Pharmacology 9 Flashcards

Terms Definitions
anti-infective
Antibiotic.
odonto-
tooth
allopurinol
Zyloprim
anticonvulsants
phenobarbital
primidone
diazepam
clonazepam
potassium bromide
felbamate
gabapentin
Demerol
meperidine
Decadron
Corticosteroid
baclofen
lioresal
gabapentin
neurontin
Tazarotene
Psoriasis Anti-inflammatory Antiproliferative Extreme caution in young women (terotagenic) TX: Psoriasis
metropolol tartrate
Lopressor
Metronidazole
p. 296
Albuterol
Proventil, Ventotin
sectral, monitan
acebutalol
penicilines
type 1
Niclosamide
Parasites (anti-cestodes)MOA: Salicylamide derivative Inhibits oxidative phosphorylationAdmin: oral SE: Mild GIOTH: no longer on US market; found to cause cysticercosis in pts infected with T. soliumTX: Cestodes (tapeworms)
Espirantel
AntiparasiticAnticestodal - "Cestex"Kills tapes
buprenorphine
mixed opioid agonist/antagonistuses:analgesic in dogs & catsalternative to methadone for addictslonger duration of action than torb, morphinereverse w/ naloxone given PRIOR to buprenorphinewell tolerated in horses
neuroleptic syndrome
sedation
tranquilization
dec. emotional behavior
dec. responsiveness to external stimuli
dec. spontaneous movement
NOT hypnotic
NO analgesia alone
examples of aminopenicillins
ampicillin
amoxicillin
Nitroglycerin
Antianginal vasodilator prototype

releases NO in smooth muscle of veins, less in arteries, and causes relaxation. Standard of therapy in angina (both atherosclerotic and variant).

Tox-
tachycardia, orthostatic hypotension, headache
OTC
Over The Counter
codeine
Opiate mu agonist
Ethambutol
suppresses mycobacteria multiplication by interfering with RNA synthesis. Used to treat TB.
Digoxin
Cardiac Glycoside (antidote: Digibind)

Must know 2 things:
apical pulse (never give if less than 60)
Potassium Levels - hypokalemia can lead to toxicity
Long t1/2: ~36hrs
SE - Vomiting = Increased loss of Potassium
Visual Disturbances such as halo's
Relief/Episooth
SkinTopical Antipruritics - NonsteroidalTemporary
q2 hr
every 2 hours
Methohexital half life
4 hours
use of clomiphene
fertility treatment
Drugs ending with:
-terol
Beta-2 agonist
Ex-Albuterol
Ipratropium
Antimuscarinic agent

aerosol for asthma, COPD. Good bronchodilator in 20−30% of patients. Not as effective as β2 agonists
Which drug prevents cavities?
fluoride
valproic acid
depakene (capsule, liquid)
Amanita mushroom toxin blocks...
AchE
Names of Loop diuretics
bumetanideethacrynic acidfurosemidetorsemide
Clonazepam (Klonopin), Anticonvulsant
Class: Anticonvulsant, anxiolyticAction: Prevents or stops seizure activity.Side Effects: ataxia, behavioral disturbances, suicidal ideation, increased salivation, leukopenia, thrombocytopenia, respiratory depression.Contraindications: Allergic, have acute angleclosure glaucoma or significan hepatic disease.Nursing considerations: assess prior to therapy, monitor drug levels, CBC, liver function test.
Cardiac Medication - Antiarrhythmic (or Antidysrhythmic)
atenolol
OXIDATIVE RXN:N-Oxidationadding oxygen to nitrogen group
examples- Chlorpheniramine
ethosuximide (Zarontin)
Succinimides Ethosuximide (Zarontin) is a succinimide anticonvulsant used in the treatment of psychomotor or tonic-clonic seizures.
Vasodilators
relaxes arterials, decreases venous return to the heart, reduces workload.
Drug reaction causing gum hyperplasia?
phenytoin
Cardiac toxicity (2)
doxorubicin (adriamycin), daunorubicin
Type of drug?
Fluphenazine
Antipsychotic- Phenothiazine
Most cardiotoxic neuroleptic
Bethanechol
Muscarinic agonist

choline ester with good resistance to cholinesterase; used for atonic bowel or bladder
What drug is an anti-tussive?
codeine
trimethroprim
AB inhibits hihydropolate reductase FH2 -> tetrahydrofolate FH4 -> nucleic acids for DNA syn
Alfuzosin
Selective for alpha-1A in genitourinary tract (treats BPH (benign prostatic hyperplasia)) Half-life: 10 h. Not to be taken with grapejuice which inhibits (p450 isozyme CYP3A4 in the liver)
Chlamydia DOC
-Tetracycline w/ azithromycin or erythromycin
Niacin
Hypolipidemic MOA: Vitamin B3 → ↓hepatic TAG synthesis & ↑lipoprotein lipase → ↓apoB → ↓VLDL → ↓LDL MET: Half-life: 1 hour Used w/: bile acid binding resin Used w/: HMG CoA reductase inh. SE: Flushing, pruritis Nausea, diarrhea, peptic ulcer Hepatotoxic, glucose intol., gout OTH: Most effective agent to ↑HDL Only agnet to ↓Lp(a) TX: HyperTAG Familial hyperTAG FC hyperTAG
tx for allergic rhinitis
Pt education
 
