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Pharm Final Drugs > THEE DRUGS! > Flashcards

THEE DRUGS! Flashcards

1
Q

What is the most effecaious of the anti-tussives?

A

Codeine

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2
Q

Category of drug for Codeine?

A

narcotic analgesic, anti-tussive

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3
Q

MOA for Codeine?

A

opiate r/c agonist especially in medulla

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4
Q

What predictable action contributes to addiction to codeine?

A

tolerance

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5
Q

What are the 4 predictable actions of Codeine?

A
  1. sedation
  2. constipation
  3. tolerance
  4. dependence if used for extended period
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6
Q

What is the level of scheduled substance for Codeine?

A

2-5 depending upon dose, usually a 5 when its in the cough syrup

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7
Q

What category of drug is Dextromethorphan?

A

non-narcotic anti-tussive

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8
Q

MOA for dextromethorphan?

A

opiate agonist exclusively in medulla

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9
Q

Is dextromethorphan a scheduled drug?

A

NOPE, OTC

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10
Q

What are the 3 predictable action or characterstic of dextromethorphan?

A
  1. occ. drowsiness
  2. usually combined with other cough/cold meds
  3. DM often on the label
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11
Q

What is another name for montelukast?

A

singular

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12
Q

category for montelukast?

A

anti-asthmatic

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13
Q

MOA for montelukast?

A

leukotriene antagonist

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14
Q

What are leukotrienes?

A

compounds produced by body as mediators of inflammation

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15
Q

What is the distinguishing characteristic of montelukast?

A

GI discomfort

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16
Q

What are the 3 predictable actions of montelukast?

A
  1. best used before asthma attack before leukotriene activates r/cs
  2. reduces bronchoconstriction
  3. reduces edema
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17
Q

Leukotrienes lead to –>

A

bronchoconstriction and secretion

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18
Q

Thromboxane leads to –>

A

platelet aggregation

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19
Q

Prostacyclin leads to –>

A

HCl reduction and gastric mucosal protection

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20
Q

Prostaglandins leads to –>

A

pain, fever and pericapillary leakage

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21
Q

Category of Albuterol (3) ?

A

sympathomimetic, bronchodilator, anti-asthmatic

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22
Q

MOA of albuterol?

A

selective B2 agonist

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23
Q

What is the half life of albuterol?

A

2 hour half life

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24
Q

where is albuterol metabolizd?

A

hepatic metabolism

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25
Q

in what forms is albuterol effective?

A

effective orally and via inhalation

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26
Q

What are the 3 distinguishing characteristics of albuterol?

A
  1. effective orally and via inhalation
  2. hepatic metabolism
  3. 2 hour half life
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27
Q

What are 4 preditable actions of albuterol?

A
  1. bronchodilation
  2. minimal tachycardia
  3. no effects on secretions
  4. stimulates Beta 2 r/c throughout the body
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28
Q

How can albuterol effect the uterus and pancreas?

A

can relax a gravid uterus, stimulate pancreas and increase insulin

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29
Q

What is another name for zoloft?

A

sertraline

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30
Q

what category of drug is sertraline?

A

antidepressant

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31
Q

MOA of sertraline

A

Selective serotonin reuptake inhibition SSRI

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32
Q

what is the distinguishing characteristic for sertraline?

A

must “titrate” dose for optimum effect

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33
Q

what drug must you “titrate” dose for optimum effect?

A

sertraline

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34
Q

What are the side effects of sertraline? (4)

A

related to serotonin activity

  1. insomnia
  2. headache
  3. nausea
  4. dry mouth
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35
Q

What is the other name for xanax?

A

alprazolam

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36
Q

what category is alprazolam?

A

anxiolytic, sedative hypnotic, anti-epileptic, muscle relaxant

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37
Q

MOA for alprazolam?

A

GABA r/c agonist (GABA is an inhibitory NE)

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38
Q

What are the 4 distinguishing characteristics of alprazolam?

