Shared Flashcard Set

Details

Winter Exam 2
Peuler Exam
71
Pharmacology
Professional
01/03/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Regular Insulin
Definition
Novolin-R, Humulin-R
Fast and short acting, used in emergencies (ketoacidosis), or for general SC maintenance
ADR: Severe Hypoglycemia, Immunologic reactions, Weight gain
Term
Lispro
Definition
Humalog
faster acting than regular insulin but same duration, used in emergencies (ketoacidosis), or for general SC maintenance
ADR: Severe Hypoglycemia, Immunologic reactions, Weight gain
Term
Insulin Aspart
Definition
Novolog
faster acting than regular insulin but same duration, used in emergencies (ketoacidosis), or for general SC maintenance
ADR: Severe Hypoglycemia, Immunologic reactions, Weight gain
Term
NPH insulin
Definition
Humulin-H, Novolin-H
Intermediate acting
Not suitable for emergencies because of solubility.
Often doses in the morning and evening to provide 24 basal insulin level
ADR: Severe Hypoglycemia, Immunologic reactions, Weight gain
Term
Insulin Glargine
Definition
Lantus
Long acting slow onset, not used in IV because of solubiltiy.
Once daily injection provides 24 hour basal insulin level
ADR: Severe Hypoglycemia, Immunologic reactions, Weight gain
Term
Insulin Detemir
Definition
Levemir
Long acting slow onset, not used in IV because of solubiltiy.
Once daily injection provides 24 hour basal insulin level
ADR: Severe Hypoglycemia, Immunologic reactions, Weight gain
Term
Glyburide
Definition
Diabeta, Micronase
Sulfonylurea
MOA: stimulate the release of endogenous insulin, largely independent of blood glucose level.
Uses: Type 2
ADR: hypoglycemia, weight gain, sulfonamide like drug allergy
Interactions: Insulin, alcohol, sulfonamides, aspirin, chloramphenicol
Term
Glipizide
Definition
Glucotrol
Sulfonylurea
MOA: stimulate the release of endogenous insulin, largely independent of blood glucose level.
Uses: Type 2
ADR: hypoglycemia, weight gain, sulfonamide like drug allergy
Interactions: Insulin, alcohol, sulfonamides, aspirin, chloramphenicol
Term
Repaglinide
Definition
Prandin
Meglitinid
Stimulates endogenous insulin release, in a more blood-glucose concentration dependent fashion than sulfonylureas
ADR: Hypoglycemia, Weight gain
Term
Nateglinide
Definition
Starlix
Prandin
Meglitinid
Stimulates endogenous insulin release, in a more blood-glucose concentration dependent fashion than sulfonylureas
ADR: Hypoglycemia, Weight gain
Term
Metformin
Definition
Glucophage, Fortamet, Riomet
Insulin sensitizing biguanide- antihyperglycemic agent
Uses: Type 2
MOA: Improves sensitivity of peripheral tissues to insulin action, Decreases hepatic glucose output, decreases glucose absorption from intestine (primary mechanism), may also lower blood pressure and serum lipids.
Elimination: Kidneys very quickly
ADR: GI effects, lactic acidosis
Interactions: increased blood levels of metformin with digoxin, morphine, quinidine, triamterene, and radio-contrast dye
Term
Rosiglitazone
Definition
Avandia
Thiazolidinediones- antihyperglycemic agent
Use: Type 2
MOA: Increased synthesis of new glucose transport molecules in insulin resistant tissues, thus correcting insulin resistance
Elimination: Hepatic, feces/bile
ADR: Vascular fluid retention and edema, Weight gain, not as good at decreasing risk for MI
Term
Pioglitazone
Definition
Actos
Thiazolidinediones- antihyperglycemic agent
Use: Type 2
MOA: Increased synthesis of new glucose transport molecules in insulin resistant tissues, thus correcting insulin resistance
Elimination: Hepatic, feces/bile
ADR: Vascular fluid retention and edema, Weight gain
Term
Acarbose
Definition
Precose
alpha-glucosidase inhibitor
MOA: inhibits enzyme responsible for complex carbohydrate digestion, smoothes out post prandial of glucose peaks
Uses: Type 1 and 2 adjunctive therapy
Elimination: Renal
ADR: GI disturbances
Precautions: diseases in which absorption is impaired
Term
Exenatide
Definition
Byetta
GLP-1 agonist
MOA: enhances glucose-dependent insulin, inhibits glucagon secretion, slows gastric emptying, increases satiety
Uses: monotherapy or adjunct for type 2
Elimination: renal
ADR: hypoglycemia when combined with sulfonylureas, GI effects
Interactions: decreased absorption by oral medications, anitbiotics and OCs taken 1 hour before byetta.
Term
Sitagliptin
Definition
Januvia
DPP-IV inhibitor
MOA: prolongs effects of incretins that would be metabolized. incretins then increase glucose-dependent insulin release, decrease glucagon secretion
Uses: monotherapy and adjunct of Type 2
ADR: hypoglycemia when combined with sulfonylureas
Term
Pramlintide
Definition
Symlin
Amylin analog
MOA: slows gastric emptying, inhibits glucagon secretion, increases satiety
Uses: adjunct therapy type 1 and 2
Elimination: Renal
ADR: Hypoglycemia; more risk when combined with insulin especially type 1, GI effects
Interactions: decreased absorption of oral medications
Term