allergen avoidance
 
pharmacotherapy
 
allergen-specific immunotherapy 
Sucralfate
GI SystemGI Ulcers - Gastromucosal Protectant"Carafate"Need acids to work, creates physical barrier
S/E of lithium
1-tremor
2 life threatening seizure
3-hypothyroidism (inhibit deiodinase )
4-Neph diabeties insipidus Rx by amiloride
teratogenic (truncus artheriosis)
Tetracycline (Achromycin and others)
Tetracyclines Tetracycline (Achromycin and others) is a tetracycline antibiotic.
– Only muscle relaxant that exerts its effects directly on the skeletal muscle by impairing the release of calcium from the SR
	- Effective in treating severe spasticity
	- Most common side effect is generalized muscle weakness
Tizanidine
movement of drugs and their metabolites out of the body
excretion
T/F: Infliximab can cause respiratory infection, fever, hypotension
TRUE
MOA epehderine
indirect and direct sympathomimetic
stimulates release of NE from sympathetic neurons
Type of drug?
Ticlopidine
Antiplatelet drug
Interferes w/ ADP-induced binding of fibrinogen to platelets
Ranitidine
H2 blocker

like cimetidine but less inhibition of hepatic drug metabolism; no antiandrogenic effects
Thiazide diuretic AE
photosensativity, dizziness, headache, blured vision, paresthesia, decreased libido, anorexia
birth control pills HRT
Minovral/Portia, Alesse/Aviane, Triquilar, Marvelon, Tri-cyclen, Yasmin, Diane 35
Pilocarpine
prototype agent for the naturally occurring muscarinic agonists. miotic agent for treating glaucoma (is an alkaloid cholinomimetic)
Apomorphine
Potent dopamine agonist that reverses off state in some patients on high levodopa doses.
Nifedipine
is a calcium channel antagonist, which is used to treat hypertension and angina. It has a relaxant effect on the smooth muscle of the blood vessels.
Erythromycin
MOA: binds the 50s ribosomal subunit, inhibits translocation step of protein synAdmin: oral, IVMET: INHIBITS CYP450RES: Bacterial plasmids coding for enzymes that inactive the drugSE: GI Cholestatic hepatitis Hypersensitivity; contraindicated with TheophyllineTX: Alt. to penicillin; Mycoplasma, Legionella, C. trachomatis, C. diphtheriae, B. pertussis
oxycodone is what kind of drug?
opiod agonist
antidiarrheal drugs:
 
3. intestinal flora modifiers 
lactobacillus acidophilus (Lactinex, Bacid)
promotes growth of E.coli-normal bacterium present in the bowel
restores gut flora depleted by abx therapy
admin w/ milk, 2 hrs before or after intake of other meds
know that adjunct of  dietary regimen high in lactose & dexrose is also effective in providing recolonization of colon (ex: yogurt, milk, buttermilk)
in pts w/ milk product allergies or intolerance, admin of Lactobacillus acidophilus may cause similar s/s of bloating, cramps, diarrhea, flatulence 
common S/e if given compination of losartan and spironolactone?
hyperkalemia
This division of the PNS controls involuntary processes such as, contraction and relaxation of smooth muscles, all exocrine and endocrine secretions, cardiac muscle function, certain metabolic functions.
Autonomic
chemical name
name that defines the chemical composition of a drug
may increase NE and serotonin activity by blocking inhibitory presynaptic autoreceptorslow incidence of sedation, anticholinergic, CV seMay cause agitation, anxiety, mood changes
Venlafaxine
Potassium Channel Blockers are also called what type of medications
Antiadrergic Medications
probenecid
a uricosuric drug that increases uric acid excretion in the urine. It is primarily used in treating gout and hyperuricemia.
couple through Gq G proteins to increase cystosolic calcium levels
MI
M3
M5
couple through Gq G proteins to increase cystosolic calcium levels
odd number mAchR
which anti-epileptic drugs can cause GI distress
valproate, ethosuximide
uses of methacholine
challenge test for asthma dx
Antihypertensive drug that can cause a (+) coombs test & hemolysis
Methyldopa
______ is determined by the percentage of administered dose that makes it to circulation in its active form
bioavailability
Example of a Centrally Acting Skeletal Muscle Relaxant
Baciofen(Lioresal)
Decongestants alpha adrenergic agonists (sympathomimetic)
phenylephrine
Imidazoles - more selective, potent
- naphazoline, oxymetazoline, tetrahydrozoline

vasoconstriction = decongestant, reduce hyperemia

use for conjunctinval hyperemia, mild allergies, but AVOID WHEN POSSIBLE (rebound congestion)!
Methylphenidate
A congener of amphetamine used to treat ADHD.
...is used in combination with the neuroleptic droperidol to make Innovar (A neurolept anesthesia)
Fentanyl
Ertapenem
beta-lactam that is good Gram -, not used for pseudomonas, can cause seizures like imipenum
diazepam is what kind of drug?
BDZ long T1/2
pharmacotherapeutics of macrolides
erythromycin is effective against the same organisms as PCN G; use in pts allergic to PCN; drug of choice for Legionnaire's disease

