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468 Cards in this Set

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asthma
chronic inflammatory disorder of the airways

involves complex interaxn between many cells and inflammatory mediators that result in inflammation,obstruction , inc airway responsiveness and episodic asthma sx
precipitating factors of an acute ashtma exacerbation
allergens
occupational exposures
viral resp tract infxn
exercise
emotions
exposure to irritants
environmental exposures
drugs
allergens
pollen
house dust mite
animal dander
mold
cockroach
food
occupational exposures
chemical irritants
flour wood
textile dusts
emotions
anxiety
stress
hard laughter
crying
exposure to irritants
strong odors
chemical
fumes
environmental exposure
weather changes
cold air
sulfur dioxide
cigarette smoke
problematic drugs
aspirin
nsaid
b adrenergic blkers
bethanechol
meds/food containing tartrazine, sulfites and other preservatives
characteristics of asthma
hypertrophy of smooth muscle
airways containing plugs consisting of inflammatory cells and their debris, proteins and mucus
inflammatory cellular infiltrate w/ vasodilation, denuded airway epithelium and microvascular leakage
vasodilation of the vasculature
denuded airway epithelium
microvascular leakage
collagen deposition in basement membranes
inflammatory cells
mast cells
eoxinophils
activated T cells
macrophages
epithelial cells
axn of inflammatory cells
secrete mediators and influnce the airways directly or via neural mechanisms
severe airway obstruction
bronchoconstriction
airway wall edema
mucus plug formation
airway remodeling
smooth muscle hypertrophy
hyperplasia
airway obstruction
reduces ventilation to some lung regions

causes a ventilation/persulsion imbalance that leads to hypoxemia
hypoxemia
reduction in partial pressure of arterila oxugen(PaO2)observed in moderate to severe exacerbations
hyperresponsiveness
exaggerated response to certain stimuli
primary mechanism resp for airway responsiveness
inc levels of inflam mediators
infiltration by inflam cells
resp for altered mucociliary fxn
inflammatory cells
acute inflammation
early recruitment of cells to the airway
subacute inflam
recruited and resident cell activation -> persistent inflam
chronic inflam
persistent cell damage and ongoing repair -> airway abnormalities and may become permanent
100mg/dL of alcohol
Ultrastructural heart damage
200-300 mg/dL
Blood alcohol levels that cause emesis
5,000-10,000 molecules
New synthesized drugs introduced
Acetylation
Phase 2 metabolic rxn
Acetylcholine
Not used due to rapid hydrolysis and lack of specificity
Acetylcholine vasodilator due to
Release of endothelial relaxing factor
Activation of G proteins and 2nd messengers
Acetylcholine (muscarinic rec),
Admin of sof bicarbonate
Increase the excretion of aspirin in the urine
Affinity
Drug-rec interaxn is reciprocal of equilibrium dissociation constant
Akathisia
Restlessness
Aldehyde dehydrogenase
Primary pathway for ethanol metabolism
Alpha 1
Vasoconstriction
Alpha 2
Inhibition of norepi release
Alpha adrenergic blocking agents
Convert EPINEPHRINE vasoconstrictor to vasodilator
Alter rate of metabolism by CYP450
Charcoal-broiled foods, cigarette smoke, grapefruit juice
Amantadine
Antiviral – effectiveness in parkinsonism
Amitriptyline
Sedative and antimuscarinic action
Animal testing
Initial evaluation of new drug toxicity
Antagonist
Binds to rec site but does not produce any direct effect
Anticholinergic agents
Hot, dry skin, delirium
Apomorphine
Induce vomiting
Atracurium
Broken down spontaneously to form laudanosine (quarternary acid)
