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Step 1 11.19.12

Pharm III

QuestionAnswer
Which types of fibers do hemicholinium, vesamicol, and botulinum affect? cholinergic
which type of fibers os metyrosine, roserpine, guanithedine, amphetimine, and Cocaine affecT? noradrenergic
What modulates NE release from a sympathetic nerve ending? NE itseld acting on presynaptic alpha 2 autorecptors and ACH, angiotensin 2 among others
What is the class of Bethanecol, carbachol, pilocarpine, methacholine? direct cholinergic agonists
What are the clinical applications of bethanechol? post op and neurogenic ileus and urinary retention
What is the mech of bethanechol? activates bowel and bladder SMM, resistant to AChE
What is the clinical use of carbachol? glaucoma, pupillary contraction, relief of intraocular pressure
What is the mech of carbochol? copy of acetylcholine
what is the clinical use of pilocarpine? potent stimulator of sweat tears and saliva
What is the mech of pilocarpine? contracts cilisry muscle of eye (open angle), pupillary sphincter ( narrow angle), restant to ACHE
What is the clinical use of methacholine? challenge test for asthma
What is the mech of methacholine? stimulates muscarinic receptors in airways when inhaled
What is the drug class of neostigmine, pyridostigmine, edrophonium, physostigimine, echothiphate, donepezil? indirect cholinergic agonists (acetylcholinesterases)
What is the clinical use of neostigmine? post op and neurogenic ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade post op
What is the mech and penetration of neostigmine? incr endogenous ACH, no CNS penetration
What is the clinical use of pyridostigmine? myasthenia gravis (long acting), does not penetrate CNS
What is the mech of pyridostigimine? incr endogenous ACHJ, incr strength esp in myasthenia gravis
What is the clinical use of edrophonium? Dx of myasthenia gravis (short acting)
What is the mech of edrophonium? incr endogenous ACH
What is the clinical use of physostigmine? glaucoma ( cosses BBB into CNs) and for atropine OD
What is the mech of physostigmine? incr endogenous ACH
What is the clinical use of echothiophate? glaucoma
What is the mech of echothiophate? incr endogenous ACH
What is the clinical use of donepezil? alzheimer's disease
What is the mech of donepazil? incr endogenous ACH
What must be watched for in the admistration of all cholinomimetic agents? exacerbation of COPD, asthma, peptic ulcers
What is the mnemonic and presentation of cholinesterase inhbitor poisoning as in organophosphates (farmers)? DUMBBELSS: diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, of SMM and CNS. lacrimation, Sweating, salivation
what is the antidote for organophosphate poisoning (cholinesterase inhibtors)? atropine + pralidoxime (regenrates active AchE
What is the drug class of atropine, homatropine, tropicamide, benztropine,scopolamine,ipratropium,oxybutynin,glyc opyrolate, methoscopolamine,pirenzipine, propantheline? muscarinic antagonists
What is the organ system and tx action of atropine, homatropine, tropicamide? eye. produce mydriasis and cycloplegia
What is the organ system and action of benztropine? CNs. used for Parkinson's
What is the organ system and action of scopolamine? CNS. tx motion sickness
What is the organ system and action of ipratropium ? respiratory. used to Tx asthma, COPD
What is the organ system and action of oxybutynin, glycopyrrolate? genitourinary. reduced urgency in mild cystitis, reduce bladder spasms
What is the organ system and action of methscopolamine, pirenzepine, propantheline? gastrointestinal, tx for peptic ulcer disease
What is atropine used to tx? bradycarcia and opthalmic applications
What is the atropine on the eye, airway, stomach, gut and bladder? blocks DUMBBELLSS. eye: block pupil dilation, cycloplegia. airway: decr secretions stomach: decr acid secretion gut: decr motility, bladder: decr urgency in cystitis
What is the mnemonic for the SE of atropine? Hot at fire, Dry as bone, Red as beet, blind as bat, mad as hatter. (incr body temp, rapid pulse, dry motuh, flushed skin, cycloplegia, constipation, disorientation
What specific conditions can atropine cause in what populations? acute angle closure glaucoma in the lederly, urinary retention in men with prostatic hyperplasia, hyperthermia in infants
