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309 Cards in this Set
- Front
- Back
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Carbonic anhydrase inhibitor*
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Acetazolamide
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Diuretic used for mountain sickness and glaucoma*
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Acetazolamide
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SE of acetazolamide
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Paresthesias, alkalization of the urine
(which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment |
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MOA of Loop Diuretics
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Inhibits Na+/K+/2Cl- cotransport
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Site of action of loop diuretics *
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Thick ascending limb
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SE of loop (furosemide) diuretics*
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Hyperuricemia, hypokalemia and ototoxicity
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Aminoglycosides used with loop diuretics potentiate what adverse effect?
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Ototoxicity
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Loops lose and thiazide diuretics retain *
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Calcium
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MOA of thiazide diuretics
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Inhibit Na+/Cl- cotransport
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Site of action of thiazide diuretics *
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Work at early distal convoluted tubule
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Class of drugs that may cause cross-sensitivity with thiazide diuretics.
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Sulfonamides
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SE of thiazide (HCTZ) diuretics*
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Hyperuricemia, hypokalemia and hyperglycemia
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Potassium sparing diuretics inhibit *
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Na+/K+ exchange
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Diuretic used to treat primary aldosteronism *
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Spironolactone
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SE of spironolactone*
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Gynecomastia hyperkalemia, and impotence
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Osmotic diuretic used to treat increased intracranial pressure*
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Mannitol
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Inhibit angiotensin-converting enzyme (ACE) *
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ACE inhibitors
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Captopril and enalapril (-OPRIL ending) are *
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ACE inhibitors
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SE of ACE inhibitors *
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Dry cough, hyperkalemia
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ACE inhibitors are contraindicated in *
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pregnancy and with K+
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Losartan and valsartan block *
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Angiotensin receptor
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Angiotensin receptor blockers do NOT cause *
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Dry cough
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Agents that block L-type calcium channel
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Calcium channel blockers
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CCB contraindicated in CHF *
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Verapamil
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CCB with predominate effect on arteriole dilation
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Nifedipine
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SE of CCB *
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Constipation, edema, and headache
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Agents that reduce heart rate, contractility, and O2 demand*
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Beta-blockers
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B-blockers that are more cardioselective
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Beta-1 selective blockers
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Cardioselective Beta 1-blockers *
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Atenolol, acebutolol, and metoprolol
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Beta-blockers should be used cautiously in
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Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia)and peripheral vascular disease
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Non-selective Beta-blocker also used for migraine prophylaxis
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Propranolol
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SE of beta blockers*
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Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)
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Alpha 1-selective blockers*
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Prazosin, terazosin and doxazosin (-AZOSIN ending)
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Non-selective Alpha1blockers use to treat pheochromocytoma
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Phenoxybenzamine
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For rebound HTN from rapid clonidine withdrawal
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Phentolamine
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A1a-selective blocker with no effects on HTN used for BPH*
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Tamsulosin (Flomax)
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SE of alpha blockers*
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Orthostatic hypotension (especially with first dose) and reflex tachycardia
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Presynaptic Alpha 2 agonist used in HTN, and acts centrally
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Clonidine, and methyldopa
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SE of methyldopa
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Positive Coomb's test, depression
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Methyldopa is contraindicated in*
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Geriatrics due to its CNS (depression) effects
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SE of clonidine
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Rebound HTN, sedation, dry mouth
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Direct vasodilator of arteriolar smooth muscle
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Hydralazine
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SE of hydralazine *
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Lupus-like syndrome
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Arterial vasodilator that works by opening K+ channels
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Minoxidil
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SE of minoxidil
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Hypertrichosis
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IV Drug used Hypertensive Crisis
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Nitroprusside
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Nitroprusside vasodilates
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Arteries and veins
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Toxicity caused by nitroprusside and treatment
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Cyanide toxicity treated with sodium thiosulfate
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What do alpha cells in the pancreas produce?
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Glucagon
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What do beta cells in the pancreas produce?
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Insulin
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Where are beta cells found in the pancreas?
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Islets of Langerhans
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What do delta cells in the pancreas produce?