B agonist in bronchial asthma
Manage acute contraction of airway smooth muscle
B blocking agents in htn
Combo of inhibition of cardiac output and renin release
B2 receptor
Smooth muscle relaxation
B3 receptor
Primary location is on the lipocytes
Benzocaine
Topical use only
Beta 2
Bronchodilation
Beta agonist with ISA
Potential to have less depressant effects on the heart
Beta carbolines
Inverse agonist
Bethanechol
Increase tone of urinary retention & not hydrolysed by cholinesterases
Botulinum toxin
Inhibits release of acetylcholine from cholinergic fibers
Bretylium
Inhibits morepi release from adrenergic nerve endings
Bromocriptine
Hyperprolactinemia
Bupivacaine
Long acting and potent amide type local anesthetic
BZ1
Zaleplon and zolpidem have selectivity
Caffeine
Most common CNS stimulation
Cardioselectivity
Bronchial asthma
Catalyzed by microsomal mixed fxn oxidase system
hydrolyses, oxidations, reduction
CBZ
Frequency repetitive firing of neurons
Chemical antagonism
Protamine/heparin
Clozapine
Antipsychotic, bone marrow suppression or agrnaulocytosis ,least likely to produce extrapyrimidal side effects
Cocaine
No vasoconstrictor is needed
Commonly affected by chirality
Ability of the drug to activates its rec
Comprehensive drug abuse prevention and and control act
Set controls on habit forming drugs manufacturing
COMT
Leads to prdxn of normetanephrine
Covalent bonds
Least likely to contribute to very selective drug action
D1 receptor
Renal vasodilation
D2
Estrapyramidal side eff of antipsychotic
Density of medium
Not included in the calculation flux
Dextromethorphan
Cough suppressant, no opiod dependence
Diazepam
Most effective in stopping attacks of gen tonic-clonic status epilepticus
Direct binding to and inhibition of an enzyme catalyzing a key metabolic reaction
Methotrexate
Dopamine
Low conc = increase blood flow to kidney
Dopamine beta hydroxylase
Found in effluent ff adrenergic nerve stimulation
Dosing rate
Clearance x target conc
Durham-Humprey
Power to FDA to determine w/c drugs sold without Rx
Effect of irreversible antagonist on an agonist conc-response curve
It will not affect the EC50 but will decrease the max effect
Effect of reversible ,competitive antagonist on an agonist conc-effect curve
Increase the EC50 but not change the max effect
Endomorphin 1
Peptide –greatest affinity for mu opiod receptors
Endozepines
Naturally occurring molecule that has affinity for benzodiazepine receptor
Enzyme inducers
Benzopyrene, Phenobarbital, phenytoin, rifampin
Epinephrine
Treat acute hypersensitivity rxn to drugs
Esmolol
In OR develop arr- quick eff-duration of action
Ester local anes
Responsible for allergic response
Ethosuximide
Absence seizures
Extraction ratio
Hepatic clearance / hepatic blood flow
F
Absorption x (1-extraction ratio)
Fentanyl
Very potent analgesic patch
Fetal alcohol syndrome
Flattened face
Flumazenil
Benzodiazepine antagonist
Fluvoxamine
No sedative and antimuscarinic action
Food, drug and cosmetic act of 1938
Required that all new drugs be safe
Gabapentin
Excreted in urine unchanged
Glaucoma
Timolol
Glucocorticoids
Inhibits reuptake of norepi into extraneuronal sites
Glutamate
Neurotransmitter aasoc w/Parkinson
Halothane
Depresses the heart rate during anesthesia
Hemicholinium
Blocks reuptake of choline into cholinergic fibers
Henderson-hasselbach equation
Calculate degree of ionization of weak acids and bases
Hyperbolic
Relationship between drug conc and eff
Hypnotic agents
Produce restful sleep
Idiosyncratic response
Infrequently observed in most pt’s
Induce CYP450
Glucocorticoids, macrolide abx, Phenobarbital, polycyclic aaromatic hydrocarbons