What is the receptor selectivity of epinephrine? highly affects alpha 1,2,Beta 1. somewhat beta 2. none on D1
What are the clinical applications of epinephrine? anaphylaxis, open angle glaucoma, asthma, hypotension
What is the receptor selectivity of norepinephrine? high at alpha 1,2, somewhat at beta 1. none at beta 2 or D1
What are the clinical applications of norepinephrine? hypotension(decr renal perfusion)
What is the receptor selectivity of isoproterenol? highly affects Beta 1, beta 2. none at alpha 1,2, D1
What are the clinical applications of isoproterenol? rarely used for AV block
What is the receptor selectivity of dopamine? alpha 1 ,2 at high dose, beta 1 ,2 at medium dose, D1 at low dose
What are the clinical applications of dopamine? shock(renal perfusion), heart failure, inotropic and chronotropic. D1>beta>alpha
What is the receptor selectivity of phenylephrine? highly affects alpha 1, some at alpha 2, none at Beta 1 ,2 , D1
What are the clinical applications of phenylephrine? pupillary dilation, vasoconstriction, nasal decongestion
What is the receptor selectivity of dobutamine? a little at alpha 1, 2, beta 2. Very strong at Beta 1. none at D1
What are the clinical applications of dobutamine? heart failutre, cardiac stress testing, inotropic but not chronotropic
What is the receptor selectivity of metaproterenol, albuterol, salmeterol, terbutaline? strongly affects Beta 2, some Beta 1. none at alpha 1,2, D1
What are metaproterenol, albuterol used for? acute asthma
What is salmeterol used for? for long term treatment of astma
What is terbuatine used for? reduces premature uterine contractions
What is the receptor selectivity of ritodrine? no activity except strongly at Beta 2
What is the use of ritodrine? reduces premature uterine contractions
What is the drug class of amphetamine, ephedrine, cocaine? indirect sympathomimetics
What is the mech of amphetamines? indirect general agonist, releases stored catecholamines
What is the clinical application of amphetamines? narcolepsy, obesity, attention deficit disorder
What is the mechof ephedrine? indirect general agonist, releases stored catecholamines
What is the clinical application of ephedrine? nasal decongestion, urinary incontinenhnce, hypotension
What is the mech of cocaine? indirect general agonist, uptake inhibitor
What is the clinical application of cocaine? causes vasoconstriction and local anasthesia
What is the drug class of clonidine, alpha methyldopa? sypathoplegic
What is the mech of clonidine, alpha metyhldopa? centrally acting alpha 2 agonists, decr central adrenergic outflow
What is the clinical application of clonidine, alphamethyldopa? hypertension, esp in renal disease (no decr blood flow to kidney)
What is the class of phenoxybenzamine? irreversible nonselective alpha blocker
What is the clinical application of phenoxybenzamine? pheochromocytoma. given before tumor is removed to block catecholamine release
What are the major SE of phenoxybenzamine? orthostatic HTN, reflex tachycardia
What is the class of phentolamine? reversible non selective alpha blocker
What is the clinical application of phentolamine? given to pt on MAO inhibitors who eat tyramine containing foods
What is the class of prazosin, terazosin, doxazosin? alpha 1 selective blockers
What is the clinical application of prazosin, terazosin, doxazosin? hypertesnion, urinary retention in BPH
What are the major SE of prazosin, terazosin, doxazosin? 1st dose orthostatic hypotension, dizziness, HA
What is the class of mirtazepine? alpha 2 selective blocker
What is the clinical application of mirtazipine? depression
What is the clinical application of mirtazepinine? sedation, incr serum cholesterol, incr appetite
What is the effect of an alpha blocker on blood pressure in epi vs phenylephrine? epi: get a reversal from the alpha response ( which is now blocked) to the beta 2 net decr response. Phenylephrine: the pressor effect of phenyephrine is depressed but not reversed because phenylephrine is a pure alpha agonist
What is the class of all -olols? beta blockers
How are beta blockers used to tx hypertension? decr CO, decr renin secretion (beta blockade on JGA cells)
How are beta blockers used to tx angina pectoris? decr HR and contractility, resulting in decr O2 consumption
