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248 Cards in this Set

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LDL: Friedwald equation
LDL = TC - [HDL +(TG/5)].....not valid if TG > 400
2ary hyperlipidemia: endocrine causes
diabetes mellitus, hypothyroidism
2ary hyperlipidemia: drug induced
HIV protease inhibitors
2ary hyperlipidemia: renal
nephrotic syndrome
2ary hyperlipidemia: hepatic
cholestatic liver disease
cholestyramine: class
bile acid sequestrant
cholestyramine: mechanism
bind bile acids
cholestyramine: dosing
given with meals
cholestyramine: side effects
GI, absorption of other drugs
cholestyramine: indications
kids; moderate LDL 2nd line; combo therapy for bad LDL
cholestyramine: interactions
bind other drugs
cholestyramine: effect on total cholesterol
decrese
cholestyramine: effect on LDL
decrease
cholestyramine: effect on HDL
increase
cholestyramine: effect on serum triglycerides
no effect
colestipol: class
bile acid sequestrant
colestipol: mechanism
bind bile acids
colestipol: dosing
given with meals
colestipol: side effects
GI, absorption of other drugs
colestipol: indications
kids; moderate LDL 2nd line; combo therapy for bad LDL
colestipol: interactions
bind other drugs
colestipol: effect on LDL
decrease
colestipol: effect on HDL
increase
colestipol: effect on serum triglycerides
no effect
bile acid sequestrants: mechanism
bind bile acids
bile acid sequestrants: 1st line which pts
children
bile acid sequestrants: dosing
given with meals
bile acid sequestrants: side effects
GI, absorption of other drugs
bile acid sequestrants: indications
kids; moderate LDL 2nd line; combo therapy for bad LDL
bile acid sequestrants: interactions
bind other drugs
bile acid sequestrants: effect on LDL
decrease
bile acid sequestrants: effect on HDL
increase
bile acid sequestrants: effect on serum triglycerides
no effect
ezetimibe: class
cholesterol absorption inhibitors
ezetimibe: mechanism
inhibit cholesterol absorption at brush border of small intestine
ezetimibe: indications
adjunct to statins
ezetimibe: pharmacokinetics
prodrug absorbed and converted to active glucuronide and excreted into gut where it is active
ezetimibe: interactions
bound by bile acid resins
ezetimibe: effect on LDL
decrease (biggest effect)
ezetimibe: effect on HDL
no effect
ezetimibe: effect on serum triglycerides
decrease
ezetimibe: predominiant serum lipid effect
decrease LDL
cholesterol absorption inhibitors: mechanism
inhibit cholesterol absorption at brush border of small intestine
cholesterol absorption inhibitors: indications
adjunct to statins
cholesterol absorption inhibitors: interactions
bound by bile acid resins
cholesterol absorption inhibitors: effect on LDL
decrease (biggest effect)
cholesterol absorption inhibitors: effect on HDL
no effect
cholesterol absorption inhibitors: effect on serum triglycerides
decrease
cholesterol absorption inhibitors: predominiant serum lipid effect
decrease LDL
gemfibrozil: class
fibric acid derivative
gemfibrozil: mechanism
PPAR receptor agonist, induce TG metabolism and clearance
gemfibrozil: indications
high triglyceride hyperlipidemia
gemfibrozil: interactions
statins and gemfibrozil--risk of skeletal muscle dysfunx
gemfibrozil: effect on total cholesterol
decrease
gemfibrozil: effect on LDL
decrease (usually)
gemfibrozil: effect on HDL
increase
gemfibrozil: effect on serum triglycerides
decrease
gemfibrozil: predominiant serum lipid effect
reduce triglyceride containing lipoproteins
fibric acid derivatives: mechanism
PPAR receptor agonist, induce TG metabolism and clearance
fibric acid derivatives: indications
high triglyceride hyperlipidemia
