Prototype Drugs For Unm-Pa Pharm 1

Front 1

What is:
Codeine

Back 1

Drug Class: Narcotic analgesic
Key Idea: Prodrug - metabolite exerts effect
Indications:Analgesia, cough, acute pulmonary edema
MOA: Mu, Delta, Kappa receptors

Front 2

What is:
Diazepam

Back 2

Drug Class: Benzodiazepines
Key Idea: Affinity for fat tissue and has multiple metabolites
Indications: anesthetic premed, sedative, anxiolytic, amnesic, anticonvulsant
MOA: CNS depressant, binds GABA receptors, enhance GABA

Front 3

What is:
Carbamazepine

Back 3

Drug Class: ANti-seizure drug
Key Idea: induces its own metabolic enzymes
Indications: Seizures, Bipolar disorder, Trigeminal neuralgia
MOA: reduces post-tetanic potentiation, otherwise unkown

Front 4

What is:
lisinoprel

Back 4

Drug Class: ACE inhibitor
Key Idea: side effect of coughing, frustrates pt and pa
Indications: HTN, CHF, MI-acute
MOA: inhibits angiotensin I and II converting enzyme

Front 5

What is:
Digoxin

Back 5

Drug Class: Cardiac glucoside
Key Idea: Narrow therapeutic index
Indications: CHF, Atrial flutter, paroxysmal atrial tachycardia
MOA: inhibits sodium-potassium ATPase

Front 6

What is:
Prednisone

Back 6

Drug Class: Corticosteroid
Key Idea: delayed impact
Indications: Inflammatory disorders, MS, asthma, adrenal insufficiency
MOA: Unknown

Front 7

What is:
Dilantin

Back 7

Drug Class: Antiepileptic
Key Idea: non-linear kinetics, saturation effect
Indications: seizure disorder
MOA: modulates neuronal voltage dependant sodium + calcium channels

Front 8

What is:
Acetominophen

Back 8

Drug Class: Non-narcotic analgesic
Key Idea: ETOH competition for P450s allows this drug to accumulate until ETOH gone, then bam!
Indications: mild pain, fever
MOA: unknown, anipyretic via hypothalamus

Front 9

What is:
Cimetidine

Back 9

Drug Class: H2 receptor blocker
Key Idea: can cross BBB and cause neurologic side effects
Indications: duodenal/gastric ulcer, GERD
MOA:Slectively antagonizes histamine H2 receptors

Front 10

What is:
Warfarin

Back 10

Drug Class: Anticoagulant
Key Idea: Narrow therapeutic index, highly variable half life
Indications: anticoagulation needed
MOA: inhibits Vit. K dependent factors

Front 11

What is:
Omeprazole

Back 11

Drug Class: Proton pump inhibitor
Key Idea: Interferes with only stomach proton pumps, takes several days to get all of them though
Indications: GERD, Duodenal/gastric ulcers,
MOA: inhibits gastric parietal cell hydrogen-potassium ATPase

Front 12

What is:
L-Dopa
Carbidopa+dopamine=levodopa

Back 12

Drug Class: Anti-parkinson's drug
Key Idea: Combo of 2 drugs to get desired drug, dopamine, across BBB
Indications: Parkinson's symptoms
MOA: Prodrug to increase dopamine

Front 13

What is:
Loratadine

Back 13

Drug Class: Antihistimine
Key Idea: non-sedating cause it does not cross BBB
Indications: allergic rhinitis, chronic idiopathic urticaria
MOA: antagonizes peripheral H1 receptor

Front 14

What is:
Fluoxetine

Back 14

Drug Class: Antidepressant-SSRI
Key Idea: Seratonin receptors in both brain and gut, must titrate to neuro effect without causing diarrhea
Indications: Bipolar, OCD, Bulimia, panic and PMS disorders
MOA: Selective Seratonin Reuptake Inhibitor

Front 15

What is:
Propanolol

Back 15

Drug Class: Antihypertensive Beta Blocker
Key Idea: Example of an antagonist blocker
Indications: HTN, Angina, Cardiac event preventions
MOA: Non selectively antagonizes B1 and B2 adrenergic receptors

Front 16

What is:
Ipratropium - inhaled

Back 16

Drug Class: Anticholinergic
Key Idea: an inhaled drug that acts as an antagonis to cholinergic receptors in the lung.
Indications: Bronchospasm, COPD, asthma maintenance
MOA: produces bronchodilation

