PLE: PHARMA PEARLS Flashcards
Master Pharma with the help of Topnotch Medical Board Prep PEARLS (170 cards)
1
Q
CYTOCHROME P450 INDUCERS MNEMONIC
A
Ethel Booba takes Phen-Phen and Refuses Greasy Carb Shakes
2
Q
Cytochrome P450 Inducers
A
Ethanol (chronic ingestion) Barbiturates exceot SECOBARBITAL Phenytoin Rifampicin Griseofulvin Carbamazepine St. John's Wort/Smoking *Glutethimide, Phenylbutazone, chronic/repeated use of Ritonavir
3
Q
CYTOCHROME P450 INHIBITORS MNEMONICS
A
Inhibitors Stop Cyberkids From Eating Grapefruit QV
4
Q
CYTOCHROME P450 INHIBITORS
A
Isoniazid Sulfonamides Cimetidine Ketoconazole Erythromycin Grapefruit Juice Ritonavir (acute ingestion) Amiodarone Quinidine Valproic Acid
5
Q
OTHER CYP450 INHIBITORS (12)
A
Allopurinol, Chloramphenicol, Chlorpromazine, Dicumarol, Disulfiram, Ethanol (acute toxicty), Itraconazole, Nortriptyline, OCP, Phenylbutazone, Saquinavir, Secobarbital, Spironolactone, Troleandromycin
6
Q
Drugs with NARROW THERAPEUTIC INDEX mnemonics
A
WALA na Cyang Papa! VasTeD na!
7
Q
Drugs with NARROW THERAPEUTIC INDEX (10)
A
Warfarin Aminoglycosides Lithium Amphotericin B Carbamzepine Phenobarbital Phenytoin Vancomycin Theophylline Digoxin
8
Q
Drugs that display ZERO ORDER KINETICS mnemonics
A
WHAT PET
9
Q
Drugs that display ZERO ORDER KINETICS (7)
A
Warfarin Heparin Aspirin Tolbutamide Phenytoin Ethanol Theophylline
10
Q
Drugs that display TACHYPHYLAXIS mnemonics
A
MEDical students Love to watch CNN in HD!
11
Q
Drugs that display TACHYPHYLAXIS (9)
A
Metoclopramide Ephedrine Dobutamin LSD Calcitonin Nitroglycerin Nicotine Hydralazine Desmopressin
12
Q
PHASE 1 of drug study
A
Is the drug safe?
Dose-response relationship, normal human volunteers, acute effects
13
Q
PHASE 2 of drug study
A
Is the drug effective for the sick patient?
Placebo, usually in the hospital, sick patients
14
Q
PHASE 3 of drug study
A
Randomized, double-blind, controlled trials
Special population, very expensive
15
Q
PHASE 4 of drug study
A
Post-marketing surveillance
Infrequent toxicities
16
Q
Pregnancy Category A
A
Safe in controlled studies of women
Fetal harm is remote
17
Q
Pregnancy Category B
A
No controlled studies in women
No risk in animal reproduction studies
OR
Not confirmed in controlled studies in women
No AE in animal reproduction studies
18
Q
Pregnancy Category C
A
No controlled studies in women
With AE in both animal studies
OR
Give only if benefit > risk
19
Q
Pregnancy Category D
A
(+) AE but Benefits > Risk
20
Q
Pregnancy Category X
A
(+) AE, Contraindicated
21
Q
Alpha 1 location and action
A
Alpha 1 in smooth muscles for vasconstriction
22
Q
Alpha 2 location and action
A
Alpha 2 in nerve terminals for inhibition of NT release
23
Q
Alpha 1 preferred substrate
A
Epinephrine
24
Q
Alpha 2 preferred substrate
A
Epinephrine
25
Beta 1 location and action
Beta 1 in heart to increase rate and contractility
26
Beta 1 preferred substrate
Isoproterenol > Epinephrine > Norepinephrine
27
Beta 2 location and action
Beta 2 in respiratory smooth muscles and uterus for bronchodilation and uterine relaxation
28
Dopamine 1 location and action
Dopamine 2 in splanchnic and renal vessels for vasodilation of renal blood vessels
29
Dopamine 2 location and action
Dopamine 2 in nerve terminals of CNS for regulation of NT
30
Muscarinic 1 location and action
Muscarinic 1 in CNS for stimulation
31
Muscarinic 1 preferred substrate
Acetylcholine
32
Muscarinic 2 location and action
