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HLTH 2511 > Pharmacopoeia > Flashcards

Pharmacopoeia Flashcards

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1
Q

Heparin (unfractionated)

A
  • Anticoagulant
  • promotes antithrombin III (ATIII) activity, inactivating factor Xa and thrombin.
  • Only given parenterally (IV, SC)
  • Requires ongoing aPTT monitoring
  • Used acutely (PE, DVT, DIC) and prophylactically in surgery or in patients at high risk for clotting disorders
  • Antidote is Protamine if excessive bleeding is present
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2
Q

Cocaine

A
  • Ester-type local anaesthetic
  • Sodium channel blocker
  • causes local vasoconstriction, prolonging duration of action
  • relatively weak anaesthetic effect and high risk of abuse, so rarely used
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3
Q

Esbriet (Perfenidone)

A
  • Anti-fibrotic, anti-inflammatory
  • Used in management of IPF
  • thought to interfere with production of inflammatory proteins like TGF-Beta and TNF
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4
Q

Claritin (Loratadine)

A
  • Second-generation antihistamine, H1 receptor antagonist
  • Blocks peripheral H1 receptors, does not closs blood-brain barrier
  • Alleviates allergy symptoms without causing significant sedation/hypnosis
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5
Q

Decadron (Dexamethasone)

A
  • Long-acting, high-potency corticosteroid
  • Causes broad anti-inflammatory effects
    • Decreases eicosanoid production
    • Decreases inflammatory cytokine production
    • Decreases inflammatory cell produciton and recruitment
    • Reduces histamine production and release
  • Used in dexamethasone suppression test and in long-term anti-inflammation, anti-immune treatment
  • Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
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6
Q

Apo-Hydro (Hydrochlorothiazide)

A
  • thiazide diuretic
  • Acts on NaCl symporter in DCT, causing natriuresis, kaliuresis, and Calcium retention
  • First line diuretic for treatment of hypertension and edematous states.
  • Also used in treatment of nephrolithiasis, diabetes insipidus, and renal disorders
  • Common side effects: hypokalemia, hyperglycemia, hyperlipidemia, hyperuricemia
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7
Q

Levophed (Norepinephrine)

A
  • Direct-acting adrenergic agonist, endogenous catecholamine
  • Has high α1 specificity, so minimal cardiac effects with signigicant peripheral vasoconstriction
  • incr. BP due to incr. SVR. high potential for reflex bradycardia (no beta effect)
  • used in treatment of shock and hypotension
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8
Q

Diprivan (Propofol)

A
  • Parenteral, non-opioid anaesthetic
  • Cause GABA potentiation (similar to BZs) to produce sedation and anaesthesia
  • generally used to induce anaesthesia which is maintained by an inhalational anaesthetic, except in short, minor procedures. (20s onset, 5-10 min duration)
  • Reduces ICP and BP, so near ideal for head injury management
  • prolonged use potentiates cardiovascular depression
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9
Q

Spiriva (Tiotropium bromide)

A
  • Muscarinic-selective receptor antagonist (synthetic atropine analog)
  • used for bronchodilation and reduced mucus secretion in asthma/COPD
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10
Q

Atrovent (Ipratropium bromide)

A
  • Muscarinic-selective receptor antagonist (synthetic atropine analog)
  • used for bronchodilation and reduced mucus secretion in asthma/COPD
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11
Q

QVAR (Beclomethasone dipropionate)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • MDI only given BID
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12
Q

Pulmicort (Budesonide)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • Turbuhaler DPI only, given BID
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13
Q

Viagra (sildenafil)

A
  • Type 5 phosphodiesterase inhibitor (PDE5 inhibitor)
  • PNS innervation of vascular smooth muscle causes vasodilation and cGMP release (causing further smooth muscle relaxation). PDE5 inhibitors slow the breakdown of cGMP leading to increased/prolonged vasodilation.
  • As Viagra, sildenafil is used to treat erectile dysfunction
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14
Q

Ativan (Lorazepam)

A
  • Benzodiazepine, sedative-hypnotic
  • Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization
  • Fast onset with medium duration of action and no active metabolites
  • Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia
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15
Q

Atropine (atropine)

A
  • muscarinic receptor antagonist (belladonna alkaloid, tertiary amine)
  • toxixicity is dose dependent, remember; dry as a bone, red as beet, mad as a hatter, blind as a bat
  • causes dilatation, positive chronotropy, decreased secretions, decreased GI motility, bronchodilation, etc.
  • used to reverse cholinesterase overdose and as a positive chronotrope
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16
Q

