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Step 1 11.19.12
Pharm III
| Question | Answer |
|---|---|
| Which types of fibers do hemicholinium, vesamicol, and botulinum affect? | cholinergic |
| which type of fibers os metyrosine, roserpine, guanithedine, amphetimine, and Cocaine affecT? | noradrenergic |
| What modulates NE release from a sympathetic nerve ending? | NE itseld acting on presynaptic alpha 2 autorecptors and ACH, angiotensin 2 among others |
| What is the class of Bethanecol, carbachol, pilocarpine, methacholine? | direct cholinergic agonists |
| What are the clinical applications of bethanechol? | post op and neurogenic ileus and urinary retention |
| What is the mech of bethanechol? | activates bowel and bladder SMM, resistant to AChE |
| What is the clinical use of carbachol? | glaucoma, pupillary contraction, relief of intraocular pressure |
| What is the mech of carbochol? | copy of acetylcholine |
| what is the clinical use of pilocarpine? | potent stimulator of sweat tears and saliva |
| What is the mech of pilocarpine? | contracts cilisry muscle of eye (open angle), pupillary sphincter ( narrow angle), restant to ACHE |
| What is the clinical use of methacholine? | challenge test for asthma |
| What is the mech of methacholine? | stimulates muscarinic receptors in airways when inhaled |
| What is the drug class of neostigmine, pyridostigmine, edrophonium, physostigimine, echothiphate, donepezil? | indirect cholinergic agonists (acetylcholinesterases) |
| What is the clinical use of neostigmine? | post op and neurogenic ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade post op |
| What is the mech and penetration of neostigmine? | incr endogenous ACH, no CNS penetration |
| What is the clinical use of pyridostigmine? | myasthenia gravis (long acting), does not penetrate CNS |
| What is the mech of pyridostigimine? | incr endogenous ACHJ, incr strength esp in myasthenia gravis |
| What is the clinical use of edrophonium? | Dx of myasthenia gravis (short acting) |
| What is the mech of edrophonium? | incr endogenous ACH |
| What is the clinical use of physostigmine? | glaucoma ( cosses BBB into CNs) and for atropine OD |
| What is the mech of physostigmine? | incr endogenous ACH |
| What is the clinical use of echothiophate? | glaucoma |
| What is the mech of echothiophate? | incr endogenous ACH |
| What is the clinical use of donepezil? | alzheimer's disease |
| What is the mech of donepazil? | incr endogenous ACH |
| What must be watched for in the admistration of all cholinomimetic agents? | exacerbation of COPD, asthma, peptic ulcers |
| What is the mnemonic and presentation of cholinesterase inhbitor poisoning as in organophosphates (farmers)? | DUMBBELSS: diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, of SMM and CNS. lacrimation, Sweating, salivation |
| what is the antidote for organophosphate poisoning (cholinesterase inhibtors)? | atropine + pralidoxime (regenrates active AchE |
| What is the drug class of atropine, homatropine, tropicamide, benztropine,scopolamine,ipratropium,oxybutynin,glyc opyrolate, methoscopolamine,pirenzipine, propantheline? | muscarinic antagonists |
| What is the organ system and tx action of atropine, homatropine, tropicamide? | eye. produce mydriasis and cycloplegia |
| What is the organ system and action of benztropine? | CNs. used for Parkinson's |
| What is the organ system and action of scopolamine? | CNS. tx motion sickness |
| What is the organ system and action of ipratropium ? | respiratory. used to Tx asthma, COPD |
| What is the organ system and action of oxybutynin, glycopyrrolate? | genitourinary. reduced urgency in mild cystitis, reduce bladder spasms |
| What is the organ system and action of methscopolamine, pirenzepine, propantheline? | gastrointestinal, tx for peptic ulcer disease |
| What is atropine used to tx? | bradycarcia and opthalmic applications |
| What is the atropine on the eye, airway, stomach, gut and bladder? | blocks DUMBBELLSS. eye: block pupil dilation, cycloplegia. airway: decr secretions stomach: decr acid secretion gut: decr motility, bladder: decr urgency in cystitis |
| What is the mnemonic for the SE of atropine? | Hot at fire, Dry as bone, Red as beet, blind as bat, mad as hatter. (incr body temp, rapid pulse, dry motuh, flushed skin, cycloplegia, constipation, disorientation |
| What specific conditions can atropine cause in what populations? | acute angle closure glaucoma in the lederly, urinary retention in men with prostatic hyperplasia, hyperthermia in infants |
