1. Time it takes for amount of drug to fall to half of its value; this is a constant in first order kinetics (majority of drugs)
    Half-life (T1/2)
  2. Relates the amount of drug in the body to the plasma concentration
    Volume of distribution (VD)
  3. Plasma concentration of a drug at a given time
  4. The ratio of the rate of elimination of a drug to its plasma concentration
    Clearance (CL)
  5. The elimination of drug that occurs before it reaches the systemic circulation
    First pass effect
  6. The fraction of administered dose of a drug that reaches systemic circulation
    Bioavailability (F)
  7. When the rate of drug input equals the rate of drug elimination
    Steady state
  8. This step of metabolism makes a drug more hydrophilic and hence augments elimination
    Phase I
  9. Different steps of Phase I
    Oxidation reduction hydrolysis
  10. Inducers of Cytochrome P450 (CYP450)
    Barbiturates phenytoin carbamazepine and rifampin
  11. Inhibitors of CYP450
    Cimetidine ketoconazole erythromycin isoniazid and grapefruit
  12. Products of Phase II conjugation
    Glucuronate acetic acid and glutathione sulfate
  13. Type of kinetics when a constant percentage of substrate is metabolized per unit time
    First order kinetics
  14. Drug elimination with a constant amount metabolized regardless of drug concentration
    Zero order kinetics
  15. Target plasma concentration times (volume of distribution divided by bioavailability)
    Loading dose (Cp*(Vd/F))
  16. Concentration in the plasma times (clearance divided by bioavailability)
    Maintenance dose (Cp*(CL/F))
  17. Strength of interaction between drug and its receptor
  18. Selectivity of a drug for its receptor
  19. Amount of drug necessary to elicit a biologic effect
  20. Ability of drug to produce a biologic effect
  21. Ability of a drug to produce 100% of the maximum response regardless of the potency
    Full agonist
  22. Ability to produce less than 100% of the response
    Partial agonist
  23. Ability to bind reversibly to the same site as the drug and without activating the effector system
    Competitive antagonist
  24. Class of drugs with ability to decrease the maximal response to an agonist
    Noncompetitive antagonist
  25. A hormone whose mechanism of action (MOA) utilizes intracellular receptors
    Thyroid and steroid hormones
  26. A hormone whose MOA utilizes transmembrane receptors
  27. Class of drugs whose MOA utilizes ligand gated ion channels
    Benzodiazepines and calcium channel blockers
  28. Median effective dose required for an effect in 50% of the population
  29. Median toxic dose required for a toxic effect in 50% of the population
  30. Dose which is lethal to 50% of the population
  31. Window between therapeutic effect and toxic effect
    Therapeutic index
  32. Term for a high margin of safety
    High therapeutic index
  33. Term for a narrow margin of safety
    Low therapeutic index
  34. Antidote used for lead poisoning
    Dimercaprol EDTA
  35. Antidote used for cyanide poisoning
  36. Antidote used for anticholinergic poisoning
  37. Antidote used for organophosphate/anticholinesterase poisoning
    Atropine pralidoxime (2-PAM)
  38. Antidote used for iron salt toxicity
  39. Antidote used for acetaminophen (APAP) toxicity
    N-acetylcysteine (Mucomyst)
  40. Antidote for arsenic mercury lead and gold poisoning
  41. Antidote used in poisonings: copper (Wilson's disease) lead mercury and arsenic
  42. Antidote used for heparin overdose
  43. Antidote used for warfarin toxicity
    Vitamin K and Fresh frozen plasma (FFP)
  44. Antidote for tissue plasminogen activator (t-PA) streptokinase
    Aminocaproic acid
  45. Antidote used for methanol and ethylene glycol
    Ethanol or fomepizole
  46. Antidote used for opioid toxicity
    Naloxone (IV) naltrexone (PO)
  47. Antidote used for benzodiazepine toxicity
  48. Antidote used for tricyclic antidepressants (TCA)
    Sodium bicarbonate
  49. Antidote used for carbon monoxide poisoning
    100% O2 and hyperbaric O2
  50. Antidote used for digitalis toxicity
    Digibind (also need to d/c digoxin normalize K+ and lidocaine if pt. Is arrhythmic)
  51. Antidote used for beta agonist toxicity (eg. Metaproterenol)
  52. Antidote for methotrexate toxicity
  53. Antidote for beta-blockers and hypoglycemia
  54. Antidote useful for some drug induced Torsade de pointes
    Magnesium sulfate
  55. Antidote for hyperkalemia
    sodium polystyrene sulfonate (Kayexalate)
  56. Antidote for salicylate intoxication
    Alkalinize urine dialysis
  57. Constant proportion of cell population killed rather than a constant number
    Log-kill hypothesis
  58. Treatment with cancer chemotherapy at high doses every 3-4 weeks too toxic to be used continuously
    Pulse therapy
  59. Toxic effect of anticancer drug can be lessened by rescue agents
    Rescue therapy
  60. Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates
  61. Pyrimidine analog that causes Thymine-less death given with leucovorin rescue
    5-flouracil (5-FU)
  62. Drug used in cancer therapy causes Cushing-like symptoms
  63. Side effect of Mitomycin
    SEVERE myelosuppression
  64. MOA of cisplatin
    Alkylating agent
  65. Common toxicities of cisplatin
    Nephro and ototoxicity
  66. Analog of hypoxanthine needs HGPRTase for activation
    6-mercaptopurine (6-MP)
  67. Interaction with this drug requires dose reduction of 6-MP
  68. May protect against doxorubicin toxicity by scavenging free radicals
  69. Blows DNA (breaks DNA strands) limiting SE is pulmonary fibrosis
  70. Bleomycin+vinblastine+etoposide+cisplatin produce almost a 100% response when all agents are used for this neoplasm
    Testicular cancer
  71. ABVD regimen used for HD but appears less likely to cause sterility and secondary malignancies than MOPP
    Adriamycin (doxorubicin) +bleomycin vinblastine +dacarbazine
  72. Regimen used for non-Hodgkin's lymphoma
    CHOP (cyclophosphamide doxorubicin vincristine and prednisone) plus rituximab
  73. Regimen used for breast cancer
    CMF (cyclophosphamide methotrexate and fluorouracil) and tamoxifen if ER+
  74. Alkylating agent vesicant that causes tissue damage with extravasation
  75. Anticancer drug also used in RA produces acrolein in urine that leads to hemorrhagic cystitis
  76. Prevention of cyclophosphamide induced hemorrhagic cystitis
    Hydration and mercaptoethanesulfonate (MESNA)
  77. Microtubule inhibitor that causes peripheral neuropathy foot drop (eg. ataxia) and pins and needles sensation
  78. Interact with microtubules (but unlike vinca which prevent disassembly of tubules) it stabilizes tubulin and cells remain frozen in metaphase
    Paclitaxel (taxol)
  79. Toxicities include nephrotoxicity and ototoxicity leading to a severe interaction with aminoglycosides
  80. Agent similar to cisplatin less nephrotoxic but greater myelosuppression
  81. Converts asparagine to aspartate and ammonia denies cancer cells of essential AA (asparagine)
  82. Used for hairy cell leukemia; it stimulates NK cells
    Interferon alpha
  83. Anti-androgen used for prostate cancer
    Flutamide (Eulexin)
  84. Anti-estrogen used for estrogen receptor + breast cancer
  85. Aromatase inhibitor used in breast cancer
    Letrozole anastrozole
  86. Newer estrogen receptor antagonist used in advanced breast cancer
    Toremifene (Fareston)
  87. Some cell cycle specific anti-cancer drugs
