Pharm for Boards

What is the drug class for chloroquine?

- Antimalarial / Amoebicide

What is the MOA for chloroquine (2)?

- prevents the parasite from breaking down heme, so it accumulates

- results in lysis of the parasite

What is the indication for chloroquine (2)?

- malaria

- amebiasis

What are the highlights to know about chloroquine usage (9)?

- can cause the following:

- bull's eye maculopathy (this makes it worse than hydroxychloroquine)

- reversible whorl keratopathy

- loss of night vision

- retinal damage

- reversible corneal opacities

- excreted by the liver

- hearing and visual disturbances

- safe with pregnancy

What is the drug class for Esomeprazole?

- PPI (proton pump inhibitor)

What is the MOA for esomeprazole?

- Inhibits H+/K+/ATPase pump in the stomach's parietal cells

What is the indication for esomeprazole (3)?

- increased acid secretion (Zollinger Ellis)

- acid reflux

- ulcers

- 1st line/DOC for peptic ulcer disease and GERDDDD

What are the highlights to know about esomeprazole usage (2)?

- can have drug interactions

- vitamin deficiencies can happen (vitamin D and B12)

- increases gastric pH

What drug class is albuterol/ipratropium?

- SABA / SAMA

What is the MOA for albuterol/ipratropium?

- short acting beta 2 agonist / muscarinic antagonist

What is the indication for albuterol/ipratropium (2)?

- asthma

- COPD

What are the highlights to know about albuterol/ipratropium (3)?

- tachycardia

- nervousness

- increased BP

- dry mouth (ipratropium)

What drug class is fluticasone/solumedrol?

- steroid / LABA

What is the MOA for fluticasone/solumedrol (2)?

- phospholipase A inhibitor

- B2 agonist

What is the indication for fluticasone/solumedrol?

- asthma

- COPD

What is a highlight for fluticasone/solumedrol?

- PSCs

- increase IOP

- dry eye

- nose bleeds

What is the drug class for Valsartan/HCTZ (2)?

- angiotensin receptor blocker

- diuretic

What is the MOA for Valsartan/HCTZ (2)?

- angiotensin receptor antagonist

- thiazide diuretic (K Wasting)

What is the indication for Valsartan/HCTZ (2)?

- hypertension

- CHF

What are the highlights for Valsartan/HCTZ (3)?

- african american

- bilateral renal artery stenosis

- pregnancy class X

What is the drug class for Glargine?

- long acting insulin

What is the MOA for Glargine (4)?

- tyrosine kinase receptor agonist

- causes series of phosphorylations

- GLUT4 translocation

- cellular intake of glucose

What is the indication for Glargine?

- diabetes

What are the highlights for glargine (3)?

- hypoglycemia

- weight gain

- lipodystrophy

What is the drug class for Duloxetine?

- SNRI

What is the MOA for Duloxetine?

- Serotonin Norepinephrine Reuptake Inhibitor

What is the indication for Duloxetine (4)?

- depression

- anxiety

- fibromyalgia

- diabetic neuropathy

What are the highlights for Duloxetine?

- suicidal thoughts and behavior

- can't give with MAOIs

- gotta taper the dose when you discontinue it

What is the drug class for lisdexamfetamine/vyvanse?

- stimulant

What is the MOA for lidexamfetamine/vyvanse?

- blocks the reuptake of norepinephrine and dopamine

What is the indication for lidexamfetamine/vyvanse?

- ADHD

- narcolepsy

- obesity

What are the highlights for Lisdexamfetamine/vyvanse (4)?

- Schedule II drug

- CI: MAOI

- Cautious use with glaucoma and HTN patients

- eye issues: mydriasis, retinopathy, hemorrhage

What is the drug class for pregabalin?

- Gamma - aminobutyric acid (GABA) neurotransmitter analog

What is the MOA for pregabalin (2)?

- binds to the alpha 2 delta subunit of voltage gated channels

- modulates the release of excitatory neurotransmitters like glutamate

What is the indication for pregabalin (2)?

- nerve pain (fibromyalgia, herpes)

- partial onset seizures

What are the highlights for pregabalin (4)?

- schedule V

- dizziness

- suicidal thoughts

- taper when you discontinue

What is the drug class for cholestyramine?

