LECOM 2012 All Pharm 1 liners
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Time it takes for amount of drug to fall to half of its value, constant in first order kinetics (majority of drugs) | Half-life (T1/2)
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Relates the amount of drug in the body to the plasma concentration | Volume of distribution (VD)
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Plasma concentration of a drug at a given time | Cp
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The ratio of the rate of elimination of a drug to its plasma concentration | Clearance (CL)
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The elimination of drug that occurs before it reaches the systemic circulation | First pass effect
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The fraction of administered dose of a drug that reaches systemic circulation | Bioavailability (F)
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When the rate of drug input equals the rate of drug elimination | Steady state
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Metabolism This step of metabolism makes drug more hydrophilic and hence augments elimination | Phase I
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Different steps of Phase I | Oxidation, reduction, hydrolysis
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Inducers of Cytochrome P450 (CYP450) | Barbiturates, phenytoin, carbamazepine, and rifampin
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Inhibitors of CYP450 | Cimetidine, ketoconazole, erythromycin, isoniazid and grapefruit
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Products of Phase II conjugation | Glucuronate, acetic acid, and glutathione sulfate
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Constant percentage of substrate metabolized per unit time | First order kinetics
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Drug elimination with a constant amount metabolized regardless of drug concentration | Zero order kinetics
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Target plasma concentration times (volume of distribution divided by bioavailability) | Loading dose (Cp*(Vd/F))
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Concentration in the plasma times (clearance divided by bioavailability) | Maintenance dose (Cp*(CL/F))
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Strength of interaction between drug and its receptor | Affinity
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Selectivity of a drug for its receptor | Specificity
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Amount of drug necessary to elicit a biologic effect | Potency
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Ability of drug to produce a biologic effect | Efficacy
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Ability of a drug to produce 100% of the maximum response regardless of the potency | Full agonist
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Ability to produce less than 100% of the response | Partial agonist
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Ability to bind reversibly to the same site as the drug and without activating the effector system | Competitive antagonist
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Ability to bind to either the same or different site as the drug | Noncompetitive antagonist
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Mechanism of action (MOA) utilizes intracellular receptors | Thyroid and steroid hormones
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MOA utilizes transmembrane receptors | Insulin
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MOA utilizes ligand gated ion channels | Benzodiazepines and calcium channel blockers
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Median effective dose required for an effect in 50% of the population | ED50
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Median toxic dose required for a toxic effect in 50% of the population | TD50
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Dose which is lethal to 50% of the population | LD50
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Window between therapeutic effect and toxic effect | Therapeutic index
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Drug with a high margin of safety | High therapeutic index
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Drug with a narrow margin of safety | Low therapeutic index
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Antidotes and agents used in drug overdose Antidote used for lead poisoning | Dimercaprol, EDTA
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Antidote used for cyanide poisoning | Nitrites
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Antidote used for anticholinergic poisoning | Physostigmine
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Antidote used for organophosphate/anticholinesterase poisoning | Atropine, pralidoxime (2-PAM)
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Antidote used for iron salt toxicity | Deferoxamine
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Antidote used for acetaminophen (APAP) toxicity | N-acetylcysteine (Mucomyst)
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Antidote for arsenic, mercury, lead, and gold poisoning | Dimercaprol
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Antidote used in poisonings: copper (Wilson's disease), lead, mercury, and arsenic | Penicillamine
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Antidote used for heparin toxicity | Protamine
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Antidote used for warfarin toxicity | Vitamin and Fresh frozen plasma (FFP)
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Antidote for tissue plasminogen activator (t-PA), streptokinase | Aminocaproic acid
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Antidote used for methanol and ethylene glycol | Ethanol
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Antidote used for opioid toxicity | Naloxone (IV), naltrexone (PO)
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Antidote used for benzodiazepine toxicity | Flumazenil
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Antidote used for tricyclic antidepressants (TCA) | Sodium bicarbonate
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Antidote used for carbon monoxide poisoning | 100% O2 and hyperbaric O2
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Antidote used for digitalis toxicity | Digibind (also need to d/c digoxin, normalize K+, and lidocaine if pt. Is arrhythmic)
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Antidote used for beta agonist toxicity (eg. Metaproterenol) | Esmolol
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Antidote for methotrexate toxicity | Leucovorin
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Antidote for beta-blockers and hypoglycemia | Glucagon
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Antidote useful for some drug induced Torsade de pointes | Magnesium sulfate
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Antidote for hyperkalemia | sodium polystyrene sulfonate (Kayexalate)
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Antidote for salicylate intoxication | Alkalinize urine, dialysis
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Cancer Chemotherapy Constant proportion of cell population killed rather than a constant number | Log-kill hypothesis
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Treatment with cancer chemotherapy at high doses every 3-4 weeks, too toxic to be used continuously | Pulse therapy
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Toxic effect of anticancer drug can be lessened by rescue agents | Rescue therapy
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Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates | Allopurinol
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Pyrimidine analog that causes "Thiamine-less death" given with leucovorin rescue | 5-flouracil (5-FU)
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Drug used in cancer therapy causes Cushing-like symptoms | Prednisone
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Side effect of Mitomycin | SEVERE myelosuppression
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MOA of cisplatin | Alkylating agent
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Common toxicities of cisplatin | Nephro and ototoxicity
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Analog of hypoxanthine, needs HGPRTase for activation | 6-mercaptopurine (6-MP)
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Interaction with this drug requires dose reduction of 6-MP | Allopurinol
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May protect against doxorubicin toxic by scavenging free radicals | Dexrazoxane
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Blows DNA (breaks DNA strands), limiting SE is pulmonary fibrosis | Bleomycin
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Bleomycin+vinblastine+etoposide+cisplatin produce almost a 100% response when all agents are used for this neoplasm | Testicular cancer
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MOPP regimen used in Hodgkin's disease (HD) | Mechlorethamine+ oncovorin (vincristine)+ procarbazine, and prednisone
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ABVD regimen used for HD, but appears less likely to cause sterility and secondary malignancies than MOPP | Adriamycin (doxorubicin) +bleomycin, vinblastine +dacarbazine
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Regimen used for non-Hodgkin's lymphoma | COP (cyclophosphamide, oncovin(vincristine), and prednisone)
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Regimen used for breast cancer | CMF (cyclophosphamide, methotrexate, and fluorouracil) and tamoxifen if ER+
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Alkylating agent, vesicant that causes tissue damage with extravasation | Mechlorethamine
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Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis | Cyclophosphamide
