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292 Cards in this Set
- Front
- Back
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botulinum toxin moa
|
prevents release of acetylcholine
at all cholinergic terminals |
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(2) are part of the sympathetic NS but are innervated by cholinergic fibers
|
adrenal medulla
sweat glands |
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ACh receptors...
|
Nicotinic ACh receptors are ligand-gated Na+/K+ channels
--Nn in autonomic ganglia --Nm in neuromuscular junction Muscarinic ACh receptors are G-protein-coupled receptors. M1, M2, M3, M4, M5 |
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Muscarinic receptors are found...
|
in the parasympathetic system
@ cardiac & smooth muscle gland cells nerve terminals in sympathetic system, @ sweat glands |
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sympathetic system talks 3 different ways...
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Muscarinic @ sweat gland
NE alpha & beta @ --cardiac & smooth muscle --gland cells --nerve terminals D1 @ --renal vascular smooth muscle |
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nicotinic receptors are more awesome than any other, because...
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they're the transmitter @
parasympathetic & sympathetic ganglia adrenal medulla skeletal muscle |
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G-protein-linked 2nd messengers mnemonic
|
G protein classes--qiss and qiq till you're siq of sqs
alpha1, alpha2, beta1, beta2: qiss M1, M2, M3: qiq (DHV): D1, D2, H1, H2, V1, V2: siq, sqs |
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alpha1 fxns
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contraction of
--vascular smooth muscle --pupillary dilator --intestinal & bladder sphincters |
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alpha2 fxns
|
v
sympathetic outflow insulin release |
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beta1 fxns
|
"Release HCL"
^ HR contractility renin release lipolysis |
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beta2 fxns
|
"Increase HCL"
^ insulin, HR, contractility, lipolysis vasodilation bronchodilation uterine relaxation |
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M1 fxn
|
CNS
ENS |
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M2 fxn
|
v HR
v contractility of atria |
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M3 fxn
|
BEG in your face (accommodation) and then BAM (peristalsis in your face!)
^ bronchoconstriction ^ exocrine secretions (e.g. sweat, gastric acid) ^ gut peristalsis ^ bladder contraction accommodation (ciliary muscle contracts) miosis (pupillary sphincter contracts) |
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D1 fxn
|
relaxes renal vascular smooth muscle
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D1 fxn
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modulates transmitter release, esp. in brain
|
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H1 fxn
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BMP
bronchoconstriction mucus production (nasal & bronchial) pruritis & pain |
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H2 fxn
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^ gastric acid
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V1 fxn
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vascular smooth muscle contraction
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V2 fxn
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^ H2O permeability & resorption
in the collecting tubules |
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Gq signaling receptors
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HAVe 1 M&M
H1, alpha1, V1 M1, M3 |
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Gs signaling receptors
|
that's 1 BaD, 2oo-Big, Hell of a Vagina
Beta 1, D1 Beta2 H2 V2 |
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Gi signaling receptors
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MAD 2's
M2, alpha2, D2 |
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release of NE from a sympathetic nerve terminal is modulated by...
|
M2 - , AII + , alpha2 - , receptors are on the nerve terminal.
NE's own negative feedback @ alpha2 ACh negative @ M2 Angiotensin II + @ ATII |
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Bethanechol Rx
|
postoperative and neurogenic ileus
urinary retention |
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cholinergic agonists
|
bethanechol
carbachol pilocarpine methacholine |
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carbachol Rx
|
glaucoma
pupillary contraction v intraocular pressure |
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pilocarpine
|
potent stimulator of
tears sweat saliva |
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bethanechol remark about its action
|
resistant to AChE
|
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_ is resistnat to AChE
|
bethanechol
pilocarpine |
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methacholine Rx
|
challenge test for diagnosis of asthma
|
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methacholine moa
|
stimulates muscarinic receptors in airway when inhaled
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pilocarpine remark about its action
|
contracts:
--ciliary muscle (open angle) --pupillary sphincter (narrow angle) resistant to AChE |
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pilocarpine mnemonic
|
PILE on the sweat & tears (& saliva)
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open angle muscle
narrow angle muscle |
ciliary
pupillary N P O C |
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AChE inhibitors (5)
|
you want to PEE? NP!