Tagamet (Cimetidine)

A
  • H2-receptor antagonist
  • reduces gastric acid secretion to reduce dyspepsia/gastroenteritis in GERD
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17
Q

Allegra (Fexofenadine)

A
  • Second-generation antihistamine, H1 receptor antagonist
  • Blocks peripheral H1 receptors, does not closs blood-brain barrier
  • Alleviates allergy symptoms without causing significant sedation/hypnosis
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18
Q

TNKase (Tenecteplase)

A
  • fibrinolytic, thrombolytic, recombinant tPA
  • causes plasmin activation from plasminogen, with high specificity for fibrin-bound plasminogen
  • longer duration of action than alteplase
  • used in resolution of STEMI
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19
Q

Alvesco (Ciclesonide)

A
  • Inhaled Corticosteroid (ICS)
  • Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
  • MDI only, given QD
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20
Q

Haldol (Haloperidol)

A
  • first generation, typical antipsychotic
  • blocks D2 receptors in the mesocortical, mesolimbic and other pathways
  • high potency, very high risks of extrapyramidal side effects
  • generally only useful in treatment of positive symptoms of schizophrenia.
  • prolonged use may lead to tardive dyskinesia or neuroleptic malignant syndrome
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21
Q

Accolate (Zafirlukast)

A
  • Leukotriene Receptor Antagonist (LTRA)
  • second-line asthma controller
  • given as adjunct with ICS or as second-line monotherapy where ICS not tolerated
  • not useful in severe exacerbations of asthma
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22
Q

Sublimaze (Fentanyl)

A
  • Strong, synthetic opioid, full opioid agonist
  • 100x potency relative to morphine with fewer CV effects, faster onset, and less hangover than morphine
  • powerful analgesic for acute and chronic pain
  • adverse effects include sedation, respiratory depression, constipation, miosis, N/V
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23
Q

Lovenox (Enoxaparin)

A
  • Anticoagulant, fractionated heparin / LMWH
  • promotes antithrombin III (ATIII) activity, inactivating factor Xa
  • Only given parenterally (IV, SC)
  • Does not require ongoing aPTT monitoring
  • Used acutely (PE, DVT, DIC) and mainly prophylactically in surgery or in patients at high risk for clotting disorders
  • Antidote is Protamine if excessive bleeding is present
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24
Q

Bricanyl (Terbutaline)