Inhibition of CYP 450 competitive inhibition
Cimetidine and ketoconazole
Intrinsic sympathomimetic activity
Pt forgets to take dose
IV barbiturate
Cause tissue necrosis ff extravasation
Kefauver-Harris
New drugs proof of efficacy
Levodopa
Prolonged w/ admin of COMT inhibitor
Local anesthetic action
Must have lipophilicity & hydrophilicity
Loperamide
Diarrhea
Lorazepam
Least likely to cause enzyme induction
Maintenance dose
Dosing rate x dosing interval
MAO
Inhibition leads to dangerous increases in BP when fermented foods are taken
MAO – fermented foods
Antidepressant most dangerous
MAOI
Phenelzine
Methacholine
Used for cardiovascular eff
Methadone
Opiod dependence
Methanol intoxication management
Folic acid,IV ethanol,alkalinization w/ bicarbonate, hemodialysis
Metyrosine
Inhibits rate limiting enzyme resp for norepi synthesis
Midazolam
Flumazenil
Mirtazapine
Unique 3rd gen , does not block the amine pump for noreepi or serotonin
Mixed function oxidase
CYP2B1
Morphine
Most appropriate for minimal circulatory reserve
Muscarinic
Bradycardia
Muscarinic agonist
Asthma, coronary insufficiency, peptic ulcer
Muscarinic M1 receptor
Activation of phosphoinositide pathway in CNS neurons and sympathetic postganglionic neuron
Muscarinic receptors
Contraction of vascular smooth muscle
naltrexone
Induce withdrawal, pinpoint pupils, respiratory depression
Nicotinic
Release of adrenal catecholamines
Nicotinic agonist
Stimulate skeletal muscle and ganglionic sites
Nicotinic Nm receptor
Skeletal muscle contraction
Nicotinic Nn receptor
Ganglionic stimulation
Nitrous oxide
Shortest induction time
nonCatecholamines Vs catecholamines
Adv noncatecholamines= longer duration of action in cns
Nongenetic factors for individual variation in drug distribution, biotransformation and elimination
Age , circadian rhythm, liver fxn, sex
Opening or closing of ligand gated ion channels
GABA, Acetylcholine (nicotinic rec)
Oral maintenance dose
Dosing rate x dosing interval
Orphan drug amendments of 1983
Incentives for development of drug that treat dz that occur less than 200,000 pt’s
Pancuronium
Moderate block of cardiac muscarinic receptor, no effect on ganglia and no tendency to cause release of histamine
Phase 1
Small # of healthy volunteers (25-50)
Phase 1 depolarizing blockade
Tetanus producing nerve stimulation
Phase 2
Patients with the target disease 4 efficacy
Phase 4
Large # after approved NDA
Phenothiazine
Orthostatic hypotension
Phenoxybenzamine
Forms ethyeneimonium ion
Phenylcyclidine (PCP)
Trmt of hallucinogenic drug overdose
Phenylephrine
Increase in peripheral resistance w/out cardiac stimulation
Phenylethanolamine n-methyltransferasse
Responsible 4 synthesis of epinephrine
Phenytoin
Interference with ion conductance thru Na channels
Phosphate
Administered w/ ethanol intoxication
Physical dependence
w/drawal results in physiologic changes
Physiological antagonism
Insulin/glucocorticoids
Potency
Ed50
Pramipexole
Dopamine agonist – non ergot
Procaine
Ester type compd –shortest duration of action
Progressive depression of CNS
Sedation - hypnosis - anesthesia - coma –death
Pseudo zero order
Ethanol eliminated from the body
Pure food and drug act of 1906
Prohibited mislabeling and adulteration of drugs
Quantal dose-effect curve
Conversion of cardiac arrhy to normal rhythms in a pt population
Quarteynary
Permanently charged amine
Rapacuronium
Most rapid onset neuromuscular
Receptor phosphorylation
Desensitization of b adrenoeceptor in continue presence of agonist
Regulation of gene transcription by intracellular receptors
