Pharm One Liners

Front 1

Basic Pharmacokinetics

Front 2

Time it takes for amount of drug to fall to half of its value, constant in first order kinetics (majority of drugs)

Back 2

Half-life (T1/2)

Front 3

Relates the amount of drug in the body to the plasma concentration

Back 3

Volume of distribution (VD)

Front 4

Plasma concentration of a drug at a given time

Back 4

Cp

Front 5

The ratio of the rate of elimination of a drug to its plasma concentration

Back 5

Clearance (CL)

Front 6

The elimination of drug that occurs before it reaches the systemic circulation

Back 6

First pass effect

Front 7

The fraction of administered dose of a drug that reaches systemic circulation

Back 7

Bioavailability (F)

Front 8

When the rate of drug input equals the rate of drug elimination

Back 8

Steady state

Front 9

This step of metabolism makes drug more hydrophilic and hence augments elimination

Back 9

Phase I

Front 10

Different steps of Phase I

Back 10

Oxidation, reduction, hydrolysis

Front 11

Inducers of Cytochrome P450 (CYP450)

Back 11

Barbiturates, phenytoin, carbamazepine, and rifampin

Front 12

Inhibitors of CYP450

Back 12

Cimetidine, ketoconazole, erythromycin, isoniazid and grapefruit

Front 13

Products of Phase II conjugation

Back 13

Glucuronate, acetic acid, and glutathione sulfate

Front 14

Constant percentage of substrate metabolized per unit time

Back 14

First order kinetics

Front 15

Drug elimination with a constant amount metabolized regardless of drug concentration

Back 15

Zero order kinetics

Front 16

Target plasma concentration times (volume of distribution divided by bioavailability)

Back 16

Loading dose (Cp*(Vd/F))

Front 17

Concentration in the plasma times (clearance divided by bioavailability)

Back 17

Maintenance dose (Cp*(CL/F))

Front 18

Strength of interaction between drug and its receptor

Back 18

Affinity

Front 19

Selectivity of a drug for its receptor

Back 19

Specificity

Front 20

Amount of drug necessary to elicit a biologic effect

Back 20

Potency

Front 21

Ability of drug to produce a biologic effect

Back 21

Efficacy

Front 22

Ability of a drug to produce 100% of the maximum response regardless of the potency

Back 22

Full agonist

Front 23

Ability to produce less than 100% of the response

Back 23

Partial agonist

Front 24

Ability to bind reversibly to the same site as the drug and without activating the effector system

Back 24

Competitive antagonist

Front 25

Ability to bind to either the same or different site as the drug

Back 25

Noncompetitive antagonist

Front 26

Mechanism of action (MOA) utilizes intracellular receptors

Back 26

Thyroid and steroid hormones

Front 27

MOA utilizes transmembrane receptors

Back 27

Insulin

Front 28

MOA utilizes ligand gated ion channels

Back 28

Benzodiazepines and calcium channel blockers

Front 29

Median effective dose required for an effect in 50% of the population

Back 29

ED50

Front 30

Median toxic dose required for a toxic effect in 50% of the population

Back 30

TD50

Front 31

Dose which is lethal to 50% of the population

Back 31

LD50

Front 32

Window between therapeutic effect and toxic effect

Back 32

Therapeutic index

Front 33

Drug with a high margin of safety

Back 33

High therapeutic index

Front 34

Drug with a narrow margin of safety

Back 34

Low therapeutic index

Front 35

Antidote used for lead poisoning

Back 35

Dimercaprol, EDTA

Front 36

Antidote used for cyanide poisoning

Back 36

Nitrites

Front 37

Antidote used for anticholinergic poisoning

Back 37

Physostigmine

Front 38

Antidote used for organophosphate/anticholinesterase poisoning

Back 38

Atropine, pralidoxime (2-PAM)

Front 39

Antidote used for iron salt toxicity

Back 39

Deferoxamine

Front 40

Antidote used for acetaminophen (APAP) toxicity

Back 40

N-acetylcysteine (Mucomyst)

Front 41

Antidote for arsenic, mercury, lead, and gold poisoning

Back 41

Dimercaprol

Front 42

Antidote used in poisonings: copper (Wilson's disease), lead, mercury, and arsenic

Back 42

Penicillamine

Front 43

Antidote used for heparin toxicity

Back 43

Protamine

Front 44

Antidote used for warfarin toxicity

Back 44

Vitamin and Fresh frozen plasma (FFP)

Front 45

Antidote for tissue plasminogen activator (t-PA), streptokinase

Back 45

Aminocaproic acid

Front 46

Antidote used for methanol and ethylene glycol

Back 46

Ethanol

Front 47

Antidote used for opioid toxicity

Back 47

Naloxone (IV), naltrexone (PO)

Front 48

Antidote used for benzodiazepine toxicity

Back 48

Flumazenil

Front 49

Antidote used for tricyclic antidepressants (TCA)

Back 49

Sodium bicarbonate

Front 50

Antidote used for carbon monoxide poisoning

Back 50

100% O2 and hyperbaric O2

Front 51

Antidote used for digitalis toxicity

Back 51

Digibind (also need to d/c digoxin, normalize K+, and lidocaine if pt. Is arrhythmic)

Front 52

Antidote used for beta agonist toxicity (eg. Metaproterenol)

Back 52

Esmolol

Front 53

Antidote for methotrexate toxicity

Back 53

Leucovorin

Front 54

Antidote for beta-blockers and hypoglycemia

Back 54

Glucagon

Front 55

Antidote useful for some drug induced Torsade de pointes

Back 55

Magnesium sulfate

Front 56

Antidote for hyperkalemia

Back 56

sodium polystyrene sulfonate (Kayexalate)

Front 57

Antidote for salicylate intoxication

Back 57

Alkalinize urine, dialysis

Front 58

Constant proportion of cell population killed rather than a constant number

Back 58

Log-kill hypothesis

Front 59

Treatment with cancer chemotherapy at high doses every 3-4 weeks, too toxic to be used continuously

Back 59

Pulse therapy

Front 60

Toxic effect of anticancer drug can be lessened by rescue agents

Back 60

Rescue therapy

Front 61

Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates

Back 61

Allopurinol

Front 62

Pyrimidine analog that causes "Thiamine-less death" given with leucovorin rescue

Back 62

5-flouracil (5-FU)

Front 63

Drug used in cancer therapy causes Cushing-like symptoms

Back 63

Prednisone

Front 64

Side effect of Mitomycin

Back 64

SEVERE myelosuppression

Front 65

MOA of cisplatin

Back 65

Alkylating agent

Front 66

Common toxicities of cisplatin

Back 66

Nephro and ototoxicity

Front 67

Analog of hypoxanthine, needs HGPRTase for activation

Back 67

6-mercaptopurine (6-MP)

Front 68

Interaction with this drug requires dose reduction of 6-MP

Back 68

Allopurinol

Front 69

May protect against doxorubicin toxic by scavenging free radicals

Back 69

Dexrazoxane

Front 70

Blows DNA (breaks DNA strands), limiting SE is pulmonary fibrosis

Back 70

Bleomycin

Front 71

Bleomycin+vinblastine+etoposide+cisplatin produce almost a 100% response when all agents are used for this neoplasm

Back 71

Testicular cancer

Front 72

MOPP regimen used in Hodgkin's disease (HD)

Back 72

Mechlorethamine+ oncovorin (vincristine)+ procarbazine, and prednisone

Front 73

ABVD regimen used for HD, but appears less likely to cause sterility and secondary malignancies than MOPP

Back 73

Adriamycin (doxorubicin) +bleomycin, vinblastine +dacarbazine

Front 74

Regimen used for non-Hodgkin's lymphoma

Back 74

COP (cyclophosphamide, oncovin(vincristine), and prednisone)

Front 75

Regimen used for breast cancer

Back 75

CMF (cyclophosphamide, methotrexate, and fluorouracil) and tamoxifen if ER+

Front 76

Alkylating agent, vesicant that causes tissue damage with extravasation

Back 76

Mechlorethamine

Front 77

Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis

Back 77

Cyclophosphamide

Front 78

Prevention of cyclophosphamide induced hemorrhagic cystitis

Back 78

Hydration and mercaptoethanesulfonate (MESNA)

Front 79

Microtubule inhibitor that causes peripheral neuropathy, foot drop (eg. ataxia), and "pins and needles" sensation

Back 79

Vincristine

Front 80

Interact with microtubules (but unlike vinca which prevent disassembly of tubules), it stabilizes tubulin and cells remain frozen in metaphase

Back 80

Paclitaxel (taxol)

Front 81

Toxicities include nephrotoxicity and ototoxicity, leading to a severe interaction with aminoglycosides

Back 81

Cisplatin

Front 82

Agent similar to cisplatin, less nephrotoxic, but greater myelosuppression

Back 82

Carboplatin

Front 83

Converts asparagine to aspartate and ammonia, denies cancer cells of essential AA (asparagine)

Back 83

L-asparaginase

Front 84

Used for hairy cell leukemia; it stimulates NK cells

Back 84

Interferon alpha

Front 85

Anti-androgen used for prostate cancer

Back 85

Flutamide (Eulexin)

Front 86

Anti-estrogen used for estrogen receptor + breast cancer

Back 86

Tamoxifen

Front 87

Newer estrogen receptor antagonist used in advanced breast cancer

Back 87

Toremifene (Fareston)