A
  1. benzodiazepine
  2. Schedule 4 substance
  3. pregnancy category D
  4. metabolized by cytochrome P450 system of liver
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39
Q

What are the 4 predictable effects of alprazolam?

A
  1. drowsiness and diminished alertness
  2. interacts with drugs metabolized by same isoenzymes (many)
  3. contraindicated with alcohol, other CNS depressants, pregnancy
  4. Rx anxiety, panic attack, social anxiety
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40
Q

Category of drug: hydrocodone?

A

analgesic

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41
Q

what is an antidote for hydrocodone?

A

maloxone (narcotic analgesic and bind to opiate r/c, its an antagonist)

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42
Q

how does maloxone work?

A

narcotic analgesic and bind to opiate r/c, its an antagonist)

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43
Q

MOA for hydrocodone?

A

opiate r/c agonist (esp. thalamus, brainstem, gut, eye)

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44
Q

What schedule is hydrocodone?

A

scheduled 2-3

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45
Q

what are the 2 distinguishing characteristics for hydrocodone?

A
  1. scheduled 2-3

2. tolerance upon repeated use

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46
Q

What are 4 predictable actions of hydrocodone?

A
  1. pain less objectionable and localizable
  2. depresses respiratory center, overdose causes apnea
  3. physical and psychological dependence
  4. miosis, constipation
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47
Q

What are two similar drugs to hydrocodone?

A

oxycodone and morphine

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48
Q

Category of levothyroxine

A

thyroid drug

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49
Q

MOA of levothyroxine

A

Bind to gene r/c in cell nucleus where hormone modulates genetic transcription and protein synthesis

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50
Q

What is the name of T4

A

tetraiodothyronine

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51
Q

Where is T4 converted to T3

A

in periphery

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52
Q

Which is the active form of thyroid?

A

T3

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53
Q

half life of levothyroxine?

A

7 days

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54
Q

what is the % bioavailability following oral administration of levothyroxine?`

A

80%

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55
Q

where is levothyroxine metabolized?

A

cytochrome P450 system

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56
Q

T/F levothyroxine is highly lipid soluble and highly protein bound?

A

True, 99%+

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57
Q

how long does it take levothyroxine to work or show signs of working?

A

slow onset of action (week or more)

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58
Q

How often will the patient take levothyroxine?

A

daily administration

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59
Q

will levothyroxine have drug or herb interactions?

A

YES, numerous drug and herb interactions due to metabolism and protein binding

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60
Q

What is the drug of choice for replacement and suppression therapy of the thyroid by most physicians?

A

Levothyroxine

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61
Q

Another name for levothyroxine?

A

synthyroid

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62
Q

Another name for metformin

A

glucophage

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63
Q

Category of drug: metformin?

A

oral hypoglycemic

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64
Q

MOA of metformin?

A

supression of hepatic gluconeogenesis via several molecular mechanisms (hepatic gluconeogenesis is elevated in DM2)

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65
Q

what is the most serious side effect of metformin?

A

lactic acidosis
- lactate is substrate for gluconeogenesis. blocking gluconeogenesis decreases uptake of lactate by liver allowing increased plasma lactate levels and lactic acidosis

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66
Q

What is the most common side effect of metformin?

A

GI upset, diarrahea (50%)

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67
Q

what are two side effects of metformin

A
  1. gi upset

2. lactic acidosis

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68
Q

which form of metformin is effective?

A

orally

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69
Q

T/F metformin is biguanide

A

T: A member of the class of oral antihyperglycemic agents that works by limiting glucose production and glucose absorption, and by increasing the body’s sensitivity to insulin.

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70
Q

What is the first line drug of tx for DM2

A

metformin

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71
Q

What should you be cautious about when taking metformin?

A

avoid use with co-morbidities that will increase lactic acid (impaired renal fxn)

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72
Q

Is metformin often combined with other oral hypoglycemic agents?

A

yes

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73
Q

What is another name for Actos?

A

Piaglitasone

74
Q

category of piaglitasone?

A

oral antidiabetic

75
Q

MOA of piaglitasone?

