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Musc/Rhuem/Derm Module > Pharmacology > Flashcards

Pharmacology Flashcards

(97 cards)

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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
greatest risk for hepatic injury by hypersensitivity mechanism
Sundilac
26
Reye's syndrome
Aspirin
27
Salycilate Poisoning Pathogenesis
Enters CNS to cause hyperventilation by stimulating the medulla. Uncoupling of ox. Phosphorylation, interupting metabloism
28
Methotrexate MOA
DMARD: DHFR Inhibitor Adenosine inhbition - impairs lymphs and prevents release of cytokines
29
Methotrexate Toxicity
Increased opportunistic infections and bleeding, avoid vaccinations Pulmonary Fibrosis Malignancies, Skin, and GI Teratogen
30
Sulfasalazine MOA
DMARD: | Metabolized to Sulfapyridine and Mesalamine - inhibits PG and LT production
31
Sulfasalazine Toxicity
Fatal blood dyscrasias
32
Sulfasalazine Contraindication
Contrindicated in history of hypersensitivity to Salicylate or Sulfonamide drugs
33
Leflunomide MOA
DMARD: Inhibits Dihydroorate Dehydrogenase (mitochondrial enzyme for pyrimidine synthesis) Also uricosuric effect
34
Leflunomide Toxicity
Do not use in immune suppression or infection | Teratogen
35
Hydrochloroquine MOA
DMARD: | Increases intracellular vacuole pH, required for MHC Class-II peptide presentation to CD4+ T Cells
36
Hydrochloroquine Toxicity
Liver toxicity Blood dyscrasias CNS toxicity: Seizures, polyneuritis, ototoxicity, neuropathy Eyes: Corneal opacities, retinopathy, keratopathy
37
Hydrochloroquine Contraindication
Alcohol use, liver disease | Contraindicated in Ocular disease
38
Adalimumab MOA
TNF - binds to TNF-a to prevent its interaction
39
Adalimumab Toxicity
CHF | Lupus-like syndrome
40
Certolizumab MOA
TNF - binds to TNF-a to prevent its interaction
41
Certolizumab Toxicity
Lupus-like syndrome | Blood Dyscrasias
42
Etanercept MOA
TNF - acts like a pseudo-receptor
43
Etanercept Toxicity
Lupus-like syndrome
44
Golimumab MOA
TNF - binds to TNF-a to prevent its interaction
45
Golimumab Toxicity
CHF
46
Infliximab MOA
TNF - binds to TNF-a to prevent its interaction
47
Infliximab Toxicity
CHF | Lupus-like syndrome
48
Abatacept MOA
CTLA-4 - prevents T-cell costimulatory signal
49
Abatacept Interaction
Conatins maltose, may interfere with blood glucose test
50
Toclizumab MOA
IL-6 - binds to recpetors and prevents signaling
51
Toclizumab Toxicity
Blood Dyscrasias
52
Rituximab MOA
CD-20 - mediates B-cell lysis
53
Rituximab Toxicity
Stevens-Johnson Syndrome Contraindicated in pregnancy (crosses placenta) CHF Blood Dyscrasias
54
Anakinra MOA
IL-1 - competitively inhibits binding to the receptor
55
Anakinra Toxicity
Blood Dyscrasias
56
Aprelimast MOA
PDE-4
57
Aprelimast Toxicity
Nausea, weight loss, headache | Depression/Suicide
58
Colchicine MOA
Inhibits depolymerization of microtubles, which prevents blocks movement and phagocytocis in Neutrophils
59
Colchicine Toxicity
GI disturbances - dose related Blood Dyscrasias, bone marrow suppression Overdose - myopathy and peripheral neuropathy
60
Indomethacin MOA
COX Inhibitor and inhibits leukoctye motility to prevent inflammation
61
Indomethacin Toxicity
N/V, ulcers, frontal headache, hematopoetic disorders
62
Allopurinol MOA
Competitive inhibitor of Xanthine Oxidase
63
Allopurinol Toxicity
Skin rash, liver function, increase in acute gout | Limitation for use is renal toxicity
64
Allopurinol Interactions
6-MP | Ampicillin and antibiotics are contraindicated
65
Febuxostat MOA
Inhibitor of Xanthine Oxidase
66
Probenecid MOA
Inhibits UA reabsorption by the organic acid transporter in the proximal tubule
67
Pegloticase MOA