fibric acid derivatives: effect on total cholesterol
decrease
fibric acid derivatives: effect on LDL
decrease (usually)
fibric acid derivatives: effect on HDL
increase
fibric acid derivatives: effect on serum triglycerides
decrease
fibric acid derivatives: predominiant serum lipid effect
reduce triglyceride containing lipoproteins
Statins: mechanism
competitive inhibition of HMG CoA reductase; upregulation of LDL receptors; decreased de novo cholesterol and VLDL
Statins: 1st line which pts
hypercholesterolemia w/ increased LDL
Statins: excretion
metabolized by liver and excreted in bile
Statins: metabolism
metabolized in liver, big 1st pass effect
Statins: adverse effx
skeletal muscle dysfnx--risk increased with gemfibrozil or CYP 3A inhibitors
lovastatin: class
statin
lovastatin: mechanism
competitive inhibition of HMG CoA reductase; upregulation of LDL receptors; decreased de novo cholesterol and VLDL
lovastatin: dosing
given with food to enhance absorption
lovastatin: excretion
metabolized by liver and excreted in bile
lovastatin: metabolism
metabolized in liver, big 1st pass effect
HMG CoA reductase: fnx
regulatory enzyme in cholesterol biosynthesis
Niacin: chemistry
nicotinic acid
Niacin: mechanism
complex: affects synthesis and metabolism of cholesterol and triglycerides
Niacin: adverse effx
flushing from PGD2 release (aspirin alleviates)
niaspan: class
controlled release niacin
niaspan: 1st line which pts
familial hyperlipidemia w/ inc VLDL and LDL, and in hyperlipoprotenemias with elevated VLDL
Strychnine : class
analeptic/conglusant
Strychnine : mechanism
inhibits GABA in CNS
Strychnine : adverse effx
tonic extensino of body and limbs
Strychnine : tx of poisoning
diazepam
picrotoxin: class
analeptic/conglusant
picrotoxin: mechanism
inhibits Glycine in spine
picrotoxin: adverse effx
generalized tonic clonic
picrotoxin: tx of poisoning
diazepam
caffeine: class
methylxanthines stimulatant
caffeine: mechanism
action at adenosine receptors (A1 and A2)
theophylline: class
methylxanthines stimulatant
theophylline: mechanism
action at adenosine receptors (A1 and A2)
theobromine: class
methylxanthines stimulatant
theobromine: mechanism
action at adenosine receptors (A1 and A2)
amphetamine: mechanism
promotes release of NE and DA; inhibits reuptake
amphetamine: indications
narcolepsy, ADD, weight loss
amphetamine: route
oral
amphetamine: time to peak plasma conc
1 to 3 hours
amphetamine: urine pH and clearance
high pH, metabolic; low pH, urine
cocaine: mechanism
blocks reuptake of NE, DA, and 5HT
cocaine: half life
~ half hour
cocaine: Spanish
la cocaína
cocaine: French
la cocaïne
cocaine: Arabic
الكوكائين
cocaine: Chinese
可卡因(kěkǎyīn)
nonamphetimine: narcolepsy
modafinil
nonamphetimine: ADD
methylphenidate
nonamphetimine: weight loss
fenfluaramine, phentermine
ergot compounds (LSD): class
indolalkylamine, chemically related to 5HT
indolamines: class
indolalkylamine, chemically related to 5HT
beta carboines: class
indolalkylamine, chemically related to 5HT
mescaline: class
phenylethylamine, chemically related to dopamine
amphetamine derivatives: class
phenylethylamine, chemically related to dopamine
LSD: half life
3 hours
psylocybin: class
indolalkylamine resembling serotonin. Tryptamine derivative
hallucinagens: mechanism
agonists of 5HT(2A) subtype
hallucinagens: tolerance
yup
hallucinagens: physical dependence
nope
Phencyclidine : mechanism
blocks NMDA receptors (subset of glutamate receptors)
benzodiazepine: mechanism
enhance GABA-ergic transmission, self limiting effect
benzodiazepine: side effects
decreased alertness, ataxia (problem for elderly, hp fx)
benzodiazepine: tolerance
yeah