pyridostigmine edrophonium echothiophate neostigmine physostigmine |
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with all cholinomimetic agents, watch for (2) s/e
|
exacerbation of COPD/asthma
peptic ulcers |
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an AChE inhibitor that penetrates CNS
|
physostigmine
|
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neostigmine Rx (4)
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postoperative & neurogenic ileus
urinary retention myasthenia gravis postoperative reversal of NMJ blockade |
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_ to Dx myasthenia gravis
_ to Rx |
edrophonium
neostigmine pyridostigmine (long-acting) |
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physostigmine Rx
|
glaucoma
atropine overdose |
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echothiophate Rx
|
glaucoma
|
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AChE inhibitors that Rx glaucoma
|
PE
physostigmine echothiophate |
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_ irreversibly inhibit AChE
e.g.? |
organophosphates
parathion |
|
|
cholinesterase inhibitor poisoning (e.g. organophosphate)
--> sxs |
DUMB BEL SS
diarrhea urination miosis bronchospasm bradycardia excitation of skeletal muscle & CNS lacrimation sweating salivation |
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antidote for organophosphate poisoning
|
atropine + pralidoxime
(regenerates active AChE) |
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_ for atropine o/d
|
physostigmine
|
|
|
cycloplegia =
how can it happen? |
loss of accommodation
(accommodation is mediated by ciliary muscle. M3 receptors) muscarinic antagonists can cause cycloplegia |
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muscarinic antagonists
|
PAM Has a Big SPIGOT
pirenzepine atropine methscopolamine homatropine benztropine scopolamine propantheline ipratropium glycopyrrolate oxybutynin tropicamide |
|
|
musc. antagon. @ eye
___ --> ___ |
atropine
homatropine tropicamide mydriasis cycloplegia |
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important musc. antag.
|
A BISOM (m for muscarinic, replaces what would be an n)
atropine -- mydriasis & cycloplegia benztropine -- parkinson's scopolamine -- motion sickness ipratropium -- asthma, COPD oxybutynin -- reduce urgency in mild cystitis; reduce bladder spasms methscopolamine -- peptic ulcer |
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muscarinic antagonists used @ eye
& their effects |
atropine
homatropine tropicamide mydriasis cycloplegia |
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muscarinic antagonists used @ genitourinary
& their effects |
oxybutynin
glycopyrrolate v urgency in mild cystitis v bladder spasms |
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musc. antagonists used @ GI system
& their effects |
methscopolamine
pirenzepine propantheline peptic ulcer |
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atropine is a _ antagonist
|
muscarinic
|
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a nicotinic antagonist
|
hexamethonium
|
|
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atropine effects
|
^ pupil dilation, cycloplegia
v secretions @ airway v gastric acid secretion v gut motility v urgency in cystitis |
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atropine s/e's
|
High-n-mighty. Get over Urself. there's an FTP server in DC, DC
hyperthermia in infants acute angle-closure glaucoma in elderly urinary retention in med with prostatic hyperplasia flushing ^ temp 2^ v sweating ^ pulse dry mouth & skin constipation disorientation cycloplegia |
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muscarininc receptor that mediates bradycardia
|
M2
|
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hexamethonium use
|
nicotinic agonist.
ganglionic blocker. used to prevent vagal reflex responses to changes in blood pressure e.g. prevents reflex bradycardia caused by NE |
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|
hexamethonium s/e
|
severe orthostatic hypotension
blurred vision constipation sexual dysfunction |
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loading dose =
|
Cp x Vd / F
target plasma concentration x volume of distribution = amount of drug / plasma [] / bioavailability |
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maintenance dose =
|
Cp x CL/F
target plasma concentration x clearance = rate of elimination/plasma [] / bioavailability |
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zero-order elimination vs.
1st-order elimination (definition) |
a constant amount is eliminated
a constant fraction is eliminated |
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zero-order elimination vs.