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Prevention of cyclophosphamide induced hemorrhagic cystitis | Hydration and mercaptoethanesulfonate (MESNA)
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Microtubule inhibitor that causes peripheral neuropathy, foot drop (eg. ataxia), and "pins and needles" sensation | Vincristine
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Interact with microtubules (but unlike vinca which prevent disassembly of tubules), it stabilizes tubulin and cells remain frozen in metaphase | Paclitaxel (taxol)
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Toxicities include nephrotoxicity and ototoxicity, leading to a severe interaction with aminoglycosides | Cisplatin
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Agent similar to cisplatin, less nephrotoxic, but greater myelosuppression | Carboplatin
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Converts asparagine to aspartate and ammonia, denies cancer cells of essential AA (asparagine) | L-asparaginase
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Used for hairy cell leukemia; it stimulates NK cells | Interferon alpha
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Anti-androgen used for prostate cancer | Flutamide (Eulexin)
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Anti-estrogen used for estrogen receptor + breast cancer | Tamoxifen
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Newer estrogen receptor antagonist used in advanced breast cancer | Toremifene (Fareston)
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Some cell cycle specific anti-cancer drugs | Bleomycin, vinca alkaloids, antimetabolites (eg., 5-FU, 6-MP, methotrexate, etoposide)
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Some cell cycle non-specific drugs | Alkylating agents (eg., mechlorethamine, cyclophosphamide), antibiotics (doxorubicin, daunorubicin), cisplatin, nitrosourea
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Anti-emetics used in association with anti-cancer drugs that are 5-HT3 (serotonin receptor subtype ) antagonist | Odansetron, granisetron
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Nitrosoureas with high lipophilicity, used for brain tumors | Carmustine (BCNU) and lomustine (CCNU)
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Produces disulfiram-like reaction with ethanol | Procarbazine
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Endocrine drugs: hypothalamic and pituitary hormones Somatostatin (SRIF) analog used for acromegaly, carcinoid, glucagonoma and other GH producing pituitary tumors | Octreotide
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Somatotropin (GH) analog used in GH deficiency (dwarfism) | Somatrem
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GHRH analog used as diagnostic agent | Sermorelin
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GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively | Leuprolide
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GnRH antagonist with more immediate effects, used for infertility | Ganirelix
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Dopamine (DA) agonist (for Parkinson's disease), used also for hyperprolactinemia | Bromocriptine
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Hormone inhibiting prolactin release | Dopamine
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ACTH analog used for diagnosis of patients with corticosteroid abnormality | Cosyntropin
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Synthetic analog of ADH hormone used for diabetes insipidus and nocturnal enuresis | Desmopressin (DDAVP)
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Thyroid and anti-thyroid drugs Most widely used thyroid drugs such as Synthroid and Levoxyl contain | L-thyroxine (T4)
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T3 compound less widely used | Cytomel
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Anti-thyroid drugs | Thioamides, iodides, radioactive iodine, and ipodate
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Thioamide agents used in hyperthyroidism | Methimazole and propylthiouracil (PTU)
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Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and should be used with extreme caution in pregnancy | PTU
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PTU (propylthiouracil) MOA | Inhibits thyroid hormone synthesis by blocking iodination of the tyrosine residues of thyroglobulin
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Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism | Iodide salts
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Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy | Radioactive iodine
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Radio contrast media that inhibits the conversion of T4 to T3 | Ipodate
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Block cardiac adverse effects of thyrotoxicosis such as tachycardia, inhibits the conversion of T4 to T3 | Beta-blockers such as propranolol
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Adrenocorticosteroid and adrenocortical antagonists 3 zones of adrenal cortex and their products | Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)
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Pneumonic for 3 zones of adrenal cortex | GFR
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Used for Addison's disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation) | Glucocorticoids
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Short acting GC's | Cortisone and hydrocortisone (equivalent to cortisol)
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Intermediate acting GC's | Prednisone, methylprednisolone, prednisolone, and triamcinolone
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Long acting GC's | Betamethasone, dexamethasone, and paramethasone
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Mineralocorticoids | Fludrocortisone and deoxycorticosterone
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Some side effects of corticosteroids | Osteopenia, impaired wound healing, inc. risk of infection, inc. appetite, HTN, edema, PUD, euphoria, psychosis
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Period of time of therapy after which GC therapy will need to be tapered | 5-7 days
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Inhibitors of corticosteroids biosynthesis Used for Cushing's syndrome (increased corticosteroid) and sometimes for adrenal function test | Metyrapone
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Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis | Aminoglutethimide
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Antifungal agent used for inhibition of all gonadal and adrenal steroids | Ketoconazole
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Antiprogestin used as potent antagonist of GC receptor | Mifepristone
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Diuretic used to antagonize aldosterone receptors | Spironolactone
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Common SE of spironolactone | Gynecomastia and hyperkalemia
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Gonadal hormones and inhibitors Slightly increased risk of breast cancer, endometrial cancer, heart disease (questionable), has beneficial effects on bone loss | Estrogen
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Antiestrogen drugs used for fertility and breast cancer respectively | Clomiphene and tamoxifen
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Common SE of tamoxifen and raloxifene | Hot flashes
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Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and currently being tested for treatment of breast cancer (Stars study) | Raloxifene
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Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy | Diethylstilbestrol (DES)
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Estrogen mostly used in oral contraceptives (OC) | Ethinyl estradiol and mestranol
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Anti-progesterone used as abortifacient | Mifepristone (RU-486)
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Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep) | Combination oral contraceptives (OC)
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Oral contraceptive available in a transdermal patch | Ortho-Evra
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Converted to more active form DHT by 5 alpha-reductase | Testosterone
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5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness | Finasteride (Proscar and Propecia respectively)
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Anabolic steroid that has potential for abuse | Nandrolone and stanozolol
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Anti-androgen used for hirsutism in females | Cyproterone acetate
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Drug is used with testosterone for male fertility | Leuprolide
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Pancreatic hormones, antidiabetics, and hyperglycemics Alpha cells in the pancreas | Produce glucagon
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Beta cells in the pancreas | Produce insulin
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Beta cells are found | Islets of Langerhans
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Delta cells in the pancreas | Produce Somatostatin
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Product of proinsulin cleavage used to assess insulin abuse | C-peptide
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Exogenous insulin | Little C-peptide
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Endogenous insulin | Normal C-peptide
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Very rapid acting insulin, having fastest onset and shortest duration of action | Lispro (Humalog)
