Final exam pharm (MOA, USE, ADVERSE)

no drug class since questions on exams give u class (All mods except 8, 9, those are in my profile/ only drugs from exam study guide) :)

Morphine MOA

• Opioid Agonists → bind to Mu receptors

• Blocks reuptake of norepinephrine and serotonin → reduces pai

Morphine Use

reduce pain

Morphine Adverse

• resp depression

• Hypotension

• Urinary retention

• Sedation

• Constipation

Acetaminophen MOA

COX 2 inhibitor but it works in the CNS

Acetaminophen Use

Used to treat mild to moderate pain and also for fevers

Acetaminophen Adverse

• hepatoxicity at 4g a day or higher

• Hypertension in women

Penicillin MOA

• Destroy cell wall: Attacks beta-lactam rings in the cell wall

• Once beta-lactam rings are destroyed, the cell lysis (cell death)

Penicillin Use

• treat broad spectrum infections

Penicillin Adverse

• anaphylaxis

• Superinfection (c. diff)

• Gi upset

Naloxone MOA

Antagonizes mu, kappa, and sigma receptors in the CNS reversing effects of the opioid.

Naloxone Use

Opioid overdose reversal

Naloxone Adverse

• HTN

• Vomiting

• Tremors

Ibuprofen MOA

blocks COX1 and COX 2, decrease prostaglandins to decrease inflammation, pain and fever

Ibuprofen Use

• Inflammation

• Mild to moderate pain

• fever

• menstrual cramps

Ibuprofen adverse

• renal dysfunction

• Reyes syndrome (vomiting, seizures, confusion)

• GI upset

• bleeding risk

Vancomycin MOA

Inhibits bacterial cell wall synthesis, which causes lysis and bacteria death

Vancomycin Use

Primary use is for gram-positive infections, C. Diff, MRSA

Vancomycin Adverse

• Nephrotoxicity

• Ototoxicity

• Red man syndrome (Tachycardia, Hypotension, rash, urticaria)

Albuterol MOA

• Stimulates beta2-adrenergic receptors in the lungs → apart of the SNS

• SNS = “Fight or Flight” → opens airways (bronchodilation

Albuterol Use

• used to treat asthma attacks (bronchospasms)

• acts as a fast acting rescue inhaler and long acting

Albuterol Adverse

• tachycardia

• anxiety

Beclomethasone MOA

Prevent the release of leukotrienes, prostaglandins, & histamine (WBCs)→ reduces inflammation/ inflammatory response

Beclomethasone Use

• Long term inhaler (NOT A RESCUE INHALER**)

• Prevents asthma attacks since immune system is suppressed to decrease inflammation

Beclomethasone Adverse

Candidiasis (oral mouth infection)

Cetirizine MOA

Blocks histamine at H1 receptors to reduce allergy symptoms, with minimal anticholinergic effects

Cetirizine USE

Used to treat allergic rhinitis & chronic idiopathic urticaria (hives with unknown origin)

Cetirizine (rhine)Adverse

Fatigue

Albuterol/ipratropium MOA

◦       Albuterol sulfate: beta-2 agonist → relaxes bronchial smooth muscle → bronchodilation

◦       Ipratropium bromide: anticholinergic (longer-acting) → blocks acetylcholine → bronchodilation + reduced secretions

Albuterol/ipratropium Use

• used for chronic asthma

• COPD Maintainence

Albuterol/ipratropium adverse

• Cant see

• Cant pee

• Cant shit

• Tachycardia

• dried mouth

Diphenhydramine MOA

• Binds to H1 receptors → blocking the release of histamine → reducing inflammation

• Mild cholinergic blocker

Diphenhydramine use

Used for mild allergic reactions such as seasonal allergies, mild transfusion reactions, and urticaria (hives)

Diphenhydramine adverse

• Anticholinergic (dry mouth, cant see, cant shit, cant pee, Tachycardia)

• CNS effects (sedation, dizziness)

Dextromethorphan MOA (smoking meth causes cough)

Suppression of cough reflex in the brain

Dextromethorphan Use

Used to reduce cough

Dextromethorphan adverse

• CNS effects (droziness, sedation)

• Respiratory depression

Guaifenesin MOA

•       reduces the surface tension of mucus secretions → thins and loosens mucus → easier to cough up

Guaifenesin Use

Productive cough with thick, difficult-to-clear mucus secretions

Guaifenesin Adverse

• GI upset

• CNS effects

Metoprolol MOA

• Directly act on the heart → ↓ HR → ↓  contractile force

• Kidney blocks renal beta 1 receptors → decrease in renin → inhibit the RAAS system

• Overall: ↓  cardiac output and ↓  myocardial oxygen demand

Metoprolol Use

• regulate BP

• regulate HR

Metoprolol adverse

• bradycardia

• Hypotension

Atorvastatin MOA (halt making gunk)

Blocks HMG-CoA reductase, which leads to decrased cholesterol levels

Atorvastatin use

To reduce LDL and increase HDL

Atorvastatin adverse (think can the muscles survive without cholesterole and fats)?

• RHABDOMYOLYSIS (life threatening muscle break down)

• Rash

• Hepatoxic

Furosemide MOA

• Works on Loop of Henle → blocks reabsorption of Na+ and Cl- → Promotes excretion

• Urine output increases → K+ excreted

• Massive diuresis → large amounts of sodium, chloride, potassium, and water are excreted

• Reduces blood volume → lowers blood pressure and decreases edema

Furosemide use

• regulate BP

• remove edema

Furosemide adverse

• Hypotension

• Hypokalemia

• dehydration

• nephrotoxicity

• ototoxicity

Lisinopril moa

Prevents conversion of Angiotensin 1 to 2, which leads to a more relaxed and wider blood vessels.