Front 88

Some cell cycle specific anti-cancer drugs

Back 88

Bleomycin, vinca alkaloids, antimetabolites (eg., 5-FU, 6-MP, methotrexate, etoposide)

Front 89

Some cell cycle non-specific drugs

Back 89

Alkylating agents (eg., mechlorethamine, cyclophosphamide), antibiotics (doxorubicin, daunorubicin), cisplatin, nitrosourea

Front 90

Anti-emetics used in association with anti-cancer drugs that are 5-HT3 (serotonin receptor subtype ) antagonist

Back 90

Odansetron, granisetron

Front 91

Nitrosoureas with high lipophilicity, used for brain tumors

Back 91

Carmustine (BCNU) and lomustine (CCNU)

Front 92

Produces disulfiram-like reaction with ethanol

Back 92

Procarbazine

Front 93

Somatostatin (SRIF) analog used for acromegaly, carcinoid, glucagonoma and other GH producing pituitary tumors

Back 93

Octreotide

Front 94

Somatotropin (GH) analog used in GH deficiency (dwarfism)

Back 94

Somatrem

Front 95

GHRH analog used as diagnostic agent

Back 95

Sermorelin

Front 96

GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively

Back 96

Leuprolide

Front 97

GnRH antagonist with more immediate effects, used for infertility

Back 97

Ganirelix

Front 98

Dopamine (DA) agonist (for Parkinson's disease), used also for hyperprolactinemia

Back 98

Bromocriptine

Front 99

Hormone inhibiting prolactin release

Back 99

Dopamine

Front 100

ACTH analog used for diagnosis of patients with corticosteroid abnormality

Back 100

Cosyntropin

Front 101

Synthetic analog of ADH hormone used for diabetes insipidus and nocturnal enuresis

Back 101

Desmopressin (DDAVP)

Front 102

Most widely used thyroid drugs such as Synthroid and Levoxyl contain

Back 102

L-thyroxine (T4)

Front 103

T3 compound less widely used

Back 103

Cytomel

Front 104

Anti-thyroid drugs

Back 104

Thioamides, iodides, radioactive iodine, and ipodate

Front 105

Thioamide agents used in hyperthyroidism

Back 105

Methimazole and propylthiouracil (PTU)

Front 106

Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and should be used with extreme caution in pregnancy

Back 106

PTU

Front 107

PTU (propylthiouracil) MOA

Back 107

Inhibits thyroid hormone synthesis by blocking iodination of the tyrosine residues of thyroglobulin

Front 108

Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism

Back 108

Iodide salts

Front 109

Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy

Back 109

Radioactive iodine

Front 110

Radio contrast media that inhibits the conversion of T4 to T3

Back 110

Ipodate

Front 111

Block cardiac adverse effects of thyrotoxicosis such as tachycardia, inhibits the conversion of T4 to T3

Back 111

Beta-blockers such as propranolol

Front 112

3 zones of adrenal cortex and their products

Back 112

Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)

Front 113

Pneumonic for 3 zones of adrenal cortex

Back 113

GFR

Front 114

Used for Addison's disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)

Back 114

Glucocorticoids

Front 115

Short acting GC's

Back 115

Cortisone and hydrocortisone (equivalent to cortisol)

Front 116

Intermediate acting GC's

Back 116

Prednisone, methylprednisolone, prednisolone, and triamcinolone

Front 117

Long acting GC's

Back 117

Betamethasone, dexamethasone, and paramethasone

Front 118

Mineralocorticoids

Back 118

Fludrocortisone and deoxycorticosterone

Front 119

Some side effects of corticosteroids

Back 119

Osteopenia, impaired wound healing, inc. risk of infection, inc. appetite, HTN, edema, PUD, euphoria, psychosis

Front 120

Period of time of therapy after which GC therapy will need to be tapered

Back 120

5-7 days

Front 121

Used for Cushing's syndrome (increased corticosteroid) and sometimes for adrenal function test

Back 121

Metyrapone

Front 122

Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis

Back 122

Aminoglutethimide

Front 123

Antifungal agent used for inhibition of all gonadal and adrenal steroids

Back 123

Ketoconazole

Front 124

Antiprogestin used as potent antagonist of GC receptor

Back 124

Mifepristone

Front 125

Diuretic used to antagonize aldosterone receptors

Back 125

Spironolactone

Front 126

Common SE of spironolactone

Back 126

Gynecomastia and hyperkalemia

Front 127

Slightly increased risk of breast cancer, endometrial cancer, heart disease (questionable), has beneficial effects on bone loss

Back 127

Estrogen

Front 128

Antiestrogen drugs used for fertility and breast cancer respectively

Back 128

Clomiphene and tamoxifen

Front 129

Common SE of tamoxifen and raloxifene

Back 129

Hot flashes

Front 130

Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and currently being tested for treatment of breast cancer (Stars study)

Back 130

Raloxifene

Front 131

Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy

Back 131

Diethylstilbestrol (DES)

Front 132

Estrogen mostly used in oral contraceptives (OC)

Back 132

Ethinyl estradiol and mestranol

Front 133

Anti-progesterone used as abortifacient

Back 133

Mifepristone (RU-486)

Front 134

Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)

Back 134

Combination oral contraceptives (OC)

Front 135

Oral contraceptive available in a transdermal patch

Back 135

Ortho-Evra

Front 136

Converted to more active form DHT by 5 alpha-reductase

Back 136

Testosterone

Front 137

5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness

Back 137

Finasteride (Proscar and Propecia respectively)

Front 138

Anabolic steroid that has potential for abuse

Back 138

Nandrolone and stanozolol

Front 139

Anti-androgen used for hirsutism in females

Back 139

Cyproterone acetate

Front 140

Drug is used with testosterone for male fertility

Back 140

Leuprolide

Front 141

Alpha cells in the pancreas

Back 141

Produce glucagon

Front 142

Beta cells in the pancreas

Back 142

Produce insulin

Front 143

Beta cells are found

Back 143

Islets of Langerhans

Front 144

Delta cells in the pancreas

Back 144

Produce Somatostatin

Front 145

Product of proinsulin cleavage used to assess insulin abuse

Back 145

C-peptide

Front 146

Exogenous insulin

Back 146

Little C-peptide

Front 147

Endogenous insulin

Back 147

Normal C-peptide

Front 148

Very rapid acting insulin, having fastest onset and shortest duration of action

Back 148

Lispro (Humalog)

Front 149

Rapid acting, crystalline zinc insulin used to reverse acute hyperglycemia

Back 149

Regular (Humulin R)

Front 150

Long acting insulin

Back 150

Ultralente (humulin U)

Front 151

Ultra long acting insulin, has over a day duration of action

Back 151

Glargine (Lantus)

Front 152

Major SE of insulin

Back 152

Hypoglycemia

Front 153

Important in synthesis of glucose to glycogen in the liver

Back 153

GLUT 2

Front 154

Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation

Back 154

GLUT 4

Front 155

Examples of alpha-glucosidase inhibitors (AGI)

Back 155

Acarbose, miglitol

Front 156

MOA of AGI's

Back 156

Act on intestine, delay absorption of glucose

Front 157

SE of AGI's

Back 157

Flatulence (do not use beano to tx), diarrhea, abdominal cramps

Front 158

Alpha-glucosidase inhibitor associated with elevation of LFT's

Back 158

Acarbose

Front 159

Amino acid derivative

Back 159

Nateglinide

Front 160

MOA of nateglinide

Back 160

Insulin secretagogue

Front 161

Biguanide

Back 161

Metformin

Front 162

Drugs available in combination with metformin

Back 162

Glyburide, glipizide, and rosiglitazone

Front 163

MOA of metformin

Back 163

Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity

Front 164

Most important potential SE of metformin

Back 164

Lactic acidosis

Front 165

Meglitinide

Back 165

Repaglinide

Front 166

MOA of repaglinide

Back 166

Insulin release from pancreas; faster and shorter acting than sulfonylurea

Front 167

First generation sulfonylurea

Back 167

Chlorpropamide, tolbutamide, tolazamide, etc.

Front 168

Second generation sulfonylurea

Back 168

Glyburide, glipizide, glimepiride, etc.

Front 169

MOA of both generations

Back 169

Insulin release from pancreas by modifying K+ channels

Front 170

Common SE of sulfonylureas, repaglinide, and nateglinide

Back 170

Hypoglycemia

Front 171

Sulfonylurea NOT recommended for elderly because of very long half life

Back 171

Chlorpropamide

Front 172

Thiazolidinediones

Back 172

Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)

Front 173

Reason troglitazone was withdrawn from market

Back 173

Hepatic toxicity

Front 174

MOA of thiazolindinediones

Back 174

Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism

Front 175

SE of Thiazolindinediones

Back 175

Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism

Front 176

Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation

Back 176

Glucagon

Front 177

Available bisphosphonates

Back 177

Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid

Front 178

MOA of Bisphosphonates

Back 178

Inhibits osteoclast bone resorption

Front 179

Only bisphosphonates available IV

Back 179

Etidronate

Front 180

Uses of bisphosphonates

Back 180

Osteoporosis, Paget's disease, and osteolytic bone lesions, and hypercalcemia from malignancy

Front 181

Major SE of bisphosphonates

Back 181

Chemical esophagitis

Front 182

Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia

Back 182

Etidronate

Front 183

Used for prevention of postmenopausal osteoporosis in women

Back 183

Estrogen (HRT-Hormone replacement therapy)

Front 184

Increase bone density, also being tested for breast CA tx.

