Pharmacology

Question 1

Aspirin:

Indications, MOA, Side effects, Poisoning

Answer 1

Antiinflamm, analgesic, anti-pyretic, antiplatelet
MOA - inhibits cycloxygenase (Cox) inhibits prostaglandin synthesis. Irreversible and predictable mechanism
SE - GI upset, N & V, bleeding, ulcers, Methotrexate toxicity ( aspirin decreases methotrexate excretion)

Salicylate poisoning: Tinnitus, N&V, lethargy/excitability, hyperventilation –> Resp alkalosis. Severe toxicity may lead to metabolic acidosis, seizures.

Question 2

Methotrexate:

Answer 2

Chemotherapy, autoimmune disease, RA
SE: Anaemia, leukopenia, thrombocytopenia, dizziness, weakness, fatigue, reduced ex tolerance, HA, Nausea, Joint pain, swelling

Question 3

NSAIDS: Non-selective

Answer 3

Ibuprofen, advil, molvin - inhibit both Cox-1 and Cox 2 eliminating the good prostaglandins (Cox1) and the inflammatory ones (Cox2) nonselectively.
SE: fluid retention, edema, CHD, GI irritation, lithium toxicity - N&V diarrhea, weakness

Question 4

NSAIDS: Selective

Answer 4

Celebrex/celecoxib - acts only on the Cox II and spares the Cox I

Question 5

Glucocorticosteroids

Answer 5

MOA: inhibit capillary dilation, edema, migration of leuokocytes and macrophages
indications: RA, DJD
SE: Fragile bone, poor growth, increased appetite, diabetes, hypokalemia –> muscle cramp/spasm
Peripheal edema, glaucoma, reduced WBC, emotional changes, hirsuitism, cushings
Withdrawal: opposite - hypotension, addisons disease

Question 6

Disease Modifying Antirheumatic Drugs (DMARDs)

- anticytokines

Answer 6

Demyelinating, lymphoma, infections, lupus like rash

Question 7

Disease Modifying Antirheumatic Drugs (DMARDs)

- Cyclosporine

Answer 7

SE: HTN Nephrotoxicity

Question 8

Biphosphonates

Answer 8

Anti-osteoporotic - Reduced osteoclast, increased BMD, SE: stomach and esophagus lesions, arrhythmia, muscle pain

Question 9

Calcitonin

Answer 9

Antiosteoporotic - inhibit osteoclasts - increased BMD used in padgets disease
SE: pain, myalgia, HA, Nasal complications

Question 10

Teriparatide (forteo)

Answer 10

Selective antiestrogen, parathyroid hormone - not for padgets disease.

Question 11

Etidrenate diphosphonate

Answer 11

Inhibition of Osteoclasts - Padgets

Question 12

Alendronate (fosamax)

Answer 12

Side effects: myalgia, esophageal lesions - standing for 30 mins after taking, take 30 mins before breakfast

Question 13

Diazepam

Answer 13

Works on the spinal interneruons

Side effects - drowsiness, muscle spasm

Question 14

Tizanidine

Answer 14

Muscle relaxant
Indications: spasticity
acts on the spinal cord
SE: hypotension

Question 15

Flexeril

Answer 15

Muscle relaxant
Local, acute muscle spasm
Acts on the brain and spinal cord
possible hypertensive crisis, tachycardia, blurry vision, dry mouth

Question 16

Baclofen

Answer 16

Spasticity, painful F/E spasm
SE: drowsiness, Seizures
MOA: inhibits neurotransmitter release in brain and spinal cord
Reduces inflammation and pain

Question 17

Dantroline

Answer 17

Acts locally on muscle fibers to block calcium release
Side effects - drowsy, diarrhea, dizziness, photosensitivity
Indications: Chronic muscle spasm

Question 18

Tricyclic Antidepressants

Answer 18

Amitryptyline, Nortryptoline, doxepine, lmipramine

Question 19

Monoamine Oxidase Inhibitors

Answer 19

MOA: Inhibits breakdown of neutrotransmitters leading to more availability
Nordil, Pornate, Morplan
Indicated for Hysteria
SE: sweating, tremor, increased BP, Increased temp

Question 20

SSRIs

Answer 20

Zoloft - OCD

SE: HA Nausea, lethargy, fatigue, insomnia

Question 21

Opiods

Answer 21

Morphine, codine, hydrocodone, oxycodone
Indications: analgesia, dyspnea, antidiarrheal, antitussive
SE: N&V, drowsiness, withdrawal, resp depression, addiction
Oxycodone - constipation
Mepiridine - tremor, twitch, seizures

Question 22

Non-opioid narcotics

Answer 22

Acetaminophen - mild-mod pain
Antipyretic
325-650mg TID 4g daily max
Large doses lead to liver damage

Question 23

Digoxin toxicity leads to

Answer 23

Distraction, indiscretion, grandiocity, increased activity, sleep deficit, talkativeness, blurry yellow vision, tachycardia, heart block

Question 24

Thiazide, hydrochlorthiazide

Answer 24

Diuretic - first line HTN
Inhibits the resorption of sodium in the kidney which inhibits water resorption = increased urine volume and decreased vascular resistance
SE: Hyperglycemia, hyperurecemia, HYPERcalcemia, hypokalemia, increased LDL

Question 25

Loop diuretics

Answer 25

affect the Loop of henle | Hyperurecemia, hyperglycemia, hypokalemia increased LDL and HYPOCALCEMIA

Question 26

Potassium sparing diuretics

Answer 26

Weak diuretics prevent hypokalemia - hyperkalemia.

Question 27

Alphaadrenergic blockers: alpha receptors cause:

Answer 27

Vasoconstricution - increased hypertension

Question 28

Alphaadrenergic blockers: beta receptors cause:

Answer 28

vasodilation - relaxation

Question 29

Glycerol trinitrate (GTN) Nitroglycerin

Answer 29

Angina SE: orthostatic hypotension, dizziness, HA, tachycardia MOA: peripheral vasodilation, blood pooling, reduced oxygen demand of the heart 3 times with no relief - Call for assistance likely MI

Question 30

Hydralazine, minoxidil

Answer 30

Vasodilators used with ACE inhibitors in CHF used with betablockers for HTN SE: GI disturbances, HA, flushing (lupus like symptoms), congestion, reflex tachycardia

Question 31

Anticoagulants: Warfarin considerations

Answer 31

CI in pregnancy | Consider purple to syndrome - microemboli

Question 32

Anticoagulants: Heparin

Answer 32

CI in renal failure

Question 33

Antiretroviral treatment

Answer 33

SE Neuralgia and myopathy, lots of water to prevent dehydration

Question 34

Beta blockers - Lols

Answer 34

``` Reduce cardiac output by slowing the heart Beta 1 act on heart Beta 2 act on lungs Selective beta blockers - Beta 1 only Non-selective - Beta and and 2 SE: Bradycardia Lethargy GIT disturbance Low BP Depression ```

Question 35

Calcium channel blockers (pines)

Answer 35

Inhibit calcium ions into heart and muscle cells = decreased peripheral resistance - coronary artery dilation - decreased contractility and conductivity of the heart, reduced oxygen demand SE: Bradycardia, peripheral vasodilation, flushing, headache, ankle swelling, reflex tachy,

Question 36

ACE Inhibitors (Prils)

Answer 36

CHF - reduced peripheral vascular resistance without increasing CO, HR or Contractility SE: dizzy, OH, GI distress, Cough, HA, Hyperkalemia