Clarithromycin/azithromycin: greater gram-neg coverage; also better penetration into lung tissues & macrophages; drugs of choicein tx of mycoplasma pneumonia
substitues for PCN to treat respiratory infections caused by streptocuccus pneumoniae
used for chlamydial infections
Stage C Heart Failure
HF symptoms, structural heart disesae,
 
4 goals: correct pulmonary/peripheral adema
prevent remodeling from getting worse
improve quality of life
prolong life
The minimum dose that is effective for 50% of the population
ED 50
2 contraindications for statins
Hypersensitivity, liver disease, and preganancy.
injectable anesthetic agents, barbiturates, advantages
-fast onset and recovery-little post-op NV-reduction of intracranial and intraocular pressures-good antiseizure activity
(Gluco S/E)

Cutaneous changes
skin, related to protein catabolism; atrophy of the skin; changes in hair and nails
NSAIDS
ASA is the prototype of the NSAIDS. ASA is not pure NSAID however it has NSAID properties.
NSAID are thought to act by inhibiting specific enzymes so that prostaglandins, substance that promote inflammation and pain, are not formed.
What does the abbreviation stand for: Rx
receipt, take
What is the antidote Deferoxamine used to treat?
Iron toxicity/overdose
Which has greater oral bioavailability?
amOxicillin (O for Oral)
what type of drug is carbechol
direct cholinergic agonist
What can cause a vitamin K deficiency?
-anticonvulsants
-antibiotics (neomycin)
Antihistamines when to notify HCP
Difficulty breathing, hallucinations, pallpatations, or tremors.
arthrotec 50,75
diclofenace 50 or 75 mg with misprostol
2 ACE inhibitors
Captopril and enalapril (a prodrug). They prevent angiotensin one from becoming two (A-2) and inhibit bradykinin breakdown. Improve left ventricular function in cardiac patients, well tolerated, infrequent resistance/tolerance, dont cause orthostatic hypo
Class I antiarrhythmic drugs
block sodium channels. depresses phase 0. And are local anasthetics or membrane stabilizing agents. (quinidine)
Side effect profile: BDZ
excessive sedation and impaired motor performanceadditive effects w/ other CNS depressantsadversely affect breathing in people with compromised respiration
general clinical use for second-generation cephalosporins
community acquired URIs (H.influencae, M. catarrhalis, S. pneumoniae) & uncomplicated UTIs (E.coli)
 
useful in mixed aerobic/anaerobic infections of the skin  & soft tissue, intra-abdominal infections, gynecological infections, surgical prophylaxis 
Respiratory acidosis Causes/Treatment
Causes: Retention of CO2 secondary to hypoventilation -Depression of the medullary respiratory center -Pathologic changes in the lungs
 
Treatment: Correct respiratory impairment; Infusion of sodium bicarbonate if severe
This adrenergic receptor is located in adrenergic and cholinergic nerve terminals and its effect is to decrease neurotransmitter release
Alpha two (α 2)
Therapeutic index (TI)
ratio of the LD50 to the ED50
Muscarinic
Found in all organs of PNS and sweat glands. Increases glandular secretions, contractions of smooth muscle, slows h/r, causes miosis (contraction of sphincter muscles of the Iris), contraction of ciliary muscle, and vasodilation to a small degree.
Define up-regulation
A drug that causes the formation of more receptors that normal.
ROCM is the ____ most common cause of hospital acquired acute renal failure.
1/3
ACE -I, name three
pg 316 - captopril, enalapril, lisinopril
What are some effects of glucocorticoids?
Causes neutrophilia, decreases lymphocytes in the blood, stimulates gluconeogenesis, stimulates protein catabolism to incresae amino acids, and inhibits phospholipase A2.
What is a problem with finasteride?
terotogenic for male fetus
Lithium theraputic levels
acute mania 1-1.5 meq/L; long term maintenance 0.6-1.2 meq/L; measure at 8-12 hours after last dose
Enter your front text here.
Enter your back text here.
2 ways opioids work
Activate descending pathway and opioid receptors on afferent nerve terminals in the spinal cord.
Fick's Law of Diffusion
Which law controls the amount of chemical that can penetrate from one side of the membrane to the other?
Potassium-sparing Diuretics
act in the distal tubule to inhibit Na absorption & K secretion
 

aldosterone antagonists: counteract effects of aldosterone by competing for aldosterone receptor sites in distal tubules; as a result, Na & water are excreted & K is retainednonaldosterone antagonists directly inhibit the exchange of Na & K in tubule; Na is eliminated & K is retained  
What type of response are baroreceptor signals?
 