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Rapid acting, crystalline zinc insulin used to reverse acute hyperglycemia | Regular (Humulin R)
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Long acting insulin | Ultralente (humulin U)
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Ultra long acting insulin, has over a day duration of action | Glargine (Lantus)
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Major SE of insulin | Hypoglycemia
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Important in synthesis of glucose to glycogen in the liver | GLUT 2
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Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation | GLUT 4
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Examples of alpha-glucosidase inhibitors (AGI) | Acarbose, miglitol
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MOA of AGI's | Act on intestine, delay absorption of glucose
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SE of AGI's | Flatulence (do not use beano to tx), diarrhea, abdominal cramps
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Alpha-glucosidase inhibitor associated with elevation of LFT's | Acarbose
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Amino acid derivative | Nateglinide
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MOA of nateglinide | Insulin secretagogue
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Biguanide | Metformin
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Drugs available in combination with metformin | Glyburide, glipizide, and rosiglitazone
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MOA of metformin | Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
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Most important potential SE of metformin | Lactic acidosis
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Meglitinide | Repaglinide
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MOA of repaglinide | Insulin release from pancreas; faster and shorter acting than sulfonylurea
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First generation sulfonylurea | Chlorpropamide, tolbutamide, tolazamide, etc.
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Second generation sulfonylurea | Glyburide, glipizide, glimepiride, etc.
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MOA of both generations | Insulin release from pancreas by modifying K+ channels
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Common SE of sulfonylureas, repaglinide, and nateglinide | Hypoglycemia
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Sulfonylurea NOT recommended for elderly because of very long half life | Chlorpropamide
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Thiazolidinediones | Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)
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Reason troglitazone was withdrawn from market | Hepatic toxicity
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MOA of thiazolindinediones | Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
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SE of Thiazolindinediones | Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism
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Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation | Glucagon
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Drugs used in bone homeostasis Available bisphosphonates | Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid
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MOA of Bisphosphonates | Inhibits osteoclast bone resorption
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Only bisphosphonates available IV | Etidronate
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Uses of bisphosphonates | Osteoporosis, Paget's disease, and osteolytic bone lesions, and hypercalcemia from malignancy
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Major SE of bisphosphonates | Chemical esophagitis
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Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia | Etidronate
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Used for prevention of postmenopausal osteoporosis in women | Estrogen (HRT-Hormone replacement therapy)
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Increase bone density, also being tested for breast CA tx. | Raloxifene (SERM-selective estrogen receptor modulator)
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Used intranasally and decreases bone resorption | Calcitonin (salmon prep)
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Used especially in postmenopausal women, dosage should be 1500 mg | Calcium
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Vitamin given with calcium to ensure proper absorption | Vitamin D
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Drugs with important actions on smooth muscle Disease caused by excess ergot alkaloids | St. Anthony's Fire
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Endogenous substances commonly interpreted as histamine, serotonin, prostaglandins, and vasoactive peptides | Autocoids
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Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea | Zollinger-Ellison Syndrome
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Drug that causes contraction of the uterus | Oxytocin
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Distribution of histamine receptors H1, H2, and H3 | Smooth muscle; stomach, heart, and mast cells; nerve endings, CNS respectively
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Prototype antagonist of H1 and H2 receptors | Diphenhydramine
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1st generation antihistamine that is highly sedating | Diphendydramine
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1st generation antihistamine that is least sedating | Chlorpheniramine or cyclizine
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2nd generation antihistamines | Fexofenadine, loratadine, and cetirizine
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Generation of antihistamine that has the most CNS effects | First generation due to being more lipid-soluble
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Major indication for H1 receptor antagonist | Use in IgE mediated allergic reaction
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Antihistamine that can be used for anxiety and insomnia and is not addictive | hydroxyzine (Atarax)
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H1 antagonist used in motion sickness | Dimenhydrinate, meclizine, and other 1st generation
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Most common side effect of 1st generation antihistamines | Sedation
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Lethal arrhythmias resulting from concurrent therapy with azole fungals (metabolized by CYP 3A4) and these antihistamines which inhibit the 3A4 iso-enzyme. | Terfenadine and astemizole (have been removed from the market)
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H2 blocker that causes the most interactions with other drugs | Cimetidine
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Clinical use for H2 blockers | Acid reflux disease, duodenal ulcer and peptic ulcer disease
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Receptors for serotonin (5HT-1) are located | Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance
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" 5HT-1d agonist used for migraine headaches " | Sumatriptan, naratriptan, and rizatriptan
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Triptan available in parenteral and nasal formulation | Sumatriptan
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H1 blocker that is also a serotonin antagonist | Cyproheptadine
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5HT2 antagonist mediate synaptic excitation in the CNS and smooth muscle contraction | Ketanserin, cyproheptadine, and ergot alkaloids (partial agonist of alpha and serotonin receptors)
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Agents for reduction of postpartum bleeding | Ergonovine and ergotamine
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Agents used in treatment of carcinoid tumor | Ketanserin cyproheptadine, and phenoxybenzamine
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"5HT-3 antagonist used in chemotherapeutic induced emesis " | "Ondansetron, granisetron,
dolasetron and alosetron "
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5ht-3 antagonist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease | Dolasetron
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DOC of chemo induced nausea and vomiting | Odansetron
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Drug used in ergot alkaloids overdose, ischemia and gangrene | Nitroprusside
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Reason ergot alkaloids are contraindicated in pregnancy | Uterine contractions
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SE of ergot alkaloids | Hallucinations resembling psychosis
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Ergot alkaloid used as an illicit drug | LSD
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Dopamine agonist used in hyperprolactinemia | Bromocriptine
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Peptide causing increased capillary permeability and edema | Bradykinin and histamine
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Mediator of tissue pain, edema, inactivated by ACE, and may be a contributing factor to the development of angioedema | Bradykinin
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Drug causing depletion of substance P (vasodilator) | Capsaicin
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Prostaglandins that cause abortions | Prostaglandin E1 (misoprostol) PGE2, and PGF2alpha
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" Difference between COX 1 and COX 2 " | "COX 1 is found throughout
the body and COX 2 is only
in inflammatory tissue"
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Drug that selectively inhibits COX 2 | Celecoxib, valdecoxib, and rofecoxib