| What is the receptor selectivity of epinephrine? | highly affects alpha 1,2,Beta 1. somewhat beta 2. none on D1 |
| What are the clinical applications of epinephrine? | anaphylaxis, open angle glaucoma, asthma, hypotension |
| What is the receptor selectivity of norepinephrine? | high at alpha 1,2, somewhat at beta 1. none at beta 2 or D1 |
| What are the clinical applications of norepinephrine? | hypotension(decr renal perfusion) |
| What is the receptor selectivity of isoproterenol? | highly affects Beta 1, beta 2. none at alpha 1,2, D1 |
| What are the clinical applications of isoproterenol? | rarely used for AV block |
| What is the receptor selectivity of dopamine? | alpha 1 ,2 at high dose, beta 1 ,2 at medium dose, D1 at low dose |
| What are the clinical applications of dopamine? | shock(renal perfusion), heart failure, inotropic and chronotropic. D1>beta>alpha |
| What is the receptor selectivity of phenylephrine? | highly affects alpha 1, some at alpha 2, none at Beta 1 ,2 , D1 |
| What are the clinical applications of phenylephrine? | pupillary dilation, vasoconstriction, nasal decongestion |
| What is the receptor selectivity of dobutamine? | a little at alpha 1, 2, beta 2. Very strong at Beta 1. none at D1 |
| What are the clinical applications of dobutamine? | heart failutre, cardiac stress testing, inotropic but not chronotropic |
| What is the receptor selectivity of metaproterenol, albuterol, salmeterol, terbutaline? | strongly affects Beta 2, some Beta 1. none at alpha 1,2, D1 |
| What are metaproterenol, albuterol used for? | acute asthma |
| What is salmeterol used for? | for long term treatment of astma |
| What is terbuatine used for? | reduces premature uterine contractions |
| What is the receptor selectivity of ritodrine? | no activity except strongly at Beta 2 |
| What is the use of ritodrine? | reduces premature uterine contractions |
| What is the drug class of amphetamine, ephedrine, cocaine? | indirect sympathomimetics |
| What is the mech of amphetamines? | indirect general agonist, releases stored catecholamines |
| What is the clinical application of amphetamines? | narcolepsy, obesity, attention deficit disorder |
| What is the mechof ephedrine? | indirect general agonist, releases stored catecholamines |
| What is the clinical application of ephedrine? | nasal decongestion, urinary incontinenhnce, hypotension |
| What is the mech of cocaine? | indirect general agonist, uptake inhibitor |
| What is the clinical application of cocaine? | causes vasoconstriction and local anasthesia |
| What is the drug class of clonidine, alpha methyldopa? | sypathoplegic |
| What is the mech of clonidine, alpha metyhldopa? | centrally acting alpha 2 agonists, decr central adrenergic outflow |
| What is the clinical application of clonidine, alphamethyldopa? | hypertension, esp in renal disease (no decr blood flow to kidney) |
| What is the class of phenoxybenzamine? | irreversible nonselective alpha blocker |
| What is the clinical application of phenoxybenzamine? | pheochromocytoma. given before tumor is removed to block catecholamine release |
| What are the major SE of phenoxybenzamine? | orthostatic HTN, reflex tachycardia |
| What is the class of phentolamine? | reversible non selective alpha blocker |
| What is the clinical application of phentolamine? | given to pt on MAO inhibitors who eat tyramine containing foods |
| What is the class of prazosin, terazosin, doxazosin? | alpha 1 selective blockers |
| What is the clinical application of prazosin, terazosin, doxazosin? | hypertesnion, urinary retention in BPH |
| What are the major SE of prazosin, terazosin, doxazosin? | 1st dose orthostatic hypotension, dizziness, HA |
| What is the class of mirtazepine? | alpha 2 selective blocker |
| What is the clinical application of mirtazipine? | depression |
| What is the clinical application of mirtazepinine? | sedation, incr serum cholesterol, incr appetite |
| What is the effect of an alpha blocker on blood pressure in epi vs phenylephrine? | epi: get a reversal from the alpha response ( which is now blocked) to the beta 2 net decr response. Phenylephrine: the pressor effect of phenyephrine is depressed but not reversed because phenylephrine is a pure alpha agonist |
| What is the class of all -olols? | beta blockers |
| How are beta blockers used to tx hypertension? | decr CO, decr renin secretion (beta blockade on JGA cells) |
| How are beta blockers used to tx angina pectoris? | decr HR and contractility, resulting in decr O2 consumption |
| How are beta blockers used to tx MI? | decr the mortality of MI |
