random pharm Flashcards by Elizabeth Mazza

what drug can be used to reverse serotonin syndrome?

Cyproheptadine

- antagonizes 5-HT2 receptor

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what drug can be used to reverse neuroleptic malignant syndrome (NMS)?

Dantrolene

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what drugs cause NMS?

Haloperidol

- Fluphenazine

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what drug can be used to reverse anticholinergic toxicity?

Physostigmine

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Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
Ziprasidone

SGA’s (atypical antipsychotics)

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Haloperidol
Trifluoperazine
Fluphenazine
Chlorpromazine
Thioridazine

FGA’s

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Gq -> IP3, DAG
• Arteriole constriction
• Mydriasis
• Reduced renin release
• Glycogenolysis
• Urinary retention (stimulates internal urethral sphincter)

alpha-1 agonists

- phenylephrine

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Gs -> increased cAMP
• Increases SA/AV conduction (inotropy)
• Increases renin release
• Increases aqueous humor

beta-1 agonists

- dobutamine

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Gs -> increased cAMP
• Vasodilation
• Bronchodilation
• Uterine relaxation
• Gluconeogenesis
• Lipolysis

beta-2 agonists

- albuterol

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Prazosin (treats hypertension and BPH)
Doxazosin
Terazosin
Tamsulosin (BPH)

alpha-1 blockers

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abx that causes hypersensitivity reactions, including Stevens-Johnson syndrome

sulfamethoxazole/trimethoprim (SMX/TMP)

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sulfamethoxazole MOA?

inhibits dihydropteroate synthase

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trimethoprim MOA?

inhibits bacterial dihydrofolate reductase

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atypical antipsychotic, is typically used to treat refractory schizophrenia
- notable side effect of this medication is decreased white blood cell count, known as agranulocytosis

clozapine

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MAOI used to treat severe and refractory depression

- most notable side effect is malignant hypertension secondary to the use of eating tyramine-rich foods

phenelzine

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short-acting benzodiazepine, is used to treat anxiety disorders
- often prescribed short-term for panic attacks

alprazolam

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what are the most common side effects of SSRI’s?

sexual

- anorgasmia, prolonged time to orgasm, nighttime tumescence

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topo II inhibitor used to treat ovarian, breast, and lung cancer

side effects:

dilated cardiomyopathy
skin reactions
nausea/vomiting
bone marrow suppression

doxorubicin

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G2-specific antineoplastic that causes formation of iron free radicals

side effects:
• Pulmonary fibrosis
• Alopecia
• Skin rash

bleomycin

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anticancer drug that binds to N7 of guanine to alkylate DNA

side effects:
• Nephrotoxicity (manage with amifostine)
• Nausea and vomiting (manage with ondansetron)
• Ototoxicity
• Peripheral neuropathy

cisplatin

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M-phase antineoplastic that inhibits microtubule depolymerization (stops disassembly)

side effects:
• Peripheral neuropathy
• Bone marrow suppression
• Hypersensitivity 
• Diarrhea

paclitaxel

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diuretic class that block Na/Cl transporter in DCT, increasing Ca reabsorption in the distal tubule

thiazides

- less Na inside cells actives the Na/Ca antiporter on the basolat membrane

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potassium-sparing diuretics that are competitive antagonists that either compete with aldosterone or intracellular cytoplasmic receptor sites at the collecting duct

spironolactone

- generally used in combination with loop diuretics to keep K+ levels WNL

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diuretic that inhibits reabsorption of water and Na, acting at the portions of the nephron that are water-permeable (PCT, thin descending loop, collecting duct)

osmotic duiretics (mannitol, acetazolamide)

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diuretic class that inhibit the Na-K-2Cl symporter in the thick ascending limb

loop diuretics | - cause an increase in K+, Mg and Ca excretion (bad for stones)

potentiates the effect of antithrombin III, thereby inhibiting thrombin and factor Xa - also inhibits *aldosterone* in the collecting duct

heparin

which diuretics cause hyperkalemia?

