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Mem Pharm 2 Test1
anitulcer emetic laxative diarrheal coagulant thrombolytic glucocorticoid
| Question | Answer |
|---|---|
| histamine H2 receptor antagonist | -tidine; decrease acid production; raise gastric and duodenal pH |
| proton pump inhibitor (PPI) | - prazole; decrease acid production |
| antimicrobial | treat H. pylori |
| antacid | neutralize acid |
| cytoprotectant | increase barrier to acids |
| cimetidine | histamine H2 receptor antagonist; decrease acid production; antiulcer agent |
| famotidine | histamine H2 receptor antagonist; decrease acid production; antiulcer agent |
| ranitidine | histamine H2 receptor antagonist; decrease acid production; antiulcer agent |
| omeprazole | proton pump inhibitor (PPI); decrease acid production; antiulcer agent |
| esomeprazole | proton pump inhibitor (PPI); decrease acid production; antiulcer agent |
| lansoprazole | proton pump inhibitor (PPI); decrease acid production; antiulcer agent |
| amoxicillin | antimicrobial; treat H. pylori; antiulcer agent |
| clarithromycin | antimicrobial; treat H. pylori; antiulcer agent |
| tetracycline | antimicrobial; treat H. pylori; antiulcer agent |
| metronidazole | antimicrobial; treat H. pylori; antiulcer agent |
| aluminum hydroxide | antacid; neutralize acid; antiulcer agent |
| magnesium hydroxide/aluminum hydroxide | antacid; neutralize acid; antiulcer agent |
| calcium carbonate | antacid; neutralize acid; antiulcer agent |
| sodium bicarbonate | antacid; neutralize acid; antiulcer agent |
| bismuth subsalicylate | viscous coating cytoprotectant; increase barrier to acids; antiulcer agent |
| sucralfate | viscous paste-forming cytoprotectant; increase barrier to acids; antiulcer agent |
| misoprostol | prostaglandin E-like mucus producing cytoprotectant; increase barrier to acids; antiulcer agent |
| cimetidine important drug interaction effect | Inhibits CYP450 enzymes |
| chronic aluminum hydroxide use causes: | decrease in plasma phosphate, and constipation |
| what is a common effect of calcium antacid use? | acid rebound, especially with large dose |
| which antiulcer types can cause abdominal pain? Is it serious? | proton pump inhibitors: contct hcp. Misoprostol: just bothersome |
| Why should you increase intake of calcium and vit D with PPI? | can decrease bone mineral density, increasing risk of fracture |
| Why should you protect yourself from exposure to microorganisms while taking H2 rec antagonists or PPI? | increased risk of pneumonia |
| What very important teaching should accompany use of bismuth subsalicylate? | do not use if allergic to aspirin, or child/adolescent with chickenpox or viral illness. |
| what GI effects can occur with misoprostol | cramping (no biggie), diarrhea |
| H2 receptor antagonist and confusion in older adult | dangerous side effect; discontinue and contact hcp |
| H2 receptor antagonist and cardiac dysrhythmias | dangerous side effect; discontinue and contact hcp |
| H2 receptor antagonist and symptoms: fatigue, weakness, pale, increased infection, bleeding | agranulocytosis or aplastic anemia; dangerous side effect; discontinue and contact hcp |
| What antiulcer agents bind other drugs? Why is this a problem? | antacids (incl with H2 receptor anatagonists) and sucralfate; prevents the drugs from absorbing |
| what is the likely effect when taking both sodium bicarbonate and glucocorticoid? | edema |
| ondansetron | 5-HT3 (serotonin) receptor antagonist; antiemetics |
| aprepitant | neurokinin (NK1) receptor antagonist; blockade receptors for substance P in CTZ; antiemetic |
| prochlorperazine | dopamine receptor antagonist; dopamine 2 receptors in CTZ; antiemetic |
| metoclopramide | dopamine receptor antagonist; dopamine 2 receptors in CTZ; antiemetic |
| dronabinol | cannabinoid; antiemetic |
| scopolamine | anticholinergic; blocks H1 or Ach receptors, stopping neural transmission betw inner ear to vomiting center; antiemetic |
| dimenhydrinate | anticholinergic effect (antihistamine); antiemetic |
| marijuana | natural product as antiemetic |
| ginger | natural product as antiemetic |
| 5-HT3 receptor antagonist | -setron blocks serotonin receptors on vagal afferents and in CTZ; chemo INV, radiation, postop |
| neurokinin receptor antagonist | -prepitant, blocks substance P/neurokinin receptors in brain; chemo INV |
| dopamine receptor antagonist | -azine and others, blocks dopamine receptors in CTZ; chemo INV, postop, other |