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Somatostatin
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Product of proinsulin cleavage used to assess insulin abuse
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* C-peptide
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Exogenous insulin contains *
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Little C-peptide
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Endogenous insulin contains
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Normal C-peptide
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Very rapid acting insulin, having fastest onset and shortest duration of action
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Lispro (Humalog), aspart, glulisine
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Rapid acting, crystalline zinc insulin used to reverse acute hyperglycemia
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Regular (Humulin R)
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Long acting insulin *
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Ultralente (humulin U)
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Ultra long acting insulin, has over a day duration of action
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Glargine (Lantus), detemir
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Major SE of insulin
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Hypoglycemia
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Important in synthesis of glucose to glycogen in the liver
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GLUT 2
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Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation
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GLUT 4
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Examples of alpha-glucosidase inhibitors (AGI)
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Acarbose, miglitol
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MOA of AGI's (alpha-glucosidase inhibitors)
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Act on intestine, delay digestion and absorption of glucose formed from digestion of starch and disacchrides
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SE of AGI's (alpha-glucosidase inhibitors)
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Flatulence (do not use beano to tx), diarrhea, abdominal cramps
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Alpha-glucosidase inhibitor associated with elevation of LFT's
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Acarbose
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Amino acid derivative, active as an insulin secretagogue *
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Nateglinide
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MOA of nateglinide
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Insulin secretagogue - closes ATP sensitive K+ channel
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Biguanide
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Metformin
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Drugs available in combination with metformin
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Glyburide, glipizide, and rosiglitazone
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MOA of metformin
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Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
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Vascular effects of metformin
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Decreased micro and macro vascular disease
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Most important potential SE of metformin
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Lactic acidosis
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Incidence of hyoglycemia with metformin
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None
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Meglitinide class of drugs
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Repaglinide
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MOA of repaglinide
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Insulin release from pancreas; faster and shorter acting than sulfonylurea
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First generation sulfonylurea
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Chlorpropamide, tolbutamide, tolazamide, etc.
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Second generation sulfonylurea
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Glyburide, glipizide, glimepiride, etc.
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MOA of both generations
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Insulin release from pancreas by modifying K+ channels
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Common SE of sulfonylureas, repaglinide, and nateglinide
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Hypoglycemia
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Sulfonylurea NOT recommended for elderly because of very long half life
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Chlorpropamide
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Thiazolidinediones
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Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)
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Reason troglitazone was withdrawn from market
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Hepatic toxicity
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MOA of thiazolindinediones
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Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
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SE of Thiazolindinediones
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Edema, mild anemia; interaction with drugs that undergo CYP3A4 metabolism
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Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe betablocker overdose and smooth muscle relaxation
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Glucagon
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MOA of quinolones
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** Inhibit DNA gyrase
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MOA of penicillin
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Block cell wall synthesis by inhibiting peptidoglycan cross-linkage
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Drug used for MRSA
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* Vancomycin
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Vancomycin MOA
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** Blocks cell wall synthesis by sequestration
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Genetic basis of low level resistance found with vancomycin
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Point mutation
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Meningitis prophylaxis for persons in contact with patients
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*Ciprofloxacin or Rifampin (for children less than 4 yrs old)