Front 17

What are trade names for:
Ipratropium

Back 17

Atrovent HFA

Front 18

What are trade names for:
Propanolol

Back 18

Inderal, Innopran

* Avoid Abrupt cessation

Front 19

What are trade names for:
Fluoxetine

Back 19

Prozac, Sarafem

* Suicidality in children adolescents and young adults with major depression

Front 20

What are trade names for:
Loratadine

Back 20

Alavert, Claratin

Front 21

What are trade names for:
L-dopa

Back 21

Parcopa, Sinemet, Sinemet CR

Front 22

What are trade names for:
Omeprazole

Back 22

Pepsid, Prilosec

Front 23

What are trade names for:
Phenytoin

Back 23

Dilantin, phenytek

Front 24

What are trade names for:
Warfarin

Back 24

Coumadin, Jantoven

* narrow therapeutic index, major or fatal bleeding

Front 25

What are trade names for:
Cimetidine

Back 25

Tagament

* Crosses Blood Brain Barrier (BBB)

Front 26

What are trade names for:
Acetominophen

Back 26

Tylenol, Parcetamol (europe)

* do not use alcohol

Front 27

What are trade names for:
Prednisone

Back 27

Sterapred (DS)

Front 28

What are trade names for:
Digoxin

Back 28

Lanoxin, Lanoxicaps

* Narrow therapeutic index

Front 29

What are trade names for:
Lisenopril

Back 29

Prinivil, zestril

* D/C if possible pregnant! Fetal mortality/morbidity

Front 30

What are trade names for:
Carbamazepine

Back 30

Carbatrol, equetro, Tegretol

* Incremental toxicity with some drugs(azol antifungals, etravine, MAOI's, nefazodone, protease inhibitors
* Serious dermatologic rxns

Front 31

What are trade names for:
Diazepam

Back 31

What is the generic name for:
Valium

Front 32

What are trade names for:
Codeine guaifenesin

Back 32

What is the generic name for:
Robitussin AC

Front 33

Prototype drug:
Codeine
what is key idea and class

Back 33

Narcotic analgesic:
its metabolite exerts desired effect (P450-IID6 converts to morphine), not everyone can do this.

Front 34

Prototype drug:
Diazepam
what is key idea and class?

Back 34

Benzodiazepine:
Has an affinity for fat tissue and multiple metabolites

Front 35

Prototype drug:
Carbamazepine
what is key idea and class?

Back 35

Anti-seizure drug:
Induces its own metabolic enzymes

Front 36

Prototype drug:
Lisinoprel
what is key idea and class?

Back 36

Ace Inhibitor:
Has an annoying side effect, induces coughing in many patients

Front 37

Prototype drug:
Digoxin
what is key idea and class?

Back 37

Cardiac glycoside:
Narrow therapeutic index

Front 38

Prototype drug:
Prednisone
what is key idea and class?

Back 38

Corticosteroid:
Has a delayed impact

Front 39

Prototype drug:
Phenytoin
what is key idea and class?

Back 39

Anti-epileptic drug:
Non-linear kinetics, builds up and saturates, then effect is quick.

Front 40

Prototype drug:
Acetaminophen
what is key idea and class?

Back 40

Non-narcotic analgesic:
P450s process ETOH first, allowing excessive acetaminophen to build up, possibly to toxic levels, once ETOH is gone then acetaminophen processes into toxic metabolite(NAPQI). Need glutathione to conjugate.

Front 41

Prototype drug:
Cimetidine
what is key idea and class?

Back 41

H2 receptor blocker:
can cross BBB readily and cause neurologic side effects

Front 42

Prototype drug:
Warfarin
what is key idea and class?

Back 42

Anticoagulant:
Narrow therapeutic index

Front 43

Prototype drug:
Prednisone
what is class and key idea?

Back 43

Corticosteroid:
Has delayed impact

Front 44

Prototype drug:
Warfarin
what is class and key idea?

Back 44

Anticoagulant:
Narrow therapeutic index

Front 45

Prototype drug:
Omprazole
what is class and key idea?

Back 45

Proton pump inhibitor:
Specifically interfers with stomach proton pump inhibitors, takes several days to effect all of them, must take consitantly

Front 46

Prototype drug:
L-dopa
what is class and key idea?

Back 46

Anti-Pakinsons drug:
actually a combo of two drugs. carbidopa carries dopamine through BBB to target receptors

Front 47

Prototype drug:
Loratidine
what is class and key idea?

