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PHARM Resp, GI, Anti-ep

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lunalovegood's version from 2016-11-08 00:45

Section

ASTHMA
Question Answer
Ammonium hydroxide & carbonate in alcoholAromatic ammonia spirit (support respiration)
Emergency drug for syncopeAromatic ammonia spirit (stimulates resp & vasomotor centers)
Used in ventilation depressionDoxapram (rarely bc side effects - convulsion)
Chronic inflammation of airwaysasthma (most common resp disease - 10%)
T/F - Asthma kills 5000 yearly.T
T/F - Allergen --> APC --> T cell --> cytokines --> B lymphocyte --> Plasma cell --> IgE --> mast cellT
c___ has bronchodilator propertiescAMP (& inhibits inflamm mediator release)
Good for anaphylatic shock acute asthma attackepinephrine
B2 agonists side effectsnervousness, tachycardia, insomnia, hyperglycemia, hypokalemia, hypomagnesmia
Corticosteroid mechanisminhibits prostaglandin synthesis (by inhibiting phospholipase A2)
Phospholipase A2 makes...AA
Corticosteroid inhalation dental implicationoropharyngeal candida (rinse mouth after inhale)
Corticosteroid side effectsAdrenal suppression, poor wound healing, immunosuppression
Prophylactic agentCromolyn (mast cell stabilizer - not absorbed orally)
Prevents influx of Calcium in antigen-antibody reactions w/ mast cellsmast cell stabilizer (Cromolyn)
Least toxic medCromolyn
Phophodiesterase inhibitormethylxanthine (theophylline)
Theophylline + _____ = Aminophyllineethylenediamine (good for IV)
Theophylline side effectsCNS & cardiac stimulation, increased gastric acid secretion, diuresis
Ipratropium side effectsdry mouth, unpleasant taste, tachycardia
Leukotriene inhibitor side effectsGIT irritation, headache, altered liver fxn
Stimulate flow of respiratory tract secretionsexpectorants
Cleave SH group to reduce viscositymucolytic agents (GI irritation, airway obstruction in hyperactive asthmatics)
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ASTHMA DRUGS
Question Answer
Epinephrinea1, a2, B1, B2
IsopreterenolB1, B2 (cardiac side effects, no bueno)
Albuterolshort B2
Metaproternolshort B2
Levalbuterol, Pirbuterolshort B2
Salmetrollong B2
Formeterollong B2
Fluticasone Inhale corticosteroid (& intranasal steroid)
BudesonideInhale corticosteroid
Mometasone, Triamcinolone, BeclomethasoneInhale corticosteroid (& intranasal steroid)
Prednisone, Dexamethasone, PrednisoloneOral corticosteroid
CromolynMast cell stabilizer
TheophyllineMethylxanthine (caffeine group)
Aminophyllinesoluble form of Theophylline (add ethylenediamine)
IpratropiumAnticholinergic
CombiventIpratropium + Albuterol
AdvairFluticasone + Salmeterol
ZileutonLOX inhibitor
ZafirilukastLTD4 receptor antagonist
MontelukastLTD4 receptor antagonist
OmalizumabIgE blocker
Ephedra DANGEROUS - herbal remedy
Codeine & Hydrocodoneopiod analgesic antitussive
Benzonatateantitussive (suppress cough center and stretch receptors)
Dextromethorphanantitussive
Noscapineantitussive
Phenylephrine, Ephedrine, Pseudoephedrinealpha adrenergic vasoconstrictor nasal decongestants
Potassium iodide, Ammonium chloride, Guaifensin, Syrup of IpecacExportants
Acetylcysteinemucolytic agents
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p450
Question Answer
PPIsinhibits (omeprazole)
H2 receptor antagonistsinhibits (cimetidine)
Valproic acidinhibits
PhenytoinINDUCES
BarbituratesINDUCES
CarbamazepineINDUCES
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GI DRUGS
Question Answer
OmeprazolePPI (OTC)
LansoprazolePPI (longer lasting)
Pentoprazole, Esomeprazole, RabeprazolePPI
CimetidineH2 receptor antagonist
Ranitidine, Famotidine, NizatidineH2 receptor antagonist
PrevpacLansoprazole + Clarithromycin + Amoxicillin (peptic ulcer tx)
Sodium bicarb, Magnesium saltsantacid
MisoprostolPGE1 derivative (inhibits H+ via inhibiting cAMP)
Atropine, Scopolamine, Propantheline, Methantheline, Cyclopyrrolateantimuscarinic antisialogogues
Scopolamineantimuscarinic antiemetic (motion sickness)
Syrup of Ipecacemetic
Apomorphineemetic
Phenothiazinesdopamine antagonist antiemetics (i.e. Chlorpromazine, Promethazine)
DiphenhydramineH1 receptor antagonist
PromethazineH1 receptor antagonist (dopamine antagonist??? both??? what???)
MeclizineH1 receptor antagonist
Metoclopramide, Domperidonedopamine antagonist antiemetics
Ondansetron5-HT3 receptor antagonist antiemetic
Castor oil, Bisacodyl, Senna, Cascarastimulant laxatives
Magnesium hydroxide, Lactulose, Glycerine, Polyethylene Glycol 3350saline cathartics laxatives