Back 184

Raloxifene (SERM-selective estrogen receptor modulator)

Front 185

Used intranasally and decreases bone resorption

Back 185

Calcitonin (salmon prep)

Front 186

Used especially in postmenopausal women, dosage should be 1500 mg

Back 186

Calcium

Front 187

Vitamin given with calcium to ensure proper absorption

Back 187

Vitamin D

Front 188

Drugs with important actions on smooth muscle

Front 189

Disease caused by excess ergot alkaloids

Back 189

St. Anthony's Fire

Front 190

Endogenous substances commonly interpreted as histamine, serotonin, prostaglandins, and vasoactive peptides

Back 190

Autocoids

Front 191

Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea

Back 191

Zollinger-Ellison Syndrome

Front 192

Drug that causes contraction of the uterus

Back 192

Oxytocin

Front 193

Distribution of histamine receptors H1, H2, and H3

Back 193

Smooth muscle; stomach, heart, and mast cells; nerve endings, CNS respectively

Front 194

Prototype antagonist of H1 and H2 receptors

Back 194

Diphenhydramine

Front 195

1st generation antihistamine that is highly sedating

Back 195

Diphendydramine

Front 196

1st generation antihistamine that is least sedating

Back 196

Chlorpheniramine or cyclizine

Front 197

2nd generation antihistamines

Back 197

Fexofenadine, loratadine, and cetirizine

Front 198

Generation of antihistamine that has the most CNS effects

Back 198

First generation due to being more lipid-soluble

Front 199

Major indication for H1 receptor antagonist

Back 199

Use in IgE mediated allergic reaction

Front 200

Antihistamine that can be used for anxiety and insomnia and is not addictive

Back 200

hydroxyzine (Atarax)

Front 201

H1 antagonist used in motion sickness

Back 201

Dimenhydrinate, meclizine, and other 1st generation

Front 202

Most common side effect of 1st generation antihistamines

Back 202

Sedation

Front 203

Lethal arrhythmias resulting from concurrent therapy with azole fungals (metabolized by CYP 3A4) and these antihistamines which inhibit the 3A4 iso-enzyme.

Back 203

Terfenadine and astemizole (have been removed from the market)

Front 204

H2 blocker that causes the most interactions with other drugs

Back 204

Cimetidine

Front 205

Clinical use for H2 blockers

Back 205

Acid reflux disease, duodenal ulcer and peptic ulcer disease

Front 206

Receptors for serotonin (5HT-1) are located

Back 206

Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance

Front 207

5HT-1d agonist used for migraine headaches "

Back 207

Sumatriptan, naratriptan, and rizatriptan

Front 208

Triptan available in parenteral and nasal formulation

Back 208

Sumatriptan

Front 209

H1 blocker that is also a serotonin antagonist

Back 209

Cyproheptadine

Front 210

5HT2 antagonist mediate synaptic excitation in the CNS and smooth muscle contraction

Back 210

Ketanserin, cyproheptadine, and ergot alkaloids (partial agonist of alpha and serotonin receptors)

Front 211

Agents for reduction of postpartum bleeding

Back 211

Ergonovine and ergotamine

Front 212

Agents used in treatment of carcinoid tumor

Back 212

Ketanserin cyproheptadine, and phenoxybenzamine

Front 213

5HT-3 antagonist used in chemotherapeutic induced
emesis

Back 213

"Ondansetron, granisetron,

Front 214

5ht-3 antagonist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease

Back 214

Dolasetron

Front 215

DOC of chemo induced nausea and vomiting

Back 215

Odansetron

Front 216

Drug used in ergot alkaloids overdose, ischemia and gangrene

Back 216

Nitroprusside

Front 217

Reason ergot alkaloids are contraindicated in pregnancy

Back 217

Uterine contractions

Front 218

SE of ergot alkaloids

Back 218

Hallucinations resembling psychosis

Front 219

Ergot alkaloid used as an illicit drug

Back 219

LSD

Front 220

Dopamine agonist used in hyperprolactinemia

Back 220

Bromocriptine

Front 221

Peptide causing increased capillary permeability and edema

Back 221

Bradykinin and histamine

Front 222

Mediator of tissue pain, edema, inactivated by ACE, and may be a contributing factor to the development of angioedema

Back 222

Bradykinin

Front 223

Drug causing depletion of substance P (vasodilator)

Back 223

Capsaicin

Front 224

Prostaglandins that cause abortions

Back 224

Prostaglandin E1 (misoprostol) PGE2, and PGF2alpha

Front 225

Difference between COX 1 and COX 2 "

Back 225

COX 1 is found throughout
the body and COX 2 is only
in inflammatory tissue

Front 226

Drug that selectively inhibits COX 2

Back 226

Celecoxib, valdecoxib, and rofecoxib

Front 227

Inhibitor of lipoxygenase

Back 227

Zileuton

Front 228

Major SE of zileuton

Back 228

Liver toxicity

Front 229

Inhibitor of leukotrienes (LTD4) receptors and used in asthma

Back 229

Zafirlukast and montelukast

Front 230

Used in pediatrics to maintain patency of ductus arteriosis

Back 230

PGE1

Front 231

Approved for use in severe pulmonary HTN

Back 231

PGI2 (epoprostenol)

Front 232

Prostaglandin used in the treatment impotence

Back 232

Alprostadil

Front 233

Irreversible, nonselective COX inhibitor

Back 233

Aspirin

Front 234

Class of drugs that reversibly inhibit COX

Back 234

NSAIDS

Front 235

Primary endogenous substrate for Nitric Oxidase Synthase

Back 235

Arginine

Front 236

MOA and effect of nitric oxide

Back 236

Stimulates cGMP which leads to vascular smooth muscle relaxation

Front 237

Long acting beta 2 agonist used in asthma

Back 237

Salmeterol

Front 238

Muscarinic antagonist used in asthma

Back 238

Ipratropium

Front 239

MOA action of cromolyn

Back 239

Mast cell stabilizer

Front 240

Enzyme which theophylline inhibits

Back 240

Phosphodiesterase

Front 241

Methylxanthine derivative used as a remedy for intermittent claudication

Back 241

Pentoxifylline

Front 242

Antidote for severe CV toxicity of theophylline

Back 242

Beta blockers

Front 243

MOA of corticosteroids"

Back 243

inhibit phospholipase A2

Front 244

SE of long term (>5 days) corticosteroid therapy and remedy

Back 244

Adrenal suppression and weaning slowly, respectively

Front 245

MOA of quinolones

Back 245

Inhibit DNA gyrase

Front 246

MOA of penicillin

Back 246

Block cell wall synthesis by inhibiting peptidoglycan cross-linkage

Front 247

Drug used for MRSA

Back 247

Vancomycin

Front 248

Vancomycin MOA

Back 248

Blocks peptidoglycan synthesis

Front 249

Type of resistance found with vancomycin

Back 249

Point mutation

Front 250

Meningitis prophylaxis in exposed patients

Back 250

Rifampin

Front 251

Technique used to diagnose perianal itching, and the drug used to treat it

Back 251

"Scotch tape technique and mebendazole

Front 252

Two toxicities of aminoglycosides

Back 252

nephro and ototoxicity

Front 253

DOC for Legionnaires' disease

Back 253

Erythromycin

Front 254

MOA of sulfonamides

Back 254

Inhibit dihydropteroate synthase

Front 255

Penicillins active against penicillinase secreting bacteria

Back 255

Methicillin, nafcillin, and dicloxacillin

Front 256

Cheap wide spectrum antibiotic DOC of otitis media

Back 256

Amoxicillin

Front 257

Class of antibiotics that have 10% cross sensitivity with penicillins

Back 257

Cephalosporins

Front 258

PCN active against pseudomonas

Back 258

Carbenicillin, piperacillin and ticarcillin

Front 259

Antibiotic causing red-man syndrome, and prevention

Back 259

Vancomycin, infusion at a slow rate and antihistamines

Front 260

Drug causes teeth discoloration

Back 260

Tetracycline

Front 261

MOA of tetracycline

Back 261

Decreases protein synthesis by inhibiting 30S ribosome

Front 262

Drug that causes gray baby syndrome and aplastic anemia

Back 262

Chloramphenicol

Front 263

Drug notorious for causing pseudomembranous colitis

Back 263

Clindamycin

Front 264

DOC for tx of pseudomembranous colitis

Back 264

Metronidazole

Front 265

Treatment of resistant pseudomembranous colitis

Back 265

ORAL vancomycin

Front 266

Anemia caused by trimethoprim

Back 266

Megaloblastic anemia

Front 267

Reason fluoroquinolones are contraindicated in children and pregnancy

Back 267

Cartilage damage

Front 268

DOC for giardia, bacterial vaginosis, pseudomembranous colitis, and trichomonas

Back 268

Metronidazole

Front 269

Treatment for TB patients (think RIPE)

Back 269

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Front 270

Metronidazole SE if given with alcohol

Back 270

Disulfiram-like reaction

Front 271

Common side effect of Rifampin

Back 271

Red urine discoloration

Front 272

MOA of nystatin

Back 272

Bind ergosterol in fungal cell membrane

Front 273

Neurotoxicity with isoniazid (INH) prevented by

Back 273

Administration of Vit. B6 (pyridoxine)

