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Pharm '14 - Block 1
| Question | Answer |
|---|---|
| which 2 classes of drugs block acid secretion | H2 blockers and PPI |
| weak bases that chemically neutralize acid | calcium carbonate |
| binds to mucosa and inhibits pepsin-catalyzed hydrolysis of mucosal proteins, ie builds up a protective wall | sulcrafate |
| prostaglandin that increases bicarb and mucus from epithelial cells, inhibits acid from parietal cells | misoprostol |
| locally acting, secretion reducing, topical that binds toxins and is anti-diarrheal | pepto |
| competitive antagonists at H2 receptors on parietal cells; inhibit meal secretions and basal secretions | H2 blockers |
| binds and irreversibly blocks ATP-dependent proton pump in parietal cell | PPI |
| which class+abx eliminates H. pylori | H2 blockers and PPI |
| relieves stress ulcers, ZE ulcers, GERD, dyspepsia, PUD | H2 blockers |
| PUD, GERD, ZE, may reduce gastric acid for 4-6 weeks | PPI |
| best 2 options for reducing acid in the elderly | ranitidine and calcium carbonate |
| PUD treatment in pts who cannot tolerate H2 or PPI | sulcrafate |
| prevents ulcers in pts taking NSAIDs | misoprostol |
| X varicella vaccine, MMRV, pts <20 w/flu, or if febrile | pepto |
| may cause Reye's syndrome | pepto |
| may cause early uterine contractions and not good w/CVD | misoprostol |
| requires acidic stomach for activation | sulcrafate and omeprazole |
| do not combine ___ with sulcrafate | antacids |
| AlOH causes____ | constipation |
| MgOH causes____ | diarrhea |
| Rolaids may increase the absorption of meds like ____ | Ldopa, weak bases |
| BB increased hip fractures in the elderly | PPI |
| interacts with atazanavir, antacids, and is CYP450 | omeprazole |
| first line agents to reduce gastric acid, suppress 90% acid | PPI |
| prokinetic agent | metoclopramide |
| anti-diarrheals | lomotil, immodium, pepto |
| stimulates smooth muscle in the GI, promotes ACh release and blocks DA | metoclopramide |
| bulk laxative that increases mass | psyllium |
| surfactant stool softener | colace |
| osmotic laxative | magnesium hydroxide and miralax |
| poorly absorbed molecules draw in water, increasing volume | magnesium hydroxide and miralax |
| preop for GI surgery | dulcolax |
| activates GI opiod receptors, decreases ACh release | lomotil and immodium |
| used for hypomotility, gastroparesis, intractable hiccup, antiemetic | metoclopramide |
| X seizures, GI obstruction, GI hemorrhage | metoclopramide |
| interacts with MAOI and may cause HTN crisis | metoclopramide |
| H2 blockers | ranitidine and famotidine |
| PPIs | omeprazole and esomeprazole |
| antacids | calcium carbonate |
| mucosal protective agents | sulcrafate, misoprostol, pepto |
| 5HT3 receptor antagonist, blocks afferent signals to CTZ | zofran |
| D2 blocker/anti-emetic and anti-psychotic | compazine |
| NK1 antagonist | emend |
| cannaboid receptor agonist | marinol |
| blocks vestibular component of vomit reflex | dramamine |
| anticholinergic, antiemetic, antidyskinetic | scopalamine |
| which 2 drugs are combined to treat chemo nausea | zofran+emend |
| chemo sickness and AIDS anorexia | marinol |
| motion sickness and parkinsons | scopalamine |
| which antiemetic has the most drug interactions? | compazine |
| a CYP450 and interacts with benzos | emend |
| stimulant laxative | dulcolax |
| opiates | morphine, heroin, methadone, buprenorphine |
| CNS depressants | alcohol, naltrexone, benzos |
| inhalents | toluene |
| CNS stimulants | methamphetamines, methylphenidate, nicotine, cocaine |
| hallucinogens | LSD, PCP, THC, XTC |