Docusate Na, Docusate Ca, Mineral oilwetting agents and lubricants laxatives (lowers surface tension, softens stool)
Plantago prep, Bran, Semi-synthetic Cellulosebulk forming agent laxatives (absorb water, expand, increase pressure perstalsis)
Attapulgitabsorbent anti-diarrheal
Codeineopioid anti-diarrheal (decreases motor)
Loperamideopioid LIKE drug anti-diarrheal (Immodium - acts on opioid receptors in intestines)
Diphenoxylateopioid anti-diarrheal (similar to Meperidine but less addictive)
LomotilDiphenoxylate + atropine
Bismuth subsalicylate, Trimethoprim, Sulfamethoxazole, Doxycyclinetreat traveler's diarrhea
Bethanechol, Metoclopramide, CisaprideGI stimulants (cholinergic or cause Ach release)
Loperamide + dietary fiber, anticholinergics, Dicyclamine, Propanthelineantispasmodics
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GI
Question Answer
Clost difficilePPI
Affect drug absorptionPPI (reduce ketoconazole, increase digoxin)
Inhibits P450PPI (change metabolism of diazepam, warfarin, phenytoin) more pronounced for Omeprazole
T/F - Vagus --> G cells --> Gastrin --> (bile, digestive enzyme, peristalsis) + enterochromaffin-like cells --> Histamine --> Parietal cells (H2 receptors) --> ACIDT
For long-term duodenal ulcers, viscous suspension for cyto-protection, directly inhibit pepsin & bile salts, increase HCO3-, PG release, minimally absorbedSucralfate (sulfated sucrose)
T/F - Antimuscarinics not often used for peptic ulcer therapy.T
Dopamine agonist derived from morphine, emeticapomorphine (large dose decreases respiration, antagonized by naloxone)
Contains 90% of body's serotonin storesenterochromaffin-like cells (5-HT - Vagus to 5HT3 receptor)
CTZchemoreceptor trigger zone
Are Phenothiazines like Chlorpromazine and Promethazine very effective for motion sickness?no
Metoclopramide, Domperidone, Ondansetron, and Cannabinoids can all help with...treating cancer emesis
Major causes of Traveler's diarrheaE. coli, salmonella, shigella
Chloral hydrate can cause...GI irritation (listed under dental related drugs, but this drug is not approved by FDA... so you know... cool)
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Antihistamines and such
Question Answer
H_ receptor - vasodilation, contraction of nonvascular smooth muscleH1
H_ receptor - vasodilation, cardiac stimulation, gastric acid secretionH2 (CV effects only at high doses)
H_ receptor - not well characterizedH3
Which generation of antihistamines cross the BBB?First
When does histamine activate both H1 and H2 receptors?at high concentrations
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Drugs
Question Answer
ChlorpheniramineH1 antihistamine - 1st generation
DiphenhydramineH1 antihistamine - 1st generation
DoxylamineH1 antihistamine -1st generation
FexofenadineH1 antihistamine - 2nd generation
LevocabastineH1 antihistamine -2nd generation
LoratadineH1 antihistamine - 2nd generation
CimetidineH2 antihistamine
RanitidineH2 antihistamine
FamotidineH2 antihistamine
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Epileptics
Question Answer
Most common generalized seizuregrand mal
Rare, but life-threateningstatus epilepticus
Drug of choice for tonic-clonic and partial seizuresphenytoin (and trigeminal neuralgia) --- Barbituates and Carbamazepine are effective
Hydantoin mechanismreversibly binds to inactive sodium channels
Small percentage eliminated via saliva - may cause gingival enlargementphenytoin
Is Phenytoin safe for pregnancy?no - caution may cause cleft lip/palate (succinimides are less teratogenic)
Enhances binding of GABAbarbituates, valproic acid, BDZ
Related to tricyclic antidepressantsCarbamazepine
More effective against absence (petit mal) and partial seizuresValproic acid
Drug of choice for absence seizuresEthosuximide (clonazepam also)
Toxic hepatic metabolitesvalproic acid
Treats status epilepticusDiazepam
Treats local-anesthetic induced seizuresDiazepam
Problem with tolerance/dependencyBDZ
Inhibits GABA transaminaseVigabartin
Decreases GABA uptakeTiagabine
GABA analogueGabapentin
Used in refractory epilepsyVigabartin, Tiagabine, Gabapentin
For convulsion control in eclampsiaMg salts
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Drugs
Question Answer
PhenytoinHydantoin antiepileptic
Mephenytoin, Ethotoin, FosphenytoinHydantoin antiepileptic
Phenobarbitalbarbituate antiepileptic
Mephobarbitalbarbituate antiepileptic
Primidonebarbituate antiepileptic
Ethosuximidesuccinimide antiepileptic
Methsuximide, Phensuximidesuccinimide antiepileptic
DiazepamBDZ
ClonazepamBDZ
Clorazepate, LorazepamBDZ
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