Shared Flashcard Set

Details

Last Pharm Exam
anti-fungal, anti-inflam, pain management, anti-viral, HIV
141
Aerospace Engineering
2nd Grade
05/29/2010

Additional Aerospace Engineering Flashcards

 


 

Cards

Term

The following are all types of what drug class?

 

Ibuprofen, Napoxen, Ketorolac, Piroxicam, Sulindac, Meloxicam, Celecoxib, Indomethacin

Definition
NSAIDS
Term

What drug class are the following:

 

methoxtrexate, hydroxychloroquine, sulfasalazine, imfliximab, etanercept, anakinra, leflunomide

Definition
DMARDS
Term

What drug class are the following?

 

Indomethacin, allopurinol, colchicine, probenecid, sulfinpyrazone

Definition
Anti-gout
Term
What drug classes are used for inflammation?
Definition

NSAIDS

 

DMARDS

 

Anti-gout

 

Corticosteroids

Term

What disease is caused by inappropriate activation of the immune system?

 

What specifically is being attacked?

Definition

RA

 

Synovium

Term
What are four steps of the inflammatory response?
Definition

1. Damaged tissue releases histamine; increasing blood flow to the area.

 

2. Histamines cause capillaries to leak, releasing phagocytes and clotting factors into the wound

 

3. phagocytes engulf the bacteria, dead cells and cellular debris

 

4. Platelets move out of the capillary to seal the wounded area.

Term
What major pathway allows prostaglandin synthesis?
Definition
Cyclooxygenase Pathway
Term
In the cyclooxygenase pathway- explain how prostaglandin synthesis occurs.
Definition

Phoslopidase A2 will cleave phospholipids out of membrane to make ARACHIDONIC ACID.

 

Cyclooxygenase I or II will be used to make the thromboxane, prostacyclin and prostaglandin 

Term

Which cyclooxygenase (I or II) is considered the "housekeeping enzyme- meaning it causes platelet aggredgation, GI protection and kidney funciton"?

 

Which is more involved in inflammation and is located in the brain, kidney and bone?

Definition

 

"housekeeping enzyme- meaning it causes platelet aggredgation, GI protection and kidney funciton"?

Cox 1

 

Which is more involved in inflammation and is located in the brain, kidney and bone?

Cox II (larger substrate binding area; more flexible)

 

Term

The following are roles of what??

 

refulated inflammatory mediation

regulate calcium movement

control hormones regulation

control cell growth

cause constricito or dilation in vascular smooth muscle cells

cause aggregation or disaggregation of platelts

sensitize spinal neurons to pain

decrease intraocular pressure

Definition

PROSTAGLANDINS

 

 

Term

Where do PGs act?

 

Where are they produced?

 

Where do they NOT act?

Definition

prostaglandins at locally

 

produced locally

 

DO NOT CIRCULATE IN THE BLOOD

Term

NSAIDS inhibit what enzymes?

 

What is the black box warning?

Definition

Inhibit COX enzymes

 

Black box warning for all NSAIDS: increase CV thrombus events/ MI/ stroke/ GI bleeding, ulceration of stomache or intestine

Term

Name the derivative for the following drugs:

 

1. Acetylsalicylic acid

2. Ibuprofen, Naproxen

3. Indomethacin, Sulindac

4. Piroxicam, Meloxicam

5. Ketorolac

6. Celecoxib

Definition

1. Acetylsalicylic acid: Salicylic acid derivative

2. Ibuprofen, Naproxen: Propionic acid derivative

3. Indomethacin, Sulindac: Acetic acid derivative

4. Piroxicam, Meloxicam Oxicam derivatives

5. Ketorolac: Hetoaryl acetic acid derivative

6. Celecoxib: Cox 2 inhibitor

Term

Name the drug:

 

Anti inflammtory

 

irreversibly acetylates COX

Definition
Aspirin
Term
What are therapeutic uses for aspirin?
Definition

Anti-inflam

Anti-pyretic

Analgesic

Corns, calluses, warts

Anti-coag

Term
What are the three most common side effects of aspirin?
Definition
nausea, vomiting, GI bleed
Term

Who should not take aspirin?

 

Who should avoid taking?

