are indirect general agonists

72

MOA of epinephrine?

stimulates all receptors A1/2 and B1/2
- at low doses it has no effect on BP
- at high doses the alpha1 receptors overpower B2 so there is an increase in BP

73

When is epinephrine use?

anaphylaxis, glaucoma, asthma, hypotension

74

MOA of NE?

Alpha receptors >> B1

75

When is NE used?

hypotension but decreases renal perfusion

76

MOA of isoproterenol?

B1 and B2 agonists

77

When is isoproterenol used?

torsade de pointes (tachycardia decreases QT interval), bradyarrhythmias ( but can worsen ischemia)

78

MOA of dopamine?

low dose - D1 receptor to increase renal blood flow
Med Dose - B1/2 receptor agonists
High dose - Alpha1/2 receptor agonists

79

When is dopamine used?

shock (renal perfusion), heart failure, inotropic and chronotropic

80

MOA of dobutamine?

Beta 1 agonists

81

When is dobutamine used?

heart failure, cardiac stress testing, inotropic and chronotropic

82

MOA of phenylephrine

Alpha 1 >> Alpha 2 so increases BP

83

When is phenylephrine used?

hypotension, ocular procedures (mydriatic), rhinitis (decongestant)

84

MOA of albuterol, salmeterol, terbutaline, and levalbuterol

B2 >> B1 agonists

85

When is albuterol used?

acute asthma

86

When is salmeterol used?

long term asthma or COPD control

87

when is terbutaline used?

to reduce premature utering contractions

88

MOA of ritodrine?

B2 agonists

89

When is ritodrine used?

reduces premature uterine contractions

90

What is amphetamine used for?

narcoplepsy, obesity, and ADHD

91

What is ephedrine used for?

nasal decongestion, urinary incontinence, hypotenion

92

What can cocaine do?

causes vasoconstriction and local anesthesia.

93

What drug is avoided w/ cocaine overdose?

B-Blockers because it can lead to an unopposed alpha 1 activation and extreme HTN

94

What happens to HR and BP with NE use?

increases BP due to Alpha 1 and there is a reflexive bradycardia (decreased HR)

95

What happens to HR and BP w/ E use?

increase in BP and HR because all four activated

96

What happens to HR and BP w/ isoproterenol use?

little alpha effect but causes B2 mediated VD resulting in decrease BP and increased HR through B1 and reflex activity.

Widened pulse pressure as well

97

What are some sympathoplegic drugs?

clonidine and alpha-methydopa, guanfacine

98

MOA of clonidine and alpha-methyldopa

Alpha 2 agonists - decrease central sympathetic outflow
- decrease BP due to vasodilation

99

Clonidine use?

low half life, used as a sleep aid for ADHD, used for HTN especially w/ renal disease

100

When is alpha-methyldopa use?

HTN in pregnancy

101

What are nonselective alpha blockers?

Phenoxybenzamine (IR)
Phentolamine (R)

102

What are some adverse side effects w/ phenoxybenzamine and phentolamine?

orthostatic hypotention and reflexive tachycardia

103

When is phenoxybenzamine used?

pheochromocytoma

104

When is phentolamine used?

givens to pts on MAO inhibitors who eat tyramine-containing foods (aged)

105

What are alpha1 selective blockers?

prazosin, terazosin, doxazosin, tamsulosin

106

When are the alpha 1 selective blockers given?

HTN, urinary retention in BPH

107

What are adverse side effects of alpha 1 selective blockers?

1st dose orthostatic hypotension, dizziness, headache

108

What is tamsulosin a special alpha 1 selective blocker?

it works only at the prostate and has no effect on BP so safe to give to pts who have only BPH symptoms

109

What is an alpha 2 selective blocker?

mirtazapine

110

When is mirtazapine used and what are some side effects?

used - depression
ADE - sedation, increases serum cholesterol, and increases appetite

111

What are beta blockers used for?