What nervous system do baroreceptors effect?
FAST!!!
 
Sympathetic NS & aleviation of PS tone in the heart
Drugs have two very basic effects on tissues: 1 ___________ and 2 __________.
Stimulate and depress
Blocks given on raceday commonly possess what type of drug?
Mainly anti-inflammatory meds - Combination of very low dose corticosteroid plus mild pain reliever
Beta 2 agonist work by
relaxing bronichial smooth muscle and causing bronchodialation
What does vasopressin (pitressin) do?
Alternative to epinephrine for shock resistant ventricular fibrillation and for cardiovascular shock. Increases blood flow and improves oxygen delivery to the brain. Action w/in 3 min effects w/in 20 min post injection. IV or IM.
what is the half life of sumatriptan
less than 2 hours
What cancer drugs have the SE Cardiotoxicity?
Doxorubicin, Daunorubicin & Trastuzumab
from adrenal glands of animals
INSULIN - beef, pork and synthetic
adrenilin and cortisone
Bella Donna Alkaloids (2)
Atropine and scopalamine. (can cross the BBB)
which loop diuretic is not a sulfonamide?
ethacrynic acid-use for sulfa allergy
major property of Beta blockers:
 
selectivity of receptor blockade 
some agents are specifically beta I, some II, and some function in combo
 
selectivity is never absolute (always side effects)
 
beta I selective blockers: cardioselective b/c lack unwanted bronchoconstrictors of nonselctive blockers
 
non-selective beta blockers: block both I & II, causing decreased CO/BP (so neg -ino, chrono-, dromo-), peripheral vasoconstriction (b/c alpha I left), decrease glycogen secretion (b/c less need for insulin), increased LDL & decreased HDL (b/c cholesterol prod. may increase)
What is epogen?
who might abuse it?
how can you create the same effect natuarlly?
epogen is a hematopoietic growth factor (stimulates RBC production).  Blood dopers might abuse this.  Alternatively one can train at high altitiudes to make the body create more RBC naturally.
Risperidone: Class of drug, use.
SDA - block serotonin AND dopamine receptors, diminishing psychosis, calming, can be used as antihistamines or thermostat *SDAs QUiETly whISPER “OLANZA!” when they are locked in the CLOSET and PINE for their #2,3,4, and 5 personalities
clinical manifestation of a seizure
depends on part of cortex affected and partern of propagation
What is the difference between an oxybarbituate and a thiobarbituate
oxybarbituate- oxygen on carbon 2

thiobarbituate- sulfer on carbon 2
What is good about lower solubility?
the quicker the anesthetic response, and the quicker the recovery
which tetracycline is fecally eliminated?
doxycycline (can be used in renal failure)
Action of loop diuretics
blocks reabsorption of Na, Cl, H2O at loop of Henle
Long term heparin is associated with 2 things
Osteoporosis and spontaneous fractures
Pharmacodynamics / Action of calcium channel blockers
prevent flow of Ca ions into cell
relax arterial smooth muscle & decrease contraction of heart muscle
slow AV conduction
reduce HR
dilate coronary & peripheral resistance
increase coronary blood flow (b/c no constriction)
reduce myocardial O2 demands
In general, what do Amphetamines do to the body?
Postpone sleep, stimulates Alpha 1 and NE receptors causing hypertension, suppress appetite for days or weeks, can treat narcolepsy, ADD, and emotional depression
What are the risks from the flu vaccine (inactivated)?
- Severe allergic reactions

Mild problems include: soreness, fever, aches
What do you always administer it with and why?
cilastatin -- it decreases inactivation of imipenem in renal tubules
which drugs --> pseudomembranous colitis
I have to take a CLAMP

clindamycin
ampicillin
What do you use to treat Burning mouth Syndrome?
Tricyclic Antidepressants and anticonvulsants.
Amitryptiline (Elavil) - mostly
Desipramine (Norpramin)
difference in responses of loop and thiazide diuretics r/t GFR
loops responses occur over large range of GFR whereas thiazides are ineffective if GFR
what test must be done weekly on patients taking clozapine
WBC count because of potential agranulocytosis
what is the effect of muscarinic action on the heart?
Muscarinic action on the heart is directed to the SA node, atria and AV node
where M2 activation slows heart rate (negative chronotropic action),
decreases the force of contraction (negative inotropic action) and suppresses AV conduction (negative dromotropy).
What is the MOA of carbonic anhydrase inhibitors?
Block carbonic anhydrase to cause bicarbonate to stay in the lumen (proximal tubule)
for asthma, what are the advantages of aerosol therapy?
fewer systemic se (but lungs are absorpative)
quick acting
non-invasive
effective
 