Definition

Children should not take with viral infection or have taken vaccine

 

avoid with gout- bc increases uric acid

Term

Btw Ibuprofen and Naproxen:

 

Which offers mostly analgesic effects?

 

Which offers mainly anti-inflamm effects?

Definition

Analgesic: Ibuprofen: Advil, Motrin

 

Anti-inflam: Naproxen: Aleve: Naprosyn

Term
What is the #1 drug causing gastritis?
Definition
Indomethacin (Indocin)
Term

What anti-inflam drug offers once daily dosing, has less GI disturbances, given PO..

 

one drug has a half life of 20-86 hrs?

other drug has a half life 15-20 hrs?

Definition

20-86 hrs: Piroxicam

 

15-20 hrs: Meloxicam

Term

Which of the anti-inflam are a poten analgesic?

 

What population needs to avoid it?

Definition

KETOROLAC

 

Avoid in PEDS

Term
This anti-inflam drug is contraindicatin in pts allergic to sulfonamides.
Definition
Celecoxib
Term
This drug inhibits Cox II and is used for RA and osteoarthritis
Definition
Celecoxib (Celebrex)
Term
Acetaminophen is an ____ but does NOT have ______ actions.
Definition

Acetaminophen is an NSAID but does NOT have ANTI-INFLAM actions.

Term

What drug do you administer if pt overdosed on tylenol?

 

It's effective if administered within __ hrs.

Definition

Aceyticystine

 

effective if admin within 10 hrs.

Term

What are two types of DMARDS?

 

Which group do you start with?

 

What's second line?

Definition

What are two types of DMARDS?

Chemical therapies

Biologic Therapies


Which group do you start with?

Chemical therapies

 

What's second line?

Biologic Therapies

Term

When do you initiate therapy in RA?

 

Most of the DMARDS are contraindicated in what population?

Definition

within 3 months to slow progression

 

Most are contraindicated in pregnant women

Term

What is the #1 drug prescribed for RA?

 

How long does it take for pt to respond?

 

Who should not use?

Definition

Methotraxate

 

takes 3-6 weeks to respond

 

Who should not use? Pregnant women, women trying to get pregnant, men trying to get wife/partner pregnant

 

CATEGORY X

Term

This DMARD causes 

 

decreased visual acuity

nausea

stomach cramps

renal toxicity

bulls eye effect in the macula of the eye

 

**SIDE NOTE: drug also used in treatment of malaria

Definition
Hydroxycholorquine
Term

This DMARD takes 1-3 mts for pt to start seeing effects

 

It casuses orange-yellow discoloration

photosensitivity

severe depression in young males

leukopenia

Definition
sulfasalazine
Term
This DMARD should not be given alone because the body will create antibodies against it. It is usually given with methotrexate.
Definition
Infliximab
Term

DMARD:

 

If you stop this drug, the symptoms will come back in one month.

Definition
Etanercept
Term

This DMARD is an interleukin 1 receptor anatgonist.

 

It should NOT be used with infliximab and etanercept.

Definition
Anakinra
Term
Define podegra.
Definition
Gout associated with the big toe
Term

What are causes of acute gout?

 

What are causes of chronic gout?

Definition

What are causes of acute gout?

Excessive alcohol consumption

kidney disease

purine rich diet

 

What are causes of chronic gout?

Genetic defect

renal deficiency

Lesch Nyhan syndrome

cancer chemotherapy

Term
What is Lesch-Nyhan syndrome?
Definition

Juvenile gout

 

lack of protein that causes build up of uric acid in all body fluids; can lead to mental problems; poor muscle control, renal problems

Term

GOUT:

 

What drugs terminate acute attacks?

 

What drugs PREVENT recurring attacks?

Definition

TERMINATORS

Colchicine

NSAIDS

Glucorticoids

 

PREVENTERS

Uricouric agents: probenacid, sulfinpyrazone

allopurinol


Term

This gout medication: inhibits leukotrienes

 

it is NOT an analgesic, but does reduce pain

 

it does NOT prevent progression of gout

 

needs to be given within 24 hrs to be effective

Definition
Colchicine
Term

This med is the drug of choice in pts with hx of kidney stones and renal clearance <50 ml/day of creatinine.