    Bleomycin vinca alkaloids antimetabolites (eg. 5-FU 6-MP methotrexate etoposide)
  88. Some cell cycle non-specific drugs
    Alkylating agents (eg. mechlorethamine cyclophosphamide) antibiotics (doxorubicin daunorubicin) cisplatin nitrosourea
  89. Anti-emetics used in association with anti-cancer drugs that are 5-HT3 (serotonin receptor subtype ) antagonists
    Odansetron granisetron
  90. Nitrosoureas with high lipophilicity used for brain tumors
    Carmustine (BCNU) and lomustine (CCNU)
  91. Produces disulfiram-like reaction with ethanol
  92. Somatostatin (SRIF) analog used for acromegaly carcinoid glucagonoma and other GH producing pituitary tumors
  93. Somatotropin (GH) analog used in GH deficiency (dwarfism)
  94. GHRH analog used as diagnostic agent
  95. GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively
  96. GnRH antagonist with more immediate effects used for infertility
  97. Dopamine (DA) agonist (for Parkinson's disease) used also for hyperprolactinemia
  98. Hormone inhibiting prolactin release
  99. ACTH analog used for diagnosis of patients with corticosteroid abnormality
  100. Synthetic analog of ADH hormone used for diabetes insipidus and nocturnal enuresis
    Desmopressin (DDAVP)
  101. SE of OCs
    Increased thromboembolic events
  102. Most widely used thyroid drugs such as Synthroid and Levoxyl contain
    L-thyroxine (T4)
  103. T3 compound less widely used
  104. Anti-thyroid drugs
    Thioamides iodides radioactive iodine and ipodate
  105. Thioamide agents used in hyperthyroidism
    Methimazole and propylthiouracil (PTU)
  106. Thioamide less likely to cross placenta inhibits peripheral conversion of T4 to T3 in high doses and should be used with extreme caution in pregnancy
  107. PTU (propylthiouracil) MOA
    Inhibits thyroid hormone synthesis by blocking iodination of the tyrosine residues of thyroglobulin
  108. Can be effective for short term therapy of thyroid storm but after several weeks of therapy causes an exacerbation of hyperthyroidism
    Iodide salts
  109. Dose may need to be increased during pregnancy or with Ocs due to increased TBG in plasma
  110. Permanently cures thyrotoxicosis patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy
    Radioactive iodine
  111. Radio contrast media that inhibits the conversion of T4 to T3
  112. Block cardiac adverse effects of thyrotoxicosis such as tachycardia inhibits the conversion of T4 to T3
    Beta-blockers such as propranolol
  113. Vitamins containing iron should NOT be taken simultaneously with levothyroxine because
    Iron deiodinates thyroxine
  114. Thyroxine dose may need to be increased in hypothyroid patient during pregnancy because
    Estogens increase maternal TBG
  115. 3 zones of adrenal cortex and their products
    Glomerulosa (mineralocorticoids) fasciculata (glucocorticoid=GC) and reticularis (adrenal androgens)
  116. Pneumonic for 3 zones of adrenal cortex
  117. Used for Addison's disease Congenital Adrenal Hyperplasia (CAH) inflammation allergies and asthma (as a local inhalation)
  118. Short acting glucocorticoids
    Cortisone and hydrocortisone (equivalent to cortisol)
  119. Intermediate acting glucocorticoids
    Prednisone methylprednisolone prednisolone and triamcinolone
  120. Long acting glucocorticoids
    Betamethasone and dexamethasone
  121. Mineralocorticoids
    Fludrocortisone and deoxycorticosterone
  122. Some side effects of corticosteroids
    Osteopenia impaired wound healing inc. risk of infection inc. appetite HTN edema PUD euphoria psychosis stria thinning of skin
  123. Period of time of therapy after which GC therapy will need to be tapered
    5-7 days
  124. Used for Cushing's syndrome (increased corticosteroid)
    Dexamethasone suppression test
  125. Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis
  126. Antifungal agent used for inhibition of all gonadal and adrenal steroids
  127. Antiprogestin used as potent antagonist of GC receptor
  128. Diuretic used to antagonize aldosterone receptors
  129. Common SE of spironolactone
    Gynecomastia and hyperkalemia
  130. Slightly increased risk of breast cancer endometrial cancer heart disease (questionable) has beneficial effects on bone loss
  131. Antiestrogen drugs used for fertility and breast cancer respectively
    Clomiphene and tamoxifen
  132. Common SE of tamoxifen and raloxifene
    Hot flashes
  133. Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and prophylaxis in women with risk factors for breast cancer
  134. Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy
    Diethylstilbestrol (DES)
  135. Estrogen mostly used in oral contraceptives (OC)
    Ethinyl estradiol and mestranol
  136. Anti-progesterone used as abortifacient
    Mifepristone (RU-486)
  137. Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)
    Combination oral contraceptives (OC)
  138. Oral contraceptive available in a transdermal patch
  139. Converted to more active form DHT by 5 alpha-reductase
  140. 5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness
    Finasteride (Proscar and Propecia respectively)
  141. Anabolic steroid that has potential for abuse
    Nandrolone oxymetholone and oxandrolone
  142. Anti-androgen used for hirsutism in females
    Cyproterone acetate
  143. Drug is used with testosterone for male fertility
  144. What do alpha cells in the pancreas produce?
  145. What do beta cells in the pancreas produce?
  146. Where are beta cells found in the pancreas?
    Islets of Langerhans
  147. What do delta cells in the pancreas produce?
  148. Product of proinsulin cleavage used to assess insulin abuse
  149. Exogenous insulin contains
    Little C-peptide
  150. Endogenous insulin contains
    Normal C-peptide
  151. Very rapid acting insulin having fastest onset and shortest duration of action
    Lispro (Humalog) aspart glulisine
  152. Rapid acting crystalline zinc insulin used to reverse acute hyperglycemia
    Regular (Humulin R)
  153. Long acting insulin
    Ultralente (humulin U)
  154. Ultra long acting insulin has over a day duration of action
    Glargine (Lantus) detemir
  155. Major SE of insulin
  156. Important in synthesis of glucose to glycogen in the liver
    GLUT 2
  157. Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation
    GLUT 4
  158. Examples of alpha-glucosidase inhibitors (AGI)
    Acarbose miglitol
  159. MOA of AGI's
    Act on intestine delay digestion and absorption of glucose formed from digestion of starch and disacchrides
  160. SE of AGI's
    Flatulence (do not use beano to tx) diarrhea abdominal cramps
  161. Alpha-glucosidase inhibitor associated with elevation of LFT's
  162. Amino acid derivative active as an insulin secretagogue
  163. MOA of nateglinide
    Insulin secretagogue - closes ATP-sensitive K+ channel
  164. Biguanide
  165. Drugs available in combination with metformin
    Glyburide glipizide and rosiglitazone
  166. MOA of metformin
    Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
  167. Vascular effects of metformin
    Decreased micro and macro vascular disease
  168. Most important potential SE of metformin
    Lactic acidosis
  169. Incidence of hyoglycemia with metformin
  170. Meglitinide class of drugs
  171. MOA of repaglinide
    Insulin release from pancreas; faster and shorter acting than sulfonylurea
  172. First generation sulfonylurea
    Chlorpropamide tolbutamide tolazamide etc.
  173. Second generation sulfonylurea
    Glyburide glipizide glimepiride etc.