A

decrease insulin resistance by regulating genes involved in glucose and lipid metabolism

76
Q

Predicted action of piaglitasone? (3)

A
  1. treat DM2
  2. slow onset d/t gene regulation
  3. weight gain is common
77
Q

Which medication is a thiazoladinedione?

A

piaglitasone

78
Q

what drug is piaglitasone ofted used in conjunction with?

A

metformin, or other oral antidiabetic agents

79
Q

what is a side effect of piaglitasone?

A

edema, fluid retention

80
Q

3 predicted actions of piaglitasone?

A
  1. treated type 2 DM
  2. slow onset (gene regulation)
  3. weight gain common
81
Q

What drug is used in prediabetics to prevent diabetes

A

piaglitasone

82
Q

MOA of estrogen?

A

bind to estrogen r/c in nuclei of target cells to regulate protein synthesis

83
Q

how can you vary the absorption of estrogen?

A

absorption varies with salt and formulation

84
Q

what are the 3 forms of estrogen that is prescribed?

A
  1. transdermal
  2. oral
  3. parenteral
85
Q

Is estrogen protein bound

A

yes, highly protein bound

86
Q

Will estrogen compete with other drugs

A

Yes, even with thyroid

87
Q

What cancer is estrogen linked to?

A

breast cancer

88
Q

what are 2 uses of estrogen?

A
  1. HRT (post-menopausal)

2. oral contraception

89
Q

category of drug: progesterone?

A

progestin

90
Q

MOA of progesterone?

A

bind to progesterone r/c in nuclei of target cells to regulate gene transcription in diverse cells

91
Q

2 unique characteristics of of progesterone?

A
  1. rapidly absorbed following oral administration

2. metabolized in liver on first pass

92
Q

is progesterone a first pass liver drug?

A

yes

93
Q

What are 2 predictable actions of progesterone?

A
  1. HRT (menopause)

2. contraception

94
Q

Category of Prednisone

A

glucocorticoid

95
Q

MOA of prednisone?

A

modify gene transcription and interfere with inflammatory activities

96
Q

what is prednisone converted to?

A

prednisolone

97
Q

how long does prednisone act?

A

short to medium acting

98
Q

what is the main effect of prednisone?

A

strong anti-inflammatory effect

99
Q

is prednisone effective orally?

A

yes

100
Q

what drug causes modest salt retention activity?

A

prednisone

101
Q

What metabolism does prednisone affect?

A

protein, lipid and carb

102
Q

how does prednisone affect the adrenals?

A

secondary followed by primary adrenal insufficiency with prolonged use

103
Q

What the the side effects of prednisone?

A 
typical glucocorticoid ones
1. Cushing’s-like syndrome (2 weeks of therapy)
2. Osteoporosis
3. Sodium retention
4. Hypertension
5. Muscle wasting
6. Cateracts & glaucoma
7. Infections
8. Peptic ulcers
9. Secondary followed by primary adrenal
insufficiency (Consider alternate day therapy)
10. CNS stimulation with insomnia
104
Q

What’s another name for aspirin?

A

acetylsalicylic acid (ASA)

105
Q

category of drug: Aspirin

A

NSAID

106
Q

MOA of aspirin?

A

inhibition of COX1 and COX2 enzymes, (irreversible)

- serves to diminish pain by decreasing tissues sensitivity to chemical mediators of pain

107
Q

What is the cause of the anti-inflammatory and analgesic effect of aspirin?

A

largely d/t to blockage of prostaglandin synthesis at target tissues

108
Q

what is the anti-pyretic effect of aspirin d/t?

A

blockade of prostaglandin synthesis at thermoregulatory centers in the hypothalamus

109
Q

Aspirin: what does prostaglandin E2 do?

A

thought to sensitize nerve endings to the actions of bradykinins, histamines and other inflammatory mediators

110
Q

What are the 7 distinguishing characteristics of aspirin?

