Flashcards in Pharmacology Deck (119):
What drugs end in "litazone”?
Thiazolidinedione-type, also called “glitazones"
What drugs end in "ronates”?
What smokinc cessation medication is lethal in children and CI in pregnancy?
Nicotin gum and patches
What is a sign of nicotine toxicity?
What substances/medication induce CYP1A2?
Caffeine, theophylline, TCA's, Warfarin, and Nicotine
What medications are indicated for glaucoma? What class are they?
Pilocarpine - cholinergic agonist
Physostigmine - cholinesterase inhibitor
What are common AE observed with neuroleptics?
Tremors/parkinsonian effects, tardive dyskinesia, postural hypotension, blurred vision, dry mouth, constipation, urinary retention, sexual dysfunction, drowsiness
What are symptoms of neuroleptic malignant syndrome?
catatonia, fluctuating BP, dysarthria, fever, death
Counteract with dopamine agonist (Bromocriptine)
What is the MOA of the phenothiazines (antipsychotics)? What about haloperidol?
Dop block + H1 blockade
What are important AE with antipsychotics?
What drugs are contraindicated in depressed patients?
What other hormone is released as a result of dopamine blockade?
What two neurotransmitters are blocked with Respiradone?
Serotonin and Dopamine
What is a serious AE of Clozapine?
How does Buproprion lowers seizure threshold?
What vitamin is required by MAO to operate properly?
What cofactors are required by COMT?
Mg and SAMe
What amino acid become serotonin?
Induce or inhibit CYP450 3A4: barbituates, glucocorticoids, phenytoin, hypericum
Induce or inhibit CYP460 3A4: ciprofloxacin, clarithromycin, erythromycin, fluconazole, fluoxetine, grapefruit juice, Itraconazole, ranitidine, miconazole, ketoconazole, metronidazole
Which drugs block reuptake of MAO and inc NE and serotonin?
TCAs - Amitriptyline, Imipramine, Doxepin, etc.
Which drugs are modified serotonin effectors?
How do MSE's work?
SSRI + Inc Serotonin prod + NE receptor effects
What case class of drug is Duloxetine?
Which medication is used for neuropathic pain, post-herpetic neuralgia, and fibromyalgia? I
Pregabalin - block alpha2delta subunit and reduces Ca dependent release of neurotransmitters
Name two serotonin transporter inhibiting medications.
Desyrel and Serzone
What neurosteroid enhances GABA in the brain?
The degradation of progesterone
High dose vitex inc what hormone?
Which drug is an anxiolytic without sedation or euphoria and modulates Serotonin/Dopamine/NE activity?
What medications are given acutely for seizure?
Diazepam and Ca Gluconate IV
What is the action of Hydroxyzine and indication?
How does glycine work in the brain?
Cl channel blocker
What herbs should you not administer within two weeks of an MAO inhibitor?
Rauwolfia or Reserpine
What two drugs for bipolar drugs require regular blood levels due to potential toxicity?
Lithium and Valproic Acid
What neuropathic pain medication is also used in bipolar?
What is Lithium's action?
Interferes with Na ions in the brain.
What dietary recommendation should you NOT make with pt taking lithium?
Low Na diets!!!
What drugs end in "tidine"?
Lower Acid in the stomach
H1 is for snotty noses
What drugs end in "prazoles"?
What mineral deficiency is a problem in PPI usage?
What is Sucralfate?
What is Metoclopramide?
Stimulates upper GI motility, can affect CNS (extrapyramidal effects)
What are two Belladonna alkaloids? And what action do they have?
Dephenoxlylate w/ Atropine as well as Loperamide are what type of drug?
How does Docusate (Colace) work?
Reduce surface tension of the oil-water interface of stool to soften it.
What is the MOA of "triptans"? What condition do you NOT want to use triptans?
agonist for a vascular 5-HTP1 receptor subtype - resulting in vasoconstriction
DO NOT USE in basilar artery disease, HTN, w/ MAO inhibitors.
What is the combo drug of carbi-levodopa?
Sinemet - can use lower dose initially
Bromocriptine and Pergolide are _____ derivative dopamine agonists.
Pramipexole and Ropinirole are _____ dopamine agonists.
In end-stage Parkinson's, what previously CI drug is used to keep dopamine from being broken down in the brain?
What type of drugs are often used in Alzheimer's dz?
Acetylcholine sparing: Donepezil, Tacrine hydrochloride, galantamine, rivastigmine
NMDA/Glutamate blocker: Namenda
T/F: Schedule 1 drugs have accepted use.
What type of medications are cyclobenzaprine carisoprodol? What is important to remember about cyclobenzaprine?
It is a tricyclic derivative - therefore do NOT use with MAO inhibitors.
Describe the symptoms of cinchonism.
Tinnitus, HA, nausea, dizziness, vertigo, visual changes
What do each of the pregnancy categories A-D mean?
A - The safest drugs to take during pregnancy. No known adverse reactions.
B - No risks have been found in humans.
C - Not enough research has been done to determine if these drugs are safe.
D - Adverse reactions have been found in humans.
What two drugs are opiate receptor blockers used for opiate overdose, CA, and AI?
Naloxone and Naltrexone
What is the MAX safety dose for acetaminophen? What is the toxic single dose?
NAPQI - toxic metabolite
What is the antidote to acetaminophen toxicity?
What is a major concern of Tramadol HCl (Ultram)?
Lowers seizure threshold.
How can NSAIDs affect asthmatics?
Can shunt toward leukotrienes - worsening asthma
What are drugs ending in "sone," "zone" or "onide"?
What is the ratio of Prednisone to Cortisone?