 

It is preferred in pts with excessive uric acid synthesis

Definition
Allopurinol
Term
what is the main NSAID used in gout?
Definition
Indomethacin
Term

This drug blocks the reabsorption of uric acid back into the kidney at the proximal tubule.

 

 

Definition

Probenecid

 

Sulfinpyrazone

Term
What is a glucocorticoid that can be taken for pregnant patient who has gout?
Definition
predinisone
Term

What are the three different opioid binding sites?

 

Where are they located?

 

What is released there?

Definition

What are the three different opioid binding sites?

Mu, Kappa, delta receptors

 

Where are they located?

Located on nerved endings


What is released there?

Substance P

 

Term
Morphine, Meperidine, Methadone, Fentanyl and Heroin are all part of what drug class?
Definition
Opioid Agonists
Term
Codeine, Oxycodone and propoxyphene are all part of what drug class?
Definition
Opioid Analgesics: Moderate Agonists
Term

This drug is centrally acting analgesic that binds to the mu ipoid receptor.

 

It weakly inhibits the reuptake of NE and serotonin.

 

Use: moderate to mod/severe pain

 

Adv rx: anaphylactoid rx; seizure

 

Who should avoid taking this med?

What is the drug I'm referring to?

Definition

Drug is Tramadol (Ultram)

 

Avoid if pt taking MAOi

 

Term
Pentazocine, Buprenorphine, nalbuphine and butorphanol are all part of what drug class
Definition
Opioid Analgesics: Mixed Agonist/Antagonists
Term

 

 

Name two drugs that are Opioid antagonists.

Definition
Naloxine and Naltrexone
Term
What's the difference between an opiate and an opioid?
Definition

Opiate: derived from poppy plant

 

Opioid: chemical that binds to opiate receptor

Term

This drug is contraindicated in labor.

 

It increases urine retention, miosis.

 

Causes constipation.

 

Does't cross the BBB; not very lipophilic. 

 

It's a prototype drug for one of the drug classes.

Definition
Morphine: AGONIST
Term

This drug is commonly used in obstetrics. 

 

Side effects: dry mouth, blurred vision, mydriasis

 

In pts with renal problems, it can be toxic causing seizures.

 

It is structurally unrelated to ______.

 

What is the drug?

What is the drug class?

Definition

It is structurally unrelated to MORPHINE.

 

What is the drug? Meperidine

What is the drug class? Strong Agonist

Term

This drug is used for heroine and morphine withdrawal. 

 

It's DOA is 3-6 hrs.

 

What is the drug?

Definition
Methadone
Term

This drug is very lipophilic

 

Short DOA: 15-30 min.

 

100 x potency of morphine.

 

How can this drug be administered? What specifically do you watch out for with one of the administrations?

Definition

Fentanyl

 

Admin: PO, IV transdermal patch

 

Transdermal patch: don't use if fever

drug gets released based on body temp.

Term
Oxycodone is called Percoset when combined with what drug?
Definition
Acetaminophen
Term

This drug has less efficacy in smokers bc tobacco increases the liver enzymes that cause oxidation.

 

It's used in geriatrics or pts with lung disease.

 

It's an analgesic. 

 

What is it?

Definition
Propoxyphene
Term

This drug can precipitate withdrawal syndrome in a morphine abuser. 

 

At high doses it can cause respiratory depression

 

It decreases activity of the GI tract.

 

What is it?

 

More info: increases BP, causes nightmares, hallucinations, dizziness, dysphoria.

Definition
Pentazocine
Term
This drug is used in opiod detox bc shorter duration of withdrawal sxs and less severe
Definition
buprenorphine
Term

This drug is an analgesic.

 

It is used to supplement anesthesia.

Definition
Nalbuphine
Term

Because Gretchen likes horses:

 

This drug is used in pain relief in horses.

Definition
Butorphanol
Term

This drug blocks the effects of heroin for up to 2 days.

 

 

Definition
Naltrexone
Term

This drug is given to patients who overdosed on opioids or heroine.

 

DOA: 60-100 minutes ** why is this imp?

Definition

Naloxone.