Digoxin

(CHF)

Definition
MOA: Increase myocardial contraction, decrease heart rate Uses: CHF, digitalis may also help with tachycardia associated with CHF, may also relieve fluid retension in CHF patient by indirect diuresis. ADR: arrhythmias, Ventricular tachycardias and fibrillations, delirium, vision impairment
Term
Digoxin immune Fab
Definition
MOA: antigen binding fragments that bind to digoxin and are excreted in the urine
Uses: Treatment of life-threating digitalis toxicity, or overdose characterized by severe hyperkalemia
Term
Dobutamine
Definition
MOA: Cardioselective B1 agonist
Uses: treatment of severe refractory congestive heart failure
ADR: tachycardia, increased oxygen demand on heart, Tolerance
Term
Dopamine
Definition
MOA: Cardioselective B1 agonist, at certain doses can increase renal blood flow
Uses: severe refractory congestive heart failure
ADR: tachycardia, increased oxygen demand on heart, Tolerance
Term
Inamrinone
Definition
MOA: Increases cardiac contractility in systole, increases diastole filling
Uses: Severe refractory CHF, or after tolerance develops to dopamine and dobutamine.
ADR: Ischemic heart disease due to increased myocardial oxygen demand, thrombocytopenia
Term
Milrinone
Definition
MOA: Increases cardiac contractility in systole, increases diastole filling
Uses: Severe refractory CHF, or after tolerance develops to dopamine and dobutamine.
ADR: Ischemic heart disease due to increased myocardial oxygen demand
Term
Captopril
Definition
MOA: ACE inhibitor
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, non-productive cough, Angioedema, fetal harm.
Term
Enalapril
Definition
MOA: ACE inhibitor
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, non-productive cough, Angioedema, fetal harm.
Term
Fosinopril
Definition
MOA: ACE inhibitor
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, non-productive cough, Angioedema, fetal harm.
Term
Quinapril
Definition
MOA: ACE inhibitor
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, non-productive cough, Angioedema, fetal harm.
Term
Losartan
Definition
MOA: Angiotensin II receptor-1 blocker
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, Angioedema, fetal harm.
Better at preventing cardiac hypertrophy than ACE-I
Term
Valsartan
Definition
MOA: Angiotensin II receptor-1 blocker
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, Angioedema, fetal harm.
Better at preventing cardiac hypertrophy than ACE-I
Term
Candesartan
Definition
MOA: Angiotensin II receptor-1 blocker
Use: CHF, through decreased preload and afterload, thus increasing cardiac output, exercise capacity, and decreasing pulmonary congestion
ADR: Hyperkalemia, excessive hypotension, Angioedema, fetal harm.
Better at preventing cardiac hypertrophy than ACE-I
Term
Hydrochlorothiazide
Definition
MOA: Thiazide Diuretic
Use: reduction of extracellualr fluid, reduced preload, relieve pulmonary congestion, and reduce peripheral edema.