Muscarinic 2 in heart for decreasing heart rate
33
Muscarinic 2 preferred substrate
Acetylcholine
34
Muscarinic 3 location and action
Muscarinic 3 in smooth muscle, GIT, GUT, pulmonary, and eyes for peristalsis, bladder contraction, bronchoconstriction, and pupil constriction
35
Muscarinic 3 preferred substrate
Isoproterenol > Epinephrine > Norepinephrine
36
Ach cholinergic inhibitor of its SYNTHESIS
Hemicholinium
37
Ach adrenergic inhibitor of its SYNTHESIS
Metyrosine
38
Ach cholinergic inhibitor of its STORAGE
Vesamicol
39
Ach adrenergic inhibitor of its STORAGE
Reserpine
40
Cholinergic inhibitor of Ach RELEASE
Botulinum
41
Adrenergic inhibitor of Ach RELEASE
Guanethidine
42
Cholinergic inhibitor of ACh metabolism
Neostigmine
43
Adrenergic inhibitor of Ach metabolism
MAOIs, COMTs
44
Cholinergic inhibitor of Ach REUPTAKE
NONE
45
Adrenergic inhibitor of Ach REUPTAKE
Cocaine, TCAs
46
How does EDROPHONIUM differentiate MYASTHENIC crisis from CHOLINERGIC crisis?
Edrophonium IMPROVES muscle strength in MYASTHENIC crisis and WEAKENS muscle strength in CHOLINERGIC crisis.
47
Spinal roots of origin of SNS
T1-T12 and L1-L5
48
Location of ganglia of SNS
Paravertebral chains that lie along the spinal columnm some along the anterior aspect of the abdominal aorta
49
Distance of preganglionic fibers of SNS
Short
50
Distance of postganglionic fibers of PNS
Long
51
Spinal roots of origin of PNS
CN III, VII, IX, X
| Sacral segments of spinal cord
52
Location of ganglia of PNS
Most are in organs innervated more distant from the spinal cord
53
Distance of preganglionic fibers of PNS
Long
54
Distance of postganglionic fibers of PNS
Short
55
Direct acting muscarinic 3 receptor for bladder and bowel atony
Betanechol
56
M3 cholinomimetic for glaucoma and Sjogren and Sicca syndrome
Pilocarpine
| Selective M3: Cevimeline
57
Indirect acting cholinomimetic for diagnosis of Myasthenia Gravis
Edrophonium (Tensilon Test)
58
ACE inhibitors teratogenic effect
fetal renal damage
59
Antiepileptic drugs teratogenic effect
neural tube defect
60
Phenytoin teratogenic effect
fetal hydantoin syndrome
61
Barbiturates teratogenic effect
neonatal dependence
62
Diethylstilbestrol (DES) teratogenic effect
Vaginal clear cell adenoCA
63
Ethanol teratogenic effect
fetal alcohol syndrome
64
LIthium teratogenic effect
Ebstein's anomaly
(septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle of the heart)
65
Isoretinoin teratogenic effect
craniofacial malformations
66
Iodide teratogenic effect
congenital hypothyroidism
67
Misoprostol teratogenic effect
Mobius sequence
| Palsy of CNs, usually VI and VII
68
Penicillamine teratogenic effect
cutis laxa
(chalazoderma, dermatochalasia, dermatolysis, dermatomegaly, generalized elastolysis, generalized elastorrhexis, or pachydermatocele)
the skin becomes inelastic and hangs loosely in folds
69
Thalidomide teratogenic effect
phocomelia
70
Smoking teratogenic effect
IUGR
71
Tetracycline teratogenic effect
tooth discoloration
72
Streptomycin teratogenic effect
ototoxicity
73
Methimazole teratogenic effect
aplasia cutis congenita
74
Sulfonamide teratogenic effect
kernicterus
75
Fluoroquinolone teratogenic effect
cartilage damage
76
Warfarin teratogenic effect 1st trimester
chondrodysplasia
77
Warfarin teratogenic effect 2nd trimester
CNS malformation
78
Warfarin teratogenic effect 3rd trimester
bleeding diatheses
79
SNS effect on pupils (general)
mydriasis (alpha 1)
| miosis (M3)