- aldosterone inhibitors (spironolactone) | - ENaC channel blockers in the late distal tubule/collecting duct (amiloride, triamterene)

first line tx for pyelonephritis?

SMX-TMP | - fluoroquinolones if sulfa allergy

MOA of fluoroquinolones?

inhibit bacterial DNA topoisomerase II and IV

old tetracycline abx - pt presents w/ polyuria and polydipsia with bouts of dehydration - proteinuria, hypokalemia, hypophosphatemia, and hyperchloremic metabolic acidosis

Fanconi syndrome - when stored for long periods of time in a moist environment, tetracycline degrades and forms the toxic degradation product, anhydro-4-epitetracycline

preferred diuretic for pt w/ fluid overload?

loop diuretics - in comparison with thiazide diuretics, loop diuretics allow for a greater loss of urine and relatively less loss of sodium making them very effective in persons who have volume overload

loop diuretics for fluid overload, thiazides for HTN

- loop diuretics keep more fluid in the tubular lumen (lose Ca, bad for stones) - thiazides excrete more sodium (reabsorb Ca, good for stones)

where does spironolactone exert its effects?

collecting tubule, NOT duct

anticonvulsant that inhibits sodium channels in neuronal axons - side effects: hirsutism, megaloblastic anemia, confusion, ataxia, nystagmus, osteomalacia, and gingival hyperplasia

phenytoin

anticonvulsant that blocks both sodium and calcium channels | - may cause Stevens-Johnson syndrome, disseminated intravascular coagulation, angioedema, and aplastic anemia

lamotrigine

decrease carbohydrate polymerization of the mycobacterium cell wall by blocking arabinosyltransferase

ethambutol

TB med that inhibits DNA-dependent RNA polymerase

rifampin

TB drug that binds to intracellular proteins in the hepatocytes, leading to actin disruption and mitochondrial disruption

isoniazid | - give pyridoxine!! (B6)

what GABA activator is used to treat MS muscle spasms?

baclophen - results in hyperpolarization by 3 distinct actions: 1. Closure of presynaptic calcium channels 2. Increased postsynaptic K+ conductance 3. Inhibition of dendritic calcium influx channels

tx for absence seizures that inhibits the T-type calcium channels in thalamocortical neurons

ethosuximide

acetylcholinesterase inhibitor used particularly for Alzheimer’s disease, which is associated with loss of cholinergic neurons

donepezil

short-acting acetylcholinesterase inhibitor used to *diagnose* myasthenia gravis

edrophonium

med used for acute gout attacks?

colchicine - inhibits polymerization of β-tubulin into microtubules, to prevent the activation, degranulation, and migration of neutrophils (affects cytoskeleton)

anti-rheumatoid drug that causes retinal deposits

hydroxychloroquine

bisphosphonate that inhibits bone resorption (osteoclast activity) and has been found to increase bone density in women with post-menopausal osteoporosis

alendronate - must be taken with water to prevent esophageal perforation. Osteonecrosis of the jaw is another complication that is caused by suppression of bone turnover

example of drug that follows zero order kinetics?

phenytoin | - rate of drug elimination is constant regardless of the plasma concentration of the drug (linear)

when would you see a narrow pulse pressure vs wide?

- narrow pulse pressure: constrictive pericarditis | - wide pulse pressure: aortic regurgitation

what is preferred tx for stabile angina?

- nitrates (dilate peripheral veins -> decrease preload, cardiac load) - b-blocker (reduce HR and contractility, decrease O2 demand)

``` overdosing on what med causes: • Bradycardia • Hypotension • *Hypoglycemia* • Fatigue ```

b-blocker | - give glucagon

``` overdosing on what med causes: • Bradycardia • Hypotension • Tachycardia • *Hyperglycemia* • Dizziness ```

