pharmacology 1
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- hemicholinium
- choline reuptake
- botulism toxine
- release
- M3 smooth ms of GIT
- I contractility ^ motility
- M3 lung
- bronchospasm ^ secretion
- m2 heart
- decrease SAN , AVN decrease HR ^ CODUCTION
- M3 ON gland
- ^ secretion
- m3 on urinary bladder
- ^ contractility relaxation to sphinctor
- m3 on endothelium
- dilatation by NO deriving relation factor
- desentisized quickly\nn or muscarinic or adrenergic receptor
- nicotinic receptor
- m1 receptor work on which G protein
- Gq which stimulate phosholipase c which release IP3 Ca DAG
- m2 receptor work on which gene?
- Gi which inhibit adenyl cyclsae
- m3 receptor work on which genes?
- Gq which stim phospholipase c which release IP3 Ca DAG
- B1 WORK on wich gene?
- Gs which stimulate adenyl cyclase
- alpha1 receptor work on which gene?
- Gq
- alpha2 receptor mechanism?
- Gi
- B2 receptor mech?
- Gi
- d1 and d2 receptor mech?
- Gs
- D1 receptor where it work?
- renal and mesenteric vascular
- pilocarpine
- muscarinic agonist for glucoma and xerostomia
- methacholine
- muscarinic agonist
- bethacholine
- muscarinic agoinst
- edrophonium
- short acting reversible acetyl choline inhibitor use for1- dx myasthenia 2-cholinergic crisis
- physostigmeine
- ach cholinesterase inh use for Rt glucoma 2- in atropine overdose (lipid soluble)
- neostigmeine
- use in urinary retension myasthenia ileus (no cross BBB)
- pyridosigmine
- U retension , ileus myasthenia
- donepezil
- ach cholinesterase inhibitor used in alzehimers
- malathion
- like parathione is irreversible organophoshates drug act as ach cholinesterase inh
- tacrine
- ach cholinesterase inh use in alzehimers
- echothiophate
- like methation and parathion but used in glucoma
- Rx of organophoshorous poison
- atropine pralidoxime 2 PAM( work on skeletal muscle) as early as possible
- manifestation of chronic organophosphate
- peripheral neuropathy and demylination
- pt leave several hours wiyhout Rx against organophoshorouse what will happen?
- desenthesization and lead to Ms paralysis
- atropine
- muscarinic antagonist
- tricyclic antidepression overdose
- 3c cardiotxicity convulsion coma
- atropine overdose Rx
- sympthomatic + physostigmine
- name 3 other muscarinic antagonist
- antihistamine tricyclic antidepression amantidine quinidine
- atropine use 4
- antispasmodic antidiarhea antisecritory op poisoning
- tropicamide
- topical eye in ophthalmology exam
- ipratropium promide
- is muscarinc receptor blocker use in asthma COPD
- scoplamine
- muscarinic receptor block use in motion sickness
- trihexyphenidyl
- muscarinic blocker antiparkinson and in acute extraparkinson induced by drug
- hexamethonium
- ganglion block
- mecamylamine
- ganglion block use in sever hypertension
- phenylephirine
- alph1 agoinist used as nasal decongestion and ophthalmology exa(syst side effect)
- methoxamine
- alpha1 agonists used in Rx of paraxysmal atrial tachycardia
- clonidine
- alpha2 agonist used in Rx of mild to mod HPT
- methyldopa
- as clonidine alpha2 agonist used in RX of HPT
- salmeterol (family and used)
- B2 agonist used in RX of asthma.
- isoproterenol (family and used)
- non selective B agonist used in asthma heart block bradyarrhythemias
- dobutamine
- B1>B2 agonist used in Rx of acute congestive heart faliure
- ritodrine
- B2 agonist used in Rx of premature labor
- terbutaline
- B2 agonist used in Rx of asthma
- who s adrenergic group icrease in pulse pressure
- B agonist , epinephrine(low and medium dose )
- name 2 releaser of norepinephrine
- tyramine amphetamine ephidrene(cold medication)
- if pts on MAO inhibitor what things should avoid and why?
- red wine ,cheese , sausage ,avocado ,dried fish(tyramine containing) amphetamine cold medication like...................................ephedrine
- name drugs work on NE reuptake
- cocain , tricyclic antidepresion
- phentolamine
- compatitive inhibitor non selective alpha antagonist
- phenoxybenzamine
- non compatitive non selective alpha antagonist
- use of phentolamine
- Rx of HPN pheochromocytoms BPH
- prazosin
- like terazosin/doxazosin\alpha 1 antagonist
- yohimbine
- alpha 2 blocker used in RX of postural HPT, impotence
- mirtazapine
- alpha 2 blocker used as antidepression
- name 3 contraindication for use B blocker
- ASTHMA vasospasm DM
- why prefer b blocker in Rx of HPN than alph blocker?
