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233 Cards in this Set

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Bronchodilators -3 Long acting B2 agonists
Salmeterol
Formoterol
Levalbuterol
Advair Diskus
long acting B2 agonist plus a steroid
Clinical use of Advair Discus
asthma
COPD
Clinical use: Theophylline
Asthma and COPD
2 S/E: Theophylline
Seizures and arrhythmia
Bronchodilators: short acting B2 agoinsts
Albuterol
terbutaline
Clinical uses: Albuterol
Asthma
COPD
Emphysema
(5) S/E: Albuterol
tremor
nervouness
nausea
Palpitations
Tachy
Clinical uses: Terbutaline
Same as albuterol

Asthma
COPD
Emphysema
(5) S/E: Terbutaline
same as Albuterol

tremor
nervouness
nausea
Palpitations
Tachy
Name one mast cell stabilizer
Cromolyn Sodium
MOA: Cromolyn Sodium
-stim mast cells mem
-prevents mediators by blking Ca gates
T/F: Cromolyn Sodium can be used for acute sx or exacerbations associated with asthma
False.
(4) S/E Cromolyn Sodium
-Broochospsm
-throat irritation
-nasal congestion
-anaphylaxis
Beclomethazone, Tramcinolone, Fluticasone
3 cortocosteroids that affect the respiratory sys by inhibiting phospholipase A2
T/F: Corticosteroids that act on the respiratory system act on bronchial smooth muscle
False - no effect on bronchial smooth muscle
S/E: corticosteroids of the respiratory sys
inhaled forms cause oral thrush
3 types of drugs that help with gastro esophageal reflux disease and peptic ulcers
1. H2 blockers
2. Proton Pump Inhibitors
3. Colloidal bismust compounds (pepto-bismol)
Gram neg rod Helicobacter pylori causes
HCL secretion, peptic ulcer dz
Two H2 blockers
Cimetidine (Tagamet)
Ranitidine (Zantac)
Two Proton Pump Inhibitors
Omeprazole
Esomeprazole
drugs that block secretion from parietal cells (remember histamine stimultates these cells)
H2 blockers
Irreversibly block the H+/K+ -ATPase Pump
Proton Pump Inhibitors
Binds to ulcer craters, inhibits pepsin activity and stimulates mucus
Colloidal bismuth compounds
S/E of Cimetindine
Gynecomastia and loss of libido
H2 Blocker S/E
diarrhea
3 S/E: Proton pump inhibitors
GI distress
skin rash
gastrin-dependent hyperplasia
Black staining of tongue, black stools and tinnitus is caused by what drug
Colloidal bismuth compounds
Two tx of diarrhea
Diphenoxylate plus atropine (Lomotil)

Loperamid (imodium)
Increase dietary fiber
Physllium (Metamucil) and Methylcellulose
Laxatives
-Magnesium sulfate
-Senna (Senakot)
4 tx for constipation
-increase dietary fiber
-increase fluids and exercise
-laxatives
-stool softeners
Stool softener
mineral oil
Exessive fecal loss of fluids and electrolytes due to increased motility, decreased fuilds, or increased fluid secretion
Diarrhea
Due to a combination of decreased intestinal and colonic motility and excessive fluid uptake by the body
Constipation
4 types of Chemotherapeutic Agents
1) Alkylating Agents
2) Antimetabolites
3) Antibiotics
4) Plant Alkaloids
Two Alkylating Agents
-Cisplatin
-Cyclophosphamide
Two Antimetabolites
-Methotrexate
-5-Fluorouracil
One antibiotic
Adriamycin
Two Plant Alkaloids
-Vincristine and Vinblastine
-Paclitaxel
Causes interstrand and intrastrand DNA crosslinking
Cisplatin
Covalently x-links DNA at guanine N-7
Cyclophosphamide
Most common drug for breast cancer
Cyclophosphamide
3 S/E of cyclophosphamide
1. Bladder cystitis
2. Alopecia
3. myelosuppresion
3 types of cancer cyclophosphamide txs
-Non-Hodgkin's lymphoma
-Breast
-Ovarian carinomas
Inhibits dihydrofolate reductase
Methotrexate
S/E: of Methotrexate
Myelosuppresion
Uses of Methotrexate
-RA
-psoriases
-leukemias and lymphoma
Non-reversible myelosuppresion, photosensitivity
S/E of 5-Fluorouracil (5-FU_
Uses of 5-Fluorouracil
-Trabeculectomy
-basal cell carinoma
-colon cancer
Non-covalently intercalates in DNA
Adriamycin
S/E of Adriamycin
-Cardiotoxicity
-alopecia
-myelosuppression
Widely used in Oncology
Adriamycin
Inhibits cell mitosis by inhibiting microtubles
Vincristine and Vinblastine
Neurotoxicity and bone marrow suppression
S/E of Vincretine and Vineblastine
Promotes microtubule polymerization
Paclitaxel
2 S/E of Paclitaxol (Txol)
-myelosuppresion (reduction in bone's ability to make RBCs)
-hypersensitivity
chemical agents that inhibit or kill microorg
disinfectant
disinfecting agents with low toxicity for host cells - used on skin, mucous mem or wounds without harm
antiseptic
3 types of disinfectants
-chlorines
-quaternary ammonium ccmpounds
-aldehydes
4 types of antiseptics
-alcohols
-iodine
-oxidizing agents (hydrogen peroxide)
-heavy metals
Name a mRNA synthesis blocker
Rifampin
What is Rifampin used classically with to tx Tb?
