Pharm Exam 3

Front 1

What are the fat soluble vitamins?


Where are they stored?

Back 1

ADEK


Can be stored in body

Front 2

What are the H2O soluble vitamins?


Can they be stored in body?

Back 2

B and C


Not stored in body

Front 3

How would celiac disease affect fat soluble vitamins?

Back 3

Disturbance of fat distribution, less absorption of fat soluble vitamins

Front 4

B1

Deficiency?

Back 4

Thiamin

Beri-beri (peripheral nerve damage)
Wenicke's encephalopathy (alcoholics)

Front 5

B2

Deficiency?

Back 5

Riboflavin

Dermatitis
Angular stomatitis

Front 6

B3

Deficiency?

Back 6

Niacin

Pellagra: dermatitis, diarrhea, and dementia

Front 7

B5?

Deficiency?

Back 7

Pantothenic Acid

Burning feet syndrome (neuronal damage)

Front 8

Folic acid deficiency?

Back 8

Megaloblastic anemia
Neural tub defects

Front 9

B12

Deficiency?

Back 9

Cyatocobalamine

Pernicious anemia

Front 10

Vit C

Deficiency?

Back 10

Ascorbic Acid

Scurvy: dec wound healing, loss of teeth

Front 11

Vit A deficiency?

Back 11

Night blindness, dry eye -> overall blindness

Front 12

Vit D deficiency?

Back 12

Kids: Rickets

Adults: osteomalacia

Front 13

Vit E deficiency?

Back 13

Hemolytic anemia of newbornds

Front 14

Vit K deficiency?

Back 14

Bleeding

Front 15

Vit A toxicity?

Back 15

1. Increased intracranial pressure (-> nausea and vomiting)
2. Skeletal abnormalities
3. Liver damage
4. Teratogen

Front 16

Beta Carotene toxicity?

Back 16

Increase in lung cancer

(like vit a)

Front 17

Vit D toxicity?

Back 17

Acute: muscle weakness, nausea
Chronic: Metastatic calcification
Tetany, convulsions
Pancreas and liver damage

Front 18

Vit E toxicity?

Back 18

Muscle weakness

Front 19

Niacin toxicity?

Back 19

Cutaneous flushing and itching

Front 20

Ascorbate toxicity?

Back 20

Kidney stones
If taking massive doses and stop suddenly -> scurvy

Front 21

Name 2 bisphosphonates

Back 21

Tiludronate
Etidronate

Front 22

Mechanism of bisphosphonates?

Back 22

Inhibit enzyme in pathway of cholesterol synthesis -> alter osteoClasts and causes apoptosis of soteoClasts

Front 23

S.E. of Bisphosphonates? (5)

Back 23

1. GI upset, peptic ulcers
2. Dec renal fnx
3. Eye inflammation
4. IV- 1st DOSE AFFECT (inc atrial fibrillation)
5. Osteonecrosis of the jaw

Front 24

Name 5 Amino Bisphosphonates

Back 24

Alendronate
Risedronate
Ibandronate
Pamidronate
Zoledronate

Front 25

Mechanism of amino bisphosphonates?

Back 25

Cause dec in ATP production in osteoClasts

Front 26

S.E. of amino bisphosphonates? (5)

Back 26

1. GI upset, peptic ulcers
2. Dec renal fnx
3. Eye inflammation
4. IV- 1st DOSE AFFECT (inc atrial fibrillation)
5. Osteonecrosis of the jaw

Front 27

Mechanism of Teripartide?

Back 27

PTH analog - stimulates bone growth

Inc blast activity

Front 28

S.E. of Teripartide?

Back 28

Long term high doses:
Inc blast activity -> inc clast activity -> bone loss

Front 29

Mechanism of Cinicalcet?

Back 29

Ca++ mimetic -> dec PTH secretion

Front 30

S.E. of Cinicalcet?

Back 30

Hypocalcemia

Front 31

Mechanism of Raloxifene?

