Pharmacology Final Exam Flashcards

Terms Definitions
-cep/-cef
anti-infectives
Chlorpromazine
neuroleptic
Coumadin
clopidogrel
Zolpidem
Alcohol
VENLAFAXINE
(blank)
ipratropium
atrovent
pregabalin
lyrica
exelon
rivastigmine
MRSA DOC
-Vancomycin
ginko
cognative memory
-azole
antifungal. Ketoconazole
librium
Chlordiazepoxide HCL
Ranitidine (example)
Zantac
flecainide
Ic anti-arrythmic
Distribution
Affected by:1.Cardiovascular function2.Regional blood flow3.Drug storage reservoirs4.Physiological barriers
Heparinn antagonist
Protamine sulfate
SLE inducer drugs?
procainamide
hydralazine
INZ
Short acting BZD
Midazolam
uses for terbutaline
asthma
Nalbuphine
Opioid

mixed agonist−antagonist analgesic that activates kappa and weakly blocks mu receptors. Effective analgesic, but with lower abuse liability and less respiratory depressant effects than most strong opioid analgesics
Lioresal metabolized?
not metabolized
norflex otc
orphenadrine citrate
Trimethoprim
-Sulfonamide
-G+ and G- coverage
-Recurrent UTI
-BONE MARROW, GI, and HAIR effects
Metronidazole
Class: Antibacterial, antiprotazaol, amebacideAction: Hinders growth of selected organisms, including most anaerobic bacteria and protozoa.Side Effects: Seizures, anorexia, nausea, vomit.Contraindications: Allergy Nursing considerations: assess infection prior, watch for edema, recording stools, assess skin.
Clomipramine
Behavioral PharmAntidepressant - Tricyclic"Clomicalm"Anticholinergic, sedation, several weeks to see effect
A potassium sparing drug
Aldactone
Chlordane
i used against termites
GI Drugs (cont.)
p. 328
What drug causes:
Osteoporosis
Corticosteroids, Heparin
Amiloride
K+−sparing diuretic

blocks Na+ channels in cortical collecting tubules
Quinine
Antimalarial

blood schizonticide; no effect on liver stages. Isomer of quinidine, same toxicity
ketorolac
toradol tablets and ophth
metoprolol
betaloc (white), lopressor (pink,blue)
Nervous System
Central Nervous System (CSN)
|
Peripheral Nervous System
/              \
                              Autonomic    Somatic
                             /              \                 
            Sympathetic            Parasympathetic
Ethinyl estradiol
Endocrine Synthetic steroidal estrogens Admin: PO ↓ first pass metabolism (ethinyl) Endometrial hyperplasia Endometrial cancer Breast tenderness Feminization in males Cholestasis (GB disease) Hepatic adenomas ↑plasma TAG Thromboembolic disease/MI Headache, migraine BC Interax: ABX, phenytoin, barbiturates Ethinyl estradiol = #1 estrogen Norethidrone = #1 progestin Low-dose mono-triphasic = #1 ~ Suppress ovulation by negative feedback on gonadotropin release ~ Progestins = thicken cervical mucus ~ Thin endometrium ↓ ovum transport ~ ↑hormone binding proteins ↑insulin secretion & resistance TX: Oral contraceptive Hormone replacement (Primary hypogonadism)
stimulant/irritant laxatives
senna (Senokot)
 
cathartic effect: stimulate peristalsis by irritating the lining of the small & large intestinal wall
strongest & most abused; results in 6-12hrs after PO admin; 15-60min after PR (rectal) admin (dose dependent)
certain foods- prunes, raisins, rhubarb, pears-contain organic acids that cause irritation of the intestinal mucosa & stimulation of peristalsis
succinimidesfxn
increase seizure threshold and decrease electrical activity in brane
Vasodilators
relaxes arterials, decreases venous return to the heart, reduces workload.
Neostigmine
Blocks cholinesterase, increases Ach and increases muscle strength, speech, swallowing. Given PO.
antidote for opioids =
naloxone, naltrexone
Does nitroglycerin increase or decrease cGMP in smooth muscle?
Increase
Type of drug?
Streptokinase
Fibrinolytic- Systemic agent
4th generation cefepime
not against mrsa
Clomiphene
Estrogen partial agonist

synthetic used in infertility to induce ovulation
Abciximab
Glycoprotein IIb/IIIa receptor antag therefore inhibitors - antiplatelet aggregation anti-angina,
Diclofenac
Liver metabolism, easier management with kidney disease. Short ½ life, SE increased serum aminotransferase.
Lamivudine
-Uses
 