Isoniazid
What are three nucleotide synthesis blockers?
-THF (Tetrahydrofolic Acid)
-Sulfonamides: Sulfamethoxazole (SMX)
-Trimethoprim
PABA + Pteriding using what enzyme to make Dihydrofolic acid
Dihydropteroate synthase
Dihydrofolic acid to THF uses what enzyme
dihydrofolate reductase
Inhibits dihydropteroate synthase
Sulfonamides: Sulfamethoxazole (SMX)
Side effect of Sulfa drugs?
Steven Johnson's syndrome
Side effect of Sulfa drugs in kids?
Kernicterus (bilirubin in the brain - jaundice)
Trimethoprim is combined with what drug to tx UTI
Sulfonamides
Inhibits dihydrofolate reductase
Trimethoprim
3 Fungal Membrane Blockers
-Fluconazole (azoles)
-Amotericin B
-Nystatin
Inhibits ergosterol synthesis and thus plasma membrane formation
Fluconazole
"Tears holes" by binding to ergosterol and creating pores for ions to leak out and disrupt membrane (name two)
Amphotericin B and Nystatin
Peptidoglycan synthesis blockers (2)
-Bacitracin
-Vancomycin
Excellent against gram + only
Bactracin
Prescribed often for skin Blepharitis and skin infxns like impetigo
Bacitracin
What form does bacitracin come in?
ointment form
T/F Baitracin has a very narrow spectrum
True
Is Bacitracin effective against gram neg bacteria?
No
Binds to D-ala, D-ala portion of cell wall and disrupts precursos
Vancomycin
Used for pseudomembranous colitis
Vancomycin
What is the tx of choice for Methicillin Resistant Staph Infections?
Vancomycin
The most severe side effect of vancomycin
Red Man's Syndrome
two side effects of Vancomycin besides red man's syndrome
-ototoxicity
-nephrotoxicity
DNA Topoisomerase blockers (1)
Fluoroquinolones - ciprofloxacin, norfloxacin, ofloxacin
Inhibits DNA gyrase AND topoisomaerase II
Fluoroquinolones
What are three things Fluoroquinolones used for ocularly?
-bacterial conjunctivitis
-CL related corneal ulcers
-gonorrhea
Three things fluoroquinolones are used for systemically?
-UTIs
-Repiratory infxns
-GI tract infxns

all affected by gram neg
The higher the generation of fluoroquinolone ...
The more gram + it becomes
Pneumonic for S/E of fluroquinolones?
FluroquinoLONES can hurt the attachments to your BONES causing tendonitis
This is contraindicated in preganancy and children due to damage in cartilage formation and inhibition of bone growth
Fluoroquinolones
3 Cell wall synthesis Blockers
-Natural Penicillin
-Penicillinase Resistant Penicillins
-Cephalosporins
Two Natural Penicillins
-Penicillin G (IM or IV)
-Penicillin V (given orally)
Primarily used for gram + infections and spirochetes such as syphillus
Natural Penicillin
What would you use to tx eyelid infections, like hordeolums or blepharitis?