Back 31

Estrogen Analog
Inhibits CLAST activity

Front 32

S.E. of Raloxifene?

Back 32

Inc in pulmonary emboli

Front 33

Bones w/ more medullary or cortex tissue are weakened most when CLAST activity is greater than blast?

Back 33

Medullary

Front 34

Mechanism of Vit D analogs?

Back 34

Increase Ca++ absorption from gut
Increase PT synthesis and release
Inc Ca++ resorption in kidney

Front 35

Mechanism of Fluoride?

Back 35

Stimulates osteoblasts

Front 36

Mechanism of Calcitonin?

Back 36

Inhibits CLASTS

Front 37

Where does calcitonin come from?

Back 37

Secreted by thyroid when Ca++ levels are too high

Front 38

S.E. of calcitonin?

Back 38

GI upset
Metallic taste

Front 39

How do glucocorticoids affect bone?

Back 39

Inhibit BLAST maturation
Dec Ca++ absorption from gut

Front 40

S.E. of glucocorticoids?

Back 40

Osteoporosis

Front 41

Mechanism of heparin?

Back 41

Activates BLASTS

Front 42

Put in order from better -> worse of relative effacacy:

Raloxifene, Alendronate, Teripartide, Calcitonin

Back 42

Teripartide
Alendronate
Raloxifene
Calcitonin

Front 43

What happens in Pagets Disease?

Back 43

Huge inc in CLAST activity, bone broken down too quickly

Front 44

3 drugs that activate/inc BLAST activity?

Back 44

1. Teriparitide
2. Fluoride
3. Heparin

Front 45

2 drugs that inhibit CLAST activity?

Back 45

Raloxifene
Calcitonin

Front 46

Inhibits BLAST maturation?

Back 46

glucocorticoids

Front 47

Name 4 H2 blockers used for GI

Back 47

Nizatidine
Famotidine
Ranitidine
Cimetidine

Front 48

Which 2 H2 blockers used for GI have 1st pass metabolism?

Back 48

Ranitidine
Cimetidine

Front 49

S.E. of Cimetidine? (2)

Back 49

Gynecomastia- decreased production of androgens b/c it:

INHIBITS p450

Front 50

2 possible cholinergic agents used for GI tract

Are they used?

Back 50

Atropine
Propantheline

No b/c of all other S.E.

Front 51

Name the 5 proton pump inhibitors

Back 51

Omeprazole
Lansoprazole
Esomeprazole
Rabeprazole
Pantoprazole

Front 52

Mechanism of Omeprazole

Back 52

Inhibits ATPase responsible for H+/K+ pump

Prodrug, activated by H+

Front 53

Side effects of Omeprazole? (4)

Back 53

Headache
GI upset
Dizziness
Hypochlorhydria (-> dec bone density)

Front 54

Speed, Duration, and neutralizing of Sodium Bicarbonate

Back 54

Rapid

Short

High

Front 55

S.E. of sodium bicarbonate? (3)

Back 55

Eructation
Na+ may compromise low sodium diets
Systemic absorption

Front 56

Speed, Duration, and neutralizing of Calcium carbonate

Back 56

Rapid
Medium
High

Front 57

"Alka Seltzer"

Back 57

Sodium bicarbonate

Front 58

"Tums"

Back 58

Calcium carbonate

Front 59

S.E. of calcium cabonate? (3)

Back 59

Chalky texture
Constipating
Hypercalcemia

Front 60

"Milk of magnesia"

Back 60

Magnesium hydroxide

Front 61

Speed, duration, and neutralizing of aluminum hydroxide?

Back 61

Slow
Long
Low

Front 62

S.E. aluminum hydroxide? (4)

Back 62

Constipating
Adsorbs drugs
Causes loss of phospate
Al ++ toxicity

Front 63

Speed, duration, and neutralizing of magnesium hydroxide?

Back 63

Slow
Medium
High

Front 64

S.E. of magnesium hydroxide? (2)

Back 64

Laxative
Some mg++ toxicity

Front 65

Mechanism of sucralfate?