80
SNS on iris
Contraction of dilator pupillae muscles (radial muscles)
| mydriasis(α1)
81
PNS on iris
Contraction of sphincter pupillae muscles (circular muscles)
| miosis (M3)
82
SNS on ciliary muscle
Relaxation for distant vision (β2)
83
PNS on ciliary muscle
Contraction (M) for accommodation of lens (near vision) and increase aqueous humor outflow into canal of Schlemm
84
SNS on ciliary body epithelium
Increased aqueous humor production (β1)
85
PNS on ciliary body epithelium
None
86
SNS on heart contractility
Increased via B1
87
PNS on heart contractility
Decreased via M2
88
SNS on skin and splanchnic blood vessels
Constriction via A1
89
PNS on skin and splanchnic blood vessels
NO EFFECT
90
SNS on skeletal blood vessels
Dilation via B2 and M3
91
PNS on skeletal blood vessels
NO EFFECT
92
SNS on bronchi
Dilation via B2
93
PNS on bronchi
Constriction via M3
94
SNS on GIT walls
Relaxation via A2 and B2
95
PNS on GIT walls
Contraction via M3
96
SNS on GIT secretion
NO EFFECT
97
PNS on GIT secretion
Increased via M1 and M3
98
SNS on bladder wall
Relaxation via B2
99
PNS on bladder wall
Contraction via M3
100
SNS on uterus
Contraction via A1
| Relaxation via B2
101
PNS on uterus
Contraction via M3
102
SNS on penis
Ejaculation via alpha
103
PNS on penis
Erection via muscarinic
104
SNS on sweat glands
Increased sweating via alpha
105
PNS on sweat glands
NO EFFECT
106
SNS on liver
Gluconeogenesis, glycogenolysis (Alpha, B2)
107
PNS on liver
NO EFFECT
108
SNS on fat cells
Lipolysis (B3)
109
PNS on fat cells
NO EFFECT
110
SNS on kidney
Increased renin secretion via B1
111
PNS on kidney
NO EFFECT
112
Effect of Gq protein stimulation on M1, M3, and M5 receptors
↑ IP 3 , DAG cascade
113
Effect of Gi protein stimulation on M2 and M4receptors
↓ cAMP synthesis
114
Effect of stimulation of Nn/Ng (ganglion) and Nm (neuromuscular) receptors
Na + /K + depolarizing current
115
ORGANOPHOSPHATE POISONING
DUMBBELSS
116
DUMBBELSS
ORGANOPHOSPHATE poisoning
Diarrhea, urination, miosis, bronchoconstriction, bradycardia, excitation of SkM & CNS, lacrimation, salivation, sweating
117
ATROPINE TOXICITY
```
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
```
118
Inhibits synthesis of catecholamines via inhibiting hydroxylation of tyrosine to dopamine
Metyrosine
119
Inhibits synthesis of acetylcholine by blocking choline transport
Hemicholinium
120
Inhibits storage of Ach into vesicles via VAT
Vesamicol
121
Alters synaptobrevin to prevent release of Ach
Botulinum toxin
122
Inhibits acetylcholinesterase
Carbamates and organophosphates (indirect acting cholinomimetics)
123
Increase stores of NE and dopamine by blocking its metabolism
MAOIs
124
Inhibits release of catecholamines via VAMPs and SNAPs
Guanethidine
125
Promotes increased release of catecholamines
Ampheramines and tyramines
126
Inhibits diffusion and reuptake of catecholamines via NET and DAT
cocaine, tricyclic antidepressants
127
Inhibits reuptake of acetylcholine
NONE
128
Low dose dopamine (1-5 mcg/kg/min) acts on
D1 receptors (to increase RBF and UO)
129
Medium dose dopamine (5-15 mcg/kg/min) acts on
B1 receptors
130
High dose dopamine (>15 mcg/kg/min) acts on
alpha receptors (increase CO and BP)
131
Non-selective beta agonist that can be used for asthma or AV block
isoprotenerol
132
Antidote for alpha 1 agonist overdose
phentolamine
133
Phenylephrine, pseudoepehdrine, oxymetazoline all act on what receptor to produce nasal decongestion