A
  1. oral
  2. readily absorbed from upper GI
  3. metabolized by liver
  4. excreted in urine
  5. increased risk of Reye’s syndrome
  6. salicylism includes dizziness, tinnitus, hyperventilation, mental status changes and potential for coma and death
  7. treatment for salicylism includes IV hydration, alkalinzation of urine and dialysis if renal insufficiency occurs
111
Q

What are 4 predictable actions/uses for aspirin?

A
  1. Rx inflammation, pain, fever
  2. GI side effects including GI irritation, peptic ulcer dz, nausea and vomiting
  3. increased risk of bleeding
  4. prophylactic for stroke and MI
112
Q

Another name for diphenhydramine?

A

benadryl, sominex

113
Q

category of drug: diphenhydramine

A

anti-inflammatory, anti-emetic, antihistamine

114
Q

MOA of diphenhydramine?

A

H1 r/c antagonist

115
Q

What are 3 distinguishing characteristics of diphenhydramine?

A
  1. Rx orally, IM, percutaneous
  2. anitmuscarinic activity
  3. lipid soluble- able to cross BBB
116
Q

How is benadryl taken (3):

A

orally, IM, percutaneous

117
Q

How does diphenhydramine affect muscarinic acitivity?

A

antimuscarinic

118
Q

can diphenhydramine cross the BBB?

A

yes, lipid soluble

119
Q

4 big predictable actions/side effects of diphenhydramine?

A
  1. drowsiness
  2. xerostomia
  3. sleep aid
  4. treat nausea, vomiting, motion sickness
120
Q

Another name for amoxcillin?

A

amoxil

121
Q

Category of drug of amoxicillin?

A

anti-biotic (pencillin group)

122
Q

MOA of amoxicillin?

A

inhibit bacterial cell wall synthesis

123
Q

Does amoxicillin contains beta lactam ring?

A

yes

124
Q

what type of bacterial activity does amoxicillin treat?

A

broad spectrum

125
Q

Where is amoxicillin absorbed?

A

yes, absorbed well from gut

126
Q

what does amoxicillin have a high incidence of?

A

high incidence of hypersensitivity

127
Q

What must you inquire about with amoxicillin?

A

must inquire about previous allergies to penicillin

128
Q

can outpatients use amoxicillin?

A

yes, used on outpatient basis

129
Q

can bacteria develop resistant to amoxicillin?

A

subject to resistance in pencillinase producing organisms

130
Q

Another name for azithromycin?

A

zithromax

131
Q

Category of drug: azithromycin?

A

antibiotic (macrolide)

132
Q

MOA of azithromycin?

A

bind reversible to bacterial microsome to inhibit protein synthesis

133
Q

Predictable effects of azithromycin?

A
  1. Z pack highly successful because of convenience

2. Frequent diarrhea

134
Q

What type of dose of azithromycin is usually required?

A

requires a large loading dose

135
Q

How many days of treatment for azithromycin to be effective?

A

usually effective with 7 day treatment

136
Q

What bacteria are affected by azithromycin?

A

bacteriostatic to broad spectrum of bacteria including gut bacteria

137
Q

Category of drug: Tetracycline?

A

antibiotic

138
Q

MOA of tetracycline?

A

binds reversible to bacterial ribosome and inhibits protein synthesis

139
Q

Which antibiotic is a chelating agent (binds covalently to calcium ions)

A

tetracycline

140
Q

which ions does tetracycline bind to, to work as a chelating agent

A

Calcium

141
Q

What bacteria can tetracycline treat?

A

very broad spectrum

1. bacteria and rickettsiae

142
Q

Which drug has a characteristic that includes photosensitive?

A

tetracycline

143
Q

When taking tetracycline what food products should you avoid?

A

dairy products

144
Q

When taking which drug should you avoid dairy products?

A

tetracycline

145
Q

which drug causes mottling of teeth in children?

A

tetracycline

146
Q

how does tetracycline affect calcium?

A

interferes with calcium absorption

147
Q

What is another name for clotrimazole?

A

lotramin

148
Q

category of drug: clotrimazole?