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Technique used to diagnose perianal itching, and the drug used to treat it
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*Scotch tape technique and mebendazole
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Two toxicities of aminoglycosides
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nephro and ototoxicity
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DOC for Legionnaires' disease
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Moxifloxacin
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MOA of sulfonamides
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*Inhibit dihydropteroate synthase
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Penicillins active against penicillinase secreting bacteria
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Methicillin, nafcillin, and dicloxacillin
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Cheap wide spectrum antibiotic DOC for otitis media ***
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Amoxicillin
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Class of antibiotics that have 10% cross sensitivity with penicillins
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Cephalosporins
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PCN active against pseudomonas
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ceftazidime, imipenem, piperacillin and ticarcillin
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Antibiotic causing red-man syndrome, and prevention
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Vancomycin, infusion at a slow rate and antihistamines
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Drug causes teeth discoloration
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Tetracycline
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MOA of tetracycline
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Decreases protein synthesis by inhibiting 30S ribosome
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Drug that causes gray baby syndrome and aplastic anemia
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Chloramphenicol
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Drug notorious for causing pseudomembranous colitis
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Clindamycin
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DOC for tx of pseudomembranous colitis (mild) **
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Metronidazole
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Treatment of severe/relapsing pseudomembranous colitis
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ORAL vancomycin
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Anemia caused by trimethoprim *
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Megaloblastic anemia
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Reason fluoroquinolones are contraindicated in children and pregnancy
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Cartilage damage
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DOC for giardia, bacterial vaginosis, and trichomonas *
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Metronidazole
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Treatment for TB patients (think RIPE) *
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Rifampin, Isoniazid, Pyrazinamide, Ethambutol
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Metronidazole SE if given with alcohol
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Disulfiram-like reaction
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Common side effect of Rifampin *
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Red urine discoloration
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MOA of nystatin
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Bind ergosterol in fungal cell membrane
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Neurotoxicity with isoniazid (INH) prevented by
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Administration of Vit. B6 (pyridoxine)
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Toxicity of amphotericin
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Nephrotoxicity
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SE seen only in men with administration of ketoconazole
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Gynecomastia
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Topical DOC in impetigo
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Topical mupirocin (Bactroban)
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DOC for influenza A
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* Oseltamivir
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DOC for RSV *
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Ribavirin
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DOC for CMV retinitis
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Ganciclovir
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SE for ganciclovir
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Neutro, leuko and thrombocytopenia
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Anti-viral agents associated with Stephen Johnson syndrome
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Nevirapine, amprenavir
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HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism *
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Protease inhibitors
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Antivirals that are teratogens
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Delavirdine, efavirenz, and ribavirin
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Antivirals associated with neutropenia
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Ganciclovir, zidovudine, saquinavir, and interferon
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HIV med used to prevent perinatal transmission
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Nevirapine
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Drug used for African sleeping sickness
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Suramin
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Drug used in Chagas disease
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Nifurtimox
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Cephalosporins able to cross the BBB
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Ceftazidime, Ceftriaxone or Cefotaxime
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Oral 3rd generation cephalosporins NOT able to cross the BBB
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Cefixime
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Drug used for N. gonorrhea in females *
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Ceftriaxone
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Cephalosporin causes kernicterus in neonates
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Ceftriaxone or cefuroxime
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SE of INH
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Peripheral neuritis and hepatitis
