OSCE Pharmacology

what is a side effect of acetaminophen?

hepatotoxicity

what is a side effect of morphine?

nausea and vomiting, dry mouth

what is a side effect of codeine?

nausea and vomiting, constipation

what is a side effect of hydrocodone?

nausea and vomiting, dry mouth (xerostomia)

what is a side effect of baclofen?

muscle weakness

what is a side effect of diazepam?

marked sedation

what is a side effect of beta blockers?

bradycardia, decreased contractility

what is a side effect of ACE inhibitors?

dry cough, rash

what is a side effect of ARBs?

hyperkalemia

what is a side effect of CCBs?

tremor

what is a side effect of dual alpha and beta blockers?

postural HTN

what drug is a dual alpha/beta blocker?

labetalol

what is a side effect of ganglionic blockers?

GI discomfort and urinary retention

what is a side effect of thiazide diuretics?

hypokalemia and hyperuricemia

what is a side effect of loop diuretics?

hypokalemia and hyperuricemia

what is a side effect of K+ sparing diuretics?

hyperkalemia and lethargy

what is a side effect of direct vasodilators?

reflex tachycardia

what drug is a direct vasodilator?

nitroprusside

what drugs are used for HTN emergency?

direct vasodilators

what is a side effect of HMG CoA reductase inhibitors?

acute renal failure

what is a side effect of nitrates?

reflex tachycardia and headache

what is a side effect of cardiac glycosides?

nausea and vomiting, dizziness

what is a side effect of anticoagulants?

hemorrhage

what is a side effect of non-selective alpha blockers?

reflex tachycardia and nasal stuffiness

what drug is a non-selective alpha blocker?

phenoxybenzamine

what is a side effect of albuterol (sympathomimetic)

tachycardia

what is a side effect of ipratropium bromide (parasympatholytic)?

tachycardia

what is a side effect of theophylline (xanthines)?

seizures (overdose); low therapeutic index

what is a side effect of ibuprofen?

GI disturbances and heartburn

what is a side effect of celecoxib (celebrex)?

MI and stroke

what drug is a Cox 2 inhibitor?

celecoxib (celebrex)

what drug would be indicated for a patient who has HTN, DM, and asthma?

-sartan (ARBs)

what drug is indicated for HTN when beta blockers are contraindicated?

-dipine (CCBs)

what drug is indicated for HTN and pregnancy?

labetalol (dual alpha/beta blockers)

what drug is indicated for HTN crisis?

trimethaphan (ganglionic blocker)

what is the primary diuretic for HTN and is good for pts with kidney stones or older adults?

hydrochlorothiazide (thiazide diuretic)

what is the primary diuretic for pulmonary edema?

furosemide (loop diuretic)

what drug is indicated for HTN emergency?

nitroprusside (direct vasodilator)

what drug is indicated for high cholesterol?

-statin (HMG CoA reductase inhibitor)

what drugs are indicated for stable angina?

nitrates + propanolol
nitrates reduce bradycardia produced by B blockers and B blockers reduce tachycardia produced by nitrates

what drug is indicated for unstable angina? what drug is indicated is MI is confirmed?

warfarin (anticoagulant). if MI is confirmed, use thrombolytic

what drug is indicated for variant angina?

-dipine (CCBs)

what drug is indicated for HTN and mild chronic stable angina?

-dipine (CCBs)

what drug is indicated to prevent clots or prevent clots from getting bigger?

warfarin (anticoagulant)

what drug is indicated to dissolve clots?

-kinase (thrombolytic)

what drug is indicated for phenochromocytoma or pain syndromes?

phenoxybenzamine (non-selective alpha blocker)

what drug is indicated for Raynaud's, hyperreflexia in pts with SCI, and prostate hyperplasia (increase urine flow)?

-zosin (selective alpha blockers)

what drug is indicated for an acute asthma attack?

albuterol (sympathomimetic)

what drug is indicated for long standing asthma, or for maintenance of asthma?

ipratropium bromide (parasympatholytic or anticholinergic)

what drug is indicated for long standing asthma, or for COPD?

theophylline (xanthines)

what drug is indicated for moderate/severe asthma after bronchodilation does not work?

corticosteroid

what drug is indicated for moderate pain, inflammation, and fever?

ibuprofen (NSAID)

what drug is indicated for RA/OA?

celecoxib (NSAID-Cox2 inhibitors)

what drug is indicated for muscle and nerve pain, or mild pain?

acetaminophen (NSAID)

what drug is indicated for moderate to severe pain or pain after MI?

morphine (opiate)

what drug is indicated to induce sleep with mild pain?

codeine (opiate)

what drug is indicated for cough and moderate to severe pain?

hydrocodone (opiate)

what drug is indicated for MS, cerebral palsy, or damage to the brain or spinal cord (spasticity)?

baclofen (benzodiazipine)

what drug is indicated for muscle spasm?

diazepam (muscle relaxant)

what is the MOA of ACE inhibitors?

block angiotensin converting enzyme (ACE), reducing synthesis of angiotensin II (a vasoconstrictor)

what is the MOA of angiotensin receptor blockers (ARB)?

block angiotensin II receptors

what is the MOA of thiazide diuretics?

inhibits Na+/Cl- cotransporter in the proximal and distal convoluted tubule, facilitating calcium reabsorption

what is the MOA of loop diuretics?

inhibit Na+/K+/2Cl- cotransporter in the ascending loop of Henle

what is the MOA of K+ sparing diuretics?

act in the collecting tubule to inhibit Na+ reabsorption and K+ excretion

what is the MOA of -statin?

inhibits HMG CoA reductase, enzyme involved in synthesis of cholesterol

what is the MOA of nitrates?

increases cAMP in blood vessels, decreases preload and afterload, increase O2 supply, increase coronary blood flow

what is the MOA of CCBs when treating variant angina?

inhibit calcium, decrease O2 demand by reducing contractility, act on coronary arteries

what is the MOA cardiac glycosides?

positive inotropic (contractility) agent; increases intracellular calcium by inhibiting Na/K pump

what is the MOA of warfarin?

interferes with hepatic synthesis of vitamin K dependent clotting factors

what is the MOA of -kinase (thrombolytic)?

dissolves clots by converting plasminogen to plasmin, which hyrdolyzes fibrin

what is the MOA of phenoxybenzamine?

irreversibly bind to receptor to induce vasodilation

what is the MOA of -zosin?

blocks alpha 1 receptors to cause vasodilation

what is the MOA of albuterol?

selective beta 2 agonist that does not cause excessive cardiac stimulation

what is the MOA of ipratropium bromide?

blocks cholinergic receptors producing bronchodilation and decreased respiratory secretions

what is the MOA of theophylline?

increase cAMP levels and inhibits chemical mediator release from mast cells; decreases secretions and stimulates respiration in COPD

what is the MOA of corticosteroids?

acute antiinflammatory effect

what is the MOA of NSAIDs?

blocks synthesis of prostaglandins

what is the MOA of COX 2 inhibitors?

inhibits cyclooxygenase-2 (which is required to produce prostaglandins)

what is the MOA of acetaminophen?

inhibits prostaglandins in PNS

what is the MOA of opiates?

binds to opioid receptors

what is the MOA of hydrocodone (opiate)?

binds to opioid receptors to stimulate analgesic, acts on cough center in medulla

what is the MOA of baclofen?

vasodilation

what is the MOA of diazepam?

increases central inhibitory effects of GABA