Precautions: Use loop diuretics if GFR is < 30ml/min
Term
Furosemide
Definition
MOA: Loop diuretics
Use: reduction of extracellualr fluid, reduced preload, relieve pulmonary congestion, and reduce peripheral edema.
Term
Spironolactone
Definition
MOA: K-sparing diuretic
Use: Given in conjunction with loop or thiazides to maintain K levels in patients with CHF, decreases digitalis toxicity, prevents myocardial stiffness due to high levels of aldosterone
Term
Epleronone
Definition
MOA: K-sparing diuretic
Use: Given in conjunction with loop or thiazides to maintain K levels in patients with CHF, decreases digitalis toxicity, prevents myocardial stiffness due to high levels of aldosterone
Term
Nitroglycerin
Definition
MOA: Direct Vasodilator
Use: Primarily a preload reducer in CHF. Patients that benefit most from vasodilators are severe CHF refractory to other therapies, patients that have just experienced a acute MI who had prexisting chronic CHF
Term
Isosorbide Dinitrate
Definition
MOA: Direct Vasodilator
Use: Primarily a preload reducer in CHF. Patients that benefit most from vasodilators are severe CHF refractory to other therapies, patients that have just experienced a acute MI who had prexisting chronic CHF
Term
Hydralazine
Definition
MOA: Direct Vasodilator
Use: Primarily a afterload reducer in CHF. Patients that benefit most from vasodilators are severe CHF refractory to other therapies, patients that have just experienced a acute MI who had prexisting chronic CHF
Term
Nitroprusside
Definition
MOA: Direct Vasodilator
Use: Both a preload and afterload reducer in CHF. Patients that benefit most from vasodilators are severe CHF refractory to other therapies, patients that have just experienced a acute MI who had prexisting chronic CHF
Term
Nesiritide
Definition
Vasodilator + Diuretic MOA: decreases both arterial and venous smooth muscle tone by increased levels of cGMP, inhibits reabsorption of Na Patients that benefit most from vasodilators are severe CHF refractory to other therapies, patients that have just experienced a acute MI who had prexisting chronic CHF
Term
Bisoprolol
(CHF)
Definition
MOA: Beta blocker
Use: CHF treatment by preventing down regulation of beta adrenergic receptors due to constant high levels of catecholamines, preventing excessive tachycardia and arrhythmais, inhibits overexpression of RAAS
Term
Metoprolol
(CHF)
Definition
MOA: Beta blocker
Use: CHF treatment by preventing down regulation of beta adrenergic receptors due to constant high levels of catecholamines, preventing excessive tachycardia and arrhythmais, inhibits overexpression of RAAS
Term
Carvedilol (CHF)
Definition

MOA: Beta and Alpha blocker

Use: CHF treatment by preventing down regulation of beta adrenergic receptors due to constant high levels of catecholamines, preventing excessive tachycardia and arrhythmais, inhibits overexpression of RAAS