1st-order elimination (graph) |
plasma drug []
--decreases linearly --decreases eponentially |
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examples of zero-order elimination of drugs (3)
|
phenytoin
ethanol aspirin -- at high or toxic [] |
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because ionized drug species are trapped in urine but neutral forms can be reabsorbed, how should you treat certain overdoses?
|
weak acids: treat overdose with bicarb
weak bases: treat overdose with ammonium chloride |
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examples of weak acids and weak bases that should be treated by changing urine pH
|
weak acids:
--phenobarbital --methotrexate --aspirin Rx: bicarbonate weak bases --amphetamines rx: ammonium chloride |
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phase I metabolism of drugs
|
cytochrome P450
reduction oxidation hydrolysis (metabolites: often still active) |
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phase II metabolism of drugs
|
conjugation:
acetylation glucuronidation sulfation inactive metabolites renally excreted |
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geriatric patients lose phase _ drug metabolism first
|
I
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a partial agonist has what effect on potency/efficacy?
|
v efficacy
potency can be ^ or v |
|
|
example of competitive antagonist
|
diazepam + flumazenil
on GABA receptor |
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example of noncompetitive antagonist
|
NE + phenoxybenzamine
on alpha receptors |
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example of partial agonist
|
morphine + buprenorphine
at opioid mu-receptor |
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a physiologic antagonist
--definition --example |
antagonizes,
but does not act @ same receptor in an asthma patient who has muscarinic overactivity, epinephrine bronchodilates at beta-2 receptors |
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therapeutic index
|
LD50/
ED50 median lethal dose/ median effective dose |
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renal vascular smooth muscle has _ receptors
|
D1
|
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sweat glands' innervation, receptors
|
sympathetic!
ACh (nicotinic) preganglionic ACh (muscarinic) postganglionic |
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ACh receptors:
nicotinic vs. muscarinic |
ligand-gated Na+/K+ channels
G-protein-coupled receptors |
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nicotinic and muscarinic subtypes
|
NN at autonomic ganglia
NM at neuromuscular junction M1-M5 |
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alpha1 receptors
(3) |
q
^ vascular contraction ^ pupillary dilator ^ intestinal and bladder sphincter |
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alpha2 receptors (2)
|
v sympathetic outflow
v insulin release |
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which receptors (alpha, beta, muscarinic, dopamine, histamine, vasopressin) affect insulin?
|
alpha2: v insulin
beta2: ^ insulin |
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beta1 receptors (4)
|
s
mnemonic: "Release HCL" ^ renin release ^ heart rate ^ contractility ^ lipolysis |
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beta2 receptors (7)
|
"Increase HCL By UV"
s ^ insulin release ^ heart rate ^ contractility ^ lipolysis bronchodilation relax uterus bronchodilation |
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M2 receptors (2)
|
i
v heart rate v contractility of atria [to me, these two make sense to be linked, because heart rate is controlled from the atria] |
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m3 receptors
|
q
exocrine gland secretions --sweat --gastric acid ^ gut peristalsis ^ bladder contraction ^ bronchoconstriction --miosis (pupillary sphincter contraction) --accommodation (ciliary muscle contraction) |
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d1 receptors
|
s
relaxes renal vascular smooth muscle |
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d2 receptors
|
i
modulates transmitter release, esp. in brain |
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H1 receptors (4)
|
q
BMPP bronchiole contraction mucus production --nasal --bronchial pruritis pain |
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H2 receptors
|
s
^ gastric acid secretion |
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what receptors (alpha, beta, muscarinic, dopamine, histamine, vasopressin)
^ gastric acid secretion? |
M3, H2: ^ gastric acid secretion
|
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receptors --> bronchodilation
/bronchoconstriction |
bronchodilation: beta2
bronchoconstriction: m3, h1 |
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receptors that affect blood vessel relaxation/contraction
|
constriction: alpha1, V1
vasocilation: beta2, D1 (relaxes renal vascular smooth muscle) |
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V1 receptors
|
q
^ vascular contraction |
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V2 receptors
|
s
^ H2O permeability in the collecting tubules "V2 is found in the 2 kidneys" |
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Gq receptors
|
"HAVe 1 M&M"
H1, alpha1, V1 M1, M3 |
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Gs receptors
|
beta1, beta2
D1 H2, V2 |
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Gi receptors