CCB's | - give calcium and insulin

``` what drug class lowers LDL, mildly decreases TG and will mildly increase HDL? - only cholesterol med with mortality benefit ```

statins

what drug class significantly lowers **TG**, mildly lowers LDL and mildly increases HDL?

fibrates

what drug class significantly lowers ***LDL***, and mildly lowers TG with no effect on HDL?

PCSK-9 inhibitors | - Evolocumab

what 2 drug classes only lowers LDL and nothing else?

1. Cholesterol absorption blockers: ezetimibe | 2. Bile acid resins: cholestyramine, colestipol

what drug lowers LDL, increases HDL, and mildly decreases TG? - causes flushing

niacin - affects glycemic control (bad for diabetics) - can precipitate gout by increasing uric acid levels

tx for chagas disease?

nifurtimox

tx for trigeminal neuralgia?

carbemazepine

what is the antidote for ethylene glycol toxicity?

Fomepizole - works as an inhibitor of alcohol dehydrogenase, the enzyme that is responsible for the metabolism of ethylene glycol and methanol

organophosphate pesticides?

cholinesterase inhibitors | - **pralidoxime** directly affects the inactivated cholinesterase enzyme

what antihypertensives cause peripheral edema?

CCB's | - amlodipine, nifedipene

what is the first line tx of glaucoma?

prostaglandins: latanoprost | - increase outflow of aqueous humor

nonselective beta blocker that also blocks a-1 receptors | - decreases venous return, SVR, and HR

labetalol

selective CCB that improves outcomes in pts with SAH, by preventing/reducing the extent of ischemic neurologic defectis caused by cerebral vasospasm

nimodipine

anti-inflammatory that binds tubulin and inhibits polymerization - reduces neutrophil chemotaxis (acute gout flare)

colchicine

glycopyrrolate, hyoscyamine, propanthelene

selective muscarinic antagonists | - used to lessen GI sx of pyridostigmine (inhibits ACh degradation) for MG

meds that increase risk of osteoporosis?

PPI's, glucocorticoids, aromatase inhibitors, anticonvulsants that induce CYP450 (carbamazepine, phenobarbital, phenytoin)

why give desmopressin to kid with vWD?

increases vWF release from endothelial cells

MOA of methimazole and PTU?

thioamides inhibit thyroid peroxidase, the enzyme responsible for iodine organification and coupling of iodotyrosines - PTU also decreases peripheral conversion of T4 -> T3

do macrolides inhibit or induce CYP3A4?

inhibit - watch out for concurrent abx use with statins (statins can cause myoglobinuria, and can be exacerbated by erythromycin/clarithromycin)

donepezil, rivastigmine

AChE-inhibitors used to treat Alzheimers | - can precipitate bradycardia and AV block d/t unopposed PNS stimulation

what meds up-regulate LPL, resulting in increased oxidation of fatty acids - also inhibit *cholesterol 7a-hydroxylase* which halts the synthesis of bile acids

fibrates (fenofibrate, genfibrozil) | - reduced bile acid production decreases cholesterol solubility -> increases likelihood of gallstones

difference between paclitaxel and vinka alkaloids?

- paclitaxel inhibits microtubule disassembly (makes it super stable) - vinkas inhibit microtubule formation both cause neuropathy!

preferred anticoag for venous thromboembolism in pregnancy?

enoxaparin (low molecular weight heparin)

anti-HER2 monoclonal Ab?

tratuzumab (trat-TWO-zumab for HER-two)

what is the antidote for b-blocker overdose?

glucagon | - increases HR and contractility independent of adrenergic receptors (upregulates cAMP -> increasing Ca release)

peripheral dopamine-1 receptor agonist that raises intracellular cAMP -> vasodilation - tx for hypertensive emergency

fenoldapam

what is the first line tx for essential tremor | - tremor that gets worse when holding an object, improves with alcohol

propranolol

what synthetic hormone acts like FSH and triggers the formation of a dominant ovarian follicle?

menotropin (human menopausal gonadotropin) | - HCG mimics LH surge (can be given to induce ovulation)

tx for organophosphate poisoning (AChE-I)?

1. atropine: relieves muscarinic hyperstimulation | 2. THEN pralidoxime: cholinesterase reactoivator works at both muscarinic and nicotinic

random pharm Flashcards

(79 cards)