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Exam 7
antidiabetics, heart failure, antiarrhythmics, penicillin 1
78
Pharmacology
Graduate
01/06/2015

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Term
insulin (humulin R, novolin R)
Definition
rapid acting--suitable for IV use (DM)
Term
insulin aspart (novolog)
Definition
rapid acting (DM)
Term
insulin glulisine (apidra)
Definition
rapid acting (DM)
Term
insulin lispro (humalog)
Definition
rapid acting (DM)
Term
NPH insulin (humulin N, novolin N)
Definition
intermediate acting--insulin aggregated with protamine and zinc (DM)
Term
insulin glargine (lantus)
Definition
long acting--2 arg added to C term--poorly soluble at pH 7 (DM)
Term
insulin detemir (levemir)
Definition
long acting--fatty acid attached--binds albumin (DM)
Term
metformin (glucophage, glumetza)
Definition
biguanide--activates AMPK in hepatocytes reducing hepatic gluconeogenesis preventing hyperglycemia and not producing hypoglycemia (1st line for DM2)
Term
glyburide (diabeta, micronase, glynase presTab)
Definition
sulfonylurea--inhibit Katp channel on B cell leading to increased insulin release (early stage DM2) --dont use with pregnant or lactating women
Term
repaglinide (prandin)
Definition
meglitinide--inhibit Katp channel on B cell leading to increased insulin release (early stage DM2) --better than sulfonylureas
Term
pioglitazone (actos)
Definition
thizolidinedione--peroxisome proliferator-activated receptor gamma (PPARy) agonist leads to increased sensitivity to insulin mainly in adipose (DM2) --lots of adverse effects, takes 1-3months for effects
Term
rosiglitazone (avandia)
Definition
thizolidinedione--peroxisome proliferator-activated receptor gamma (PPARy) agonist leads to increased sensitivity to insulin mainly in adipose (DM2) --lots of adverse effects such as MI/stroke, takes 1-3months for effects
Term
acarbose (precose)
Definition
alpha-glucosidase inhibitor--inhibits breakdown of complex carbs and oligosaccharides in gut delaying absorption of glucose (DM2) --give glucose tabs for instances of hypoglycemia
Term
pramlitide (symlin)
Definition
amylin analogue--acts at amylin receptor in hindbrain to suppress glucagon release, delay gastric emptying, promote satiety (DM1 and 2 as adjunct to insulin)
Term
exenatide (byetta)
Definition
GLP-1 agonist--increases insulin synthesis and secretion in a glucose dependent manner, delays gastric emptying, decreases appetite, suppresses glucagon release (DM2)
Term
sitagliptin (januvia)
Definition
DPP-4 inhibitor--increases levels of incretins GLP-1 and GIP increasing insulin secretion and decreasing glucagon (DM2) --increased rate of infections
Term
canagliflozin (invokana)
Definition
SGLT2 inhibitor--inhibits glucose reabsorption in proximal tubule (DM2) --risk of UTI's
Term
glucagon
Definition
G-protein receptor agonist in liver--increases cAMP, increasing glycogen phosphorylase, stimulating glycogenolysis, also stimulates gluconeogenesis and ketogenesis (ER treatment of severe hypoglycemia, OD of B-adrenoreceptor blocker) --has inotropic effects on heart leading to tachycardia and hypertension
Term
digoxin (lanoxin)
Definition
digitalis glycoside inotropic agent--inhibits Na/K ATPase increasing Na and Ca in myocytes leading to increased contractility and decreased rate (CHF) -risk of arrhythmias
Term
digoxin immune fab (digifab)
Definition
digoxin antibodies (severe digitalis glycoside toxicity or OD combined w/ hyperkalemia) -KCl is treatment for OD but not if hyperkalemia is present
Term
dobutamine
Definition
B1 agonist inotropic agent--increased CO (severe, refractory CHF) -only give IV
Term
dopamine
Definition
B1 agonist inotropic agent--increase CO (severe, refractory CHF) -only give IV, more powerful than dobutamine
Term
inamrinone
Definition
inotropic agent--phosphodiesterase inhibitor increasing cAMP and Ca available increasing CO, also peripheral vasodilator (severe, refractory CHF) -watch out for thrombocytopenia
Term
