Pharmacology Exam III

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iishvo
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243851
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Pharmacology Exam III
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2013-10-30 03:04:09
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drug clases
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drug classes
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  1. 5 major classes of diuretics
    • Osmotic
    • Carbonic anhydrase inhibitors
    • thiazides
    • organic acid/loop
    • Potassium sparing
  2. Osmotic diuretics
    • filtered by glomerulus but not reabsorbed so it is excreted
    • create osmotic gradient, water migrates and follows the molecule
  3. Osmotic diuretic drug
    Mannitol
  4. Mannitol
    • osmotic diuretic
    • can't penetrate membrane so it must be taken by IV
    • used in acute renal failure
    • useful in drug overdoses; used to help water to follow to excrete drug used in overdose
    • increases systemic blood volume
    • shouldn't be given to those who have compromised cardiac function
  5. Carbonic anhydrase inhibitors
    • increase Na+ and H2O by inhibiting carbonic anhydrase
    • enzyme produces H+ and biocarbonate (HCO3) from CO2 and H2O; so CA inhibitors block the reaction above so we are left wtih CO2 and H2O
    • takes place in proximal and distal tubules
    • MAJOR SIDE EFFECT: alter acid/base balance
  6. Carbonic anhydrase inhibitors drug
    Acetazolamide
  7. Acetazolamide
    • carbonic anhydrase inhibitor
    • used for glaucoma
    • mainly used for toxicity
    • body attempts to exchange potassium wtih Na, so lose potassium
    • major problem is it alters acid/base balance
  8. Thiazide diuretics
    • inhibit Na+ reabsorption
    • increase Cl- and K+ excretion as well
    • orthostatic hypotension
    • MAJOR SIDE EFFECT: loss of K+
  9. Thiazide drug
    Hydrochlorothiazide
  10. Organic Acid/loop
    • inhibits Na+/Cl- transport in loop of henle
    • common side effect: tone deafness which is reversible, when off the drug hearing will come back
  11. Organic Acid/loop
    Lasix (furosemide)
  12. Potassium Sparing diuretics
    • used in conjunction with loop and thiazides to compensate for loss of K+
    • inhibits K+ excretion
    • Spirolactone -> antgonist of aldosterone receptors which excretes K+ secretion
    • MAJOR SIDE EFFECT: prolongs repolarization and collides with cardiac glycosides
  13. Potassium sparing diuretics drug
    Amiloride
  14. Amiloride
    • Potassium sparing diuretics drug
    • alters membrane so K+ can't be secreted
    • major side effect: prolongs repolarization and collides with cardiac glycosides
  15. Anti-psychotic drugs
    • work through serotonin and dopamine receptors
    • Phenothiazines
    • Butyrophenones
    • Thioxanthenes
    • Atypical anti-psychotics
  16. Phenothiazines
    • three main side effects:
    • 1)dystonic reactions (muscle spasm)
    • 2)Akathisia (continous body movement)
    • 3)Parkinsonism
    • Block D2 receptor, histamine receptors, AcH receptor, and alpha adrenergic
    • interacts with serotonin to cause weight gain and therapeutic effect
    • no control over secretion
    • blurred vision, constipation, dry mouth and eyes, hypotension, drooling on yoruself
  17. Phenothiazine drugs
    • chlorpromazine
    • thorazine?