  174. MOA of both generations
    Insulin release from pancreas by modifying K+ channels
  175. Common SE of sulfonylureas repaglinide and nateglinide
  176. Sulfonylurea NOT recommended for elderly because of very long half life
  177. Thiazolidinediones
    Pioglitazone Rosiglitazone Troglitazone (withdrawn/d from market)
  178. Reason troglitazone was withdrawn from market
    Hepatic toxicity
  179. MOA of thiazolindinediones
    Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
  180. SE of Thiazolindinediones
    Edema mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism
  181. Hyperglycemic agent that increases cAMP and results in glycogenolysis gluconeogenesis reverses hypoglycemia also used to reverse severe beta-blocker overdose and smooth muscle relaxation
  182. Available bisphosphonates
    Alendronate etidronate risedronate pamidronate tiludronate and zoledronic acid
  183. MOA of Bisphosphonates
    Inhibits osteoclast bone resorption
  184. Only bisphosphonate available IV
  185. Uses of bisphosphonates
    Osteoporosis Paget's disease and osteolytic bone lesions and hypercalcemia from malignancy
  186. Major SE of bisphosphonates
    Chemical esophagitis
  187. Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia
  188. Used for prevention of postmenopausal osteoporosis in women
    Estrogen (HRT-Hormone replacement therapy)
  189. Increase bone density also being tested for breast CA prophylaxis
    Raloxifene (SERM-selective estrogen receptor modulator)
  190. Used intranasally and decreases bone resorption
    Calcitonin (salmon prep)
  191. Used especially in postmenopausal women dosage should be 1500 mg
  192. Vitamin given with calcium to ensure proper absorption
    Vitamin D
  193. Disease caused by excess ergot alkaloids
    St. Anthony's Fire
  194. Endogenous substances commonly interpreted as histamine serotonin prostaglandins and vasoactive peptides
  195. Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea
    Zollinger-Ellison Syndrome
  196. Drug that causes contraction of the uterus
  197. Distribution of histamine receptors H1 H2 and H3
    Smooth muscle; stomach heart and mast cells; nerve endings CNS respectively
  198. Prototype antagonist of H1 and H2 receptors
    Diphenhydramine and cimetridine respectively
  199. 1st generation antihistamine that is highly sedating
  200. 1st generation antihistamine that is least sedating
    Chlorpheniramine or cyclizine
  201. 2nd generation antihistamines
    Fexofenadine loratadine and cetirizine
  202. Generation of antihistamine that has the most CNS effects
    First generation due to being more lipid-soluble
  203. Major indication for H1 receptor antagonist
    Use in IgE mediated allergic reaction
  204. Antihistamine that can be used for anxiety and insomnia and is not addictive
    hydroxyzine (Atarax)
  205. H1 antagonist used in motion sickness
    Dimenhydrinate meclizine and other 1st generation
  206. Most common side effect of 1st generation antihistamines
  207. Lethal arrhythmias resulting from concurrent therapy with azole fungals (metabolized by CYP 3A4) and these antihistamines which inhibit the 3A4 iso-enzyme.
    Terfenadine and astemizole (have been removed from the market)
  208. H2 blocker that causes the most interactions with other drugs
  209. Clinical use for H2 blockers
    Acid reflux disease duodenal ulcer and peptic ulcer disease
  210. Receptors for serotonin (5HT-1) are located
    Mostly in the brain and they mediate synaptic inhibition via increased K+ conductance
  211. 5HT-1d agonist used for migraine headaches "
    Sumatriptan naratriptan and rizatriptan
  212. Triptan available in parenteral and nasal formulation
  213. H1 blocker that is also a serotonin antagonist
  214. Agents for reduction of postpartum bleeding
    Oxytocin ergonovine and ergotamine
  215. Agents used in treatment of carcinoid tumor
    Ketanserin cyproheptadine and phenoxybenzamine
  216. 5HT-3 antagonist used in chemotherapeutic induced emesis
    Ondansetron granisetron dolasetron and alosetron
  217. 5HT-3 antagonist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease
  218. DOC to treat chemo-induced nausea and vomiting
  219. Drug used in ergot alkaloids overdose ischemia and gangrene
  220. Reason ergot alkaloids are contraindicated in pregnancy
    Uterine contractions
  221. SE of ergot alkaloids
    Hallucinations resembling psychosis
  222. Ergot alkaloid used as an illicit drug
  223. Dopamine agonist used in hyperprolactinemia
  224. Peptide causing increased capillary permeability and edema
    Bradykinin and histamine
  225. Mediator of tissue pain edema inactivated by ACE and may be a contributing factor to the development of angioedema
  226. Drug causing depletion of substance P (vasodilator)
  227. Prostaglandins that cause abortions
    Prostaglandin E1 (misoprostol) PGE2 and PGF2alpha
  228. Difference between COX 1 and COX 2 "
    "COX 1 is found throughout the body and COX 2 is only in inflammatory tissue
  229. Drug that selectively inhibits COX 2
    Celecoxib and rofecoxib
  230. Inhibitor of lipoxygenase
  231. Major SE of zileuton
    Liver toxicity
  232. Inhibitor of leukotrienes (LTD4) receptors and used in asthma
    Zafirlukast and montelukast
  233. Used in pediatrics to maintain patency of ductus arteriosis
  234. Approved for use in severe pulmonary HTN
    PGI2 (epoprostenol)
  235. Prostaglandin used in the treatment of impotence
  236. Irreversible nonselective COX inhibitor
  237. Class of drugs that reversibly inhibit COX
  238. Primary endogenous substrate for Nitric Oxidase Synthase
  239. MOA and effect of nitric oxide
    Stimulates cGMP which leads to vascular smooth muscle relaxation
  240. Long acting beta 2 agonist used in asthma
  241. Muscarinic antagonist used in asthma
  242. MOA action of cromolyn
    Mast cell stabilizer
  243. Methylxanthine derivative used as a remedy for intermittent claudication
  244. MOA of corticosteroids"
    inhibit phospholipase A2
  245. SE of long term (>5 days) corticosteroid therapy and remedy
    Adrenal suppression and weaning slowly respectively
  246. MOA of quinolones
    Inhibit DNA gyrase
  247. MOA of penicillin
    Block cell wall synthesis by inhibiting peptidoglycan cross-linkage
  248. Drug used for MRSA
  249. Vancomycin MOA
    Blocks peptidoglycan synthesis
  250. Type of resistance found with vancomycin
    Point mutation
  251. Meningitis prophylaxis in exposed patients
  252. Technique used to diagnose perianal itching and the drug used to treat it
    "Scotch tape technique
  253. and mebendazole"
  254. Two toxicities of aminoglycosides
    nephro and ototoxicity
  255. DOC for Legionnaires' disease
  256. MOA of sulfonamides
    Inhibit dihydropteroate synthase
  257. Penicillins active against penicillinase secreting bacteria
    Methicillin nafcillin and dicloxacillin
  258. Cheap wide spectrum antibiotic DOC for otitis media
  259. Class of antibiotics that have 10% cross sensitivity with penicillins
  260. PCN active against pseudomonas
    Carbenicillin piperacillin and ticarcillin
  261. Antibiotic causing red-man syndrome and prevention
    "Vancomycin infusion
  262. at a slow rate and antihistamines"
  263. Drug causes teeth discoloration
  264. MOA of tetracycline
    Decreases protein synthesis by inhibiting 30S ribosome
  265. Drug that causes gray baby syndrome and aplastic anemia
  266. Drug notorious for causing pseudomembranous colitis
  267. DOC for tx of pseudomembranous colitis
  268. Treatment of resistant pseudomembranous colitis
    ORAL vancomycin
  269. Anemia caused by trimethoprim
    Megaloblastic anemia
  270. Reason fluoroquinolones are contraindicated in children and pregnancy
    Cartilage damage
  271. DOC for giardia bacterial vaginosis pseudomembranous colitis and trichomonas
  272. Treatment for TB patients (think RIPE)
    Rifampin Isoniazid Pyrazinamide and Ethambutol
  273. Metronidazole SE if given with alcohol
    Disulfiram-like reaction
  274. Common side effect of Rifampin
    Red urine discoloration
  275. MOA of nystatin
    Bind ergosterol in fungal cell membrane
  276. Neurotoxicity with isoniazid (INH) prevented by
    Administration of Vit. B6 (pyridoxine)
  277. Toxicity of amphotericin
  278. SE seen only in men with administration of ketoconazole
  279. Topical DOC in impetigo
    Topical mupirocin (Bactroban)
  280. DOC for influenza A
  281. DOC for RSV
  282. DOC for CMV retinitis
  283. SE for ganciclovir
    Neutro leuko and thrombocytopenia
  284. Anti-viral agents associated with Stephen Johnson syndrome
    Nevirapine amprenavir
  285. HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism
    Protease inhibitors
  286. Antivirals that are teratogens
    Delavirdine efavirenz and ribavirin
  287. Antivirals associated with neutropenia