1. Angina - decreased heart rate and contractility, resulting in decreased O2 consumption
2. MI - decreased mortality
3. SVT - decreased AV conduction velocity
4. HTN - decreased CO and decreased renin secretion (due to B1 receptor blockade on JGA cells)
5. CHF - slows progression of chronic failure
6. Glaucoma (timolol) - decreases secretion of aqueous humor

112

What are ADE of beta blockers?

impotence, exacerbation of asthma, CV effects such a bradycardia, AV block, CHF; CNS effects such as seizures, sedation, sleep alterations. Use w/ caution w/ diabetics b/c they can mask symptoms of low glucose

113

What are B1 selective antagonists?

acebutolol, betaxolol, esmolol (short acting), atenolol, metoprolol
- they are advantageous in pts w/ comorbid pulmonary dz

114

What are nonselective B antagonists?

Propranolol, timolol, nadolol, pindolol

115

What are nonselective alpha and beta antagonists?

Carvediolol and labetaolol

116

What are partial Beta agonists

Pindolol and acebutolol

117

What are the Beta blockers of choice for MI

carvedilol and metoprolol

118

What is the Beta blocker of choice for thryoid toxicosis?

propranolol

119

What Beta blocker is given for esopheal varicies?

nadolol

120

What do beta blockers do when treating aortic dissection?

1. decrease BP
2. decrease slope of rise of BP

121

For Michaelis-Menten kinetics, what is Vmax?

- Vmax is directly related to enzyme concentration

122

For Michaelis-Menten kinetics, what is km?

- concentration of substrate at 1/2Vmax
- inversely related to affinity of enzyme for its substrate

123

What is the y and x intercept for Lineweaver Burk plot?

1. X-intercept: -1/km
2. Y-intercept: 1/vmax

124

What is the slope of the LIneweaver Burk plot?

km/Vmax

125

What happens when the y-intercept increases on the Lineweaver Burk plot?

- Vmax decreases

126

What happens when you go further right on the Lineweaver Burk plot?

- the greater the Km and lower the affinity

127

What effect do competitive inhibitors have on Michaelis Menten kinetics?

1. Vmax is unchanged
2. Km is increased
- can be overcome by increasing substrate concentration
- binds to the active site of the enzyme
- decreases potency

128

What effect do noncompetitive inhibitors have on Michaelis Menten kinetics?

1. Vmax is decreased
2. Km is unchanged
3. Efficacy is decreased
4. doesn't resemble substrate, doesn't bind to active site, and can't be overcome by increasing substrate concentration

129

What is bioavailability?

- fraction of administered drug that reaches systemic circulation unchanged
- for an IV dose = 100%
- Orally: F typically 100% to incomplete absorption and first pass metabolism

130

What is the volume of distribution of a drug?

- theoretical fluid volume required to maintain the total absorbed drug amount at plasma concentration

131

What is the Vd equation?

= amount of drug in the body/plasma drug concentration

132

What can alter the Vd of plasma protein bound drugs

- liver and kidney disease (decreased protein binding, increased Vd)

133

What part of the body has a low Vd?

- blood: usually contains large/charged molecules; plasma protein bound

134

What part of the body has a medium Vd?

ECF: contains small hydrophilic molecules

135

What part of the body has high Vd?

All tissue: contains small lipophilic molecules especially if bound to tissue protein

136

What is the definition of half life?

- time required to change the amount of drug in the body by 1/2 during elimination (or constant infusion)

137

How many half lives does it take for a drug to reach steady state?

- 4-5: 94% of drug at 4 half lives
1. after 1 half life: 50% of drug is remaining
2. after 2 half lives: 25% remaining
3. after 3 half lives: 12.5% remaining
4. after 4 half lives: 6.25% remaining

138

what is the equation for half life?

= 0.7 *Vd/CL

139

What is the definition of clearance?

- relates the rate of elimination to the plasma concentration
- may be impaired w/ defects in cardiac, hepatic, or renal function

140

What is the loading dose equation

LD= VD*Css

141

What is the maintenance dose equation?

MD = CL * Css

142

What happens to maintenance and loading dose in liver and kidney disease?

maintenance dose is decreased but loading dose is unchanged

143

T or F. Time to steady state depends on dosing frequency or size.