what are the shape and dimensions of a microtubule?
cylindrical, 24 nm in diameter, variable length.
How do you calculate Dosing Interval? How do you calculate the average concentration at the Steady State?
Dosing Interval = (1.44 X Dose in mg X half-life)/APA… Concentration at steady state = APA/Volume distributed
How can most problems with taking aspirin be alleviated?
By taking the med with food or a full glass of water, or one can take enteric coated aspirin
Ketaconozole
AntiinfectivesAntifungalsHepatotoxicity
Bumetanide
Bumex
Keflex
cefdinir
COCAINE
(blank)
rivastigmine
exelon
donepezil
aricept
propanolol
inderal
-pril
ACE inhibitor
narco-
numbness; stupor
Cholinoreceptor blockers:
p303
Fluorouracil
Antineoplastic

pyrimidine antimetabolite (cell cycle−specific) causes "thymine−less" cell death; used mainly for solid or superficial tumors.

Tox-
GI distress, myelosuppression
od
right eye
temazepam
benzodiazepine hypnotic
Ribavirin
-Uses
-Toxicity
-Respiratory syncytial virus
-Combined with interferon alfa to treat hep c
-EXTREMELY teratogenic: pt or partern CANNOT use
-Anemia
acebutolol
beta1 selective antagonist
cefixime
3ed generation cephalosporine
Analgesia
Absence of pain
Nonsurgical antimicrobial prophylaxis
p297
Minoxidil
Antihypertensive

pro−drug of minoxidil sulfate, a high efficacy arteriolar vasodilator. Used in HTN; topically for baldness.

Tox-
tachycardia, salt and water retention, pericardial effusion PGE1 derivative: orally active prostaglandin used to prevent peptic ulcers in patients taking
Amphetamine
Indirectly acting sympathomimetic

displaces stored catecholamines in nerve endings. Marked CNS stimulant actions; high abuse liability.

Tox:
psychosis, HTN, MI, seizures
ditropan(xl), oxytral patch
oxybutinin
Tetracyclines
-Action
-Resistance
-30S, prevent tRNA binding
 
-Pumped out
Tetrahydrogestrinone
Endocrine (Anabolic Steroids)THG "Designer Testosterone" produced to avoid earlier drug tests.Admin: Cycling, Stacking, PyramidingSE: Retention of Na/H2O (↑vascular resistance, ↑blood volume, ↑hypertension); ↑risk of coronary heart disease (↓ HDL:↑LDL); Acne; Liver Toxicity (oral preps; blood cysts, ↑liver tests, tumors)
Oxymorphone
Nervous System AND Pain/AntiinflammatoryOpioid Agonist10x morph., 1-3 hours, no hist. release
apomorphine
misc. opioid agentsstrong dopaminergic agonist emetic of choice in dogsgive conjunctivally (or SQ)
Pharmacokinetic Processes
Absorption, Distribution, Biotransformation, Elimination
Epilepsy drug toxicities
p. 309
Type of drug?
Ticarcillin
Anti-pseudomonal penicillin
Flecainide
Group IC antiarrhythmic prototype

used in ventricular tachycardia and rapid atrial arrhythmias with Wolff−Parkinson−White syndrome.

Tox-
arrhythmogenic, CNS excitation
Penicillamine
Chelator, immunomodulator

copper and sometimes lead, mercury, arsenic. Used in Wilson’s disease and rheumatoid arthritis
Ropivacaine
(A)
long-acting
S enantiomer only
less toxic and potent
EPIDURAL
enflurane
volatile general anaesthetic inhaled
Clonazepam
Benzodiazepines, enhances the activity of GABA, used as an anxiolytic.
Carboprost
Endocrine (PGF2α analogue)EYE: ↓ intraocular pressureVASC: vasocx (↑ IP3 & ↑ Ca2+)LUNG: bronchocx (↑ IP3 & ↑ Ca2+)REPRO: ↑ Uterine CX (↑ oxytocin)TX: control postpartum bleeding; elective abortion
contraindications of benzodiazapines
hypersensitivity, angle-closure glaucoma, severe respiratory distress
pregnancy/lactation (unless nothing else avail)cross placenta
beleived to cause fetal anomalies when taken during early stages of pregnancy; may cause fetal dependence w/ resulting withdrawl symptoms in the neonate when taken at the end of the 3rd trimeste; when taken at labor will cause CNS depression in the neionate 1st trimester deformities

caution in pts w/ h/o ETOH/drug abuse
caution in elderly or debilitated pts b/c of altered metabolism that may allow then or their metaboites to accumulate in the plasma & lead to excessive sedation & ataxia; the outcome of these common effects is incrased risk of falls & injury
Adverse effects Mannitol [Osmitrol]
Edema
 