5mg Pred = 20 mg Cortisone
Cortisone is basically to what we make naturally.
What are two gout medications that are also toxic to the liver and often cause GI upset?
Allopurinol and colchicine
Can used prednisone or naproxen which are less toxic.
Which hormone has a gaba-like effect as a neurosteroid?
Which neurotransmitters are blocked in cocaine use?
Dopamine, NE, Serotonin
Euphoria, energy, confidence
T/F: MDMA or Ecstasy has a very weak affinity for serotonin transporters.
F, STRONG affinity for serotonin
For what condition is Tolterodine indicated? What is it's MOA?
Urinary incontinence or overactive bladder
What is a finding on ECG of Amitriptyline overdose?
Wide QRS complex ventricular tachycardia
indication(s), side effect(s), and interaction(s)/contraindication(s).
What drugs end in "cyclovir or vir”?
What drugs end in "azole”?
What drugs end in "cycline”?
What drugs end in "penicillin”?
What drugs end in "olol”?
What drugs end in "pril”?
What drugs end in "sartan”?
What drugs end in "amlodipine or pine”?
Ca Channel Blocker
What are the side effects of alendronate?
Esophageal irritation. Avascular necrosis of the jaw.
What are the adverse events related to atorvostatin?
Increased CK, mild upper GI disturbance, sleep issues, HA, rash, myopathy, Coq10 depletion
Rare: periph neuro, impotence
What is important to check every 3 months when taking a statin?
ALT liver function
What cholesterol marker is most affected by a statin medication?
What cholesterol marker is most affected by fibrate medication?
What drugs/supplements require ionization (requiring stomach acid)?
Problem with PPIs
How does substances that increase albumin binding affect drug availability? Decrease albumin binding?
Describe phase 1 and phase 2 detox.
Phase 1 - CYP450, render non-polar substance polar through oxidation, reduction, hydrolysis, and hydration. Cofactors: B2, 3, 4, 12, folate, GSH, AA's
Phase 2 - Conjugation, tak more polar P450 metabolites and conjugate them with amino acids
What consideration is made for pt w/ kidney dz or dec GFR when dosing renally cleared medication?
Might need to have a lower dose due to higher conc in the blood.
Term: time required for half of that substance to be removed from an organism.
How many half-lives does sit take for a drug's serum conc to reach steady state?
4.7 (5X rule)
Drugs that are easily displaced from album, therefore inc plasma drug level
Drugs that induce P450, therefore dec plasma drug levels
Drugs that inhibit P450, inc plasma drug level
Drugs that compete for renal transporters, inc plasma drug levels
Which antibiotics are famous for their ototoxicity side effects?
Name the antidote:
4) Methanol/Ethylene glycol
5) 100% O2
6) Amyl nitrate
10) Vit K
Name the acetylcholine receptor:
1) found at postsynaptic parasympathetic locations
2) autonomic ganglia, adrenal medulla, neuromuscular junction
1) sympathomimetic drug
2) sympatholytic drug
3) Pilocarpine (used in ophthalmology)
How does digitalis act to improve atrial dysfunction?
Increases intracellular Ca elongating plateau of cardiac AP (by blocking Na/K ATPase pump)
What drugs end in "sone," "zone," or "onide"?
What medication for allergic rxn is CI w/ CNS depressants and MAO inhibitors?
What nasal spray (or rx eye drops) stimulate a1 receptors causing vasoconstriction? What is it CI in? What interaction is important to remember
CI in severe HTN
DO NOT USE w/ MAO inhibitors
Which drugs require therapeutic monitoring?
Digoxin, phenytoin, lithium, carbamazepine, theophylline.
What drugs end in "afil"?
erectile dysfunction meds
What drugs end in "romycin"?
T/F: Macrolides are CI in pregnancy.
What is the concern with tetracyclines in children < 9yo?
Permanent discoloration of teeth
ALSO interferes with OCPs
What drugs can cause a hemolytic crisis in g6p deficiency
What side effect is a hallmark of Fluoroquinolones? What pt population should you NOT prescribe fluoroquinolones?
Achilles Tendon Rupture (BBW)
Can arrest growth plates
What is the biggest problem/adverse event with aminoglycosides?
What are the three TB drugs?
Depletes B6 - give w/ B6
Three type of HIV tx.
Nucleoside Reverse-transcriptase Inhibitors
Non Nucleoside Reverse-transcriptase Inhibitors
What is the indication for Adalimumab? Action?
RA, psoriatic arthritis, ankylosing spondylitis, Crohn's dz, mod-sev chronic psoriasis, and juvenile RA
TNF - blocker
Adverse events with interferon tx.
What is the indication for Tacrolimus? Action?
Chronic tx of mod-sev atopic derm
Suppresses cell-mediated immune reaction
What is the indication for Anastrozole? Action?
Breast CA after surgery and for METS
Aromatase inhibitor - block conversion of testosterone to estrogen
What is the indication for Doxorubicin? Action? Most serious AE?
Hematologic malignancy, Carcinomas, soft tissue Sarcoma
Antibiotic (Anti-DNA) - administered IV
Life-threatening heart damage
What is the indication for Paclitaxel? Action? Common SE?
Lung, ovarian, breast, head/neck CA and advanced Kaposi's sarcoma
Mitotic inhibitor (from Pacific yew tree)
What is the indication for Vinblastine? Action?
Hodgkin's lymphoma, non-small cell lung CA, breast, head/neck, testicular CA
What is the indication for Methotrexate? Action? What would you NOT give with methotrexate?
Chemo, Preg termination, Autoimmune disorders
Dihydrofolate reductase inhibitor
Drugs that end in "sone," "zone," or "onide"?