    Ganciclovir zidovudine saquinavir and interferon
  288. HIV med used to reduce transmission during birth
    AZT (zidovudine)
  289. Drug used for African sleeping sickness
  290. Drug used in Chagas disease
  291. Cephalosporins able to cross the BBB
    Cefuroxime (2nd) generation and Cefixime (3rd) generation
  292. Drug used for N. gonorrhea in females
  293. Cephalosporin causes kernicterus in neonates
    Ceftriaxone or cefuroxime
  294. SE of INH
    Peripheral neuritis and hepatitis
  295. Aminoglycoside that is least ototoxic
  296. Drug used in exoerythrocytic cycle of malaria
  297. Oral antibiotic of choice for moderate inflammatory acne
  298. Drug of choice for leprosy
    Dapsone rifampin and clofazimine combination
  299. DOC for herpes and its MOA
    Acyclovir; incorporated into viral DNA and chain termination
  300. Anti-microbials that cause hemolysis in G6PD-deficient patients
  301. MOA of erythromycin
    Inhibition of protein synthesis at the 50s subunit of ribosome
  302. Anti-biotic frequently used for chronic UTI prophylaxis
    sulfamethoxazole/ trimethoprim
  303. Lactam that can be used in PCN allergic patients
  304. SE of imipenem
  305. Anti-viral with a dose limiting toxicity of pancreatitis
  306. Common side effect of hypnotic agents
  307. Occurs when sedative hypnotics are used chronically or at high doses
  308. The most common type of drug interaction of sedative hypnotics with other depressant medications
    Additive CNS depression
  309. Benzodiazepines used to promote sleep
    Temazpam trizolam flurazepam
  310. Benzodiazepine used for anxiety
  311. Non-benzodiazepine used as an anxiolytic
  312. Non-benzodiazepine used for sleep
  313. Major effect of benzodiazepines on sleep at high doses
    REM is decreased
  314. Neurologic SE of benzodiazepines
    Anterograde amnesia
  315. Reason benzos are used cautiously in pregnancy
    Ability to cross the placenta
  316. Main route of metabolism for benzodiazepines
  317. Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired)
    Lorazepam oxazepam and temazepam
  318. "MOA for benzodiazepines
    increase the FREQUENCY of GABA-mediated chloride ion channel opening
  319. Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects)
  320. Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin
  321. Benzodiazepine that has efficacy against absence seizures and in anxiety states such as agoraphobia
  322. Benzodiazepines that are the most effective in the treatment of panic disorder
    Alprazolam and Clonazepam
  323. "Benzodiazepine that is used for anesthesia
  324. DOC for status epilepticus
  325. Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs
    Chlordiazepoxide and Diazepam
  326. Agents having active metabolites long half lives and a high incidence of adverse effects
    Diazepam Flurazepam chlordiazepoxide and clorazepate
  327. Barbiturates may precipitate this hematologic condition
    Acute intermittent porphyria
  328. Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property
    Liver enzyme INDUCTION
  329. Barbiturates MOA
    Increase the DURATION of GABA-mediated chloride ion channels
  330. Barbiturate used for the induction of anesthesia
  331. Site of action for zaleplon and zolpidem
    Benzodiazepine receptor BZ1 (although do not have a benzodiazepine ring structure)
  332. Good hypnotic activity with less CNS SE than most benzodiazepines
    Zolpidem zaleplon
  333. Agent that is a partial agonist for the 5-HT1A receptor
  334. Drug of choice for generalized anxiety disorder NOT effective in acute anxiety
  335. Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS)
  336. Agent with zero-order kinetics
  337. Rate limiting step of alcohol metabolism
    Aldehyde dehydrogenase
  338. System that increases in activity with chronic ethanol exposure and may contribute to tolerance
  339. Enzyme that metabolizes acetaldehyde to acetate
    Aldehyde dehydrogenase
  340. Agents that inhibit alcohol dehydrogenase
    Disulfiram metronidazole certain sulfonylureas and cephalosporins
  341. Agent used in the treatment of alcoholism if alcohol is consumed concurrently acetaldehyde builds up and results in nausea headache flushing and hypotension
  342. The most common neurologic abnormality in chronic alcoholics
    Peripheral neuropathy (also excessive alcohol use is associated with HTN anemia and MI)
  343. Agent that is teratogen and causes a fetal syndrome
  344. Agent that is the antidote for methanol overdose
    Ethanol fomepizole
  345. Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure
  346. Most frequent route of metabolism
    Hepatic enzymes
  347. Mechanisms of action for Phenytoin Carbamazepine Lamotrigine
    Sodium channel blockade
  348. MOA for benzodiazepines and barbiturates
    GABA-related targets
  349. MOA for Ethosuximide
    Calcium channels
  350. MOA for Valproic acid at high doses
    Affect calcium potassium and sodium channels
  351. Drugs of choice for generalized tonic-clonic and partial seizures
    Valproic acid and Phenytoin
  352. DOC for febrile seizures
  353. Drugs of choice for absence seizures
    Ethosuximide and valproic acid
  354. Drug of choice for myoclonic seizures
    Valproic acid
  355. Drugs of choice for status epilepticus
    IV diazepam for short term (acute) treatment; phenytoin for prolonged therapy
  356. Drugs that can be used for infantile spasms
  357. Anti-seizure drugs used also for bipolar affective disorder (BAD)
    Valproic acid carbamazepine phenytoin and gabapentin
  358. Anti-seizure drugs used also for Trigeminal neuralgia
  359. Anti-seizure drugs used also for pain of neuropathic orgin
  360. Anti-seizure agent that exhibits non-linear metabolism highly protein bound causes fetal hydantoin syndrome and stimulates hepatic metabolism
  361. SE of phenytoin
    Gingival hyperplasia nystagmus diplopia and ataxia
  362. Anti-seizure agent that induces formation of liver drug-metabolism enzymes is teratogen and can cause craniofacial anomalies and spina bifida
  363. Agent that inhibits hepatic metabolism is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress
    Valproic acid
  364. Laboratory value required to be monitored for patients on valproic acid
    Serum ammonia and LFT's
  365. SE for Lamotrigine
    Stevens-Johnson syndrome
  366. SE for Felbamate
    Aplastic anemia and acute hepatic failure
  367. Anti-seizure medication also used in the prevention of migraines
    Valproic acid
  368. Carbamazepine may cause
  369. Anti-seizure drugs used as alternative drugs for mood stabilization
    Carbamazepine gabapentin lamotrigine and valproic acid
  370. MOA of general anesthetics
    Most are thought to act at GABA-A receptor - chloride channel
  371. Inhaled anesthetic with a low blood/gas partition coefficient
    Nitrous oxide
  372. Inversely related to potency of anesthetics
    Minimum alveolar anesthetic concentration (MAC)
  373. Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents
    Halothane and methoxyflurane
  374. Most inhaled anesthetics SE
    Decrease arterial blood pressure
  375. Inhaled anesthetics are myocardial depressants
    Enflurane and halothane
  376. Inhaled anesthetic causes peripheral vasodilation
  377. Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis
  378. Inhaled anesthetic less likely to lower blood pressure than other agents and has the smallest effect on respiration
    Nitrous oxide
  379. Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency
  380. Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia
    Nitrous oxide
  381. Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm
  382. DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics
  383. IV barbiturate used as a pre-op anesthetic
  384. Benzodiazepine used adjunctively in anesthesia
  385. Benzodiazepine receptor antagonist it accelerates recovery from benzodiazepine overdose
  386. This produces dissociative anesthesia is a cardiovascular stimulant which may increases intracranial pressure and hallucinations occur during recovery
  387. Opioid associated with respiratory depression but is used in high risk patients who may not survive full general anesthetia
  388. State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide
  389. Produces both rapid anesthesia and recovery has antiemetic activity and commonly used for outpatient surgery may cause marked hypotension
  390. MOA of local anesthetics (LA's)
    Block voltage-dependent sodium channels
  391. This may enhance activity of local anesthetics
  392. This may antagonize activity of local anesthetics
  393. Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity
  394. Local anesthetic with vasoconstrictive property favored for head neck and pharyngeal surgery
  395. Longer acting local anesthetics which are less dependent on vasoconstrictors