|
M2, alpha2, D2
"MAD 2's" |
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|
some drugs that act at the cholinergic neuron
(they're listed on the picture in first aid) |
hemicholinium:
- choline transporter (uptake into the neuron) vesamicol: - ACh transporter (uptake into vesicle) botulinum: - ACh vesicle release from neuron Ca++: --> ACh vesicle to fuse with membrane and release its contents |
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_ inhibits choline uptake into neuron
|
hemicholinium
|
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_ inhibits ACh uptake (within neuron) into vesicle
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vesamicol
|
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metyrosine moa
|
- conversion of
Tyrosine --> DOPA |
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reserpine moa
|
- dopamine uptake into vesicle
(where it's converted into NE) |
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precursors to NE
|
Tyrosine
DOPA Dopamine |
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_ inhibit NE reuptake into neuron
|
cocaine
TCAs amphetamine |
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amphetamine effects at a noradrenergic neuron
|
+ vesicle containing NE to fuse with membrane and release its contents
- reuptake of NE into neuron |
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_ opposes
_ stimulates release of NE from neuron |
guanethidine
amphetamine |
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_ inhibits tyrosine --> DOPA conversion
|
metyrosine
|
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_ inhibits dopamine uptake into vesicle, where it's converted to NE
|
reserpine
|
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modulation of NE release (3)
|
NE inhibits, by alpha2
ACh inhibits, by M2 angiotensin II stimulates, by ATII |
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cholinergic direct agonists
|
bethanechol
carbachol pilocarpine methacholine |
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bethanechol rx
|
postoperative and neurogenic ileus and urinary retention
|
|
|
a couple direct cholinomimetic agents are stout in a certain way...
|
bethanechol
pilocarpine resistant to AChE (acetylcholinesterase) |
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|
carbachol rx
|
1. glaucoma
2. --> pupillary contraction 3. relief of intraocular pressure |
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pilocarpine
|
potent stimulator of
--sweat --tears --saliva contracts ciliary muscle of eye (open angle) and pupillary sphincter (narrow angle) |
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_ is useful for diagnosis of asthma
|
methacholine
|
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methacholine rx
|
diagnosis of asthma
|
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_ are rx for
postoperative and neurogenic ileus and urinary retention |
bethanechol
neostigmine |
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indirect cholinomimetic agonists (anticholinesterases)
|
neostigmine
pyridostigmine edrophonium physostigmine echothiophate |
|
|
with all cholinomimetic agents, watch for (3)
|
exacerbation of COPD
asthma peptic ulcers |
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neostigmine rx
|
postoperative and neurogenic ileus and urinary retention
myasthenia gravis reversal of neuromuscular junction blockade (postoperative) |
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pyridostigmine rx
|
myasthenia gravis (long acting)
|
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myasthenia gravis drugs
|
neostigmine
pyridostigmine (long acting) edrophonium (extremely short acting) |
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physostigmine rx
|
glaucoma
atropine overdose |
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atropine overdose rx
|
physostigmine
|
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echothiophate rx
|
glaucoma
|
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cholinomimetic glaucoma drugs
|
carbachol
physostigmine echothiophate |
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anticholinesterases that
do not penetrate CNS do penetrate CNS |
neostigmine
pyridostigmine ------------------- physostigmine |
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organophosphates do _
|
irrreversibly inhibit AchE (acetylcholinesterase)
|
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an organophosphate: _
|
parathion
|
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parathion is _
|
an organophosphate
|
|
|
antidote to organophosphate poisoning
|
atropine + pralidoxime
|
|
|
organophosphate poisoning sxs
|
DUMB BELS S
diarrhea urination miosis bronchospasm bradycardia excitation of skeletal muscle and CNS lacrimation sweating salivation |
|
|
muscarinic antagonists @ the eye
their effects? |
atropine
homatropine tropicamide mydriasis cycloplegia |
|
|
muscarinic antagonists @ CNS
rx? |
benztropine: parkinson's
scopolamine: motion sickness |
|
|
muscarinic antagonist that acts at respiratory system
rx? |
ipratropium
asthma COPD |
|
|
muscarinic antagonists @ genitourinary system
rx? |
oxybutynin
glycopyrrolate v urgency in mild cystitis v bladder spasms |
|
|
muscarinic antagonists @ gastrointestinal system
|
methscopolamine
pirenzepine propantheline peptic ulcer treatment |
|
|
atropine is a _
|
muscarinic antagonist
|
|
|
atropine affects what systems specifically?
