Pharmacology Exam 4

Tolerance aka ceiling effect occurs with what types of drug classes? not with?
what are analgesics used for? what drug classes are used as analgesics? (4)
cox 1 & cox 2?
what's a selective NSAID? MOA? TX? (2) ADR? (2) CX?

opioids & benzodiazepines; NOT with tylenol & NSAIDs
fever, pain, inflammation; opioids, non-opioids, NSAIDs, glucocorticoids
cox 1 is good prostaglandin that lays mucus lining in the stomach; cox 2 is bad prostaglandin that occurs when there's an inflamm

what are 4 non-selective NSAIDs?
Ibuprofen & naproxen- MOA? ADR? (2)
Ketorolac (toradol)- MOA? ADR? RNC?
Aspirin- MOA? (3)
general, high & low dose
; toxicity ADR (5) & late sign? CX? those who cannot take aspirin should take?

aspirin, ibuprofen (motrin & advil), naproxen (aleve), ketorolac (toradol)
inhibits cox 1 & 2; GI bleeding and PUD
powerful NSAID; nephrotoxicity due to dec. blood flow to afferent arteriole; limited to every 12 hour use for 5 days
cox 1 inhibitor, low do

what are 2 examples of glucocorticoids? MOA? long acting steroids injected where?
what is a non-opioid containing drug? MOA? (3) ADR (2) & late ADR? what do you treat toxicity with? RNC? dosage for healthy and unhealthy?

Prednisone & Medrol Dose Pack ; gold standard for relieving pain; into joints for arthritis
tylenol acetaminophen;
MOA- inhibits E2 prostaglandins which will dec. fever, induce endocannabinoids for analgesic effect, weak COX inhibitor which will relieve p

morphine sulphate MOA? TX? (6) which dose is higher PO/IV?
Codeine MOA?
Meperidine (demerol) ADR?
Hydromorphone (dilaudid) MOA? IV or PO?
Buprenorphine (buprenex) MOA? importance?
Tramadol (ultram) MOA? CX?
Fentanyl (transdermal patch) MOA? TX? what is IV

MOA- binds completely to Mu receptors & gives high
TX- pain, cough, diarrhea, vasodilates, anxiety & dyspnea
PO dose
codeine - prodrug to morphine
meperidine - toxic metabolite that causes seizures, coma and death in patients with renal insufficiency
dila

Opioid analgesic: ADR? (6) CX? (2) RNC? (3) Antidote for toxicity?
what 2 drug classes combine with opioids for neuropathic pain? what 2 drugs are in each class?

ADR- CNS depression, respiratory depression, orthostatic hypotension, constipation, miosis, pruritis (itching from histamine release)
CX- CNS depressants and anti-cholinergic drugs
RNC- LOC, laxatives, if RR<10 -> toxic
Antidote- Nalaxone (narcan) which b

Drugs for COPD & Asthma: which 2 goes under Acute and which goes under anti-cholinergic?
Albuterol MOA? ADR of serial treatments? (2) CX?
name of steroids IV & TX? name of steroids PO & TX? name of steroids inhaled?
when is steroids given? what happens if

Acute SABA: albuterol (proventil); steroids (IV/PO/inhaled)
Anti-cholinergic: atrovent (ipratropium bromide)
stimulates B2 receptors -> bronchodilation
ADR- inc. in HR & tremors due to loss of B2 specificity
CX- hypertension
IV: solumedrol for severe
PO:

what are 3 maintenance drugs for COPD & Asthma?
inhaled corticosteroids: MOA? TX? RNC for MDI handheld?
LABA: what falls under here? MOA? TX? what can it be added to? what is a DPI? CX?
Theophylline: MOA? name for IV? PO? therapeutic index? what's conside

inhaled corticosteroids, LABA, theophylline
MOA: stabilize cell membranes to dec. leukotriene production
TX: long term prevention of attacks; used daily; rinse mouth after every use to prevent infection
Advair inhaler; stimulates beta 2 receptors; long te

Anti-Fungal: what 2 drugs can be used for oral/esophageal candidiasis?
what 2 drugs can be used for vaginal candidiasis?
what 2 drugs can be used for systemic?
Amphoteracin B: TX? ADR? (5) what happens if given too fast? RNC? (2)

nystatin (mycostatin) & fluconazole (diflucan)
nystatin & diflucan
IV diflucan & IV amphoteracin B
TX- severe infections
ADR- hypokalemia, hypomagnesemia, N/V, cardiac dysrhythmia; fevers & chills
RNC- give IV slow 2-6 hours and patients can take a tyleno

Anti-Viral: what 2 drugs fall under here? what is each for? MOA? ADR? (7) CX? (2) RNC?

acyclovir (zovirax) & oseltamivir (tamiflu)
acyclovir: herpes 1 (cold sores), herpes 2 (genital), herpes zoster (shingles)
tamiflu is for influenza A & B
inhibit DNA polymerase
ADR: SJS, anaphylaxis, TEN, coma, seizures, renal failure, hallucinations
CX:

Antacids: CX? (4)
Tums? ADR? (4)
Amphogel? ADR?
Mylanta? ADR?