milrinone
Definition
inotropic agent--phosphodiesterase inhibitor increasing cAMP and Ca available increasing CO, also peripheral vasodilator (severe, refractory CHF)
Term
captopril (capoten)
Definition
ACE inhibitor--decrease vasoconstriction and aldosterone levels which decreases preload and afterload increasing CO indirectly (CHF) -non productive cough
Term
enalapril (vasotec)
Definition
ACE inhibitor--decrease vasoconstriction and aldosterone levels which decreases preload and afterload increasing CO indirectly (CHF) -non productive cough, prodrug
Term
fosinopril (monopril)
Definition
ACE inhibitor--decrease vasoconstriction and aldosterone levels which decreases preload and afterload increasing CO indirectly (CHF) -non productive cough
Term
quinapril (accupril)
Definition
ACE inhibitor--decrease vasoconstriction and aldosterone levels which decreases preload and afterload increasing CO indirectly (CHF) -non productive cough
Term
losartan (cozaar)
Definition
angiotensin-II receptor blocker--decrease vasoconstriction and aldosterone, decreasing preload and afterload (CHF)
Term
valsartan (diovan)
Definition
angiotensin-II receptor blocker--decrease vasoconstriction and aldosterone, decreasing preload and afterload (CHF)
Term
candesartan (atacand)
Definition
angiotensin-II receptor blocker--decrease vasoconstriction and aldosterone, decreasing preload and afterload (CHF)
Term
hydrochlorothiazide (microzide)
Definition
thiazide diuretic--inhibit Na/Cl symporter in distal convoluted tubule (CHF)
Term
furosemide (lasix)
Definition
loop diuretic--inhibit Na/K/2Cl transporter in loop of henle (CHF when GFR<30ml/min)
Term
spironolactone (aldactone)
Definition
K sparing aldosterone antagonist (CHF)
Term
epleronone (inspra)
Definition
K sparing aldosterone antagonist (CHF)
Term
hydralazine
Definition
direct vasodilator--afterload reduction (refractory or post MI CHF)
Term
nitroprusside (nitropress)
Definition
direct vasodilator--preload and afterload reduction (refractory or post MI CHF) -IV and monitor
Term
nitroglycerin (minitran)
Definition
direct vasodilator--preload reduction (refractory or post MI CHF) -tolerance
Term
isosorbide dinitrate (isosordil)
Definition
direct vasodilator--preload reduction (refractory or post MI CHF) -tolerance
Term
nesiritide (natrecor)
Definition
direct vasodilator and diuretic--increases cGMP, decreasing preload and afterload (refractory or post MI CHF) -IV and monitor
Term
bisoprolol (zebeta)
Definition
beta blocker--prevent down regulation of beta receptors, excessive tachycardia and arrhythmias, and renin release (early CHF)
Term
carvedilol (coreg)
Definition
beta and alpha blocker--prevent down regulation of beta receptors, excessive tachycardia and arrhythmias, and renin release (early CHF) -antioxidant
Term
metoprolol (toprol-XL)
Definition
beta blocker--prevent down regulation of beta receptors, excessive tachycardia and arrhythmias, and renin release (early CHF)
Term
conivaptan (vaprisol)
Definition
vasopressin 1a/2 receptor antagonist--decreases excess H2O retention (CHF w/ hyponatremia, SIADH) -IV
Term
tolvaptan (samsca)
Definition
vasopressin 2 receptor antagonist--decreases excess H2O retention (CHF w/ hyponatremia, SIADH)
Term
quinidine
Definition
Class 1A antiarrhythmic--inhibits sodium and potassium channels (versatile, inhibits ectopic atrial and ventricular arrhythmias, given prior to cardioversion) -QT prolongation
Term
procainamide
Definition
Class 1A antiarrhythmic--inhibits sodium and potassium channels (versatile, inhibits ectopic atrial and ventricular arrhythmias, given prior to cardioversion)
Term
lidocaine (xylocaine)
Definition
Class 1B antiarrhythmic--inhibits late openin Na channels (ER treatment of ventricular arrhythmias during MI, stops torsades)
Term
flecainide (tambocor)
Definition
Class 1C antiarrhythmic--greatest inhibition of Na channels (severe arrhythmias) -neg. inotropic effects
Term
propranolol (inderal-LA)
Definition