Term
Quinidine
Definition
MOA: Class IA antiarrhythmic drug, inhibits Na and K channels
Uses: Supraventricular and ventricular arrhythmais, reentry arrhythmias, ectopic atrial arrhythmias, maintain normal rhythm after cardioversion
ADR: TdP, decreased BP, increases SA rate, Increased digoxin levels, alpha block, atropine like effects
Term
Procainamide
Definition
MOA: Class IA antiarrhythmic drug, inhibits Na and K channels
Uses: Supraventricular and ventricular arrhythmais, reentry arrhythmias, ectopic atrial arrhythmias, maintain normal rhythm after cardioversion
ADR: Reversible lupus syndrome, CNS effects, GI, TdP, ventricular arrhythmias, alpha block, and atropine like effects
Misc: Larger effect in fast acetylaters, NAPA eliminated via kidney
Term
Lidocaine
Definition
Class IB antiarrhythmic drug, rapidly interacts with Na channels to shorten phase 3
Uses: emergency treatment of ventricular arrhythmias due to ischemia, or abnormal automaticity, or reentry pulses, stops TdP
ADR: convulsions, arrhythmias, confusion
Term
Felcainide
Definition
MOA: Class IC antiarrhythmic drug, slowly interacts with Na channels to decrease slope of phase 0, also increases threshold
Uses: abnormal automatcity, several refractory arrhythmias
ADR: aggravation of CHF, arrhythmias, life-threatening ventricular tachycardia due to hyperkalemia
Term

Propanolol

(arrhythmias)

Definition
Class II antiarrhythmic drug MOA: Beta blocker, used to decreasing inward Ca currents thus depressing automaticity and phase 4 depolarization especially in nodes. Decreases conduction velocity in nodes, increases APD USES: arrhythmias caused by increased sympathetic neural activity and/or excess catecholamine presense, adrenergically driven arrhythmic death after MI ADR: bradycardia, inhibtion of RAAS
Term
acebutolol
Definition
Class II antiarrhythmic drug
MOA: Beta blocker, used to decreasing inward Ca currents thus depressing automaticity and phase 4 depolarization especially in nodes. Decreases conduction velocity in nodes, increases APD
USES: arrhythmias caused by increased sympathetic neural activity and/or excess catecholamine presense
ADR: bradycardia, inhibtion of RAAS
MISC: reduced risk of broncospasm, partial agonist activity lowers risk of too much suppression
Term
Esmolol
Definition
Class II antiarrhythmic drug
MOA: Beta blocker, used to decreasing inward Ca currents thus depressing automaticity and phase 4 depolarization especially in nodes. Decreases conduction velocity in nodes, increases APD
USES: arrhythmias caused by increased sympathetic neural activity and/or excess catecholamine presense, acute arrhythmias during surgery or emergency
ADR: bradycardia, inhibtion of RAAS
MISC: Very short acting used IV
Term
Amiodarone
Definition
Class III antiarrhythmic drug also has class I, II, IV activity as well
MOA: inhibition of K channels, so prolongs phase 3, also decreases cell to cell coupling
USES: severe refractory supraventricular and ventricular tachyarrhythmia, adjunctive therapy with ICD
ADR: interstitial pulmonary fibrosis, hyper or hypothyroidism, blue skin discoloration
Term
Dofetilide
Definition
Pure class III antiarrhythmic drug MOA: inhibits K channels so prolongs APD, ERP