CX: allergies, electrolyte imbalance, GI obstruction, renal failure
TUMS has calcium; constipation, kidney stones, rebound hyperacidity, metabolic alkalosis
aluminum; constipation
magnesium; diarrhea

what 2 classes of drugs can be used for Antacids?
what 3 drugs are H2 blockers? MOA? TX? important ADR? RNC?
PPI: OTC drug? PO/IV prescription drug? IV drug? MOA? ADR? RNC?

H2 blockers or PPIs
ranitidine (zantac), cimetidine (tagament), famotidine (pepcid);
MOA- block acid production by inhibiting cell energy that drives pump in cells
TX- acid reducer
ADR- gynecomastia
RNC- strong cyp450 inhibitor
prilosec (omeprazole); nexi

what drug class falls under stool softener? example of a drug? MOA?
what 3 drugs are a hyperosmotic laxative? MOA? dosage for each? what are each for?
what drug is a stimulant laxative? MOA?
what drug is a saline laxative? TX?
what drug is a bulk-forming

emollients; ducosate (colace); cause water & fat to be absorbed into stool
SuPrep, Go Lytely, Miralax; draws water into stool;
SuPrep- 2 doses, 32 oz each, 12 hours apart
Go Lytely- 8 oz. every 15 minutes
Miralax PEG 3350- daily;
Miralax is for daily cons

anti-diarrheal: what is an adsorbant drug?
bismuth subsalicylate (Peptobismol)- what is it made out of? ADR? (2)
what 2 anti-cholinergic drugs can help with diarrhea?
Atropine- TX (2)? MOA? (2)
Opiates- MOA? OTC name? RNC? Prescription name? what is it ma

cholestyramine (questran);
antacid + salicylate; GI bleeding & black stool
atropine & opiates;
Atropine- pre-med surgery or chemotherapy; dec. secretions & slows peristalsis
Opiates- bind to Mu receptors in gut which will block peristalsis
OTC- imodium; s

what 3 drug classes are anti-emetic & anti-nausea?
what 3 drugs are anti-dopaminergic? preferred administration of phenergan? which is not preferred? what else does Reglan do? ADR? (2)
what drug is a serotonin blocker? TX? (3) ADR? (2)
what 2 drugs are an

anti-dopaminergic, serotonin blockers 5HT3, anti-histamine aka H1 blockers/anti-cholinergic;
chlorpromazine (compazine), prochlorperazine (phenergan), reglan; gel inside wrist; IV which should be diluted to 10-15mls saline & free running for 15 minutes; g

Macrolide: MOA? half life? TX? (3) RNC?
what drug is an older macrolide? ADR? (3) what can occur in IV?
what 2 drugs are a newer macrolide?
Z pack: TX? high vs low dose? ADR? limit?
Biaxin: ADR?
what is Fidaxomicin (dificid)?

inhibits protein synthesis; long half-life; broad spectrum (STDs, AIDs, pneumonia/bronchitis); cardiac side effects in some
erythromycin; hepatotoxicity, GI upset, CYP450 inhibitor which inc. drug levels of theophylline, warfarin & carbamazepine; thrombop

Tetracyline: what drug falls under here? bactericidal or static? broad or narrow? MOA? TX? (4) ADR? (3) CX? (4)

doxacycline (vibramycin); bacteriostatic; broad;
MOA- inhibit protein synthesis
TX- GI/Skin infections, anthrax, STI
ADR- superinfection, bad teeth coloring, anemic
CX- children under 8, pregnant, contraceptives are less effective, supplements dec. bioava

Sulfonamide: what drug falls under here? bactericidal or static? broad or narrow? MOA? TX (2)? ADR? (5) CX?
Topical name?

Bactrim/Septra sulfamethoxazole trimethoprim; static; broad;
MOA- prevents folic acid synthesis
TX- skin infections or UTI
ADR- crystalluria & pain, anemic, SJS & TEN
CX- don't give to infants under 2 months because its highly protein bound and will inc.

Quinolones: what drug falls under here? bactericidal or static? broad or narrow? MOA? (3) TX? (3) ADR? CX?

ciprofloxacin; bactericidal; broad;
MOA- alter DNA of bacteria; long half life; CYP 450 inhibitor
TX- infection all around the body, anthrax, STD
ADR- cartilage rupture
CX- children and pregnancy because it can cause myasthenia gravis

Aminoglycosides: what drug falls under here? bactericidal or static? broad or narrow? MOA? (2) TX? ADR? (2)

garamycin (gentamicin); bactericidal; narrow Gram -;
MOA- inhibit protein synthesis & blocks ACh in skeletal muscles
TX- severe infections not responsive to other anti-infectives
ADR- ototoxic & nephrotoxic

Vancomycin: bactericidal or static? broad or narrow? MOA? TX? (3) ADR? (3) RNC? (2)

bactericidal; narrow gram +; inhibits cell wall synthesis
TX- patients allergic to penicillin; IV for MRSA, PO for C. Diff.
ADR- nephrotoxicity, ototoxicity, Red Man Syndrome which is itching from histamine release
RNC- slow IV faster than 60-90 minutes &

Flagyl (metronidazole): bactericidal or static? broad or narrow? MOA? (2) TX? (2) ADR?

bactericidal; broad;
MOA- inhibits DNA & protein synthesis
TX- genitourinary infections & C. Diff but not FDA approved
ADR- disulfuram reaction with alcohol