    Tetracaine and bupivacaine
  396. These LA's have surface activity
    Cocaine and benzocaine
  397. Most important toxic effects of most local anesthetics
    CNS toxicity
  398. Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage cardiac arrhythmias and myocardial infarction
  399. LA causing methemoglobinemia
  400. Structurally related to acetylcholine used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation
    Neuromuscular blocking drugs
  401. These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)
    Inhaled anesthetics especially isoflurane aminoglycosides and antiarrhythmic
  402. These prevent the action of Ach at the skeletal muscle endplate to produce a surmountable blockade effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)
    Nondepolarizing type antagonists
  403. Agent with long duration of action and is most likely to cause histamine release
  404. Non-depolarizing skeletal muscle antagonist that has short duration
  405. Skeletal muscle agent that can block muscarinic receptors
  406. Skeletal muscle agent that undergoes Hofmann elimination (breaks down spontaneously)
  407. One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis causes muscle pain postoperatively and myoglobinuria may occur
  408. During Phase I these agents worsen muscle paralysis by succinylcholine but during phase II they reverse the blockade produced by succinylcholine
    Cholinesterase inhibitors
  409. Agents acting in the CNS or in the skeletal muscle used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease
    Spasmolytic drugs
  410. Facilitates GABA presynaptic inhibition
  411. GABA agonist in the spinal cord
  412. Similar to clonidine and may cause hypotension
  413. DOC for malignant hyperthermia by acting on the sacroplasmic reticulum or skeletal muscle
  414. Agent used for acute muscle spasm
  415. Irreversible condition resulting from the use of antipsychotics reserpine at high doses and MPTP (by-product of illicit meperidine analog)
    Drug induced Parkinsonism
  416. Agent used in drug therapy of Parkinson's instead of Dopamine which has low bioavailability and does not cross the BBB
  417. This is combined with L-dopa inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE's (GI distress postural hypotension and dyskinesias)
  418. Clinical response that may fluctuate in tx of Parkinson's dx
  419. Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma
  420. Ergot alkaloid that is a partial agonist at D2 receptors in the brain used for patients who are refractory or cannot tolerate levodopa causes erythromelalgia
  421. Non ergot agents used as first-line therapy in the initial management of Parkinson's
    Pramipexole and ropinirole
  422. Enhances dopaminergic neurotransmission SE's include CNS excitation acute toxic psychosis and livedo reticularis
  423. Inhibitor of MAO type B which metabolizes dopamine used adjunct to levodopa or as sole agent in newly diagnosed patients
  424. Inhibitors of catechol-O-methyltransferase (COMT) used as adjuncts in Parkinson's dx and cause acute hepatic failure (monitor LFT's)
    Entacapone and Tolcapone
  425. Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects
  426. Agent effective in physiologic and essential tremor
  427. Agents used in Huntington's Disease
    Tetrabenazine (amine depleting drug) Haloperidol (antipsychotic)
  428. Agents used in Tourette's dx
    Haloperidol or pimozide
  429. Chelating agent used in Wilson's disease
  430. Extrapyramidal dysfunction is more common with these agents which block this subtype of dopamine receptor
    Older antipsychotic agents D2 receptors
  431. MOA of neuroleptics
    Dopamine blockade
  432. Side effects occuring in antipsychotics that block dopamine
    Hyperprolactinemia menorrhea galactorrhea confusion mood changes decreased sexual interest and weight gain
  433. Antipsychotics that reduce positive symptoms only
    Older antipsychotics
  434. Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation
    Olanzapine aripiprazole and sertindole
  435. Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia
  436. Atypical antipsychotic causing high prolactin levels
  437. Newer atypical antipsychotic used for bipolar disorder known to cause weight gain and adversely affect diabetes
  438. Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine diphenhydramine or muscarinic blocker
  439. Drug used in neuroleptic malignant syndrome
  440. Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)
    Muscarinic blockers
  441. Antipsychotic having the strongest autonomic effects
  442. Antipsychotic having the weakest autonomic effects
  443. Only phenothiazine not exerting antiemetic effects can cause visual impairment due to retinal deposits and high doses have been associated with ventricular arrhythmias
  444. Agent having no effect on D2 receptors blocks D4 reserved for resistant schizophrenia and can cause fatal agranulocytosis
  445. Anti-psychotic not shown to cause tardive dyskinesia
  446. Anti-psychotics available in depot preparation
    Fluphenazine and haloperidol
  447. Reduced seizure threshold
    Low-potency typical antipsychotics and clozapine
  448. Orthostatic hypotension and QT prolongation
    Low potency and risperidone
  449. Increased risk of developing cataracts
  450. Major route of elimination for Lithium
  451. Patients being treated with lithium who are dehydrated or taking diuretics concurrently could develop
    Lithium toxicity
  452. Drug increases the renal clearance hence decreases levels of lithium
  453. Lithium is associated with this congenital defect
    Cardiac anomalies and is contraindicated in pregnancy or lactation
  454. DOC for bipolar affective disorder
  455. Concern using lithium
    Low therapeutic index
  456. SE of lithium
    Tremor sedation ataxia aphasia thyroid enlargement and reversible diabetes insipidus
  457. Example of three antidepressants that are indicated for obsessive compulsive disorder
    Clomipramine fluoxetine and fluvoxamine
  458. Neurotransmitters affected by the action of antidepressants
    Norepinephrine and serotonin
  459. Usual time needed for full effect of antidepressant therapy
    2 to 3 weeks
  460. Population group especially sensitive to side effects of antidepressants
    Elderly patients
  461. All antidepressants have roughly the same efficacy in treating depression agents are chosen based on these criterion
    Side-effect profile and prior pt response
  462. Well-tolerated and are first-line antidepressants
    SSRI's bupropion and venlafaxine
  463. Most useful in patients with significant anxiety phobic features hypochondriasis and resistant depression
    Monamine oxidase inhibitors
  464. Condition will result from in combination of MAOI with tyramine containing foods (ex. wine cheese and pickled meats)
    Hypertensive crisis
  465. MAOI should not be administered with SSRI's or potent TCA's due to development of this condition
    Serotonin syndrome
  466. Sedation is a common side effect of these drugs they lower seizure threshold uses include BAD acute panic attacks phobias enuresis and chronic pain and their overdose can be deadly
    Tricyclic antidepressants (TCA)
  467. Three C's associated with TCA toxicity
    Coma Convulsions Cardiac problems (arrhythmias and wide QRS)
  468. Agents having higher sedation and antimuscarinic effects than other TCA's
    Tertiary amines
  469. TCA used in chronic pain a hypnotic and has marked antimuscarinic effects
  470. TCA used in chronic pain enuresis and ADD
  471. TCA with greatest sedation of this group and marked antimuscarinic effects used for sleep
  472. TCA used in obsessive compulsive disorder (OCD) most significant of TCA's for risk of seizure weight gain and neuropsychiatric signs and symptoms
  473. Secondary amines that have less sedation and more excitation effect
    Nortriptyline Desipramine
  474. Side effects seen with tricyclic antidepressants
    Muscarinic blockade (dry mouth constipation); weak alpha-1 block (orthostatic hypotension); weak hisamine block (sedation)
  475. Antidepressant associated with neuroleptic malignant syndrome
  476. Antidepressant associated with seizures and cardiotoxicity
  477. Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure
  478. Antidepressant inhibiting norepinephrine serotonin and dopamine reuptake
  479. Antidepressant also used for sleep that causes priapism
  480. Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure
  481. Heterocyclic antidepressants least likely to affect sexual performance used for management of nicotine withdrawal SE's include dizziness dry mouth aggravation of psychosis and seizures
  482. Antidepressant with MOA as alpha 2 antagonist has effects on both 5-HT and NE blocks histamine receptors and is sedating
