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Pharm Block 2 pt. 1

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alex0624's version from 2016-06-30 22:04

NSAIDs

Question Answer
Occurs with higher dose (both as acute and chronic) which is characterized by Vomiting, Tinnitus, Vertigo, loss of hearing (resembles quinine poisoning)Salicylism-Aspirin (Adverse effect)
Renal ulcers, gastric and duodenal ulcers are side effects ofNSAIDs
Side effect of NSAIDs:Gastric and duodenal ulcers is caused byReducing mucus secretion
Reduce Prostaglandins synthesis by inhibiting Cyclooxygenase (COX) enzymeNSAIDs
Protective benefits of GI Cytoprotection(mucous productions) & Platelet AggregationCOX-1
Causes Inflamation ,Pain, FeverCOX-2
Inhibition of COX-1 will not reduce the inflammation. Rather produces harmful effects likeGastric ulcers
Highly selective COX-2 inhibitorsCelecoxib, Roficoxib (discontinued), Valdecoxib, Eterocoxib (coxib)
irreversible/prolonged inhibition inhibitors of both cox-1 and cox-2Aspirin ( acetylsalicylic acid)
Reversible Nonselective inhibitors of both cox-1 and cox-2NSAIDs except for (coxib & Aspirin)
Renal toxicity: papillary necrosis and tubulo-interstitial inflammation of the kidney is a side effect ofNSAIDS
Common Adverse effects of all NSAIDsGastric, duodenal ulcers & Renal toxicity
Beneficial action of NSAIDs is by inhibiting COX-1 & COX-2.
Adverse effect of NSAIDs is by inhibition ofCOX-1
NSAID with anti-inflammatory & antiplateleteffect (only NSAID with antiplatelet effect--> acetylation affect make it irreversible!!!!!)(very potent)Aspirin (Acetyl salicylic acid)
By acetylation of enzymes, ____ inhibits irreversibly both COX-1 and COX-2Aspirin (Acetyl salicylic acid)
DOC In myocardial infarction and TIAAspirin (Acetyl salicylic acid), Low Dose (baby)
DOC In Acute rheumatic feverAspirin (Acetyl salicylic acid)-high doses
Overdose of Aspirin causesReyes Syndrome & Hyperthermia. Most common cause of death pulmonary edema(rep. failure)
Occurs with higher dose (both as acute and chronic ) which is characterized by Vomiting, Tinnitus, Vertigo, loss of hearing (resembles quinine(malaria treatment) poisoning)salicylism
DOC** for Rheumatoid arthritis(MOST POWERFUL ANTI-INFLAMMATORY)Indomethacin (NSAIDs)
DOC** for GoutIndomethacin (NSAIDs)
used for chronic or acute musculoskeletal pain, general inflammatory swellings and feverIbuprofen, Diclofenac, Naproxene
DOC for closing Patent Ductus Arteriosus (PDA)Indomethacin (NSAIDs)
DOC for opening Patent Ductus Arteriosus (PDA)Prostaglandin
Best used in mild to moderate post operative pain (opiods for severe pain/ VERY GOOD ANALGESIC)Ketorolac (NSAID)
Used in patients suffering from inflammatory conditions with co existing gastritis or peptic ulcer Highly selective cox-2 inhibitors (Coxib's)
Drugs to avoid in patients who are allergic to sulfonamidesHighly selective cox-2 inhibitors (Coxib's)
Good anti-inflammatory without causing gastric peptic ulcers(can be used in patnt with peptic ulcers) Coxibs
If patient i sallergic to sulfonamides which drug is contraindicativeCoxibs
MOA: Inhibits COX better in non inflammatory area, great pain killer.Acetaminophen (Tylenol)
Uses: Any kind of fever and non inflammatory pain (eg: Headache, Toothache), in Hypothalamus. VERY GOO ANTIPYRETIC AND ANALGESIC DRUG.(NOT GOOD ANTI INFLAMMATORY DRUG.Acetaminophen (Tylenol)
Overdose of this drug can cause hepatic cell necrosis(seen in children)
ALSO CAN CAUSE ______
Acetaminophen (Tylenol)/ Alcoholic acetaminophen syndrome
What minor metabolite from acetaminophen cause hepatic cellular necrosisN-acetyl benzoquinone
Treatment for Acetaminophen poisoningGive more glutathione in the form of N-acetyl cysteine
Used for hemorragic cystitisN-acetyl cysteine
Corticosteroid used to treat Rheumatoid ArthritisPrednisone
Slow acting drugs that modify the disease course of Rheumatoid Arthritis, should be given for long time Disease Modifying Anti Rheumatoid Drugs (DMARD) also called as SAARDs (Slow Acting Anti Rheumatoid Drugs) (Infliximab, Etanercept, Anakinra & Methotrexate)
Is used in very low dose in R.arthritis (in cancer high dose is used). Folic acid inhibitor--> inhibit purines= no t cells no inflammation.Methotrexate (DMARD)
Recombinant IL-1 receptor (blocker) antagonist used in treating R.arthritisAnakinara (DMARD)
Mimics the inhibitory effects of naturally occurring soluble TNF receptors used in treating R.arthritis, i.e TNF Receptor BlockerEtanarecept (DMARD)
The important monoclonal antibody used in RA treatment. Acts as TNF-alpha blocker.Infliximab (DMARD)
Also known as "anti-TNF antibodies"Infliximab (DMARD)
Adverse effects: Infections, reactivation of TB and heptatitis, Discoid Lupus Erythematosus (DLE)Infliximab (DMARD)
TNF antagonists are also useful in treating Psoriasis, crohn’s disease and ulcerative colitisInfliximab (DMARD)
Treatment of Acute Gout NSAIDs & Colchicine
Treatment of chronic GoutProbenecid & Allopurinol
This drug acts as anti-inflammatory drug Only In goutColchicine
Promoting Excretion of uric acidProbenecid
Inhibits the tubular reabsorption of uric acid, promotes excretion of uric acid. Thereby it reduces blood level of uric acidProbenecid
Inhibiting the synthesis of uric acidAllopurinol
Decreases the production of uric acid by preventing the conversion of Hypoxanthine to uric acid. This is done by inhibiting the enzyme Xanthine oxidase.Allopurinol
triggers inflammation, produce fever, neurons to painProstaglandins
non opioid analgesics; Antipyretics(reduce fever drugs)NSAIDS
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Asthma