Glucocorticoids, Thyroid hormones, Vitamin D
Reserpine
Leads to loss of granular storage of norepinephrine
Sedative agents
Produce reduction of anxiety
Selectivity
Comparing the ED50 for different responses to the same drug in vivo
Selegiline
Inhibits metabolism of dopamine
Smooth endoplasmic reticulum
Most CYP450 enzymes located
SSRI
Fluoxetine
Stage 2
Breath holding, retching, irregular respiration
Steady state
First dose / 0.5
Succinylcholine
Shortest duration- depolarization type
Synaptobrevin
Cellular protein promotes fusion of vesicular membrane
Tachyphylaxis
Rapid diminution of a tissues sensitivity to a drug after administration
TCA
Imipramine
TCA excessive quantity
Death
Tetracaine
Ester local anesthetic high potency, long duration of action
Timolol
Reduce MI mortality
TPA
Biotech and cloning genes ex
Transport by diffusion across membranes
Most dependent on the ability of a drug to dissolve in a lipid membrane
Transport proteins
Macromolecule targeted by cardioactive dig glycosides to produce eff on heart
Trazodone
Considerable sedative action , no antimuscatinic side eff
Treatment of alcohol withdrawal
Maintain K and MG balance,
Tubocurarine
Nondepolarizing neuromuscular blocker
Valproate
Absence, complex partial, generalized tonic-clonic, simple partial
Vesamicol
Alters storage of acetylcholine in dense core vesicles
2ndary hypercholesterolemia
Early nephrosis
Abciximab, eptifibatide, tirofiban
Reduces platelet aggregation by bunding to the platelet IIb/IIIa receptor complex
ACE
Altered taste
ADHD
Interference w/ hormone receptors
Alpha receptor of vessels
Nonselective drug action leads to excessive tachycardia
Aminocaproic acid
Inhibitor of fibrinolysis
Amiodarone
Antiarr broad spectrum activity
Amiodarone
Markedly prolong action potential duration
Angiotensin 1
Enzymatic action of renin
Antiatherogenic
HDL
Aspirin
Irreversibly acetylates cyclooxygenase=> inhibition of the synthesis of thromboxane A2
Atherogenic
VLDL, IDL, LDL
Atrial natriuretic peptide
Regulation of Na excretion
B receptors of juxtaglomerular cells
Hypotensive action – propranolol
Blue Monday
Throbbing headaches caused by loss of tolerance
BPH
Avoid K sparing diuretics
Bradykinin
Vasodilator axn-arteries ;contracts veins
Bretylium
Cause initial tachycardia
Calcium overload
Digoxin induced arrhythmias
Cardiac inotropic actions of digoxin
Consequence of Na/K aTPase inhibition
Ccb+ tachy
Verapamil
CHF = digoxin
Avoid high intake of sodium
Clopidrogel
Blocks adenosine diphosphate receptor on platelets =>reduce platelet aggregation
Colestipol
Inhibits absorption of cholesterol bile acids
Digoxin
Eliminated in the kidney
Dihydropyridine – nimodopine, nifedipine, nicardipine
More selective vasodilator than verapamil (phenylalkylamine)
Diuresis
Elimination of urine volume
ECG induced digoxin
Increasing PR interval
Effect of warfarin
Reversed by vitamin K
Endothelin
Vasoactive peptide – iv injection causes vasodilation followed by vasoconstriction
Furosemide
Altered hearing
Gemfibrozil
Elevated triglyceride levels
Half life of digoxin
Requires 1 week to stabilize pt w/ maintenance dose
Isosorbide dinitrate
Orally effective form of nitrovasodilator
Kidney tubules
African American respond better
Lepirudin
Inactivates fibrin bound thrombin in thrombi
Lidocaine
Shortens the duration of action potential
Low MW heparin
inhibits factor X
Magnesium
Counter the cardiotoxicity of digoxin
Metoprolol
Inhibits catecholamine-induced arr
Niacin
Reduced HDL levels
Nsaids inhibit
Aldosterone antagonists , carbonic anhydrase inhibitor, thiazides, triamterene
NTG
Relaxes smooth muscle
Omega 3 fatty acid ingestion