How are beta blockers used to tx MI? decr the mortality of MI
How are beta blockers used to tx SVT, which betablockers used? propanolol, esmolol. decr AV conduction velocity (class II antiarrythmics)
How are beta blockers used to tx CHF? slows progression of chronic failure
How are beta blockers used to tx glaucoma? decr secretion of acqueous humor
What are the major SE of beta blockers? impotence, exacerbation of asthma, CV effects (bradycardia, AV blcok, CHF), CNS adverse effects (sedations, sleep alterations). cuation use in DM
Which are the beta 1 selective Beta blockers (B1>B2)? acebutolol(partial), betaxolol, esmolol (short acting, atenolol, metoprolol
What is a mnemonic for the beta 1 selective Beta blockers and when are they advantageous? A BEAM: advantageous in pateints with comorbid pulmonary disease
What is the mnemonic for the non selective beta blockers? Please Try Not being Picky: propanolol, timolol, nadolol, pindolol
Which are the nonselective alpha and beta blockers? carvetolol, labetolol
Which are the partial beta agonists which are beta blockers? pindolol, acebutolol
What is the antidote for an OD of acetominphen ? n-acetylcysteine (replenishes glutathione)
What is the antidote for an OD of salicylates? NaHCO3(alkalinize urine), dialysis
What is the antidote for an OD of amphetamines? NH4Cl (acidifies urine)
What is the antidote for an OD of acetylcholinesterase inhibtors, organophosphates? atropine, pralidoxime
What is the antidote for an OD of anitmuscarinic or anticholinergic agents? physostigamine salicylate
What is the antidote for an OD of beta blockers? glucagon
What is the antidote for an OD of digitalis? stop dig. normalize K+, lidocaine, anti-dig fab fragments, Mg2+ (KLAM)
What is the antidote for an OD of iron? deferoxamine
What is the antidote for an OD of Lead? CaEDTA,dimercaprol, succimer, penicillamine
What is the antidote for an OD of mercury, arsenic, gold? dimercaprol (BAL), succimer
What is the antidote for an OD of copper, arsenic, gold? penicillamine
What is the antidote for an OD of cyanide? nitrite, hydroxocobalamin, thisulfate
What is the antidote for an OD of methemoglobin? methylene blue, vit C
What is the antidote for an OD of carbon monoxide? 100% O2, hyperbaric O2
What is the antidote for an OD of methanol, ethylene glycol? fomeprizole>ethanol, dialysis
What is the antidote for an OD of opioids? naloxone/naltrexone
What is the antidote for an OD of benzodiazepines? flumazenil
What is the antidote for an OD of TCAs? NaHCO3 (plasma alkinization)
What is the antidote for an OD of heparin? protamine
What is the antidote for an OD of warfarin? vit K, fresh frozen plasma
What is the antidote for an OD of tPA, streptokinase, urokinase? aminocaproic acid
What is the antidote for an OD of theophylline? betablocker
What drugs can cause coronary vasospasm? cocaine, sumatriptan
What drugs can cause cutaneous flushing? VANC: vancomycin, adenosine, Niacin, Ca++ channel blockers
What drugs can cause dilated cardiomyopathy? doxorubicin (adriamycin), daunorubicin
What drugs can cause torsades des pointes? class III (sotalol), Class IA (quinidine) antiarrythmics
What drugs can cause agranulocytosis? Agranulocytosis could certainly cause pretty major damage: clozapine, carbamazepine, colchisine, propylthiouracil, methimazole, dapsone
What drugs can cause aplastic anemia? chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole
What drugs can cause direct coombs-positive hemolytic anemia? methyldopa
What drugs can cause gray baby syndrome? chloramphenicol
What drugs can cause hemolysis in G6PD deficient patients? (hemolysis IS PAIN) isoniazid (INH), sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin
What drugs can cause megaloblastic anemia? phenytoin, methotrexate, sulfa drugs (PMS)
What drugs can cause thrombotic complications? OCP's (estrogens, progestins)`
What drugs can cause cough? ACE inhibitors (NOT WITH ARBS like losartan)
What drugs can cause pulmonary fibrosis? BLAB: bleomycin, amiodarone, busulfan
What drugs can cause acute cholestatic hepatitis? macrolides
What drugs can cause focal to massive hepatic necrosis? halothane, acetaminophen, valproic acid, amantia phalloides (HAVAc)
What drugs can cause pseudomembranous colitis? clindamycin, ampicillin
What drugs can cause adrenocortical insufficiency? glucocorticoid withdrawl (HPa surpression)
