Pharmacology Class Quiz

Anti-inflammatory Agents

• Salicylates (Aspirin):

  • Used for mild to moderate pain and inflammatory conditions.
  • Reduces risk of stroke and myocardial infarction (MI).
  • Caution: Bleeding disorders, Reye's syndrome, impaired renal function, nausea, vomiting, heartburn, tinnitus, Reye's syndrome, acidosis.

• NSAIDs (Ibuprofen):

  • Relieves symptoms of rheumatoid arthritis, osteoporosis, and mild to moderate pain.
  • Reduces fever.
  • Caution: Cardiovascular (CV) dysfunction, hypertension (HTN), renal/hepatic dysfunction, headache, dizziness, myocardial infarction (MI), stroke, blood dyscrasias (BMS), constipation.

• NSAIDs (Acetaminophen):

  • Relieves mild to moderate pain, cold/flu symptoms, and musculoskeletal pain.
  • Caution: Chronic alcoholism, rash, fever, liver toxicity/failure, blood dyscrasias (BMS).

Antiarthritis

• Gold Compounds (Auranofin):
  • Used in adults with rheumatoid arthritis.
  • Caution: Diabetes, congestive heart failure (CHF), hypertension (HTN), renal/hepatic dysfunction, blood dyscrasias (BMS), renal toxicity, dermatitis, nausea, vomiting, stomatitis.

TNF Blockers (Entanercept)

• ↓ s/s rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ankylosing Spondylitis, plaque psoriasis
• Caution: Acute infection, cancer, sepsis, MI, failure, HTN
• Made from Chinese hamster ovary products
• Teratogenic

Antigout

• Colchicine:
  • Treats gout flares.
  • Caution: Renal/hepatic dysfunction, GI upset, rhabdomyolysis, blood dyscrasias.

Immune Stimulants

• Interferons (Interferon Alfa-2b):

  • Treats hairy cell leukemia, malignant melanoma, AIDS sarcoma, chronic hepatitis B+C.
  • Caution: Cardiovascular (CV) disease, myelosuppression, Central Nervous System (CNS) effects, anorexia, skin discoloration, blood dyscrasias (BMS), flu-like symptoms.

• Interleukins (Aldesleukin):

  • Treats metastatic renal cell carcinoma and metastatic melanoma
  • Caution: Escherichia coli (E. Coli) products, pregnancy, renal/liver/cardiovascular (CV) dysfunction, central nervous system (CNS) effects, blood dyscrasias (BMS), sinus tachycardia, arrhythmia, hypotension, dizziness, gastrointestinal (GI) bleed.

Colony Stimulating Factors (Filgrastim)

• Use for infection risk for chemo patients, bone marrow transplants
• Caution: E. Coli products, headache, fatigue, alopecia, nausea, vomiting, bone pain

Immune Suppresants

• T+B Cell Suppressors (Cyclosporine):
  • Prevents rejection for organ transplants, treats rheumatoid arthritis, and cancer
  • Caution: Teratogenic, cancer, tremors, hypertension, gingival hyperplasia, blood dyscrasias (BMS), acidosis.

Monoclonal Clonal Antibodies (Bevacizumab)

• Treats metastatic colorectal cancer, lung cancer, glioblastoma, renal cell carcinoma, cervical/ovarian cancer
• Caution: Fever, teratogenic
• GI perforations, headaches, hemorrhages

Vaccines

• Active immunity: Immune system protects against pathogens.
• Passive immunity: Body receives immunity from another source (breast milk, medication)
• MMR Vaccine (protection against measles, mumps, and rubella)
• Fever, rash, injection site irritation, high fever

Antibiotics

• Aminoglycosides (Gentamicin):

  • Treats serious infections from susceptible bacteria.
  • Caution: Nephrotoxic, renal disease, preexisting hearing loss, hypersensitivity, sinusitis, dizziness, fever, nephrotoxicity, ototoxicity.

• Carbapenems (Ertapenem):

  • Treats community-acquired pneumonia, gastrointestinal (GI) infections, and skin infections.
  • Caution: Poor renal function, headache, dizziness, nausea, vomiting, pseudomembranous colitis.

• Cephalosporins (Cefaclor):

  • Treats respiratory, dermatologic, urinary tract, and middle ear infections.
  • Caution: Allergy to penicillin, hepatic renal impairment, nausea, vomiting, superinfection, blood dyscrasias (BMS), rash.