Lower triglycerides
Organic nitrites
Effective in erectile dysfunction
Pindolol
Partial agonist, ISA
Procainamide
Renal failure, torsade de pointes
Quinidine
Blocks Na channels and increases duration of the action potential
Re-entry phenomena
Abnormalities in cardiac conduction that give rise to abnormal cardiac rhythms
Rifampin
Decrease anticoagulant effect of warfarin by inducing hepatic enzymes that transform the anticoagulant in the body
Simvastatin and lovastatin
Must be converted in GI tract to an active compound
Spironolactone
Hyperkalemia
Streptokinase
Proactivator plasminogen
Sympathetic nerve terminals
Antihypertensive action of reserpine and guanethidine
Unfractionated heparin
Activated partial thromboplastin time
Unstable angina
Decreased platelet aggregation
Vasoactive intestinal peptide
Modulator, relax airway & vascular smooth muscle
Vasomotor center – clonidine
Lower BP
Vasopressin
Increase water absorption
Verapamil
Dependent on Calcium channel blockade
Warfarin
Blocks gamma carboxylation of glutamate residues in factors 2,7,9,10
Iron deficiency
Chronic anemia
Iron dextran
Appropriate for parenteral admin
Hydroxycobalamin
Treat pernicious anemia
Erythropoietin
Anemia caused by renal failure
Respond to G-CSF granulocyte colony stimulating factor
Neutropenia caused by cancer chemotherapy
Folic acid
Provides a cofactor to produce deoxythymidylate
Rhodopsin
11-cis-retinal
Hypervitaminosis A
Erythematous dermatitis, neurologic sx, pain and tenderness of bones, papilledema
Vitamin K 1
Prevent hypoprothrombinemia newborn
Vitamin D
Hypocalcemia asso chronic renal failure
Hypervitaminosis D
Elevated 25-hydroxyvitamin D
Hydroxylation of 1 carbon only
Conversion Vit D3 to calcitriol
Effect of PTH in kidney
Decrease excretion of Ca but increase excretion of phosphate
Calcitriol effect
Bone/intestine- increase Ca & phosphate
Etidronate
Osteomalacia not seen in fosamax
Alendronate
Increase bone density w/ osteoporosis
Hypercalcemia
Calcitonin, etidronate, furosemide, gallium nitrate
Oxytocin
Activation of receptors coupled to a G protein which activates calcium phosphoinositide signaling pathway
Leuprolide
Synthetic analog of GnRH
Order of potency
T3>T4> reverse T3
<1%
Free circulating thyroid hormone
Influence oral absorption of levothyroxine
Al containing antacids, food, iron, sucralfate
Thyroid hormones action
Activate receptors in cell nucleus, modulating formation of mRNA coding for certain proteins
Levothyroxin (T4)
Agent of choice for thyroid replacement
Thioamides
Methimazole and PPU
Methimazole
Qd dosing – mild to moderate hyperthyroidism – accumulated by thyroid gland; onset = 3-4 weeks
Propylthiouracil
Inhibits peroxidase catalyzed reaction to block iodine organification in thyroid gland
Estrogens
Increase binding of thyroxine by TBG
Potassium perchlorate
Antithyroid action – competitive inhibition of uptake of iodide into thyroid gland
Iodide
Inhibition of release of preformed thyroid hormone from the thyroid gland
Neutrophils
Leukocyte increases blood conc after single dose of short acting glucocorticoid
Glucocorticoids
Interfere with Vit D action
Fludrocortisone
Synthetic steroid greatest salt-retaining activity
Dexamethasone
Steroid longest duration of action
Betamethasone
OB to prevent incidence of respiratory distress syndrome in infants premature delivery
Hydrocortisone
Corticosteroid cause Na and fluid retention and loss of potassium
Thin emaciated facial features
Least likely to occur after 2 weeks of glucocorticoid admin
Complication of long term glucocorticoid therapy
Muscle wasting, osteoporosis, peptic ulcers , thinning of the skin