A

antifungal drug (topical)

149
Q

MOA of clotrimazole?

A

reduce fungal formation of ergosterol (by inhibiting fungal cytochrome P450)

150
Q

how is clotrimazole used?

A

used only topically

151
Q

what can be treated with clotrimazole?

A
  1. vaginal candidiasis

2. dermatophyte infections (tinea pedis, cruris, corporis)

152
Q

Rx or OTC clotrimazole?

A

OTC

153
Q

is clotrimazole toxic?

A

considered low toxicity

154
Q

category of drug: insulin glargin

A

antidiabetic

155
Q

Another name for insulin glargine?

A

lantus

156
Q

Is insulin glargine rapid, short, intermediate or long acting?

A

long-acting

157
Q

MOA of insulin?

A

binds to insulin r/c –> activates tyrosine kinase–> phosphorylates proteins –> alter metabolic enzymes. MOVES GLUCOSE INTO CELL FROM PLASMA

158
Q

What are 3 unique characteristics of insulin?

A
  1. protein
  2. short half-life (3-5 min)
  3. multiple forms differ in solubility and release from site of injection
159
Q

Does taking insulin cause an increase or decrease in plasma glucose?

A

decreased plasma glucose

160
Q

What conditions is insulin used to treat?

A

DM1 and occassional DM2

161
Q

can you take insulin orally?

A

no, its ineffective orally (ex subcutaneously usually)

162
Q

What will happen if insulin is used in excess?

A

will cause hypoglycemia

163
Q

Typical brand name of acetaminophen?

A

tylenol

164
Q

What is another name for acetaminophen in most countries?

A

paracetamol

165
Q

category of drug: acetaminophen?

A

analgesic and anti-pyretic, sometimes referred to as a NSAID altho poor anti-inflammatory

166
Q

MOA of acetaminophen?

A

not fully understoof

  1. weak peripheral blockage of prostaglandin synthesis
  2. somewhat stronger blockade of prostaglandin syntehsis in hypothalamus
167
Q

indication to take acetaminophen?

A

pain, fever

168
Q

which drug is AKA APAP or n-acetly-p-aminophenol?

A

acetaminophen

169
Q

how do you take acetaminophen?

A

orally

170
Q

where is acetaminophen metabolized?

A

conjugated in liver with glucuronic acid and sulfate.

remainder is oxidized by cytochrome P450. oxidation metabolites may be toxic

171
Q

Where is acetaminophen excreted?

A

urine following phase II metabolism

172
Q

is there an increased risk of GI bleeding with acetaminophen?

A

NOPE

173
Q

is there an increased risk of Reye’s syndrome with acetaminophen?

A

NOPE

174
Q

Acetaminophen: dose for adults?

A

325 mg, 500mg and 625 mg tablets taken 4-6 hrs

175
Q

What is the overdose amount for acetaminophen?

A

> 7 gm/24 or when acetaminophen is taken with alcohol can lead to severe hepatic necrosis leading to liver failure, coma and death

176
Q

in absence of conjugation acetaminophen undergoes phase I metabolism to _______

A

n-acetyl-nezoquinoneimine

177
Q

acetaminophen reacts with ______ groups of glutathione

A

sulfhydril

178
Q

can acetaminophen lead to hepatic necrosis?

A

yes

179
Q

What are the 4 stages of acetaminophen hepatotoxicity?

A
  1. 12-24 hrs: nausea, vomiting, anorexia, abdominal pain
  2. 24-48 hrs: may be clinically improved but liver fxn tests reveal rising aminotransferases and bilirubin levels
  3. 72-96 hrs: peak elevations in liver enzymes
  4. beyond 96 hours: recovery or death
180
Q

What is the antidote for acetaminophen overdose?

A

NAC, n-acetylcysteine, should be administered as early as possible, preferably within 8 hours of the overdose ingestion for optimal results.

181
Q

Should I have a glass of wine and tylenol?

A

NOOO. NEVER mix alcohol and tylenol

Pharm Final Drugs (2 decks)

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