  483. SE of mirtazapine
    Liver toxicity increased serum cholesterol
  484. Except for these agents all SSRI have significant inhibition of CytP450 enzymes
    Citalopram and its metabolite escitalopram
  485. Side effects frequently seen with SSRIs
    CNS stimulation; GI upset
  486. Antidepressants with no effect on BP no sedation
  487. SSRI with long T1/2 and can be administered once weekly for maintenance not acute tx
  488. SSRI indicated for premenstrual dysphoric disorder
    Fluoxetine (Sarafem)
  489. Some of SSRIs' therapeutic effects beside depression
    Panic attacks social phobias bulimia nervosa and PMDD (premenstrual dysphoric disorder) OCD
  490. SSRI less likely to cause a withdrawal syndrome
  491. Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons
    Ascending pathways
  492. Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release
    Presynaptic mu delta and kappa receptors
  493. Activation of these receptors open K+ ion channels to cause membrane hyperpolarization
    Postsynaptic Mu receptors
  494. Tolerance to all effects of opioid agonists can develop except
    Miosis and constipation
  495. All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction
  496. SE of these drugs include dependence withdrawal syndrome sedation euphoria respiratory depression nausea and vomiting constipation biliary spasm increased ureteral and bladder tone and reduction in uterine tone
    Opioid Analgesics
  497. Strong opioid agonists
    Morphine methadone meperidine and fentanyl
  498. Opioids used in anesthesia
    Morphine and fentanyl
  499. Opioid used in the management of withdrawal states
  500. Opioid available trans-dermally
  501. Opioid that can be given PO by epidural and IV which helps to relieve the dyspnea of pulmonary edema
  502. Use of this opioid with MAOI can lead to hyperpyrexic coma and with SSRI's can lead to serotonin syndrome
  503. Moderate opioid agonists
    Codeine hydrocodone and oxycodone
  504. Weak opioid agonist poor analgesic its overdose can cause severe toxicity including respiratory depression circulatory collapse pulmonary edema and seizures
  505. Partial opioid agonist considered a strong analgesic has a long duration of action and is resistant to naloxone reversal
  506. Opioid antagonist that is given IV and had short DOA
  507. Opioid antagonist that is given orally in alcohol dependency programs
  508. These agents are used as antitussive
    Dextromethorphan Codeine
  509. These agents are used as antidiarrheal
    Diphenoxylate Loperamide
  510. Inhalant anesthetics
    NO chloroform and diethyl ether
  511. Toxic to the liver kidney lungs bone marrow peripheral nerves and cause brain damage in animals sudden death has occurred following inhalation
    Fluorocarbons and Industrial solvents
  512. Cause dizziness tachycardia hypotension and flushing
    Organic nitrites
  513. Causes acne premature closure of epiphyses masculinization in females hepatic dysfunction MI and increases in libido and aggression
  514. Readily detected markers that may assist in diagnosis of the cause of a drug overdose include
    Changes in heart rate blood pressure respiration body temperature sweating bowel signs and pupillary responses
  515. Most commonly abused in health care professionals
    Heroin morphine oxycodone meperidine and fentanyl
  516. This route is associated with rapid tolerance and psychologic dependence
    IV administration
  517. Leads to respiratory depression progressing to coma and death
    Overdose of opioids
  518. Lacrimation rhinorrhea yawning sweating weakness gooseflesh nausea and vomiting tremor muscle jerks and hyperpnea are signs of this syndrome
    Abstinence syndrome
  519. Treatment for opioid addiction
    Methadone followed by slow dose reduction
  520. This agent may cause more severe rapid and intense symptoms to a recovering addict
  521. Sedative-Hypnotics action
    Reduce inhibition suppress anxiety and produce relaxation
  522. Additive effects when Sedative-Hypnotics used in combination with these agents
    CNS depressants
  523. Common mechanism by which overdose result in death
    Depression of medullary and cardiovascular centers
  524. Date rape drug
    Flunitrazepam (rohypnol)
  525. The most important sign of withdrawal syndrome
    Excessive CNS stimulation (seizures)
  526. Treatment of withdrawal syndrome involves
    Long-acting sedative-hypnotic or a gradual reduction of dose clonidine or propranolol
  527. These agents are CNS depressants
    Ethanol Barbiturates and Benzodiazepines
  528. Withdrawal from this drug causes lethargy irritability and headache
  529. W/D from this drug causes anxiety and mental discomfort
  530. Treatments available for nicotine addiction
    Patches gum nasal spray psychotherapy and bupropion
  531. Chronic high dose abuse of nicotine leads to
    Psychotic state overdose causes agitation restlessness tachycardia hyperthermia hyperreflexia and seizures
  532. Tolerance is marked and abstinence syndrome occurs
  533. Amphetamine agents
    Dextroamphetamines and methamphetamine
  534. These agents are congeners of Amphetamine
    DOM STP MDA and MDMA ecstasy
  535. Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias seizures respiratory depression or severe HTN (MI and stroke)
    Cocaine super-speed
  536. Most dangerous of the currently popular hallucinogenic drugs OD leads to nystagmus marked hypertension and seizures presence of both horizontal and vertical nystagmus is pathognomonic
  537. Removal of PCP may be aided
    Urinary acidification and activated charcoal or continual nasogastric suction
  538. THC is active ingredient SE's include impairment of judgment and reflexes decreases in blood pressure and psychomotor performance occur
  539. Muscarinic agonists or parasympathomimetic
  540. This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention
  541. Only direct acting agent that is very lipid soluble and used in glaucoma
  542. This agent used to treat dry mouth in Sj�gren's syndrome
  543. Indirect-Acting ACh Agonist alcohol short DOA and used in diagnosis of myasthenia gravis
  544. Carbamate with intermediate action used for+A1170 postoperative and neurogenic ileus and urinary retention
  545. Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect which may lead to convulsions
  546. Treatment of myasthenia gravis
  547. Antiglaucoma organophosphate
  548. Associated with an increased incidence of cataracts in patients treated for glaucoma
    Long acting cholinesterase inhibitors
  549. Scabicide organophosphate
  550. Organophosphate anthelmintic agent with long DOA
  551. Toxicity of organophosphate:
    DUMBELSS (diarrhea urination miosis bronchoconstriction excitation of skeletal muscle and CNS lacrimation salivation and sweating)
  552. The most frequent cause of acute deaths in cholinesterase inhibitor toxicity
    Respiratory failure
  553. The most toxic organophosphate
  554. Treatment of choice for organophosphate overdose
  555. This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure
  556. Prototypical drug is atropine
    Nonselective Muscarinic Antagonists
  557. Treat manifestations of Parkinson's disease and EPS
    Benztropine trihexyphenidyl
  558. Treatment of motion sickness
    Scopolamine meclizine
  559. Produce mydriasis and cycloplegia
    Atropine homatropine C1208 tropicamide
  560. Bronchodilation in asthma and COPD
  561. Reduce transient hyper GI motility
    Dicyclomine methscopolamine
  562. Cystitis postoperative bladder spasms or incontinence
    Oxybutynin dicyclomine
  563. Toxicity of anticholinergics
    block SLUD (salivation lacrimation urination defecation
  564. Another pneumonic for anticholinergic toxicity
    dry as a bone red as a beet mad as a hatter hot as a hare blind as a bat
  565. Atropine fever is the most dangerous effect and can be lethal in this population group
  566. Contraindications to use of atropine
    Infants closed angle glaucoma prostatic hypertrophy
  567. Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate
    Severe hypertension
  568. Reversal of blockade by neuromuscular blockers
    Cholinesterase inhibitors
  569. Tubocurarine is the prototype pancuronium atracurium vecuronium are newer short acting agent produce competitive block at end plate nicotinic receptor causing flaccid paralysis
    Nondepolarizing Neuromuscular Blockers
  570. Only member of depolarizing neuromuscular blocker causes fasciculation during induction and muscle pain after use; has short duration of action
  571. Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred)
    Cholinesterase regenerators pralidoxime
  572. Used to treat patients exposed to insecticides such as parathion
    Pralidoxime atropine
  573. Pneumonic for beta receptors
    You have 1 heart (Beta 1) and 2 lungs (Beta 2)