Front 274

Toxicity of amphotericin

Back 274

Nephrotoxicity

Front 275

SE seen only in men with administration of ketoconazole

Back 275

Gynecomastia

Front 276

Topical DOC in impetigo

Back 276

Topical mupirocin (Bactroban)

Front 277

DOC for influenza A

Back 277

Amantadine

Front 278

DOC for RSV

Back 278

Ribavirin

Front 279

DOC for CMV retinitis

Back 279

Ganciclovir

Front 280

SE for ganciclovir

Back 280

Neutro, leuko and thrombocytopenia

Front 281

Anti-viral agents associated with Stephen Johnson syndrome

Back 281

Nevirapine, amprenavir

Front 282

HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism

Back 282

Protease inhibitors

Front 283

Antivirals that are teratogens

Back 283

Delavirdine, efavirenz, and ribavirin

Front 284

Antivirals associated with neutropenia

Back 284

Ganciclovir, zidovudine, saquinavir, and interferon

Front 285

HIV med used to reduce transmission during birth

Back 285

AZT (zidovudine)

Front 286

Drug used for African sleeping sickness

Back 286

Suramin

Front 287

Drug used in Chagas disease

Back 287

Nifurtimox

Front 288

Cephalosporins able to cross the BBB

Back 288

Cefixime (2nd) and 3rd generation

Front 289

Drug used for N. gonorrhea in females

Back 289

Ceftriaxone

Front 290

Cephalosporin causes kernicterus in neonates

Back 290

Ceftriaxone or cefuroxime

Front 291

SE of INH

Back 291

Peripheral neuritis and hepatitis

Front 292

Aminoglycoside that is least ototoxic

Back 292

Streptomycin

Front 293

Drug used in exoerythrocytic cycle of malaria

Back 293

Primaquine

Front 294

Oral antibiotic of choice for moderate inflammatory acne

Back 294

Minocycline

Front 295

Drug of choice for leprosy

Back 295

Dapsone

Front 296

DOC for herpes and its MOA

Back 296

Acyclovir and inhibits thymidine kinase Acyclovir and inhibits thymidine kinase

Front 297

Anti-microbials that cause hemolysis in G6PD-deficient patients

Back 297

Sulfonamides

Front 298

MOA of erythromycin

Back 298

Inhibition of protein synthesis at the 50s subunit of ribosome

Front 299

Anti-biotic frequently used for chronic UTI prophylaxis

Back 299

sulfamethoxazole/ trimethoprim

Front 300

Lactam that can be used in PCN allergic patients

Back 300

Aztreonam

Front 301

SE of imipenem

Back 301

Seizures

Front 302

Anti-viral with a dose limiting toxicity of pancreatitis

Back 302

Didanosine

Front 303

Common side effect of hypnotic agents

Back 303

Sedation

Front 304

Occurs when sedative hypnotics are used chronically or at high doses

Back 304

Tolerance

Front 305

The most common type of drug interaction of sedative hypnotics with other depressant medications

Back 305

Additive CNS depression

Front 306

Major effect of benzodiazepines on sleep at high doses

Back 306

REM is decreased

Front 307

Neurologic SE of benzodiazepines

Back 307

Anterograde amnesia

Front 308

Reason benzos are used cautiously in pregnancy

Back 308

Ability to cross the placenta

Front 309

Main route of metabolism for benzodiazepines

Back 309

Hepatic

Front 310

Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired)

Back 310

Lorazepam, oxazepam, and temazepam

Front 311

MOA for benzodiazepines

Back 311

increase the FREQUENCY of GABA-mediated chloride ion channel opening

Front 312

Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects)

Back 312

Flumazenil

Front 313

Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin

Back 313

Diazepam

Front 314

Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia

Back 314

Clonazepam

Front 315

Benzodiazepines that are the most effective in the treatment of panic disorder

Back 315

Alprazolam and Clonazepam

Front 316

Benzodiazepine that is used for anesthesia

Back 316

Midazolam

Front 317

DOC for status epilepticus

Back 317

Diazepam

Front 318

Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs

Back 318

Chlordiazepoxide and Diazepam

Front 319

Agents having active metabolites, long half lives, and a high incidence of adverse effects

Back 319

Diazepam, Flurazepam, chlordiazepoxide, and clorazepate

Front 320

Barbiturates may precipitate this hematologic condition

Back 320

Acute intermittent porphyria

Front 321

Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property

Back 321

Liver enzyme INDUCTION

Front 322

Barbiturates MOA

Back 322

Increase the DURATION of GABA-mediated chloride ion channels

Front 323

Barbiturate used for the induction of anesthesia

Back 323

Thiopental

Front 324

Important drug interaction with chloral hydrate

Back 324

May displace coumadin from plasma proteins

Front 325

Site of action for zaleplon and zolpidem

Back 325

Benzodiazepine receptor BZ1 (although are not considered benzodiazepines)

Front 326

Good hypnotic activity with less CNS SE than most benzodiazepines

Back 326

Zolpidem, zaleplon

Front 327

Agent that is a partial agonist for the 5-HT1A receptor

Back 327

Buspirone

Front 328

Drug of choice for generalized anxiety disorder, NOT effective in acute anxiety

Back 328

Buspirone

Front 329

Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS)

Back 329

Ethanol

Front 330

Agent with zero-order kinetics

Back 330

Ethanol

Front 331

Rate limiting step of alcohol metabolism

Back 331

Aldehyde dehydrogenase

Front 332

System that increases in activity with chronic exposure and may contribute to tolerance

Back 332

MEOS

Front 333

Agent that metabolize acetaldehyde to acetate

Back 333

Aldehyde dehydrogenase

Front 334

Agents that inhibit alcohol dehydrogenase

Back 334

Disulfiram, metronidazole, certain sulfonylureas and cephalosporins

Front 335

Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension

Back 335

Disulfiram

Front 336

The most common neurologic abnormality in chronic alcoholics

Back 336

Peripheral neuropathy (also excessive alcohol use is associated with HTN, anemia, and MI)

Front 337

Agent that is teratogen and causes a fetal syndrome

Back 337

Alcohol

Front 338

Agent that is the antidote for methanol overdose

Back 338

Alcohol

Front 339

Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure

Back 339

Fomepizole

Front 340

Most frequent route of metabolism

Back 340

Hepatic enzymes

Front 341

Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine

Back 341

Sodium blockade

Front 342

MOA for benzodiazepines and barbiturates

Back 342

GABA-related targets

Front 343

MOA for Ethosuximide

Back 343

Calcium channels

Front 344

MOA for Valproic acid at high doses

Back 344

Affect calcium, potassium, and sodium channels

Front 345

Drugs of choice for generalized tonic-clonic and partial seizures

Back 345

Valproic acid and Phenytoin

Front 346

DOC for febrile seizures

Back 346

Phenobarbital

Front 347

Drugs of choice for absence seizures

Back 347

Ethosuximide and valproic acid

Front 348

Drug of choice for myoclonic seizures

Back 348

Valproic acid

Front 349

Drugs of choice for status epilepticus

Back 349

IV diazepam or phenytoin (for prolonged therapy not acute)

Front 350

Drugs that can be used for infantile spasms

Back 350

Corticosteroids

Front 351

Anti-seizure drugs used also for bipolar affective disorder (BAD)

Back 351

Valproic acid, carbamazepine, phenytoin and gabapentin

Front 352

Anti-seizure drugs used also for Trigeminal neuralgia

Back 352

Carbamazepine

Front 353

Anti-seizure drugs used also for pain of neuropathic orgin

Back 353

Gabapentin

Front 354

Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism

Back 354

Phenytoin

Front 355

SE of phenytoin

Back 355

Gingival hyperplasia, nystagmus, diplopia and ataxia

Front 356

Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida

Back 356

Carbamazepine

Front 357

Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress

Back 357

Valproic acid

Front 358

Laboratory value required to be monitored for patients on valproic acid

Back 358

Serum ammonia and LFT's

Front 359

SE for Lamotrigine

Back 359

Stevens-Johnson syndrome

Front 360

SE for Felbamate

Back 360

Aplastic anemia and acute hepatic failure

Front 361

Anti-seizure medication also used in the prevention of migraines

Back 361

Valproic acid

Front 362

Carbamazepine may cause

Back 362

Agranulocytosis

Front 363

Anti-seizure drugs used as alternative drugs for mood stabilization

Back 363

Carbamazepine, gabapentin, lamotrigine, and valproic acid

Front 364

MOA of general anesthetics

Back 364

Unclear, thought to increase the threshold for firing of CNS neurons

Front 365

Inhaled anesthetic with a low blood/gas partition coefficient

Back 365

Nitrous oxide

Front 366

Inversely related to potency of anesthetics

Back 366

Minimum alveolar anesthetic concentration (MAC)

Front 367

Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents

Back 367

Halothane and methoxyflurane

Front 368

Most inhaled anesthetics SE

Back 368

Decrease arterial blood pressure

Front 369

Inhaled anesthetics are myocardial depressants

Back 369

Enflurane and halothane

Front 370

Inhaled anesthetic causes peripheral vasodilation

Back 370

Isoflurane

Front 371

Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis

Back 371

Halothane

Front 372

Inhaled anesthetics, less likely to lower blood pressure than other agents, and has the smallest effect on respiration