| releases NE and DA, inhibits MAO | methamphetamines |
| ACh mediator of SNS and PSNS | nicotine |
| inhibits reuptake of DA and NE | cocaine |
| related to ketamin, once used as a vet tranq | PCP |
| binds in CNS @ CB1, binds in PNS @ CB2 | THC |
| semi-synthetic partial opiod used to treat opiod addiction | buprenorphine |
| inhibits NMDA glutamate receptor, penetrates BBB and placenta | alcohol |
| used in mgmt of EtOH and opiod addiction | naltrexone |
| CNS depressant used to stabilize alcoholics | benzos |
| stimulates androgen receptors | steroids |
| toluene is toxic to which organs | liver, kidney, brain |
| toluene cause of death | sudden sniffing death |
| used for euphoria, but tolerance rises rapidly-->respiratory depression and pinpoint pupils | morphine and heroin |
| which organs are damaged with alcohol? | liver and brain |
| which drug has a cross tolerance with EtOH | benzos |
| abused for feelings of oneness with the universe | hallucinogens |
| abused for euphoria, exhilaration, confidence, decreased fatigue | CNS stimulants |
| how does nicotine damage the heart? | sympathoactivation without physical exertion "silent stress" |
| what do you give to detox cocaine | TA-CD vaccine |
| how do you treat PCP withdrawl | prevent injury reduce stimuli ameliorate psychosis with drugs |
| SE of XTC | bruxism, hypothermia, dehydration |
| what happens if a depressed person takes methamphetamines? | suicide |
| antidepressant and sex dysfunction | 5HT1 stimulation |
| anxiety and sex dysfunction | 5HT2 stimulation |
| GI motility, nausea, increased memory | 5HT3 stimulation |
| increased BP | NE reuptake inhibitor |
| antidepressant, activation, psychosis, motivation | DA reuptake inhibitor |
| constipation and dry mucous membranes | muscarinic antagonists |
| sedation and weight gain | H1 antagonist |
| orthostatic hypotension and reflex tachy | alpha1 antagonism |
| increased NE levels | alpha2 autoreceptor antagonism |
| increased 5HT (mirtazapine) | alpha2 heteroreceptor antagonism |
| which drug is a triazolopyridine | trazadone (also SARI) |
| what labs should you draw with lithium? | Pregnancy Thyroid Blood EKG Electrolytes Renal function |
| which drug is similar to lithium, but with faster onset | carbemazepine |
| which antipsychotics are safe in 1st trimester | haloperidol |
| which antipsychotocs are safe in 2nd and 3rd trimesters? | atypicals |
| BB for clozapine | seizures and agranulocytosis |
| what should clozapine pts report signs of? | fever, weakness, sore throat |
| EPS are indicative of ___ | high potency typicals |
| sedation is seen with which receptor? | histamine |
| what are the atypicals? | chlorpromazine, fluphenazine, haloperidol |
| SE for typicals? | seizure photosensitivity lactation weight gain temp regulation issues SCD |
| which drugs may cause akathisia/motor restlessness, parkinsonism | fluphenazine, haloperidol |
| which drug causes low EPS sx and dystonia pseudoparkinsonism, tachy | chlorpromazine |
| which drugs are high potency | fluphenazine and haloperidol |
| available in depot? | flu and hal |
| which drug is similar to clozapine | zyprexa |
| used for depression maintenance in combo with fluoxitine | zyprexa |
| gives EPS in doses >6mg | risperdal |
| which drug causes cataracts | seroquel |
| which atypical has the weakest adverse effects | ziprasidone |
| causes HA/n/v akathesia | abilify |
| causes heavy sedation, dystonia, pseudoparkinsons | clozapine |
| causes somnolence, akathesia, high glucose, EPS, prolactin, Weight LOSS | lurasidone |
| which atypicals are approved for maintenance of depression (4) | zyprexa, risperdal, seroquel, abilify |