-Hep B DOC
-HIV reverse transcriptase inhibitor
 
-HIV adjunct becase it is tolerated so well
Titanium oxide
SunblockMOA: Absorbs UV lightSE: creates carcinogenic free radicals, must be coated with silica/alumina
Anaphylaxis
most serious allergic reaction.  Can take a few seconds or up to 30 mins to occur.
Gabapentin
Pain and Antiinflammatory Orig for epilepsy, works on nerve endings, SE: sedation, ataxia, wean slow to decrease seizures/rebound pain
uses of TCAs ?
major depression
anuresis
obssesive compulsive disorder
panic attack
neuroleptic pain
Examples of loop diuretics
Lasix or Bumex
Local anestintermediate onset, short duration
POLYSYNAPTIC INHIBITORS
Delivers medications by absorption through the GI tract
Enternal Routes
antidote for TCA's =
sodium bicarbonate (nonspecific)
Do thiazide diuretics increase or decrease levels of urine calcium ion?
Decrease
meningococcal proph
rifampin (drug of choice)
minocycline
Type of drug?
Tiotropium
Muscarinic antagonist- asthma drug
Dopamine
Neurotransmitter and agonist drug at dopamine receptors

used in shock to increase renal blood flow, stimulate heart
risperidone (Risperdal) indication
schizophrinia (treats negative systems)
ASA
top trade names: asprin, entrophen, asasphen, novasen, bufferin
Salicyclism
Aspirin toxicity. Symptoms include nausea, vomitting, tinnitus, decreased hearing, and vertigo. More severe is hyperventilation and hyperthermia. Most severe is vasomotor collapse, coma, renal and respiratory failure.
Spironolactone
(synthetic steroid) Potassium sparing diuretic, competitively inhibits aldosterone receptor binding in DCT and collecting ducts.
Lithium
is used to treat bipolar disorder. Alters cation transport across cell membrane in nerve and muscle cells and influences re-uptake of serotonin and/or norepinephrine.
What is Albumin
protien found in the blood
CNS effects of BDZs
AnxiolyticSEdation, muscle relaxation, anticonvulsantHypnosis, anterograde amnesiaAtaxia, confusionSuptor
pharmacokinetics of carbamazepine:
absorbed slowly following PO admin
enters brain rapidly b/c of high lipid solubility
initial half-life: 40hrs; continued use = 15hrs

induces its own metabolism, which is known as time-dependent kinetics; shortly after therapy begins, metabolism of this drug may increase significantly & half-life decreases w/ chronic use, causing fluctuation in serum levels over time

enhanced hepatic P-450 system activity also incrases the metabolism of other antiepileptic drugs
Almost all drugs are__________ bound to plasma proteins, primarily ___________.
reversibly; albumin
This is a direct acting catecholamine synthesized in the adrenal medulla. It interacts strongly with α and β receptors.
Epinephrine
Schedule II Drugs
*high potential for abuse*severe physcial or psychological dependence, accepted medicinal use with specfic restrictionsex:opium, codeine, morphine, amphetamines, ritalin
TNFa inhibitor
TNFa mediator of inflammation, being used more often earlier in disease, very expensive, all injectables

SE: infection (TB status?), malignacy (rare)
Study of drugs and their interactions with the human body
Pharacology
Less common TCA types, most likely seen in other countries

DPTL
Dothiepan
Protriptyline
Trimipramine
Lofepramine
Mirtazapine =
a2 blocker - atypical depression (causes side effects like dry mouth, inc. appetite, wt. gain)
What pharmacologic relationship would determine the existence of spare receptors?
EC50 < Kd
other than for epilepsy, what can phenytoin be used for?
anti-arrhythmic
Amphotericin B
Antifungal

polyene drug of choice for most systemic mycoses; binds to ergosterol to disrupt fungal cell membrane permeability.

Tox:
chills and fever, hypokalemia, hypotension, nephrotoxicity (dose−limiting, possibly less with liposomal forms)
What are the bacteria that require oxygen to survive known as?
aerobic
Propanolol (Inderal)
Beta blocker
Beta 1 and 2 blocker
-HTN, dysrhythmias, post-MI, hypertrophic subaortic stenosis, essential tremor, migraine, pheochromocytoma surgery, and serious dysrhythmias
Tubocurarine
A competitive NMJ blocker that is eliminated by the kidneys and has a relatively long duration of action.
Opioid used in obstetrics
Meperidine (demerol...AKA pethidine hydrochloride)
Drugs used to affect the sympathetic Nervous System
Adrenergic Agonists
sympathomimetics
Adrenergic Antagonists
sympatholytics
Skeletal Muscle Relaxants
____mL= 1 fl. dram
4 mL= 1 fl. dram
disruptors of cell membrane permeability
 
examples: 
amphothericin B, imidazoles, polymixins
Regulation of potassium levels...
Primarily by the kidneys
 