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Inhibitor of lipoxygenase | Zileuton
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Major SE of zileuton | Liver toxicity
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Inhibitor of leukotrienes (LTD4) receptors and used in asthma | Zafirlukast and montelukast
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Used in pediatrics to maintain patency of ductus arteriosis | PGE1
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Approved for use in severe pulmonary HTN | PGI2 (epoprostenol)
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Prostaglandin used in the treatment impotence | Alprostadil
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Irreversible, nonselective COX inhibitor | Aspirin
🗑
|
||||
Class of drugs that reversibly inhibit COX | NSAIDS
🗑
|
||||
Primary endogenous substrate for Nitric Oxidase Synthase | Arginine
🗑
|
||||
MOA and effect of nitric oxide | Stimulates cGMP which leads to vascular smooth muscle relaxation
🗑
|
||||
Long acting beta 2 agonist used in asthma | Salmeterol
🗑
|
||||
Muscarinic antagonist used in asthma | Ipratropium
🗑
|
||||
MOA action of cromolyn | Mast cell stabilizer
🗑
|
||||
Enzyme which theophylline inhibits | Phosphodiesterase
🗑
|
||||
Methylxanthine derivative used as a remedy for intermittent claudication | Pentoxifylline
🗑
|
||||
Antidote for severe CV toxicity of theophylline | Beta blockers
🗑
|
||||
" MOA of corticosteroids" | inhibit phospholipase A2
🗑
|
||||
SE of long term (>5 days) corticosteroid therapy and remedy | Adrenal suppression and weaning slowly, respectively
🗑
|
||||
Antimicrobials MOA of quinolones | Inhibit DNA gyrase
🗑
|
||||
MOA of penicillin | Block cell wall synthesis by inhibiting peptidoglycan cross-linkage
🗑
|
||||
Drug used for MRSA | Vancomycin
🗑
|
||||
Vancomycin MOA | Blocks peptidoglycan synthesis
🗑
|
||||
Type of resistance found with vancomycin | Point mutation
🗑
|
||||
Meningitis prophylaxis in exposed patients | Rifampin
🗑
|
||||
Technique used to diagnose perianal itching, and the drug used to treat it | "Scotch tape technique
and mebendazole"
🗑
|
||||
Two toxicities of aminoglycosides | nephro and ototoxicity
🗑
|
||||
DOC for Legionnaires' disease | Erythromycin
🗑
|
||||
MOA of sulfonamides | Inhibit dihydropteroate synthase
🗑
|
||||
Penicillins active against penicillinase secreting bacteria | Methicillin, nafcillin, and dicloxacillin
🗑
|
||||
Cheap wide spectrum antibiotic DOC of otitis media | Amoxicillin
🗑
|
||||
Class of antibiotics that have 10% cross sensitivity with penicillins | Cephalosporins
🗑
|
||||
PCN active against pseudomonas | Carbenicillin, piperacillin and ticarcillin
🗑
|
||||
Antibiotic causing red-man syndrome, and prevention | "Vancomycin, infusion
at a slow rate and antihistamines"
🗑
|
||||
Drug causes teeth discoloration | Tetracycline
🗑
|
||||
MOA of tetracycline | Decreases protein synthesis by inhibiting 30S ribosome
🗑
|
||||
Drug that causes gray baby syndrome and aplastic anemia | Chloramphenicol
🗑
|
||||
Drug notorious for causing pseudomembranous colitis | Clindamycin
🗑
|
||||
DOC for tx of pseudomembranous colitis | Metronidazole
🗑
|
||||
Treatment of resistant pseudomembranous colitis | ORAL vancomycin
🗑
|
||||
Anemia caused by trimethoprim | Megaloblastic anemia
🗑
|
||||
Reason fluoroquinolones are contraindicated in children and pregnancy | Cartilage damage
🗑
|
||||
DOC for giardia, bacterial vaginosis, pseudomembranous colitis, and trichomonas | Metronidazole
🗑
|
||||
Treatment for TB patients (think RIPE) | Rifampin, Isoniazid, Pyrazinamide, and Ethambutol
🗑
|
||||
Metronidazole SE if given with alcohol | Disulfiram-like reaction
🗑
|
||||
Common side effect of Rifampin | Red urine discoloration
🗑
|
||||
MOA of nystatin | Bind ergosterol in fungal cell membrane
🗑
|
||||
Neurotoxicity with isoniazid (INH) prevented by | Administration of Vit. B6 (pyridoxine)
🗑
|
||||
Toxicity of amphotericin | Nephrotoxicity
🗑
|
||||
SE seen only in men with administration of ketoconazole | Gynecomastia
🗑
|
||||
Topical DOC in impetigo | Topical mupirocin (Bactroban)
🗑
|
||||
DOC for influenza A | Amantadine
🗑
|
||||
DOC for RSV | Ribavirin
🗑
|
||||
DOC for CMV retinitis | Ganciclovir
🗑
|
||||
SE for ganciclovir | Neutro, leuko and thrombocytopenia
🗑
|
||||
Anti-viral agents associated with Stephen Johnson syndrome Nevirapine, amprenavir HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism | Protease inhibitors
🗑
|
||||
Antivirals that are teratogens | Delavirdine, efavirenz, and ribavirin
🗑
|
||||
Antivirals associated with neutropenia | Ganciclovir, zidovudine, saquinavir, and interferon
🗑
|
||||
HIV med used to reduce transmission during birth | AZT (zidovudine)
🗑
|
||||
Drug used for African sleeping sickness | Suramin
🗑
|
||||
Drug used in Chagas disease | Nifurtimox
🗑
|
||||
Cephalosporins able to cross the BBB | Cefixime (2nd) and 3rd generation
🗑
|
||||
Drug used for N. gonorrhea in females | Ceftriaxone
🗑
|
||||
Cephalosporin causes kernicterus in neonates | Ceftriaxone or cefuroxime
🗑
|
||||
SE of INH | Peripheral neuritis and hepatitis
🗑
|
||||
Aminoglycoside that is least ototoxic | Streptomycin
🗑
|
||||
Drug used in exoerythrocytic cycle of malaria | Primaquine
🗑
|
||||
Oral antibiotic of choice for moderate inflammatory acne | Minocycline
🗑
|
||||
Drug of choice for leprosy | Dapsone
🗑
|
||||
DOC for herpes and its MOA | Acyclovir and inhibits thymidine kinase Acyclovir and inhibits thymidine kinase
🗑
|
||||
Anti-microbials that cause hemolysis in G6PD-deficient patients | Sulfonamides
🗑
|
||||
MOA of erythromycin | Inhibition of protein synthesis at the 50s subunit of ribosome
🗑
|
||||
Anti-biotic frequently used for chronic UTI prophylaxis | sulfamethoxazole/ trimethoprim
🗑
|
||||
Lactam that can be used in PCN allergic patients | Aztreonam
🗑
|
||||
SE of imipenem | Seizures
🗑
|
||||
Anti-viral with a dose limiting toxicity of pancreatitis | Didanosine
🗑
|
||||
Sedative Hypnotics Common side effect of hypnotic agents | Sedation
🗑
|
||||
Occurs when sedative hypnotics are used chronically or at high doses | Tolerance
🗑
|
||||
The most common type of drug interaction of sedative hypnotics with other depressant medications | Additive CNS depression
🗑
|
||||
Benzodiazepines Major effect of benzodiazepines on sleep at high doses | REM is decreased
🗑
|
||||
Neurologic SE of benzodiazepines | Anterograde amnesia
🗑
|
||||
Reason benzos are used cautiously in pregnancy | Ability to cross the placenta
🗑
|
||||
Main route of metabolism for benzodiazepines | Hepatic
🗑
|
||||
Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired) | Lorazepam, oxazepam, and temazepam
🗑
|
||||
"MOA for benzodiazepines " | increase the FREQUENCY of GABA-mediated chloride ion channel opening
🗑
|
||||
Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects) | Flumazenil
🗑
|
||||
Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin | Diazepam
🗑
|
||||
Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia | Clonazepam
🗑
|
||||
Benzodiazepines that are the most effective in the treatment of panic disorder | Alprazolam and Clonazepam
🗑
|
||||
"Benzodiazepine that is used for anesthesia " | Midazolam
🗑
|
||||
DOC for status epilepticus | Diazepam
🗑
|
||||
Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs | Chlordiazepoxide and Diazepam
🗑
|
||||
Agents having active metabolites, long half lives, and a high incidence of adverse effects | Diazepam, Flurazepam, chlordiazepoxide, and clorazepate
🗑
|
||||
Barbiturates Barbiturates may precipitate this hematologic condition | Acute intermittent porphyria
🗑
|
||||
Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property | Liver enzyme INDUCTION
🗑
|
||||
Barbiturates MOA | Increase the DURATION of GABA-mediated chloride ion channels
🗑
|
||||
Barbiturate used for the induction of anesthesia | Thiopental
🗑
|
||||
Alcohols Important drug interaction with chloral hydrate | May displace coumadin from plasma proteins
🗑
|
||||
Others Site of action for zaleplon and zolpidem | Benzodiazepine receptor BZ1 (although are not considered benzodiazepines)
🗑
|
||||
Good hypnotic activity with less CNS SE than most benzodiazepines | Zolpidem, zaleplon
🗑
|
||||
Agent that is a partial agonist for the 5-HT1A receptor | Buspirone
🗑
|
||||
Drug of choice for generalized anxiety disorder, NOT effective in acute anxiety | Buspirone
🗑
|
||||
Alcohols Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS) | Ethanol
🗑
|
||||
Agent with zero-order kinetics | Ethanol
🗑
|
||||
Rate limiting step of alcohol metabolism | Aldehyde dehydrogenase
🗑
|
||||
System that increases in activity with chronic exposure and may contribute to tolerance | MEOS
🗑
|
||||
Agent that metabolize acetaldehyde to acetate | Aldehyde dehydrogenase
🗑
|
||||
Agents that inhibit alcohol dehydrogenase | Disulfiram, metronidazole, certain sulfonylureas and cephalosporins
🗑
|
||||
Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension | Disulfiram
🗑
|
||||
The most common neurologic abnormality in chronic alcoholics | Peripheral neuropathy (also excessive alcohol use is associated with HTN, anemia, and MI)
🗑
|
||||
Agent that is teratogen and causes a fetal syndrome | Alcohol
🗑
|
||||
Agent that is the antidote for methanol overdose | Alcohol
🗑
|
||||
Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure | Fomepizole
🗑
|
||||
Anti seizure Drugs Most frequent route of metabolism | Hepatic enzymes
🗑
|
||||
Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine | Sodium blockade
🗑
|
||||
MOA for benzodiazepines and barbiturates | GABA-related targets
🗑
|
||||
MOA for Ethosuximide | Calcium channels
🗑
|
||||
MOA for Valproic acid at high doses | Affect calcium, potassium, and sodium channels
🗑
|
||||
Drugs of choice for generalized tonic-clonic and partial seizures | Valproic acid and Phenytoin
🗑
|
||||
DOC for febrile seizures | Phenobarbital
🗑
|
||||
Drugs of choice for absence seizures | Ethosuximide and valproic acid
🗑
|
||||
Drug of choice for myoclonic seizures | Valproic acid
🗑
|
||||
Drugs of choice for status epilepticus | IV diazepam or phenytoin (for prolonged therapy not acute)
🗑
|
||||