| influences negative sx, and used in neuroleptics for + sx | ziprasidone |
| used for tx resistant schizophrenia | clozapine |
| used for acute schizo and acute mania with bipolar | asenapine |
| BB for all atypicals | elderly with dementia @increased risk of death and high glucose |
| which drug prolongs QT | ziprasidone |
| prescribers must register | clozapine |
| must get CBC before initiation | clozapine |
| may increase suicide ideations | abilify |
| take with food | ziprasidone and lurasidone |
| "me too" drug that can be used when other neuroleptics d/ced due to EPS | clozapine |
| +signs | delusions hallucinations disorganized speech behavior disturbance |
| - signs | social isolation flat affect poverty of speech anhedonia |
| may cause weight gain, sex dysfunction, leukopenia, tremor, orthostatic hypotension | phenelzine |
| may cause insomnia, decreased libido, nausea, diarrhea, weight loss, poor appetite (class) | SSRI and SNRI |
| don't use with NSAIDs or other anti-platelets | SSRI |
| take with food | vilazodone |
| don't use with tobacco, warfarin, SSRIs, St Johns Wort, or MAOIs | amitriptylline |
| what drugs cause hypertensive crisis | phenelzine+tyramine or stimulants or Ldopa or pseudoephidrine |
| what causes serotonin syndrome | phenelzine +SSRI or TCA |
| what class has SE of HTN crisis and serotonin syndrome? | MAOI |
| BB cardiac toxicity | amitriptylline |
| may cause anorgasmia, anorexia, impotency | SSRI and SNRI |
| longest duration of action for SSRIs | fluoxetine (prozac) |
| potent and selective serotonin and NE reuptake inhibitor | pristiq |
| inhibits reuptake of serotonin and NE | amitriptylline |
| deposits into lipid membranes | amitriptylline |
| 5HT1 receptor partial agonist | SSRI |
| inhibits 5HT and NE reuptake, weak reuptake DA | SNRI |
| weak block of DA | buproprion |
| serotonin 2 antagonist | trazodone |
| causes increased cholesterol, proteinuria, high blood pressure | pristiq |
| causes sedation, weight gain, neutropenia | mirtazapine |
| X in hx of seizures, bulemia | buproprion |
| causes priapism | trazodone |
| decreases NE release and increases serotonin synthesis | lithium |
| histone deacetylase inhibitor | VPA |
| sodium channel blocker | lamotrigine |
| tricyclic that limits electrical action | carbamazepine |
| used for acute mania, acute depression, bipolar maintenance | lithium |
| used for acute mania, mixed, maintenance | VPA |
| long term maintenance of adults with bipolar | lamotrigine |
| used for acute and mixed mania (bipolar) | carbamazepine |
| may cause tremor, hair loss, hepatotox | VPA |
| wt gain, polydipsia, polyuria, hypothyroid, arrythmias, ataxia | lithium |
| causes rash if rushed | lamotrigine |
| causes SJS, lots skins stuffs, anti-diuretic, ataxia, diplopia | carbamazepine |
| may become toxic if pt is dehydrated | lithium |
| don't use with diuretics, NSAIDs, ACEi, ARBs | lithium |
| don't use with HIV meds | VPA |
| inhibits CYP450, so dont use with warfarin | VPA and vilazodone |
| what are the mood stabilizers? | lithium, VPA, lamotrigine, carbamazepine |
| what is the indication for SNRIs? | severe depression when increased drive is desired |
| are tricyclics or SSRI more potent for depression? | tricyclics |
| do tricyclics or SSRIs have more SE? | tricyclics |
| which drug is ok to breastfeed? | amitriptylline |
| what should you monitor with pristiq? | BP and urine analysis |
| all Anti-Depressants cause weight gain except.... | SSRI, SNRI, buproprion |
| most teratogenic? | lithium and VPA and carbamazepine |
| non-selective ß-blocker causes splanchnic vasoconstriction | nadolol |