how? |
eye
-- ^ pupil dilation, cycloplegia airway -- v secretions stomach -- v acid secretion gut -- v motility bladder -- v urgency in cystitis |
|
|
cycloplegia is
|
paralysis of ciliary muscle -->
loss of accommodation |
|
|
toxicity of atropine
|
there's an FTP server in DC, DC that'll give you a HUG
flushing ^ temperature (due to v sweating) ^ pulse dry mouth constipation cycloplegia disorientation --hyperthermia in infants --urinary retention in men with prostatic hyperplasia --acute angle-closure glaucoma |
|
|
_ is a nicotinic antagonist
|
hexamethonium
|
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|
hexamethonium rx (2)
|
nicotinic antagonist, ganglionic blocker
prevents vagal reflex bradycardia caused by NE |
|
|
hexamethonium s/e (4)
|
orthostatic hypotension
blurred vision constipation sexual dysfunction |
|
|
direct sympathomimetics
|
epinephrine
NE isoproterenol dopamine dobutamine phenylephrine metaproterenol --albuterol --salmeterol --terbutaline ritodrine |
|
|
epinephrine receptors
|
alpha1, alpha2, beta1, beta2
low doses selective for beta1 |
|
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NE receptors
|
alpha1, alpha2 > beta1
|
|
|
isoproterenol receptors
|
beta1 = beta2
"isolated to beta" |
|
|
dopamine receptors
dobutamine receptors |
D1 = D2 > beta > alpha
inotropic and chronotropic beta1 > beta 2 inotropic but not chronotropic |
|
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phenylephrine receptors
|
alpha1 > alpha2
|
|
|
selective beta2 antagonists include
beta1 < = > beta2 ? |
metaproterenol
albuterol salmeterol terbutaline beta2 > beta1 |
|
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ritodrine receptors
|
beta2
|
|
|
indirect sympathomimetics
moa? |
they're all indirect general agonists!
amphetamine and ephedrine release stored catecholamines cocaine is an uptake inhibitor |
|
|
epinephrine rx
|
anaphylaxis
asthma glaucoma (open angle) hypotension |
|
|
NE rx
|
hypotension
(but v renal perfusion) |
|
|
isoproterenol rx
|
AV block (rare)
|
|
|
dopamine rx
dobutamine rx |
both: heart failure
dopamine: shock (^ renal perfusion) dobutamine: cardiac stress testing |
|
|
phenylephrine rx
|
pupillary dilation
vasoconstriction nasal decongestion |
|
|
MAST
metaproterenol albuterol salmeterol terbutaline rx |
metaproterenol and albuterol: acute asthma
salmeterol: long-term treatment of asthma terbutaline: reduce premature uterine contractions |
|
|
(2) reduce premature uterine contractions
|
terbutaline
ritodrine |
|
|
ritodrine rx
|
reduce premature uterine contractions
|
|
|
amphetamine rx
|
narcolepsy
obesity attention deficit |
|
|
ephedrine rx
|
nasal decongestion
urinary incontinence hypotension |
|
|
cocaine rx
|
vasoconstriction
local anesthesia |
|
|
(2) centrally acting alpha2-agonists
|
clonidine
alpha-methyldopa |
|
|
clonidine,
alpha-methyldopa rx |
hypertension, especially with renal disease (no v in blood flow to kidney)
|
|
|
clonidine
alpha-methyldopa moa |
centrally-acting alpha2 agonists
v central adrenergic outflow |
|
|
nonselective alpha-blockers
|
phenoxybenzamine (irreversible)
phentolamine (reversible) |
|
|
phenoxybenzamine
phentolamine are what in what group of drugs? |
nonselective alpha blockers
|
|
|
phenoxybenzamine
phentolamine s/e |