False. Depends only on half life

144

What is zero order elimination?

rate of elimination is constant regardless of amount of drug eliminated per unit time
- capacity limited elimination
- Plasma concentration of drug decreases linearly w/ time

145

What are examples of drugs that undergo zero order elimination?

PEA
Phenytoin
EtOH
ASA

146

What is first order elimination?

aka Flow-dependent elimination
- rate of elimination is directly proportional to the drug concentration -- constant fraction of drug eliminated per unit time
- plasma concentration of drug decrease exponentially w/ time

147

What types of drugs are trapped in urine and cleared quickly?

- ionized species
- neutral forms can be reabsorbed

148

What are examples of weak acid drugs?

Phenobarbital
MTX
ASA

149

What type of environments are weak acids trapped in?

basic = makes weak acids ionized

150

How can you treat weak acid overdose?

- bicarbonate - traps weak acids in urine

151

What are examples of weak base drugs?

Amphetamines

152

How are weak bases trapped in urine?

acidic environment

153

How can you treat weak base overdose?

Ammonium chloride

154

What type of rxns take place in phase 1 drug metabolism?

Reduction, oxidation, hydrolysis w/ CYP450

155

What kind of metabolites form after first phase metabolism?

- slightly polar, water soluble metabolites
often still active

156

Who often loses phase 1 metabolism abilities?

Geriatric pts

157

What types of rxns take place in phase 2 drug metabolism?

Conjugation - glucuronidation, acetylation, sulfation

158

What kind of metabolites form after phase 2 metabolism?

- very polar, inactive metabolites
- renally excreted

159

What is efficacy?

maximal effect a drug can produce = Vmax

160

What are some highly efficacious drugs?

- analgesic (pain) meds, antibiotics, antihistamines, decongestants
- partial agonists have less efficacy than full agonists

161

What is potency?

- amount of drug needed for a given effect
- increased potency leads to increased affinity for receptor

162

What are some highly potent drugs?

- chemotherapeutic, antihypertensive, and antilipid drugs

163

What effect do competitive antagonsts have on potency or efficacy?

- shift curve to right which decrease potency
- there is no change w/ efficacy

164

What effect do noncompetitive antagonists have on potency or efficacy?

- shift curve down which decreases efficacy
-

165

What effect do partial agonists have on potency or efficacy?

- acts at same site as full agonist but w/ reduced maximal effect = decreases efficacy
- potency is a different variable and can be increased or decreased

166

What is therapeutic index?

- measurement of drug safety
= LD50/ED50 (median lethal dose/median effective dose)

167

What types of drugs have a higher therapeutic index?

- safer drugs

168

What are examples of drugs w/ lower therapeutic index?

digoxin, lithium, theorphylline, and warfarin

169

What is therapeutic window?

- measure of clinical drug safety. range of minimum effective dose to minimum toxic dose

170

What is the antidote/treatment for the following toxicities?
1. Acetaminophen
2. Salicylates
3. Amphetamines
4. ACE inhibitors, organophosphates
5. Antimuscarinic, anticholinergic agents

1. N-acetylcystein (replenishes GSH)
2. NaHCO3 (alkalinizes urine), dialysis
3. NH4Cl (acidify urine)
4. atropine, pralidoxime
5. Physostimgine salicylate, control hyperthermia

171

What is the antidote/treament for the following toxicities?
1. Beta blocerks
2. Digitalis
3. Iron
4. Lead
5. Mercury, arsenic, gold

1. glucagon
2. normalize K, Lidocaine, anti-dig Fab graments, Mg
3. Deferoxamine, defersairox
4. CaEDTA, dimercaprol, succimer, penicillamine
5. dimercaprol, succimer

172

What is the antidote/treament for the following toxicities?
1. copper, arsenic, gold
2. cyanide
3. Methmeoglobin
4. CO
5. Methanol, ethylene glycol (antifreeze)

1. penicillamine
2. nitrite + thiosulfate, hydoxocobalamin
3. methylene blue, Vitamin C
4. 100% O2, hyperbaric O2
5. Fomepizole > ethanol, dialysis