Progesterone receptors
Stimulated by estrogens
Estrogen admin
Fertility least likely to occur
Progestin
Reduce risk of endometrial cancer
Effects of HRT in postmenopausal
Reduction of osteoporosis, relief of atropic vaginitis,relief of hot flashes, relief of excessive sweating
Osteoporosis risk factor
Caucasian,inactive lifestyle. Smoking
17 alpha alkylated androgen
Side effect in liver
Half life of circulating insulin
3-5 minutes
Insulin on liver
Inhibits conversion of amino acid to glucose
Ultralent insulin
Longest duration of action
Hypoglycemia
Most common complication of insulin
Sulfonyurea
Inhibit efflux of K ions thry ATP sensitive K channels in pancreatic B cell
Rosiglitazone and pioglitazone
Act as agonists for nucler PPAR -> activates insulin-responsive genes
Acarbose and Miglitol
Inhibit alpha glucosidase activity in the intestine
Repaglinide and nateglinide
Release insulin from pancreas
2nd gen sulfonylurea
Glyburide, glimepride, glipizide
Glyburide
Hypoglycemia
Repaglinide
Control postprandial glucose excursion
Glucose
Precipitate symptoms of thiamine deficiency in marginally nourished pt’s
Nicotinic acid
Prophylaxis & trmt of pellagra
Oxacillin
B lactam abx most resistant to staphylococcal beta lactamases
Ampicillin
Improved activify against gram –ive rods
Transpeptidation reaction
B lactam abx – bactericidal action
Induction of transpeptidase
Least likely to contribute to bacterial resistance to PCN
Methicillin
Most nephrotoxic
Amoxicillin
Cleared by kidneys lowere dose in renally compromised function
Beta lactamase inhibitor
Clavulanic acid
PCN
Cross-reacting and cross sensitizing
Cefaclor
Most susceptible to hydrolysis by beta lactamases
Ceftriaxone
3rd gen cepha achieves conc in the CSF sufficient to inhibit most pathogens
Staphylococcus bacteria
Beta lactamase are most effective against beta lactamases produced by
Erythromycin abx axn
Ribosomal protein biosynthesis
Interfere with TCN absorption
Alkalin pH,antacids,dairy products, divalent cations
Doxycycline
Most suitable for renal insufficient pt
Minocycline
Tcn longest duration of action
TCN admin during pregnancy
Affect bone tissue
Clarithromycin
Better acid stability & oral absorption than erythromycin
Cross resistance
Linezolid VS clinda, ery,quinupristin-dalfopristin
Ribosomal protein biosynthesis
Antibiotic activity of type B streptogramins due to blockade
Chloramphenicol
Greatest liability for producing toxic effects on the bone marrow
Aminoglycosides abx
Useful with aerobic gram(-)
Streptomycin
Vestibular dysfunction – toxic eff
Neomycin
Least absorbed from GI tract after oral
Tobramycin
Most similar to gentamicin
Sulfonamide chemical structure
Most similar to PABA
Sulfadoxine
Sulfonamide with the longest duration of action
Sodium bicarbonate
Useful in treating nephrotoxicity caused by sulfadiazine
Trimethoprim
Given therapeutic doses concentrate in the prostatic fluid and vaginal fluid
Quinolone
Synthetic fluorinated analogs of nalidixic acid
Cipro
Antimicrobial axn –topoisomerase II /IV
Fluoroquinolone
Most common N/V , diarrhea
Pyridoxine
Reverse peripheral neuropathy caused by isoniazid
Mutation preventing binding of rifampin to RNA polymerase
Main cause of resistance of mycobacteria to rifampin
Ethambutol
Visual disturbance
Amphotericin B
Renal toxicity
Flucytosine
Antifungal activity – inhibition of DNA and RNA synthesis
Terbinafine
Antifungal activity – inhibition of squalene epoxidase
DNA synthesis
Viral replication targeted by Acyclovir
Alteration of thymidine kinase
Resistance to acyclovir develops
Cidofovir IV
Nephrotoxicity
Inhibition of protein synthesis