Back 372

Nitrous oxide

Front 373

Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency

Back 373

Methoxyflurane

Front 374

Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia

Back 374

Nitrous oxide

Front 375

Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm

Back 375

Desflurane

Front 376

DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics

Back 376

Dantrolene

Front 377

IV barbiturate used as a pre-op anesthetic

Back 377

Thiopental

Front 378

Benzodiazepine used adjunctively in anesthesia

Back 378

Midazolam

Front 379

Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose

Back 379

Flumazenil

Front 380

This produces "dissociative anesthesia", is a cardiovascular stimulant which may increases intracranial pressure, and hallucinations occur during recovery

Back 380

Ketamine

Front 381

Opioid associated with respiratory depression, but is used in high risk patients who may not survive full general anesthetia

Back 381

Fentanyl

Front 382

State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide

Back 382

Neuroleptanesthesia

Front 383

Produces both rapid anesthesia and recovery, has antiemetic activity and commonly used for outpatient surgery, may cause marked hypotension

Back 383

Propofol

Front 384

MOA of local anesthetics (LA's)

Back 384

Block voltage-dependent sodium channels

Front 385

This may enhance activity of local anesthetics

Back 385

Hyperkalemia

Front 386

This may antagonize activity of local anesthetics

Back 386

Hypercalcemia

Front 387

Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity

Back 387

Vasodilation

Front 388

Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery

Back 388

Cocaine

Front 389

Longer acting local anesthetics which are less dependent on vasoconstrictors

Back 389

Tetracaine and bupivacaine

Front 390

These LA's have surface activity

Back 390

Cocaine and benzocaine

Front 391

Most important toxic effects of most local anesthetics

Back 391

CNS toxicity

Front 392

Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction

Back 392

Cocaine

Front 393

LA causing methemoglobinemia

Back 393

Prilocaine

Front 394

Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation

Back 394

Neuromuscular blocking drugs

Front 395

These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)

Back 395

Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic

Front 396

These prevent the action of Ach at the skeletal muscle endplate to produce a "surmountable blockade," effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)

Back 396

Nondepolarizing type antagonists

Front 397

Agent with long duration of action and is sost likely to cause histamine release

Back 397

Tubocurarine

Front 398

Non-depolarizing antagonist has short duration

Back 398

Mivacurium

Front 399

Agent can blocking muscarinic receptors

Back 399

Pancuronium

Front 400

Agent undergoing Hofmann elimination (breaking down spontaneously)

Back 400

Atracurium

Front 401

One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis, xcuses muscle pain postoperatively and myoglobinuria may occur

Back 401

Succinylcholine

Front 402

During Phase I these agents worsen the paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine

Back 402

Cholinesterase inhibitors

Front 403

Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease

Back 403

Spasmolytic drugs

Front 404

Facilitates GABA presynaptic inhibition

Back 404

Diazepam

Front 405

GABA agonist in the spinal cord

Back 405

Baclofen

Front 406

Similar to clonidine and may cause hypotension

Back 406

Tizanidine

Front 407

DOC for malignant hyperthermia by acting on the sacroplasmic reticulum or skeletal muscle

Back 407

Dantrolene

Front 408

Agent used for acute muscle spasm

Back 408

Cyclobenzaprine

Front 409

Antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog) and is irreversible

Back 409

Drug induced Parkinsonism

Front 410

Agent used in drug therapy of Parkinson's instead of Dopamine which has low bioavailability and does not cross the BBB

Back 410

L-dopa

Front 411

This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE's (GI distress, postural hypotension, and dyskinesias)

Back 411

Carbidopa

Front 412

Clinical response that may fluctuate in tx of Parkinson's dx

Back 412

"On-off-phenomenon"

Front 413

Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma

Back 413

Levodopa

Front 414

Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia

Back 414

Bromocriptine

Front 415

Non ergot agents used as first-line therapy in the initial management of Parkinson's

Back 415

Pramipexole and ropinirole

Front 416

Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis

Back 416

Amantadine

Front 417

Inhibitor of MAO type B which metabolizes dopamine, used adjunct to levodopa or as sole agent in newly diagnosed pt's

Back 417

Selegiline

Front 418

Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson's dx and cause acute hepatic failure (monitor LFT's)

Back 418

Entacapone and Tolcapone

Front 419

Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects

Back 419

Benztropine

Front 420

Agent effective in physiologic and essential tremor

Back 420

Propranolol

Front 421

Agents used in Huntington's Disease

Back 421

Tetrabenazine (amine depleting drug), Haloperidol (antipsychotic)

Front 422

Agents used in Tourette's dx

Back 422

Haloperidol or pimozide

Front 423

Chelating agent used in Wilson's disease

Back 423

Penicillamine

Front 424

Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor

Back 424

Older antipsychotic agents, D2 receptors

Front 425

Side effects occuring in antipsychotics that block dopamine

Back 425

Hyperprolactinemia, menorrhea, galactorrhea, confusion, mood changes, decreased sexual interest, and weight gain

Front 426

Antipsychotics that reduce positive symptoms only

Back 426

Older antipsychotics

Front 427

Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation

Back 427

Olanzapine, aripiprazole, and sertindole

Front 428

Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia

Back 428

Risperidone

Front 429

Atypical antipsychotic causing high prolactin levels

Back 429

Risperidone

Front 430

Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes

Back 430

Olanzapine

Front 431

Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker

Back 431

Haloperidol

Front 432

Drug used in neuroleptic malignant syndrome

Back 432

Dantrolene

Front 433

Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)

Back 433

Muscarinic blockers

Front 434

Antipsychotic having the strongest autonomic effects

Back 434

Thioridazine

Front 435

Antipsychotic having the weakest autonomic effects

Back 435

Haloperidol

Front 436

Antipsychotic that does not block muscarinic or histamine receptors, and it prolongs the QT interval

Back 436

Sertindole

Front 437

Only phenothiazine not exerting antiemetic effects, can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias

Back 437

Thioridazine

Front 438

Agent having no effect on D2 receptors, blocks D4, reserved for resistant schizophrenia, and can cause agranulocytosis

Back 438

Clozapine

Front 439

Anti-psychotic not shown to cause tardive dyskinesia

Back 439

Clozapine

Front 440

Anti-psychotics available in depot preparation

Back 440

Fluphenazine and haloperidol

Front 441

Reduced seizure threshold

Back 441

Low-potency typical antipsychotics and clozapine

Front 442

Orthostatic hypotension and QT prolongation

Back 442

Low potency and risperidone

Front 443

Increased risk of developing cataracts

Back 443

Quetiapine

Front 444

Major route of elimination for Lithium

Back 444

Kidneys

Front 445

Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop

Back 445

Lithium toxicity

Front 446

Drug increases the renal clearance hence decreases levels of lithium

Back 446

Theophylline

Front 447

Lithium is associated with this congenital defect

Back 447

Cardiac anomalies and is contraindicated in pregnancy or lactation

Front 448

DOC for bipolar affective disorder

Back 448

Lithium

Front 449

SE of lithium

Back 449

Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus

Front 450

Example of three antidepressants that are indicated for obsessive compulsive disorder

Back 450

Clomipramine, fluoxetine and fluvoxamine

Front 451

Neurotransmitters affected by the action of antidepressants

Back 451

Norepinephrine and serotonin

Front 452

Usual time needed for full effect of antidepressant therapy

Back 452

2 to 3 weeks

Front 453

Population group especially sensitive to side effects of antidepressants

Back 453

Elderly patients

Front 454

All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion

Back 454

Side-effect profile and prior pt response

Front 455

Well-tolerated and are first-line antidepressants

Back 455

SSRI's, bupropion, and venlafaxine

Front 456

Monoamine oxidase inhibitors (MAOI)

Front 457

Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression

Back 457

Monamine oxidase inhibitors

Front 458

Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)

Back 458

Hypertensive crisis

Front 459

MAOI should not be administered with SSRI's or potent TCA's due to development of this condition

Back 459

Serotonin syndrome

Front 460

Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly

Back 460

Tricyclic antidepressants (TCA)

Front 461

Three C's associated with TCA toxicity

Back 461

Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)

Front 462

Agents having higher sedation and antimuscarinic effects than other TCA's

Back 462

Tertiary amines

Front 463

TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects

Back 463

Amitriptyline

Front 464

TCA used in chronic pain, enuresis, and ADD

Back 464

Imipramine

Front 465

TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep

Back 465

Doxepin

Front 466

TCA used in obsessive compulsive disorder (OCD), most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms

Back 466

Clomipramine

Front 467

Secondary amines that have less sedation and more excitation effect

Back 467

Nortriptyline, Desipramine

Front 468

Antidepressant associated with neuroleptic malignant syndrome

Back 468

Amoxapine

Front 469

Antidepressant associated with seizures and cardiotoxicity

Back 469

Maprotiline

Front 470

Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure

Back 470

Venlafaxine

Front 471

Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake

Back 471

Venlafaxine

Front 472

Antidepressant also used for sleep that causes priapism

Back 472

Trazodone

Front 473

Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure

Back 473

Nefazodone

Front 474

Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures

Back 474

Bupropion

Front 475

Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating

Back 475

Mirtazapine

Front 476

SE of mirtazapine

Back 476

Liver toxicity, increased serum cholesterol

Front 477

Except for these agents all SSRI have significant inhibition of CytP450 enzymes

Back 477

Citalopram and its metabolite escitalopram

Front 478

SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx

Back 478

Fluoxetine

Front 479

SSRI indicated for premenstrual dysphoric disorder

Back 479

Fluoxetine (Sarafem)