  574. This is the drug of choice for anaphylactic shock
  575. Phenylisopropylamines that are used legitimately and abused for narcolepsy attention deficit disorder and weight reduction
  576. Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy it does not cause cycloplegia
  577. Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to
    Reduce aqueous secretion
  578. Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis
  579. Longer acting Beta 2 agonist is recommended for prophylaxis of asthma
  580. These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock
    Beta1 agonists
  581. These agents decrease blood flow or increase blood pressure are local decongestants and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion
    Alpha1 agonists
  582. Shock due to septicemia or myocardial infarction is made worse by
    Increasing afterload and tissue perfusion declines
  583. Epinephrine is often mixed with a local anesthetic to
    Reduce the loss from area of injection
  584. Chronic orthostatic hypotension can be treated with
  585. Beta 2 agonist used to suppress premature labor but cardiac stimulatory effects may be hazardous to mother and fetus
  586. Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses
  587. Mast cells to reduce release of hisamine and inflammatory mediators
  588. Agent used in shock because it dilates coronary arteries and increases renal blood flow
  589. Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance
  590. Long acting sympathomimetic sometimes used to improve urinary continence in children and elderly with enuresis
  591. Alpha 1 agonist toxicity
  592. Beta 1 agonist toxicity
    Sinus tachycardia and serious arrhythmias
  593. Beta 2 agonist toxicity
    Skeletal muscle tremor tachycardia
  594. The selective agents loose their selectivity at
    high doses
  595. Nonselective alpha-blocking drug long acting and irreversible and used to treat pheochromocytoma. Blocks 5-HT so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis
  596. Nonselective alpha-blocking drug short acting and reversible used for rebound HTN from rapid clonidine withdrawal and Raynaud's phenomena
  597. Selective Alpha 1 blocker used for hypertension BPH may cause first dose orthostatic hypotension
    Prazosin terazosin doxazosin
  598. Selective Alpha-1A blocker used for BPH but with little effect on HTN
  599. Selective Alpha 2 blocker used for impotence (controversial effectiveness)
  600. SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma
    Acebutolol atenolol esmolol metoprolol
  601. Combined alpha and beta blocking agents that may have application in treatment of CHF
    Labetalol and carvedilol
  602. Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
    Pindolol and acebutolol
  603. This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma
  604. This parenteral beta blocker is a short acting (minutes)
  605. This beta blocker is the longest acting
  606. These beta blockers are less lipid soluble
    Acebutolol and atenolol
  607. This beta blocker is highly lipid soluble and may account for side effects such as nightmares
  608. Clinical uses of these agents include treatment of HTN angina arrhythmias chronic CHF and selected post MI patients
    Beta blockers
  609. Toxicity of these agents include bradycardia AV blockade exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia tremor and anxiety)
    Beta blockers
  610. Cholinomimetics that increase outflow open trabecular meshwork and cause ciliary muscle contraction
    Pilocarpine carbachol physostigmine
  611. Nonselective alpha agonists that increases outflow probably via the uveoscleral veins
    Epinephrine dipivefrin
  612. Selective alpha agonists that decreases aqueous secretion
    Apraclonidine brimonidine
  613. These Beta blockers decrease aqueous secretion
    Timolol (nonselective) betaxolol (selective)
  614. This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias alkalinization of the urine may precipitate calcium salts hypokalemia acidosis
  615. This agent cause increased aqueous outflow
    Prostaglandin PGF2a
  616. Inhibit angiotensin-converting enzyme (ACE)
    ACE inhibitors
  617. Captopril and enalapril (-OPRIL ending) are
    ACE inhibitors
  618. SE of ACE inhibitors
    Dry cough hyperkalemia
  619. ACE inhibitors are contraindicated in
    pregnancy and with K+
  620. Losartan and valsartan block
    Angiotensin receptor
  621. Angiotensin receptor blockers do NOT cause
    Dry cough
  622. Agents that block L-type calcium channel
    Calcium channel blockers
  623. CCB contraindicated in CHF
  624. CCB with predominate effect on arteriole dilation
  625. SE of CCB
    Constipation edema and headache
  626. Agents that reduce heart rate contractility and O2 demand
  627. B-blockers that are more cardioselective
    Beta-1 selective blockers
  628. Cardioselective Beta 1-blockers
    Atenolol acebutolol and metoprolol
  629. Beta-blockers should be used cautiously in
    Asthma (bronchospastic effects) diabetes (block signs of hypoglycemia) and peripheral vascular disease
  630. Non-selective Beta-blocker also used for migraine prophylaxis
  631. SE of beta blockers
    Bradycardia SEXUAL DYSFUNCTION decrease in HDL and increase in Triglycerols (TG)
  632. Alpha 1selective blockers
    Prazosin terazosin and doxazosin (-AZOSIN ending)
  633. Non-selective Alpha1blockers use to treat pheochromocytoma
  634. For rebound HTN from rapid clonidine withdrawal
  635. A1a-selective blocker with no effects on HTN used for BPH
    Tamsulosin (Flomax)
  636. SE of alpha blockers
    Orthostatic hypotension (especially with first dose) and reflex tachycardia
  637. Presynaptic Alpha 2 agonist used in HTN and acts centrally
    Clonidine and methyldopa
  638. SE of methyldopa
    Positive Comb's test depression
  639. Methyldopa is contraindicated in
    Geriatrics due to its CNS (depression) effects
  640. SE of clonidine
    Rebound HTN sedation dry mouth
  641. Direct vasodilator of arteriolar smooth muscle
  642. SE of hydralazine
    Lupus-like syndrome
  643. Arterial vasodilator that works by opening K+ channels
  644. SE of minoxidil
  645. IV Drug used Hypertensive Crisis
  646. Nitroprusside vasodilates
    Arteries and veins
  647. Toxicity caused by nitroprusside and treatment
    Cyanide toxicity treated with sodium thiosulfate
  648. Carbonic anhydrase inhibitor
  649. Diuretic used for mountain sickness and glaucoma
  650. SE of acetazolamide
    Paresthesias alkalization of the urine (which may ppt. Ca salts) hypokalemia acidosis and encephalopathy in patients with hepatic impairment
  651. MOA of loop diuretics
    inhibits Na+/K+/2Cl- cotransport
  652. Site of action of loop diuretics
    Thick ascending limb
  653. SE of loop (furosemide) diuretics
    Hyperuricemia hypokalemia and ototoxicity
  654. Aminoglycosides used with loop diuretics potentiate adverse effect
  655. Loops lose and thiazide diuretics retain
  656. MOA of thiazide diuretics
    Inhibit Na+/Cl- cotransport
  657. Site of action of thiazide diuretics
    Work at early distal convoluted tubule
  658. Class of drugs that may cause cross-sensitivity with thiazide diuretics
  659. SE of thiazide (HCTZ) diuretics
    Hyperuricemia hypokalemia and hyperglycemia
  660. Potassium sparing diuretics inhibit
    Na+/K+ exchange
  661. Diuretic used to treat primary aldosteronism
  662. SE of spironolactone
    Gynecomastia hyperkalemia and impotence
  663. Osmotic diuretic used to treat increased intracranial pressure
  664. ADH agonist used for pituitary diabetes insipidus
    Desmopressin (DDAVP)
  665. Used for SIADH
  666. SE of demeclocycline
    Bone marrow and teeth discoloration for children under 8 years of age
  667. MOA of class I A (eg. Procainamide) class IB (eg. Lidocaine) and class IC (eg. Flecainide) antiarrhythmics
    Sodium channel blockers
  668. SE of procainamide
    Lupus-like syndrome
  669. Limiting side effect of Quinidine
    Prolongs QT interval
  670. Other side effects of Quinidine
    Thrombocytopenic purpura and CINCHONISM
  671. Major drug interaction with Quinidine
    Increases concentration of Digoxin
  672. DOC for management of acute ventricular arrhythmias
  673. DOC for digoxin induced arrhythmias
  674. SE of phenytoin
    Gingival hyperplasia
  675. Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial) therefore are used as last line agents
    Class IC (flecainide propafenone moricizine)
  676. Class II antiarrhythmics are
  677. Antiarrhythmic that exhibits Class II and III properties
  678. Side effect of sotalol
    prolongs QT and PR interval
  679. Used intravenously for acute arrhythmias during surgery
  680. Anti-arrhythmics that decrease mortality
  681. MOA of class III antiarrhythmics
    Potassium channel blockers