Fomiversen inhibits virus replication by
Nucleoside reverse transcriptase inhibitor
Zidovudine
Didanosine
Pancreatitis
Zalcitabine
Peripheral neuropathy
Indinavir
Protease inhibitor – highest CSF penetration
Ritonavir + saquinavir
Increase the conc of saquinavir reaching the systemic circulation
Metronidazole
Most effective – extraintestinal infection by Entamoeba histolytica
Bactrim
P carinii pneumonia
Primaquine
Doc for eradication of dormant hepatic stages of Plasmodium vivax and ovale
Pyrimethamine
Antimalarial plasmodial dihydrofolate reductase
Alkylating agents
Cell cycle nonspecific
P glycoprotein
Cellular glycoprotein that transports foreign molecules
Reduction of WBC
Major toxicity produced by alkylating
Plant alkaloids
Cell cycle specific anticancer drugs
Methotrexate
Intracellular formation of polyglutamate
Chlorambucil
Cause cell death
Cytarabine
Converted in the body to a metabolite that blocks DNA synthesis by competitive inhibition of DNA polymerase
Vinblastine
Arrest in metaphase
Etoposide
Block progression thru cell cycle by inhibition of topoisomerase II
Dactinomycin
Anticancer drug inhibits DNA dependent RNA synthesis mainly as a result of its intercalation between adjacent guanine-cytosine base pairs in double stranded DNA
Immunosuppression in transplant pt’s
Antiproliferative/antimetabolic agents,
Cyclosporine
Binds to cyclophilin, => inhibit calcineurin in T lymphocytes
Sirolimus
Binds to intracellular protein FK506 binding protein 12
Tacrolimus
Binds to FKBP-12
Glucocorticoids
Admin prior to treatment with muromonab-CD3 to suppress cytokine release syndrome
Infliximab
Chimeric antitumor necrosis factor-alpha monoclonal antibody
CD154
Molecule that downregulates immune responses
Levamisole
Restore depressed immune function of B and T lymphocytes, monocytes and macrophages
Thalidomide
Immune modulating agents carries the strongest warning against OB
Human recombinant IL-2
Linked to serious cardiovascular toxicity due to capillary leak syndrome
Interferon gamma 1B
Most effective in causing activation of phagocytes and production of oxygen metabolites that are toxic to microorganisms
1-3 months
Protection from passive immunization using an immune globulin prep typically last
Carbon monoxide
Most abundant pollutant
Paraquat
Toxicity due to free radicals
Nitrogen oxide
Inhaled agents where farmers or workers who deal with silage can be poisoned
Ozone
Bluish irritant gas
Pyrethrum
Botanical poisoning, seizures, allergic response => contact dermatitis
Nicotine
Salt not readily absorbed thru the skin but the base is
Halogenated hydrocarbon
Assoc liver, renal, cardiac toxicity
Glucagons
Treat b adrenergic blocker intoxication
Organophosphate insecticides
Dumbels
Beta antagonists
Theophyline intoxication
Tricyclic drug overdose
Admin norepi to raise blood pressure
Edetate calcium disodium
Lead intoxication
Penicillamine
1st line of treatment for Wilson’s dz
Deferoxime
Iron poisoning
British anti-lewisite
Dimercaprol
oxygen
Carbon monoxide poisoning
Ethanol
Methanol toxicity
Naloxone
Opioid overdose
Pralidoxime
Early stages of organophosphate intoxication
Acetylcysteine
Acetaminophen toxicity
Cathartics
Enhance elimination of iron tabs, enteric coated agents, illicit drug packages
Emesis
Should be avoided in pt;s who have ingested a petroleum distillate
Activated charcoal
Eliminates toxic compound- gut dialysis
Cyclosporine
RA, DMARD (disease modifying antirheumatic drug
Allopurinol,
Decrease formation of uric acid by inhibiting xanthine oxidase
Colchicines
Discontinue due to abdominal pain/diarrhea
Probenecid
Organic acid inhibit excretion of PCN