Question Answer
Short Acting Adrenergic (β2 selective) agonists (SABA) to treat AsthmaAlbuterol & Terbutaline
Long Acting Adrenergic (β2 selective) agonists (LABA) to treat AsthmaSalmeterol & Formeterol
Mechanism of action for Adrenergic (β2 selective) agonists ↑ In cyclic AMP, ↓ Of muscle tone, Bronchial smooth muscle relaxation
Used As-needed `in maintenance of chronic asthma (As needed, Not everyday). Can cause hypokalemia and tachycardia. Inhaled have minimal side effects.Albuterol
Used for Prophylaxis (inhalation)-for prevention, not treatment. Not used for treatment of acute asthma due to delayed onset of actionSalmeterol
Side effects of albuterolTolerance (tachyphelaxis)
Short acting, slower response Muscarinic antagonists to treat asthmaIpratropium
Long acting (24hr), Muscarinic antagonists to treat asthmaTiotropium
Muscarinic antagonists used to treat asthmaIpratropium & Tiotropium
Used in treating COPDIpratropium & Tiotropium
Used in COPD and asthma to increase the mucociliary clearance and increase cGMPIpratropium & Tiotropium
Inhibition Phosphodiesterase (PDE4)- ↑ cAMP used in treatment of asthma (cause vasodilation)Methyl Xanthines - Theophylline
Used ti treat nocturnal asthmaTheophylline
Used to treat Severe chronic asthmaPrednisolone (oral)
Used to treat Status asthmaticusHydrocortisone (i.v)
Competitively block LTD4, LTE4 receptors . Actions: Block bronchoconstriction, Reduce edema. Decrease mucus production. Used to treat asthmaMontelukast & Zafirlukast
Blocks affects of LeukotrienesMontelukast & Zafirlukast
Used to treat Aspirin induced asthmaZileuton
5-lipoxygenase inhibitor used to treat asthmaZileuton
Blocks Synthesis of Anti LeukotrieneZileuton
Act by stabilizing the mast cell from degranulation and inhibiting the further release of inflammatory mediators from the mast cell in treating asthmaSodium cromoglicate & Nedocromil Sodium
Humanized monoclonal antibody to human IgE (Anti- IgE antibody)Omalizumab
adverse drug reactions: tremors, hypokalemia, agitations, palpitations(tachycardia), dizz, etc.adrenergic agonist(albuterol, salmeterol)
Adverse effects--> dysphonia and oropharyngeal candidiases. Action(Anti-inflamatory)inhaled corticosteroids(glucocorticoids)
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GI Pharm-Peptic Ulcer