Influenced by extracellular pH
 
Insulin has a profound effect on potassium level
how should a patient taking carbamazepine be followed
monitor LFT's weekly
What is an example of non specific physiologic?
Chemotherapy
sources of calcium
milk sardines, cheese, salmon, green leafy vegetables, whole grains
Generalized seizure
Focus activity has spread to both hemispheres
Schedule ____ drugs have a very low abuse potential and are generally used for cough and diarrhea.
V
Drug effect is greater than the plasma concentration
unloading
what catecholamine is used to treat AV block
isoproterenol
Agranulocytosis (3, all start with letter C)
clozapine, carbamazepine, colchicine
what effect does furosemide have on the following serum levels:
K
HCO3
Ca
Mg
urate
decreased
increased
decreased
decreased
increased
Where is lead stored in the body?
in bone
Normal PTT values
1.5-2.5 times control; usually control is 25-35 seconds thus theraputic is 45-70 seconds
What is the helf life of flagyl?
6-8 hours
side effects of sympatholytics(a-2 agonist like clonidine)
dry mouth, dizziness, constipation,sedation and impotence.
Methotrexate
is a folate inhibitor and is used in the treatment of rheumatoid arthritis
_____ fl. oz= 1 TBS
1/2 fl. oz= 1 TBS
Thiazides & related agents
most widely used diuretic drug (weak)
sulfonamide derivatives, related in structure to CAH inhibitors
work by preventing Na from being reabsorbed in the kidney; as Na is excreted, it pulls water along with it
also, excretion of Cl, K, Mg, HCO is increased
work in distal convoluted tubules (cortical diluting tubule)
They also:augment Ca absorption in distal tubule
relax arterial smooth muscle & reduce PVR
interfere w/ insulin release (dose dependent, but my actualy create diabetics due to increased glucose levels)
Ketorolac Toradol/non steroidal antinflammatory
Dosage:30mg IV/IM(15mg over 65 yrs less than 50kg/110 lbs)Injectable NSAID that exhibits analgsesic antinflamatory and antipyretic properties w/o sedative effectsInd:mild to moderate painCON:Hypersensititvity ASA NSAID AsthmaPre:Peptic ulcer,renal or heptic impairment elderly 60mg has to be given IM straight to liver cannot break down
This drug has the following Pharmacokinetics:* Active orally* Absorption from the g.i.t. is slow (only 30% of oral dose is absorbed* half-life is about 8 hrs.* Undergoes liver metabolism and excretion in the urine
Dantrolene Sodium (Dantrim, prototype)
What are the 4 phases of processing a drugs within the body?
AbsorptionDistributionMetabolismExcretion
How is the PPV administered?
SC or IM in deltoid.
The highest level the drug reaches in the body
Peak concentration
What does the abbreviation stand for: bid (or bis in die)
twice each day
What is the antidote atropine used to treat?
anticholinesterase toxicity/overdose
Whch signals cross-talk with vitamin D?
-cyclin D1
-cell cycle factors
-apoptosis factors
==> cell-cycle arrest
cinetidine (Tagamet)
1st drug in the H2antagonists class to be developed, met/live, exc/urine, CPEBM, ava in O, P forms
magnesium trisilicate
as antacid - neutralise acid attack on ulcers but no healing promotion too large/freq dose req
What type of intermediate linkage does lidocaine and procaine have?
Amide and ester.
order of lipid solubility (potency)
least to greatest
nitrous oxide <<< desflurane < sevoflurane < isoflurane = enflurane < halothane
Pharmacokinetics of anticholinergics:
onset 5-15 min; peak 1-2 hrs; duration 4-6 hrs
 
minimal systemic absorption (very safe)
What is the benefit of niacin?
adverse effects?
niacin raises HDLs
 
adverse effects:
flushing
GI disturbances
hepatotoxicity
hyperglycemia
gouty arthritis
Neostigmine: Class of drug, use.
Muscarinic, Indirect Stimulants - to treat myasthenia gravis and neuromuscular blockade
1.Which drug inhibits DNA polymerase and is used to treat AML? 2.Some side effects are leukopenia, thrombocytopenia, name another side effect?
1. Cytarabine 2. Megaloblastic anemia
How is the flu vaccine administered?
Admin in deltoid, 1-inch needle.
What does the abbreviation stand for: U
unit, a dosage measure
how do propanolol and esmolol treat SVT
decrease AV conduction velocity
clinical uses of HCTZ?
HTN
edema
DI (by inducing mild volume depletion)
to stop recurrent renal calcium stones
What term is used to describe a severe response to a chemical that is characterized by life-threatening respiratory distress and shock?
anaphylactic reaction
quantal dose response curve
% of population showing a defined response
How do drugs that treat generalized/absence seizures work?
Reduce low-threshold Ca2+ current (T-type calcium current). Gives rise to oscillatory responses in thalamic neurons and can drive cortical activity.
Why is it dangerous to administer oxygen to a person under morphine administration?
Morphine depresses the brain-stem respiratory generator, so respiration becomes soley dependent on the carotid chemoreceptors which are stimulated by HYPOXIA and a higher than normal PCO2 to keep respiration going.
What is the oral anticoagulant?
What is its antidote?
Warafin (Coumadin)
 
