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Musc/Rhuem/Derm Module > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Atracurium/Cisatricurium Toxicity

A

produces Laudanosine which causes siezures

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2
Q

Succinylcholine Toxicity

A

Malignant Hyperthermia (treat with Dantrolene)
Hemodynamic changes
Hyperkalemia (due to upregulation of AchR)
Increase in intraocular/ intracranial pressure
Myoglobinuria

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3
Q

Tubocurarine MOA and action

A

Non-depolarizing and Moderate Histamine Release

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4
Q

Pancuronium/Rocuronium/Vecuronium MOA and Action

A

Non-depolarizing, Pancuronium - Moderate block of cardiac M-receptor

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5
Q

Succinylcholine Off target action

A

Stimulation of Ganglia and Cardiac M-Receptor

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6
Q

Neostigmine/Edrophonium/Pyridostigmine MOA

A

AchE Inhibitors

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7
Q

Sugammadex MOA

A

Encapsulates steroids Rocuronium and Verocuronium

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8
Q

Succinylcholine Metabolism

A

Plasma enzyme Pseudocholinesterase - extremely short mechnism of action

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9
Q

Duloxetine/Milnacipran MOA

A

SSRI for Fibromyalgia

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10
Q

Duloxetine/Milnacipran Toxicity

A

Condraindicated in Closed-Angle Glaucoma
BBW: Suicidal Ideation
Hyponatremia - SIADH
CV- increase in HR and BP

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11
Q

Duloxetine/Milnacipran Metabolism

A

Duloxetine - CYP metabolized and 2D6 inhibitor

Milnacipran - NOT metabolized by CYP

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12
Q

Pregabalin MOA

A

Fibromyalgia:

Inhibits presynaptic a-2-d subunit of L-Type Ca2+ channels - inhibits the excitatory transmission of Glutamate

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13
Q

Pregabalin Toxicity

A

Rebound worsening of symptoms on withdrawal
Depression/Suicide
Dizziness, Sedation, blurry vision, xerostomia

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14
Q

Carisoprodol MOA

A

Muscle Relaxer:

CNS action in Reticular Activating System, sedation and altered perception of pain

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15
Q

Carisoprodol Toxicity

A

Drowziness, dizziness
CNS effects: agitation, insomnia, vertigo, ataxia
vision loss

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16
Q

Cyclobenzaprine MOA

A

Muscle Relaxer:
Central action, maybe at level of brainstem
Significant anticholinergic action (leads to side-effects)

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17
Q

Cyclobenzaprine Toxicity

A

Drowziness, xerostomia, NV, blurred vision
QT prolongation
1st gen Antihistamines - leads to paralytic ileus

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18
Q

Methocarbomol MOA

A

Muscle Relaxer:
Generalized sedative
CNS effects

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19
Q

Tizanidine MOA

A

Muscle Relaxer:

Presynaptic alpha-2 receptor agonist, leads to decreased activation of motor neurons (reduces tone but not strength)

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20
Q

Tizanidine Toxicity

A

Hepatocellular toxicity
CNS effects (additive)
Hypotension (additive)

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21
Q

Baclofen MOA

A

Spasticity:
GABA-b agonist - produces inhibitory signals/prevents excitatory
Inhibits Substance P action for pain relief

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22
Q

Baclofen Toxicity

A

BBW: Rebound seizures, confusion, hallucinations, mental health
CNS depression (additive)
Increased blood glucose (diabetics)

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23
Q

Dantrolene MOA

A

Spasticity:

Interacts with the Ryanodine receptor to interfere with Ca2+ release form SR, uncouples excitation-contraction

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24
Q

Dantrolene Toxicity

A

Crosses the placenta and causes “Floppy Baby Syndrome”
Vfib and cardiovascular collapse with other Ca-channel blockers
Additive CNS effects

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25
Q

greatest risk for hepatic injury by hypersensitivity mechanism

A

Sundilac

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26
Q

Reye’s syndrome

A

Aspirin

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27
Q

Salycilate Poisoning Pathogenesis

A

Enters CNS to cause hyperventilation by stimulating the medulla.
Uncoupling of ox. Phosphorylation, interupting metabloism

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28
Q

Methotrexate MOA

A

DMARD:
DHFR Inhibitor
Adenosine inhbition - impairs lymphs and prevents release of cytokines

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29
Q

Methotrexate Toxicity

A

Increased opportunistic infections and bleeding, avoid vaccinations
Pulmonary Fibrosis
Malignancies, Skin, and GI
Teratogen

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30
Q

Sulfasalazine MOA

A

DMARD:

Metabolized to Sulfapyridine and Mesalamine - inhibits PG and LT production

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31
Q

Sulfasalazine Toxicity

A

Fatal blood dyscrasias

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32
Q

Sulfasalazine Contraindication

A

Contrindicated in history of hypersensitivity to Salicylate or Sulfonamide drugs

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33
Q

Leflunomide MOA

A

DMARD:
Inhibits Dihydroorate Dehydrogenase
(mitochondrial enzyme for pyrimidine synthesis)
Also uricosuric effect

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34
Q

Leflunomide Toxicity

A

Do not use in immune suppression or infection

Teratogen

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35
Q

Hydrochloroquine MOA

A

DMARD:

Increases intracellular vacuole pH, required for MHC Class-II peptide presentation to CD4+ T Cells

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36
Q

Hydrochloroquine Toxicity

A

Liver toxicity
Blood dyscrasias
CNS toxicity: Seizures, polyneuritis, ototoxicity, neuropathy
Eyes: Corneal opacities, retinopathy, keratopathy

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37
Q

Hydrochloroquine Contraindication

A

Alcohol use, liver disease

Contraindicated in Ocular disease

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38
Q

Adalimumab MOA

A

TNF - binds to TNF-a to prevent its interaction

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39
Q

Adalimumab Toxicity

A

CHF

Lupus-like syndrome

40
Q

Certolizumab MOA

A

TNF - binds to TNF-a to prevent its interaction

41
Q

Certolizumab Toxicity

A

Lupus-like syndrome

Blood Dyscrasias

42
Q

Etanercept MOA

A

TNF - acts like a pseudo-receptor

43
Q

Etanercept Toxicity

A

Lupus-like syndrome

44
Q

Golimumab MOA

A

TNF - binds to TNF-a to prevent its interaction

45
Q

Golimumab Toxicity

A

CHF

46
Q

Infliximab MOA

A

TNF - binds to TNF-a to prevent its interaction

47
Q

Infliximab Toxicity

A

CHF

Lupus-like syndrome

48
Q

Abatacept MOA

A

CTLA-4 - prevents T-cell costimulatory signal

49
Q

Abatacept Interaction

A

Conatins maltose, may interfere with blood glucose test

50
Q

Toclizumab MOA

A

IL-6 - binds to recpetors and prevents signaling

51
Q

Toclizumab Toxicity

A

Blood Dyscrasias

52
Q

Rituximab MOA

A

CD-20 - mediates B-cell lysis

53
Q

Rituximab Toxicity

A

Stevens-Johnson Syndrome
Contraindicated in pregnancy (crosses placenta)
CHF
Blood Dyscrasias

54
Q

Anakinra MOA

A

IL-1 - competitively inhibits binding to the receptor

55
Q

Anakinra Toxicity

A

Blood Dyscrasias

56
Q

Aprelimast MOA

A

PDE-4

57
Q

Aprelimast Toxicity

A

Nausea, weight loss, headache

Depression/Suicide

58
Q

Colchicine MOA

A

Inhibits depolymerization of microtubles, which prevents blocks movement and phagocytocis in Neutrophils

59
Q

Colchicine Toxicity

A

GI disturbances - dose related
Blood Dyscrasias, bone marrow suppression
Overdose - myopathy and peripheral neuropathy

60
Q

Indomethacin MOA

A

COX Inhibitor and inhibits leukoctye motility to prevent inflammation

61
Q

Indomethacin Toxicity

A

N/V, ulcers, frontal headache, hematopoetic disorders

62
Q

Allopurinol MOA

A

Competitive inhibitor of Xanthine Oxidase

63
Q

Allopurinol Toxicity

A

Skin rash, liver function, increase in acute gout

Limitation for use is renal toxicity

64
Q

Allopurinol Interactions

A

6-MP

Ampicillin and antibiotics are contraindicated

65
Q

Febuxostat MOA

A

Inhibitor of Xanthine Oxidase

66
Q

Probenecid MOA

A

Inhibits UA reabsorption by the organic acid transporter in the proximal tubule

67
Q

Pegloticase MOA

A

Recombinant form of Urate Oxidase - converts UA into Allantoin

68
Q

Imiquimod MOA

A

Direct activation of TLR7 and TLR8
Adenosine Receptor blockade
Activation of NF-kB to upregulate cytokines