benzodiazepine: physical dependence
yeah
benzodiazepine: effect on dose resonse curve of GABA
increased potency, unaffected efficacy
benzodiazepine: antidote
Flumazenil
diazepam: class
benzodiazepine
diazepam: trade name
valium
chordiazepoxide: class
benzodiazepine
chordiazepoxide: trade name
librium
lorazepam: class
benzodiazepine
lorazepam: excretion
glucoronidation
lorazepam: trade name
ativan
lorazepam: duration
short
midazolam: class
benzodiazepine
midazolam: excretion
hydroxylation and glucoronidation
midazolam: trade name
versed
midazolam: duration
short

(diazapine)
buspirone: mechanism
erotonergic agonists acting at the 5HT1A
buspirone: clinical effect
anti anxiety
Zolpidem : clinical effect
sleep aid
ethanol: cytochrome intx
augments metabolism of CYP 450
methanol: antidote
4-methylpyrazole, and ethanol
methanol: toxicity
anion gap acidosis, blindness
ethelyne glycol: toxicity
oxalate crystals in urine, anion gap acidosis
delirium tremens: tx
diazepine, (watch out diazepam if liver disease)
Chlorpromazine : class
phenothiazine and related antipsychotic
reserpine: class
rauwolfia alkaloids antipsycotic
reserpine: mechanism
blockade of D2 receptors
neuroleptics: effect at reticular activating system
depression
neuroleptics: effect at mesolimbic dopamine system
reduction in psychosis
neuroleptics: effect at mesocortical system
increased negative sx of schizo
neuroleptics: effect at nigrostriatal system
parkinsonian like sx
neuroleptics: effect at hypothalamus
poikilothermia, increase prolactin
neuroleptics: time till effect
3-6 weeks
neuroleptics: neuroleptic malignant syndrome characteristics
muscular rigidity; fever; elevated CPK
haloperidol: class
depot antipsychotic
risperidone microspheres: class
depot antipsychotic
depot antipsychotic: advantages
compliance not problem
depot antipsychotic: disadvantages
increased risk of side effx
neuroleptic malignant sydrome: tx
datrolene, fever reduction, keep 'em alive
typical antipsychotics: protein binding
highly protein bound
typical antipsychotics: protein binding
0.9
clozapine: class
atypical antipsychotic
clozapine: mechanism
blockade of 5HT2a/2c, which stimulates dopamine release in mesolimbic area
clozapine: side effects
agranulocytosis
Risperidone : class
atypical antipsychotic
Risperidone : mechanism
Mixed D2 - 5HT2a effects (most prominent D2 of atypical class)
Olanzapine : class
atypical antipsychotic
Olanzapine : mechanism
Receptor binding affinity almost identical to clozapine (5HT2a, weak D2)
Aripiprazole : class
atypical antipsychotic
Aripiprazole : mechanism
D2 partial agonist
phenelzine : class
Hydrazines MAO inhibitor
phenelzine : side effects
hypotension, antisymp sx; tyramine induced hypertension
tranylcypromine : class
nonhydrazine MAO inhibitor
tranylcypromine : side effects
hypotension, antisymp sx; tyramine induced hypertension
MAO inhibitor: side effects
hypotension, antisymp sx; tyramine induced hypertension; fat, can't fuck
MAO inhibitor: indications
depresssion and anxiety disorders
MAO inhibitor: interactions
central serotonin syndrome, central symp sydrome, reduced metabolism some drugs
MAO inhibitor: inhibit metabolism of what drugs
pseudoephedrine, phenylpropanolamine; meperidine
amitryptyline: class
tricyclic
amitryptyline: mechanism
block monoamine reuptake
amitryptyline: side effects
cholinergic blockade; a1 receptor inhibition (orthostatic hypo); histamine blockade (drowsy, weight gain), extra symp (cant fuck
amitryptyline: indications
depresssion and anxiety disorders
nefadazone: class
heterocyclic
nefadazone: mechanism
block monoamine reuptake
nefadazone: side effects