Headache
 
 Nausea Vomiting
 
 Fluid and electrolyte imbalance
sufentanil
pure opioid agonistanesthetic adjunct in dogs
Chemical Name
Chemical comp of drug.
Which induction agents provide analgesia
Dexmedtomidine
Ketamine
-oxin
cardiac glycoside (inotropic agent). Digoxin
examples of 1st generation sulfonylureas
tolbutaminde
chlorpropamide
What G-protein is a/w:
M1 receptor
q
Carbachol
Nonselective muscarinic and nicotinic agonist

choline ester with good resistance to cholinesterase; used for glaucoma (not a first−line drug)
levothyroxine
eltroxin (cheaper less strengths), synthroid (more $, more strengths)
Hirudin
Anticoagulant that directly binds thrombins catalytic and substrate recognition site. Irreversible thrombin inhibitor. Action is independent of presence of antithrombin.
Sorafenib
Mechanism: TKI targeting VEGFR2, 3, cKIT, and RAF
 
treatment: RCC and may treat GIST
 
 
Physical dependencd: alcohol
severe and life threatening
Class - Statins (think "liver")Inhibits cholesterol production
Atorvastatin (Lipitor)
bupropion
dopamin reuptake blocker ,used in smoke cessation
For medical and postop. patients
24-22 gauge
opioid antagonists
-pure anatagonists at all receptors-prevent and reverse all actions of clinically available opioids-can be used to treat opioid OD and post-op effects-helps to avoid opioid dependence because it can prevent high (naltrexone)-naloxone (narcan)-naltrexone (ReVia)-nalmefene (revex)
The primary antiplatelet drug used is
Aspirin
Hexamethonium =
Nicotinic ACh receptor antagonist --> ganglion blocker to prevent reflex bradycardia caused by NE
Other toxicities?
CNS stimulation, contraindicated with SSRI's or B-agonists
antidote to organophosphate poisoning
atropine + pralidoxime
Type of drug?
Tadalafil
Inhibits cGMP phosphodiesterase→ vasodilation
Tx of ED
Leuprolide
GnRH analog

synthetic peptide used in pulse therapy to stimulate gonadal steroid synthesis (infertility); used in continuous or depot therapy to shut off steroid synthesis, especially in prostate carcinoma
Centrally acting skeletal muscle relaxants contraindication
rheumatic disorders
types of ocular allergies
hayfever allergic conjunctivitis
vernal (kerato)conjunctivitis - childhood, warm climates
giant papillary conjunctivitis - CL
atopic keratoconjunctivits - adulthood, males
contact dermatitis
blepharoconjunctivitis
Vesamicol
Inhibits uptake of Ach into vesicles
Desipramine
Secondary TCA that affects almost exclusively NE reuptake. Not very sedative. Has been associated with sudden death in children
Silver Sulfadiazine
-Sulfonamide
-Topical used in tx of infections caused by 2nd and 3rd degree burns
What is effectiveness?
How well the drugs work
0.3937 in=  ___cm.
0.3937 inches = 1 centimeter
2nd generation quinolones/1st generation fluoroquinolones:
 
example 
ciprofloxacin (Cipro)
 
best gram-neg coverage 
Pergolide
Dopamine agonist, used with L-dopa for synergistic effect or for early treatment in pts who don't tolerate L-dopa well
This condition is characterized by an increase in tonic stretch reflexes (exaggerated muscle stretch reflex). It is often associated with cerebral palsy, MS, stroke and traumatic lesions to the brain and spinal cord (including quadriplegia and paraplegia
Spasticity
verapamil (Calan)
Calcium channel blockers Verapamil (Calan) is a calcium channel blocker used to treat dysrhythmia and angina.
Ibuprophen
Non-selective COX 1 AND COX 2 NSAID.
Alpha 1 antagonism is indicated for
Contolling Hypertension
Blood-Brain Barrier
A single layer of capillary endothelial cells that line the blood vessels entering the CNS.
Drug reaction causing cardio toxicity?
doxorubicin (Adriamycin), daunorubicin
what glaucoma should epinephrine NOT be used for
closed-angle glaucoma
MOA cephalosporins
same as penicillins, less susceptible to penicillinases
loading dose
given to rapidly establish a theurapuetic dose
Which of the following general anesthetics is administered intravenously?
ketamine (Ketalar)
Parasympathetic Activity
Rest and Digest (Peace)
Decreased Cardiac, Lungs, Blood Flow
Increased GI
1. decrease heart rate
2. Increase gastric secretions
3. Bladder emptying
4. Bowel emptying
5. Focus on near vision
6. constriction of pupils
7. contraction of bronchial smoothe muscle.
-SLUDGE
Salivation
Lacrimation
Urinary Incontinence
Diarrhea
Gastrointestinal Cramps
Emesis
Yohimbine
Increases heart rate and BP. No clinical uses. Competitive alpha-2 antagonist. Comes from the bark of a tree and is found among homeopathic remedies (said to be for male sexual perfomance, but not convincingly)
Amiloride
Blocks Na+ channels in principal cells of late distal tubule and collecting ducts.(also potassium sparing) Is secreted in ORGANIC BASE TRANSPORTER MECHANISM.
Ibuprofen
is an NSAID. It is used for mild-moderate analgesia. Inhibits both COX-1 and COX-2 pathway.
Clearance
What is the measure of the body's efficiency in eliminating drugs?
pharmacotherapeutics of potassium-sparing diuretics
adjunctive therapy w/ other diuretics to minimize K loss
 