 

DOA imp bc other meds work 3-6 hrs so if someone comes in on overdose and once naloxone wears off they can replace until all of opiates are out of system

Term
Why should you be careful when giving pt an opioid agonist who is already on a mixed agonist/antagonist?
Definition
Because it can precipitate withdrawal sxs.
Term
Most fungal infections invades humans via what route?
Definition
inhalation
Term
What are 3 types of antifungal drugs?
Definition

1. topical drugs for superficial/dermatophytic infections

2. oral drugs for mucocutaneous/serious dermatophytic infections

3. oral/parenteral admin for systemic infections that primarily occur in those who are immunosuppressed

Term

Define dermatophytic infections.

 

Mucocutaneous infections

 

Systemic infections

Definition

Dermatophytic: infections fo the skin, nails or scalp

 

Mucocutaneous: involve infections of the GI tract, gums, perinanal regions, or vagina

 

Systemic infections: difficult to diagnose; often uneradicable

Term
What is the DOG for life threatening systemic mycoses?
Definition
Amphotericin B
Term
This drug causes an infusion rxn, renal dysfunction, and neuropathies.
Definition
Amphotericin B
Term
What is the pyrogenic infusion rx assoc with amphotericin B?
Definition
due to release of mediators, interleukin 1/TNF from WBCs
Term
This drug binds ergosterol in the cell membrane to form leaky pores with loss of ions and essential metabolites.
Definition
Amphotericin B
Term

This drug's main use is for candidiasis.

 

Can be give as tablets, that you put in solution, you swish and swallow and its for upper/lower GI tract infections.

Definition
Nystatin
Term

This drug is used for CNS infections involving meningitis.

 

It is used in combo with ______.

Definition

Flucytosine

 

used in combo with Amphotericin B

Term

This drug binds to keratin so nail is protected wehn it grows out.

 

It usually required 6-12 mts of therapy to be effective.

Definition
Griseofulvin
Term

This drug has a possible PNC cross-sensitivity allergy.

 

It is used for ringworm infections/tineas.

Definition
Griseofulvin
Term
All azoles are contraindicated in who?
Definition
Pregnancy
Term
What is the major difference between imidazoles and triazoles?
Definition

Imidazoles: decreases synthesis of ergosterol AND some sex/steroid hormones in human

 

Triazoles: litle of any sex/steroid inhibition

Term

This drug should not be taken with antacids/antiulcer drugs/

 

It causes hepatocellular toxicity.

 

It inhibits gonadal sex hormones/adrenal steroids.

Definition
Ketoconazol
Term

This is the DOC for coccidiodal meningitis, and prophylaxis pts undergoing organ transplantation/those at risk serious infections.

 

Preferred drug for chronic suppressive therapy cryptococal meningitis.

Definition
Flucanozole
Term

If pts don't respond well to amp B or itraconazole.

 

What drug should you consider?

 

Hint: inhibits synthesis of D-glucan, an essential component of fungal cell wall

Definition

Caspofungin

 

part of drug class Echinocandins

Term

This is the preferred drug for nail infections

 

bc its administered daily 12 weeks.

 

 

Definition
Terbinafine
Term
This is a topical nail lacquer for onychomycosis.
Definition
Ciclopirox
Term

For coagulation cascade:

 

What is the common pathway of both extrinsic and intrinsic pathway?

Definition
degeneration of thromboplastin
Term
This is a drug used during MI thallium imaging to evaluate coronary arteries.
Definition
Dipyridamole
Term
What are the 4 A's of aspirin?
Definition

analgeic

antipyretic

anti-inflammatory

anti-platelet

Term

Pt comes into your office and asks about using aspirin for their gout to help with the pain.

 

What do you say?

Definition

HELL NO!

 

It will increase the uric acid levels...sorry!

Term

Name the drug.

 

This is an anti-viral medication that admin IV for severe infections. It can cause nephotoxicity when given IV and it can decrease renal function if given PO.

 

Hint: prototype drug for herpes infections.

Definition
Acyclovir
Term
This anti-viral med is the DOC for HSV keratoconjunctivitas and recurrent eptihelial keratitis.
Definition
Trifluridine
Term
Name three anti-viral meds that are administered as eye drops.
Definition

Trifluridine

 

Vidarabine

 

IDOXURIDINE

Term

This drug has a 20x greater efficacy than acyclovir on CMV retinitis.

