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Pharmacology Comprehensive

Terms

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Quick Relief of Asthma
1. Beta 2 agonists
(pirbuterol, albuterol, levalbuterol)
2. anti-cholinergics (ipratropium)
Side effects of Beta 2 agonists
- skeletal muscle tremor
- tachycardia
Long term control of Asthma
1. anti-IgE-Ab
2. Long acting Beta 2 agonists
3. theophylline
4. corticosteroids
5. mast cell stabilizers
6. leukotriene modifiers
Long acting Beta 2 agonists
- FORMOTEROL
- Salmeterol
corticosteroid for asthma
- budesonide
short term side effects of corticosteroids
- cough
- dysphonia
- thrush
- fluid retention
- weight gain
- mood alteration
long term side effects of corticosteroids
- adrenal axis suppression
- growth suppression
- HTN
- DM
- cataracts
- osteoporosis
Mast cell stabilizer for asthma and its side effect
- cromolyn
- unpleasant taste
Anti-IgE-Ab
- Omalizumab
Anticholinergic side effects
- dry mouth, blurred vision, constipation...etc.
COPD bronchodilator treatment
1. long acting Beta 2 agonist
(formoterol)

2. anti-cholinergic (ipratropium)
Non-nicotinic treatment used for smoking cessation
1. Buprion (Zyban)
2. TCAs
3. Lobeline (not available)
Treatment of Stable Angina
1. Anti-platelets
2. Beta-blockers
3. CCB
4. Nitrates
1st line treatment in stable angina (in absence of CI)
- beta blockers
2nd line treatment in stable angina
- CCB
1st line treatment for vasospastic angina
- CCB
when does prinzmetals variant angina (vasospastic) occur?
- in the morning and at rest
Nitrates
1. NTG
2. isosorbide dinitrate
3. isosorbide mononitrate
MOA of Nitrates
- increase cGMP
- increase venodilation
- increase arterial dilation
(decreasing preload and afterload)
Nitrate - drug interaction
- Viagra within last 24 hours
Beta blockers
a) selective
b) non-selective
a) selective - BBAAM
b) nonselective - the rest

- all end in "olol"
Beta blockers - MOA
- decrease contractility
- decrease HR
- decrease arterial pressure
- decrease MVO2 demand
Beta blockers - CI
- AV block without pacemaker
- decompensated HF
- HR < 50
- systolic BP < 90
- asthma/COPD
- PVD
- masks sxs of hypoglycemia
Beta-blocker - cardioselectivity
- selective BBs have great affinity for beta 1 receptors vs. nonselective (beta 1 and 2)
CCBs
a) Non-dihydropyridines
b) Dihydropyridines
a) verapamil, diltiazem
b) "dipine"
CCB - MOA
- increase O2 supply
- decrease MVO2 demand
- decrease contractility
- decrease HR
- decrease afterload
CCB - CI
- AV block without pacemaker
- bradycardia
- systolic HF
Antiplatelets
1. ASA
2. Clopidogril, Ticlopidine (Thienopyridines)
ASA indications
- indicated for all patients with ischemic heart disease without CI
- prevention of UA, MI and death
absolute contraindication in UA/NSTEMI
- thrombolytics
Treatment of UA/NSTEMI
1. Anti-platelets
2. Anti-coagulation
3. ACE-Is
Anti-platelet therapy (listed for UA/NSTEMI)
1. ASA
2. Clopidogrel
3. Glycoprotein IIb/IIIa receptor blockers
Glycoprotein IIb/IIIa receptor blockers
1. Reopro
2. Aggrastat
3. Integrillin
Anti-coagulation Therapy (UA/NSTEMI)
1. LMWH (Lovenox) - preferred tx
2. UFH
ACE-Is
- "prils"
atopic dermatitis (eczema)
Steroids:

1. Aclovate (cm)
2. Elidel (cm)
vaginal candidiasis
1. Fluconazole (Diflucan)
2. Clotrimazole (Gyne-Lotrimin vaginal suppositories)
acne rosacea
1. metrogel
2. clindagel
herpetic neuralgia
1. Zostrix (capsaicin cream)
2. Elavil tablets (TCA)
3. Neurontin capsules (gabapentin)
Herpes
a) HSV 1 & 2
b) Zoster
a) Fever sore and Facial:
Abreva, Valtrex (valcyclovir)

b) Valtrex, prednisone po, tapered
DOC for obese DM II patients
- metformin
Adverse effects of this DM II oral agent include:
- hypoglycemia
- photosensitivity
- disulfiram reaction
- sulfonylurea
Pramlintide
a) indication
b) targets...
c) action
a) adjuvant therapy for DMI & II
b) post prandial hyperglycemia
c) improves long-term glycemic and weight control in DM II pts.
Treatment of Lipid Disorders
1. HMG-CoA-reductase inhibitors
2. Bile acid resins
3. Niacin
4. Fibric acid derivatives
5. Cholesterol absorption inhibitors
HMG-CoA-reductase inhibitors
- "statins"
HMG-CoA-reductase inhibitors
- MOA
- inhibit rate limiting step in novo cholesterol biosynthesis

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