Drugs that can be used for infantile spasms | Corticosteroids
🗑
|
||||
Anti-seizure drugs used also for bipolar affective disorder (BAD) | Valproic acid, carbamazepine, phenytoin and gabapentin
🗑
|
||||
Anti-seizure drugs used also for Trigeminal neuralgia | Carbamazepine
🗑
|
||||
Anti-seizure drugs used also for pain of neuropathic orgin | Gabapentin
🗑
|
||||
Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism | Phenytoin
🗑
|
||||
SE of phenytoin | Gingival hyperplasia, nystagmus, diplopia and ataxia
🗑
|
||||
Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida | Carbamazepine
🗑
|
||||
Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress | Valproic acid
🗑
|
||||
Laboratory value required to be monitored for patients on valproic acid | Serum ammonia and LFT's
🗑
|
||||
SE for Lamotrigine | Stevens-Johnson syndrome
🗑
|
||||
SE for Felbamate | Aplastic anemia and acute hepatic failure
🗑
|
||||
Anti-seizure medication also used in the prevention of migraines | Valproic acid
🗑
|
||||
Carbamazepine may cause | Agranulocytosis
🗑
|
||||
Anti-seizure drugs used as alternative drugs for mood stabilization | Carbamazepine, gabapentin, lamotrigine, and valproic acid
🗑
|
||||
General Anesthetics MOA of general anesthetics | Unclear, thought to increase the threshold for firing of CNS neurons
🗑
|
||||
Inhaled anesthetic with a low blood/gas partition coefficient | Nitrous oxide
🗑
|
||||
Inversely related to potency of anesthetics | Minimum alveolar anesthetic concentration (MAC)
🗑
|
||||
Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents | Halothane and methoxyflurane
🗑
|
||||
Most inhaled anesthetics SE | Decrease arterial blood pressure
🗑
|
||||
Inhaled anesthetics are myocardial depressants | Enflurane and halothane
🗑
|
||||
Inhaled anesthetic causes peripheral vasodilation | Isoflurane
🗑
|
||||
Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis | Halothane
🗑
|
||||
Inhaled anesthetics, less likely to lower blood pressure than other agents, and has the smallest effect on respiration | Nitrous oxide
🗑
|
||||
Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency | Methoxyflurane
🗑
|
||||
Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia | Nitrous oxide
🗑
|
||||
Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm | Desflurane
🗑
|
||||
DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics | Dantrolene
🗑
|
||||
IV barbiturate used as a pre-op anesthetic | Thiopental
🗑
|
||||
Benzodiazepine used adjunctively in anesthesia | Midazolam
🗑
|
||||
Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose | Flumazenil
🗑
|
||||
This produces "dissociative anesthesia", is a cardiovascular stimulant which may increases intracranial pressure, and hallucinations occur during recovery | Ketamine
🗑
|
||||
Opioid associated with respiratory depression, but is used in high risk patients who may not survive full general anesthetia | Fentanyl
🗑
|
||||
State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide | Neuroleptanesthesia
🗑
|
||||
Produces both rapid anesthesia and recovery, has antiemetic activity and commonly used for outpatient surgery, may cause marked hypotension | Propofol
🗑
|
||||
Local Anesthetics MOA of local anesthetics (LA's) | Block voltage-dependent sodium channels
🗑
|
||||
This may enhance activity of local anesthetics | Hyperkalemia
🗑
|
||||
This may antagonize activity of local anesthetics | Hypercalcemia
🗑
|
||||
Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity | Vasodilation
🗑
|
||||
Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery | Cocaine
🗑
|
||||
Longer acting local anesthetics which are less dependent on vasoconstrictors | Tetracaine and bupivacaine
🗑
|
||||
These LA's have surface activity | Cocaine and benzocaine
🗑
|
||||
Most important toxic effects of most local anesthetics | CNS toxicity
🗑
|
||||
Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction | Cocaine
🗑
|
||||
LA causing methemoglobinemia | Prilocaine
🗑
|
||||
Skeletal Muscle Relaxants Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation | Neuromuscular blocking drugs
🗑
|
||||
These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB) | Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic
🗑
|
||||
These prevent the action of Ach at the skeletal muscle endplate to produce a "surmountable blockade," effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine) | Nondepolarizing type antagonists
🗑
|
||||
Agent with long duration of action and is sost likely to cause histamine release | Tubocurarine
🗑
|
||||
Non-depolarizing antagonist has short duration | Mivacurium
🗑
|
||||
Agent can blocking muscarinic receptors | Pancuronium
🗑
|
||||
Agent undergoing Hofmann elimination (breaking down spontaneously) | Atracurium
🗑
|
||||
One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis, xcuses muscle pain postoperatively and myoglobinuria may occur | Succinylcholine
🗑
|
||||
During Phase I these agents worsen the paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine | Cholinesterase inhibitors
🗑
|
||||
Spasmolytic drugs Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease | Spasmolytic drugs
🗑
|
||||
Facilitates GABA presynaptic inhibition | Diazepam
🗑
|
||||
GABA agonist in the spinal cord | Baclofen
🗑
|
||||
Similar to clonidine and may cause hypotension | Tizanidine
🗑
|
||||
DOC for malignant hyperthermia by acting on the sacroplasmic reticulum or skeletal muscle | Dantrolene
🗑
|
||||
Agent used for acute muscle spasm | Cyclobenzaprine
🗑
|
||||
Drugs Used in Parkinsonism & Other Movement Disorders Antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog) and is irreversible | Drug induced Parkinsonism
🗑
|
||||
Agent used in drug therapy of Parkinson's instead of Dopamine which has low bioavailability and does not cross the BBB | L-dopa
🗑
|
||||
This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE's (GI distress, postural hypotension, and dyskinesias) | Carbidopa
🗑
|
||||
Clinical response that may fluctuate in tx of Parkinson's dx | "On-off-phenomenon"
🗑
|
||||
Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma | Levodopa
🗑
|
||||
Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia | Bromocriptine
🗑
|
||||
Non ergot agents used as first-line therapy in the initial management of Parkinson's | Pramipexole and ropinirole
🗑
|
||||
Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis | Amantadine
🗑
|
||||
Inhibitor of MAO type B which metabolizes dopamine, used adjunct to levodopa or as sole agent in newly diagnosed pt's | Selegiline
🗑
|
||||
Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson's dx and cause acute hepatic failure (monitor LFT's) | Entacapone and Tolcapone
🗑
|
||||
Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects | Benztropine
🗑
|
||||
Agent effective in physiologic and essential tremor | Propranolol
🗑
|
||||
Agents used in Huntington's Disease | Tetrabenazine (amine depleting drug), Haloperidol (antipsychotic)
🗑
|
||||
Agents used in Tourette's dx | Haloperidol or pimozide
🗑
|
||||
Chelating agent used in Wilson's disease | Penicillamine
🗑
|
||||
Antipsychotics Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor | Older antipsychotic agents, D2 receptors
🗑
|
||||
Side effects occuring in antipsychotics that block dopamine | Hyperprolactinemia, menorrhea, galactorrhea, confusion, mood changes, decreased sexual interest, and weight gain
🗑
|
||||
Antipsychotics that reduce positive symptoms only | Older antipsychotics
🗑
|
||||
Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation | Olanzapine, aripiprazole, and sertindole
🗑
|
||||
Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia | Risperidone
🗑
|
||||
Atypical antipsychotic causing high prolactin levels | Risperidone
🗑
|
||||
Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes | Olanzapine
🗑
|
||||
Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker | Haloperidol
🗑
|
||||
Drug used in neuroleptic malignant syndrome | Dantrolene
🗑
|
||||
Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment) Muscarinic blockers Antipsychotic having the strongest autonomic effects | Thioridazine
🗑
|
||||
Antipsychotic having the weakest autonomic effects | Haloperidol
🗑
|
||||
Antipsychotic that does not block muscarinic or histamine receptors, and it prolongs the QT interval | Sertindole
🗑
|
||||
Only phenothiazine not exerting antiemetic effects, can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias | Thioridazine
🗑
|
||||
Agent having no effect on D2 receptors, blocks D4, reserved for resistant schizophrenia, and can cause agranulocytosis | Clozapine
🗑
|
||||
Anti-psychotic not shown to cause tardive dyskinesia | Clozapine
🗑
|
||||
Anti-psychotics available in depot preparation | Fluphenazine and haloperidol
🗑
|
||||
Reduced seizure threshold | Low-potency typical antipsychotics and clozapine
🗑
|
||||
Orthostatic hypotension and QT prolongation | Low potency and risperidone
🗑
|
||||
Increased risk of developing cataracts | Quetiapine
🗑
|
||||
Lithium Major route of elimination for Lithium | Kidneys
🗑
|
||||
Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop | Lithium toxicity
🗑
|
||||
Drug increases the renal clearance hence decreases levels of lithium | Theophylline
🗑
|
||||
Lithium is associated with this congenital defect | Cardiac anomalies and is contraindicated in pregnancy or lactation
🗑
|
||||
DOC for bipolar affective disorder | Lithium
🗑
|
||||
SE of lithium | Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus
🗑
|
||||
Antidepressants Example of three antidepressants that are indicated for obsessive compulsive disorder | Clomipramine, fluoxetine and fluvoxamine
🗑
|
||||
Neurotransmitters affected by the action of antidepressants | Norepinephrine and serotonin
🗑
|
||||
Usual time needed for full effect of antidepressant therapy | 2 to 3 weeks
🗑
|
||||
Population group especially sensitive to side effects of antidepressants | Elderly patients
🗑
|
||||
All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion | Side-effect profile and prior pt response
🗑
|
||||
Well-tolerated and are first-line antidepressants | SSRI's, bupropion, and venlafaxine
🗑
|
||||
Monoamine oxidase inhibitors (MAOI) Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression | Monamine oxidase inhibitors
