Pharm Final

2 effects of asthma

Bronchoconstriction
Inflammation and swelling of airway

Albuterol

Most widely prescribed and most effective agent for bronchoconstriction
*Relaxes smooth muscle

Prednisone

Glucocorticoid
Inhibits production of inflammatory mediators
*Drug of choice in newly dx asthma patients

Montelukast/Zafirlukast

Leukotriene receptor antagonist
Decreases inflammation and bronchoconstriction
*Effective for treating aspirin-induced asthma

How are monoclonal antibodies administered?

Take through IV or injection

What is an example of an enteric hormone and it's function?

Gastrin
Acid secretion

Omeprazole/Lansoprazole

Acid Treatment
*Treatment of GERD

Bismuth Subsalicylate

Acid Treatment
Forms protective barrier
*Displaces H. pylori

Histamine receptor antagonists:
(Cimetidine)

Acid Treatment
Inhibits metabolism of several drugs

Category of Ranitidine and Famotidine

Histamine (H2) receptor antagonists

Misoprostol

Acid Treatment
Inhibit acid secretion
Prevents ulcers in patients on NSAIDs
Side effects: stimulates abortion

Antacids

Acid Treatment
Neutralize HCl
Immediate relief = short duration

Side effect of Aluminum Hydroxide

Constipation

Side effect of Magnesium Hydroxide

Laxative

What is Prednisone used for? (IBD)

Drug of choice for acute attacks IBD

What is Olsalazine used for?

Drug of choice for reoccurring IBD

What is the function of Loperamide?

Best OTC agent for diarrhea

What is dimenhydrinate used for?

Anti-emetic
Motion Sickness

What is Metoclopramide used for?

Anti-emetic
Blocks CTZ for N/V

What is Lorazepam used for? (Anti-emetic)

Stage fright-induced or anticipatory vomiting

What is the use of Magnesium Hydroxide and what are the effects?

Constipation
Water and electrolyte retaining cathartic
May produce dehydration

What is the difference between albuterol and beta-blockers?

Both beta-adrenergic agonists and bronchodilators
Albuterol: widely prescribed
Beta-blockers: should not be used to treat CV disease

Antidepressants a form of therapy for bipolar patients. Should they be taken alone or with another medication?

NEVER ANTIDEPRESSANT ALONE

What does a drug have to be to enter and cross the BBB?

Drug needs to be lipid soluble

What is Alprazolam used for?

General anxiety disorder
Panic disorder

What is Lorazepam used for? (Anxiolytic)

General anxiety
NO USE W/ KIDNEY FAILURE

What is Diazepam used for? (Anxiolytic)

Anesthesia, muscle relaxant
Rapidly absorbed, rapid passage through BBB

What is the drug of choice for sedatives?

Benzodiazepines

Describe the use of Flurazepam and it's effects.

BDZ
Rapid onset, long duration of action

Describe the use of Triazolam and it's effects.

BDZ
Rapid onset, short duration
*Hallucinations

Describe the use of Zolpidem and it's effects.

Binds to Omega-1 BDZ receptor
Used for BDZ overdose

Describe the use of Secobarbital and it's effects.

Rarely used hypnotic

What is the mechanism of action of tricyclic antidepressants?

Block uptake 1

What is Amitriptyline used for?

Tricyclic Antidepressant
Chronic pain

What is Clomipramine use for?

Tricyclic Antidepressant
OCD

What is Fluoxetine used for?

SSRI
Effects other drugs metabolism

What is Sertraline used for?

SSRI
Less effect on drug metabolism

What is Paroxetine used for?

SSRI
Highest specificity for serotonin
No effects on drug metabolism

What is Bupropion used for? (Antidepressants)

Newer Antidepressant
Blocks dopamine uptake
Used in nicotine withdrawal

What is Venlafaxine used for?

Newer Antidepressant
Effective in severe depression and anxiety
Blocks uptake of NE and serotonin

Describe the use of Phenytoin and it's effects.

Epileptic drug
Sodium influx
Partial/Generalized
Difficulty dosing
Overgrowth of gums, thickening of facial hair

Describe the use of Carbamazepine and what else it can be used for.

Sodium influx
Partial/Generalized
NOT IN ABSENCE
Used for bipolar disease

Describe the use of Valproic Acid and what else it can be used for.

Sodium, Calcium, GABA
Partial/Generalized
Used for bipolar and migraines

Describe the use of Ethosuximide and what it is used for.

Calcium influx
Drug of choice for absence

Describe the use of Phenobarbital and what it can be used for.

GABA
Partial/Generalized
NOT ABSENCE
Can reduce seizures without causing sedation

Describe the use Oxcarbazepine and its effects.

Sodium influx
Partial
Better tolerated/More $

Describe the use of Topiramate and its effects.

GABA, Sodium influx, Glutamate
Partial/Generalized
Possibility of Glaucoma

Describe the use of Zonisamide and its effects.

Sodium and Calcium influx
Partial only
Stops seizure spread

Should BDZ and Lorazepam be used in patients with kidney failure?

NOOOOOO

What is the difference between BDZs and Barbiturates in the GABA channel?

BDZ = frequency
Barbiturates = duration

Which Tourette's treatment is the most common and what are the effects?

Haloperidol
More potent, less sedation, less anticholinergic, more EPS effects

Describe the use of Pimozide and its effects.

Only for symptoms of Tourette's
High potency

Describe the use of Clozapine and its effects.

Newer Atypical Agent
Works on dopamine and serotonin
High sedation, Less EPS

Describe the use of Risperidone and its effects.

Newer Atypical Agent
Works on dopamine and serotonin
Low sedation, Less EPS

Describe the use of Olanzapine and its effects.