Front 480

Some of SSRIs' therapeutic effects beside depression

Back 480

Panic attacks, social phobias, bulimia nervosa, and PMDD premenstrual dysphoric disorder), OCD

Front 481

SSRI's less likely to cause a withdrawal syndrome

Back 481

Fluoxetine

Front 482

Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons

Back 482

Ascending pathways

Front 483

Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release

Back 483

Presynaptic mu, delta, and kappa receptors

Front 484

Activation of these receptors open K+ ion channels to cause membrane hyperpolarization

Back 484

Postsynaptic Mu receptors

Front 485

Tolerance to all effects of opioid agonists can develop except

Back 485

Miosis and constipation

Front 486

All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction

Back 486

Meperidine

Front 487

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

Back 487

Opioid Analgesics

Front 488

Strong opioid agonists

Back 488

Morphine, methadone, meperidine, and fentanyl

Front 489

Opioids used in anesthesia

Back 489

Morphine and fentanyl

Front 490

Opioid used in the management of withdrawal states

Back 490

Methadone

Front 491

Opioid available trans-dermally

Back 491

Fentanyl

Front 492

Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema

Back 492

Morphine

Front 493

Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome

Back 493

Meperidine

Front 494

Moderate opioid agonists

Back 494

Codeine, hydrocodone, and oxycodone

Front 495

Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

Back 495

Propoxyphene

Front 496

Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal

Back 496

Buprenorphine

Front 497

Opioid antagonist that is given IV and had short DOA

Back 497

Naloxone

Front 498

Opioid antagonist that is given orally in alcohol dependency programs

Back 498

Naltrexone

Front 499

These agents are used as antitussive

Back 499

Dextromethorphan, Codeine

Front 500

These agents are used as antidiarrheal

Back 500

Diphenoxylate, Loperamide

Front 501

Inhalant anesthetics

Back 501

NO, chloroform, and diethyl ether

Front 502

Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation

Back 502

Fluorocarbons and Industrial solvents

Front 503

Cause dizziness, tachycardia, hypotension, and flushing

Back 503

Organic nitrites

Front 504

Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression

Back 504

Steroids

Front 505

Readily detected markers that may assist in diagnosis of the cause of a drug overdose include

Back 505

Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses

Front 506

Most commonly abused in health care professionals

Back 506

Heroin, morphine, oxycodone, meperidine and fentanyl

Front 507

This route is associated with rapid tolerance and psychologic dependence

Back 507

IV administration

Front 508

Leads to respiratory depression progressing to coma and death

Back 508

Overdose of opioids

Front 509

Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome

Back 509

Abstinence syndrome

Front 510

Treatment for opioid addiction

Back 510

Methadone, followed by slow dose reduction

Front 511

This agent may cause more severe, rapid and intense symptoms to a recovering addict

Back 511

Naloxone

Front 512

Sedative-Hypnotics action

Back 512

Reduce inhibition, suppress anxiety, and produce relaxation

Front 513

Additive effects when Sedative-Hypnotics used in combination with these agents

Back 513

CNS depressants

Front 514

Common mechanism by which overdose result in death

Back 514

Depression of medullary and cardiovascular centers

Front 515

"Date rape drug"

Back 515

Flunitrazepam (rohypnol)

Front 516

The most important sign of withdrawal syndrome

Back 516

Excessive CNS stimulation (seizures)

Front 517

Treatment of withdrawal syndrome involves

Back 517

Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol

Front 518

These agents are CNS depressants

Back 518

Ethanol, Barbiturates, and Benzodiazepines

Front 519

Withdrawal from this drug causes lethargy, irritability, and headache

Back 519

Caffeine

Front 520

W/D from this drug causes anxiety and mental discomfort

Back 520

Nicotine

Front 521

Treatments available for nicotine addiction

Back 521

Patches, gum, nasal spray, psychotherapy, and bupropion

Front 522

Chronic high dose abuse of nicotine leads to

Back 522

Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures

Front 523

Tolerance is marked and abstinence syndrome occurs

Back 523

Amphetamines

Front 524

Amphetamine agents

Back 524

Dextroamphetamines and methamphetamine

Front 525

These agents are congeners of Amphetamine

Back 525

DOM, STP, MDA, and MDMA "ecstasy"

Front 526

Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)

Back 526

Cocaine "super-speed"

Front 527

Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic

Back 527

PCP

Front 528

Removal of PCP may be aided

Back 528

Urinary acidification and activated charcoal or continual nasogastric suction

Front 529

THC is active ingredient, SE's include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur

Back 529

Marijuana

Front 530

This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention

Back 530

Bethanechol

Front 531

Only direct acting agent that is very lipid soluble and used in glaucoma

Back 531

Pilocarpine

Front 532

This agent used to treat dry mouth in Sjögren's syndrome

Back 532

Cevimeline

Front 533

Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis

Back 533

Edrophonium

Front 534

Carbamate with intermediate action postoperative and neurogenic ileus and urinary retention

Back 534

Neostigmine

Front 535

Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions

Back 535

Physostigmine

Front 536

Treatment of myasthenia gravis

Back 536

Pyridostigmine

Front 537

Antiglaucoma organophosphate

Back 537

Echothiophate

Front 538

Associated with an increased incidence of cataracts in patients treated for glaucoma

Back 538

Long acting cholinesterase inhibitors

Front 539

Scabicide organophosphate

Back 539

Malathion

Front 540

Organophosphate anthelmintic agent with long DOA

Back 540

Metrifonate

Front 541

Toxicity of organophosphate:

Back 541

DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)

Front 542

The most important cause of acute deaths in cholinesterase inhibitor toxicity

Back 542

Respiratory failure

Front 543

The most toxic organophosphate

Back 543

Parathion

Front 544

Treatment of choice for organophosphate overdose

Back 544

Atropine

Front 545

This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure

Back 545

Pralidoxime

Front 546

Prototypical drug is atropine

Back 546

Nonselective Muscarinic Antagonists

Front 547

Treat manifestations of Parkinson's disease and EPS

Back 547

Benztropine, trihexyphenidyl

Front 548

Treatment of motion sickness

Back 548

Scopolamine

Front 549

Produce mydriasis and cycloplegia

Back 549

Atropine, homatropine tropicamide

Front 550

Bronchodilation in asthma and COPD

Back 550

Ipratropium

Front 551

Reduce transient hyper GI motility

Back 551

Dicyclomine, methscopolamine

Front 552

Cystitis, postoperative bladder spasms, or incontinence

Back 552

Oxybutynin, dicyclomine

Front 553

Toxicity of anticholinergics

Back 553

block SLUD (salivation, lacrimation, urination, defecation

Front 554

Another pneumonic for anticholinergic toxicity

Back 554

"dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat"

Front 555

Atropine fever is the most dangerous effect and can be lethal in this population group

Back 555

Infants

Front 556

Contraindications to use of atropine

Back 556

Infants, closed angle glaucoma, prostatic hypertrophy

Front 557

Prototype ganglion blocker

Back 557

Hexamethonium

Front 558

Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate

Back 558

Severe hypertension

Front 559

Reversal of blockade by neuromuscular blockers

Back 559

Cholinesterase inhibitors

Front 560

Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis

Back 560

Nondepolarizing Neuromuscular Blockers

Front 561

Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use

Back 561

Succinylcholine

Front 562

Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred)

Back 562

Cholinesterase Regenerators

Front 563

Used to treat patients exposed to insecticides such as parathion

Back 563

Pralidoxime

Front 564

Pneumonic for beta receptors

Back 564

You have 1 heart (Beta 1) and 2 lungs (Beta 2)

Front 565

This is the drug of choice for anaphylactic shock

Back 565

Epinephrine

Front 566

Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction

Back 566

Amphetamines

Front 567

Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia

Back 567

Phenylephrine

Front 568

Epinephrine and dipivefrin are used for

Back 568

Glaucoma

Front 569

Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma

Back 569

Reduce aqueous synthesis

Front 570

Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis

Back 570

Albuterol

Front 571

Longer acting Beta 2 agonists is recommended for prophylaxis of asthma

Back 571

Salmeterol

Front 572

These agents increase blood flow and may be beneficial in treatment of acute heart failure and some types of shock

Back 572

Beta1 agonists

Front 573

These agents decrease blood flow or increase blood pressure, are local decongestant, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion

Back 573

Alpha1 agonists

Front 574

Shock due to septicemia or myocardial infarction is made worse by

Back 574

Increasing afterload and tissue perfusion declines

Front 575

Often mixed with local anesthetic to

Back 575

Reduce the loss from area of injection

Front 576

Chronic orthostatic hypotension can be treated with

Back 576

Midodrine

Front 577

Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus

Back 577

Terbutaline

Front 578

Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis

Back 578

Ephedrine

Front 579

Alpha 1 agonist toxicity

Back 579

Hypertension

Front 580

Beta 1 agonist toxicity

Back 580

Sinus tachycardia and serious arrhythmias

Front 581

Beta 2 agonist toxicity

Back 581

Skeletal muscle tremor

Front 582

The selective agents loose their selectivity at

Back 582

high doses

Front 583

Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis

Back 583

Phenoxybenzamine

Front 584

Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud's phenomena

Back 584

Phentolamine

Front 585

Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension

Back 585

Prazosin, terazosin, doxazosin

Front 586

Selective Alpha 2 blocker used for impotence (controversial effectiveness)