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Aminoglycoside that is least ototoxic
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Streptomycin
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Drug used in exoerythrocytic cycle of malaria
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Primaquine
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Oral antibiotic of choice for moderate inflammatory acne
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Minocycline
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Drug of choice for leprosy
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Dapsone, rifampin and clofazimine combination
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DOC for herpes and its MOA*
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Acyclovir; phosphorylation, incorporation into viral DNA, and chain termination
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Anti-bacterials that cause hemolysis in G6PD-deficient patients *
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Sulfonamides
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MOA of erythromycin
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Inhibition of protein synthesis at the 50s subunit of ribosome
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Antibiotic frequently used for chronic UTI prophylaxis *
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sulfamethoxazole/ trimethoprim
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Lactams that can be used in PCN allergic patients
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Aztreonam/carbapenems
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SE of imipenem
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Seizures
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Anti-viral with a dose limiting toxicity of pancreatitis
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Didanosine
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Constant proportion of cell population killed rather than a constant number
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Log-kill hypothesis
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Treatment with cancer chemotherapy at high doses every 3-4 weeks, too toxic to be used continuously
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Pulse therapy
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Toxic effect of anticancer drug can be lessened by rescue agents
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Rescue therapy
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Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates
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Allopurinol
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Pyrimidine analog that causes "Thymine-less death" given with leucovorin rescue
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5-flouracil (5-FU)
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Drug used in cancer therapy causes Cushing-like symptoms
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Prednisone
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Side effect of Mitomycin
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SEVERE myelosuppression
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MOA of cisplatin
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Alkylating agent
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Common toxicities of cisplatin
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Nephro and ototoxicity
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Analog of hypoxanthine, needs HGPRTase for activation
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6-mercaptopurine (6-MP)
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Interaction with this drug requires dose reduction of 6-MP
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** Allopurinol
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May protect against doxorubicin toxicity by scavenging free radicals
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* Dexrazoxane
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Blows DNA (breaks DNA strands), limiting SE is pulmonary fibrosis
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* Bleomycin
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Bleomycin+vinblastine+etoposide+cisplatin produce almost a 100% response when all agents are used for this neoplasm
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Testicular cancer
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ABVD regimen used for HD, but appears less likely to cause sterility and secondary malignancies than MOPP
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Adriamycin (doxorubicin) +bleomycin, vinblastine +dacarbazine
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Regimen used for non-Hodgkin's lymphoma
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CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus rituximab
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Regimen used for breast cancer
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CMF (cyclophosphamide, methotrexate, and fluorouracil) and tamoxifen if ER+
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Alkylating agent, vesicant that causes tissue damage with extravasation
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Mechlorethamine
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Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis
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Cyclophosphamide
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Prevention of cyclophosphamide induced hemorrhagic cystitis
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Hydration and mercaptoethanesulfonate (MESNA)
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Microtubule inhibitor that causes peripheral neuropathy, foot drop (eg. ataxia), and "pins and needles" sensation
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Vincristine
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Interact with microtubules (but unlike vinca which prevent disassembly of tubules), it stabilizes tubulin and cells remain frozen in metaphase
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**Paclitaxel (taxol)
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Toxicities include nephrotoxicity and ototoxicity, leading to a severe interaction with aminoglycosides
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Cisplatin
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Agent similar to cisplatin, less nephrotoxic, but greater myelosuppression
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Carboplatin
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Converts asparagine to aspartate and ammonia, denies cancer cells of essential AA (asparagine)
|
L-asparaginase
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|
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Used for hairy cell leukemia ; it stimulates NK cells
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Interferon alpha