orthostatic hypotension
reflex tachycardia |
|
|
rx of pheochromocytoma before removing the tumor
|
phenoxybenzamine
|
|
|
alpha1 selective alpha blockers
|
prazosin
terazosin doxazosin |
|
|
prazosin
terazosin doxazosin rx |
hypertension
urinary retention in BPH |
|
|
prazosin
terazosin doxazosin what class of drugs? |
alpha-1 selective blockers
|
|
|
prazosin
terazosin doxazosin s/e |
1st-dose orthostatic hypotension
dizziness headache |
|
|
alpha-2 selective blockers
|
mirtazapine
|
|
|
mirtazapine is a _ (class of drug)
|
alpha2 selective blocker
|
|
|
mirtazapine rx
|
depression
|
|
|
mirtazapine s/e
|
sedation
^ serum cholesterol ^ appetite |
|
|
blood pressure effects:
epinephrine epinephrine + phentolamine phenylephrine phenylephrine + phentolamine |
^ due to alpha agonism
v due to beta agonism ^ due to alpha agonism -- due to alpha agonism that's blocked by the phentolamine |
|
|
beta blockers applications
|
hypertension
angina pectoris MI SVT (propranolol, esmolol) CHF glaucoma (timolol) |
|
|
the beta blockers that rx
SVT |
propranolol
esmolol |
|
|
the beta blockers that rx glaucoma
|
timolol
|
|
|
beta blockers s/e
|
impotence
asthma exacerbation bradycardia AV block CHF sedation, sleep alterations may mask the effects of hypoglycemia |
|
|
beta blockers applications
|
hypertension
angina pectoris MI SVT (propranolol, esmolol) CHF glaucoma (timolol) |
|
|
beta blockers for SVT
|
propranolol
esmolol |
|
|
how do beta blockers rx htn?
|
v cardiac output
v renin secretion (due to beta receptor blockade on JGA cells) |
|
|
how do beta blockers rx angina?
|
v heart rate and contractility
--> v O2 consumption |
|
|
how do beta blockers rx SVT
|
v AV conduction velocity
(class II antiarrhythmic) |
|
|
how do beta blockers rx glaucoma?
which one treats it? |
v secretion of aqueous humor
timolol |
|
|
beta blockers s/e
|
impotence
asthma exacerbation bradycardia AV block CHF sedation, sleep alterations may mask the signs of hypoglycemia (use with caution in diabetics) |
|
|
nonselective beta blockers
|
beta1 = beta2
timolol nadolol propranolol pindolol Tim and Nate have Proper Pins (that's why their beta1 = beta2) |
|
|
beta1-selective antagonists
|
beta1 > beta2
A BEAM acebutolol (partial agonist) betaxolol esmolol (short acting) atenolol metoprolol |
|
|
nonselective alpha- and beta- antagonists
|
carvedilol
labetalol |
|
|
partial beta agonists
|
pindolol
acebutolol |
|
|
acebutolol is a _
|
partial beta agonist
/ beta1 selective antagonist |
|
|
betaxolol is a _
|
beta1-selective antagonist
|
|
|
esmolol is a _
|
short-acting beta1-selective antagonist
|
|
|
atenolol is a _
|
beta1-selective antagonist
|
|
|
metoprolol is a _
|
beta1-selective antagonist
|
|
|
carvedilol is a _
|
nonselective alpha- and beta- antagonist
|
|
|
labetalol is a _
|
nonselective alpha- and beta- antagonist
|
|
|
pindolol is a _
|
partial beta-agonist
|
|
|
beta1-selective antagonists are advantageous in _
|
patients with comorbid pulmonary disease
|
|
|
antidote for acetaminophen
|
N-acetylcysteine
|
|
|
antidote for salicylates
|
NaHCO3 (alkalinizes urine)
dialysis |
|
|
antidote for amphetamines
|
they're basic... so
NH4 Cl (acidify urine) |
|
|
antidote for acetylcholinesterase inhibitors
|
they're organophosphates.