edema associated w/ CHF, cirrhosis of the liver & nephritic syndrome
 
only PO 
Name which drug is a Selective Aldosterone Receptor Antagonists (SARA)— for the treatment of high blood pressure?
Eplerenone (Inspra®)
why does phenytoin cause megaloblastic anemia
causes decreased vitamin B-12
CV effects of xylazine
transient hypertension followed by prolonged hypotensionbradycardiaarrhythmias
Define tachyphylaxis
A rapidly occuring tolerance to a drug
(Opiate Agonist - S/E)

Emesis
(vomiting) Stimulates CTZ. More frequency in ambulatory patients. Greatest with first dose. Pre-treat with antiemetic.
What did the first law regulate?
testing for toxicity
The half-time of equilibration between the drug concentration in the plasma and the drug effect that can be measured
effect site equilibration
clinical uses of barbiturates
induction
tx of seizures
to decrease ICP & tx cerebral edema
euthanasia
What is the antidote for methemoglobin toxicity/overdose
methylene blue
side effects of captopril
cough from increased bradykinin
can cause renal insufficiency b/c GFR is not increased in low volume states
Name two current drugs that cause azoospermia:
-busulfan
-colchisine
(anti-cancer drugs/block proliferating cells)
Dopaminergic drugs and phenytoin cause?
decrease effectiveness of levodopa
the cleansing of a canal by flushing with water or other fluids
irrigation
Arbutamine
It is a beta-1, beta-2 and alpha-1 agonist that increases heart rate (positive chronotropy), force of contraction (positive inotropy) and systolic blood pressure. It has a rapid onset of action and relatively short plasma half-life (about 8 min). It is
Systemic vs topical antifungal
-Systemic can be used as topical
 
-Topical CANNOT be used as systemic
_____ fl. oz= 15 mL
1/2 fl. oz= 15 mL
tx of allergic rhinitis:
 
Pharmacotherapy 
topical intranasal corticoids are the first step
proven to be more effective than antihistamines/docongestants
able to relieve: nasal itching, sneezing, runny nose, nasal congestion
inhibit inflammatory process leading to the late phase reaction of the allergic process; given prophylactically (prevent or reduce symptoms that occur w/ the early stage rxn)
available by prescription only

