Pharmacology Flashcards
(22 cards)
Calcitonin
Mech: BONE: Binds to Osteoclast receptors–> Inhibits bone resorption–> Decreased blood Ca2+ and Phosphate. KIDNEY: decreases resorption.
Uses: Hypercalcemia, neoplasia, Paget disease, osteoporosis.
SE: Nausea, vomiting, tingling sensation, unpleasant taste.
Bisphosphonates
Risedronate, Alendronate, Clodronate, Etidronate, Ibandronate, Pamidronate, Tiludronate, Zoledronate
Mech: Binds to Bone–> inhibits Osteoclast bone resorption. Also stimulates osteoblasts activity
Uses: Osteoporosis, Paget disease, Hypercalcemia, Bone cancer
SE: GI disturbance (dyspepsia), bone pain
Teriparatide
Recombinant PTH (Forteo)
Mech: KIDNEY: Stimulates Ca2+ absorption in Renal DCT. BONE: Ca2+ release.
Uses: Osteoporosis.
SE: Nausea, HA, dizziness, hypercalcemia, leg cramps
Selective Estrogen Receptor Modulators (SERMs)
Raloxifene, Tamoxifen
Mech: Activates ERs in bone/cardio. Antagonizes ERs in Mammary/Uterus tissue. Inhibit cytokines, recruit osteoclasts, block PTH.
Uses: Prevention of osteoporosis, Breast cancer.
SE: Hot flashes, flushing, Increased risk for DVT and Pulm. embolism.
TNF-alpha Antagonists
Adalimumab, Certolizumab, Etanercept, Golimumab, Infliximab
Mech: Block inflamm. cytokine TNF-alpha
Uses: RA, psoriasis, psoriatic arthritis, ankylosing spondylosis
SE: Hypersensitivity, infection, risk of malignancy
List Drugs to treat Bone disorders
- Bisphosphonates
- Calcitonin
- Teriparatide
- Selective Estrogen Receptors Modulators
- TNF-alpha Antagonists
Colchicine
Mech: Prevents neutrophil and leukocyte migration into joint by binding to tubulin–> depolymerize Microtubules–> disrupting migration and degranulation
Uses: Gout (Acute and prophylaxis)
SE: GI disturbance, severe diarrhea, GI hemorrhage, Hepatic toxicity
Xanthine Oxidase Inhibitors
Allopurinol, Febuxostat
Mech: Reduced synthesis of uric acid.
Uses: Chronic gout. NOT acute (can make worse).
Allopurinol–> also used for prevention of Urate Nephrolithiasis and Tumor Lysis Syndrome
SE: BOTH: GI disturbance, liver dysfunction. Allopurinol: Allergic skin reactions
Probenecid
Mech: Inhibits absorption of uric acid in PCT–> increasing excretion.
Uses: Chronic gout. MUST have adequate renal fcn. Be careful w/ Penicillins (will increase Penicillin levels)
SE: Dyspepsia and peptic ulcers, drug-induced nephritic syndrome
List drugs used to Gout
- Colchicine
- Xanthin-Oxidase Inhibitors
- Probenecid
Corticosteroids
Mech: bind to cytosolic receptors–> alter gene expression–> Inhibition of inflamm. cytokine production. Relieve mucosal inflammation, bronchial reactivity, and increases airway caliber
Uses: Disease flare-ups, acute inflammation, asthma
SE: Short-term: insomnia, dyspepsia, increased appetite, anxiety/psychosis. Long-term: Cushing’s syndrome, obesity, diabetes, osteoporosis, immune suppression.
Cyclophosphamide
Mech: Liver metabolizes–> Active Phosphoramide mustard–> cross-links DNA and inhibit T- and B-cell fcn.
Uses: SLE, RA, vasculitis, cancer
SE: Ovaria failure, infertility, bone marrow suppression, risk for malignancy
List drugs used to treat Connective Tissue Disorders
- Cortiocosteroids
2. Cyclophosphamide
Opioids
Mech: Bind/Activate Opioid receptors–> inhibit AC–> Open K+ channels–> Hyperpolarize–> inhibits transmitter release. Inhibit NT release
Uses: Pain relief, cough suppression, diarrhea, Acute pulmonary edema, opioid addicts, drug overdose
SE: sedation, resp. depression, miosis, constipation
Different uses of Opioids and Corresponding meds (Contraindications)
Cough Suppression: Dextromethorphan
Diarrhea: Loperamide, Diphenoxylate
Opioid addiction: Methadone
Opioid Overdose: Naloxone and Naltrexone
***Contraindicated: Supp. O2 is contraindicated in COPD pt that had Morphine overdose.
Aspirin
Mech: Acetylates and IRREVERSIBLY inhbits COX-1 and COX-2–> prevent conversion of Arachidonic acid to PGs
Uses: Antipyretic, analgesic, anti-inflamm, anti-platelet activity, Kawasaki, OA, inflamm. arthritides
SE: Increase bleeding (NO effect on PT or PTT), Gastric ulcers, hyperventilation, Reye syndrome, tinnitus.
Nonsteroidal Anti-Inflammatory Drugs
Ibuprofen, Naproxen, Indomethacin, Ketorolac, others
Mech: REVERSIBLY inhibits Arachidonic acid and COX-1/2–> inhibit production of PGs and Thromboxanes
Uses: Anti-inflammatory, analgesic, antipyretic, anti-platelet effects.
SE: Renal damage, aplastic anemia, GI distress, ulcers, fluid retention, HTN
COX-1 vs. COX-2
COX-1: constitutive enzyme in most tissues, including platelets
COX-2: induced in inflammatory cells upon activation
What is Indomethacin?
NSAID
Use: Close patent ductus-arteriosus
Cyclooxygenase-2 Inhibitors
Celecoxib
Mech: Selectively inhibit COX-2 (inflamm. cells)
Uses: Analgesic, RA, CTDs, muscle strains, soft tissue diseases
SE: Similar to NSAIDs, but less GI disturbance. Increased cardio risk.
Acetominophen
Mech: REVERSIBLY weakly inhibits COX. Peripherally inactivated–> MOSTLY CNS effects.
Uses: Antipyretic, analgesic. NO effect on inflammation.
SE: Hepatic necrosis (deplete Glutathione).
What prophylaxis can you give to prevent hepatic toxicity w/ Acetaminophen?
N-acetylcysteine
Methinonine
–> Regenerate Glutathione