  18. Butyrophenones
    • D2 antagonists
    • minimal mACH
    • fewer side effects than phenothiazines but they produce strong movement distributions
    • interact with alpha adrenergic but not histamine (sedation)
  19. Butyrophenone drugs
    • Haldol (one of first drugs for people with turrets)
    • Haloperidol (more potent and produces fewer side effects; main effects on dopamine)
  20. Atypical anti-psychotics
    • D2 receptor antagonist
    • Serotonin blockade (blocks serotonin)
  21. Atypical anti-psychotic drugs
    • Aripiprazole (Abilify)
    • Resperidone - same receptors as abilify but different structures
  22. Benzodiazepines
    • work by GABAa receptors (they do not bind directly onto receptors)
    • respiratory, Cardiovascular, and CNS depression
    • benzodiazepine receptors are co-localized on GAABA receptors
  23. Benzodiazepine drugs
    • diazepam
    • lorazepam
  24. Pentylentetrazol
    GABA antagonist
  25. Mania
    • hyperexcitability and elation
    • appears to be excess of Norepi
  26. Treatment for mania
    • lithium
    • body uses lithium for sodium and disrupts neuronal action
    • increase uptake of dopamine and norepi
    • dopamine is then retaken up and broken down by monoamine oxidase (MAO) so less will interact with receptors to create excitability
  27. Anti-depressant classes
    • Monoamine oxidase inhibitors
    • Tricyclic anti-depressants
    • Selective serotonin reuptake inhibitors (SSRI)
    • Atypical anti-depressants
    • Herbal supplements
  28. Monoamine oxidase inhibitors
    • oldest class of anti-depressants and still widely used
    • very cheap (30 day prescription fr 1.50)
    • inhibits MAO and there a buildup of NE and 5-HT in synaptic cleft
    • dietary restrictions: no wine, cheese, or beer since they have tyarmine
    • insomia, convulsions, tremors
    • really potent and many side effects but usually last choice unless financial situations
  29. Monoamine oxidase inhibitor drug
    Phenylzine
  30. Tricyclic anti-depressants
    • block reuptake of norepi and serotonin in nerve endings
    • causes sedation, tremors or mania by blocking alpha adrenergic and cholinergic receptors
  31. Tricyclic anti-depressant drugs
    Nortriptyline (aventyl)
  32. Selective serotonin reuptake inhibitors (SSRI)
    • little to no action on cholinergic and adrenergic recptors
    • block reuptake of serotonin
    • serotonin syndrome: too much serotonin in synaptic cleft which increases cardiovascular activity and causes tremors
  33. SSRI drugs
    • Sertraline (zoloft)
    • Fluoxetine (prozac)
    • Paxil - used to treat children under 10 for depression and increased suicidal tendencies
  34. Atypical anti-depressants
    • block serotonin and norepi or dopamine
    • little to no cholinergic or adrenergic activity
  35. Atypical anti-depressant drugs
    • Bupropion (wellbutrin) - inhibit dopamine and norepi reuptake; sometimes prescribed to weight loss but you can become psychotic
    • Venlafaxine (effexor) - inhibit serotonin and norepi reuptake
    • Duloxetine (cymbalta) - inhibit serotonin and  norepi reuptake
  36. Herbal supplements
    • St. John's wort:
    • serotonin and norepi reuptake inhibitors
    • drug interactions
    • not FDA regulated b/c the label does not say to treat depression but instead mood
    • Valarian:
    • anti-anxiety
    • binds to dopamine receptor
  37. Drugs used for Epilepsy
    • Barbituates
    • K+/Na+ bromide
    • Carbamazepine (drug)
    • Gabapentin (drug)
    • Keppra (leutiracetam)
  38. Barbituates
    • developed in 1912
    • phenobarbitol
    • binds directly to GABA receptor and acts as agonist to produce sedative effects
    • side effects: puts to sleep, lipid soluble and addicive
  39. Carbamazepine
    • blocks Na+ channels
    • decrease action potential
  40. Gabapentin
    • interacts with Ca++ chanels
    • decrease conduction across syapses
  41. Keppra (leutiraetam)
    • inhibits Ca++ channels
    • decreases conduction across synapses
  42. Illicit drugs
    • Amphetamines
    • Cocaine
    • LSD
    • Bath Salts
    • Spice or K2
    • 2-CI or smiles
    • Phenylcycldine (PCP) 
    • Ketamine
  43. Amphetamines
    • treatment of ADHD, weight loss, narcolepsy, and hypotension
    • inhibits reuptake of serotonin, norepi, and dopamine
    • increase release of neurotransmitters
    • decrease fatigue
    • increase aggresion
    • decrease human empathy
  44. Amphetamine drugs
    • Adderall (amphetamine and dextroamphetamine)
    • Ritalin (methylphenalate)
    • Stratthera (amoxetine)