atropine pralidoxime |
|
|
antidote for antimuscarinic, anticholinergic agents
|
physostigmine salicylate
|
|
|
antidote for beta blockers
|
glucagon
|
|
|
antidote for digitalis
|
stop dig
normalize K+ lidocaine anti-dig Fab fragments Mg++ |
|
|
antidote for iron
|
deferoxamine
|
|
|
antidote for lead
|
Ca EDTA
dimercaprol succimer penicillamine |
|
|
antidote for mercury
arsenic gold |
dimercaprol
succimer |
|
|
dimercaprol, succimer are antidotes for _
|
mercury
arsenic gold |
|
|
penicillamine is an antidote for _
|
lead
copper, arsenic, gold |
|
|
antidote for copper, arsenic, gold
|
penicillamine
|
|
|
antidote for cyanide
|
nitrite
hydroxocobalamin thiosulfate |
|
|
antidote for methemoglobin
|
methylene blue
vitamin C |
|
|
antidote for methanol, ethylene glycol
|
ethanol
dialysis fomepizole |
|
|
antidote for opioids
|
naloxone/naltrexone
|
|
|
antidote for benzodiazepines
|
flumazenil
|
|
|
flumazenil is _
|
antidote for benzodiazepines
|
|
|
antidote for TCAs
|
NaHCO3 (plasma alkalinization)
|
|
|
antidote for heparin
|
protamine
|
|
|
antidote for warfarin
|
vitamin K
fresh frozen plasma |
|
|
antidote for tPA, streptokinase
|
aminocaproic acid
|
|
|
antidote for theophylline
|
beta-blocker
|
|
|
atropine-like side effects: think __
|
TCAs
|
|
|
coronary vasospasm: think __ caused it
|
cocaine
sumatriptan |
|
|
cutaneous flushing, think _ caused it
|
VANC
vancomycin adenosine niacin ca++ channel blockers |
|
|
dilated cardiomyopathy: think __ caused it
|
doxorubicin
daunorubicin |
|
|
doxorubicin is aka
|
adriamycin
|
|
|
adriamycin is aka
|
doxorubicin
|
|
|
torsades de pointes: think __ caused it
|
class III (sotalol)
class IA (quinidine) |
|
|
agranulocytosis: think __ caused it
|
clozapine
carbamazepine colchicine propylthiouracil methimazole dapsone |
|
|
aplastic anemia: think __ caused it
|
chloramphenicol
benzene NSAIDs propylthiouracil, methimazole |
|
|
direct coombs-positive hemolytic anemia: think ___ caused it
|
methyldopa
|
|
|
hemolysis in G6PD-deficient patients: think ___ caused it
|
isoniazid
sulfonamides primaquine aspirin ibuprofen nitrofurantoin "hemolysis IS PAIN" |
|
|
megaloblastic anemia: think __ caused it
|
phenytoin
methotrexate sulfa drugs "having a 'blast' with PMS" |
|
|
thrombotic complications: think _ caused it
|
OCPs (estrogens and progestins)
|
|
|
pulmonary fibrosis: think __ caused it
|
bleomycin,
amiodarone busulfan |
|
|
acute cholestatic hepatitis: think ___ caused it
|
macrolides
|
|
|
focal to massive hepatic necrosis: think ____ caused it
|
valproic acid
acetaminophen Amanita phalloides halothane "Valerie took a seat on the lap of a man who had a halo" |
|
|
hepatitis: think _ caused it
|
INH
|
|
|
gynecomastia: think _ caused it
|
Some Drugs Create Awesome Knockers
spironolactone digitalis cimetidine chronic Alcohol use estrogens ketoconazole |
|
|
hot flashes: think _ caused it
|
tamoxifen
clomiphene |
|
|
hypothyroidism: think _ caused it
|
lithium
amiodarone |
|
|
gingival hyperplasia: think _ caused it
|
phenytoin
|
|
|
gout: think _ caused it
|
furosemide
thiazides |
|
|
osteoporosis: think _ caused it
|
corticosteroids
heparin |
|
|
photosensitivity: think _ caused it
|
SAT for a photo
sulfonamides amiodarone tetracycline |
|
|
rash (Stevens-Johnson syndrome): think _ caused it
|
ethosuximide
lamotrigine carbamazepine allopurinol phenytoin penicillin phenobarbital sulfa drugs its unEthical for a Lamb to have a Carbon footprint Although it's okay for a Pheny Peni Phiend to have a Sulfa footprint |
|
|
SLE-like syndrome: think _ caused it
|
Hydralazine
INH Procainamide Phenytoin it's not HIPP to have lupus |
|
|
fanconi's syndrome: think _ caused it
|
expired tetracycline
|
|
|
interstitial nephritis: think _ caused it
|
NSAIDs
methicillin furosemide "Not My Fucking nephron!" |
|
|
hemorrhagic cystitis
|
cyclophosphamide
ifosfamide (prevent by coadministering with mesna) |
|
|
fanconi's syndrome
|
disease of proximal tubule.