 

What is it?

Definition
Ganciclovir
Term

This antiviral drug causes myelosuppression.

 

It is give IV for acute infection and PO for maintenance and prophylaxis to prevent reactivation.

Definition
Ganciclovir
Term
This is the preferred drug for CMV.
Definition
Valganciclovir
Term

This drug has a broad antiherpetic activity. 

 

adverse effects: can cause nephrotoxicity so it's recommended that a pt also take probenacid to help and saline hydration before/after dose.

Definition
Cidofovir
Term
This drug is injected into your eyeball. It is used when other therapies for CM retinitis fail.
Definition
FOMIVERSEN
Term

This anti-viral med causes nephrotoxicity and electrolyte disturbances. It is used to treat CMV retinitis.

 

It's the last resort for CMV infections.

Definition
FOSCARNET
Term

This drug is used for respiratory viral infections.

 

It causes livedo reitcularis (discoloration of the lower extremities with edema)

Definition
Amantadine
Term

Which of the following two drugs crosses the BBB?

 

Amantidine

OR

Rimantidine

Definition
Amantidine
Term

This drug is used for prophylaxis treatment for influenza A. It binds viral M2 protein.

 

Used in nursing homes- offers some protection if pt can't get vaccine.

Definition
Amantadine
Term
What is the MOA of neuraminidase inhibitors?
Definition

doesn't eliminate the infection; prevents from infecting more cells and replicating.

 

Prevents new virus from getting in and old viruses from getting out

Term
This drug is orally inhaled or admin intranasally for treatment of influneza A.
Definition
Zanamivir
Term

This is a popular anti-viral med.

 

It is used for the prevention/treatment of Influenza A/B; probenacid doubles the t 1/2.

Definition
Oseltamivir
Term
This drug is admin PO for hep C in combo with interferon.
Definition
Ribavirin
Term

This drug is used to prevent infeciton in neonates at risk for RSV infections

 

ie premature infants (less than 35 weeks) those with bronchopulmonary dysplasia.

Definition
Palivizumab
Term
This is an HIV/AID drug that was the first drug available for HIV in 1987. It causes bone marrow suppression/anemia/neutropenia. It increases toxicity with drugs requiring glucuronidation.
Definition
Zidovudine
Term
This HIV drug required a buffering agent. It can cause pancreatitis which can be fatal and peripheral neuropathy. It is food dependent.
Definition
Didanosine
Term
This HIV drug causes peripheral neuropathy which may be due to inhibition of NGF (nerve growth factor).However, it was removed from the market.
Definition
Zalcitabin
Term

If a patient becomes resistant to AZT, what do you think about for next line?

 

Hint: non-food dependent

Definition
Stavudine
Term
This HIV drug is reported to have minimal toxicity. It is given when, for example, a healthcare worker is exposed to HIV.
Definition
Lamivudine
Term

This HIV drug requires the individual to also take L-carnitine supplementation for muscle energy which the drug depletes it. 

 

Advs effects: nephrotoxicity

Definition
Adefovir
Term

This HIV drug causes Adv effects: rash, severe/fatal hypersensitivity

NO BONE MARROW SUPPRESSION

Definition
Abacavir
Term
This HIV drug is used when they have failed the other HIV drugs. Resistance develops slowly.
Definition
Tenofovir
Term
This HIV drug causes skin hyperpigmentation of the soles and palms.
Definition
Emtricitabine
Term

Zidovudine, Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir, Adefovir, Tenofovir, Emtricitabine and Trizivir.

 

What drug class?

Definition
NRTI
Term

Neviripine, Delavirdine, Efavirenz and Etraviridine.

 

What drug class?

Definition
NNRTI
Term

Ritonavir, Indinavir, Saquinavir - H, Saquinavir-S, ??Nelfinavir, Amprenavir, Kaletra, Atazanavir and Enfuvirtide

 

What drug class?

Definition
Protease Inhibitors
Term

Raltegravir

 

 

What drug class?