🗑
|
||||
Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats) | Hypertensive crisis
🗑
|
||||
MAOI should not be administered with SSRI's or potent TCA's due to development of this condition | Serotonin syndrome
🗑
|
||||
Tricyclic antidepressants (TCA) Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly | Tricyclic antidepressants (TCA)
🗑
|
||||
Three C's associated with TCA toxicity | Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)
🗑
|
||||
Agents having higher sedation and antimuscarinic effects than other TCA's | Tertiary amines
🗑
|
||||
TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects | Amitriptyline
🗑
|
||||
TCA used in chronic pain, enuresis, and ADD | Imipramine
🗑
|
||||
TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep | Doxepin
🗑
|
||||
TCA used in obsessive compulsive disorder (OCD), most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms | Clomipramine
🗑
|
||||
Secondary amines that have less sedation and more excitation effect | Nortriptyline, Desipramine
🗑
|
||||
Heterocyclics Antidepressant associated with neuroleptic malignant syndrome | Amoxapine
🗑
|
||||
Antidepressant associated with seizures and cardiotoxicity | Maprotiline
🗑
|
||||
Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure | Venlafaxine
🗑
|
||||
Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake | Venlafaxine
🗑
|
||||
Antidepressant also used for sleep that causes priapism | Trazodone
🗑
|
||||
Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure | Nefazodone
🗑
|
||||
Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures | Bupropion
🗑
|
||||
Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating | Mirtazapine
🗑
|
||||
SE of mirtazapine | Liver toxicity, increased serum cholesterol
🗑
|
||||
Selective serotonin reuptake inhibitors (SSRI) Except for these agents all SSRI have significant inhibition of CytP450 enzymes | Citalopram and its metabolite escitalopram
🗑
|
||||
SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx | Fluoxetine
🗑
|
||||
SSRI indicated for premenstrual dysphoric disorder | Fluoxetine (Sarafem)
🗑
|
||||
Some of SSRIs' therapeutic effects beside depression | Panic attacks, social phobias, bulimia nervosa, and PMDD premenstrual dysphoric disorder), OCD
🗑
|
||||
SSRI's less likely to cause a withdrawal syndrome | Fluoxetine
🗑
|
||||
Opioid Analgesics & Antagonists Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons | Ascending pathways
🗑
|
||||
Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release | Presynaptic mu, delta, and kappa receptors
🗑
|
||||
Activation of these receptors open K+ ion channels to cause membrane hyperpolarization | Postsynaptic Mu receptors
🗑
|
||||
Tolerance to all effects of opioid agonists can develop except | Miosis and constipation
🗑
|
||||
All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction | Meperidine
🗑
|
||||
SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone | Opioid Analgesics
🗑
|
||||
Strong opioid agonists | Morphine, methadone, meperidine, and fentanyl
🗑
|
||||
Opioids used in anesthesia | Morphine and fentanyl
🗑
|
||||
Opioid used in the management of withdrawal states | Methadone
🗑
|
||||
Opioid available trans-dermally | Fentanyl
🗑
|
||||
Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema | Morphine
🗑
|
||||
Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome | Meperidine
🗑
|
||||
Moderate opioid agonists | Codeine, hydrocodone, and oxycodone
🗑
|
||||
Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures | Propoxyphene
🗑
|
||||
Partial agonist or mixed antagonists Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal | Buprenorphine
🗑
|
||||
Opioid antagonist that is given IV and had short DOA | Naloxone
🗑
|
||||
Opioid antagonist that is given orally in alcohol dependency programs | Naltrexone
🗑
|
||||
These agents are used as antitussive | Dextromethorphan, Codeine
🗑
|
||||
These agents are used as antidiarrheal | Diphenoxylate, Loperamide
🗑
|
||||
Drugs of Abuse Inhalant anesthetics | NO, chloroform, and diethyl ether
🗑
|
||||
Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation | Fluorocarbons and Industrial solvents
🗑
|
||||
Cause dizziness, tachycardia, hypotension, and flushing | Organic nitrites
🗑
|
||||
Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression | Steroids
🗑
|
||||
Readily detected markers that may assist in diagnosis of the cause of a drug overdose include | Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses
🗑
|
||||
Opioid Analgesics Most commonly abused in health care professionals | Heroin, morphine, oxycodone, meperidine and fentanyl
🗑
|
||||
This route is associated with rapid tolerance and psychologic dependence | IV administration
🗑
|
||||
Leads to respiratory depression progressing to coma and death | Overdose of opioids
🗑
|
||||
Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome | Abstinence syndrome
🗑
|
||||
Treatment for opioid addiction | Methadone, followed by slow dose reduction
🗑
|
||||
This agent may cause more severe, rapid and intense symptoms to a recovering addict | Naloxone
🗑
|
||||
Sedative-Hypnotics Sedative-Hypnotics action | Reduce inhibition, suppress anxiety, and produce relaxation
🗑
|
||||
Additive effects when Sedative-Hypnotics used in combination with these agents | CNS depressants
🗑
|
||||
Common mechanism by which overdose result in death | Depression of medullary and cardiovascular centers
🗑
|
||||
"Date rape drug" | Flunitrazepam (rohypnol)
🗑
|
||||
The most important sign of withdrawal syndrome | Excessive CNS stimulation (seizures)
🗑
|
||||
Treatment of withdrawal syndrome involves | Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol
🗑
|
||||
These agents are CNS depressants | Ethanol, Barbiturates, and Benzodiazepines
🗑
|
||||
Stimulants Withdrawal from this drug causes lethargy, irritability, and headache | Caffeine
🗑
|
||||
W/D from this drug causes anxiety and mental discomfort | Nicotine
🗑
|
||||
Treatments available for nicotine addiction | Patches, gum, nasal spray, psychotherapy, and bupropion
🗑
|
||||
Chronic high dose abuse of nicotine leads to | Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures
🗑
|
||||
Tolerance is marked and abstinence syndrome occurs | Amphetamines
🗑
|
||||
Amphetamine agents | Dextroamphetamines and methamphetamine
🗑
|
||||
These agents are congeners of Amphetamine | DOM, STP, MDA, and MDMA "ecstasy"
🗑
|
||||
Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke) | Cocaine "super-speed"
🗑
|
||||
Hallucinogens Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic | PCP
🗑
|
||||
Removal of PCP may be aided | Urinary acidification and activated charcoal or continual nasogastric suction
🗑
|
||||
THC is active ingredient, SE's include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur | Marijuana
🗑
|
||||
This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention | Bethanechol
🗑
|
||||
Only direct acting agent that is very lipid soluble and used in glaucoma | Pilocarpine
🗑
|
||||
This agent used to treat dry mouth in Sjögren's syndrome | Cevimeline
🗑
|
||||
Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis | Edrophonium
🗑
|
||||
Carbamate with intermediate action postoperative and neurogenic ileus and urinary retention | Neostigmine
🗑
|
||||
Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions | Physostigmine
🗑
|
||||
Treatment of myasthenia gravis | Pyridostigmine
🗑
|
||||
Organophosphates Antiglaucoma organophosphate | Echothiophate
🗑
|
||||
Associated with an increased incidence of cataracts in patients treated for glaucoma | Long acting cholinesterase inhibitors
🗑
|
||||
Scabicide organophosphate | Malathion
🗑
|
||||
Organophosphate anthelmintic agent with long DOA | Metrifonate
🗑
|
||||
Toxicity of organophosphate: | DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)
🗑
|
||||
The most important cause of acute deaths in cholinesterase inhibitor toxicity | Respiratory failure
🗑
|
||||
The most toxic organophosphate | Parathion
🗑
|
||||
Treatment of choice for organophosphate overdose | Atropine
🗑
|
||||
This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure | Pralidoxime
🗑
|
||||
Cholinoreceptor Blockers & Cholinesterase Regenerators Prototypical drug is atropine | Nonselective Muscarinic Antagonists
🗑
|
||||
Treat manifestations of Parkinson's disease and EPS | Benztropine, trihexyphenidyl
🗑
|
||||
Treatment of motion sickness | Scopolamine
🗑
|
||||
Produce mydriasis and cycloplegia | Atropine, homatropine tropicamide
🗑
|
||||
Bronchodilation in asthma and COPD | Ipratropium
🗑
|
||||
Reduce transient hyper GI motility | Dicyclomine, methscopolamine
🗑
|
||||
Cystitis, postoperative bladder spasms, or incontinence | Oxybutynin, dicyclomine
🗑
|
||||
Toxicity of anticholinergics | block SLUD (salivation, lacrimation, urination, defecation
🗑
|
||||
Another pneumonic for anticholinergic toxicity | "dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat"
🗑
|
||||
Atropine fever is the most dangerous effect and can be lethal in this population group | Infants
🗑
|
||||
Contraindications to use of atropine | Infants, closed angle glaucoma, prostatic hypertrophy
🗑
|
||||
Nicotinic Antagonists Prototype ganglion blocker | Hexamethonium
🗑
|
||||
Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate | Severe hypertension
🗑
|
||||
Reversal of blockade by neuromuscular blockers | Cholinesterase inhibitors
🗑
|
||||
Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis | Nondepolarizing Neuromuscular Blockers
🗑
|
||||
Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use | Succinylcholine
🗑
|
||||
Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred) | Cholinesterase Regenerators
🗑
|
||||
Used to treat patients exposed to insecticides such as parathion | Pralidoxime
🗑
|
||||
Sympathomimetics Pneumonic for beta receptors | You have 1 heart (Beta 1) and 2 lungs (Beta 2)
🗑
|
||||
This is the drug of choice for anaphylactic shock | Epinephrine
🗑
|
||||
Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction | Amphetamines
🗑
|
||||
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia | Phenylephrine
🗑
|
||||
Epinephrine and dipivefrin are used for | Glaucoma
🗑
|
||||
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma | Reduce aqueous synthesis