A
  • Non-catecholamine direct-acting adrenergic
  • selective, short-acting β2 agonis (SABA). May activate β1 reeptors at higher doses.
  • used to promote bronchodilation in COPD and asthma as a rescue medication
  • adverse effects include tachycardia, tremor, and nervousness
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25
**Deltasone** (Prednisone)
* Intermediate acting corticosteroid * Causes broad anti-inflammatory effects * Decreases eicosanoid production * Decreases inflammatory cytokine production * Decreases inflammatory cell produciton and recruitment * Reduces histamine production and release * Used to treat cancer, inflammation, allergy, and autoimmune disorders * Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
26
**Sotacor** (Zaleplon)
* non-BZ sedative-hypnotic * used in management of sleep disorders * increases GABA activity in CNS * less tolerance and dependence forming than the BZ drugs * preserves sleep architecture
27
**Pravachol** (Pravastatin)
* Statin, antihyperlipidemic * HMG-CoA inhibitor, reduces LDL by 20-50% * Shown to reduce mortality due to atherosclerosis * adverse effects include muscle damage, GI issues, memory impairment, and NIDDM * Pravachol has the lowest rate of adverse effects and drug interactions of any statin
28
**Lopressor** (Metoprolol)
* Selective β1-antagonist (beta-blocker) * oral or parenteral * good antihypertensive, antianginal, antiarrhythmic * relatively short half-life (3-4hr)
29
**Aldactone** (Spironolactone)
* Potassium-sparing diuretic, aldosterone receptor antagonist * inhibits binding of aldosterone in the late DCT and collecting duct, which prevents expression of sodium channels. * Used in combination with other diuretics to prevent hyperkalemia, in treatment of primary hyperaldosteronism, and in PCOS as an anti-androgenic * Adverse effects; gynecomastia and infertility in men, hyperkalemia.
30
**Anexate** (Flumazenil)
* Benzodiazepine antagonist, reversal agent * Competitive BZ receptor antagonist * used to reverse BZ overdose and BZ sedation * short half-life (7-15 minutes) with unpredictable effects that may potentiate seizures. Rarely indicated due to low mortality with benzo overdose
31
**Singulair** (Montelukast)
* Leukotriene Receptor Antagonist (LTRA) * second-line asthma controller * given as adjunct with ICS or as second-line monotherapy where ICS not tolerated * not useful in severe exacerbations of asthma
32
**Persantine** (Dipyridamole)
* antiplatelet * relatively weak antiplatelet effect, but also acts as a coronary vasodilator by causing adenosine release * Often combined with aspirin for post-CVA therapy
33
**Protamine** (Protamine sulphate)
* heparin antidote * used to treat uncontrollable bleeding in the context of heparin administration
34
**BLES** (Bovine Lipid Extracted Surfactant)
* Natural surfactant extracted from bovine lungs * First choice treatment for managment of RDS * Reduces pulmonary gas-liquid interface surface tension and work of breathing * Instilled through **endotracheal tube**
35
**Celebrex** (Celecoxib)
* NSAID, selectie COX-2 inhibitor * Reduces PG production associated with inflammation without causing gastric irritation * used in management of pain and inflammation * increased risk of cardiovascular events (MI, CVA)
36
**Oxeze** (Formoterol)
* Long-acting Beta Agonist (LABA), Fast-acting Beta Agonist (FABA) * 12hr duration of action with relatively fast onset * Used always as combination therapy with an ICS for asthma control * causes bronchodilation and potentiates anti-inflammatory effects of ICS * may be used for asthma control or relief
37
**Flovent** (Fluticasone propionate)
* Inhaled Corticosteroid (ICS) * Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control * MDI or Diskus DPI given BID
38
**Xylocaine** (Lidocaine)
* Class 1B antiarrhythmic * Preferentially binds to sodium channels in the inactivated state * Has fast, rate-dependant kinetics. Slows conduction in rapidly depolarizing tissue and limits reentry * Used in the management of **refractory Ventricular arrhythmias**, esp. VTach and VFib * Second-line choice if amiodarone is unsuccessful
39
**Xylocaine** (Lidocaine)
* Amide-type local anaesthetic * sodium channel blocker that produces use-dpendent and size-dependent blockade * may be given with epi to induce vasoconstriction and prolong duration of action * relatively strong local anaesthetic effect
40
**Prozac** (fluoxetine)
* SSRI antidepressent * selectively blocks reuptake of serotonin, increasing serotonin concentration in the synaptic cleft * highly effective with a low rate of adverse effects (e.g. sedation, anticholinergic effects, ortho hypo, dysrhythmia) * most common and first line drug in treatment of depression
41
