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FA PHARM

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laracrystalo's version from 2015-06-11 00:17

Direct Muscarinic agonists

Question Answer
tx post-op ileusBethanechol
tx urinary retentionCarbachol
challenge test for asthmaMethacholine
tx open and closed angle glaucomaPilocarpine (cry, drool, sweat on your Pilo)
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ANTICHOLINESTERASES --> increased ACh

Question Answer
tx alzheimersDonepezil, galantamine, rivastigmine
diagnose Myasthenia GravisEdrophonium (very short acting)
reverses NMJ blockade post opneostigmine
no CNS penetrationneostigmine
postop urinary retention and myasthenia gravisneostigmine
tx anticholinergic toxicityphysostigmine (phyxes atropine overdose)
crosses BBBphysostigmine
long acting myasthenia gravis treatmentpyridostigmine
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MUSCARINIC BLOCKERS

Question Answer
produce mydriasis and cycloplegiaatropine, homatropine, tropicamide (work at the eye)
tx parkinson diseaseBenztropine (park my benz) works at CNS
reduce airway secretions pre opglycopyrrolate
antispasmodic for IBSHyoscyamine, dicyclomine
COPD and asthma txIpratropium, tiotropium (I pray I can breath soon)
tx overactive bladderOxybutynin, solifenacin, tolterodine
tx motion sicknessscopolamine (CNS)
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SYMPATHOMIMETIC RECEPTOR PREFERENCES

Question Answer
albuterolB2 > B1
dobutamineB1 > B2
dopamineD1 = D2
epinephrineB > alpha (increases Bp before alpha blockade, decreases Bp after alpha blockade)
IsoproterenolB1 = B2 (decreased Bp, increased HR)
NEalpha1 > alpha2 > B1 (increased Bp, decreased HR)
Phenylephrinealpha1 > alpha2 (increases Bp before alpha blockade, no effect on Bp after alpha blockade)
indirect sympathomimeticsinhibit repute or release stored catecholamines (amphetamine, cocaine, ephedrine)
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RANDO

Question Answer
SYMPATHOLYTICSalpha2 agonists --> decreased sympathetic tone
tx HTN urgencyClonidine (alpha2 agonist)
HTN in pregnancyalpha-methyldopa (alpha2 agonist)
nonselective alpha blockersphenoxybenzamine (irreversible for preop pheo) and Phentolamine (reversible for Maoi who eat tyramine foods)
alpha1 blockers-zosins for BPH, PTSD, HTN
alpha2 blockersmirtazapine for depression
tx BPHalpha1 blockers (zosins)
tx PTSDPrazosin (alpha1 blocker)
for MAO inhibitor patients who eat tyramine foodphentolamine (reversible alpha blockers)
for preop pheophenoxybenzamine (irreversible alpha blocker)
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DRUG REACTIONS 1

Question Answer
coronary vasospasmCocaine, Sumitraptan, Ergot alkaloids
cutaneous flushingVancomycin, Adenosine, Niacin, Ca++ channel blockers (VANC)
DCManthracyclines (Doxorubicin and daunorubicin) --> prevent with dexrazoxane
torsadesClass III (sotalol), class IA (quinidine), macrolides, antipsychotics, TCAs
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DRUG REACTIONS 2

Question Answer
adrenocortical insufficiencyHPA suppression secondary to glucocorticoid withdrawal
hot flashesTamoxifen, clomiphene
hyperglycemiaTacrolimus, Protease inhibitors, Niacin, HCTZ, Corticosteroids
hypothyroidismLithium, amiodarone, sulfonamides
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DRUG REACTIONS 3

Question Answer
acute cholestatic hepatitis, jaundiceerythromycin
diarrheaMetformin, Erythromycine, Colchicine, Orlistat, Acarbose
Focal to massive hepatic necrosisHalothane, Amanita phalloides (death cap shroom), Valproic acid, Acetaminophen
HepatitisRifampin, Isoniazid, Pyrazinamide, Statins, Fibrates
PancreatitisDidanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics
Pseudomembranous ColitisClindamycin, ampicillin, cephalosporins
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DRUG REACTIONS 4