- 1_ no reflex tachycardia with b blocker. 2_no reflex increase in renine secretion.
- which B blocker has no hyperlipidemic effeck
- acebutolol pindolol
- which B blocker has no sedative effect?
- atenolol
- which B blocker has B1 selectivity?
- atenolol acebutalol metoprolol
- which B blocker has strongest sedative effect?
- propranolol
- atenolol, propranolol , timolool ,pindolol which one is safe in asthma , DM ,prinzmetal angina?
- atenolol or any B1 blocker
- HPN Pts whith BPH what best drug?
- alph1 blocker like phentolamine.
- HPN with MI which antiHPN prefer?
- B blocker
- USED OF B blocker?
- HPN antiarrhythemia glucoma(timolol) migraine , thyrotoxicosis(propranolol)
- sotalol
- k channel blocker +b blocker (antiarrhythemia)
- quinidine use
- antiarrhythemia class 1 (na channel blocker block open or active state channels)
- quinidine antiarrhythmic and proarrhythemic effect?
- antiarrhythemic block fast na channel and increase action potential duration proarrhythemic cause M receptor blocker--^HR and alpha blocker---reflex tacycardia
- quinidine S/E
- GIT upset, tinnitius,blurred vision, prolonged QRS and QT interval
- procainamide
- class 1 antiarrhythemia (Na blocker) has same quinidine effect but less muscarinic receptor blocker
- procainamide S/E
- 1_SLE like syndrome 2_hematotoxicity(thrombocytopenia ) CVS effect
- SLE inducer drugs?
- procainamide hydralazine INZ
- what assesstement need for pts on procainamide?
- hematological assesstment like cbc regulary
- lidocain
- class 1b antarrythemia work on inactivated na channal
- lidocain uses?
- antiarrhythemia esp post MI ,open heart, digitalies toxicity given iv
- name class 1b drug antiarrhythemia given orally ?
- mexiletine tocainide
- S/E of lidocain ?
- CNS TOXICITY seizure
- flecainide
- class 1 c antiarrhythemic drug block all channel in his purkinje fibers
- S/E of flecainide?
- suuden death so limitted use
- esmolol
- cardioselective B blocker class 2 use in Rx of SVT
- effect of fecainide on APD IS ? INCREASE DECREASE NO CHANGE
- NO CHANGE
- amidarone
- class 4 ant arrhythemic dx used as K blocker
- amidarone S/E
- pulmonary fibrosis thyroid dysfunction liver toxicity corneal deposition blue pigmentation of skin( smurf skin)
- verapamil
- like deltiazem ca channel blocker use in Rx of SVT
- S/E OF Deltiazem
- hypotension flashing face constipation AV blocker
- what things should be avoided with verapamil or any ca channel blocker?
- 1_add with B blocker becouse it cause AV block 2_ verapamil cause displacement digoxine from binding site
- adenosine
- work on Gi coupled decrease in cAMP used in SVT
- drugs cause torsades?
- k channel blocker eg amidarone 2_class 1 c eg quinidine ,procainamide. 3_tricyclic antidepression 4_thioridazine other disease like prolonged QT syndrome
- Rx torsades
- Rx hypokalemia Rx hypomagnesemia RX magnesium
- S/E of methyldopa
- coombs test positive -CNS depression -oedema
- reserpine
- destroys vesicles so decrease NE,seretonine,dopamine used in Rx of HPN
- reserpine S/E
- depression edema
- prazosine(azosin)
- DOC in Rx HPT with BPH
- Prazosine S/E
- first dose syncope orthostatic hypotension urinary incontaince
- hydralazine
- arteriolar dilatation through NO. use in Rx mod to sever HPN.
- S/E hydrlazine
- SLE like syndrome edema no cause CNS depreesion or postural Hypotesion reflex tachycardia
- nitroprosside
- work on arteriolar and venules decrease in TPR (NO)
- nitroprosside S/E
- cyanide toxicity
- nifidipine
- Ca channel blocker more selective VD
- S/E of Ca channel blocker
- gingival hyperplasia reflex tachcardia
- DOC in emmergency HPN
- nitroprosside but should be less than 12-24hr.
- losortan
- block AT1 receptors
- use of losortan
- 1_mild to mod HPN 2_protective of diabetic nephropathy 3_CHF
- S/E of captpril
- dry cough (bradykinine degredation) hyperkalemia acute renal faliure in renal artery stenosis angioedema
- HPN + ANGINA
- B blocker, CCB
- HPN+DM
- ACEI,ARBS
- HPT+HEART FALIURE
- ACEI ,ARBS
- HPT + POST MI
- B blocker
- HPT + BPH
- ALPH blocker
- HPN + DYSLIPIDEMIA
- ALPHA blocker + CCBs ,ACEI
- Bosentan
- endothelin A receptor antagonest used in Rx of pulmonary HPN highly teratogenic
- mannitol?