glucose AAs uric acid phosphate bicarb are passed into urine, instead of reabsorbed |
|
|
cinchonism: think _ caused it
|
quinidine
quinine |
|
|
diabetes insipidus: think _ caused it
|
lithium
demeclocycline |
|
|
parkinson-like syndrome: think _ caused it
|
"He Can't Really Move"
haloperidol chlorpormazine reserpine metoclopramide |
|
|
seizures: think _ caused it
|
bupropion
imipenem/cilastatin isoniazid |
|
|
disulfiram-like reaction: think _ caused it
|
metronidazole
certain cephalosporins procarbazine 1st-generation sulfonylureas |
|
|
nephrotoxicity/neurotoxicity: think _ caused it
|
polymyxins
|
|
|
nephrotoxicity/ototoxicity: think _ caused it
|
cisplatin
vancomycin aminoglycosides loop diuretics a Platinum Van can drive a Mean Loop |
|
|
p-450 inducers
|
quinidine
barbiturates St. John's wort Phenytoin Rifampin Griseofulvin Queen Barb Steals Phen-phen and Refuses Greasy Carbs Chronically |
|
|
p-450 inhibitors
|
Inhibit yourself from drinking beer from a
KEG because it makes you Acutely SICk HIV protease inhibitors ketoconazole erythromycin grapefruit juice acute alcohol use sulfonamides isoniazid cimetidine |
|
|
_ alcohol use vs.
_ alcohol use: effect on p-450 |
chronic alcohol use: + P-450
acute alcohol use: - P-450 |
|
|
why does alcohol make you pee?
|
ethylene glycol
methanol ethanol are all competitive substrates for ADH |
|
|
fomepizole moa
|
- alcohol dehydrogenase
|
|
|
_ inhibits alcohol dehydrogenase
|
fomepizole
|
|
|
ethylene glycol metabolism
|
by alcohol dehydrogenase -->
oxalic acid --> acidosis nephrotoxicity |
|
|
methanol metabolism
|
by alcohol dehydrogenase -->
formaldehyde formic acid --> severe acidosis retinal damage |
|
|
ethanol metabolism
|
by alcohol dehydrogenase -->
acetaldehyde -- nausea, vomiting; -- headache, hypotension acetaldehyde --> by acetaldehyde dehydrogenase --> acetic acid |
|
|
inhibitors of ethanol metabolism
|
fomepizole inhibits
alcohol dehydrogenase disulfiram inhibits acetaldehyde dehydrogenase |
|
|
alcohol metabolism depletes _, which ...
|
NAD+ which is needed for
--fatty acid oxidation in the liver --conversion pyruvate -->lactate thereby causing --fatty liver --lactic acidosis |
|
|
glow in some individuals after drinking is b/c
|
polymorphism in the gene that codes for acetaldehyde dehydrogenase
--> -- facial flushing -- buildup of acetaldehyde |
|
|
patients with sulfa allergies may develop... sxs
|
fever
pruritic rash urticaria Stevens-Johnson syndrome hemolytic anemia thrombocytopenia agranulocytosis sxs range from mild to life-threatening |
|
|
celecoxib is a _
|
cox-2 selective inhibitor
|
|
|
drug name
-azine means |
phenothiazine (e.g. chlorpromazine)
neuroleptic antiemetic |
|
|
phenobarbital is a _
|
barbiturate
|
|
|
-ipramine means _
e.g. _ |
TCA
imipramine |
|
|
-operidol means _
e.g. _ |
butyrophenone (neuroleptic)
haloperidol |
|
|
-olol means _
-terol means _ e.g. |
beta antagonist e.g. propranolol
beta2 agonist e.g. albuterol |
|
|
-tidine means
|
H2 antagonist
e.g. cimetidine |
|
|
-triptan means
e.g. |
5-HT (1B/1D) agonists
for migraine e.g. sumatriptan |
|
|
sumatriptan rx
|
migraine
|
|
|
-triptyline means _
e.g. |
TCA
amitriptyline |
|
|
two suffixes for TCAs
|
-ipramine
-triptyline |