Class II antiarrhythmic--beta blocker which decreases inward Ca currents (adrenergically-driven arrhythmic death post-MI) -stabilizes membrane
Term
acebutolol (sectral)
Definition
Class II antiarrhythmic--beta 1 blocker w/ ISA which decreases inward Ca currents (adrenergically-driven arrhythmias)
Term
esmolol (brevibloc)
Definition
Class II antiarrhythmic--short acting beta 1 blocker which decreases inward Ca currents (acute arrhythmias)
Term
amiodarone (cordarone)
Definition
Class III antiarrhythmic--mainly inhibits K channels, also may decrease conduction velocity by decreasing cell-to-cell coupling (resistant tachyarrhythmias, patients with ICD's) -interstitial pulmonary fibrosis, thyroid issues because it contains iodine
Term
dofetilide (tikosyn)
Definition
Class III antiarrhythmic--inhibits K channels (supraventricular arrhythmias such as A-fib) -torsades
Term
verapamil (calan)
Definition
Class IV antiarrhythmic--inhibits voltage sensitive L-type Ca channels mainly in AV node (mainly supraventricular arrhythmias especially reentrant ones) -makes arrhythmias worse w/ WPW accompanied by A-fib
Term
diltiazem (cardizem)
Definition
Class IV antiarrhythmic--inhibits voltage sensitive L-type Ca channels mainly in AV node (mainly supraventricular arrhythmias especially reentrant ones) -makes arrhythmias worse w/ WPW accompanied by A-fib
Term
adenosine (adenocard)
Definition
antiarrhythmic--inhibits Ca channels and activates acetylcholine sensitive phase 4 K current, hyperpolarizing the membrane. This decreases conduction velocity, abnormal impulse formation in AV node and prolongs AV node refractory period (acute paroxysmal supraventricular tachycardia) -IV, very short duration
Term
Class 1 antiarrhythmics (quinidine, procainamide, lidocaine, flecainide)
Definition
inhibit Na channels which decreases phase 0 and phase 4 slopes, increasing the threshold for excitation and slowing conduction
Term
Class 2 antiarrhythmics (propranolol, acebutolol, esmolol)
Definition
beta blockers which decrease inward Ca currents, this diminishes phase 0 and 4 depolarization, depressing automaticity and conduction in nodal tissues
Term
Class 3 antiarrhythmics (amiodarone, dofetilide)
Definition
inhibit phase 3 K channels prolonging repolarization and action potential duration
Term
Class 4 antiarrhythmics (verapamil, diltiazem)
Definition
block voltage sensitive L-type Ca channels in AV node mainly, decreasing phase 0 and 4 slopes. slightly prolong APD in phase 3
Term
penicillin G (pfizerpen)
Definition
natural penicillin
Term
penicillin V potassium (generic)
Definition
natural penicillin
Term
penicillin G procaine (wycillin)
Definition
natural penicillin
Term
penicillin G benzathine (bicillin L-A, permapen)
Definition
natural penicillin
Term
penicillin G benzathine + penicillin G procaine (bicillin C-R)
Definition
natural penicillin
Term
methicillin
Definition
penicillinase resistant penicillin (staph, other gram +)
Term
nafcillin (generic)
Definition
penicillinase resistant penicillin (staph, other gram +) -90% protein bound, biliary excretion
Term
oxacillin (generic, bactocill)
Definition
penicillinase resistant penicillin (staph, other gram +) -94% protein bound, biliary excretion
Term
ampicillin (generic, principen)
Definition
extended spectrum penicillin (aminopenicillin)
Term
amoxicillin (generic, amoxil, trimox)
Definition
extended spectrum penicillin (aminopenicillin) -food does not impair absorption
Term
ticarcillin + clavulanate potassium (timentin)
Definition
antipseudomonal penicillin
Term
piperacillin + tazobactam (zosyn)
Definition
antipseudomonal penicillin
Term
aztreonam (azactam)
Definition
mono-bactam drug
Term
imipenem + cilastatin (primaxin)
Definition
carbapenem (beta-lactam drug)
Term
clavulanic acid
Definition
B-lactamase inhibitor
Term
tazobactam
Definition
B-lactamase inhibitor
Term
amoxicillin + clavulanic acid (augmentin)
Definition
combo penicillin w/ B-lactamase inhibitor
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