  682. Class III antiarrhythmic that exhibits properties of all 4 classes
  683. Specific pharmacokinetic characteristic of amiodarone
    Prolonged half-life up to six weeks
  684. Antiarrhythmic effective in most types of arrhythmia
  685. SE of Amiodarone
    Cardiac dysfunction photosensitivity skin (blue smurf syndrome) Pulmonary fibrosis thyroid and corneal deposits
  686. MOA of class IV antiarrhythmics
    Calcium channel blockers
  687. Life threatening cardiac event that prolong QT leads to
    Torsades de pointes
  688. Agent to treat torsades de pointes
    Magnesium sulfate
  689. Drug used supraventricular arrhythmias
  690. DOC for paroxysmal supraventricular tachycardia (PSVT)
  691. Adenosine's MOA
    Activattion on an inward K+ current and inhibition of Ca++ current resulting in marked hyperpolarization
  692. Anti-arrhythmic with 15 second duration of action
  693. MOA of sildenafil (Viagra)
    Inhibits phosphodiesterase-5 enhancing effects of nitric oxide-activated increases in cGMP
  694. Drugs used in the management of angina
    Aspirin Nitrates CCB and Beta blockers
  695. Aspirin reduces mortality in unstable angina by
    Platelet aggregation inhibition
  696. MOA of nitrates
    Relax vascular smooth muscle at low doses dilate veins and at high doses dilate arterioles
  697. Nitrate used for acute anginal attacks
    Nitroglycerin sublingual tablets
  698. Nitrate used to prevent further attacks
    Oral and transdermal forms of nitroglycerin
  699. Nitrate free intervals are needed due to
  700. SE of nitrates
    Postural hypotension reflex tachycardia hot flashes and throbbing headache due to meningeal artery dilation
  701. CCB are DOC for
    Prinzmetal's angina
  702. Beta blockers are used for which type of anginal attack
  703. MOA of Cardiac glycosides (eg. digoxin)
    Indirectly increase intracellular calcium and cardiac contractility by inhibiting Na+/K+ ATPase
  704. Digoxin is used in
    Atrial fibrillation and CHF
  705. Digoxin toxicity can be precipitated by
  706. Antidote for digoxin toxicity
  707. Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects
    Amrinone and milrinone
  708. SE of amrinone
  709. Beta 1 agonists used in acute CHF
    Dobutamine and dopamine
  710. Diuretics work in CHF by
    Reducing preload
  711. Beta blockers work in CHF by
    Reducing progression of heart failure (never use in acute heart failure)
  712. Peptide drug used to treat CHF
    Nesiritide (BNP)
  713. "MOA of nesiritide
    Increasing sodium excretion and decreases arterial and venous tone
  714. SE of nesiritide
    Excessive hypotension and kidney failure
  715. Agent used in CHF that is a selective alpha and nonselective beta blocker
  716. Agent used in acutely decompensated CHF resembling natriuretic peptide
    Nesiritide (Natrecor)
  717. Vitamin K dependent anticoagulant
    Warfarin (PT)
  718. Warfarin is contraindicated in
  719. Anticoagulant of choice in pregnancy
  720. Heparin (PTT) increases activity of
    Antithrombin 3
  721. Route of administration of warfarin
  722. Routes of administration of heparin
    IV and IM (only LMW)
  723. SE of both warfarin and heparin
  724. SE of heparin
    Heparin induced thrombocytopenia (HIT)
  725. Alternative anticoagulant used if HIT develops
  726. Antidote to reverse actions of warfarin
    Vitamin K or fresh frozen plasma
  727. Antidote to reverse actions of heparin
    Protamine sulfate
  728. MOA of aspirin
    Irreversibly blocking cyclooxygenase
  729. Agent used to treat MI and to reduce incidence of subsequent MI
    Aspirin metoprolol
  730. SE of Aspirin
    GI bleeding
  731. Antiplatelet drug reserved for patients allergic to aspirin
  732. SE for ticlopidine
    Neutropenia and agranulocytosis
  733. Effective in preventing TIA's
    Clopidogrel and ticlopidine
  734. Prevents thrombosis in patients with artificial heart valve
  735. Block glycoprotein IIb/IIIa involved in platelet cross-linking
    Abciximab tirofiban and eptifibatide
  736. MOA of thrombolytics
    Degradation of fibrin clots and are administered IV
  737. Thrombolytics are used for
    Pulmonary embolism and DVT
  738. Thrombolytic that can cause allergic reaction
  739. Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA
    Tissue plasmin activator
  740. SE of tPA
    Cerebral hemorrhage
  741. Antidote for thrombolytics
    Aminocaproic acid
  742. Agent to treat hypochromic microcytic anemias
    Ferrous sulfate
  743. Chelating agent used in acute iron toxicity
  744. Agent for pernicious anemia
    Cyanocobalamin (Vit B12)
  745. Agent used for neurological deficits in megaloblastic anemia
    Vitamin B12
  746. Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy
    Folic acid
  747. Agent used for anemias associated with renal failure
  748. Agent used neutropenia especially after chemotherapy
    G-CSF (filgrastim) and GM-CSF (sargramostim)
  749. Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy
    Interleukin 11 (oprelvekin)
  750. Drugs decrease intestinal absorption of cholesterol
    Bile acid-binding resins
  751. Cholestyramine and colestipol are
    Bile acid-binding resins
  752. Major nutritional side effect of bile acid-binding resins
    Impair absorption of fat soluble vitamin absorption (A D E K)
  753. MOA of lovastatin (STATIN)
    inhibits HMG COA reductase
  754. HMG CoA reductase inhibitors are contraindicated in
  755. MOA of drug or foods (grapefruit juice) that increase statin effect
    Inhibit Cytochrome P450 3A4
  756. SE of HMG COA reductase inhibitors
    Rhabdomyolysis and Hepatotoxicity
  757. Monitoring parameter to obtain before initiation of STATINS
  758. Decreases liver triglycerol synthesis
  759. SE of niacin
    Cutaneous flush
  760. Cutaneous flush and be reduced by pretreatment with
  761. Fibrates (gemfibrozil) increase activity of
    Lipoprotein lipase
  762. Most common SE of fibrates
  763. Fibrates are contraindicated in
  764. Concurrent use of fibrates and statins increases risk of
  765. New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins
    Ezetimibe (Zetia)
  766. MOA of NSAIDS
    inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
  767. Difference between aspirin and other NSAIDS
    Aspirin irreversibly inhibits cyclooxygenase
  768. Four main actions of NSAIDS
    Anti-inflammatory analgesia antipyretic and antiplatelet activity
  769. Agent used for closure of patent ductus arteriosus
  770. Aspirin is contraindicated in children with viral infection
    Potential for development of Reye's syndrome
  771. SE of salicylates
    Tinnitus GI bleeding
  772. NSAID also available as an ophthalmic preparation
    Diclofenac ketoralac
  773. NSAID available orally IM and ophthalmically
  774. NSAID that is used for acute condition such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
  775. Newer NSAID that selectively inhibits COX-2
  776. COX 2 inhibitors may have reduced risk of
    Gastric ulcers and GI Bleeding
  777. COX 2 inhibitors should be used cautiously in pts with
    Pre-existing cardiac or renal disease
  778. Acetaminophen only has
    Antipyretic and analgesic activity
  779. SE of acetaminophen
  780. Antidote for acetaminophen toxicity
  781. DMARDs are slow acting drugs for
    Rheumatic disease
  782. Initial DMARD of choice for patients with RA
  783. Drug ofter used in combination with TNF - alpha inhitors for RA
  784. Causes bone marrow suppression
  785. SE of penicillamine
    Aplastic anemia and renal toxicity
  786. Interferes with activity of T-lymphocytes
  787. Anti-malarial drug used in rheumatoid arthritis (RA)
  788. SE of hydroxychloroquine
    Retinal destruction and dermatitis
  789. MOA of Leflunomide (newer agent)
    Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis decreased T cell proliferation and decreased antibody production by B cells
  790. Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
    Adalimumab infliximab and etanercept
  791. Anti-rheumatic agent also used for ulcerative colitis
  792. Anti-rheumatic agent also used for Chron's disease
  793. NSAID used in gout
  794. NSAID contraindicated in gout
  795. MOA of colchicine (used in acute gout)
    Selective inhibitor of microtubule assembly
  796. SE of colchicine
    Kidney and liver toxicity diarrhea
  797. Agent used to treat chronic gout by increasing uric acid secretion and excretion
    Probenecid and sulfinpyrazone
  798. Allopurinol treats chronic gout by decreasing uric acid production by inhibiting
    Xanthine oxidase
  799. Rapid acting insulins that do not self-aggregate
    lispro insulin aspart insulin glulisine insulin
  800. Peakless ling acting insulin
    Insulin glargine
  801. DOC for paroxysmal supraventricular tachycardia; has high efficacy and short duration of action
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