Oral dicloxacillin
Blocks transpeptidase cross-linking of cell wall, blocks penicillin binding proteins/activates autolytic enzymes, not pencillin resistant
Natural penicillins
4 clinical uses of Natural pencillin?
-streptococcus
-syphilus
-meningitis
-pneumococcal infections
T/F Penicillins are very safe in all trimeters of pregnancy
True
Is the oral absorption of pencillin poor or good?
Poor
When should pencillin be taken?
hour before or two hours after meals
Cell wall synthesis blocker that is NOT degraded quickly by the gastric mucosa
Dicloxallin
What is the precentage that if a person is allergic to penicillin he will be allergic to cephalosporin to?
15%
What pencillins are penicillinase resistant?
-Methicillin
-Nafcillin
-Dicloxacillin
Which one has better oral absorption ampicillin or amoxicillin?
Amoxicillin
Side effect of Ampicillin
Hypersensitivity reactions
3 Cephalosporins
-Cefaclor
-Cefalexin
-Ceftrioxone
Bacteriocidal adn is less susceptible than penicillin to penicillinases
Cephalosporins
Which higher generation cephalosporins they become ...
more gram negative
Treatment for meningitis?
Ceftrioxone
Treatment for skin infections like dacryoadenitis, dacryocysitis, and preseptal cellulitis?
Cefalexin
S/E of cephalosporins
-rashes
-hypersensitivity reactions
-nephrotoxicity
"Pat an empty Stomach"
Penicillin, Azithromycin, Tetracycline are generally taken w/o food
Protein synthesis blockers (2)
-Aminoglycosides
-Tetracyclines
Aminoglycosides and tetracyclines
inhibit 30s Ribosomal subunit
Aminoglycosides
ineffective against anaerobes
What type of bac are aminoglycosides good for and bad for?
good for staph and bad for strep
Toxicity for aminoglycosides (2)
-Nephrotoxicity and Ototoxicity
Which AB have the broadest spectrum of activity for any group of AB?
Tetracyclines
3 types of tetracyclines?
-Tetracycline
-Doxycycline
-Minocycline
What is Minocycline used for?
longterm management of acne
What is doxycycline used for in the eye?
-Meibomianitis and acne rosacea
What shouldn't be take with tetracyclines?
dairy products
Can tetracyclines be used in children and pregnant women?
No!
What will tetracyclines do to pregnant women and children?
-discolors teeth
-retards bone growth
-photosensitivity
-GI distress
-Pseudotumor cerebri in the eye
3 protein blockers for the 50 s ribosomal subunit?
-Chloramphenicol
-Erythromycin
-Lincomycin
Chloramphenicol with extended use causes?
-optic neuritis
-grey baby syndrome
Are 50s protein synthesis blockers bacteriostatic or bacteriocidal?
All are bacteriostatic!
Five Macrolides?
-Erthromycin
-Azithromycin
-Clarithromycin
-Lincomycin
-Clindamycin
Erythromycin, Azithromycin, Clarithromycin are effect against what type of bacteria?
gram +
Side effects of erythromycin?
-nausea
-diarrhea
-abdominal pain
Erythromycin is the drug of choice for what type of systemic diseases?
mycoplasma pneumonia and Chlamydia
What is the alternative med to give pts who are allergic to penicillin?
Macrolides
Saved for Methacillin Resistant strains of bacteria and anaerobic infections above the diaphragm
Lincomycin, Clindomycin
S/E of Lincomycin?
pseudomembranous colitis
Metronidazole causes what when taken with alcohol?
GI upset
Waht are infections below the diaphragm treated with?
-Clindamycin
-Metronidazole
-Chloramphenicol
Waht do you add to kill any aerobic organisms?
Aminoglycosides
Causes orange-pink saliva, tears, sweat and urine
Rifampin
What is the only agent that can be used prophylaxis against TB?
Isoniazid
Current tx for TB is a 6 month regiment?
-Rifampin, isoniazid, and pyrazinamide for 2 mo.
-Isoniazid and pyrazinamide for the next 4 mo.
Pyrazinamide can cause
hepatotoxicity
3 types of Antiviral Drugs?