173

What is the antidote/treament for the following toxicities?
1. Opiods
2. Benzodiazepines
3. TCAs
4. Heparin
5. Warfarin

1. naloxone/naltrexone
2. Flumazenil
3. NaHCO3 (plasma alkalinization)
4. Protamine
5. Vit K, Fresh frozen plasma

174

What is the antidote/treament for the following toxicities?
1. tPA, streptokinase, urkokinase
2. theophylline

1. aminocaproic acid
2. beta blocker

175

What category of drugs are the following endings?
1. azole
2. cillin
3. cycline
4. navir
5. triptan

1. antifungal
2. penicillin
3. antiobiotic, protein synthesis inhibitor - tetracycline
4. protease inhibitor
5. 5HT agonists (migraine) : sumatriptan

176

What category of drugs are the following endings?
1. ane
2. caine
3. operidol
4. azine
5. barbital

1. inhalational general anesthetic - halothane
2. local anesthetic - lidocaine
3. butyrophenone (neuroleptic) - haloperidol
4. Typical antipsychotic - phenothiazine (neuroleptic, antiemetic) - chlorpromazine, thioridazine
5. barbiturate - phenobabital

177

What category of drugs are the following endings?
1. zolam
2 azepam
3. etine
4. ipramine
5. triptyline

1. benzodiazepine
2. benzodiazepine
3. SSRI - fluoxetine
4. TCA
5. TCA

178

What category of drugs are the following endings?
1. olol
2. terol
3. zosin
4. oxin
5. pril

1. beta blocker
2. beta agonist
3. alpha 1 antagonists
4. cardiac glycosides (inotropic agent)
4. ACE inhibitor

179

What category of drugs are the following endings?
1. afil
2. tropin
3. tidine
4. ivir
5. navir

1. erectile dysfunction
2. pituitary hormone
3. H2 antagonists
4. Neuraminidase inhibitor
5. protease inhibitor

180

What category of drugs are the following endings?
1. thromycin
2. chol
3. curium or curonium
4. stigmine
5. dipine

1. Macrolide abx
2. cholinergic agonist
3. non depolarizing paralytic
4. AChE inhibitor
5. dihydropyridine CCB

181

What category of drugs are the following endings?
1. dronate
2. glitazone
3. prazole
4. prost
5. ximab
6. zumab

1. bisphosphonate
2. PPAR- gamma activator
3. proton pump inhibitor
4. PG analog
5. chiimeric monoclonal ab
6. humanized monoclonal ab

182

What drugs cause coronary vasospasm?

cocaine, sumatriptan, ergot alkaloids

183

what drugs cause cutaneous flushing?

vancomycin, adenosine, niacin, CCB (VANC)

184

what drugs cause dilated cardiomyopathy?

doxorubicine and daunorubicin

185

What drugs cause torsades de pointes?

Class III (sotalol) and Class IA (DQP), macrolides, antipsychotics, and TCAs

186

What can cause adrenocortical insufficiency?

HPA suppression secondary to glucocorticoid withdrawal

187

What drugs can cause hot flashes?

tamoxifen
clomiphene

188

What drugs can cause hyperglycemia?

Tacrolimus, protease inhibitors, niacin, HCTZ, Beta blockers, corticosteroids.
- taking pills necessitates having blood checked

189

What drugs can cause hypothyroidism?

lithium, amiodarone, sulfonamide

190

What drug causes acute cholestatic hepatitis and jaudice?

erythromycin

191

What drugs can cause diarrhea?

Metformin, erthryomycin, colchicine, orlistat, acarbose

192

What drugs can cause focal to massive hepatic necrosis?

Halothane, amanita phalloides (death cap mushroom), valproic acid, acetaminophen
- liver HAVAc

193

What drug causes hepatitis?

- INH

194

What drugs cause pancreatitis?

didanosine, corticosteroids, alcohol, valproic acid, azathioprine, diuretics
- Drugs Causing A Violent Abdominal Distress

195

What drugs cause pseudomembranous colitis?