BCC

69
Q

Imiquimod Toxicity

A

Increases photosensitivity

Can affect condom and diaphragm integrity

70
Q

Vismodegib MOA

A

SMO protein inhibitor, causes antagonism of proliferative signals

BCC

71
Q

Vismodegib Toxicity

A

BBW: Intrauterine fetal death
Male-mediated Teratogenicity
Pregnancy

72
Q

Aldesleukin; IL-2 MOA

A

Binds to IL-2 receptor, Induces proliferation and differentiation of lymphocytes

Melanoma

73
Q

Aldesleukin; IL-2 Toxicity

A

BBW: CNS, Cardiac, Pulmonary, Renal, Hepatic disease contraindication

Organ Transplant patients
Capillary Leak Syndrome

74
Q

Interferon-a MOA

A

Endogenous interferon mimic/ Immunomodulator

Increased ability to activate CD8 T-Cells and NK Cells to lyse tumors

Melanoma

75
Q

Interferon-a Toxicity

A

BBW: Autoimmune Disease exacerbation
Cardiac Disease
Deppression

Blood Toxicities
Pulmonary effects

76
Q

Ipilimumab
Nivolumab
Pembrolizumab MOA

A

CTLA4 - functions as a signal dampener to maintain cosistent level of T-Cell activation
PD1 - downregulate activity of T-Cells to limit collateral damage

Melanoma

77
Q

Ipilimumab
Nivolumab
Pembrolizumab Toxicity

A

BBW: Endocrinopathies, Diarrhea, Peripheral Neuropathy, Rash (Toxic Epidermal Necrolysis)
Avoid in pregnancy

78
Q

Dabrafenib
Sorafenib
Trametinib
Vemurafenib MOA

A

BRAF
multiple targets
MEK1 and MEK2
BRAF

Melanoma

79
Q

Dabrafenib
Sorafenib
Trametinib
Vemurafenib Toxicity

A 
Heart- QT prolongation, myopathy
Vascular- DVT, PE, bleeding
Skin- new cancer, SJS
Renal failure
Eye- Retinal detachment
Avoid in pregnancy
80
Q

Retinoids MOA

A

Act upon nuclear retinoid receptors (RXR/RAR) and Modulation of proliferation and differentiation
Inhibition of keratinization
Alterations of cellular cohesiveness
Inhibits MMPs in UV exposure

81
Q

Retinoids Toxicity

A

Systemic: dry skin, nosebleeds, conjuctivitis
Potent teratogens
Depression/Suicide
Topical: erythema, desquamation, increased risk of sunburn

82
Q

Calcipotriene MOA

A

Binds vitamin D receptor, associates with RXR and binds to DNA response elements - Modulation of epidermal differentiation and inflammation

83
Q

Calcipotriene Toxicity

A

Hypercalcemia and Hypercalciuria, which leads to abdominal pain, constipation, fatigue, hypotension and thirst
Increased susceptibility to UV cancers

84
Q

Topical Steroid Toxicity

A

Dermal atrophy, telangiectasias, purpura and ecchymoses

Corticoid rosacea, acne, hyperpigmentation, ocular pressure

85
Q

Benzoyl Peroxide MOA

A

Free radical liberation which is lethal to P. Acnes

86
Q

Salicylic Acid MOA

A

Keratolytic that causes desquamation of horny layer of skin

87
Q

Azoles

(Ketoconazole) Topical Toxicity

A

Impotence, menstrual irregularity, gynecomastia, hot flashes

Some drugs can cause QT prolongation, teratogenic, and enter CNS

88
Q

Griseofulvin Toxicity

A

Contraindications:
Hepatotoxic
Teratogenic
Porphyria (neurologic and skin manifestations)
Cross-reactive with penicillin antibiotics
Increased sensitivity to sun

89
Q

Terbinafine Toxicity

A

Lymphpenia and neutropenia leading to immunosuppression

Blood dyscrasias

90
Q

Malathione MOA

A

Acetylcholinesterase inhibition

hyperstimulation and paralysis

91
Q

Permethrin MOA

A

Inhibits voltage-gated Na channels

Paralysis

92
Q

Ivermectin MOA

A

Binds Glutamate receptors gating Chloride causing hyperpolarization of cell
Agonist of GABA

93
Q

Dimethicone MOA

A

Silicone based polymer that mechanically suffocates the lice

94
Q

Glycopyrrolate/ Propantheline
VS.
Oxybutynin

A

Quaternary antimuscarinic agents – do NOT cross BBB

95
Q

Minoxidil (Rogaine) MOA

A

Potent vasodilator (anti-hypertensive), mechanism for hair growth unknown

96
Q

Finasteride MOA

A

Testosterone analog that blocks 5-a-Reductase levels

97
Q

Eflornithine MOA

A

Decreases Ornithine Decarboxylase, which decreases cell division and differentiation (to stop facial hair growth)

Musc/Rhuem/Derm Module (2 decks)

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