**Imovane** (Zopiclone)
* non-BZ sedative-hypnotic * used in management of sleep disorders * increases GABA activity in CNS * less tolerance and dependence forming than the BZ drugs * preserves sleep architecture
42
**Xolair** (Omalizumab)
* Anti-IgE antibody * inhibits inflammatory mediator release from mast cells * used to treat asthma that is not controlled by med/high ICS/LABA combination therapy * given SQ every 2-4 weeks for 3-4 months
43
**Spiriva** (Tiotropium)
* Long-Acting Anti-Muscarinic * Used as combination therapy with ICS for "ultra" long-acting control of asthma symptoms * also used in COPD management * most useful where there is parasympathetic/vagal mediated bronchoconstriction and mucus production
44
**Neosynephrine** (Phenylephrine)
* Non-catecholamine direct-acting adrenergic * relatively pure **α1-agonist** * Used to promote **mydriasis** * Used as a nasal **decongestant** * Used in the emergency or surgical setting as a **vasopressor** (prominent push-dose vasopressor)
45
**Prolastin**
* Alpha1 Proteinase Inhibitor * Used in patients with alpha1 antitrypsin deficiency to reduce alveolar damage due to elastin degradation * alpha1 antitrypsin usually inhibits elastase and protease, preventing damage from these endogenous enzymes. * Used in management of alpha1 antitrypsin-associated emphysema
46
**Noctec** (Chloral hydrate)
* Non-BZ sedative hypnotic * given as a prodrug * generally only given as preanesthetic sedation in **pediatric patients**
47
**Normodyne** (Labetalol)
* α and β blocker * used in the treatment of hypertension and for its potent anti-oxidant effects * non-selctive beta effect, so should not be used in persons with asthma
48
**Aspirin** (Acetylsalicylic acid)
* NSAID, antiplatelet * non-competitive cyclooxygenase inhibitor. At low doses selectively inhibits thromboxane A2 production without affecting prostacyclins * prevents platelet aggregation * given prophylactically or acutely for MI and stroke
49
**Diamox** (Acetazolamide)
* Carbonic anhydrase inhibitor, diuretic * Inhibits Carbonic anhydrase at the PCT, which causes increased bicarbonate excretion and a weak diuretic effect * may cause a secondary metabolic acidosis * used in treatment of glaucoma, acute mountain sickness, and epilepsy
50
**Amidate** (Etomidate)
* Parenteral anaesthetic * Acts on GABA receptors to produce anaesthesia/sedation * **Rapid onset and very few cardiovascular side effects**, so ideal for hyperacute situations * used in RSI and conscious sedation * Prolonged use inhibits steroid synthesis
51
**Lipitor** (Atorvastatin)
* Statin, antihyperlipidemic * HMG-CoA inhibitor, reduces LDL by 20-50% * Shown to reduce mortality due to atherosclerosis * adverse effects include muscle damage, GI issues, memory impairment, and NIDDM * Lipitor has a long half life and can be taken at any time of day
52
**Dobutrex** (Dobutamine)
* Direct-acting adrenergic agonist, exogenous catecholamine * Has only β affinity, so produces positive cardiac effects and vasodilation * Positive **inotrope** and **dromotrope** without significant **chronotropic** effects! Increases SBP and stroke volume without increasing HR while dropping SVR * preferred drug for treating cradiogenic shock or heart failure
53
**Symbicort** (Budesonide+ Formoterol)
* Combination ICS and LABA * used to control asthma that is not adequately controlled with low-dose ICS alone * ICS and LABA potentiate each others' effects, improving both anti-inflammatory and bronchodilatory actions * May be used as a reliever for brief exacerbations of asthma
54
describe the function of Zyban (bupropion) in smoking cessation therapy
* antidepressant (atypical, norep and dopamine reuptake inhibitor) * increases dopamine concentration when ceasing smoking * more effective when combined with NRT
55
**Elavil** (amitryptiline)
* tricycylic antidepressent (TCA) * inhibits reuptake of serotonin and norepinephrine, increasing synaptic concentration * highly effective in treatment of depression, but with many adverse effects * onset of 2-4 weeks * adverse effects include; sedation, anticholinergic effects, orthostatic hypotension, and cardiac dysrhythmia. OD may cause wide-QRS tachy. Prolonged use may lead to serotonin syndrome
56
**Cinquair** (Rexlizumab)
* Anti-IL-5 agent * Inactivates interleukin-5 (IL-5) which is involved in recruitment, activation, differentiation, and growth of eosinophils. Cinquair reduces number of activated eosinophils in blood and sputum * used in management of refractory asthma, reduces inflammation and airway remodelling
57
**Dilaudid** (Hydromorphone)
* Strong, semi-synthetic opioid, full opioid agonist * 10x potency relative to morphine with fewer CNS, GI, and CV effects than morphine * powerful analgesic for acute and chronic pain * adverse effects include sedation, respiratory depression, constipation, miosis, N/V
58