| decreases intestinal NH3 by acting against urease producing bacteria | neomycin sulfate |
| somatostatin analog; inhibits serotonin, gastrin, insulin, glucagon and alters mesenteric/sphlanchnic blood flow promoting hemostasis | octreotide |
| inhibits binding of aldosterone to receptor | spironolactone |
| inhibits sodium-potassium symport in ascending limb | furosemide |
| used in cirrhosis induced hepatic encephalopathy | neomycin sulfate |
| used for bleeding esophageal varicies | octreotide and nadolol |
| used for cirrhosis induced edema | spironolactone and furosemide |
| causes nephro and ototoxicity | neomycin sulfate |
| causes gynecomastia | spironolactone |
| monitor B12 levels, cholelithiasis, hypothyroidism, anemia | octreotide |
| avoid NSAIDs | spironolactone and furosemide |
| aides in hydrolysis of fats, proteins and starches | pancrelipase |
| interacts with iron salts, iron, multivitamins | pancrelipase |
| monitor growth and development | pancrelipase |
| titrate "low and go slow" | pancrelipase |
| how do you monitor the effectivity of neomycin sulfate? | clinical improvement |
| used after removal of >5L paracentesis | albumin 25% |
| how long for diuretics to reach "steady state"? and how often should you adjust dose? | 3-5 days |
| don't use with DM or renal impairment | octreotide |
| which 2 cirrhosis drugs are pricy? | octreotide and albumin 25% |
| treats constipation, eliminates poisons | miralax |
| treats hepatic encephalopathy and constipation | lactulose |
| used for women with constipation IBS | amitiza |
| relieves short-term constipation IBS | zelnorm (tegaserod) |
| women with diarrhea IBS | alosetron |
| relieves abdominal pain and bloating in pts w/o constipation | rifaximin |
| relieves abdominal pain due to smooth muscle relaxation and anti-cholinergic effects | dicyclomine (bentyl) |
| X with GI obstruction or appendicitis | miralax and amitiza |
| X with low galactose diet | lactulose |
| X crohns, UC, constipated patients | alosetron |
| don't use with other anticholinergics or during lactation | dicyclomine (bentyl) |
| must be taken BID q12 h | alosetron |
| dyspnea with first dose | amitiza |
| may cause electrolyte imbalances | miralax and lactulose |
| treats HBV | entecavir, adefovir, lamivudine |
| treats HCV | ribavirin |
| X in pregnancy (men too), anemia, ESRD | ribavirin |
| X lactation and kids<12 | adefovir |
| causes dose dependent hemolytic anemia | ribavirin |
| may cause exacerbation of hepatitis w/in 12 weeks of stopping med | adefovir |
| causes lactic acidosis, hepatic steatosis, pancreatitis, peripheral neuropathy | lamivudine |
| common SE is flu-like syndrome | interferons |
| HBV monotherapy and HCV +ribavirin | interferons |
| Xhepatic decompensation, autoimmune dz, hx of cardiac arrhythmias | interferons |
| interacts with psych meds and zidovudine | interferon alpha 2a |
| which interferon has a longer half life? | alpha 2a |
| BB lactic acidosis, hepatomegaly, steatosis | lamivudine |
| BB hep B exacerbation, HIV resistance, hepatomegaly | adefovir |
| BB hx of anemia | ribavirin |
| take with food | ribavirin |
| X acute HSV, vaccines, fungal infections | prednisolone |
| used for alcholic liver disease and alcoholic hepatitis | prednisolone |
| used in alcoholic hepatitis in pts who are not steroid candidates | pentoxifylline |
| non-steroidal phosphodiesterase inhibitor | pentoxifylline |
| may decrease mortality by decreasing hepatorenal syndrome | pentoxifylline |
| which anti-viral is CYP450 | ribavirin |
| arthralgia, dyspepsia, anemia | sulfasalazine |