Back 586

Yohimbine

Front 587

SelectiveB1 Receptor blockers that may be useful in treating patients with asthma

Back 587

Acebutolol, atenolol, esmolol, metoprolol

Front 588

Combined alpha and beta blocking agents that may have application in treatment of CHF

Back 588

Labetalol and carvedilol

Front 589

Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma

Back 589

Pindolol and acebutolol

Front 590

This beta blocker lacks local anesthetic activity (decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma

Back 590

Timolol

Front 591

This parenteral beta blocker is a short acting

Back 591

Esmolol

Front 592

This beta blocker is the longest acting

Back 592

Nadolol

Front 593

These beta blockers are less lipid soluble

Back 593

Acebutolol and atenolol

Front 594

This beta blocker is highly lipid soluble and may account for side effects such as nightmares

Back 594

Propranolol

Front 595

Clinical uses of these agents include treatment of HTN, angina, arrhythmias, and chronic CHF

Back 595

Beta blockers

Front 596

Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF, signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)

Back 596

Beta blockers

Front 597

Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction

Back 597

Pilocarpine, carbachol, physostigmine

Front 598

Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins

Back 598

Epinephrine, dipivefrin

Front 599

Selective alpha agonists that decreases aqueous secretion

Back 599

Apraclonidine, brimonidine

Front 600

These Beta blockers decrease aqueous secretion

Back 600

Timolol (nonselective), betaxolol (selective)

Front 601

This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis

Back 601

Acetazolamide

Front 602

This agent cause increased aqueous outflow

Back 602

Prostaglandin PGF2a

Front 603

Inhibit angiotensin-converting enzyme (ACE)

Back 603

Ace inhibitors

Front 604

Captopril and enalapril (-OPRIL ending) are

Back 604

Ace inhibitors

Front 605

SE of ACE inhibitors

Back 605

Dry cough, hyperkalemia

Front 606

Ace inhibitors are contraindicated in

Back 606

pregnancy and with K+

Front 607

Losartan and valsartan block

Back 607

Angiotensin receptor

Front 608

Angiotensin receptor blockers do NOT cause

Back 608

Dry cough

Front 609

Block L-type calcium channel

Back 609

Calcium channel blockers

Front 610

CCB contraindicated in CHF

Back 610

Verapamil

Front 611

CCB with predominate effect on arteriole dilation

Back 611

Nifedipine

Front 612

SE of CCB

Back 612

Constipation, edema, and headache

Front 613

Reduce heart rate, contractility, and O2 demand

Back 613

Beta-blockers

Front 614

B-blockers that are more cardioselective

Back 614

Beta C2001-selective blockers

Front 615

Cardioselective Beta 1-blockers

Back 615

Atenolol, acebutolol, and metoprolol

Front 616

Beta-blockers should be used cautiously in

Back 616

Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease

Front 617

Non-selective Beta-blocker also used for migraine prophylaxis

Back 617

Propranolol

Front 618

SE of beta blockers

Back 618

Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)

Front 619

Alpha 1selective blockers

Back 619

Prazosin, terazosin and doxazosin (-AZOSIN ending)

Front 620

Non-selective Alpha1blockers use to treat pheochromocytoma

Back 620

Phenoxybenzamine

Front 621

For rebound HTN from rapid clonidine withdrawal

Back 621

Phentolamine

Front 622

A1a-selective blocker used for BPH

Back 622

Tamsulosin (Flomax)

Front 623

SE of alpha blockers

Back 623

Orthostatic hypotension (especially with first dose) and reflex tachycardia

Front 624

Presynaptic Alpha 2 agonist used in HTN

Back 624

Clonidine, and methyldopa

Front 625

SE of methyldopa

Back 625

Positive Comb's test, depression

Front 626

Methyldopa is contraindicated in

Back 626

Geriatrics due to its CNS (depression) effects

Front 627

SE of clonidine

Back 627

Rebound HTN, sedation, dry mouth

Front 628

Ganglionic blockers formerly used in HTN

Back 628

Trimethaphan, and hexamethonium

Front 629

Direct vasodilator of arteriolar smooth muscle

Back 629

Hydralazine

Front 630

SE of hydralazine

Back 630

Lupus-like syndrome

Front 631

Arterial vasodilator that works by opening K+ channels

Back 631

Minoxidil

Front 632

SE of minoxidil

Back 632

Hypertrichosis

Front 633

IV Drug used Hypertensive Crisis

Back 633

Nitroprusside

Front 634

Nitroprusside vasodilates

Back 634

Arteries and veins

Front 635

Toxicity caused by nitroprusside and treatment

Back 635

Cyanide toxicity treated with sodium thiosulfate

Front 636

Carbonic anhydrase inhibitor

Back 636

Acetazolamide

Front 637

Diuretic used for mountain sickness and glaucoma

Back 637

Acetazolamide

Front 638

SE of acetazolamide

Back 638

Paresthesias, alkalization of the urine (which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment

Front 639

MOA of loop diuretics

Back 639

inhibits Na+/K+/2Cl- cotransport

Front 640

Site of action of loop diuretics

Back 640

Thick ascending limb

Front 641

SE of loop (furosemide) diuretics

Back 641

Hyperuricemia, hypokalemia and ototoxicity

Front 642

Aminoglycosides used with loop diuretics potentiate adverse effect

Back 642

Ototoxicity

Front 643

Loops lose and thiazide diuretics retain

Back 643

Calcium

Front 644

MOA of thiazide diuretics

Back 644

Inhibit Na+/Cl- cotransport

Front 645

Site of action of thiazide diuretics

Back 645

Work at early distal convoluted tubule

Front 646

Class of drugs that may cause cross-sensitivity with thiazide diuretics

Back 646

Sulfonamides

Front 647

SE of thiazide (HCTZ) diuretics

Back 647

Hyperuricemia, hypokalemia and hyperglycemia

Front 648

Potassium sparing diuretics inhibit

Back 648

Na+/K+ exchange

Front 649

Diuretic used to treat primary aldosteronism

Back 649

Spironolactone

Front 650

SE of spironolactone

Back 650

Gynecomastia hyperkalemia, and impotence

Front 651

Osmotic diuretic used for increased intracranial pressure

Back 651

Mannitol

Front 652

ADH agonist used for pituitary diabetes insipidus

Back 652

Desmopressin (DDAVP)

Front 653

Used for SIADH

Back 653

Demeclocycline

Front 654

SE of demeclocycline

Back 654

Bone marrow and teeth discoloration for children under 8 years of age

Front 655

MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics

Back 655

Sodium channel blockers

Front 656

SE of procainamide

Back 656

Lupus-like syndrome

Front 657

Limiting side effect of Quinidine

Back 657

Prolongs QT interval

Front 658

Other side effects of Quinidine

Back 658

Thrombocytopenic purpura, and CINCHONISM

Front 659

Major drug interaction with Quinidine

Back 659

Increases concentration of Digoxin

Front 660

DOC for management of acute Ventricular arrhythmias

Back 660

Lidocaine

Front 661

DOC for digoxin induced arrhythmias

Back 661

Phenytoin

Front 662

SE of phenytoin

Back 662

Gingival hyperplasia

Front 663

Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents

Back 663

Class IC (flecainide, propafenone, moricizine)

Front 664

Class II antiarrhythmics are

Back 664

B-blockers

Front 665

Antiarrhythmic that exhibits Class II and III properties

Back 665

Sotalol

Front 666

Side effect of sotalol

Back 666

prolongs QT and PR interval

Front 667

Used intravenously for acute arrhythmias during surgery

Back 667

Esmolol

Front 668

Anti-arrhythmics that decrease mortality

Back 668

B-blockers

Front 669

MOA of class III antiarrhythmics

Back 669

Potassium channel blockers

Front 670

Class III antiarrhythmic that exhibits properties of all 4 classes

Back 670

Amiodarone

Front 671

Specific pharmacokinetic characteristic of amiodarone

Back 671

Prolonged half-life, up to six weeks

Front 672

Antiarrhythmic effective in most types of arrhythmia

Back 672

Amiodarone

Front 673

SE of Amiodarone

Back 673

Dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits

Front 674

MOA of class IV antiarrhythmics

Back 674

Calcium channel blockers

Front 675

Life threatening cardiac event that prolong QT leads to

Back 675

Torsades de pointes

Front 676

Agent to treat torsades de pointes

Back 676

Magnesium sulfate

Front 677

Drug used supraventricular arrhythmias

Back 677

Digoxin

Front 678

DOC for paroxysmal supraventricular tachycardia (PSVT)

Back 678

Adenosine

Front 679

Adenosine's MOA

Back 679

Activates acetylcholine sensitive K+ channels in SA and AV node

Front 680

Anti-arrhythmic with 15 second duration of action

Back 680

Adenosine

Front 681

MOA of sildenafil (Viagra)