- bile acid sequestrant

What is the MOA for cholestyramine?

- binds directly to bile salts in the intestine

What is the indication for cholesyramine?

- elevated LDL

What are the highlights for cholestyramine?

- increased TG levels

- GI upset

- Fatty stools

- Constipation

- Can bind other meds & vitamins so give 1 hr before or 4-6 hours after food

- CI: TG greater than 400mg/dL

What is the drug class for Naphazoline (Albalon)?

- alpha 1 agonist

What is the MOA for Naphazoline (Albalon)?

- stimulates alpha 1 receptors in the arterioles of the conjunctiva to whiten the sclera (lessen the appearance of redness)

What is the indication for Naphazoline (Albalon) (2)?

- red eyes

- decongestant

What are the highlights for Naphazoline (Albalon) (4)?

- rebound hyperemia (if used more than 3 days and stop abruptly)

- mydriasis: glaucoma

- available OTC and RX

- increased BP and HR

What is the drug class for Nedocromil (Alocril)?

- mast cell stabilizer

What is the MOA for Nedocromil (Alocril)?

- inhibit mast cell degranulation in response to stimuli, by blocking calcium channels essential for mast cell degranulation, preventing the release of histamine and related mediators

What is the indication for Nedocromil (Alocril)?

- allergies / allergic conjunctivitis

What is the drug class for Brimonidine (alphagan P)?

- alpha 2 agonist

What is the MOA for Brimonidine (alphagan P) (2)?

- decreases aqueous humor production

- increased uveoscleral outflow

What is the indication for Brimonidine (alphagan P)?

glaucoma

What are the highlights for Brimonidine (alphagan P) (5)?

- lumify 0.025% for ocular redness

- crosses the BBB

- hypotension

- drowsiness

- lethargy

What is the drug class for loteprednol (Alrex)?

- ester based steroid (only ester one!)

What is the MOA for loteprednol (Alrex)?

- phospholipase A inhibitor

What are the indications for loteprednol (Alrex) (2)?

- inflammation

- seasonal allergic conjunctivitis

What are the highlights for loteprednol (Alrex) (4)?

- suspension (shake)

- less increase in IOP

- cataracts

- CI: epithelial herpes simplex keratitis or other viral/fungal infections

What is the drug class for Flurbiprofen 0.03%?

- NSAID

What is the MOA for Flurbiprofen 0.03%?

- inhibits COX 1 and 2

- prostaglandins also appear to produce a miotic response during ocular surgery by constricting the iris sphincter independently of cholinergic mechanisms

What is the indication for Flurbiprofen 0.03%?

- prophylaxis of intraoperative miosis

What is the highlight for Flurbiprofen 0.03%?

- SE: corneal melt

What is the drug class for Simbrinza?

- CAI (brinzolamide)

- Alpha 2 agonist (brimonidine)

What is the MOA for Simbrinza (2)?

- Brinzolamide: lowers IOP by inactivating carbonic anhydrase and interferes with the sodium pump which decreases aqueous humor formation

- Brimonidine: alpha 2 agonist receptors located in the presynaptic adrenergic neurons and the ciliary body

What is the indication for Simbrinza?

- glaucoma

What are the highlights for Simbrinza?

- Suspension so shake that assssssssss

- Brinzolamide CI: sulfa allergy & it primarily works in the CB

- Brimonidine: crosses BBB, hypotension, drowsiness, lethargy

What is the drug class for Bepotastine (Bepreve)?

- H1 antagonist and mast cell stabilizer

What is the indication for Bepotastine (Bepreve)?

- allergic conjunctivitis

What is the drug class for Timolol (Betimol)?

- Beta 1 and Beta 2 blocker

What is the MOA for Timolol (Betimol)?

- lowers IOP by decreasing aqueous humor production by blocking B1 and B2 receptor activation on NPCE

What is the indication for Timolol (Betimol)?

- glaucoma

What are the highlights for Timolol (Betimol)?

- bradycardia

- lower BP

- sexual dysfunction

- weakness

- depression

- CI: asthma or hx of asthma, severe COPD, heart block, bradycardia

- caution: can mask thyroid and glycemic issues

What is the drug class for Ranibizumab (Lucentis)?