• Fluoroquinolones (Ciprofloxacin):

  • Treats respiratory, dermatologic, urinary tract infections (UTIs), ear, eye, bone/joint infections, anthrax, and typhoid fever.
  • Caution: Tendonitis, tendon rupture, central nervous system (CNS) effects, headache, hypotension, nausea, vomiting, fever.

• Penicillins (Amoxicillin):

  • Treats infections from susceptible/bacteria, Helicobacter infection.
  • Caution: Penicillin allergy. nausea, vomiting, glossitis, blood dyscrasias (BMS), lethargy.

• Sulfonamides (Trimethoprim-sulfamethoxazole/Cotrimoxazole):

  • Treats urinary tract infections (UTIs), acute otitis media, chronic bronchitis, and traveler's diarrhea.
  • Caution: Older adults, kidney stones, teratogenic, nausea, vomiting, hepatocellular necrosis, hematuria, hyperkalemia, blood dyscrasias (BMS), Stevens-Johnson syndrome (SJS).

• Tetracyclines (Tetracycline):

  • Treats susceptible bacterial infections, acne, and counteracts penicillin use.
  • Caution: Teeth discoloration in children under 8, nausea, vomiting, glossitis, blood dyscrasias (BMS).

• Leprostatic drugs (Isoniazid):

  • Treats tuberculosis (TB) and prevention in family members.
  • Caution: Severe renal/hepatic disease, peripheral neuropathy, nausea, vomiting, blood dyscrasias (BMS), hepatitis, gynecomastia.

• Lincosamides (Clindamycin):

  • Treats serious infections.
  • Caution: Hepatic impairment, nausea, vomiting, blood dyscrasias (BMS), pseudomembranous colitis.

• Lipoglycopeptides (Vancomycin):

  • Treats septicemia, infective endocarditis, skin infections, bone infections, and lower respiratory tract infections (RTIs).
  • Caution: Nephrotoxicity, ototoxicity, hypokalemia.

Other Drugs

• Nonnucleoside Reverse Transcriptase Inhibitor (Nevirapine):

  • HIV treatment.
  • N/V, liver dysfunction, chills, fever.

• Nucleoside Reverse Transcriptase Inhibitor (Zidovudine):

  • Symptomatic HIV.
  • Caution: Renal dysfunction, nausea, vomiting, blood dyscrasias (BMS), insomnia, fever.

• Protease Inhibitors (Fosamprenavir):

  • Symptomatic HIV.
  • Caution: Hepatic dysfunction, mood changes, nausea, vomiting, Stevens-Johnson syndrome (SJS), redistribution of body fat.

• Fusion Inhibitor (Enfuvirtide):

  • HIV treatment for immunological deterioration.
  • Caution: Lung disease, teratogenic, nausea, vomiting, anorexia, pneumonia, chills.

• CCR5 Coreceptor (Maraviroc):

  • Treats CCR5-tropic HIV infection.
  • Caution: Liver disease, cardiovascular (CV) disease, paresthesia, hepatotoxicity, upper respiratory infection, musculoskeletal symptoms, fever.

• Integrase Strand Transfer Inhibitor (Raltegravir):

  • Resistant HIV.
  • Rhabdomyolysis, Stevens-Johnson syndrome (SJS), nausea, vomiting, fever.

• Anti-hep B agent (Adefovir):

  • Chronic HBV treatment.
  • Caution: Renal/hepatic disease, hepatomegaly, nephrotoxicity, lactic acidosis, weakness.

• Azoles (Fluconazole):

  • Treats oropharyngeal, esophageal, vaginal, and cryptococcal meningitis, systemic fungal infections.
  • Caution: Liver/renal disease, headache, nausea, vomiting, abdominal pain, rash.

• Topical Antifungal (Clotrimazole):

  • Treats oral candidiasis, vulvovaginal candidiasis, and athlete's foot.
  • Stinging, burning, irritation (in sexual partner).

• Antimalarial (Chloroquine):

  • Treats/prophylaxis of malaria.
  • Caution: Renal/hepatic impairment, visual/auditory disturbances, hypotension, nausea, vomiting.

• Other (Metronidazole):

  • Treats intestinal parasites, trichomoniasis.
  • Caution: Teratogenic, compromised central nervous system (CNS), hepatic disease, nausea, vomiting, metallic taste, ataxia, seizures, darkened urine (harmless).

• Antihelminitic (Mebendazole):

  • Treats whipworm, pinworm, roundworm, and hookworm infections.
  • Caution: Teratogenic, hepatic disease, abdominal pain, diarrhea, fever.