| How are beta blockers used to tx SVT, which betablockers used? | propanolol, esmolol. decr AV conduction velocity (class II antiarrythmics) |
| How are beta blockers used to tx CHF? | slows progression of chronic failure |
| How are beta blockers used to tx glaucoma? | decr secretion of acqueous humor |
| What are the major SE of beta blockers? | impotence, exacerbation of asthma, CV effects (bradycardia, AV blcok, CHF), CNS adverse effects (sedations, sleep alterations). cuation use in DM |
| Which are the beta 1 selective Beta blockers (B1>B2)? | acebutolol(partial), betaxolol, esmolol (short acting, atenolol, metoprolol |
| What is a mnemonic for the beta 1 selective Beta blockers and when are they advantageous? | A BEAM: advantageous in pateints with comorbid pulmonary disease |
| What is the mnemonic for the non selective beta blockers? | Please Try Not being Picky: propanolol, timolol, nadolol, pindolol |
| Which are the nonselective alpha and beta blockers? | carvetolol, labetolol |
| Which are the partial beta agonists which are beta blockers? | pindolol, acebutolol |
| What is the antidote for an OD of acetominphen ? | n-acetylcysteine (replenishes glutathione) |
| What is the antidote for an OD of salicylates? | NaHCO3(alkalinize urine), dialysis |
| What is the antidote for an OD of amphetamines? | NH4Cl (acidifies urine) |
| What is the antidote for an OD of acetylcholinesterase inhibtors, organophosphates? | atropine, pralidoxime |
| What is the antidote for an OD of anitmuscarinic or anticholinergic agents? | physostigamine salicylate |
| What is the antidote for an OD of beta blockers? | glucagon |
| What is the antidote for an OD of digitalis? | stop dig. normalize K+, lidocaine, anti-dig fab fragments, Mg2+ (KLAM) |
| What is the antidote for an OD of iron? | deferoxamine |
| What is the antidote for an OD of Lead? | CaEDTA,dimercaprol, succimer, penicillamine |
| What is the antidote for an OD of mercury, arsenic, gold? | dimercaprol (BAL), succimer |
| What is the antidote for an OD of copper, arsenic, gold? | penicillamine |
| What is the antidote for an OD of cyanide? | nitrite, hydroxocobalamin, thisulfate |
| What is the antidote for an OD of methemoglobin? | methylene blue, vit C |
| What is the antidote for an OD of carbon monoxide? | 100% O2, hyperbaric O2 |
| What is the antidote for an OD of methanol, ethylene glycol? | fomeprizole>ethanol, dialysis |
| What is the antidote for an OD of opioids? | naloxone/naltrexone |
| What is the antidote for an OD of benzodiazepines? | flumazenil |
| What is the antidote for an OD of TCAs? | NaHCO3 (plasma alkinization) |
| What is the antidote for an OD of heparin? | protamine |
| What is the antidote for an OD of warfarin? | vit K, fresh frozen plasma |
| What is the antidote for an OD of tPA, streptokinase, urokinase? | aminocaproic acid |
| What is the antidote for an OD of theophylline? | betablocker |
| What drugs can cause coronary vasospasm? | cocaine, sumatriptan |
| What drugs can cause cutaneous flushing? | VANC: vancomycin, adenosine, Niacin, Ca++ channel blockers |
| What drugs can cause dilated cardiomyopathy? | doxorubicin (adriamycin), daunorubicin |
| What drugs can cause torsades des pointes? | class III (sotalol), Class IA (quinidine) antiarrythmics |
| What drugs can cause agranulocytosis? | Agranulocytosis could certainly cause pretty major damage: clozapine, carbamazepine, colchisine, propylthiouracil, methimazole, dapsone |
| What drugs can cause aplastic anemia? | chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole |
| What drugs can cause direct coombs-positive hemolytic anemia? | methyldopa |
| What drugs can cause gray baby syndrome? | chloramphenicol |
| What drugs can cause hemolysis in G6PD deficient patients? | (hemolysis IS PAIN) isoniazid (INH), sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin |
| What drugs can cause megaloblastic anemia? | phenytoin, methotrexate, sulfa drugs (PMS) |
| What drugs can cause thrombotic complications? | OCP's (estrogens, progestins)` |
| What drugs can cause cough? | ACE inhibitors (NOT WITH ARBS like losartan) |
| What drugs can cause pulmonary fibrosis? | BLAB: bleomycin, amiodarone, busulfan |
| What drugs can cause acute cholestatic hepatitis? | macrolides |
| What drugs can cause focal to massive hepatic necrosis? | halothane, acetaminophen, valproic acid, amantia phalloides (HAVAc) |
| What drugs can cause pseudomembranous colitis? | clindamycin, ampicillin |
| What drugs can cause adrenocortical insufficiency? | glucocorticoid withdrawl (HPa surpression) |