Question Answer
Antacids uses to relieve the heart burn causes DiarrheaMagnesium hydroxide
Antacids uses to relieve the heart burn causes ConstipationAluminum hydroxide
Antacids uses to relieve the heart burn causes Belching, Metabolic alkalosis, Milk Alkali Syndrome.Calcium Carbonate and Sodium bicarbonate
Best consumed in between meals to relieve heart burnAntacids
Large doses of ____ can cause the milk-alkali syndrome, which consists of hypercalcemia, renal insufficiency and metabolic alkalosis Antacids (containing calcium)
H2-Receptor AntagonistsCimetidine, Famotidine, Ranitidine, Nizatidine (tidines)
2.Proton Pump InhibitorsOmeprazole, Rabeprazole, Lansoprazole, Pantoprazole, Esomeprazole (Zole)
Drugs used in GI to reduce acid secretion H2-Receptor Antagonists, Proton Pump Inhibitors & Muscarinic antagonists
Inhibit ~ 70% of 24 h acid output H2-Receptor Antagonists (tidines)
Only H2-Receptor Antagonists to produce major side effects, by inhibiting CYP-450Cimetidine
Antiandrogenic effects, Gynaecomastia, Galactorrhea, CYP-450 inhibitionCimetidine
Irreversible of enzymes, suicide inhibition of H+/K+-ATPase (the proton pump) and thus blocks the final common pathway of acid secretionPPIs (Zole)
Inhibit >90% of 24 h acid output. Short half life (30 m) but long duration of action. PPIs (Zole)
DOC for both prevention and treatment of NSAID induced ulcers.PPIs (Zole)
DOC for Zollinger Ellison Syndrome.PPIs (Zole)
Stimulates the EP-3 on parietal cells and increases the mucus and bicarbonate secretion and mucosal blood flowMisoprostol, Sucralfate, Bismuth
Mucosal Protective AgentsMisoprostol, Sucralfate, Bismuth
Mucosal Protective Agent with the following adverse effects;Diarrhea, stimulates uterus contraction, therefore contraindicated in pregnancyMisoprostol
Mucosal Protective Agent use to; Induction of labor (used with oxytocin), Abortion, Prevention of NSAID induced ulcersMisoprostol
PG E1 analog that acts by increasing mucus production. Used for prevention of NSIAD induced ulcers. Also used for induction of labor (with oxytocin) and MTP or abortion (with mifepristone)Misoprostol
In water or acidic solutions it forms a viscous, tenacious paste, the sucrose sulfate that binds selectively to base of ulcers or erosions, forms a physical barrier and coats the ulcers. Given to patients that have peptic ulcersSucralfate
Coats the ulcer lesions and protect them from acid. Also stimulates production of PGs and HCO3- . Used to treat bleeding ulcers.Sucralfate
Mucosal Protective Agents use in prevention of traveler's diarrhea. Black discoloration of the stool and tongueBismuth
Standard "triple therapy" regimens for Anti H-Pylori drugsPPI +Clarithromycin+ Amoxicillin or Metronidazole or Tinidazole
Standard "triple therapy" regimens for Anti H-Pylori drugsPPIs+ Bismuth+ Metronidazole+ Tetracycline
All drugs are given twice daily for 14 days and PPIs are continued for additional 4-6 weeksStandard "triple therapy" regimens for Anti H-Pylori drugs
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GIT Pharmacology

Question Answer
Agents that would be CONTRAINDICATED in bowel obstruction (they can cause the obstruct bowel to burst)Prokinetic
Increase GI motility after surgeryBethanachol (Muscarinic agonist)
Anticholinestrase that increase GI motility, by inhibit ACh degradationNeostigmine
Blocks inhibitory D2 receptor. Dopamine D2 blockers. Does not cross blood brain barrier. Effective against vomiting and nauseaDomperidome
Blocks inhibitory D2 receptor. Dopamine D2 blockers. Crosses blood brain barrier. Effective against vomiting and nauseaMetoclopramide
D2 antagonists used in treating vomiting due to blood borne emeticsMetaclopramide & Domperidone
Serotonergic agonist, activates excitatory 5-HT4 receptors. Promote upper G.I.T MotilityCisapride, Mosapride
Causes ventricular arrhythmia by torsades de pointes (when combined with CYP450 inhibitors-ketoconazole, macrolides etc)Cisapride
Macrolide antibiotic & acts as a motilin agonist. Activate neural & smooth muscle motilin receptor. Promote upper G.I.T MotilityErythromycin
Relieves motion sicknessScopalamine
Acts on M and H1 receptors to reduce vomitingScopalamine
Used to prevent nausea and vomiting caused by cancer chemotherapyOndansetron
Works on Serotonin 5-HT3 receptors to fight vomitingOndansetron
Blocks vomiting due to psychaitaric disorders, stress, anxietyBenzodiazapines, Dronobinol, Phenothiazines (Prochloroperazine and promethazine)
Reduces vomiting by blocking M and D2 receptors. Because they also blocks H1, causes sedation.Phenothiazines: Prochloroperazine and promethazine
Used to treat Inflammatory bowel diseases5-aminosalicylates (Sulfasalazine and Mesalamine)
First line drugs in mild or moderate ulcerative colitis and also in Crohn’s disease. Inhibition of PGs and leukotriene biosynthesis5-aminosalicylates (Sulfasalazine and Mesalamine)
Used only to induce vomiting in case of any poisoningApomorphine (Emetic)
Acts on the CTZ to stimulate the opioid receptorsApomorphine (Emetic)
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