  45. Cocaine
    • blocks reuptake of NE and dopamine
    • increases sympathetic activity, euphoria, stimulation of motor system
    • first person to use was Freud on his family
    • blocks Na+ channels
  46. What drug is used to reverse effects of cocaine?
    benzos (benzodiazepam) used for overdose
  47. LSD
    • serotonin agonist
    • hallucinations
    • no known death associated with LSD
    • synthesia (see sounds)
  48. Bath Salts
    • MDPV (methylenedioxypyrovalerone)
    • bath salts don't have a half life like cocaine which will lessen effects as it leaves body)
    • 100x more potent than cocaine
    • target 5-HT, NE, dopamine
    • increase blood pressure, heart rate, aggitation, and delusions
  49. Spice or K2
    • synthetic cannabinoid
    • 4-5x more potent than THC and won't show up in drug test
    • JWH-018
    • JWH-073
    • jwh stands for company
    • and # stands for derivative
  50. 2-CI or Smileeffect
    • class of drugs similar to phenythethyamine (produced in body; NE and dopamine)
    • simliar to amphetamine
    • hallucinations
    • increase sympathetic activity
    • taken orally no effect b/c of first pass effect
  51. Phencyclidine (PCP)
    • Ketamine (derivative of PCP; used in animales)
    • blocks glutamate activated NMDA receptors
    • originally produced as anaesthetic
    • disorientation,mania, hallucinations
  52. Opiod Analgesics
    • block bain receptors; used for dental, trauma, cancer, post-operative, visceral
    • Dextromethorphan (weak opiod over the counter)
    • Morphine (first opiod)
    • Heroin was produced (ended up being 3-4x more potent;heroin ends up being metabolized to morphien and binds to mu,kappa form receptors to produce therapetuic properties)
  53. Methadone
    • very weak opiod agonist
    • 1/2 potent as morphine
    • used to ween you off of morphine or heroin
  54. Noloxone
    • antagonist opiod
    • blocks receptors and effects
    • used in overdose
    • mu receptor antagonist
  55. Suboxone
    • combo of naloxone and buprenorphine
    • more potent than noloxone itself
    • used in overdose
  56. Codeine and dextromethorphan
    anti-tussive (suppress cough reflex) opiod
  57. most common side effect of opiod?
    nausea and vomiting
  58. Acute Coronary syndrome
    • nitrates - nitroglycerin
    • verapamil (ca++ channel blocker)
    • prazosin (alpha 1 blocker)
    • diazepam or barbitols increase sedation and decrease sympathetic activity
  59. Hypertension
    diazepam or prazosin
  60. Edema
    • diuretic
    • lasix (loop diuretic) 
    • decrease sodium absorption so it can be eliminated
  61. Parkinson's
    • loss of dopamine crucial for disease progression
    • chief symptoms: tremors at rest, muscle rigidity, suppression of voluntary movements
    • causes are viral infections, brain tumors, and other diseases
  62. Treatments for Parkinson's
    • L-dopa:
    • precursor to dopamine (easily corsses blood brain barrier to easily go to dopa receptors)
    • increases dopamine synthesis
    • usually given with carbidopa which inhibits the production of L-dopa  decarboxylate)
    • Dopamine receptor agonist:
    • useed in combination with L-dopa for severe parkinsons
    • specific drug = bromocriptine
  63. Bromocriptine
    Dopamine agonist used for parkison's in later stages
  64. Alzhemier's
    • loss of cholinergic synapses -> AcH signalling
    • AcHesterase inhibitors which increases AcH in synapse to interact wtih receptor
    • NMDA-glutamate: too much glutamate causes excitatoxicity
  65. drug used for Alzhemiers
    • Aricept (donepezil) used therapeutically
    • NMDA Antagonists such as Namenda (momantine) used for dementia associated with Alzheimers

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