vit K is antidote
These drugs do not directly bind on the receptor. They act on ganglia in both parasympathetic and sympathetic.
Indirect acting Cholinergic Drugs
entry of drugs into the CNS (4)
-CSF-Cerebral and spinal cord vasculature-peripheral capillaries-cerebral and spinal cord capillaries
This is a derivative of Physostigma venenosum Balfour?
Carbamates - Calabar bean alkaloid
what are the side effects of phenytoin
nystagmus, diplopia, ataxia, sedation, ginigival hyperplasia, hirsutism, anemias, teratogenic
What are the side effects of oxytocin?
water retention and hyponatremia, uterine rupture, and hypertensive crisis.
Distribution: drug is transported in blood to another site
Distribution: drug is transported in blood to another site
Which local anesth. can cause allergies?
Ester type (metab. to PABA derivative)
What are morphines physiologic actions?
Morphine gives you one "HECC of a DREAM" Hisamine and Hormonal actions; Emesis; Contraction of biliary smooth muscle (biliary colic) and Cardiovascular changes (hypotension); Decreased cough reflex, Decreased GI motility, Depression of mental functioning; Respiratory depression; Eurphoria; Analagesia; Miosis
what is the clinical use and toxicity?
adjunctive agent to L-dopa for Parkinsons. May enhance adverse effects of L-dopa
How do the effects of drugs typically occur?
Through binding to regulatory molecules (receptors) and activating or inhibiting normal body processes.
differentiate between the two kinds of blockage caused by succinylcholine
Phase I- blockage by gradual depolarization of the motor end plate
Phase II- if given over a long period of time via IV, the end plate eventually repolarizes but remains unable to transmit a signal
differentiate between the two kinds of blockage caused by succinylcholine
Note:
There is a return of some muscle tone and administration of Neostigmine or Edrophonium can return normal function
What is dexamethasone used for?
Used in cerebral edema because it has long half-life in the CNS
Beta blockers are myocardial suppressants because. . .
They cause bradycardia at the SA node and increase the PR interval
How Ach or adenosine decreases heartrate
Acts on M2 receptors (A1 for adenosine) through inhibitory G protein to decrease cAMP. Increases K+ efflux through more channel openings and more negative resting potential. Inhibits If and Isi decreasing slope of phase 4 and amplitude of phase 0.
4.) PHASE 1 of clinical studies
Gather data on drug safety and pharmacokinetics in healthy volunteers.Seek to determine the pharmacokinetic and safety of an IND in healthy human subjects. The subjects typically undergo physical examination, imaging studies, and chemical and pharmacokinetic analyses of samples of blodd and other body fluids. The pharmacokinetic analyses provide a basis for estimating doses to be employed in the next phase of studies and the other examinations seek to determine if the drug is safe for use in humans.
What does the abbreviation stand for: KVO
keep vein open, very slow infusion rate
Long acting insulin - glargine (Lantus) administration
1 time daily or BID; food dosn't matter
How come TCAs and SSRIs are able to potentiate opiate analgesia?
there are descending pathways from pons that potentiate spinal analgesia that use serotonin and noradrenaline as NTs
list the two kinds of skeletal muscle blocking drugs and give examples
1) Competitive antagonists- d-tuboCURarine, atraCURium, doxaCURium and roCURronium
2) Depolarizing blockers ( agonist)- succinylcholine
list the two kinds of skeletal muscle blocking drugs and give examples
all the antagonist contains CUR in them
What role do PGE2 and PGI2 play in the role of pain?
they sensitive the peripheral nerve endings
What position do you put the patient into for a rectal supository?
Patient should be on his Left side in a Sims position, drape appropriately.
verapamil
Isoptin
meso-
middle
cyclobenzaprine
Flexeril
Diuril
Antihypertensive
Nasacort
Decongestant
celecoxib
celebrex
olanzapine
zyprexa
paroxetine
paxil
nadolol
beta nonselective antagonist
Celexa liq
escitalopram
Sumatriptan
p. 308
Mevacor
Antihyperlipidemic Agent
benzocaine
topical anasthetic
sudafed
phenylephrine (Pseudoephrine)
Pioglitazone
Endocrine (Thiazolidinediones)MOA: Bind PPAR-γ receptor + RXR →↑GLUT1 & GLUT4 ↑lipoprotein lipase, FABPaP2 ↓TNFα, ↓leptinMET: Metabolized to weak metabolitesHalf-life: 3-7 hours ↑albumin boundSE: Troglitazone: hepatotoxicity Heart failure Angina, MIOTH: Dep on presence of insulin for their activity. Do not cause hypoglycemia Current TZD's do not cause hepatotoxicityTX: Type 2 diabetes
Marbofloxacin
AntiinfectivesQuinolones - "Zeniquin"Resp, skin, tissue infex, ears, cystitis/UTIs, broad, gm-/+, cidal, very fast acting, seizures w/NSAIDS, articular damage w/ young/pregs
C&S
culture and sensitivity
Local anesthetics
pg 313
MOA inhaled anesthetics
unknown
Fludrocortisone
Synthetic corticosteroid