- anti VEGF

What is the MOA for Ranibizumab (Lucentis)?

- binds to the receptor binding site of active forms of VEGF-A, preventing the interaction of VEGF-A with its receptors (VEGFR1 & VEGFR2) on the surface of endothelial cells, reducing endothelial cell proliferation, vascular leakage, and new blood vessel formation

What is the indication for Ranibizumab (Lucentis) (2)?

- wet AMD

- macular edema following RVO or diabetic macular edema

What are the highlights for Ranibizumab (Lucentis) (5)?

- monthly injections

- can cause increase in IOP

- RDs

- thromboembolic events

- CI: ocular or periocular infections

What is the drug class for Simvastatin/Ezetimibe (2)?

- HMG Coenzyme A Reductase Inhibitor

- Cholesterol Absorption Inhibitor

What is the MOA for Simvastatin/Ezetimibe?

- blocks the rate limiting step of conversion of HMG-CoA to mevalonate (halting the synthesis of cholesterol)

What is the indication for Simvastatin/Ezetimibe?

- Hypercholesterolemia (increase LDL, TG, and decrease HDL)

What are the highlights for Simvastatin/Ezetimibe?

- muscle pain

- rhabdomyolysis

- liver disease

- pregnancy (monitor liver levels and CK enzymes for Rhabdomyolysis)

- Statin: Pregnancy X

What is the drug class of celecoxib?

- selective COX2 inhibitor

What is the MOA of celecoxib?

- selective inhibition of COX2 which is responsible for prostaglandin synthesis, an integral part of the pain and inflammation pathway

What is the indication of Celecoxib (2)?

- inflammation

- pain

What are the highlights of Celecoxib (3)?

- less GI SE than other NSAIDS

- can be used in patients with GI issues over other NSAIDS

- increased risk of cardiac events (MI, stoke, clots)

What is the drug class of aripiprazole?

- atypical antipsychotic (2nd generation)

What is the MOA for aripiprazole (5)?

- partial agonist D2

- therefore acts as a dopamine modulator

- if dopamine levels are too high: it's an antagonist

- if dopamine levels are too low: it's an agonist

- also affects serotonin

What is the indication of aripiprazole (2)?

- schizophrenia

- bipolar mania

What are the highlights of aripiprazole (8)?

- less EPS

- less effect on prolactin

- less TD

- less enhanced efficacy over first generation drugs

- akathisia

- insomnia

- restlessness

- sexual dysfunction

What is the drug class of sitagliptin?

- DPP4 inhibitor

What is the MOA for sitagliptin (2)?

- dipeptidyl peptidase - IV inhibitor

- increases and prolongs incretin hormone activity, which is inactivated by DPP4 enzyme

What is the indication for sitagliptin?

- type 2 DM

What is the highlight for sitagliptin?

- discontinue if patient has pancreatitis

What drug class is memantine?

- NMDA antagonist

What is the MOA for memantine?

- NMDA receptor antagonist, preventing excitatory glutamate's action on that receptor (stops excitotoxicity)

What is the indication for memantine?

- alzheimer's

What is the highlight of memantine?

- SE: dizziness

What is the drug class of sidenafil?

- PDE5 inhibitor

What are the MOAs for sidenafil (3 different MOAs for 3 different indications)?

- erectile dysfunction: inhibits PDE-5 increasing cyclic guanosine monophosphate (cGMP) to allow smooth muscle relaxation and inflow of blood into corpus cavernosum

- BPH: increased cGMP relaxes muscle cells in the bladder and prostate to ease urinary symptoms of BPH

- pulmonary arterial hypertension: increased cGMP allows relaxation of pulmonary vascular smooth muscle and vasodilation of pulmonary vasculature

What are the indications for sidenafil (3)?

- erectile dysfunction

- BPH

- pulmonary arterial hypertension

What are the highlights for sidenafil (3)?

- sudden vision loss attributed to NAION

- dose related impairment of color discrimination (use caution in pts with RP)

- CI: nitrates

What is the drug class for mometasone?

- inhaled corticosteroid

What is the MOA for mometasone?

- inhibits phospholipase A to inhibit COX1 and COX2 production

What is the indication for mometasone?

- asthma