Pharm - winter

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kwon0070
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198067
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Pharm - winter
Updated:
2013-02-05 01:56:33
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Pharmacology
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General MOA
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  1. Acetazolamide (Diamox)
    • Carbonic Anhydrase enzyme Inhibitor 
    • Proximal tubule
    • Inhibit CA to prevent HCO3- reabsorption

    Use: Glaucoma, oral 
  2. Mannitol
    Osmotic Diuretic 

    Works on filtrate limiting the reabsorption

    Use: 1. Maintain function in acute renal failure 2. acute angle closure
  3. glycerol
    • Given orally and topically
    • Less effective but safe
  4. Dorzolamide (Trusopt)
    Carbonic anhydrase inhibitors 

    Use: Glaucoma, topical 
  5. hydrochlorothiazide (HydroDiuril)
    Thiazide diuretics

    • Distal tubule on the luminal side 
    • Increased Na+ and Cl- EXCRETION by blocking the co-transport protein found in the DT  

    Oral hypertension
  6. indapamide (lozol) 
    Thiazide diuretics

    • Distal tubule on the luminal side Increased
    • Na+ and Cl- EXCRETION by blocking the co-transport protein found in the DT  

    Oral hypertension
  7. chlorthalidone (Hygroton)
    Thiazide diuretics

    Distal tubule on the luminal side Increased Na+ and Cl- EXCRETION by blocking the co-transport protein found in the DT  

    Oral hypertension
  8. furosemide (Lasix)
    high ceiling/loop diuretics - best diuretics

    • TAL of the LOH
    • Block the Na/Cl/K co-transport protein leading on the luminal surface to increase in the loss of NaCl and K 
  9. bumetanide (Bumex) 
    high ceiling/loop diuretics - best diuretics

    • TAL of the LOH
    • Block the Na/Cl/K co-transport protein leading on the luminal surface to increase in the loss of NaCl and K 

    Hepatic, renal, cardiac edema/ oral, IV/ combination therapy in hypertension 
  10. spironolactone (Aldactone)
    Antagonizes aldosterone receptor as a steroid 

    • Collecting Tubule 
    • Block aldosterone's action of increasing Na/K exchange so to conserve K+ 
  11. triamterene (Dyrenium)
    Collecting tubule 

    Works without aldosterone (directly blocking the Na/K exchange mech), and block Na+ channels in the lumen side of tubular cells   
  12. amiloride (Midamor)
    collecting tubule 

    block Na+ channels in the lumen side of tubular cells   
  13. Dyazide
    hydrochlorithiazide + triamterene
  14. Methylxanthine derivatives
    theophylline /  caffein / theobromine

    • Block phosphodiesterase and adenosine receptors
    • Increase NaCl excretion, increase GFR, decreased reabsoprtion 
  15. Alcohol
    • Blocks ADH release 
    • Osmotic activity 
  16. Quinidine
    • Class 1a anti-AR
    • Block Na+ channel: decrease membrane responsiveness, increase threshold, and decrease conduction velocity (increase conduction time) 

    Blockade of K+ efflux current also increases refractory period, increase action potential duration
  17. disopyramide (Norpace)
    Class 1a anti-AR

    • Block both Na+ and K+ channel
    • (same as Quinidine)
  18. lidocaine (Xylocaine)
    class 1b anti-AR

    • Block both active and inactive Na channels
    • NO increase in action potential duration or increase in refractory period 
    • Increases threshold for excitability
  19. propranolol (Inderal)
    class II anti-AR 

    Beta blocker: decrease rate contractibility and conductive velocity (AV node)
  20. sotalol 

    (d-sotalol)
    class 2 and class 3 anti-AR

    Both beta blocker and K+ channel blocking activities
  21. amiodarone (Cordarone)
    class III anti-AR 

    Block K channel involved in repolarization prolonging the the cardiac action potential  
  22. verapamil (Isoptin)
    Class IV anti-AR

    blocks Ca influx at SA and AV node to decrease impulse formation and conduction especially in AV node 
  23. diltiazem
    Class IV anti-AR

    blocks Ca influx but less selective for cardiac muscle and more problems with hypotension
  24. adenosine
    Acts on adenosine receptor: no class Anti-AR

    • Increases K+ outward current to decrease rise in Phase 4: Hyperpolarize nodal cells
    • Decrease spontaneous depolarization, decreases automaticity

    Use: supraventricular tachycardia
  25. Digoxin
    • Anti-AR
    • Decreases SNS, increase PNS, slows HR
  26. Atopine
    Anti-AR, anti-muscarinic 

    Treatment of sinus bradycardia by blocking AV node activity 
  27. epinephrine 
    Anti-AR

    Treatment of cardiac arrest 
  28. magnesium chloride 
    Treatment of digoxin induced fibrillation 
  29. Atrial Tachycardia (acute)
    • Digoxin
    • Verapamil
    • Adenosine 

    (effective choice in flutter or fibrillation)
  30. Ventricular Tachycardia (acute)
    Cardioversion then Lidocaine
  31. EDTA
    in vitro only 

    • Ca++ chelator
    • Prevent coagulation
  32. Oxalate
    in vitro only 

    • Ca++ chelator 
    • Prevent coagulation
  33. Heparin 
    in vitro and in vivo 

    • Accelerates anti-thrombin III activity to inactivate several clotting factors:
    • IIa, Xa, IXa, XIIa, XIa
  34. warfarin (Coumadin)
    only in vivo 

    vitamin K antagonists
  35. Wafarin in the system
    • Inc vitamin K in diet Dec anticoagulant effect
    • Dec vitamin K in diet Inc anticoagulant effect
    • Hepatic disease Inc anticoagulant effect
    • Hyperthyroid Inc anticoagulant effect
    • Very young/ old age Inc anticoagulant effect
    • Pregnancy Dec anticoagulant effect
  36. Tetracycline with warfarin 
    blocks synthesis of vitamin K and increases anticoagulant effect 
  37. Aspirin with warfarin 
    potentiates anticoagulant effect 
  38. phenylbutazone with warfarin 
    disrupt protein binding to transiently increase warfarin blood level 
  39. Phenobarbital with warfarin 
    increases anticoagulant metabolism and decreases effect 
  40. Allopurinol with warfarin 
    inhibits metabolism of anticoagulant and decreases effect
  41. Cholestyramine with warfarin 
    blocks fat absorption and vitamin K (lipid soluble) to block anticoagulant absorption ?? decrease or increase anticoagulation 
  42. dibigatran (Pradaxa)
    Direct thrombin inhibitor

    • Competitive reversible antagonist 
    • Orally active 
    • Less risk of bleeding than warfarin
  43. rivaroxaban (Xarelto)
    active factor Xa inhibitor, oral
  44. apixaban (Eliquis)
    direct inhibitor of active factor Xa 
  45. streptokinase 
    Plasminogen activator

    from the streptococcus bacteria 

    must bind to plasminogen to plasmin to dissolve the clot
  46. alteplase (Activase)
    DNA recombinant tPA 

    a tissue plasminogen activator
  47. tenecteplase (TNKase)
    DNA recombinant tPA 

    a tissue plasminogen activator
  48. aminocaproic acid (Amicar)
    Given IV to control bleeding from excessive plasmin activation (Antidote)
  49. tranexamic acid (Lysteda) 
    Given orally and IV to control bleeding from excessive plasmin activation (Antidote)
  50. Aspirin 
    anti-platelet 

    • 1. Irreversibly inhibits prostaglandin synthesase (COX-1 and COX-2)
    • 2. Block thromboxane A2 synthesis (TXA2)

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