high mineralocorticoid and moderate glucocorticoid activity; long duration of action
NSAID
Nonsteroidal Anti-Inflammatory Drug
clonazepam
benzodiazepine, epilepsy anti-convulsant
common loop diuretic
furosemide (Lasix)
Statins adverse effects:
 
headache
rash 
GI disturbances
myopathy/rhabdomyolysis (rare)
hepatotoxicity (rare)
 
Indication of vit K
hypoprothrombinemia
Dose reduction for elderly
30%
uses of adh
pituitary DI
Albuterol
metaproterenol
terbutaline
Important β2−agonists

used mainly for asthma.
Indomethacin
NSAID prototype

highly potent. Usually reserved for acute inflammation (eg, acute gout), not chronic; neonatal patent ductus arteriosus.

Tox-
GI (bleeding), renal damage
Celecoxib
rofecoxib
First COX−II−selective NSAIDs. Reduced GI toxicity
non rep
Do not repeat
oxybutynin
ditropan (xl), oxytral patch
mCPP
Decreases serotonin activity, increases obsessive activity.
Methacholine
Mechanism: choline ester with quaternary ammonium group (poorly absorbed, low penetration of CNS); muscarinic receptor agonist; less susceptible to hydrolysis relative to acetylcholine
 
Treatment: diagnose asthma
 
Side effects:nausea, vomiting, diarrhea, salivation, sweating, cutaneous vasodilation bronchial constriction. Atropine for overdose
 
weak
Most drugs are _____ electrolytes.
Coumadin Interactions
Many drugs, ETOH, antibiotics
cefuroxime
second generation cephalosporine and cross BBB
Durham-Humphrey Admendment
(1951)*specified how prescription drugs could be ordered and dispensed*required warning labels concerning drowsiness, habit-forming etc...*legend drugs "caution: federal law prohibits dispensing without prescription"
Life threatening condition, charaterized by uninterupted tonic-clonic seizures lasting more than 30 min
Sticus Epilepticus
amino acid neurotransmitters
aspartate, glycine, glutamate
which alkylating agent requires bioactivation
nitrosureas
What drug causes:
Adrenocortical insufficiency
Glucocorticoid withdrawl
Penicillin G
Penicillin prototype

active against common streptococci, gram−positive bacilli, gram− negative cocci, spirochetes, and enterococci (if used with an aminoglycoside); penicillinase−susceptible.