USES: Supraventricular arrhythmias such as atrial fibrillation

ADR: Ventricular TdP

Term
Sotalol
Definition
Class III but also has Class II activity
MOA: beta blocker and inhibtion of K channles thus prolonging APD, ERP
USES: arrhythmias recurrences, adjunctive therapy for ICD patients
ADR: bradycardia, inhibtion of RAAS
Term
Verapamil
Definition
Class IV antiarrhythmic drug
MOA: Calcium channel blocker, suppressing automaticity by decreasing slope phase 0 and 4, increase APD, ERP
USES: reentrant supraventricular arrhythmias, stopping DAD in both supra and ventricular arrhythmias
ADR: decreased Sinus Rate and A-V conduction, worsens WPW in atrial fibrillation
Term
Diltiazem
Definition
Class IV antiarrhythmic drug
MOA: Calcium channel blocker, suppressing automaticity by decreasing slope phase 0 and 4, increase APD, ERP
USES: reentrant supraventricular arrhythmias, stopping DAD in both supra and ventricular arrhythmias
ADR: decreased Sinus Rate and A-V conduction, worsens WPW in atrial fibrillation
Term
Digoxin
(arrhythmia)
Definition
shortens APD and ERP in ventricular muscle cells, and decreases conduction in A-V and Purkinje fibers
USES: atrial fibrillation and flutter
ADR: arrhythmias, TdP
MISC: use lidocaine to treat digoxin induced ventricular arrhythmias
Term
Adenosine
Definition
decreases abnormal impulse formation in AV node thru hyperpolarization of membrane, increases ERP
USES: acute paroxysmal supraventricular tachycardia
ADR: flushing, SOB, chest pain
MISC: 15 sec duration of action
Term
Aspirin
(Antiplatelet)
Definition
MOA: Irreversibly inhibits COX 1 which prevents platelet aggregation
Uses: prevention of MI, ischemia, arterial thrombosis
ADR: GI bleed, operative bleeding, damage to fetus
Term
Dipyridamole
(antiplatelet)
Definition
MOA: inhibits platelet aggregation by blocking phophodiesterase which raises cAMP
Uses: prevents thrombosis, used with coumadin
ADR: hypotensin
Term
Clopidrogel
(antiplatelet)
Definition
MOA: irreversibly binds to platelet ADP receptor which prevents aggregation
USES: MI, Stroke, Vascular death
ADR: Bleeding
Term
Heparin
(Anticoagulant)
Definition
MOA: inactivates factor Xa and thrombin which inhibits thrombin formation
USES: catheters, pregnancy, venous and arterial thromboembolic disease
ADR: bleeding, thrombocytopenia, local capillary rupture
Term
Enoxaparin
(anticoagulant)
Definition
MOA: inactivates factor Xa and thrombin which inhibits thrombin formation
USES: catheters, pregnancy, venous and arterial thromboembolic disease
ADR: bleeding, thrombocytopenia, local capillary rupture
Term
Protamine Sulfate
(anticoagulant)
Definition
MOA: Binds to heparin and inactivates
USES: Heparin overdose
ADR: Anaphlylactic RXNs when patients are allergic to fish
Term
Warfarin
(anticoagulant)
Definition
MOA: Blocks vitamin K, an essential cofactor in the post-translational modification of clotting factors. Thus they are unable to bind to calcium.
USES: Prevention clotting arteries, veins, prosthetic heart valves
ADR: Hemorrhage, necrotic lesions, teratogenic
Term
Lepirudin
(anticoagulant)
Definition
MOA: inhibits factor VIII, thrombin
USES: anticoagulation in patients with heparin-induced thrombocytopenia
ADR: Hypersensitivity, possibly teratogenic
Term
Streptokinase
(Thrombolytic)
Definition
MOA: activates fibrinolytic enzyme plasmin (indirectly)
USES: venous and arterial thromboembolic disease, dissolving existing thrombus on shunts and catheters
ADR: Allergic rxn if patient had previous strep infection, intercranial hemorrhage
Term
Urokinase
(Thrombolytic)
Definition
serine protease that generates plasmin (directly)
USES: venous and arterial thromboembolic disease, dissolving existing thrombus on shunts and catheters
ADR: Bleeding, intercranial hemorrhage
Term
Alteplase
(thrombolytic)
Definition
MOA: activates fibrin-bound plasmin
USES: venous and arterial thromboembolic disease, dissolving existing thrombus on shunts and catheters
ADR: Bleeding, intercranial hemorrhage
Term
Amicar
(Thrombolytic)
Definition
MOA: Competitively inhibits plasmin activation
USES: Reversal of Thrombolysis
Term
Factor VIII
(hemostatic)
Definition
MOA: Blood coagulation factor
USES: Hemophilia A
Term
Factor IX
(Hemostatic)
Definition
MOA: Blood coagulation factor
USES: Hemophilia B
Term
Phytonadione
(Hemostatic)
Definition
MOA: Vitamin K, required for coagulation
USES: Newborn hemorrhagic disease, coumadin overdose
ADR: Anaphylaxis
Supporting users have an ad free experience!