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71 Cards in this Set

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  • Back
Which two drugs can cause methemoglobinemia?
1. Benzocaine
2. Prilocaine
What drug blocks the actions of glutamate and sodium?
Topiramate
Topiramate is also used to treat what disorder?
Lennox-Gastaut Syndrome
What is the prodrug form of phenobarbital?
Primidone
Which COMT inhibitor has received a black box warning?
Tolcapone
What is a risk of someone on Fluoxetine? How is the risk handled
1. Seratonin syndrome
2. Cyproheptadine - H1 blocker
Name three other SSRIs.
1. Paroxetine
2. Sertraline
3. Citalopram (Escitalopram is more potent)
What two drugs blocks the re-uptake of NE and 5HT while antagonizing the 5HT-2 receptor?
1. Nefazodone
2. Trazodone
What drug acts as a 5HT re-uptake inhibitor at low doses and a NE re-uptake inhibitor at high doses? What else is special about this drug?
1. Venlafaxine
2. Does not inhibit CYP450
What drug acts as a 5HT-2 and 5HT-3 blocker?
Mirtazapine
What drug blocks the re-uptake of dopamine and NE? What is a side-effect of this drug?
1. Buproprion
2. Lower thresh-hold for SZ
What is an odd side-effect of hydrochlorothiazide?
It increases blood sugar, cholesterol and triglycerides.
With hydrochlorothiazide, is there an increase or decrease in calcium in the blood?
Increase
What is an odd side-effect of Furosemide?
Ototoxicity
How does spironolactone affect K, Na, Cl and pH levels? What is an odd side-effect of the drug?
1. Increased K
2. Decreased Na
3. Decreased Cl
4. Lower pH
5. Antiandrogenic effects
What are two problems that arise with people on acetazolamide?
1. Kindey stones - calcium phosphate is less soluble in alkaline urine
2. Encephalopathy - cannot excrete NH3 in alkaline urine
What are some of the problems seen when using imipramine?
1. Excess sedation
2. Anticholinergic
3. Postural hypotension and tachycardia
4. Quinidine-like effects
5. Precipitate mania
What is the MOA for finasteride? What are two clinical uses for it?
1. It is a 5-alpha reductase inhibitor.
2. Benign prostatic hyperplasia
3. Male pattern baldness
Why is diethylstilbestrol no longer used during pregnancy?
It causes increased incidence of vaginal and cervical cancer in offspring.
What is special about mestranol?
It has to be demethylated in the liver by a demethylase in order to be active.
Why would someone want to use raloxifene over tamoxifen?
Raloxifene doesn't increase the risk of endometrial cancer like tamoxifen does.
Where does buspirone work?
It is an antagonist at 5-HT1A receptors.
What does chlorpromazide block?
Everything
What is the major side-effect of clozapine?
It can cause agranulocytosis.
Which anti-psychotic blocks both + and - symptoms of schizophrenia?
Risperidone
What is the main side-effect of bromocriptine?
Fibrosis
What is an alternative use for carbamazepine? What other drug can be used as well?
1. Used to treat bipolar disorder.
2. Valproic acid
Carbamazepine is the drug of choice for what?
Partial seizures.
What is special about metabolism of carbamazepine?
It is an autoinducer of its own p450 enzyme.
What are 4 side-effects of carbamazepine?
1. Diplopia
2. Rash
3. Ataxia
4. Rare idiosyncratic blood dyscrasias
What is the drug of choice for myoclonic seizures?
Valproic acid
What is the main side-effect of valproic acid?
Idiosyncratic hepatotoxicity
What is a less serious side-effect of valproic acid?
Alopecia
How are MAO inhibitors metabolized?
Acetylated
What is special about selegiline?
It only inhibits MAO B
Name three other MAO inhibitors?
1. Tranylcypromine - reversible
2. Phenelzine - irreversible
3. Isocarboxazid - irreversible
Name two tertiary amine TCAs.
1. Imipramine
2. Amitriptyline
Name two secondary amine TCAs.
1. Desipramine
2. Nortiptyline
Ketamine's onset is slow/fast?
Slow
What happens during Etomidate's onset?
Clonus
What does Ketamine potentiate?
Amnestic effects
Sodium thipental causes the release of what?
Histamine
What is Propofol's action on blood vessels?
Vasodilation
Ketamine blocks what effect?
Wind-up
What two drugs, when mixed together, precipitate?
Succinylcholine and pentothal.
Which drugs has the least incidence of postop nausea and vommitting?
Propofol
What was used to reverse sedation before Flumazenil?
Physostigmine
In metabolism, what happens to all the benzos?
They become conjugated
Why is Midazolam preferred in the OR?
It's metabolite does not have any effect.
What spasmolytic is used to quiet down GABA receptors at the level of the spinal cord?
Baclofen
Thiopentone will reduce the requirement for....
Oxygen at the level of the brain.
Which have a better therapuetic index, benzos or barbituates?
Benzos
Etomidate decreases the activity of...
Alpha and beta hydroxylases - decrease in cortisol
What is something that has to be taken into consideration when using Vecuronium?
Its metabolite has channel blocking properties and is also excreted by the kidney. If you have kindey problems, then you will have channel blocking metabolites in your blood longer.
Curare can cause what as a side effect....
Hypotension
What class is Lys-pro insulin considered? How long until its max effect?
Very-rapid acting - max effect is in 15-60 minutes
What class is glulisine insulin considered? How long until its max effect?
Very-rapid acting - max effect is in 15-60 minutes
What class is Insulin aspart insulin considered? How long until its max effect?
Very-rapid acting - max effect is in 15-60 minutes
What class is NPH insulin considered? How long until its max effect?
Long acting - max effect 4-6 hours
What class is ultralente insulin considered? How long until its max effect?
Long acting - max effect 6-12 hours
What class is lyspro protamine insulin considered? How long until its max effect?
Long acting - max effect 6-12 hours
What class is Glargine insulin considered? How long until its max effect?
Ultra long acting - acts at a constant level for 24-36 hours due to its slow precipitation
What class is insulin detemir considered? How long until its max effect?
Ultra long acting - it has a long duration of over 24 hours due to the lipophilic attachment that allows prolonged binding to albumin
Can glargine be mixed with other insulins?
No because it must be kept at a low pH.
What are some "other" therapuetic considerations for Type I DM?
1. Insulin pump
2. Pancrease transplant
3. ACE inhibitor
4. Statins
What affect do alpha-adernergic agonists have on insulin releasal?
They inhibit it
What affect does phenytoin have on insulin releasal?
Inhibition
What affect does dizoxide, vinblastine and colchicine have on insulin releasal?
Inhibition
What affect do GLP-1, GIP and beta-adernergic agonists have on insulin releasal?
Amplification
What is Resveratol?
Compound dervied from red-wine that is a histone deacetylase.
What is the function of Cyproterone?
It is an antiandrogenic drugs used for women to decrease hirsutism and in men to decrease sexual drive.