-Influenza Virus drugs
-Herpes Drugs
-HIV drugs
2 Influenza Virus drugs
-Amantadine and Rimantadine
-oseltaminivir
5 Antiherpes Virus Agents?
-Trifluridine
-Acyclovir
-Valacyclovir
-Ganciclovir
-Foscarnet
2 HIV drugs?
-Zidovudine
-Didanosine
Treats influenza A and Parkinsons
Amantadine
Prophylaxis and treament of influenza A and B and Avian Flu
Oseltaminivir
Acyclovir treats what two infections in the eye
-Herpes simplex
-Herpes Zoster
Valacyclovir treats 3 things
-Gential Herpes
-cold sores
-Herpes zoster
Trifluridine (Viroptic) treats ...
Herpes lesions in the eye
Topical lesions are used for simplex infections in the eye. And, Oral antivirals are used for ....
zoster infections in the eye
What are two antiherpes virus agents that are oral?
-Acyclovir
-Valacyclovir
What does Ganciclovir do?
Treatment of CMV (cytomegalovirus) - IV
What would you use if ganciclovir doesn't work?
Foscarnet
What does CMV cause?
retinopathy in AIDs patients
Two HIV drugs
-Zidovudine (AZT)
-Didanosine
What is triple therapy?
treatment for HIV that contains two nucleosides and a protease inhibitors (saquinavir and ritonavir)
What do protease inhibitors do?
inhibit new virus assembly by blocking protease enzymes
MOA of Antiparasitic Drugs?
-inhibit microtubule polymerization
Treatment for Onchocerciases (river blindness)
Ivermectin
Treatment for Trichomoniasis and Giardiasis
Metronidazole
the most common intestinal protozoal infection in the US
Giardiasis
Tx of Malaria, lupus, rheumatoid arthritis
Chloroquine (Plaquenil)
What can Chloroquine cause?
"bulls eye" maculopathy
3 drugs to tx malaria
Chloroquine, Malarone, Doxycycline
Two Anti-inflammatory agent categories
1. glucocorticoids
2. mineralcortocoids
Metabolic effects of glucocorticoids
-increase in blood glucose
-increase in protein breakdown
-mobilization of fat from adipose (buffalo bump)
What lowers phospholipase A2 activity, vasoconstriction
mineralcortocoids (Aldosterone)
S/E of aldosterone
-promote DM or insulin resistance
-cataracts and glaucoma
Long term use of aldosterone
-immune suppression and poor wound healing
4 types of non-steroids
-Salicylates
-Propionic acid derivatives
-Para-aminophermols
-Cox-2 Inhibitors
Inhibits prostaglandin and thromboxane synthesis by inhibiting the Cox-1 pathway
Aspirin
Is the MOA of aspirin irreversible or reversible
irreversible
Aspirin causes what side effect in children
Reyes Syndrome
What are reversible inhibiors of cyclooxygenase?
-Ibuprofen, Naproxen, Naproxen
(all are propionic acid derivatives)
NSAID that is safe in preg w and kids
Acetaminophen (Tylenol)
No anti-inflammatory action
Acetaminophen
Cox-2 inhibitors
-Celecoxib
-Rofecoxib
C/I for celecoxib
-sulfa allergies and pregnancy
What was Rofecoxib taken off the market?
-increased risk of heart attacks
Celecoxib treats two things
osteoarthritis and rheumatoid arthritis
Prolonged bleeding time
Propionic acid derivatives: Ibuprofen (Advil, Motrin), Naproxen, Naproxen Sodium (Aleve)
When Acetylcholine binds to a receptor and cases depolarization this is called ...
Excitatory postsynaptic potential (EPSP)
Ach can cause hyperpolarization leading to ...