Indomethacin
Initial trmt of gout as prostaclandin syntase inhibitor
GASTROINTESTINAL PHARMACOLOGY
PPI
Prodrugs
Suppression of nocturnal acid secretion
Most important determinant of rate of healing of duodenal ulcer
Chemoreceptor trigger zone
Antiemetic agent , inhibit chemically induced N/V
Metoclopramide
Restore motility
Cimetidine
Alter drug metabolism
Aluminum based antacid
Constipation
Cascara
Laxation when stimulation of peristalsis is desired
Mineral oil
Stool softener
Sulfasalazine
Inflammatory bowel disease
Methylcellulose
Hydrophilic colloid used a laxative
Infliximab
Inhibitor to tumor necrosis factor alpha for management of Crohns dz
Bismuth subsalicylate
Mucosal protective agents
Bronchial asthma
Nonspecific bronchial hyperreactivity
Controller drugs
Mgmt of bronchial asthma
Inhaled corticosteroid
Airway inflammation is linked to increase airway responsiveness
Aminophylline
Methylxanthine
Methylxanthine action
Inhibition of adenosine receptors
Theophylline
Requires periodic monitoring of plasma levels
Cromolyn
Inhibition of delayed chloride channels
Nedocromil
Administered prophylactically
Ipratropium
Quarternary amine
Corticosteroids adv eff
Adrenal suppression, hoarseness, oral candidiasis, osteoporosis
Physiologic inhibition
Occurs upon Epinephrine admin
H2 receptor
Similar to serotonin
Sleepiness
Penetration of antihistamines into CNS
Fexofenadine
Nonsedating
Promethazine
Antiemetic
Melatonin
Regularize sleep patterns
5HT2 receptors
Stimulation = intense CNS vasoconstrictive action of ergot alkaloids
Epinephrine reversal
Vasoconstriction of ergot alkaloids leads to gangrene
Guinea pig
Hypersensitive to histamine
Motion sickness
Ephedrine + H1 antagonist
Anticholinergic action of benztropine
Parkinson like tremor antagonized for antipsychotic agents
At this point, initiating agents is most likely methacholine, IgE is binding to mast cells at this time.
Cromakalim
activator of K channels
Zafirlukast
Inhibitor of leukotriene at receptor level
Prednisone
Used in large doses for severe acute episodes of asthma
Zileuton
Lipoxygenase inhibitor
Salmeterol
Long acting agent of choice for management of nocturnal asthma
Glutathione
Limited amt in phase 2 reaction , inability to convert toxic metabolites to inactive products
Pentazocine
Produce hallucinations and nightmares
Continuos loss of nigrostiratal neurons
Waning of Levodopa therapy Parkinson
Epinephrine
Reverse bonchospasm
Vecuronium
Eliminated from the body mainly by excretion of unchanged drug or its 3-hydroxy metabolite in bile
S-mephenytoin
More slowly metabolized in some individuals due to reduced rate of hydroxylation caused by genetic polymorphism of CYP2C19
Dantrolene
Most appropriate for treating the malignant hyperthermia triggered by a combination of general anesthesia and a neuromuscular blocking agent
Dissociative anesthesia
Ketamine produces catatonic state with amnesia and analgesia
Flunitrazepam
Date rape drug
Furosemide
High sodium
Hypothyroidism
Radio iodine therapy
Metformin
GI disturbances
Iv and smoking
Fastest and highest blood levels of cocaine route
Hyperlipidemias
Primary chylomicronemia
Antifungal activity axole drugs
Inhibition of CYP450
Nevirapine
Severe & life threatening skin rashes
Hemolysis
Glucose 6 phosphate dehydrogenase deficiency
Acute myelogenous leukemia
2nd most frequent malignancy encountered in cancer chemotherapy
Lipocortin
Inhibition of the production of prostaglandins and leukotriene in macrophages, monocytes, endothelial cells and fibroblast
Rattlesnake envenomation
Managed by large amts of antivenin
H3 receptors
Presynaptic