- osmotic diuretic
- mannitol uses?
- 1_decrease IOP 2_decrease intracranial pressure 3_rhabdomyolysis 4_anuric state
- acetazolamide
- like dorzolamide which is carbonic anhydrase inhibitor
- dorzolamide
- like acetazolamide used in 1_glucoma 2_metabolic acidosis 3_acute motion sickness
- acetazolamide S/E
- like dorzolamide can cause 1_m acidosis 2_hypokalemia 3_renal stone 4_hyperchloemia
- furasemide
- loop diuretic
- used of furasemide
- acute pulmonary edema heart faliure hypertension acute renal faliure hypercalemia
- pts found sensitive to sulf group and you want to give loop diuretic what will select?
- ethacrynic acid
- S/E of furasemide
- hypokalemia hypocalcemia hyperuresemia hypophosphatemia sulf group sensitivity ototoxicity (more with ethacrynic acid)
- precusion with furasemide ?
- co adminestered with aminoglycoside lithium digoxine
- hydrochorothiazide use?
- HPN CHF nephrolithiasis nephrogenic DI
- S/E OF HYDROCHOROTHIAZIDE
- sulfa sensitivity hypokalemia hypercalcemia alkalosis hyperurecemia hyperglycemia hyperlipidemia
- spirnolactone used
- k sparing diuretic hyperaldosteron add with other diuretic to avoid hypokalemia antiandrogen use (female hirstism) CHF
- precusion with use thiazide?
- not used in DM not use in hyperlipedemia
- eplerenone
- selective aldosterone receptor blocker have no antiandrogenic effect
- pts with prinzmetal angina DOC is?
- Ca channel blocker esp nifidipine
- what role of B blocker in prinzmetal angina?
- C/I
- which antiangina drug is safe in DM pts and use chronic use?
- isosorpide di nitrate.
- what mechanism nitrate is chare with sildenafil?
- both increase cGMP so C/I CO adaminester togather
- amiloride
- Na channel blocker work as k sparing like aldosteron.
- common S/e if given compination of losartan and spironolactone?
- hyperkalemia
- what is MOA for BZ?
- inhibit GABAa receptor which activate Cl- channel--hyperploarization
- BZ1 work on ?
- sedation
- BZ2 work on ?
- antianxity
- what effect of barbiturates on mitochondria?
- inhibit complex 1 of electron transport chain
- name drug act as antidot to BZ?
- flumazenil(non specific BZ receptor antagonest
- pts with liver disease and want to use BZ which drugs are safe?
- lorazepam ,oxazepam tamazepam are safe becouse not metabolite in liver
- imitriptyline
- tricyclic antidepreesor
- imipramine
- TCAs drugs like imitriptyline
- uses of TCAs ?
- major depression anuresis obssesive compulsive disorder panic attack neuroleptic pain
- tri cyclic antidepression toxicity?
- 3 c cardiotoxicity convulsion coma
- phenalzine
- MAO inhibitor
- tranylcypromine
- MAO inhibitor
- paroxitine
- SSRIs
- fluoxitine
- SSRI drug
- mirtazepine
- like yohimbine alpha 2 antagonist but used as antisuppression associated with wt gain
- bupropion
- dopamin reuptake blocker ,used in smoke cessation
- DOC for bipolar Disorder
- lithium
- MOA of lithium
- prevent recycle of inositol and decrease in cAMP
- S/E of lithium
- 1-tremor 2 life threatening seizure 3-hypothyroidism (inhibit deiodinase ) 4-Neph diabeties insipidus Rx by amiloride teratogenic (truncus artheriosis)
- names 2 drug used for bipolar disorder
- Lithium valproat
- drug used for neuroleptic pain?
- 1- tricyclic antidepreesion 2-carpamazepine(trigeminal neuralgia) 3-gabapentine
- tolcapone
- COMT inhibitor which ihnibit conversion L dopa to 3 o methydopa
- S/E of tolcapone ?
- hepatotoxicity
- selegiline
- MAOb inhibitor
- seritonin syndrom
- rigidity,sweating, hyperthermia,myoclonus seizure
- cefazolin
- first generation cephalosporine
- cephalexin
- first generation cephalosporine
- cefotetan
- second generation cephalosporine
- cefaclor
- second generation cephalosporine
- cefuroxime
- second generation cephalosporine and cross BBB
- cefoperazone
- 3ed generation cephalosporine and doesnt cross BBB
- cefdinir
- 3ed generation cephalosporine
- cefixime
- 3ed generation cephalosporine
- cephepime
- 4ed generation cephalosporine
- organism that not cover with cephalosporine
- listeria monocytogenesis atypical eg mycoplasma MRSA enterococci
- name drug which commonly given with imipenem that inhibit rapid metabolities in kindney?