| increased LFTs, infectious complications, lymphoma | azathioprine |
| hypertrichosis, hyperglycemia, hypertriglycerides, increased infection and lymphoma | cyclosporin |
| interacts with cardiac glycosides and heparin | sulfasalazine |
| decreased effectivity with antacids, PPI, H2 blockers | mesalamine |
| increased bleeding risk with heparin (class) | aminosalicyclates |
| take with food (2) | sulfasalazine and ribavirin |
| supplement with folic acid | sulfasalazine and methotrexate |
| BB warning for malignancy | azathioprine |
| allopurinol increases risk for toxicity | azathioprine |
| contraindicated with antibiotics, anti-convulsants, allopurinols, CCB, grapefruit juice, statins...CYP3A4 pathway | cyclosporin |
| category X (2) | methotrexate and cipro |
| primarily UC | sulfasalazine |
| distal UC and mild-mod Crohns | mesalamine |
| steroid sparing in IBD | azathioprine |
| Crohns>UC for mod-severe maintenance | methotrexate |
| severe refractory UC | cyclosporin |
| mild-moderate Crohns, maintain UC remission | budesonide |
| IBD that fails other treatments | inflixamab |
| may cause infusion reaction, sepsis, serum sickness, TB reactivation | inflixamab |
| BB for UC | natalizumab |
| reactivates JCV | natalizumab |
| used for refractory Crohns disease | ustekinumab |
| causes pruritis, injection site erythema, increased malignancy risk | ustekumab |
| don't use these 2 with other immune suppressants or vaccines | natalizumab and ustekinumab |
| may cause tendon rupture | cipro |
| do not use with warfarin (2) | cipro and flagyl |
| alcohol intolerance | flagyl |
| only used for crohns | natalizumab |
| used for refractory crohns | ustekinumab |
| 1st generation ASA that interferes with prostaglandin synthesis | sulfasalazine |
| inhibits dihydrofolate reductase-->death of T-lymphocytes | methotrexate |
| calcineurin inhibitor, inhibits Tcell signal transduction | cyclosporin |
| inhibits production of IL1, TNF and inflammation molecules | budesonide |
| chimeric monoclonal antibody and anti-TNF | infliximab |
| DNA gyrase inhibitor | cipro |
| inhibits DNA synthesis, bactericidal | metronizadole |
| aldehyde dehydrogenase inhibitor | disulfiram |
| do not use for aerobic bacteria | metronizadole |
| do not take with heparin | aminosalicyclates |
| AE elevated LFTs, agranulocytosis | mirtazapine |
| SNRIs | effexor, cymbalta and pristiq |
| SSRIs | prozac, zoloft, lexapro, and viibryd |
| MAOIs | phenelzine (nardil) |
| mesolimbic pathway | causes + symptoms |
| mesocortical pathway | cuases - symptoms |
| nigrostriatal pathway | inhibition causes EPS typicals inhibit atypicals do NOT inhibit |
| tuberoinfundibular pathway | inhibition elevates serum prolactin |
| direct acting antivirals | boceprevir and telaprevir |
| treats naive and experienced Hep C | boceprevir and telaprevir |
| must be given with PegIFN and wt based ribavirin | boceprevir and telaprevir |
| genotype 1 is wt based doseing, 2 and 3 are fixed | ribavirin |
| alpha 1 antagonist | orthostatic hypotension, reflex tachy |
| alpha 2 Heteroreceptor antagonist | increased 5HT |
| alpha 2 autoreceptor antagonist | increased NE |
| 5HT1 (+) | AAAS (antidepressant, anciety, addiction tx, sexual dysfxn) |
| 5HT2 (+) | AGIS (anxiety, GI motility, improved behavior/sleep, sexual dysfxn) |
| 5HT3 (+) | GAIN (GI motility, anxiety, improved memory, nausea) |
| NE reuptake (-) | AAB (antidpressant, activatino, increased BP) |
| Dopamine reuptake (-) | AAMP (antidepressant, activation, motivation, phychosis) |
| Muscarinic (-) | CDD (constipation, dry mouth, dry eyes) |
Created by:
duanea00
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