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59 Cards in this Set
- Front
- Back
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2 most potent statins
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atorvastatin and rosuvastatin
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statins metabolized by P450 3A4 enzyme
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lovastatin, simvastatin, atorvastatin
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increased risk of myopathy when combining statin with what other drug?
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niacin
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co-administration of statin with what drug increases risk of rhabdomyoloysis?
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gemfibrozil
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contraindications to statin prescription
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active liver disease; pregnancy and lactation
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3 drugs classified as "inhibitors of bile acid absorption"
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cholestyramine
colesevalam colestipol |
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Do inhibitors of bile acid absorption increase or decrease triglycerides?
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increase TG levels
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What population is prescribed bile acid absorption inhibitors over statins
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younger patients/patients for whom statins alone do not sufficiently decrease LDL
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contraindications to inhibitors of bile acid absorption
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complete biliary obstruction
Hyperlipidemia (types III, IV, V) |
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Action/Function of ezetimibe
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decrases cholesterol transport from micelles in enterocyte by inhibiting NPC1L1 receptor on brush border
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Mechanism of gemfibrozil and fenofibrate
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agonists of peroxisome proliferator-activated receptor alpha (PPARalpha)
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What is the drug of choice for hypertriglyceridemia?
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fibrates (gemfibrozil or fenofibrate)
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What drug level is increased by administration of fibrates?
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warfarin
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What drug reduces free fatty acid release from adipose tissue and increases plasma residence time for apoA1?
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niacin
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Contraindication to niacin administration
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active liver disease, peptic ulcer, arterial bleeding
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What cholesterol reducing drug is associated with impaired insulin sensitivity?
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niacin
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contraindications to fibrate use
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preexisting gallbladder disease, hepatic dysfunction, severe renal impairment
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contraindications to ezetimibe administration
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active liver disease
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what three drugs increase bone formation by osteoblasts?
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bone anabolic agents--
hPTH 1-34, hPTH 1-84, fluoride |
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contraindications to bone anabolic agents
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open epiphyses, prior radiation therapy, paget's disease, hypercalcemia
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What class of drug would you administer to chronic kidney disease patients regarding bone homeostasis?
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oral phosphate binders (aluminum hydroxide, calcium carbonate/acetate, sevelamer)
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which oral phosphate binder also lowers serum cholesterol by binding bile acids?
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sevelamer
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what GI conditions are necessary for calcium carbonate/caclium acetate absorption?
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acidic gastric pH
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vitamin D3 is also called--
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cholecalciferol
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vitamin D2 is also called
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ergocalciferol
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1,25(OH)2D3 also known as..
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calcitriol
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What is the mechanism of cinacalcet?
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increases sensitivity of calcium-sensing receptors to calcium in parathyroid cells causing decreased secretion of PTH
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Does aspirin act reversibly or irreversibly to inhibit COX enzymes?
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irreversably
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what is the exact mechanism of aspirin?
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acetylates the active site serine residue in both COX-1 and COX-2
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contraindications to aspirin administration
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aspirin-triggered asthma, children and teenagers with chickenpox/flu symptoms due to risk of Reye's syndrome
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What are the four propionic acid NSAIDS?
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ibuprofen
naproxen ketoprofen flurbiprofen |
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What are the five acetic acid NSAIDS?
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indomethacin
sulindac etodolac diclofenac ketorolac |
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What is used for analgesia in post surgical patients?
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ketorolac
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What is the mechanism of acetaminophin?
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weak inhibition of COX-3 in the CNS
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What is celecoxib?
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selective inhibitor of COX-2
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What decreases the efficacy of ACE inhibitors?
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celecoxib
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What is the mechanism of glucocorticoids?
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inhibits COX-2 action and prostaglandin synthesis by inducing lipcortins, activating endogenous anti-inflammatory pathways
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What does anakinra inhibit?
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IL-1
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What are the contraindications to alprostadil?
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Sickle cell anemia, leukemia, myeloma, neonatal respiratory distress syndrome, penile implant or Peyronie's disease
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What is used for maintaining patent ductus arteriosus in tetraology of fallow, eisenmenger pulmonary hypertension, and aortic valve atresia?
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alprostadil (PGE1 analogue)
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What is a contraindication to misprostol?
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pregnancy
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What is a PGF2alpha analogue that stimulates uterine contraction?
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carboprost
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Contraindications to carboprost?
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acute pelvic inflammatory disease, cardiac/pulmonary/renal/hepatic disease
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what is a prostacyclin analogue that stimulates vasodilation and inhibits platelet aggregation?
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epoprostenel
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What three drugs inhibit thromboxane synthase or antagonize the thromboxane recepotor?
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dazoxiben, pirmagrel, ridogrel
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What is the main clinical use for zileuton? It's mechanism?
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asthma;
inhibits 5-lipoxygenase which catalyzes the formation of leukotrienes from AA |
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what are the two leukotriene receptor antagonists?
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motelukast and zafirlukast
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What H2 receptor antagonist inhibits the cytochrome-P450 metabolism of drugs?
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cimeditine
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What is the mechanism of H2 receptor antagonists?
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decreases acid secretion by inhibiting histamine binding to H2 receptors on parietal cells
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Which H2 receptor antagonist would you choose to administer via IV for hypersecretory conditions?
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ranitidine
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which H2 receptor antagonist has the highest bioavailability?
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nizatidine
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the suffix -ole indicates what type of drug class?
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proton pump inhibitors
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what is the mechanism of the proton pump inhibitors?
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decreases acid secretion by irreversibly inhibiting H+/K+ ATPases on parietal cells
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What metabolizes proton pump inhibitors?
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CYP2C19 and CYP3A4 within the liver
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What are three contraindications to sodium bicarbonate administration?
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respiratory alkalosis, hypocalcemia, hypochloremia
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What is a contraindication to calcium carbonate?
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severe renal insufficiency
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What two drugs coat the gastric mucosa with a protective layer?
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sucralfate; colloidal bismuth
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What drug causes decreased effectiveness of ciprofloxacin?
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sucralfate
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What is the mechanism of dicyclomine?
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This is an anticholinergic agent-- decreases acid secretion by inhibiting acetylcholine binding to muscarinic ACh receptors on parietal cels
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