🗑
|
||||
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis | Albuterol
🗑
|
||||
Longer acting Beta 2 agonists is recommended for prophylaxis of asthma | Salmeterol
🗑
|
||||
These agents increase blood flow and may be beneficial in treatment of acute heart failure and some types of shock | Beta1 agonists
🗑
|
||||
These agents decrease blood flow or increase blood pressure, are local decongestant, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion | Alpha1 agonists
🗑
|
||||
Shock due to septicemia or myocardial infarction is made worse by | Increasing afterload and tissue perfusion declines
🗑
|
||||
Often mixed with local anesthetic to | Reduce the loss from area of injection
🗑
|
||||
Chronic orthostatic hypotension can be treated with | Midodrine
🗑
|
||||
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus | Terbutaline
🗑
|
||||
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis | Ephedrine
🗑
|
||||
Alpha 1 agonist toxicity | Hypertension
🗑
|
||||
Beta 1 agonist toxicity | Sinus tachycardia and serious arrhythmias
🗑
|
||||
Beta 2 agonist toxicity | Skeletal muscle tremor
🗑
|
||||
The selective agents loose their selectivity at | high doses
🗑
|
||||
Adrenoceptor Blocker Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis | Phenoxybenzamine
🗑
|
||||
Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud's phenomena | Phentolamine
🗑
|
||||
Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension | Prazosin, terazosin, doxazosin
🗑
|
||||
Selective Alpha 2 blocker used for impotence (controversial effectiveness) | Yohimbine
🗑
|
||||
Beta-Blocking Drugs SelectiveB1 Receptor blockers that may be useful in treating patients with asthma | Acebutolol, atenolol, esmolol, metoprolol
🗑
|
||||
Combined alpha and beta blocking agents that may have application in treatment of CHF | Labetalol and carvedilol
🗑
|
||||
Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma | Pindolol and acebutolol
🗑
|
||||
This beta blocker lacks local anesthetic activity (decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma | Timolol
🗑
|
||||
This parenteral beta blocker is a short acting | Esmolol
🗑
|
||||
This beta blocker is the longest acting | Nadolol
🗑
|
||||
These beta blockers are less lipid soluble | Acebutolol and atenolol
🗑
|
||||
This beta blocker is highly lipid soluble and may account for side effects such as nightmares | Propranolol
🗑
|
||||
Clinical uses of these agents include treatment of HTN, angina, arrhythmias, and chronic CHF | Beta blockers
🗑
|
||||
Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF, signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety) | Beta blockers
🗑
|
||||
Glaucoma (all agents topical except for diuretics) Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction | Pilocarpine, carbachol, physostigmine
🗑
|
||||
Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins | Epinephrine, dipivefrin
🗑
|
||||
Selective alpha agonists that decreases aqueous secretion | Apraclonidine, brimonidine
🗑
|
||||
These Beta blockers decrease aqueous secretion | Timolol (nonselective), betaxolol (selective)
🗑
|
||||
This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis | Acetazolamide
🗑
|
||||
This agent cause increased aqueous outflow | Prostaglandin PGF2a
🗑
|
||||
Antihypertensive Agents Inhibit angiotensin-converting enzyme (ACE) | Ace inhibitors
🗑
|
||||
Captopril and enalapril (-OPRIL ending) are | Ace inhibitors
🗑
|
||||
SE of ACE inhibitors | Dry cough, hyperkalemia
🗑
|
||||
Ace inhibitors are contraindicated in | pregnancy and with K+
🗑
|
||||
Losartan and valsartan block | Angiotensin receptor
🗑
|
||||
Angiotensin receptor blockers do NOT cause | Dry cough
🗑
|
||||
Block L-type calcium channel | Calcium channel blockers
🗑
|
||||
CCB contraindicated in CHF | Verapamil
🗑
|
||||
CCB with predominate effect on arteriole dilation | Nifedipine
🗑
|
||||
SE of CCB | Constipation, edema, and headache
🗑
|
||||
Reduce heart rate, contractility, and O2 demand | Beta-blockers
🗑
|
||||
B-blockers that are more cardioselective | Beta C2001-selective blockers
🗑
|
||||
Cardioselective Beta 1-blockers | Atenolol, acebutolol, and metoprolol
🗑
|
||||
Beta-blockers should be used cautiously in | Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease
🗑
|
||||
Non-selective Beta-blocker also used for migraine prophylaxis | Propranolol
🗑
|
||||
SE of beta blockers | Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)
🗑
|
||||
Alpha 1selective blockers | Prazosin, terazosin and doxazosin (-AZOSIN ending)
🗑
|
||||
Non-selective Alpha1blockers use to treat pheochromocytoma | Phenoxybenzamine
🗑
|
||||
For rebound HTN from rapid clonidine withdrawal | Phentolamine
🗑
|
||||
A1a-selective blocker used for BPH | Tamsulosin (Flomax)
🗑
|
||||
SE of alpha blockers | Orthostatic hypotension (especially with first dose) and reflex tachycardia
🗑
|
||||
Presynaptic Alpha 2 agonist used in HTN | Clonidine, and methyldopa
🗑
|
||||
SE of methyldopa | Positive Comb's test, depression
🗑
|
||||
Methyldopa is contraindicated in | Geriatrics due to its CNS (depression) effects
🗑
|
||||
SE of clonidine | Rebound HTN, sedation, dry mouth
🗑
|
||||
Ganglionic blockers formerly used in HTN | Trimethaphan, and hexamethonium
🗑
|
||||
Direct vasodilator of arteriolar smooth muscle | Hydralazine
🗑
|
||||
SE of hydralazine | Lupus-like syndrome
🗑
|
||||
Arterial vasodilator that works by opening K+ channels | Minoxidil
🗑
|
||||
SE of minoxidil | Hypertrichosis
🗑
|
||||
IV Drug used Hypertensive Crisis | Nitroprusside
🗑
|
||||
Nitroprusside vasodilates | Arteries and veins
🗑
|
||||
Toxicity caused by nitroprusside and treatment | Cyanide toxicity treated with sodium thiosulfate
🗑
|
||||
Diuretics Carbonic anhydrase inhibitor | Acetazolamide
🗑
|
||||
Diuretic used for mountain sickness and glaucoma | Acetazolamide
🗑
|
||||
SE of acetazolamide | Paresthesias, alkalization of the urine (which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment
🗑
|
||||
MOA of loop diuretics | inhibits Na+/K+/2Cl- cotransport
🗑
|
||||
Site of action of loop diuretics | Thick ascending limb
🗑
|
||||
SE of loop (furosemide) diuretics | Hyperuricemia, hypokalemia and ototoxicity
🗑
|
||||
Aminoglycosides used with loop diuretics potentiate adverse effect | Ototoxicity
🗑
|
||||
Loops lose and thiazide diuretics retain | Calcium
🗑
|
||||
MOA of thiazide diuretics | Inhibit Na+/Cl- cotransport
🗑
|
||||
Site of action of thiazide diuretics | Work at early distal convoluted tubule
🗑
|
||||
Class of drugs that may cause cross-sensitivity with thiazide diuretics | Sulfonamides
🗑
|
||||
SE of thiazide (HCTZ) diuretics | Hyperuricemia, hypokalemia and hyperglycemia
🗑
|
||||
Potassium sparing diuretics inhibit | Na+/K+ exchange
🗑
|
||||
Diuretic used to treat primary aldosteronism | Spironolactone
🗑
|
||||
SE of spironolactone | Gynecomastia hyperkalemia, and impotence
🗑
|
||||
Osmotic diuretic used for increased intracranial pressure | Mannitol
🗑
|
||||
Antidiuretic hormone (ADH) agonist and antagonist ADH agonist used for pituitary diabetes insipidus | Desmopressin (DDAVP)
🗑
|
||||
Used for SIADH | Demeclocycline
🗑
|
||||
SE of demeclocycline | Bone marrow and teeth discoloration for children under 8 years of age
🗑
|
||||
Antiarrhythmic agents MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics | Sodium channel blockers
🗑
|
||||
SE of procainamide | Lupus-like syndrome
🗑
|
||||
Limiting side effect of Quinidine | Prolongs QT interval
🗑
|
||||
Other side effects of Quinidine | Thrombocytopenic purpura, and CINCHONISM
🗑
|
||||
Major drug interaction with Quinidine | Increases concentration of Digoxin
🗑
|
||||
DOC for management of acute Ventricular arrhythmias | Lidocaine
🗑
|
||||
DOC for digoxin induced arrhythmias | Phenytoin
🗑
|
||||
SE of phenytoin | Gingival hyperplasia
🗑
|
||||
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents | Class IC (flecainide, propafenone, moricizine)
🗑
|
||||
Class II antiarrhythmics are | B-blockers
🗑
|
||||
Antiarrhythmic that exhibits Class II and III properties | Sotalol
🗑
|
||||
Side effect of sotalol | prolongs QT and PR interval
🗑
|
||||
Used intravenously for acute arrhythmias during surgery | Esmolol
🗑
|
||||
Anti-arrhythmics that decrease mortality | B-blockers
🗑
|
||||
MOA of class III antiarrhythmics | Potassium channel blockers
🗑
|
||||
Class III antiarrhythmic that exhibits properties of all 4 classes | Amiodarone
🗑
|
||||
Specific pharmacokinetic characteristic of amiodarone | Prolonged half-life, up to six weeks
🗑
|
||||
Antiarrhythmic effective in most types of arrhythmia | Amiodarone
🗑
|
||||
SE of Amiodarone | Dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits
🗑
|
||||
MOA of class IV antiarrhythmics | Calcium channel blockers
🗑
|
||||
Life threatening cardiac event that prolong QT leads to | Torsades de pointes
🗑
|
||||
Agent to treat torsades de pointes | Magnesium sulfate
🗑
|
||||
Drug used supraventricular arrhythmias | Digoxin
🗑
|
||||
DOC for paroxysmal supraventricular tachycardia (PSVT) | Adenosine
🗑
|
||||
Adenosine's MOA | Activates acetylcholine sensitive K+ channels in SA and AV node
🗑
|
||||
Anti-arrhythmic with 15 second duration of action | Adenosine
🗑
|
||||
Vasodilators and treatment of angina MOA of sildenafil (Viagra) | Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP
🗑
|
||||
Drugs used in the management of angina | Aspirin, Nitrates, CCB, and Beta blockers
🗑
|
||||
Aspirin reduces mortality in unstable angina by | Platelet aggregation inhibition
🗑
|
||||
MOA of nitrates | Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles
🗑
|
||||
Nitrate used for acute anginal attacks | Nitroglycerin sublingual tablets
🗑
|
||||
Nitrate used to prevent further attacks | Oral and transdermal forms of nitroglycerin
🗑
|
||||
Nitrate free intervals are needed due to | Tolerance
🗑
|
||||
SE of nitrates | Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation
🗑
|
||||
CCB are DOC for | Prinzmetal's angina
🗑
|
||||
Beta blockers are used for which type of anginal attack | Classic
🗑
|
||||
Drugs used to treat CHF MOA of Cardiac glycosides (eg. digoxin) | Indirectly increase intracellular calcium and cardiac contractility by inhibit Na+/K+ ATPase