Definition
Integrase Inhibitor
Term
This HIV drug class causes liver disturbances/hepatitis/liver toxicity. They are non food dependent.
Definition
NNRTI
Term
This drug is an alternate to AZT. It prevents transmission during pregnancy. It increases all drug enzymes.
Definition
Nevirapine
Term
This NNRTi is contraindicated in pregancy. It can cause delusions, "disconnectedness."
Definition
Efavirenz
Term

This drug class causes lipodystrophy.

 

 

Causes hyperglycemia/ inc TGs/cholesterol

 

 

Definition
Protease inhibitors
Term

This HIV drug is used in low doses to increase drug levels of other drugs.

 

It is very potent and not well tolerated.

Definition
Ritonavir
Term

This HIV drug requires drinking at least 1/5 liters of   fluid/day to avoid kidney stones.

 

Adv reactions: crystalluria/nephrolithiasis/flank pain

Definition
Indinavir
Term
This HIV drug when given in a single dose during labor plus 1 dose to the newborn within 3 days reduces infant infection by 1/2
Definition
Nelfinavir
Term
This HIV drug causes eosinophilia. It is the ONLY drug that works outside the cell.
Definition
Enfuvirtide
Term
This HIV drug prevents the viral HIV DNA from entering the host's healthy DNA.
Definition
Raltegravir
Term
What does HAART stand for?
Definition
highly active antiretroviral therapy
Term
What are the three proteins that are essential for the virus getting into our cells?
Definition

M2: proton/ion pump

 

HA: hemagluten

 

NA: neurominadase

Term
Are the NNRTI's food dependent?
Definition

NOPE

 

NON FOOD DEPENDENT!

Term
Pt comes in with suspected DVT...what's the first thing you're thinking of giving because you want sometime that will work in at least 30 minutes?
Definition

heparin injection

 

T: 1/2-2 hrs. RAPID ONSET

 

low molecular weight heparin- has longer half life

Term
What's the half life of warfarin?
Definition
half life: 40 hrs.
Term
This drug can be a good thrombolytic because it is SELECTIVE for fibrin bound plasminogen (in clot).
Definition
T-PA
Term

What do you need to tell your patient to be aware in regards to drug interactions when taking an opiod? (What substances/meds specifically?)

 

What are the 3 most common effects?

Definition

What do you need to tell your patient to be aware in regards to drug interactions when taking an opiod? (name the classes)

CNS depressants, alcohol additives, general anesthetics, sedative-hypnotics, tricyclic antidepressants, MAO inhibitors

What are the 3 most common effects?

hypotension, inc respiratory depression, coma

Term
This is a topical cream used for recurrent herpes labialis (fever blister, cold sores)
Definition
Penciclovir
Term

This anti-viral causes chain termination as it's MOA.

 

This anti-viral does NOT cause chain termination.

Definition

This anti-viral causes chain termination as it's MOA.

ACYCLOVIR

 

This anti-viral does NOT cause chain termination.

FAMCICLOVIR/PENCICLOVIR

Term
This is the DOC for HSV keratoconjunctivitis and recurrent epithelial keratitis.
Definition
TRIFLURIDINE
Term
This NSAID is used for allergicl conjunctivitis as well as analgesia (post op)
Definition
KETOROLAC
Term
This is a DMARD that can cause hyperkalemia, alopecia, weight loss, skin rash, and it's teratogenic.
Definition
Leflunomide
Term
This DMARD inhibits lymphocyte proliferation so they can't go to the site of inflammation.
Definition
Leflunomide
Term
What are some adverse effects of glucocorticoids?
Definition

causes redistribution of fat

 

muscle atrophy

 

hyperglycemia

 

thinning skin bc metabolized connective tissue

 

ulcers

 

high BP bc increase reabsorption of sodium, Cl, and water

 

Osteoporosis-bc suppress Ca absorption

 

Cushing syndrome

Term
What two systems do fungi have that humans don't?
Definition
permease system (takes drug up into fungi) AND enzyme cytosine deaminase (converts drug to active metabolite)
Term
What is the 4th most common organism isolated from blood cultures in the USA?
Definition
Candida Albicans
Term
What type of fungal infection is the leading cause of death in bone marrow transplant recipients?
Definition
Aspergillosis
Term
Where are opioid receptors located? (6)
Definition

brainstem

medial thalamus

hypothalamus

limbic system

periphery

immune cells

Supporting users have an ad free experience!