most common side effect: nasal irritaion, congestion, throat irritation, unpleasant bitter taste, cough 
SSRI S/E - greater safety
Sexual dysfunction, nausea, weight gain, anxiety, insomnia, SES
The parmacological actions of this drug include:inhibits HR, increase in gastrointestinal motility, contraction of smooth muscle of the bronchioles, urinary bladder, uterus, circular muscle of the iris, cillary muscle of eye. It also stimulates sal
Direct acting Cholinergic drugs
Loop Diuretics - MOA
Most effective & strongest; produces the greatest amount of diuresis.MOA: Acts in the loop of Henle to block reabsorption of Na & Cl (where the most usually gets absorbed). Doesn't require good renal blood flow.
- Polysynaptic reflex arc is comprised of several small interneurons that link (afferent) input into the dorsal horn with (efferent) outflow to the A-motor neuron
- Drugs inhibit neurons: decrease alpha motor neuron excitability OR they just cause sed
POLYSYNAPTIC INHIBITORS class
Name the three principal parenteral routes of administration
intravenous, subcutaneous, and intramuscular
Explain what antihistamine results look like.
soothes manifestations caused by allergic reactions (ex. Benadryl)
"tropi" are anti-muscarinic
while vacationing in the tropics you lie on a beach and your muscles waste away!
Mechanism of action of Interferons.
Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis.
distribution
how it gets to the organs and tissues from exterstitial
Direct acting skeletal muscle relaxants manage? associated with?
Manage spasticity associated with neuromuscular disease
What type of drug is penicillin?
Narrow spectrum beta lactam
Describe opioid receptor
Gi protein receptors that inhibit cAMP (and thus PKA)
Formulation means what?
How the drug is administered. IV is the quickest absorption.
Adverse Effects of Digitalis
potential for toxicity is the major side effect; cardiac arrhythmias are most life threatening & major contributing factor is serum levels of K+ (too high or low)
cardiac glycosides have a low therapeutic index
serum levels greater than 2 indicate toxicity
doses should be individualized based on pt's serum digitalis conc.
Catecholamines are...? And what part of the N.S. are they released from?
norepinephrine and epinephrine...and they are released from the sympathetic N.S. ganglion's
The therapeutic uses of this drug include:* Relief of spasticity regardless of underlying pathology* Management of malignant hyperthermia syndrome precipitated by administration of neuromuscular blocker and inhalational anesthectics during su
Dantrolene Sodium (Dantrim, prototype)
What are some components of Aspirin?
Very old med; Antipyretic,(reduces fever) Anti-inflammatory; Analgesic; Anti-platelet activity(thins the blood)
Indirect acting cholinergic agents (anticholinesterase)
Inhibits cholinesterase, gets more Ach to the receptor site.
- works by drecreasing the effects of an enzyme, end result is increase in Ach at the receptor sites.
Uses- Treat glaucoma, myasthenia gravis, relieve post post-op bladder atony, suppress PAT, treat Alzheimers and downe's syndrome, antidote to atropine, also is in toxic insecticides and nerve gas (LT effects). PAT is proximal atrial tachicardia.
The amount of time it takes to clear one half of the drug from the plasma
half time
What class of drugs are used tto treat erectile dysfunction
cGMP Inhibitors
which receptors are associated with Gs
B1, B2, D1, H2, V2
what is the adult dosage for MDI for epineprhine?
.22 mg/puff
Drug receptors
Parts of a cell usually an enzyme or large protein molecule with which a drug molecule interacts to trigger its desired response or effect
4 antiepileptic drugs that bind protein a lot
Phenytoin, benzos, valproate, and tiagabine.
Drug transporters can be induced or inhibited by other drugs, for example?
Macrolide antibiotics inhibit MDR1 thus leading to an increase of serum digoxin. NB that MDR1 is transcriptionally regulated by PXR thus drugs that induce P450 via PXR also induce MDR1 thus double effect
As Elimination increases what happens to half-life ?
Half life will decrease becase more drug is being eliminated.
what are the side effects of barbiturates
dependence, additive CNS depression effects with alcohol, respiratory or CV depression (death), drug interactions due to CYP induction
This Purine compound is converted to uric acid which leads to gout? 2. Name the enzyme involved in the conversion? Name the other 3 purine compounds? Name the end product of these purines?
1.Xanthine (converted from excess purines) 2. Xanthine oxidase in two xanthine reactions. 3. Guanine, Hypoxanthine and Adenosine 4. Uric acid (liver, excreted by urine)
Define duration of action
Length of time the amount of drug remains above its minimum effective concentration.
what types of seizures is gabapentin indicated for
simple and complex partial, tonic-clonic
What is a relative risk?
RR = (disease in exposed/disease in unexposed)
2 repeating units of chains that bind together to make peptidoglycan
Nac-glucosamine and NAc-muramic acid.
3 main CNS affects of the methylxanthines
caffeine and theophylline 1. increase alterness 2. stimulate respiration 3. convulsive potential
Which one increases release of NE and 5HT via alpha 2 antagonism?
mirtazapine. Also potent 5HT Rantagonist. Toxicity - sedation, increase serum cholesterol, increase appetite
Discuss drug abuse and its effects on health professionals
Drug MisuseDrug AbuseDrug HabitDrug DependencyDrug Addiction
When does vasopressin become unstable?
When expired or when outside of temp range of 15-30 degrees celsius
In its effects on myocardial oxygen consumption, is Nifedipine similar to Nitrates or B-blockers?
Nitrates (Nifedipine is similar to Nitrates)
What is a Scored Tablet?
A tablet that can be broken in half
3 drugs that compete with alcohol for MEOS
Phenytoin, barbiturates, and oral hypoglycemics
How should Adenosine be administered?
Close to the heart and as fast as possible
A = AIRWAY
What are examples of situations when there is an inability to protect the airway?
When someone has taken 1. Sedative hypnotics, 2. Opioids, 3. Anticonvulsants
what is the adult dose hfa mdi for ipratropium bromide?
17 microgram/puff, 2 puffs qid
Liver - 100
Intestine - 40
Lung - 15
What are the three most common area's for CytP450's?
Apart from giving AC and measuring salicylate levels, what are other options of Tx?
Lavage may be used if performed soon after ingestion, Repeat AC with very large ingestions if bezoar is present, consider whole bowel irrigation in conjunction with repeat AC in large overdoses with enteric coated formulas, correct acid base, fluid and electrolyte distrubances. Balance hypotnoic saline solutions with dextrose and K along with sodium bicarb. Urine alkalinization
Diclofenac
RA (COX1 & COX2 Inh) MET: Liver CYP3A4 CYP2C9 Duration: Short (2hr) OTH: 1)↑ serum aminotransferase activity in liver 2) Renal dysfx doesn't impair clearance SE: Typical NSAID TX: Rheumatoid arthritis, Inflammation
Degree of drug effects on body is proportional to...
Log of the drug concentrations in the body.
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