🗑
|
||||
Digoxin is used in | Atrial fibrillation and CHF
🗑
|
||||
Digoxin toxicity can be precipitated by | Hypokalemia
🗑
|
||||
Antidote for digoxin toxicity | Digibind
🗑
|
||||
Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects | Amrinone and milrinone
🗑
|
||||
SE of amrinone | Thrombocytopenia
🗑
|
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Beta 1 agonists used in acute CHF | Dobutamine and dopamine
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Diuretics work in CHF by | Reducing preload
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Beta blockers work in CHF by | Reducing progression of heart failure (never use in acute heart failure)
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Agent used in CHF that is a selective alpha and nonselective beta blocker | Carvedilol
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Agent used in acutely decompensated CHF resembling natriuretic peptide | Nesiritide (Natrecor)
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Drugs used in coagulation disorders Vitamin K dependent anticoagulant | Warfarin (PT)
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Warfarin is contraindicated in | Pregnancy
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Anticoagulant of choice in pregnancy | Heparin
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Heparin (PTT) increases activity of | Antithrombin 3
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Route of administration of warfarin | Oral
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Routes of administration of heparin | IM (only LMW) and IV
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SE of both warfarin and heparin | Bleeding
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SE of heparin | Heparin induced thrombocytopenia (HIT)
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Alternative anticoagulant used if HIT develops | Lepirudin
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Antidote to reverse actions of warfarin | Vitamin K or fresh frozen plasma
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Antidote to reverse actions of heparin | Protamine sulfate
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|
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MOA of aspirin | Irreversibly blocking cyclooxygenase
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|
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Agent used to treat MI and to reduce incidence of subsequent MI | Aspirin
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|
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SE of Aspirin | GI bleeding
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|
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Antiplatelet drug reserved for patients allergic to aspirin | Ticlopidine
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|
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SE for ticlopidine | Neutropenia and agranulocytosis
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|
||||
Effective in preventing TIA's | Clopidogrel and ticlopidine
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|
||||
Prevents thrombosis in patients with artificial heart valve | Dipyridamole
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|
||||
Block glycoprotein IIb/IIIa involved in platelet cross-linking | Abciximab, tirofiban and eptifibatide
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|
||||
MOA of thrombolytics | Degradation of fibrin clots and are administered
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|
||||
Thrombolytics are used for | Pulmonary embolism and DVT
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|
||||
Thrombolytic that can cause allergic reaction | Streptokinase
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|
||||
Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA | Tissue plasmin activator
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|
||||
SE of tPA | Cerebral hemorrhage
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|
||||
Antidote for thrombolytics | Aminocaproic acid
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|
||||
Agents used in anemias and hematopoietic growth factors Agent to treat hypochromic microcytic anemias | Ferrous sulfate
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|
||||
Chelating agent used in acute iron toxicity | Deferoxamine
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|
||||
Agent for pernicious anemia | Cyanocobalamin (Vit B12)
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|
||||
Agent used for neurological deficits in megaloblastic anemia | Vitamin B12
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|
||||
Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy | Folic acid
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|
||||
Agent used for anemias associated with renal failure | Erythropoietin
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|
||||
Agent used neutropenia especially after chemotherapy | G-CSF (filgrastim) and GM-CSF (sargramostim)
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|
||||
Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy | Interleukin 11 (oprelvekin)
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|
||||
Antihyperlipidemics Decrease intestinal absorption of cholesterol | Bile acid-binding resins
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|
||||
Cholestyramine and colestipol are | Bile acid-binding resins
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|
||||
Major nutritional side effect of bile acid-binding resins | Impair absorption of fat soluble vitamin absorption (A,D,E,K)
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|
||||
MOA of lovastatin (STATIN) | inhibits HMG COA reductase
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|
||||
HMG CoA reductase inhibitors are contraindicated in | Pregnancy
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|
||||
Drug or foods (grapefruit juice) that increase statin effect | Inhibit Cytochrome P450 3A4
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|
||||
SE of HMG COA reductase inhibitors | Rhabdomyolysis and Hepatotoxicity
🗑
|
||||
Monitoring parameter to obtain before initiation of STATINS | LFT's
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|
||||
Decreases liver triglycerol synthesis | Niacin
🗑
|
||||
SE of niacin | Cutaneous flush
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|
||||
Cutaneous flush and be reduced by pretreatment with | Aspirin
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|
||||
Fibrates (gemfibrozil) increase activity of | Lipoprotein lipase
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|
||||
Most common SE of fibrates | Nausea
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|
||||
Fibrates are contraindicated in | Pregnancy
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|
||||
Concurrent use of fibrates and statins increases risk of | Rhabdomyolysis
🗑
|
||||
New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins | Ezetimibe (Zetia)
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|
||||
NSAIDS and DMARDS MOA of NSAIDS | inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
🗑
|
||||
Difference between aspirin and other NSAIDS | Aspirin irreversibly inhibits cyclooxygenase
🗑
|
||||
Four main actions of NSAIDS | Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
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|
||||
Agent used for closure of patent ductus arteriosus | Indomethacin
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|
||||
Aspirin is contraindicated in children with viral infection | Potential for development of Reye's syndrome
🗑
|
||||
SE of salicylates | Tinnitus, GI bleeding
🗑
|
||||
NSAID also available as an ophthalmic preparation | Diclofenac
🗑
|
||||
NSAID available orally, IM and ophthalmically | Ketoralac
🗑
|
||||
NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity | Ketoralac
🗑
|
||||
Newer NSAIDs that selectively inhibit COX-2 | Celecoxib and rofecoxib
🗑
|
||||
COX 2 inhibitors may have reduced risk of | Gastric ulcers and GI Bleeding
🗑
|
||||
COX 2 inhibitors should be used cautiously in pts with | Pre-existing cardiac or renal disease
🗑
|
||||
Acetaminophen only has | Antipyretic and analgesic activity
🗑
|
||||
SE of acetaminophen | Hepatotoxicity
🗑
|
||||
Antidote for acetaminophen toxicity | N-acetylcysteine
🗑
|
||||
Drugs-Modifying Anti-Rheumatic Agents (DMARDS) DMARDs are slow acting drugs for | Rheumatic disease
🗑
|
||||
MOA of gold salts | Alter activity of macrophages and suppress phagocytic activity of PMNs
🗑
|
||||
SE of gold salts | Dermatitis of the mouth aplastic anemia and agranulocytosis
🗑
|
||||
Causes bone marrow suppression | Methotrexate
🗑
|
||||
SE of penicillamine | Aplastic anemia and renal
🗑
|
||||
Interferes with activity of T-lymphocytes | Hydroxychloroquine
🗑
|
||||
Anti-malarial drug used in rheumatoid arthritis (RA) | Hydroxychloroquine
🗑
|
||||
SE of hydroxychloroquine | Retinal destruction and dermatitis
🗑
|
||||
MOA of Leflunomide (newer agent) | Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
🗑
|
||||
Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha) | Infliximab and etanercept
🗑
|
||||
Anti-rheumatic agent also used for ulcerative colitis | Sulfasalazine
🗑
|
||||
Drugs used in Gout NSAIDS used in gout | Indomethacin and phenylbutazone
🗑
|
||||
NSAID contraindicated in gout | Aspirin
🗑
|
||||
SE of phenylbutazone | Aplastic anemia and agranulocytosis
🗑
|
||||
MOA of Colchicine (used in acute gout) | Selective inhibitor of microtubule assembly
🗑
|
||||
SE of colchicine | Kidney and liver toxicity
🗑
|
||||
Agent used to treat chronic gout by increasing uric acid secretion | Probenecid and sulfinpyrazone
🗑
|
||||
Allopurinol treats chronic gout by inhibiting | Xanthine oxidase
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
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To hide a column, click on the column name.
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You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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