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Anti-androgen used for prostate cancer
|
Flutamide (Eulexin)
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Anti-estrogen used for estrogen receptor + breast cancer
|
** Tamoxifen
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Aromatase inhibitor used in breast cancer
|
Letrozole, anastrozole
|
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Newer estrogen receptor antagonist used in advanced breast cancer
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Toremifene (Fareston)
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Some cell cycle specific anti-cancer drugs
|
Bleomycin, vinca alkaloids, antimetabolites (eg., 5-FU, 6-MP, methotrexate, etoposide)
|
|
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Some cell cycle non-specific drugs
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Alkylating agents (eg., mechlorethamine, cyclophosphamide), antibiotics (doxorubicin, daunorubicin), cisplatin, nitrosourea
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Anti-emetics used in association with anti-cancer drugs that are 5-HT3 (serotonin receptor subtype ) antagonists
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*Odansetron, granisetron
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Nitrosoureas with high lipophilicity, used for brain tumors
|
Carmustine (BCNU) and lomustine (CCNU)
|
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Produces disulfiram-like reaction with ethanol
|
Procarbazine
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3 zones of adrenal cortex and their products
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Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)
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Pneumonic for 3 zones of adrenal cortex
|
GFR
|
|
|
Used for Addison's disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)
|
Glucocorticoids
|
|
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Short acting glucocorticoids
|
Cortisone and hydrocortisone (equivalent to cortisol)
|
|
|
Intermediate acting glucocorticoids
|
Prednisone, methylprednisolone, prednisolone, and triamcinolone
|
|
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Long acting glucocorticoids
|
Betamethasone and dexamethasone
|
|
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Mineralocorticoids
|
Fludrocortisone and deoxycorticosterone
|
|
|
Some side effects of corticosteroids
|
Osteopenia, impaired wound healing, inc. risk of infection, inc. appetite, HTN, edema, PUD, euphoria, psychosis, stria, thinning of skin
|
|
|
Period of time of therapy after which GC therapy will need to be tapered
|
5-7 days
|
|
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Used for Cushing's syndrome (increased corticosteroid)
|
Dexamethasone suppression test
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|
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Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis
|
Aminoglutethimide
|
|
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Antifungal agent used for inhibition of all gonadal and adrenal steroids
|
Ketoconazole
|
|
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Antiprogestin used as potent antagonist of GC receptor
|
Mifepristone
|
|
|
Diuretic used to antagonize aldosterone receptors
|
Spironolactone
|
|
|
Common SE of spironolactone
|
Gynecomastia and hyperkalemia
|
|
|
Available bisphosphonates
|
Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid
|
|
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MOA of Bisphosphonates
|
Inhibits osteoclast bone resorption
|
|
|
Names of three bisphosphonates available IV
|
Pamidronate, zoledronate, ibandronate
|
|
|
Uses of bisphosphonates
|
Osteoporosis, Paget's disease, and osteolytic bone lesions, and hypercalcemia from malignancy
|
|
|
Major SE of bisphosphonates
|
Chemical esophagitis
|
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Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia
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Etidronate
|
|
|
Used for prevention of postmenopausal osteoporosis in women
|
Estrogen (HRT-Hormone replacement therapy)
|
|
|
Increase bone density, also being tested for breast CA prophylaxis
|
Raloxifene (SERM-selective estrogen receptor modulator)
|
|
|
Used intranasally and decreases bone resorption
|
Calcitonin (salmon prep)
|
|
|
Used especially in postmenopausal women, dosage should be 1500 mg
|
Calcium
|
|
|
Vitamin given with calcium to ensure proper absorption
|
Vitamin D
|
|
|
Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons
|
Ascending pathways
|
|
|
Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release
|
Presynaptic mu, delta, and kappa receptors
|
|
|
Activation of these receptors open K+ ion channels to cause membrane hyperpolarization
|
Postsynaptic Mu receptors
|
|
|
Tolerance to all effects of opioid agonists can develop except
|
Miosis and constipation
|
|
|
All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction
|
Meperidine
|
|
|
SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone
|
Opioid Analgesics
|
|
|
Strong opioid agonists
|
Morphine, methadone, meperidine, and fentanyl
|
|
|
Opioids used in anesthesia
|
Morphine and fentanyl
|
|
|
Opioid used in the management of withdrawal states
|
Methadone
|
|
|
Opioid available trans-dermally
|
Fentanyl
|
|
|
Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema
|
Morphine
|
|
|
Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome
|
Meperidine
|
|
|
Moderate opioid agonists
|
Codeine, hydrocodone, and oxycodone
|
|
|
Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures
|
Propoxyphene
|
|
|
Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal
|
Buprenorphine
|
|
|
Opioid antagonist that is given IV and had short DOA
|
Naloxone
|
|
|
Opioid antagonist that is given orally in alcohol dependency programs
|
Naltrexone
|
|
|
Opioid agents used as antitussive
|
Dextromethorphan, Codeine
|
|
|
Opioid agents used as antidiarrheal
|
Diphenoxylate, Loperamide
|
|
|
Most commonly abused opiods in health care professionals
|
Heroin, morphine, oxycodone, meperidine and fentanyl
|
|
|
This opioid route is associated with rapid tolerance and psychologic dependence
|
IV administration
|
|
|
Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome
|
Opioid Abstinence syndrome
|
|
|
Treatment for opioid addiction
|
Methadone, followed by slow dose reduction
|
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This agent may cause more severe, rapid and intense symptoms to a recovering opioid addict
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Naloxone
|
|
|
MOA of general anesthetics
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Most are thought to act at GABA-A receptor - chloride channel
|
|
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Inhaled anesthetic with a low blood/gas partition coefficient
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Nitrous oxide
|
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Inversely related to potency of anesthetics
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Minimum alveolar anesthetic concentration (MAC)
|
|