- cilastatin
- aztreonam advantage ?
- no cross allerenicity with penicilline or cephalosporine
- vancomycine MOA?
- inhibit D ala D ala muramyl pentapeptide
- ototoxicity drugs?
- aminoglycoside vancomycine ethacrynic acid
- S/E of vancomycine?
- 1-red man syndrome 2-ototoxicity nephrotoxicity
- piperacilline
- like ticarcillin antipseudomonus
- azlocillin
- antipseudomonus
- which penicilline group are lipid soluble
- nafcillin oxacillin
- which penicilline drug cause interstitial nephrities
- methacillin
- ticarcilline
- antipseudomonus
- abcixiumab
- antiplatet(monoclonal antibody against gp11b 111a
- infliximab
- monoclonal AB against TNF used in Rheum arthrities,crhons disease
- trastuzumab
- used in breast cancer (monoclonal ab against erb b2
- dacliximab
- kindney tansplant ab block IL2 receptor
- muromonab
- used in kidney transplant against allograft rejection
- palivizumab
- used against RSV
- rituximab
- non hodkin lymphoma
- aldeslekin 2
- useed in renal cell cancer ,melanoma
- filgrastim
- increase granulocytes used for bone marrow recovery
- sargramostim
- inrease both granulocyte and macrophage usd in bone marrow recovery
- interferon gamma
- used in chronic granulomatouse disease by increase TNF
- interferone B
- used in multiple myloma
- interlukine 11
- icrease in platelat formation used in thrombocytopenia
- myclophenal add to cyclosporine as adjuvent by work on ?
- inhibit purine synthesis
- cyclosporine MOA?
- bind to cyclophilin which reduce calcineurin (cytoplasm phosphatase)then decrease T cell transcription factor
- S/E OF cyclosporine
- gingival hypertrophy ,hepatotoxicity ,nephrotoxicity ,hyerglycemia,hyperlipidemia,HPN,peripheral neuropathies,hirstism
- azathioprim
- prodrug to 5MP
- tacrolimus
- work as cyclosporine but not bind to cyclophiline(direct inh calcineurin)
- alendrolate
- IS bisphosphonate used as DOC FOR postmonopousal osteoporosis ,glucocorticoid induced osteoporosis paget disease
- MOA of alendronate
- enhanced hydroxyapatite bone strucure,and induce oseoblasts and reduce osteoclast activity...decrease progress of osteoporesis
- S/E of alendronate
- oesophageal ulcer
- teriparatide
- recombinant DNA PTH analogus
- S/E of teriparatide
- if given more than 2 year has high risk of osteosarcoma
- leuprolide
- GnRH analogus used in case of endometriosis and prostate cancer
- pergolide
- dopamie used in Rx of hyperprolactenemia
- cosyntropin
- ACTH used in Rx of infantile spasm
- octreotide
- somatostatine used in Rx of acromegaly
- somatrem
- GH derivative
- somatropine
- human recombanant GH
- nafreline
- as leuprolide is GnRH analogus
- glipizide
- second generation sulfonylurea need ndecrease dose in hepatic dysfunction
- acetohexamide
- first generation sulphonylurea
- glyburide
- second generation oral hypoglycemia
- S/E of sulfonylurea
- hypoglycemia weight gain hypersensitivity
- chloropropamide? S/E
- first generation oral hyoglycemia disulfiram
- S/E of metformine
- lactic acidosis
- ACARBOSE?
- ORAL hypoglycemic drug
- ACARBOSE? MOA?
- ORAL Hypoglycemia drug act by inhibit alpha glucosidase in brush border of GIT
- S/E of ACARBOSE?
- GIT Disturbance diarrhea ,flatulenc hepatotoxicity, no hypoglycemia
- pioglitazone
- like rosiglitazone bind to PPAR....INCREASE insuline genes ,increase receptor
- S/E of rosiglitazone?
- hyoglycemia hyperTG(wt gain) oedema
- danaparoid
- heparine with different structure and safe in nhypersensitivity to heparin
- enoxaparin
- LMW heparine less heparine induce thrombocytopenia
- argatroban
- direct thrombin inhibitor \doesnot reguired AT111---used in heparin iduced thrombocytopenia.
- argatropan used?
- heparine induced thrombocytopenia
- warfarin MOA ?
- inhibit epoxide reductase
- warfarin antidot
- vit k in slow onset fresh frozen plasma (fast)
- increase platelet aggregation ?
- ADP,5TH,TXA2,THROMBINE,ALPHA2 AGONEST
- DECREASE plt aggregation by?
- PGI2, cAMP,ASA,GP 11b/111a BLOCKER