Pharm Final

2 effects of asthma

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