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233 Cards in this Set
- Front
- Back
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Bronchodilators -3 Long acting B2 agonists
|
Salmeterol
Formoterol Levalbuterol |
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|
Advair Diskus
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long acting B2 agonist plus a steroid
|
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Clinical use of Advair Discus
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asthma
COPD |
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Clinical use: Theophylline
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Asthma and COPD
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2 S/E: Theophylline
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Seizures and arrhythmia
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Bronchodilators: short acting B2 agoinsts
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Albuterol
terbutaline |
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Clinical uses: Albuterol
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Asthma
COPD Emphysema |
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(5) S/E: Albuterol
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tremor
nervouness nausea Palpitations Tachy |
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Clinical uses: Terbutaline
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Same as albuterol
Asthma COPD Emphysema |
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(5) S/E: Terbutaline
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same as Albuterol
tremor nervouness nausea Palpitations Tachy |
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Name one mast cell stabilizer
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Cromolyn Sodium
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MOA: Cromolyn Sodium
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-stim mast cells mem
-prevents mediators by blking Ca gates |
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T/F: Cromolyn Sodium can be used for acute sx or exacerbations associated with asthma
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False.
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(4) S/E Cromolyn Sodium
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-Broochospsm
-throat irritation -nasal congestion -anaphylaxis |
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Beclomethazone, Tramcinolone, Fluticasone
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3 cortocosteroids that affect the respiratory sys by inhibiting phospholipase A2
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T/F: Corticosteroids that act on the respiratory system act on bronchial smooth muscle
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False - no effect on bronchial smooth muscle
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S/E: corticosteroids of the respiratory sys
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inhaled forms cause oral thrush
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3 types of drugs that help with gastro esophageal reflux disease and peptic ulcers
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1. H2 blockers
2. Proton Pump Inhibitors 3. Colloidal bismust compounds (pepto-bismol) |
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Gram neg rod Helicobacter pylori causes
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HCL secretion, peptic ulcer dz
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Two H2 blockers
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Cimetidine (Tagamet)
Ranitidine (Zantac) |
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Two Proton Pump Inhibitors
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Omeprazole
Esomeprazole |
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drugs that block secretion from parietal cells (remember histamine stimultates these cells)
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H2 blockers
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Irreversibly block the H+/K+ -ATPase Pump
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Proton Pump Inhibitors
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Binds to ulcer craters, inhibits pepsin activity and stimulates mucus
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Colloidal bismuth compounds
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S/E of Cimetindine
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Gynecomastia and loss of libido
|
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H2 Blocker S/E
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diarrhea
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3 S/E: Proton pump inhibitors
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GI distress
skin rash gastrin-dependent hyperplasia |
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Black staining of tongue, black stools and tinnitus is caused by what drug
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Colloidal bismuth compounds
|
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Two tx of diarrhea
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Diphenoxylate plus atropine (Lomotil)
Loperamid (imodium) |
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Increase dietary fiber
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Physllium (Metamucil) and Methylcellulose
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Laxatives
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-Magnesium sulfate
-Senna (Senakot) |
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4 tx for constipation
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-increase dietary fiber
-increase fluids and exercise -laxatives -stool softeners |
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Stool softener
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mineral oil
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Exessive fecal loss of fluids and electrolytes due to increased motility, decreased fuilds, or increased fluid secretion
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Diarrhea
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Due to a combination of decreased intestinal and colonic motility and excessive fluid uptake by the body
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Constipation
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4 types of Chemotherapeutic Agents
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1) Alkylating Agents
2) Antimetabolites 3) Antibiotics 4) Plant Alkaloids |
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Two Alkylating Agents
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-Cisplatin
-Cyclophosphamide |
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Two Antimetabolites
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-Methotrexate
-5-Fluorouracil |
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One antibiotic
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Adriamycin
|
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Two Plant Alkaloids
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-Vincristine and Vinblastine
-Paclitaxel |
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Causes interstrand and intrastrand DNA crosslinking
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Cisplatin
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Covalently x-links DNA at guanine N-7
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Cyclophosphamide
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Most common drug for breast cancer
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Cyclophosphamide
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3 S/E of cyclophosphamide
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1. Bladder cystitis
2. Alopecia 3. myelosuppresion |
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3 types of cancer cyclophosphamide txs
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-Non-Hodgkin's lymphoma
-Breast -Ovarian carinomas |
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Inhibits dihydrofolate reductase
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Methotrexate
|
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S/E: of Methotrexate
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Myelosuppresion
|
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Uses of Methotrexate
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-RA
-psoriases -leukemias and lymphoma |
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Non-reversible myelosuppresion, photosensitivity
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S/E of 5-Fluorouracil (5-FU_
|
|
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Uses of 5-Fluorouracil
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-Trabeculectomy
-basal cell carinoma -colon cancer |
|
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Non-covalently intercalates in DNA
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Adriamycin
|
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S/E of Adriamycin
|
-Cardiotoxicity
-alopecia -myelosuppression |
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Widely used in Oncology
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Adriamycin
|
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Inhibits cell mitosis by inhibiting microtubles
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Vincristine and Vinblastine
|
|
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Neurotoxicity and bone marrow suppression
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S/E of Vincretine and Vineblastine
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Promotes microtubule polymerization
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Paclitaxel
|
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2 S/E of Paclitaxol (Txol)
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-myelosuppresion (reduction in bone's ability to make RBCs)
-hypersensitivity |
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chemical agents that inhibit or kill microorg
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disinfectant
|
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disinfecting agents with low toxicity for host cells - used on skin, mucous mem or wounds without harm
|
antiseptic
|
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3 types of disinfectants
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-chlorines
-quaternary ammonium ccmpounds -aldehydes |
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4 types of antiseptics
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-alcohols
-iodine -oxidizing agents (hydrogen peroxide) -heavy metals |
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Name a mRNA synthesis blocker
|
Rifampin
|
|
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What is Rifampin used classically with to tx Tb?