**Ventolin** (Salbutamol)
* Non-catecholamine direct-acting adrenergic * selective, short-acting β2 agonis (**SABA**). May activate β1 reeptors at higher doses. * used to promote bronchodilation in COPD and asthma as a **rescue medication** * adverse effects include tachycardia, tremor, and nervousness
59
**Coumadin** (Warfarin)
* anticoagulant * Inhibits production of clotting factors II, VII, IX, and X, thereby inhibiting both intrinsic and extrinsic pathways, but especially extrinsic * Delayed onset of action (3-5 days), initially given with LMWH * effectiveness is assessed by INR (should be 2-3 for warfarin. 1.1 or less is normal) * Used in long term **PO** prophylactic treatment for DVT, with artificial heart valves, and AFib
60
**Cymbalta** (duloxetine)
* SNRI antidepressant * Inhibits reuptake of Serotonin and Norep with few other NT interactions * Used in treatment of affective and anxiety disorders * Fewer adverse effects than TCAs
61
**Provocholine** (Methacoline)
* Direct-acting cholinergic with greater M3 muscarinic specificity * Broad systemic effects, but mainly respiratory (SLUDGE), decreased heart rate, increased PR-interval, increased gastric secretions and GI motility * Used in the **methacholine challenge test (MCT)** for asthma. Small doses of methacholine may induce bronchospasm and excessive mucus production in those with reactive airways
62
Versed (Midazolam)
* Benzodiazepine, sedative-hypnotic * Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization * **Fast onset with short duration of action, generally only given IV (or IM)** * Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia * **used in acute settings for induction of anaesthesia, termination of seizures, and delirium**
63
**Aspirin** (ASA)
* NSAID, non-specific COX inhibitor * causes irreversible inhibition of platelet COX enzymes. Reduces PG and TXA2 production in a dose-dependent fashion * used for anti-inflammation, anti-inflammatory, analgesic, and anti-platelet effects * Has an anti-platlet effect which is longer-acting than analgesia * Increased risk of GI bleeding, ulcers, can cause tinnitus, respiratory alkalosis, and asthma * may potentiate Reye's syndrome in children with viral infection
64
**Serevent** (Salmeterol)
* Long-acting Beta Agonist (LABA) * 12hr duration of action with relatively slow onset * Used **always** as combination therapy with an ICS for asthma control * causes bronchodilation and potentiates anti-inflammatory effects of ICS * never to be used as monotherapy or as a rescue inhaler
65
**Coreg** (Carvedilol)
* α and β blocker * used in the treatment of hypertension and for its potent anti-oxidant effects * non-selctive beta effect, so should **not** be used in persons with asthma
66
**Nucala** (Mepolizumab)
* Anti-IL-5 agent * Inactivates interleukin-5 (IL-5) which is involved in recruitment, activation, differentiation, and growth of eosinophils. Nucala reduces number of activated eosinophils in blood and sputum * used in management of refractory asthma, reduces inflammation and airway remodelling
67
**Cordarone** (Amiodarone)
* Class 3 antiarrhythmic, potassium channel blocker, thyroxine analog * also blocks sodium and potassium channels and beta-adrenoceptors * Decreases SA automaticity, prolongs AV nodal and ventricular refractory periods. Increases PR and QT intervals and may widen QRS. * Orally given to suppress both supraventricular and ventricular dysrhytmias * Given IV to terminate VT and VF * Many adverse effects; bradycardia, torsades de pointes, thyrotoxicity, photosensitivity, pulmonary fibrosis
68
**Mannitol**
* osmotic diuretic * increases filtrate osmolarity, drawing additional fluid into urine and causing diuresis * Used in treatment of cerebral edema, increased intraocular pressure (glaucoma), and to icrease urine volume
69
**Sufenta** (Sufentanil)
* Strong, synthetic opioid, full opioid agonist * 1000x potency relative to morphine with fewer CV effects, faster onset, and less hangover than morphine * powerful analgesic for acute and chronic pain * adverse effects include sedation, respiratory depression, constipation, miosis, N/V
70
**Robinul** (Glycopyrrolate)
* Quaternary amine muscarinic receptor antagonist * not absorbed by CNS * used in the setting of surgery to dry secretions and inhibit muscarinic effects of neuromuscular blocking agents (rocuronium, succinylcholine)
71
**Adenocard** (Adenosine)
* Antiarrhythmic, endogenous nucleoside, non-Vaughan-Williams class * Binds to A1 receptors to cause **AV Nodal Blockade** (may cause complete heart block and brief asystole). Causes increased **potassium efflux** and **membrane hyperpolarization**. * Used to terminate **PSVT**, including in WPW * Extremely short T1/2 (~10s) * May cause bronchoconstriction and reduces epinephrine sensitivity
72