Alpha 1
134
Side effectof phenylephrine, pseudopehedrine, oxymetazoline
Rebound nasal congestion (rhinitis medicamentosa)
135
MOA of clonidine
When given orally, they accumulate in the CNS to decrease central sympathetic outflow
136
Pregnancy category of methyldopa
B
137
Alpha 2 agonist that decreases CNS sympathetic outflow for pre-eclampsia and gestational HPN
methyldopa
138
Alpha 2 agonist used for reducing conscious sedation
dexmedetomidine
139
Alpha 2 agonist used as muscle relaxant
tinazinidine
140
Side effect of methyldopa
(+) Coomb's test - hemolytic anemia
141
Alpha 2 agonist used in glaucoma to decrease secretion of aqueous humor
apraclonidine, brimonidine
142
Side effect of dobutamine
tachyphylaxis
143
General clinical use of alpha 1 agonist
Hemostasis (epinephrine locally)
Decongestion
Spinal shock
144
General clinical use of alpha 2 agonist
Hypertension
| Glaucoma
145
General clinical use of beta 1 and dopa 1 agonsit
Acute heart failure
| Septic shock
146
General clincal use of beta 2 agonist
Bronchospasm
| Premarture labor
147
Has a direct adrenergic receptor agonist aside from causing release of NE;
Nasal vasoconstrictor and appetite stimulant
phenylpropanolamine
148
Adverse effect of phenylpropanolamine
hemorrhagic stroke
149
Longest acting Beta blocker
Nadolol
150
non-selective beta blocker that can cause reduction in size of infantile hemangioma
propanolol
151
beta blockers for heart failure
labetolol, carvedilol, metoprolol
152
Irreversible non-selective alpha blocker used for pre-op of pheochromocytoma
phenoxybenzamine
153
Reversible non-selective short acting alpha antagonist for rebound hypertension
phentolamine (tolazoline)
154
Disadvantage of using betablockers in the eye
Local anesthetic activity (membrane stabilizing activity)
| Decreased protective reflexes
155
Beta blockers with partial agonist activity
(with intrinsic sympathomimetic activity)
beneficial for asthma bec less bronchospasm
```
Acebutolol
Pindolol
Carteolol, Celiprolol
Bopindolol
Penbutolol
```
156
Beta 1 blocker used parenterally for SVT
esmolol
157
Teratogenic effect of atenolol
Low BW and impaired fetal growth
158
Beta blocker for decreasing secretion of aqueous humor
timolol
159
Osmotic agent for decreasing aqueous humor
mannitol
160
Alpha 2 agonist for decreasing aqueous humor
apraclonidine
161
Carbonic anhydrase inhibitor for decreasing aqueous humor
acetazolamide
| dorzolamide
162
Cholinomimetics for ciliary muscle contraction causing opening of trabecular meshwork, and increased aqueous humor outflow
pilocarpine
| physostigmine
163
Prostaglandin that increases outflow through canal of Schlemm
latanoprost
164
Non-selective alpha agonist that increases outflow via uveoscleral veins
epinephrine
165
Beta blockers with combined alpha and beta blocking actions
Do not cause epinephrine reversal
Labetalol
Carvedilol
166
Chronic use of beta blockers contributes which mechanism for anti hypertension?
Chronic use of beta blockers can cause decreasenin vascular resistance from reduced renin release from kidney
167
A newer beta blocker that has some direct vasodilator action caused by NO release
Nebivolol
168
Anti hypertensive (sympathoplegic directly acting on CNS) that is associated with positive Coombs test
Methyldopa
169
Calcium channel blocker associated with lupus like syndrome
Hydralazine
170
Common electrolyte imbalance caused by aliskiren and other RAAS blockers
Hyperkalemia