Back 65

Becomes viscous when exposed to acid, binds to stomach and covers damaged areas

Front 66

T/F Always give sucralfate in combo w/an acid depleter.

Back 66

FALSE

you need acid to activate it...

Front 67

"Pepto Bismol"

Back 67

Bismuth Subsalicylate

Front 68

Mechanism of bismuth subsalicylate? (2)

Back 68

Inc mucous production
Inhibits growth of H Pylori

Front 69

S.E. of bismuch subsalicylate?

Back 69

Darkening of feces, tongue, and teeth

Front 70

Mechanism of misoprostole?

Back 70

PGE2 analog- produces mucous, bicarb, and decreases H+

Front 71

S.E. of misoprostole?

Back 71

Increases uterin contractility

Front 72

When is misoprostole used?

Back 72

In NSAID-induced ulceration

Front 73

What 3 antibiotics can be used to enhance mucosal decnses?

Back 73

1. Metronidazole
2. Amoxicillin
3. Tetracycline

Front 74

What two drugs increase gastric emptying rate?

Back 74

Metoclopromide
Erythromycin

Front 75

Mechanism of Metoclopromide?

Back 75

DA and 5HT blocker

Front 76

S.E. of metoclopromide?

Back 76

Parkinson-like symptoms
Sedation

Front 77

What are side effects of all gastric emptying agents? (4)

Back 77

Nausea
Bloating
Loss of apetite
Slowing of digestive process

Front 78

Mechanism of erythromycin?

Back 78

Acts on motilin receptors on muscle of sm intestine

Front 79

S.E. erythromycin?(3)

Back 79

Ototoxicity
GI upset
Pseudomembranous Colitis

Front 80

S.E. of Cathartics? (4)

Back 80

Fluid imbalances: K+ and H2O loss
Colitis- mucosal injury
Malabsorption of nutrients
Dec in normal bowel reflexes

Front 81

Mechanism of dioctal sodium sulfosuccinate?

Back 81

Allows more ready dispersion of fatty substances w/in gut

Front 82

Mechanism of mineral oil

Back 82

Non-absorbed lubricant
May impair absorption of fat soluble nutrients

Front 83

S.E. of mineral oil?

Back 83

Aspiration in elderly -> pnemonia -> stays in lungs, destroys lung tissue

Front 84

4 types of bulk-adding agents

Back 84

Bran
Methyl cellulose
Psyllium
Polycarbophil

Front 85

3 types of gastric irritants?

Back 85

1. Anthraquinones
2. Caster Oil
3. Bisacodyl

Front 86

Mechanism of gastric irritants?

Special one for bisacodyl

Back 86

Increase fluid secretions in colon

Stimulates gut neuronal system

Front 87

S.E. of gastric irritants

Back 87

Renal and liver damage

Front 88

4 types of osmotic agnets

Back 88

MgSO4
Mg(OH)2
Polyethylene Glycol
Lubriprostone

Front 89

Mechanism of Lubriprostone?

Back 89

PGE analog - binds prostaglandin RECEPTOR in gut -> inc Cl- rich GI fluid

Front 90

4 Narcotic agents used for diarrhea?

Back 90

1. Opioids
2. Codeine (or morphine)
3. Diphenoxylate
4. Loperamide

Front 91

Mechanism of opioids on gut?

Back 91

Cause a nonrhythmic contraction

Front 92

Diphenoxylate is combined w/what so it's not abused?

Back 92

Atropine

Front 93

S.E. of diphenoxylate?

Back 93

Enters CNS at high doses

Front 94

Loperamide S.E.?

Back 94

Doesn't enter CNS (vs diphenoxylate does)

Front 95

Mechanism of simethicone?

Back 95

Dec gas buildup in GI tract
Alters surface tension of gas bubbles

Front 96

Mechanism of octreotide?

Back 96

Somatostatin analog
Dec secretion of intestinal hormones

Front 97

Which diarrhea drug is used for emergencies only?

Back 97

Octreotide