**Valium** (Diazepam)
* Benzodiazepine, sedative-hypnotic * Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization * **Fast onset with long duration of action** * Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia
73
**Tylenol** (Acetaminophen)
* Not strictly an NSAID; non-opioid analgesic/antipyretic * MOA not udnerstood, but may involve COX-3. Does not affect COX-1 or COX-2 * reduces pain and fever associated with inflammation * No associated GI effects or Reye's syndrome * causes hepatic toxicity in overdose that rapidly escalates with higher doses as toxic metabolites accumulate
74
**TXA** (Tranexamic Acid)
* procoagulant, antiplasmin * inhibits activation of plasmin from plasminogen * used in management of heavy menstrual bleeding, hemophilia, and **traumatic hemorrhage**
75
**Cortef / Solu-Cortef** (Hydrocortisone)
* Short-acting corticosteroid * Causes broad anti-inflammatory effects * Decreases eicosanoid production * Decreases inflammatory cytokine production * Decreases inflammatory cell produciton and recruitment * Reduces histamine production and release * Short-acting CS mainly used in CS-replacement therapy (addison's) or as topical anti-inflammatory * Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
76
**Benadryl** (Diphenhydramine)
* First-generation antihistamine, H1 receptor antagonist * Blocks H1 receptors systemically, including the CNS * Used to manage symptoms of allergy, but may cause unwanted sedation/hypnosis
77
**Activase** (Alteplase-Recombinant)
* fibrinolytic, thrombolytic, recombinant tPA * causes plasmin activation from plasminogen, with moderate-to-high specificity for fibrin-bound plasminogen * only thrombolytic recommended for acute PE * also used in stroke and MI management (tenecteplase preferred for STEMI)
78
**Isuprel** (Isoproterenol)
* Direct-acting adrenergic agonist, exogenous catecholamine * Has **only β affinity**, so produces positive cardiac effects and vasodilation (as well as bronchodilation) * Strong positive chronotrope! Causes increased HR and SBP, with decreased SVR and diastolic BP * Risk of tachyarrhythmias, useful in treatment of heart blocks and bradycardia
79
**Clozaril** (Clozapine)
* second generation, atypical antipsychotic * blocks 5-HT and D2 receptors in the mesocortical, mesolimbic and other pathways * high potency, low risk of EPSs, but many other systemic side effects stemming from alpha blockade and anticholinergic effects * useful in treating both positive and negative symptoms of schizophrenia * prolonged use may lead to tardive dyskinesia or neuroleptic malignant syndrome
80
**Zemuron** (Rocuronium)
* non-depolarizing neuromuscular blocking agent (ND NMBA) * competitive inhibitor of muscle-type nicotinic ACh receptors * induction of paralysis during medical procedures (ex: intubation) * **intermediate acting** consider pancuronium for longer duration of action
81
**Tracium** (Atracurium)
* non-depolarizing neuromuscular blocking agent (ND NMBA) * competitive inhibitor of muscle-type nicotinic ACh receptors * induction of paralysis during medical procedures (ex: intubation) * intermediate acting, may have increased histamine release but lower hepatotoxicity vs. rocuronium
82
**Zantac** (Ranitidine)
* H2-receptor antagonist * reduces gastric acid secretion to reduce dyspepsia/gastroenteritis in GERD
83
**Advair** (Fluticasone + Salmeterol)
* Combination ICS and LABA * used to control asthma that is not adequately controlled with low-dose ICS alone * ICS and LABA potentiate each others' effects, improving both anti-inflammatory and bronchodilatory actions * Should **NOT** be used as a reliever
84
**Inderal** (Propranolol)
* Non-selective β-antagonist (beta-blocker) * Primarily given orally but may be given parenterally * One of the first developed and thus has the ridest range of approved clinical uses * hypertenion, angina, cardiac dysrhythmias, migraine, AMI, pheochromocytoma * Has more CNS side effects than other non-selective beta-blockers
85
**Adrenalin** (Epinehrine)
* Direct-acting adrenergic agonist, endogenous catecholamine * Has equal α and β affinity, so both cardiac and vascular effects * effects are highly **dose dependent!** at lower doses there is greater β activation, so there is MSK vasodilation and positive cardiac effects leading to increased systolic, decreased diastolic. At higher doses there is increased α1 effect and diastolic may increase as well. * used in treatment of shock and hypotension
86
**Prostigmin** (Neostigmine)
* Reversible cholinesterase inhibitor (indirect-acting cholinergics) * Relatively long-acting (compared to edrophonium) * Used in long-term treatment of myasthenia gravis
87
**Tenormin** (Atenolol)
* Selective β1-antagonist (beta-blocker) * oral or parenteral * good antihypertensive, antianginal, antiarrhythmic * Low rate of CNS side effects due to poor lipid solubility