What drugs can cause gynecomastia? Some drugs create awesome knockers: spironolactone, digitalis, cimetidine, chronic alcohol use, estrogens, ketoconazole
What drugs can cause hot flashes? tamoxifen, clomiphene
What drugs can cause hypothyroidism? lithium, amiodarone, sulfonamides
What drugs can cause hyperglycemia? niacin, tacrolimus, protease inhibitors
What drugs can cause fat redistrobution? glucocorticoids, protease inhibitors
What drugs can cause gingival hyperplasiA? phenytoin, verapamill
What drugs can cause gout? furosemide, thiazides, niacin, cyclosporine, pyrazinamide
What drugs can cause myopathy? Fish N CHIPS Gives: fibrates, niacin, colchicine, hydroxychloroquine, interferone alpha, penicillamine, statins, glucocorticoids
What drugs can cause osteoporosis? corticosteroids, heparin
What drugs can cause photosensitivity? SAT: sulfonamides, amiodarone, tetracycline
What drugs can cause Rash: Steven's Johnson syndrome? PEC SLAPP: penicilline, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital
What drugs can cause SLE like syndrome? HIPP: hydraliazine, INH, procainamide, phenytoin
What drugs can cause tendonitis, tendon rupture, and cartilage damage especially in kids? fluoroquinolones
What drugs can cause diabetes insipidus? lithium, demeclocycline
What drugs can cause Fanconi's syndrome? expired tetracycline
What drugs can cause interstitial nephritis? methicillin, NSAIDS, furosemide
What drugs can cause hemorragic cystitis? How can it be prevented? cyclophosphamide, ifosfamide. prevent by coadminstering mensa
What drugs can cause SIADH? carbamazepine, cyclophosphamide
What drugs can cause cinchonism? quinidine, quinine
What drugs can cause Parkinson-like syndrome? antipsychotics, reserpine, metoclopramide
What drugs can cause seizures? buproprion, imipenem/cilastatin, isoniazid
What drugs can cause tardive dyskinesiA? antipsychotics
What drugs can cause anitmuscarinic effects? atropine, TCAs, H1 blockers, neuroleptics, digoxin
What drugs can cause a disulfram like reaction? metronidazole, some cephalosporins, procarbazine, 1st gen sulfonylureas
What drugs can cause nephrotoxicity/ototoxicity? aminoglycosylides, vancomycin, loop diuretics, cisplatin
What is the mnemonic for the cyt P450 inducers? Queen Barb Steals Phen-phen and Refuses Greasy carbs Chronically: qunidine, barbituates, St. John's wort, phenytoin, rafampin, griseofulvin, carbamazepine, chronic EtOh use
What is the mnemonic for the cyt p450 inhibitors? MAGIC RACKS: macriolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir, acute EtOh abuse, ciprofloxacin, ketoconazole, sulfonamides
What is a mneomic for the sulfa drugs? Popular FACTSSS: probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide antibiotics, sulfasalazine, sulfonylureas
What might be seen in a pt with sulfa allergies? fever, urinary tract infection, pruritic rash, SJ syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, uticaria
What is the drug category of -azoles? antifungal
What is the drug category of -cillin? penicillins
What is the drug category of -cyclines? antibiotic protein synthesis inhibtor
What is the drug category of -navir? protease inhbitor
What is the drug category of -triptans? 5-Ht 1b/d agonists in migraines
What is the drug category of -anes? inhalational general anasthetic
What is the drug category of -caines? local anasthetic
What is the drug category of -operidol? butyrophenone (neuroleptic)
What is the drug category of -azine? phenothiazine (neuroleptic, antiemetic)
What is the drug category of -barbital? barbituate
What is the drug category of -zolam? benzodiazepine
What is the drug category of -azepam? benzodiazepine
What is the drug category of -etine? SSRIs
What is the drug category of ipramine? TCA
What is the drug category of -triptyline? TCA
What is the drug category of -olol? Beta antagonist
What is the drug category of -terol? beta 2 agonist
What is the drug category of -zosin? alpha 1 antagonist
What is the drug category of -oxin? cardiac glycoside (inotropic agent)
What is the drug category of -prils? ACE inhbitors
What is the drug category of -afil? for erectile dysfx
What is the drug category of -tropin s? pituitary hormones
What is the drug category of -tidines? H2 antagonist
Created by: tjs2123