cholinergic blockade; a1 receptor inhibition (orthostatic hypo); histamine blockade (drowsy, weight gain), extra symp (cant fuck
nefadazone: indications
depresssion and anxiety disorders
nefadazone: cytochrome metabolism
CYP P450 3A4 (cyclosporine)
fluoxetine: class
SSRI
fluoxetine: mechanism
block serotonin reuptake
fluoxetine: side effects
cholinergic blockade; a1 receptor inhibition (orthostatic hypo); histamine blockade (drowsy, weight gain), extra symp (cant fuck
fluoxetine: indications
OCD, depression

(SSRI)
fluoxetine: cytochrome metabolism
CYP P450, competitively inhibit (inc beta blockers)
sertaline: class
SSRI
sertaline: mechanism
block serotonin reuptake
sertaline: side effects
cholinergic blockade; a1 receptor inhibition (orthostatic hypo); histamine blockade (drowsy, weight gain), extra symp (cant fuck
sertaline: indications
depression, panic
sertaline: cytochrome metabolism
CYP P450, competitively inhibit (inc beta blockers)
paroxetine: class
SSRI
paroxetine: mechanism
block serotonin reuptake
paroxetine: side effects
cholinergic blockade; a1 receptor inhibition (orthostatic hypo); histamine blockade (drowsy, weight gain), extra symp (cant fuck
paroxetine: indications
OCD
paroxetine: cytochrome metabolism
CYP P450, competitively inhibit (inc beta blockers)
tricyclic & related with dopamine blockade: side effects
more psychosis
tricyclics: heart side efx
Ia antiarrhythmics, AV block
SSRIs: cytochrome metabolism
CYP P450, competitively inhibit (inc beta blockers)
Lithium: class
mood stabalizer
Lithium: mechanism
inhibit Gs proteins and antagonize phospholipase C (probably)
Lithium: side effects
hypothyroidism (weight gain); polydypsia, interstitial nephritis; heart conduction problems; birth defects
Lithium: indications
typical bipolar I
Lithium: interactions
diuretics decrease clearance; NSAIDS increase plasma level (not aspoirin); neuromuscular drugs potentiated
Lithium: contraindx
sick sinus synd; pregnancy
Lithium: alternatives in biopolar (3 from lecture)
Carbamazepine; divalproex; olanzapine
carbamazepine: class
mood stabalizer
carbamazepine: mechanism
inhibit Gs proteins and antagonize phospholipase C (probably)
divalproex: chemistry
valproic acid
divalproex: class
mood stabalizer
divalproex: mechanism
inhibit Gs proteins and antagonize phospholipase C (probably)
divalproex: indications
bipolar i and ii
Olanzapine : class
mood stabalizer
Olanzapine : intracellular mechanism
inhibit Gs proteins and antagonize phospholipase C (probably)
fast pain: fiber type
A delta (myelinated)
slow pain: fiber type
C (unmyelinated)
hyperalgesia/allodynia: involved nerurecepter type in dorsal horn neurons
substance P receptor (NMDA(
analgesia: involved nerurecepter type in dorsal horn neurons
mu opiate receptor; alpha 2 adrenergic
endomorphins: involved nerurecepter type in dorsal horn neurons
mu opiate receptor
morphine: class
opiate
morphine: mechanism
binds mu opiate receptor
morphine: side effects
itcing (histamine release); puking
morphine: involved nerurecepter type in dorsal horn neurons
mu opiate receptor
morphine: effect at D2 receptors
agonist
morphine: first pass effect
stupid big
morphine: bioavailability
under 50%
codeine: class
opiate
codeine: bioavailability
0.7
meperidine: class
opiate
meperidine: side effects
neurotoxicity; only short term
meperidine: indications
p
meperidine: contraindx
end stage renal failure
fentanyl: class
opiate
methadone: class
opiate
naloxone: class
opiate antagonist
naloxone: indications
opiate toxicity
naloxone: duration
under hour
opiate overdose: signs
miosis (small pupils); slow, shallow resp; coma
opiate overdose: tx
naloxone
status epilepticus: best tx
lorazepam followed by fosphenytoin