| What drugs can cause gynecomastia? | Some drugs create awesome knockers: spironolactone, digitalis, cimetidine, chronic alcohol use, estrogens, ketoconazole |
| What drugs can cause hot flashes? | tamoxifen, clomiphene |
| What drugs can cause hypothyroidism? | lithium, amiodarone, sulfonamides |
| What drugs can cause hyperglycemia? | niacin, tacrolimus, protease inhibitors |
| What drugs can cause fat redistrobution? | glucocorticoids, protease inhibitors |
| What drugs can cause gingival hyperplasiA? | phenytoin, verapamill |
| What drugs can cause gout? | furosemide, thiazides, niacin, cyclosporine, pyrazinamide |
| What drugs can cause myopathy? | Fish N CHIPS Gives: fibrates, niacin, colchicine, hydroxychloroquine, interferone alpha, penicillamine, statins, glucocorticoids |
| What drugs can cause osteoporosis? | corticosteroids, heparin |
| What drugs can cause photosensitivity? | SAT: sulfonamides, amiodarone, tetracycline |
| What drugs can cause Rash: Steven's Johnson syndrome? | PEC SLAPP: penicilline, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital |
| What drugs can cause SLE like syndrome? | HIPP: hydraliazine, INH, procainamide, phenytoin |
| What drugs can cause tendonitis, tendon rupture, and cartilage damage especially in kids? | fluoroquinolones |
| What drugs can cause diabetes insipidus? | lithium, demeclocycline |
| What drugs can cause Fanconi's syndrome? | expired tetracycline |
| What drugs can cause interstitial nephritis? | methicillin, NSAIDS, furosemide |
| What drugs can cause hemorragic cystitis? How can it be prevented? | cyclophosphamide, ifosfamide. prevent by coadminstering mensa |
| What drugs can cause SIADH? | carbamazepine, cyclophosphamide |
| What drugs can cause cinchonism? | quinidine, quinine |
| What drugs can cause Parkinson-like syndrome? | antipsychotics, reserpine, metoclopramide |
| What drugs can cause seizures? | buproprion, imipenem/cilastatin, isoniazid |
| What drugs can cause tardive dyskinesiA? | antipsychotics |
| What drugs can cause anitmuscarinic effects? | atropine, TCAs, H1 blockers, neuroleptics, digoxin |
| What drugs can cause a disulfram like reaction? | metronidazole, some cephalosporins, procarbazine, 1st gen sulfonylureas |
| What drugs can cause nephrotoxicity/ototoxicity? | aminoglycosylides, vancomycin, loop diuretics, cisplatin |
| What is the mnemonic for the cyt P450 inducers? | Queen Barb Steals Phen-phen and Refuses Greasy carbs Chronically: qunidine, barbituates, St. John's wort, phenytoin, rafampin, griseofulvin, carbamazepine, chronic EtOh use |
| What is the mnemonic for the cyt p450 inhibitors? | MAGIC RACKS: macriolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir, acute EtOh abuse, ciprofloxacin, ketoconazole, sulfonamides |
| What is a mneomic for the sulfa drugs? | Popular FACTSSS: probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide antibiotics, sulfasalazine, sulfonylureas |
| What might be seen in a pt with sulfa allergies? | fever, urinary tract infection, pruritic rash, SJ syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, uticaria |
| What is the drug category of -azoles? | antifungal |
| What is the drug category of -cillin? | penicillins |
| What is the drug category of -cyclines? | antibiotic protein synthesis inhibtor |
| What is the drug category of -navir? | protease inhbitor |
| What is the drug category of -triptans? | 5-Ht 1b/d agonists in migraines |
| What is the drug category of -anes? | inhalational general anasthetic |
| What is the drug category of -caines? | local anasthetic |
| What is the drug category of -operidol? | butyrophenone (neuroleptic) |
| What is the drug category of -azine? | phenothiazine (neuroleptic, antiemetic) |
| What is the drug category of -barbital? | barbituate |
| What is the drug category of -zolam? | benzodiazepine |
| What is the drug category of -azepam? | benzodiazepine |
| What is the drug category of -etine? | SSRIs |
| What is the drug category of ipramine? | TCA |
| What is the drug category of -triptyline? | TCA |
| What is the drug category of -olol? | Beta antagonist |
| What is the drug category of -terol? | beta 2 agonist |
| What is the drug category of -zosin? | alpha 1 antagonist |
| What is the drug category of -oxin? | cardiac glycoside (inotropic agent) |
| What is the drug category of -prils? | ACE inhbitors |
| What is the drug category of -afil? | for erectile dysfx |
| What is the drug category of -tropin s? | pituitary hormones |
| What is the drug category of -tidines? | H2 antagonist |
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tjs2123
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