Back 681

Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP

Front 682

Drugs used in the management of angina

Back 682

Aspirin, Nitrates, CCB, and Beta blockers

Front 683

Aspirin reduces mortality in unstable angina by

Back 683

Platelet aggregation inhibition

Front 684

MOA of nitrates

Back 684

Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles

Front 685

Nitrate used for acute anginal attacks

Back 685

Nitroglycerin sublingual tablets

Front 686

Nitrate used to prevent further attacks

Back 686

Oral and transdermal forms of nitroglycerin

Front 687

Nitrate free intervals are needed due to

Back 687

Tolerance

Front 688

SE of nitrates

Back 688

Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation

Front 689

CCB are DOC for

Back 689

Prinzmetal's angina

Front 690

Beta blockers are used for which type of anginal attack

Back 690

Classic

Front 691

MOA of Cardiac glycosides (eg. digoxin)

Back 691

Indirectly increase intracellular calcium and cardiac contractility by inhibit Na+/K+ ATPase

Front 692

Digoxin is used in

Back 692

Atrial fibrillation and CHF

Front 693

Digoxin toxicity can be precipitated by

Back 693

Hypokalemia

Front 694

Antidote for digoxin toxicity

Back 694

Digibind

Front 695

Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects

Back 695

Amrinone and milrinone

Front 696

SE of amrinone

Back 696

Thrombocytopenia

Front 697

Beta 1 agonists used in acute CHF

Back 697

Dobutamine and dopamine

Front 698

Diuretics work in CHF by

Back 698

Reducing preload

Front 699

Beta blockers work in CHF by

Back 699

Reducing progression of heart failure (never use in acute heart failure)

Front 700

Agent used in CHF that is a selective alpha and nonselective beta blocker

Back 700

Carvedilol

Front 701

Agent used in acutely decompensated CHF resembling natriuretic peptide

Back 701

Nesiritide (Natrecor)

Front 702

Vitamin K dependent anticoagulant

Back 702

Warfarin (PT)

Front 703

Warfarin is contraindicated in

Back 703

Pregnancy

Front 704

Anticoagulant of choice in pregnancy

Back 704

Heparin

Front 705

Heparin (PTT) increases activity of

Back 705

Antithrombin 3

Front 706

Route of administration of warfarin

Back 706

Oral

Front 707

Routes of administration of heparin

Back 707

IM (only LMW) and IV

Front 708

SE of both warfarin and heparin

Back 708

Bleeding

Front 709

SE of heparin

Back 709

Heparin induced thrombocytopenia (HIT)

Front 710

Alternative anticoagulant used if HIT develops

Back 710

Lepirudin

Front 711

Antidote to reverse actions of warfarin

Back 711

Vitamin K or fresh frozen plasma

Front 712

Antidote to reverse actions of heparin

Back 712

Protamine sulfate

Front 713

MOA of aspirin

Back 713

Irreversibly blocking cyclooxygenase

Front 714

Agent used to treat MI and to reduce incidence of subsequent MI

Back 714

Aspirin

Front 715

SE of Aspirin

Back 715

GI bleeding

Front 716

Antiplatelet drug reserved for patients allergic to aspirin

Back 716

Ticlopidine

Front 717

SE for ticlopidine

Back 717

Neutropenia and agranulocytosis

Front 718

Effective in preventing TIA's

Back 718

Clopidogrel and ticlopidine

Front 719

Prevents thrombosis in patients with artificial heart valve

Back 719

Dipyridamole

Front 720

Block glycoprotein IIb/IIIa involved in platelet cross-linking

Back 720

Abciximab, tirofiban and eptifibatide

Front 721

MOA of thrombolytics

Back 721

Degradation of fibrin clots and are administered

Front 722

Thrombolytics are used for

Back 722

Pulmonary embolism and DVT

Front 723

Thrombolytic that can cause allergic reaction

Back 723

Streptokinase

Front 724

Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA

Back 724

Tissue plasmin activator

Front 725

SE of tPA

Back 725

Cerebral hemorrhage

Front 726

Antidote for thrombolytics

Back 726

Aminocaproic acid

Front 727

Agent to treat hypochromic microcytic anemias

Back 727

Ferrous sulfate

Front 728

Chelating agent used in acute iron toxicity

Back 728

Deferoxamine

Front 729

Agent for pernicious anemia

Back 729

Cyanocobalamin (Vit B12)

Front 730

Agent used for neurological deficits in megaloblastic anemia

Back 730

Vitamin B12

Front 731

Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy

Back 731

Folic acid

Front 732

Agent used for anemias associated with renal failure

Back 732

Erythropoietin

Front 733

Agent used neutropenia especially after chemotherapy

Back 733

G-CSF (filgrastim) and GM-CSF (sargramostim)

Front 734

Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy

Back 734

Interleukin 11 (oprelvekin)

Front 735

Decrease intestinal absorption of cholesterol

Back 735

Bile acid-binding resins

Front 736

Cholestyramine and colestipol are

Back 736

Bile acid-binding resins

Front 737

Major nutritional side effect of bile acid-binding resins

Back 737

Impair absorption of fat soluble vitamin absorption (A,D,E,K)

Front 738

MOA of lovastatin (STATIN)

Back 738

inhibits HMG COA reductase

Front 739

HMG CoA reductase inhibitors are contraindicated in

Back 739

Pregnancy

Front 740

Drug or foods (grapefruit juice) that increase statin effect

Back 740

Inhibit Cytochrome P450 3A4

Front 741

SE of HMG COA reductase inhibitors

Back 741

Rhabdomyolysis and Hepatotoxicity

Front 742

Monitoring parameter to obtain before initiation of STATINS

Back 742

LFT's

Front 743

Decreases liver triglycerol synthesis

Back 743

Niacin

Front 744

SE of niacin

Back 744

Cutaneous flush

Front 745

Cutaneous flush and be reduced by pretreatment with

Back 745

Aspirin

Front 746

Fibrates (gemfibrozil) increase activity of

Back 746

Lipoprotein lipase

Front 747

Most common SE of fibrates

Back 747

Nausea

Front 748

Fibrates are contraindicated in

Back 748

Pregnancy

Front 749

Concurrent use of fibrates and statins increases risk of

Back 749

Rhabdomyolysis

Front 750

New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins

Back 750

Ezetimibe (Zetia)

Front 751

MOA of NSAIDS

Back 751

inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)

Front 752

Difference between aspirin and other NSAIDS

Back 752

Aspirin irreversibly inhibits cyclooxygenase

Front 753

Four main actions of NSAIDS

Back 753

Anti-inflammatory, analgesia, antipyretic and antiplatelet activity

Front 754

Agent used for closure of patent ductus arteriosus

Back 754

Indomethacin

Front 755

Aspirin is contraindicated in children with viral infection

Back 755

Potential for development of Reye's syndrome

Front 756

SE of salicylates

Back 756

Tinnitus, GI bleeding

Front 757

NSAID also available as an ophthalmic preparation

Back 757

Diclofenac

Front 758

NSAID available orally, IM and ophthalmically

Back 758

Ketoralac

Front 759

NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity

Back 759

Ketoralac

Front 760

Newer NSAIDs that selectively inhibit COX-2

Back 760

Celecoxib and rofecoxib

Front 761

COX 2 inhibitors may have reduced risk of

Back 761

Gastric ulcers and GI Bleeding

Front 762

COX 2 inhibitors should be used cautiously in pts with

Back 762

Pre-existing cardiac or renal disease

Front 763

Acetaminophen only has

Back 763

Antipyretic and analgesic activity

Front 764

SE of acetaminophen

Back 764

Hepatotoxicity

Front 765

Antidote for acetaminophen toxicity

Back 765

N-acetylcysteine

Front 766

DMARDs are slow acting drugs for

Back 766

Rheumatic disease

Front 767

MOA of gold salts

Back 767

Alter activity of macrophages and suppress phagocytic activity of PMNs

Front 768

SE of gold salts

Back 768

Dermatitis of the mouth aplastic anemia and agranulocytosis

Front 769

Causes bone marrow suppression

Back 769

Methotrexate

Front 770

SE of penicillamine

Back 770

Aplastic anemia and renal

Front 771

Interferes with activity of T-lymphocytes

Back 771

Hydroxychloroquine

Front 772

Anti-malarial drug used in rheumatoid arthritis (RA)

Back 772

Hydroxychloroquine

Front 773

SE of hydroxychloroquine

Back 773

Retinal destruction and dermatitis

Front 774

MOA of Leflunomide (newer agent)

Back 774

Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis

Front 775

Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)

Back 775

Infliximab and etanercept

Front 776

Anti-rheumatic agent also used for ulcerative colitis

Back 776

Sulfasalazine

Front 777

NSAIDS used in gout

Back 777

Indomethacin and phenylbutazone

Front 778

NSAID contraindicated in gout

Back 778

Aspirin

Front 779

SE of phenylbutazone

Back 779

Aplastic anemia and agranulocytosis

Front 780

MOA of Colchicine (used in acute gout)

Back 780

Selective inhibitor of microtubule assembly

Front 781

SE of colchicine

Back 781

Kidney and liver toxicity

Front 782

Agent used to treat chronic gout by increasing uric acid secretion

Back 782

Probenecid and sulfinpyrazone

Front 783

Allopurinol treats chronic gout by inhibiting

Back 783

Xanthine oxidase