Tox-
penicillin allergy
Lithium interactions
Thiazide diuretics (increased toxicity); angiotensis steroidal; antiinflammatory
d-Fenfluramine
monoamine reuptake inhibitor, anti obesity
Triotropium
bronchial effects similar to ipratropium, and is administered as an inhalant. Its advantages are its long-duration of action and its greater selectivity for M1 and M3 receptors. Can treat COPD.
Erythromycin
is an antibiotic which prevents bacterial protein formation by binding to a ribosomal subunit. Related to clarithromycin
Urofollitropin
Endocrine (FSH)MOA: Used for FSH activity (merotropin w/LH component removed)Urofollitropin: IM/subQ rFSH: subQSE: Multiple births, ovarian hyperstimulation syndrome, fluid accumulation in cavitiesTX: Female infertility
example of second-generation cephalosporins
cefaclor (Ceclor) PO
Side Effects of Thiazides:
Hypokalemia,Hyperuricemia (can precipitate gout),Hyperglycemia,Hyperlipidemia, and hypercholesterolemia
can you use epinephrine in closed-angle glaucoma
NO
Chemical Name
identifies the exact chemical compound & it's molecular structureex: 2-(4-isobutylphenyl)propionic acid
One example of an Iminostilbene drug
Tegrital
Psychotherapeutic drugs include:
-Antipsychotic agents:block dopamine receptors in CNS
-Antidepressants:affect mood disturbances.
-Lithium:preferred tx of mania due to massive calming.
Ethanol competes with ethylene glycol and methanol (if present) for alcohol dehydrogenase. ADH action on EtOH produces -------.
acetaldehyde
which epileptic drugs --&gt; stevens johnson syndrome
ethosuxamide
lamotragine
Type of drug?
Nitroglycerin
Antianginal drug- Nitrates
Metabolized into NO
Type of drug?
Neostigmine
Anti-cholinesterase
Used for urinary retention, myasthenia gravis, neuromuscular blockade reversal
Interferon−α
Important cytokine for the treatment of hepatitis B and C infection.
Avastimibe
Acyl CoA Cholesterol Acyl transferase ACAT inhibitor, prevents cholesterol absorption
Mucomyst
to treat acetaminophen OD, maintains liver glutathione stores by binding to the reactive metabolite as it is produced. It can be given up to 36h after OD
White thrombus
Forms initially in high-pressure arteries by adherence of circulating platelets to areas of abnormal endothelium.
anesthetic
Drug that causes temporary loss of ability to perceive sensations at a conscious level.
Clofazimine
LeprosyMOA: binds DNA and inhibits its replicationAdmin: oralSE: Distinctive reddish-brown discoloration of the skin, GITX: Leprosy
Early signs ASA toxicity
tinnitus & decreased hearing
Heparin administration
Sub Q or IV, quicker onset
aldeslekin 2
useed in renal cell cancer ,melanoma
What is the normal function of Alpha-1 Receptors?
Vasoconstriction
Kefauver-Harris Amendments
1. required proof of efficacy2. guidelines for conducting clinical trials3. established Drug Efficacy Study Implementation-brought about as a result of Thalidomide birth defects
Receptor
Reactive cellular site on a molecule or cell; what the drug interacts with.
Poorly absorbed salts that increase osmotic pull, there by increasing water content
osmotic laxatives
Which induction agents are painful on injection
Brevital
Diprivan
Etomidate
prodrugs
these are metabolized and THEN they become active -

most drugs are metabolized to inactive metabolytes
Clinical uses of Pentamidine.
Pneumocystis carinii pneumonia prophylaxis.
uses of captopril
HTN
CHF
ischemic heart disease
decreases proteinuria and progression of nephropathy in diabetics
Type of drug?
Procaine, Cocaine, Tetracaine
Ester local anesthetics
Intracellularly binds and blocks Na channels
What can an excess of retinol cause?
terotogenic
Antihistamines indications
nasal allergies, seasonal and pernnial allergic rhinitis, and some symptoms of common cold, allergic reactions, mostion sickness and vertigo.
What is the brand name for Edrophonium?
Tensilon
Donepezil
Another ChEI similar in features to tacrine, i.e., a noncompetitive, reversible ChEI, but with a high degree of selectivity for AChE in the CNS, and with minimal peripheral activity. Donepezil has a half-life around 70 hours, and some results suggest mil
Most common adverse reaction to heparin
Transient thrombocytopenia
Amiodarone
Class 3 with wide capacity to block inactivated sodium, weakly calcium, potassium channels and weakly beta-adrenoceptors. Prolongs QT by K blockade. Effects last 1-3 months after discontinuation.
 
Treatment: all arrythmias (adjuvant)
 
Side-effects: microcrystalline deposits in cornea and skin, thyroid dysfunction (hyper/hypo), paresthesias, tremor, and pulmonary fibrosis
Mechanism of action of bupropion
a non-sedative atypical Antidepressant, it has DA releasing aspects that help nicotine addiction
drugs to treat herpesvirus infections:
 
penciclovir (Denavir) 
very expensive
 
poorly absorbed after PO
 
available only in topical form; more effective than topical acyclovir, esp for herpes labialis 
Atypical Antidepressants Nefazodone & Trazodone (Desyrel)/ ACTIONS/SIDE EFFECTS
ACTIONS:

WEAK serotonin uptake inhibitor


blocks 5HT1 presynaptic autoreceptors, therefore incr. serotonin release

SIDE EFFECTS:

sedation potent H1 blocking activity


priapism (erection that won't go away)
This drug is a depolarizing agent. It binds to the nicotinic receptor (like ACh), and unlike ACh, it causes a persistent depolarization of the motor end plate leading to a block in the conduction of impulses. With prolonged exposure to this drug there is
Succinylcholine
Antimetabolites, steroid hormones and etoposides are the cell cycle specific oncologic drugs - name three more?
Plant alkaloids, bleomycin, paclitaxel
Alzheimers Disease: basics
-beings subtly and insidiously and follows a gradual deteriorating course resulting in an incapacity for self care-decreases life expentancy -4.2 years for men, 5.7 years for women to live post-diagnosis-death is due to prolonged immobility (pneumonia or pulmonary embolism, infection, accident, or aspiration-women are more susceptible-2% are autosomal dominant, but mostly sporadic
In CNS Stimulants these are used to increase the relaxtion of the of exitatory neurotransmitters
Amphetamines
Hypersensitivity
A reaction to a substance that is normally more profound than seen in the normal population.
What does the abbreviation stand for: ac (or 'ante cibum')
before meals
what is tardive dyskinesia
side effect of neuroleptics; stereotypic oral-facial movements, may be due to dopamine receptor sensitization
Ach inhibits the release of NE from the noradrenergic nerve terminal by binding to --------- receptors.
M1.
Type of drug?
Colestipol
Lipid lowering agent
Bile acid resin- keeps bile from getting reabsorbed
what is the receptor preference for salmeterol?
beta 2
TEMAZEPAM
Mechanism: Bind to BZ binding site on GABAa receptor to increase frequency of Chloride channel opening. No GABA mimetic activity.
Uses: Sleep disorders.
"Out The Liver" metabolism to inactive compound.
myasthenia gravis
a disease of impaired transmission of motor nerve impulses, characterized by episodic muscle weakness and easy fatigability, esp. of the face, tongue, neck, and respiratory muscles: caused by autoimmune destruction of acetylcholine receptors.
Sick sinus syndrome
Group of abnormal heart rhythms (arrhythmias) presumably caused by a malfunction of the sinus node, the heart's primary pacemaker.[1] Bradycardia-tachycardia syndrome is a variant of sick sinus syndrome where atrial flutter and fibrillation alternate with
Cautions with aminoglycosides and NMB?
aminoglycosides can potentiate NMB agents. The reappearance of the neuromuscular blockade is a possibility if aminoglycosides are given in the early post-op period. The effects of lidocaine can be enhanced in the presence of NMB and aminoglycosides. The neostigmine(reversal drug) and Ca-induced antagonism of NMB may be incomplete and transient.
T1/2 Methadone
long - 15 hrs (compare with morphines 4 hrs)
pharmacotherapeutics of quinolones/fluoroquinolones
active against a wide range  of gram-neg & gram-pos bacteria
 
used to treat infections involvoing the respiratory, urinary & GI tracts, infections of the sinus, skin, soft tissue, bones, joints & prostate; anthrax, infections, diarrhea  & STDs 
Mechanism of action of Osmotic Diuretics
Filtered at the glomerulus
 
 Undergo limited reabsorption
 
 Promote osmotic diuresis
Name the one irreversible and strongest bond. Name the three weakest, reversible bonds from increasing to decreasing strength.
Covalent. Ionic bonds>Hydrogen bonds>Van der Waal's forces
pharmacokinetics
the effects of the body on the drug. has reference to the activity of drugs once they enter the body. this includes the processes of absorption, distribution, localization in body tissues, chemical transformations that occur within the body (biotransformation), and excretion.
Plasma level profile/drug response curve
The relationship between plasma concentration of the drug and the level of therapeutic effectiveness over time.
Antidysrhythmics work by
-Direct action of the cardiac cell membrane (lidocane)
-Indirect action that affects the cell (propranolol AKA Inderal)
-Or both
What is a disulfiram-like reaction like?
flushing, vasodilation, nausea, hypotension, respiratory difficulty
What are the major toxicities?
GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes
uses for rubicins
&quot;MS. Hodgkin's will LOB the RED ball&quot;
myeloma
sarcoma
Hodkin's
lung
ovarian
breast
Name the targets for female contraception:
-block ovulation
-block egg transport
-block fertilization
-block zygote formation
-affect implantation
...many targets!!!
7 Methods for administering Meds
Oral, Inhalation, Topical, Vaginal, Rectal, Urethral, Injections
Yohimbine- a2 antagonist
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)
MOA of warfarin and coumarin
Blocks gamma-carbox. of several glutamate residues in prothrombin and coag. factors VII, IX, and X. Also blocks epoxide reductase (essential for regeneration of active hydroquinone form of vit. K (KH2) from oxidized vit. K epoxide (KO). (prevents hepatic
Used for: non selective MAOI
2nd/3rd line drugs in unipolar depressionNarcolepsy (b/c of REM sleep suppression)Parkinson's disease
adverse effects of cephalosporins
usually tolerated well and are the safest type of abx
 

hypersensitivity: resembles PCN allergy, most frequent side effect; occurs in 1-2% pts w/o PCN allergy; risk of allergy lower w/ PO route

disulfiram-like effect: when ingested w/ ETOH or ETOH-containing meds (become violently sick)