Diuretics

• Thiazide/Thiazide-like (Hydrochlorothiazide):

  • First-line hypertension treatment, hypovolemia, renal disease, GI upset
  • Caution: Orthostatic hypotension

• Osmotic Diuretics (Mannitol):

  • Prevents renal failure, ↑ intracranial pressure treatment.
  • Dry mouth, thirst, hypotension

• Potassium Sparing (Spironolactone):

  • Improves survival in heart failure (HF) pts @ risk for hypokalemia.
  • Caution: Hyperkalemia, deepening voice, gynecomastia

• Loop diuretics (Furosemide):

  • Rapid and extensive diuresis for failure/pulmonary edema.
  • Gout, hypokalemia, alkalosis, hypokalemia, vertigo.

• Carbonic Anhydrase Inhibitors (Acetazolamide):

  • Used in combination with other diuretics, glaucoma treatment.
  • Caution: Pregnancy, renal/hepatic failure, COPD, respiratory acidosis, blood marrow suppression, hypokalemia, tinnitus.

• Other Diuretics

  • Details not included for brevity

Urinary

• UTI Anti-infective (Fosfomycin):
  • Treats uncomplicated UTIs and vaginitis.
  • Dizziness, and nausea
• Anti-spasmodics (Oxybutin):
  • Neurogenic bladder treatment, overactive bladder (overactivity), blurred vision, urinary hesitance, dry mouth, and sweating.
• Urinary Analgesics:
  • Pain relief for UTIs, red urine, GI upset.
• Bladder Protectant (Pentosan polysulfate sodium):
  • For bladder pain with cystitis.
  • Bleeding, alopecia, and GI upset.
• Benign-Prostatic Hyperplasia (Doxazosin):
  • Treats BPH.
  • Sexual dysfunction, palpitations, and vertigo, + Finasteride.

Eyes

• Prostaglandin Analogs (Lantanaprost):
  • Glaucoma treatment.
  • Harmless brown pigmentation.
• Beta-Adrenergic Blockers (Timolol):
  • Treats open-angle glaucoma.
  • Minimal adverse effects.
• Alpha-Adrenergic Agonists (Apraclonidine & Brimonidine):
  • Short-term glaucoma treatment, long-term use.
  • Minimal side effects.
• Cholinergic Agonists (Pilocarpine):
  • Emergency treatment for angle-closure glaucoma, and retinal detachment:
  • Lowers intraocular pressure (IOP), blurred vision.
• Cycloplegics + Mydriatics:
  • Paralyze and dilate eye muscles to treat certain conditions.
  • Blurred vision, photophobia

Upper Respiratory

• Antitussives (Dextromethorphan):
  • Reduces cough symptoms.
  • Caution: Pregnancy, head injury.
• Topical Nasal Decongestant (Tetrahydrozoline):
  • Relieves nasal congestion.
  • Caution: Lesions in mouth/nose, pregnancy.
• Oral Decongestants (Pseudophedrine/Phenylephrine):
  • Relieves nasal congestion, and treats otitis media.
  • Caution: Polypharmacy.
• Steroid Nasal Decongestant (Fluisolide):
  • Treats rhinitis or pain relief post-nasal polyp surgery.
    • Caution: Active infection, pregnancy.

Lower Respiratory

• Antihistamines (Diphenhydramine):
  • Treats allergies, allergic rhinitis, and (sometimes) blood transfusions.
  • Caution: Renal/hepatic impairment.
• Expectorants (Guaifenesin):
  • ↑ respiratory fluid output (unproductive coughs).
  • GI upset
• Mucolytics (Acetylcysteine):
  • Liquifies and clears secretions.
  • Caution: Asthma and COPD.
• Bronchodilators (Xanthines [Theophylline]):
  • Relieves asthma, COPD, bronchospasm.
  • Smokers ↑ risk of toxicity & cardiac dysrhythmias.

Sympathomimetics (Allbuterol)

• Rescue treatment for asthma and COPD.
• Restlessness, jitters, paradoxical bronchospasm, respiratory arrest.

Anticholinergics (Ipratropium)

• Maintains bronchodilation (for COPD).
• Can develop tolerance with chronic use.

Inhaled Steroids (Budesonide)

• Prevents and treats asthma.
• Warning: Can worsen infections.

Leukotriene Receptor Antagonists (Zafir lukast)

• Prophylactic/long-term asthma treatment:
• Caution: Avoid combining with warfarin/theophylline/aspirin, possible suicidal thoughts, and elevated liver enzymes.