Clindamycin, ampicillin, cephalosporins
- predispose to superinfxn by resistant C difficile

196

What drugs cause agranulocytosis?

Dapson, clozapine, carbamazepine, colchicine, methimazole, PTU
- Drugs CCCrush Myeloblasts and Promyelocytes

197

What drugs cause aplastic anemia?

Carbamazepine, methimazole, NSAIDS, benzene, chloramphenicol, PTU
- Can't Make New Blood Cells Properly

198

What drugs can direct coombs positive hemolytic anemia

Methyldopa and penicillin

199

What drugs cause gray baby syndrome?

chloramphenicol

200

What drugs cause hemolysis in G6PD deficiency?

INH, sulfonamides, dapsone, primaquine, aspirin, ibuprofen, nitrofurantoin

201

What causes megaloblastic anemia?

Phenytoin, MTX, Sulfa drugs

202

What causes thrombocytopenia?

heparin, cimetidine

203

What causes thrombotic complications

OCPs

204

What causes fat redistribution?

protease inhibitors and glucocorticoids

205

What causes gingival hyperplasia?

Phenytoin, verapamil, cyclosporine, nifedipine

206

What causes hyperuricemia (gout)?

Pyrazinamide, thiazides, furosemide, niazin, cyclosporine

207

What causes myopathy?

Fibrates, niacin, colchicine, hydroxychloroquine, IFN alpha, penicillamine, statins, glucocorticoids

208

What causes osteoporosis

corticosteroids and heparin

209

What causes photosensivity

Sulfonamides, amiodarone, tetracyclines, and 5FU

210

What causes Rash (SJS)?

anti-epileptic drugs (ethosiximide, carbamazepine, lamotrigine, phenytoin, phenobarbital)
- allopurinol, sulfa drugs, penicillin

211

What causes SLE like symptoms?

sulfa drugs, hydralazine, INH, procainamide, phenytoin, etanercept

212

What causes teeth discoloration?

tetracyclines

213

What causes tendonitis, tendon rupture, and cartilage damage

fluroquinolones

214

What causes cinchonism?

quinidine and quinine

215

What causes parkinson like syndrome?

Antipsychotics, Reserpine, Metoclopramie

216

What causes seizures?

INH (vit B6 deficiency), Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide
- I BITE My tongue

217

What causes tardive dyskinesia

antipsychotics and metoclopramide

218

What causes diabetes insipidues?

lithium and demeclocycline

219

What causes fanconi syndrome?

expired tetracycline

220

What causes hemorrhagic cystits?

cyclophosphamide and ifosfamide

221

What causes interstitial nephritis?

Methicillin, NSAIDS, furosemide

222

What causes SIADH?

Carbamazepine, cyclophosphamide, SSRIs

223

What causes pulmonary fibrosis?

Bleomycin, Amiodarone, Busulfan, MTX

224

What causes antimuscarinic reactions?

Atropines, TCAs, H1 blockers, Antipsychotics

225

What causes disulfiram like reaction?

Metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st gen sulfonylureas

226

What causes nephrotoxicity/ototoxicity?

Aminoglycosides, vanocmyin, loops diuretics, cisplatin

227

What are you CYP inducers?

1. Chronic alcohol use
2. Modafinil
3. St John's wort
4. Phenytoin
5. Phenobarbital
6. Nevirapine
7. Rifampin
8. Griseofulvin
9. Carbamazepine

228

What are CYP substrates?

Anti-epileptics
Anti-depressants
Anti - psychotics
Anethetics
Theophylline
Warfarin
Statins
OCPs

229

What are CYP inhibitors?

1. Acute alcohol abuse
2. Gemfibrozil
3. Ciprofloxacin
4. INH
5. Grapefruit juice
6. Quinindine
7. Amiodarone
8. Ketoconazole
9. Macrolides
10. Sulfonamides
11. Cimetidine
12. Ritonavir

230

What are you sulfa drugs?

Probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide abx, sulfasalazine, sulfonylureas