Back 47

Antihistamine:
non-sedating because it does not cross BBB

Front 48

Prototype drug:
Fluoxetine
what is class and key idea?

Back 48

Antidepressant SSRI:
Must titrate brain effect carefully as it also effects receptors in the gut - to much = diarrhea

Front 49

Prototype drug:
Propanolol
what is class and key idea?

Back 49

Anithypertensive blocker:
Example of an antogonist/blocker

Front 50

Prototype drug:
Ipratropium inhaled
what is class and key idea?

Back 50

Anticholinergic:
an inhaled drug that acts as antogonist to cholinergic receptors in the lung producing dilation

Front 51

What is acetylcysteine used for?

Back 51

Acylcysteine restores hepatic glutathione which conjugates the toxic metabolite NAPQI in a acetaminophen overdose. IV or PO (tastes nasty)

Front 52

What are the important markers for prescribing in the face of CKD (Chronic Kidney Disease)

Back 52

A normal GFR or (Glomerular Filtration Rate) is about 120 ml/minute.
Stage 1 CKD > 90 ml/min.
Stage 2 CKD 60-89 ml/min.
Stage 3 CKD 30-59 ml/min. Must adjust dosages - referal to nephrology
Stage 4 CKD 15-29 ml/min.
Stage 5 CKD < 15 ml/min. = dialysis needed

Front 53

What to look for in Acetaminophen overdose?

Back 53

Mental status
tylenol blood levels
Liver enzymes

Front 54

Where are COX 1 and 2 found? What do they do?

Back 54

COX-1 and COX-2 are found in the blood vessels, kidneys and stomach.
Cox-1 will make your backgound/baseline prostaglandin and Cox-2 will help make more when stimulated to do so.
So if we can inhibit cox-2 selectively we can mediate inflammation.

Front 55

What is nociception

Back 55

the neural process of encoding noxious stimuli, mechanical, chemical, and thermal.
Processed along alpha-delta and C fibers up the posterior horn of the spinal cord. Crossovers in transmission can lead to somatic pain.

Front 56

Where is nociceptive pain found

Back 56

Nociceptive=
Somatic - skin, muscle, joints, bones and CT, sharp local and reproducible
Visceral - Organs of the 3 cavities, stretch, inflammation, ischemia

Front 57

Where is non-nociceptive pain found?

* Not from specific receptors but from nerve cell dysfunction

Back 57

Neuropathic - nerves of the CNS or PNS, impingement, degeneration, infection.
Sympathetic - possibly due to overaction in SNS/CNS/PNS, post-trauma; casalgia,, RSD, CRPS(complex regional pain syndrome)

Front 58

How to treat Neuropathic pain?

Back 58

Anti epileptic drugs, tricyclics, NMDA antagonists, topical capsacin, partly responsive to NSAIDs and opioids

Front 59

How to treat Sympathetic CRPS pain?
Complex Regional Pain Syndrome

Back 59

Anti epileptic drugs, tricyclics, Sympathetic blockers, vasodilators, multimodal regimines, Rehab services, surgical sympathectomy

Front 60

How to treat somatic pain

Back 60

Acetaminophen, NSAIDs and weak or strong opioids

Front 61

How to treat visceral pain

Back 61

Weak or strong opioids

Front 62

Components of the Persistent Pain Management check list:

Back 62

1. Activity level
2. Aberrant behavior
3. ADR's (adverse drug rxns)
4. Adequacy of analgesia
5. Patient affect
6. Adherence to plan
7. Date&results of drug screening
8. Date of most recent narcotic contract

Front 63

What is ADME

Back 63

Absorption
Distribution
Metabolism
Excretion

Front 64

The perfect drug would have what components?

Back 64

Super specific for target receptor
Effective at very low concentration
Toxic dose would be super high

Front 65

What happens in phase 1 metabolism?

Back 65

In the liver phase 1 metabolism is carried out by P450 (CYP _ _ _) enzymes via oxidative processes

Front 66

What is Phase II metabolism

Back 66

Occurs in the liver, via conjugation with ion groups, gluthathione, methyl, acetyl groups. Effect is to make metabolites more water soluble

Front 67

Aspirin
(ASA)

Back 67

fever, mild pain,acute coronary syndrome, MI prevention, TIA/stroke prevention, Arthritis, Rheumatic fever
Inhibits platelet aggregation