Recombinant form of Urate Oxidase - converts UA into Allantoin
68
Imiquimod MOA
Direct activation of TLR7 and TLR8 Adenosine Receptor blockade Activation of NF-kB to upregulate cytokines BCC
69
Imiquimod Toxicity
Increases photosensitivity | Can affect condom and diaphragm integrity
70
Vismodegib MOA
SMO protein inhibitor, causes antagonism of proliferative signals BCC
71
Vismodegib Toxicity
BBW: Intrauterine fetal death Male-mediated Teratogenicity Pregnancy
72
Aldesleukin; IL-2 MOA
Binds to IL-2 receptor, Induces proliferation and differentiation of lymphocytes Melanoma
73
Aldesleukin; IL-2 Toxicity
BBW: CNS, Cardiac, Pulmonary, Renal, Hepatic disease contraindication Organ Transplant patients Capillary Leak Syndrome
74
Interferon-a MOA
Endogenous interferon mimic/ Immunomodulator Increased ability to activate CD8 T-Cells and NK Cells to lyse tumors Melanoma
75
Interferon-a Toxicity
BBW: Autoimmune Disease exacerbation Cardiac Disease Deppression Blood Toxicities Pulmonary effects
76
Ipilimumab Nivolumab Pembrolizumab MOA
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
Ipilimumab Nivolumab Pembrolizumab Toxicity
BBW: Endocrinopathies, Diarrhea, Peripheral Neuropathy, Rash (Toxic Epidermal Necrolysis) Avoid in pregnancy
78
Dabrafenib Sorafenib Trametinib Vemurafenib MOA
BRAF multiple targets MEK1 and MEK2 BRAF Melanoma
79
Dabrafenib Sorafenib Trametinib Vemurafenib Toxicity
``` Heart- QT prolongation, myopathy Vascular- DVT, PE, bleeding Skin- new cancer, SJS Renal failure Eye- Retinal detachment Avoid in pregnancy ```
80
Retinoids MOA
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
Retinoids Toxicity
Systemic: dry skin, nosebleeds, conjuctivitis Potent teratogens Depression/Suicide Topical: erythema, desquamation, increased risk of sunburn
82
Calcipotriene MOA
Binds vitamin D receptor, associates with RXR and binds to DNA response elements - Modulation of epidermal differentiation and inflammation
83
Calcipotriene Toxicity
Hypercalcemia and Hypercalciuria, which leads to abdominal pain, constipation, fatigue, hypotension and thirst Increased susceptibility to UV cancers
84
Topical Steroid Toxicity
Dermal atrophy, telangiectasias, purpura and ecchymoses | Corticoid rosacea, acne, hyperpigmentation, ocular pressure
85
Benzoyl Peroxide MOA
Free radical liberation which is lethal to P. Acnes
86
Salicylic Acid MOA
Keratolytic that causes desquamation of horny layer of skin
87
Azoles | (Ketoconazole) Topical Toxicity
Impotence, menstrual irregularity, gynecomastia, hot flashes | Some drugs can cause QT prolongation, teratogenic, and enter CNS
88
Griseofulvin Toxicity
Contraindications: Hepatotoxic Teratogenic Porphyria (neurologic and skin manifestations) Cross-reactive with penicillin antibiotics Increased sensitivity to sun
89
Terbinafine Toxicity
Lymphpenia and neutropenia leading to immunosuppression | Blood dyscrasias
90
Malathione MOA
Acetylcholinesterase inhibition | hyperstimulation and paralysis
91
Permethrin MOA
Inhibits voltage-gated Na channels | Paralysis
92
Ivermectin MOA
Binds Glutamate receptors gating Chloride causing hyperpolarization of cell Agonist of GABA
93
Dimethicone MOA
Silicone based polymer that mechanically suffocates the lice
94
Glycopyrrolate/ Propantheline VS. Oxybutynin
Quaternary antimuscarinic agents -- do NOT cross BBB
95
Minoxidil (Rogaine) MOA
Potent vasodilator (anti-hypertensive), mechanism for hair growth unknown
96
Finasteride MOA
Testosterone analog that blocks 5-a-Reductase levels
97
Eflornithine MOA
Decreases Ornithine Decarboxylase, which decreases cell division and differentiation (to stop facial hair growth)

Musc/Rhuem/Derm Module (2 decks)

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