Inhibitory postsynaptic potential (IPSP)
3 Monoamines
-dopamine
-norepinephrine
-Serotonin
Serotonin is derived from
L-tryptophan
Too little dopamine
Parkinson's
Too much dopamine
Schizophrenia
Used in both PNS and CNS. In PNS it raises BP and vasocontricts. In CNS it is used on smooth muscle, cardiac muscle, and glands
Norepinephrine
Most abundant NT in the brain
GABA
Inhibitory and hyperpolarizes the postsynaptic membrane
GABA
Too little GABA (excitatory movements present)causes what disease
Huntington's Chorea
Two opiods
-morphine
-codeine
A compound purified from the juice or resin of opium poppies
Opiate
drugs with similar activities to opiates
Opiods
3 receptor sites of opiods
-Mu (supraspinal analgesia, anti-anxiety effects, respiratory depression, euphoria and physical dependence)
-Kappa (spinal analgesia, miosis, sedation and hallucinations
-delta (Dependence, euphoria and analgesia)
opiod agonist
Morphine
4 uses of morphine
-analgesia w/o loss of consciousness
-anxiety
-pulmonary edema
-sickle cell crisis
S/E of morphine
pupillary constriction
Two clinical uses of codeine
-suppress coughing
-pain
4 similar drugs to codeine
-Heroin
-methodone
-meperidine
-dextromethophan
4 Sedative Hypnotics
-Triazolam Benzodiazepine
-Temazepam Benzodiazepine
-Zolpiden
-Antihistamines
Which Sedative hynotic has low incidence of daytime drowsiness?
Temazepam Benzodiaepine
Two Anxiolytics for anxiety, insomnia, panic attacks
-Alprazolam
-Diazepam
S/E of Alprazolam and Diazepam
Drowsiness and sedation
Decreases dopamine levels
Antipsychotics
Positive sx of Schizophrenics
-Delusions
-Thought Disoreder
-Inappropriate affect
-Increase in motor functions
Neg sx of Schnizophrenics
-lack of speech and thought
-loss of emotional response
-no affect
-social isolation
D2 Receptor antagonists
Chloropromazine and Haloperidol
Low affinity for the D2 receptor
Chloropromazine
High affinity for the D2 receptor but higher side effects
Haloperidol
3 Adverse rections for Chloropromazine and Haloperidol
-blurred vision
-urinary retention
-sedation
Too much of chloropromazine and Haloperidol causes what?
-parkinson like effects
-neuroleptic malgnant syndrome and Tardive dyskinesias
Chloropromazine in high concentrations can cause what two ocular manifestation?
-retinal toxicity and hyperpigmentation of the RPE (due to increase in melanin w/in the RPE cells
Prominent sx of Parkinson's
TRAP
-Tremor at rest
-Rigidity
-Akinesia
-loss of Postural reflexes
6 tx of Parkinson's Disease
-Levodopa
-Cabidopa
-Selegeline
-COMT inh: Entacapone
-Anticholinergis: Benztropine
-Amantadine
C/I for Levodopa
-Angle-Closure glaucoma
-Schizophrenia
-Cardiac arrhythmias
-Melanoma
Side effects of Anticholinergics: Benztropine
-dry mouth
-dry eyes
-blurred vision
-constipation
-urinary retention
-memory impairment
-psychosis
Antiviral agent that helps reduce tremors in Parkinson's and also helpful w/ influenza A
Amantadine
Four major classes of Antidepressants
-Monoxamine Oxidase Inhibitors: Phenelzine (Nardil)
-Tricycline Antidepressants (TCAs)
-SSRI (selective serotonin reuptake inhibitors
-Atypical Antidepressants
Name a MOI
Phenelzine
Name a TCA
Amitriptyline
Name a SSRI
-Fluoxetine
-Sertraline
Prominent sx of Parkinson's
TRAP
-Tremor at rest
-Rigidity
-Akinesia
-loss of Postural reflexes
6 tx of Parkinson's Disease
-Levodopa
-Cabidopa
-Selegeline
-COMT inh: Entacapone
-Anticholinergis: Benztropine
-Amantadine
C/I for Levodopa
-Angle-Closure glaucoma
-Schizophrenia
-Cardiac arrhythmias
-Melanoma
Side effects of Anticholinergics: Benztropine
-dry mouth
-dry eyes
-blurred vision
-constipation
-urinary retention
-memory impairment
-psychosis
Antiviral agent that helps reduce tremors in Parkinson's and also helpful w/ influenza A
Amantadine
Four major classes of Antidepressants
-Monoxamine Oxidase Inhibitors: Phenelzine (Nardil)
-Tricycline Antidepressants (TCAs)
-SSRI (selective serotonin reuptake inhibitors
-Atypical Antidepressants
Name a MOI
Phenelzine
Name a TCA
Amitriptyline
Name a SSRI
-Fluoxetine
-Sertraline