Lisinopril use

• used for heart failure

• used for HTN

Lisinopril adverse

• angioedema (swelling of lips, tongue, throat)

• Hyperkalemia

Digoxin MOA

Inhibits Na/K ATPase pump, which helps increase heart contractions.

Digoxin use

• Heart failure (not the first line of drug)

• A fib

Digoxin adverse

• yellow halo

• arrythmias

Hydrochlorothiazide MOA

Works on the Loop of Henle to block reabsorption of Na+ and Cl—> Promotes

excretion→ Urine output (UOP) goes up, K+ excreted

Hydrochlorothiazide use

• Used for HTN (first line)

• Used for edema caused by HF

Hydrochlorothiazide (HTCZ Rhymes with Hyper G) adverse

• Hypotension

• Ototoxicity

• Hyperglycemia

• Uric acid increase

Losartan MOA

ARB that blocks angiotensin 2 which then lower the BP

Losartan Use

• HTN

Losartan adverse

• Angioedema

• Dizziness

• Hypotension

• Insomnia

Omeprazole moa

inhibit the hydrogen potassium ATPase enzyme system

• Suppresses gastric acid production

Omeprazole use

• Gastric and Duodenal ulcers

• GERD

• Hypersecretory disorders (zollingers ellison syndrome)

Omeprazole adverse (omagprazole) Mag=hypomagnesia

• GI upset

• C diff

• Hypomagnesemia

• long term bone loss

Ondansetron MOA

• Blocks serotonin (5-HT3) receptors in the brain’s vomiting center (CTZ) and in the stomach, which helps stop nausea & vomiting

• Blocks vagal nerves (ANS) in the stomach & small intestine

Ondansetron Use

Nausea and vomiting

Ondansetron adverse

• headache

• dizziness

• constipation

• Prolonged QT syndrome (heart takes longer to reset between beats)

Docusate sodium MOA

Change the surface tension of the stool  stool softens by absorbing more water

Docusate sodium use

Used for constipation, fecal impaction.

Docusate sodium adverse (sodium can irritate throat)

• diarrhea

• throat irritation (normal)

• rash

Aluminum hydroxate MOA

Neutralize the gastric acid in the stomach

Aluminum hydroxate use

• peptic ulcer

• GERD

Aluminum hydroxate adverse

• Constipation

• hypophosphatemia

Promethazine moa

Blocks H1 receptors

• Histamine levels can increase with nausea  promethazine binds to H1 receptors, blocking histamine, thereby stopping the nausea reflex

• Also acts as a blocking agent for dopamine 2 (D2) receptors. These are involved in the neural pathway that triggers vomiting, particularly after surgery or chemotherapy

Promethazine use

• motion sickness

• nausea vomiting (post surgery)

Promethazine adverse (think how rich homie quan died from promethazine OD, so it can cause tissue death) RIP quan

• resp depression

• tissue death

Metoclopramide MOA

Prokinetic drug → increase GI motility

• Increases tone of the lower esophageal sphincter

• Increases the threshold of the CTZ

Metoclopramide Use

• Gerd

• To increase GI motilitiy

Metoclopramide adverse

• Neuroleptic malignant syndrome (rapid high fever, and muscle rigidity)

• Restlessness

Psyllium MOA

Non-digestible substance that absorb water from the gut and add bulk to the stool

Psyllium Use

Constipation

Psyllium Adverse

• Bowel obstruction

Sevelamer MOA

Inhibits phosphate absorption in the intestine by binding dietary phosphate→lowers serum phosphorus level

Sevelamer Use

Controls serum phosphate in pt with CKD on dialysis

Sevelamer Adverse

Gi upset

Constipation

Calcitriol MOA

Works in the kidneys to convert inactive vitamin D into its active form for patients with

renal dysfunction

Calcitriol Use

Treats hypocalcemia

Calcitriol adverse

Hypercalcemia

Calcium supplements (calcium citrate/calcium carbonate) MOA

enhances absorption of calcium from the intestine

Calcium supplements (calcium citrate/calcium carbonate) Use

Used to replace calcium

Calcium supplements (calcium citrate/calcium carbonate) Adverse

Hypercalcemia

Allopurinol MOA

Promotes excretion of uric acid by the kidneys

Allopurinol Use

Used for Gout

Allopurinol adverse

• hypersensitivity syndrome (rash, fever, kidney or liver dysfunction)

• GI upset (nausuea, vomiting)

• CNS effects

• Bone marrow suppression

• Hepatoxic

• nephrotoxic

Isotretinoin MOA

Works by reducing size and output of the skin’s sebaceous glands to prevent clogged pores and

inflammation

Isotretinoin use

used to treat severe, recalcitrant nodular acne that has not responded to other

treatments such as antibiotics or creams

Isotretinoin Adverse

Hepatoxic

Warfarin MOA

• Inhibits vitamin K epoxide reductase, preventing activation of vitamin K-dependent clotting factors II, VII, IX, X

• Reduces fibrin formation, slowing the blood clotting process

Warfarin use

• used to prevent clots

Warfarin adverse

• bleeding

• toxicity (vitamin K levels)

Apixaban

MOA

Factor Xa Inhibitor

• Acts as a selective, reversible site inhibitor of factor Xa, inhibiting both free and bound factor.

• Does not affect platelet aggregation directly, but does inhibit thrombin-induced

platelet aggregation.

• Decreases thrombin generation and thrombus development.

• Shorter onset and duration than warfarin