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Pharm '14 - Block 1

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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