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Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents
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Halothane and methoxyflurane
|
|
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Most inhaled anesthetics SE
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Decrease arterial blood pressure
|
|
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Inhaled anesthetics are myocardial depressants
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Enflurane and halothane
|
|
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Inhaled anesthetic causes peripheral vasodilation
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Isoflurane
|
|
|
Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis
|
Halothane
|
|
|
Inhaled anesthetic, less likely to lower blood pressure than other agents, and has the smallest effect on respiration
|
Nitrous oxide
|
|
|
Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency
|
Methoxyflurane
|
|
|
Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia
|
Nitrous oxide
|
|
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Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm
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Desflurane
|
|
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DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics
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Dantrolene
|
|
|
IV barbiturate used as a pre-op anesthetic
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Thiopental
|
|
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Benzodiazepine used adjunctively in anesthesia
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Midazolam
|
|
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Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose
|
Flumazenil
|
|
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This produces "dissociative anesthesia", is a cardiovascular stimulant which may increases intracranial pressure, and hallucinations occur during recovery
|
Ketamine
|
|
|
Opioid associated with respiratory depression, but is used in high risk patients who may not survive full general anesthetia
|
Fentanyl
|
|
|
State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide
|
Neuroleptanesthesia
|
|
|
Produces both rapid anesthesia and recovery, has antiemetic activity and commonly used for outpatient surgery, may cause marked hypotension
|
Propofol
|
|
|
MOA of NSAIDS
|
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
|
|
|
Difference between aspirin and other NSAIDS
|
Aspirin irreversibly inhibits cyclooxygenase
|
|
|
Four main actions of NSAIDS
|
Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
|
|
|
Agent used for closure of patent ductus arteriosus
|
Indomethacin
|
|
|
Aspirin is contraindicated in children with viral infection
|
Potential for development of Reye's syndrome
|
|
|
SE of salicylates
|
Tinnitus, GI bleeding
|
|
|
NSAID also available as an ophthalmic preparation
|
Diclofenac, ketoralac
|
|
|
NSAID available orally, IM and ophthalmically
|
Ketoralac
|
|
|
NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
|
Ketoralac
|
|
|
Newer NSAID that selectively inhibits COX-2
|
Celecoxib
|
|
|
COX 2 inhibitors may have reduced risk of
|
Gastric ulcers and GI Bleeding
|
|
|
COX 2 inhibitors should be used cautiously in pts with
|
Pre-existing cardiac or renal disease
|
|
|
Acetaminophen only has
|
Antipyretic and analgesic activity
|
|
|
SE of acetaminophen
|
Hepatotoxicity
|
|
|
Antidote for acetaminophen toxicity
|
N-acetylcysteine
|
|
|
DMARDs are slow acting drugs for
|
Rheumatic disease
|
|
|
Initial DMARD of choice for patients with RA
|
Methotrexate
|
|
|
Drug ofter used in combination with TNF - alpha inhitors for RA
|
Methotrexate
|
|
|
Causes bone marrow suppression
|
Methotrexate
|
|
|
SE of penicillamine
|
Aplastic anemia and renal toxicity
|
|
|
Interferes with activity of T-lymphocytes
|
Hydroxychloroquine
|
|
|
Anti-malarial drug used in rheumatoid arthritis (RA)
|
Hydroxychloroquine
|
|
|
SE of hydroxychloroquine
|
Retinal destruction and dermatitis
|
|
|
MOA of Leflunomide (newer agent)
|
Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis, decreased T cell proliferation and decreased antibody production by B cells
|
|
|
Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
|
Adalimumab, infliximab and etanercept
|
|
|
Anti-rheumatic agent also used for ulcerative colitis
|
Sulfasalazine
|
|
|
Anti-rheumatic agent also used for Chron's disease
|
Infliximab
|
|
|
Pneumonic for beta receptors
|
You have 1 heart (Beta 1) and 2 lungs (Beta 2)
|
|
|
This is the drug of choice for anaphylactic shock
|
Epinephrine
|
|
|
Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction
|
Amphetamines
|
|
|
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia
|
Phenylephrine
|
|
|
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to
|
Reduce aqueous secretion
|
|
|
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis
|
Albuterol
|
|
|
Longer acting Beta 2 agonist is recommended for prophylaxis of asthma
|
Salmeterol
|
|
|
These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock
|
Beta1 agonists
|
|
|
These agents decrease blood flow or increase blood pressure, are local decongestants, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion
|
Alpha1 agonists
|
|
|
Shock due to septicemia or myocardial infarction is made worse by
|
Increasing afterload and tissue perfusion declines
|
|
|
Epinephrine is often mixed with a local anesthetic to
|
Reduce the loss from area of injection
|
|
|
Chronic orthostatic hypotension can be treated with
|
Midodrine
|
|
|
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus
|
Terbutaline
|
|
|
Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses
|
Epinephrine
|
|
|
Mast cells to reduce release of hisamine and inflammatory mediators
|
Epinephrine
|
|
|
Agent used in shock because it dilates coronary arteries and increases renal blood flow
|
Dopamine
|
|
|
Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance
|
Dobutamine
|
|
|
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis
|
Ephedrine
|
|
|
Alpha 1 agonist toxicity
|
Hypertension
|
|
|
Beta 1 agonist toxicity
|
Sinus tachycardia and serious arrhythmias
|
|
|
Beta 2 agonist toxicity
|
Skeletal muscle tremor, tachycardia
|
|
|
The selective agents loose their selectivity at
|
high doses
|
|
|
MOA of local anesthetics (LA's)
|
Block voltage-dependent sodium channels
|
|
|
This may enhance activity of local anesthetics
|
Hyperkalemia
|
|
|
This may antagonize activity of local anesthetics
|
Hypercalcemia
|
|
|
Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity
|
Vasodilation
|
|
|
Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery
|
Cocaine
|
|
|
Longer acting local anesthetics which are less dependent on vasoconstrictors
|
Tetracaine and bupivacaine
|
|
|
These Local Anesthetics's have surface activity
|
Cocaine and benzocaine
|
|
|
Most important toxic effects of most local anesthetics
|
CNS toxicity
|
|
|
Commonly abused local anesthetic which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction
|
Cocaine
|
|
|
Local anesthetic causing methemoglobinemia
|
Prilocaine
|