| cannabinoid | chemo INV;m activate receptors in vomiting center |
| anticholinergic | affects neural transmission between the inner ear and vomiting center in the brain; motion |
| antihistamine | anticholinergic effect; motion sickness |
| psyllium | bulk-forming laxative |
| methylcellulose | bulk-forming laxative |
| docusate sodium | surfactant laxative (stool softener) |
| bisacodyl | stimulant laxative (irritant laxative, cathartic) |
| senna | stimulant laxative (irritant laxative, cathartic) |
| cascara sagrada (no FDA) | natural product stimulant laxative (irritant laxative, cathartic) |
| aloe vera (no FDA) | natural product stimulant laxative (irritant laxative, cathartic) |
| magnesium salts | saline laxative |
| polyethylene glycol | saline laxative |
| mineral oil | lubricant laxative |
| lubiprostone | chloride channel activator |
| methylnaltrexone | peripheral opioid receptor antagonist |
| diphenoxylate with atropine | opioid antimotility agents; antidiarrheal |
| loperamide | opioid antimotility agents; antidiarrheal |
| bismuth subsalicylate | intraluminal antidiarrheal |
| psyllium | intraluminal antidiarrheal |
| various antibiotics and antiprotozoals | miscellaneous antidiarrheal |
| What effects should be monitored if taking opioid antidiarrheal? | urinary retention, dry mouth, impaired heat regulation, drowsiness, dizziness |
| heparin | unfractionated heparin; anticoagulant |
| dalteparin | low molecular weight heparin; anticoagulant |
| enoxaparin | low molecular weight heparin; anticoagulant |
| warfarin | anticoagulant |
| dabigatran | direct thrombin inhibitor; anticoagulant |
| rivaroxaban | factor Xa inhibitor; anticoagulant |
| protamine sulfate | antidote for heparin overdose |
| phytonadione | antidote for warfarin overdose |
| aspirin | cyclooxygenase inhibitor; antiplatelet agent |
| clopidogrel | ADP Receptor antagonist; antiplatelet agent |
| eptifibatide | glycoprotein IIb/IIIa inhibitor; antiplatelet agent |
| alteplase | tissue plasminogen activator (tPA); thrombolytic |
| What do anticoagulants do? | reduce ability of blood to clot: inhibit formation of fibrin |
| Where do anticoagulants prevent thrombi? | veins and cardiac atria |
| What do antiplatelet agents do? | interfere with platelet activation and aggregation |
| Where do antiplatelet agents prevent thrombi? | arteries |
| which antiplatelet agent is for short-term Iv use? | glycoprotein IIb/IIIa inhibitor |
| Which antiplatelet agent is for chronic use, prevention of CV events for those at high risk? | ADP receptor antagonist |
| What do thrombolytics do? | dissolve clots that already are formed |
| What is the benefit of thrombolytic effects? | restore blood flow |
| What is unfractionated heparin? | "Normal" heparin; molecules vary in weight, requires lab measure aPTT |
| Why is aPTT measured when taking unfractionated heparin? | activated partial thromboplastin time measures coagulation, to make sure unfr. Heparin is working at appropriate level |
| Why is aPTT not required when taking LMW heparin? | low molecular weight heparin is at predictable levels in blood; do require CBC and fecal occult blood tests |
| How is heparin use different in those with severe liver disease? | They synthesize less antithrombin so response to heparin is altered |
| What are parameters for heparin administration? | Parenteral, polarized molecule doesn't cross membranes; protein bound; does not cross placenta; renal impairment delays heparin elimination (inc levels); rapid onset/offset of action |
| what dietary teaching is important when taking warfarin? | don't change intake of vit K foods: leafy greens, cauliflower, milk, mayonnaise, yogurt |
| How does warfarin acheive anticoagulation? | inhibit synthesis of vit K related clotting factors; may be several days to effect while existing factors are used up |
| Warfarin is pregnancy category... | X -- enters placenta/ breastmilk; causes birth defects |
| What is the genetic issue with warfarin metabolism? | Some people have genetic variations of the CP450 enzyme that metabolizes warfarin; they may have inc levels and bleed |
| Why is warfarin therapy monitored with PT or INR? | Prothrombin time, or adjusted International Normalized Ratio, measures coagulation effect, dose can be adjusted |
| What needs to be considered when remembering time factor for heparin/warfarin antidotes? | time factor of the drug itself |
| Who should not use dabigatran? | those with decreased kidney function -- can lead to toxicity |