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Isoniazid
|
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What are three nucleotide synthesis blockers?
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-THF (Tetrahydrofolic Acid)
-Sulfonamides: Sulfamethoxazole (SMX) -Trimethoprim |
|
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PABA + Pteriding using what enzyme to make Dihydrofolic acid
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Dihydropteroate synthase
|
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Dihydrofolic acid to THF uses what enzyme
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dihydrofolate reductase
|
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Inhibits dihydropteroate synthase
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Sulfonamides: Sulfamethoxazole (SMX)
|
|
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Side effect of Sulfa drugs?
|
Steven Johnson's syndrome
|
|
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Side effect of Sulfa drugs in kids?
|
Kernicterus (bilirubin in the brain - jaundice)
|
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Trimethoprim is combined with what drug to tx UTI
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Sulfonamides
|
|
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Inhibits dihydrofolate reductase
|
Trimethoprim
|
|
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3 Fungal Membrane Blockers
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-Fluconazole (azoles)
-Amotericin B -Nystatin |
|
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Inhibits ergosterol synthesis and thus plasma membrane formation
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Fluconazole
|
|
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"Tears holes" by binding to ergosterol and creating pores for ions to leak out and disrupt membrane (name two)
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Amphotericin B and Nystatin
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Peptidoglycan synthesis blockers (2)
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-Bacitracin
-Vancomycin |
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Excellent against gram + only
|
Bactracin
|
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Prescribed often for skin Blepharitis and skin infxns like impetigo
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Bacitracin
|
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What form does bacitracin come in?
|
ointment form
|
|
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T/F Baitracin has a very narrow spectrum
|
True
|
|
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Is Bacitracin effective against gram neg bacteria?
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No
|
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Binds to D-ala, D-ala portion of cell wall and disrupts precursos
|
Vancomycin
|
|
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Used for pseudomembranous colitis
|
Vancomycin
|
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What is the tx of choice for Methicillin Resistant Staph Infections?
|
Vancomycin
|
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The most severe side effect of vancomycin
|
Red Man's Syndrome
|
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two side effects of Vancomycin besides red man's syndrome
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-ototoxicity
-nephrotoxicity |
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DNA Topoisomerase blockers (1)
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Fluoroquinolones - ciprofloxacin, norfloxacin, ofloxacin
|
|
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Inhibits DNA gyrase AND topoisomaerase II
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Fluoroquinolones
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What are three things Fluoroquinolones used for ocularly?
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-bacterial conjunctivitis
-CL related corneal ulcers -gonorrhea |
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Three things fluoroquinolones are used for systemically?
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-UTIs
-Repiratory infxns -GI tract infxns all affected by gram neg |
|
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The higher the generation of fluoroquinolone ...
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The more gram + it becomes
|
|
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Pneumonic for S/E of fluroquinolones?
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FluroquinoLONES can hurt the attachments to your BONES causing tendonitis
|
|
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This is contraindicated in preganancy and children due to damage in cartilage formation and inhibition of bone growth
|
Fluoroquinolones
|
|
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3 Cell wall synthesis Blockers
|
-Natural Penicillin
-Penicillinase Resistant Penicillins -Cephalosporins |
|
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Two Natural Penicillins
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-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 |
|
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T/F Penicillins are very safe in all trimeters of pregnancy
|
True
|
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Is the oral absorption of pencillin poor or good?
|
Poor
|
|
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When should pencillin be taken?
|
hour before or two hours after meals
|
|
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Cell wall synthesis blocker that is NOT degraded quickly by the gastric mucosa
|
Dicloxallin
|
|
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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 |
|
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Which one has better oral absorption ampicillin or amoxicillin?
|
Amoxicillin
|
|
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Side effect of Ampicillin
|
Hypersensitivity reactions
|
|
|
3 Cephalosporins
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-Cefaclor
-Cefalexin -Ceftrioxone |
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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
|
|
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What type of bac are aminoglycosides good for and bad for?
|
good for staph and bad for strep
|
|
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Toxicity for aminoglycosides (2)
|
-Nephrotoxicity and Ototoxicity
|
|
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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
|
|
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What shouldn't be take with tetracyclines?
|
dairy products
|
|
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Can tetracyclines be used in children and pregnant women?
|
No!
|
|
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What will tetracyclines do to pregnant women and children?
|
-discolors teeth
-retards bone growth -photosensitivity -GI distress -Pseudotumor cerebri in the eye |
|
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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
|
|
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Metronidazole causes what when taken with alcohol?
|
GI upset
|
|
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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 |
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6 tx of Parkinson's Disease
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-Levodopa
-Cabidopa -Selegeline -COMT inh: Entacapone -Anticholinergis: Benztropine -Amantadine |
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C/I for Levodopa
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-Angle-Closure glaucoma
-Schizophrenia -Cardiac arrhythmias -Melanoma |
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Side effects of Anticholinergics: Benztropine
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-dry mouth
-dry eyes -blurred vision -constipation -urinary retention -memory impairment -psychosis |
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Antiviral agent that helps reduce tremors in Parkinson's and also helpful w/ influenza A
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Amantadine
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Four major classes of Antidepressants
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-Monoxamine Oxidase Inhibitors: Phenelzine (Nardil)
-Tricycline Antidepressants (TCAs) -SSRI (selective serotonin reuptake inhibitors -Atypical Antidepressants |
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Name a MOI
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Phenelzine
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Name a TCA
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Amitriptyline
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Name a SSRI
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-Fluoxetine
-Sertraline |