Question Answer
AgranulocytosisGancyclovir, Clozapine, Carbamazepine, Colchicine, Methimazole, Propylthiouracil
Aplastic anemiaCarbamazepine, NSAIDS, Benzene, Chloramphenicol, Propylthiouracil, Methimazole
Direct coombs + hemolytic anemiaMethyldopa, penicillin
Gray baby syndromeChloramphenicol
Hemolysis in G6PD deficiencyIsoniazid, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin, fava beans
Megaloblastic anemiaphenytoin, methotrexate, Sulfa drugs
ThrombocytopeniaHeparin
Thrombotic complicationsOCPs, hormone replacement therapy
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DRUG REACTIONS 5

Question Answer
Fat RedistributionProtease inhibitors, glucocorticoids
Gingival hyperplasiaPhenytoin, Ca++ channel blockers (verapamil), Cyclosporin
Hyperuricemia (gout)Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporin
MyopathyFibrates, Niacin, colchicine, hodroxychloroquine, IFNalpha, penicillamine, statins, glucocorticoids
Osteoporosiscorticosteroids, heparin
Photosensitivitysulfonamides, amiodarone, tetracyclin, 5-FU (Sat for foto)
SJSanti epileptic drugs (esp LAMOTRIGINE), allopurinol, sulfas, penicillin
drug induce SLEsulfa drugs, hydralazine, isoniazid, procainamide, phenytoin, etanercept
tooth discolorationtetracycline
tendonitis/rupturefluoroquinolones
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DRUG REACTIONS 6

Question Answer
Cinchonismquinidine, quinine
parkinson-like syndromeantipsychotics, reserpine, metoclopramide
seizuresisoniazid (B6 deficiency), Buproprion, Imipenem, Enflurane
tardive dyskinesiaantipsychotics, metocloprmide
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DRUG REACTIONS 7

Question Answer
diabetes insipiduslithium, demeclocycline
fanconi syndromeexpired tetracycline
hemorrhagic cystitiscyclophosphamide, isosfamide (prevent by coadministering with MESNA)
interstitial nephritismethicillin, NSAIDS, furosemide
SIADHCarbamazepine, Cylcophosphamide, SSRI
dry coughACE inhibitors
pulmonary fibrosisBleomycin, Amiodarone, Busulfan, Methotrexate
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DRUG REACTIONS 8

Question Answer
antimuscarinicatropine, TCAs, H1 blockers, antipsychotics
disulfiram-like reactionmetronidazole, some cephalosporins, griseofulvin, procarbazine
nephrotoxicity, ototoxicityaminoglycosides, vancomycin, loops
sulfa drugsprobenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonamide antibiotics, sulfasalazine, sulfonylurea (Popular FACTSSS)
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CYP450

Question Answer
Chronic EtOHinducer
st johns wortinducer
phenytoininducer
nevirapineinducer
rifampininducer
griseofulvininducer
carbamazepineinducer
barbituatesinducer
acute EtOHinhibitor
ritonovirinhibitor
amiodaroneinhibitor
cimetidineinhibitor
-azolesinhibitor
sulfasinhibitor
isoniazidinhibitor
grapefruit juiceinhibitor
quinidineinhibitor
macrolidesinhibitor (except azithromycin)
ciproinhbitor
omeprazoleinhibitor
metronidazoleinhibitor
substratesanti-epileptics, theophylline, warfarin, OPCs
what do inducers do to substrate?speed up their metabolism therefore decrease their effectiveness --> so you'd want to increase the substrate dose
what do inhibitors do to substrate?slow down their metabolism and therefore increase their toxicity --> so you'd want to decrease the substrate dose
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IMMUNOMODULATORS

Question Answer
what type of infection are IFNs good for?viral infections
mechanisms of IFN?inhibit viral protein synthesis via ribonuclease that degrades viral mRNA and protein kinase that inactivates EF2, activates NK cells
EPO toxicity?HTN
G-CSF med for increasing granulocytes?Filgrastim
calcineurin inhibitors?cyclosporine and tacrolimus --> decrease Il2 --> decrease IFN gamma --> decrease macrophages and T cell activation
toxicity of calcineurin inhibitors?nephrotoxic
what does Sirolimus do?binds mTOR to decrease IL2 and decrease T cell activation
monoclonal antibody against IL2 receptor?Daclizumab
monoclonal antibody agaisnt epsilon chain of CD3 on T cells?Muromonab-CD3
azathioprine mechansim?antimetabolite precursor of 6MP that decreases lymphocyte production
azathioprine toxicity?increased with allopurinol
mycophenolate mofetil?inhibits IMP dehydrogenase and decreases guanine synthesis --> decreased T cells
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