Bleeding: may occur due to vit. K inhibition; admin of vit K corrects the problem

nephrotoxicity: when used w/ other nephrotoxic drugs & in elderly
pain at the IM injection site & phlebitis (vein inflammation) at the IV infusion site)
arthritis
superinfections
What type of channels do class IV drugs work on?
Ca channels (block)
Bretylium: Class of drug, use, mechanism
indirect adrenergic receptor blockers - treats hypertension and arrhythmias *NE stored in vesicles is depleted (who stole all my EPI?!)
Prescription Drug Marketing Act
1. prohibits sale, purchase, or trade of drug SAMPLES2. intent is to prevent DRUG DIVERSION
Durham-Humphrey Amendments of 1951
Required pharmacists to have a written or verbal prescription to dispense Med
How does atropine affect:
- eye
- airway
- stomach
- gut
- bladder
- mydriasis, cycloplegia
- dec. secretions
- dec. acid secretion
- dec. motility
- dec. urgency in cystitis
what are the side effects of lamotrigine
life-threatening rash, Stevens-Johnson syndrome
What is Ephedra used for?
Herbal agent used for weight loss
How to take Lovenox
with 8 oz of water and food
2 fluoroquinolones and their one target
Ciprofloxacin and levofloxacin. DNA gyrase (topo II), Topo IV. This blocks DNA replication eventually. These are bactericidal and are very commonly used. Often used in eyedrops.
1
 
 
 
 
 
Basiliximab
1
1 Monoclonal antibody (IgG) used as an immunosuppressant 
 
Antibody is directed against the IL-2 receptor alpha chain which is on the surface of T-lymphocytes, it binds to it and prevents binding of IL-2 (signal for T-cell proliferation)
adverse effects of glucocorticosteroids:
compared to PO steroids, very safe for all ages
most common from inhalation: hoarseness, dysphonia, aphagia, cough, oral candidiasis (thrush) with inappropriate use, cataracts
use of spacer device and rinsing mouth after inhalation decreases incidence of candidiasis
adverse effects of nasal inhalant: sneezing, epistaxis, HAs, n/v
daily use in kids/adolescents MAY cause supression of growth by a small amount
What is the GFR when you start to see problems?
Below 50
Name the 3 Muscarinic, Indirect Stimulants.
1 Neostigmine 2 Physostigmine 3 Echothiophate
What is a weak acid?
A netural molecule that can reversible dissociate into an anion and a proton (Hydrogen ion).
What does the abbreviation stand for: i, ii
one, two (as in &quot;gr&quot;,&quot;gr&quot;)
Name a symptom of sotalol toxicity.
Torsades de pointes (K+ channel blocker)
examples of nitrosureas
&quot;you MUST not let the Nitro go to your head, or you'll do a strip tease- a sin!&quot;

carmustine
lmoustine
semustine
streptozacin
What are MAOI Inhibitors purpose?
Inhibits the enzyme that breaks down dopamine
Why should patients with congestive heart failure not use NSAIDS?
They inhibit prostaglandins and cause vasoconstriction and decreased GFR. This stimulates the kidney to save fluid and contribute to heart failure.
traditional (1st generation) antipsychotics may still be appropriate for:
pts w/ hx of good response w/o EPS
pts who ahve responded better to these drugs than the atypicals
pts who have responded better to depot versus oral
Describe how norepinephrine is made. Where is epinephrine made?
Tyrosine > DOPA > Dopamine > Norepinephrine. Epinephrine is made in the adrenal medulla
What causes Renin to be released?
Decreased b/p and blood volume can cause renin to be released.
Most common resistance mechanism for vancomycin.
Terminal D-ala of cell wall component replaced with D-lac; decrease affinity.
A _____ mutation results when a SNP causes a different amino acid
Missense

Can be conservative or Non-conservative
Whats similar between A-2 and muscarinic-2 receptors? (2 things)
They both have negative feedback (auto and heteroreceptors) and they are presynaptic and postsynaptic.
What is a Loading Dose?
the initial dose of a drug that is higher than a normal dose to achieve therapeutic levels quickly
Name the three locations that have H1 receptors.
1 Bronchi/Bronchioles 2 Arterioles 3 Ileum (all have smooth muscle)
What do you use it for?
Gram pos cocci, gram neg rods and anaerobes (broad spectrum)
What are the five types of muscarinic receptors?
M1: nerve
M2: heart and smooth muscle
M3: heart and smooth muscle
M4: smooth muscle and glands
M5 : ?
What are the 3 changes in potential that cause arrhythmias?
 
 
1) Slope of phase 4 increases
2) Threshold potential is more negative
3) Maximum diasolic potential is more positive
What is the mechanism of action of sulfonylureas?
1. Binds to Sulfonyureal receptors on B cell causing closure of K+ channel. This leads to depolarization and subsequent Calcium influx leading to insulin release.
An ideal drug must have properties to do what?
*To be transported to site of action and excreted or metabolized at a reasonable rate so the actions are selective with a suitable length of action.&#10;&#10;
which drugs are in the class Ic anti-arrythmics?
See (C)! And Can't (EnCain) We FLEe if we PROP up PHENOMS?

encainide
flecainide
propafenone
/ 298
Term:
Definition:
Definition:

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