| Important teaching about dabigatran | keep in original packaging -- can't be exposed to moisture |
| What is the use of oral rivaroxaban? | prevent VT after hip/orthopedic surgery |
| Parameters of rivaroxaban? | highly protein bound; metabolized by CYP450; some excreted renally as active drug |
| how is clopidogrel metabolized? | prodrug: requires CYP450 enzyme metabolism to take active form |
| Is a thrombolytic a good idea after surgery? | no -- need to form clots to stop bleeding and allow tissue healing |
| When is use of thrombolytics ideal? | within a few hours of clot formation; life threatening: pulmonary embolism, ischemic stroke |
| -sone; -olone | glucocorticoids |
| budesonide | glucocorticoids -- asthma |
| dexamethasone | glucocorticoids |
| fluticasone | glucocorticoids -- asthma |
| hydrocortisone | glucocorticoids |
| methylprednisolone | glucocorticoids |
| prednisolone | glucocorticoids |
| prednisone | glucocorticoids |
| triamcinolone | glucocorticoids -- topical |
| types of bronchodilators | adrenergic agonists, xanthines, anticholinergics |
| epinephrine | nonselective alpha and beta adrenergic agonist; adrenergic bronchodilator; antiasthmatic |
| albuterol | -terol; selective beta2-adrenergic agonist; adrenergic bronchodilator; antiasthmatic; rapid onset, short duration by inhalation; slow onset, long duration orally |
| salmeterol | slow onset, long duration by inhalation; selective beta2-adrenergic agonist; adrenergic bronchodilator; antiasthmatic |
| theophylline | -ophylline; xanthine bronchodilator (methylxanthine); adrenergic bronchodilators; antiasthmatics |
| ipratropium | by inhalation; anticholinergic bronchodilator; adrenergic bronchodilator; antiasthmatic |
| glucocortisoids | fluticasone by inhalation; prednisone |
| montelukast | -lukast; oral; leukotriene modifier; antiinflammatory; antiasthmatic |
| zafirlukast | -lukast; oral; leukotriene modifier; antiinflammatory; antiasthmatic |
| cromolyn sodium | inhalation; mast cell stabilizer; antiinflammatory; antiasthmatic |
| omalizumab | subq; anti-IgE monoclonal antibody; antiinflammatory; antiasthmatic |
| how do glucocorticoids reduce inflammation? | stop action of prostaglandins, leukotrienes; stop WBC and antibody production; stop pro-inflammatory cytokines; stop histamine release |
| What is a major drawback to use of glucocorticoids? | impairs wound healing |
| glucocorticoid metabolism | specific CYP450 enzymes |
| glucocorticoid absorption | well absorbed through multiple routes |
| why is cortisol secretion inhibited by exogenous glucocorticoids? | amounts much larger than normal cortisol, triggers negative feedback |
| what effects will glucocorticoids have in the body (general)? | the same as cortisol: homeostasis in fight or flight (sympathetic) response |
| S/s of adrenal insufficiency | Weakness, weight loss, anorexia, nausea, vomiting, hypotension, hypoglycemia, hyponatremia, and hyperkalemia |
| what are the four classess of antidiarrheals? | 1. absorbents; 2. anticholinergics; 3. intestinal flora modifiers; 4. Opiates; |
| MOA for absorbents? | coat the wall of the intestines; bind with the causative bacteria or toxin and eliminate it in the stools; |
| MOA for Anticholinergics? | decrease peristalsis |
| MOA for intestinal flora modifiers? | obtained from bacteria; restore the body's normal flora; |
| MOA for Opiates? | decrease bowel motility; |
| Classification of Kaopectate (PeptoBismol)? | absorbant antidiarrheal agents |
| Adverse rxn of Kaopectate (PeptoBismol)? | increased bleeding time, constipation, dark stools, confusion, tinnitus, hearing loss, twitching, metalic taste in mouth |
| Classification fo Belladonna Alkaloid (Donnatal)? | anticholinergic; antidiarrheal |
| Adverse rxn of Belladonna Alkaloid (Donnatal)? | urinary retention/hesitancy, impotence, drowsiness, headache, hypotension, tachycardia, blurred vision, photophobia; |
| Classification of Lactobaccilus Acidophillus? | intestinal flora modifier given as a food additive; |
| Adverse rxn of Lactobaccilus Acidophillus? | drowsiness, sedation, respiratory depression, bradycardia, hypotension, urinary retention; |
| Classification and therapeutic use of Diphenoxylate (Lomotil) & Loperamide (Immodium)? | opiate used as anti-diarrheal. |
| Adverse rxn of Diphenoxylate (Lomotil) & Loperamide (Immodium)? | drowsiness, sedation; |
Created by:
hezasan
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