88
**Lasix** (Furosemide)
* Loop diuretic * Inhibits the Na/K/2Cl cotransporter in thick ascending limb of loop of henle * **high-ceiling** dose-dependent diuretic * Preffered first line diuretic for edematous states * Adverse effects: hypokalemia, hypomagnesemia, hypocalcemia, hyperglycemia, hyperuricemia, **ototoxicity**
89
**Tensilon** (Edrophonium)
* Short-acting reversible cholinesterase inhibitor (indirect-acting cholinnergic) * rapidly increases ACh concentrations * may be used to reverse neuromuscular blockade * used to diagnose between myasthenic crisis (not enough ACh) and a cholinergic crisis (too much ACh) in myasthenia gravis
90
**Motrin/Advil** (Ibuprofen)
* NSAID, non-selective COX inhibitor * competitively inhibits COX enzymes, reducing PG and TXA2 synthesis in inflammation * used to reduce pain, inflammation * May cause GI, hepatic, and renal side effects due to COX-1 inhibition * does not produce the anti-platelet effects of ASA
91
**Zenhale** (Mometasone + Formoterol)
* Combination ICS and LABA * used to control asthma that is not adequately controlled with low-dose ICS alone * ICS and LABA potentiate each others' effects, improving both anti-inflammatory and bronchodilatory actions * May be used as both controller and reliever
92
**Pradaxa** (dabigatran)
* Anticoagulant, direct thrombin inhibitor * Competitively inhibits thrombin protease site, which inhibits fibrin formation * no INR monitoring is required * is increasingly replacing warfarin for chronic management of DVT, AFib due to lower risk of adverse events, no need for monitoring, and fewer food interactions * **not for patients with valve replacement!**
93
**Inotropin** (Dopamine)
* Direct-acting adrenergic agonist, endogenous catecholamine * Effect is **highly dose-dependent**. At **low** doses it is D1 selective and promotes renal perfusion (uncommon). At **medium** doses it stimulates β1 receptors (incr. inotropy and decr. SVR). At **high** doses it stimulates α1 receptors, causing vasoconstriction * used in treatment of shock and hypotension
94
Describe the function of Champix (verenicline) in smoking cessation therapy
* partial nictone receptor agonist * acts as a competitive antagonist in presence of nicotine while maintaining baseline dopamine release
95
**Ketamar** (Ketamine)
* Non-opioid parenteral anaesthetic, sedative, dissociative * Blocks excitatory NTs at NMDA receptors. Produces **dissociative anaesthesia** * Anaesthesia characterized by analgesia, reduced sensory perception, incomplete loss of consciousness, immobility, and amnesia * Causes increased BP and no respiratory depression (great for trauma) * produces unpleasent emergence including hallucinations and delirium; **less common in pediatric patients!**
96
Morphine
* Strong, natural opioid, full opioid agonist * considered the prototype opioid * powerful analgesic for acute and chronic pain * adverse effects include sedation, respiratory depression, constipation, miosis, N/V * hydromorphone preferred for chronic pain management due to fewer adverse effects
97
**Anectine** (Succinylcholine)
* depolarizing neuromuscular blocking agent (D NMBA) * non-competitive agonist of muscle-type nicotinic ACh receptors causes protracted depolariztion * induction of paralysis during medical procedures (ex: intubation) * **short onset and short-acting**
98
**Demerol** (Meperidine)
* Strong synthetic full opioid analgesic * 0.1X potency relative to Morphine * Less smooth muscle effects less pronounced than with other opioids. Fewer GI, biliary, and uterine side effects * Safer for pregnant patients, or those with cholecystitis
99
**Buscopan** (Scopolamine)
* muscarinic receptor antagonist (belladonna alkaloid, tertiary amine) * toxixicity is dose dependent, remember; dry as a bone, red as beet, mad as a hatter, blind as a bat * causes dilatation, positive chronotropy, decreased secretions, decreased GI motility, bronchodilation, etc. * **greater CNS effect than atropine** therefore used to treat motion sickness
100
**Precidex** (Dexmetetomidine)
* alpha-2 agonist * used in treatment of hypertension and for sedation in anaesthetized/intubated patients in an ICU setting * used due to lack of respiratory depression
101
**Brevibloc** (Esmolol)
* Selective β1-antagonist (beta-blocker) * IV-only! * good antihypertensive, antianginal, antiarrhythmic * very short half-life compared to other beta-blockers, used in emergent settings (check out that trade name!)
102
**Dolophine** (Methadone)
* Long-acting synthetic full opioid agonist * Does not tend to produce euphoria or other reinforcing effects * Used in management of chronic pain and in opioid addiction treatment

HLTH 2511 (11 decks)

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