Newer Atypical Agent
Works on dopamine, serotonin, histamine, ACh, NE
Less EPS

Describe the use of Ariprazole and its effects.

Only antipsychotic that reduces dopamine
Less EPS, reduce positive symptoms

What is the most effective treatment for Parkinson's?

Levodopa
50% reduction in symptoms

Describe the use of Carbidopa (3 things)

PD Drug
No effect alone
Inhibits decarboxylation of Levodopa in periphery
Does not cross BBB

Describe the use of Pramipexole and how it is used in early vs late stages.

PD Drug
Dopamine agonist
Alone in early stage; with Levodopa in late stage

Describe the use of Amantadine and its effects.

PD Drug
Anti-viral agent
Most likely releases dopamine
Given with Levodopa

Describe the use of Selegiline and when it is prescribed.

PD Drug
MAO-B inhibitor
Prescribed as soon as possible; slows spread

Describe the use of Entacapone and its mechanism of action.

PD Drug
Inhibitor of COMT
Metabolism of dopamine inhibited
Given with Levodopa

Describe the differences in the causes of Parkinson's, Alzheimer's, ALS, and Schizophrenia.

PD: Decrease of dopamine
AD: Decrease of ACh
ALS: Loss of periphery
Schizophrenia: Increase of dopamine

Describe the difference between Type I and Type II Diabetes.

Type I (insulin-dependent): a severe form that often occurs in juveniles
Type II (insulin-independent): a milder form that predominantly occurs in adults

Describe the difference between short and long acting insulin.

Short: given to mimic nutrient-stimulated insulin
Long: given to mimic 24 hr basal insulin secretion

Describe the insulin time of action:
Short
Intermediate
Long-acting

Short: Regular (0.5 hrs)
Intermediate: NPH (1-2 hrs), Lente (1-3 hrs)
Long-acting: Ultra Lente (4-6 hrs), Lantus (24 hrs)

Describe the use of Sulfonylureas and its effects.

Type II Med
Increase insulin release from pancreas

Describe the use of Biguanides and its effects.

Type II Med
Reduce insulin resistance
A given amount of insulin is more effective

What is an example of an Alpha-Glucosidase Inhibitor and what is its effect?

Acarbose (Type II Med)
Modulates digestion and absorption of starch and sugar

Describe the use of SGLT-2 Inhibitors and its effects.

Type II Med
Blocks process of reabsorbing glucose and excrete through urine lowering blood glucose and body weight

Describe the use of GLP-1 Receptor Agonists and its effects.

Type II Med
Lowers fasting blood glucose by:
- Stimulating insulin secretion
- Lowering glucagon secretion
- Delays gastric emptying

Which steroids are abused orally?

Anadrol
Ozandrin
Dianabol

Which steroids are abused by injection?

Durabolin
Deca-Durabolin
Depo-Testosterone

Which steroids are abused through supplements?

Dehydroepiandrosterone (DHEA)
Androstenedione (Andro)

What is the most commonly abused anabolic steroid?

Stanozolol

Describe the use of Octreotide.

For hormone-secreting tumors and acromegaly

Describe the uses of Bromocriptine.

Treat prolactin related diseases
Hyperprolactinemia

Describe when a patient would take Leuprolide?

Precocious puberty

What is Desmopressin used for?

Treatment of diabetes insipidus

What is Oxytocin used for?

Stimulates uterine contractions

What is the drug of choice for hypothyroidism?

Levothyroxine Sodium

For hyperthyroidism treatment, when is a thyroidectomy performed?

Best for large glands of multinodular goiters

For hyperthyroidism treatment, what is the treatment of choice for most adults?

Radioactive Iodine

What is the use and mechanism of action for Bisphosphonates?

Given for 3 days normally for malignancy
Inhibits production of Vitamin D

What is Calcitonin used for?

Lowers serum calcium --> ancillary treatment

What is the mechanism of action for Sildenafil?

Release nitric oxide and activates cGMP

Describe the function of Clomiphene and what it is used for.

Anti-Estrogen
Prevents normal feedback inhibition of estrogen of pituitary
Treats infertility in men and women

Describe the function of Tamoxifen and what it is used for.

Anti-Estrogen
Estrogen receptor blocker
Treatment of estrogen-dependent breast cancer

Why is patient info important?

Describe what Vitamin A helps with and what is a good source of it.

Night vision
Carrots

Describe what Vitamin D regulates and what a good source of it is.

Regulates Calcium and Phosphate
Via ultraviolet rays

Describe the use of Vitamin E.

Fights free radical damage

Describe how newborns are affected by Vitamin K and what happens with a deficiency of K.

Newborns: deficient in Vitamin K
Deficiency: lots of bleeding

Describe the use of Vitamin C and what a good source of it is.

Antioxidant properties
Via citrus fruits

Describe the use of Niacin and what happens in a deficiency.

Reduce high cholesterol
Deficiency = pellagra ("rough skin")

What is the use of Riboflavin and is there any toxicity associated with it?

No toxicity
Migraine headaches med

What is the use of Thiamin and what happens in alcoholics?

Carbohydrate metabolism
Alcoholics: Wernicke-Korsakoff Syndrome

What is the use of Pyridoxine, drug interactions, and what population is it important for?

Metabolism of sugar, fat, protein
Drug interaction: interferes with Levodopa
Important for athletes

Describe the use of Cyanocobalamin/Folic Acid and its effects.

Synthesis of DNA and RBCs
Folic acid deficiency and pregnancy
Folic acid protects from colorectal cancer

What is the difference between Enteral vs Parenteral?

Enteral: administered through GI
Parenteral: administered through IV