Immune Modulators (Omalizumab)

• Severe asthma treatment.
• Caution: Not for acute asthma, not for children under 6, possible upper respiratory infection, anaphylaxis.
• Lung Surfactant (Beractant)
• Treatment for premature infants with respiratory distress syndrome (RDS).

Gastric Motility

• Chemical Stimulants (Bisacodyl):
  • Short-term constipation treatment.
  • Caution: CAD, blockage, nausea and vomiting.
• Bulk-forming laxatives (Psyllium):
  • Treat constipation.
  • Caution: Don't take with antacids, hypovolemia.
• Osmotic Laxatives (Magnesium Citrate):
  • Treat constipation.
  • Caution: Avoid abdominal surgery patients.
• Lubricants (Docusate):
  • Patients with constipation who shouldn’t strain
• Opioid Antagonists (Methylnaltrexone Bromide):
  • Treats opioid-induced constipation
  • GI upset, muscle spasms, hot flashes.

GI Stimulant (Metoclopramide)

• GI movement treatment for GERD.
• Caution: Do not take with antipsychotics, nausea and vomitting, tardive dyskinesia, Parkinson-like symptoms.
• Anti-diarrheals (Loperamide):
  • Slows GI transit
  • Caution: Distention, toxic megacolon.
• IBS-D drug (Alosetron):
  • Severe IBS-D treatment
• Ischemic colitis

Histamine Antagonists (Cimetidine)

• Short-term treatment for ulcers/GERD.
• Caution: CNS effects (fall risk in older adults), arrhythmias, cardiac arrest, gynecomastia, impotence.

Antacids (Sodium Bicarb.)

• Treats upset stomach/GI bleeding.
  • Caution: Gastric rupture, systemic alkalosis, hypokalemia, acid rebound.

Proton-pump Inhibitors (PPI) (Protonix, Omeprazole)

• Short-term active ulcer/burn/GERD.
• C-Diff, upper respiratory issues, bone loss, hypertension

Prostaglandins (Misoprostol)

• Prevent NSAID ulcers, off-lable abortion for some conditions and N/V
• Digestive Enzymes (Pancrelipase)
• Replaces deficient pancreatic secretions.
• N/V, proteinuria

Antiemetics

• Phenothiazine (Prochlorperazine) -Severe N/V -Caution: Pink/brown urine, extrapyramidal signs, fever, neuroleptic malignant syndrome

• Non-phenothiazines (Metoclopramide) -GERD, prevent N/V with chemo -Caution: Extrapyramidal signs, Parkinson's-like symptoms, seizures

5HT3 Receptor Blocker (Ondansetron)

• First-line for nausea/vomiting (N/V)
• Prolonged QT interval, urinary retention, GI upset, serotonin syndrome.

Miscellaneous

• Dexamethasone
• Dronabinol
• Scopolamine

Blood Pressure

• ACE Inhibitors (Captopril):
  • Treats hypertension, failure, and left ventricular dysfunction.
  • Caution: Renal failure, acute heart failure (HF), dry cough, angioedema, neutropenia, hypotension, tachycardia, ulcers, bone marrow suppression.
• ARBs (Losartan):
  • Combo treatment for hypertension and diabetic neuropathy.
  • Caution: Hepatic/renal dysfunction, hypovolemia, angioedema, alopecia, upper respiratory infection, hypotension
• Calcium Channel Blockers (Diltiazem):
  • Treats hypertension, angina, rapid, irregular heart rhythms (arrythmias).
  • Caution: Grapefruit juice, central nervous system (CNS) effects, peripheral edema, atrioventricular (AV) block, Bradycardia, hypotension, gastrointestinal (GI) upset
• Vasodilators (Nitroprusside):
  • Treats severe hypertension/acute heart failure (HF).
  • Caution: Cyanide toxicity, nausea, vomiting, hypotension
• Beta blockers (Metoprolol):
  • Treats stable angina, hypertension, and prevents heart attacks (MI).
  • Caution: Can mask symptoms of diabetes, COPD, or asthma.

Antiarrhythmics

• Class I (Lidocaine):

  • Manages acute ventricular arrhythmias.
  • Caution: Bradycardia, respiratory depression, chest pain, palpitations, CNS, hypotension, vasodilation.

• Class II (Propranolol):

• Treats rapid atrial fibrillation (AF), atrial flutter, supraventricular tachycardia (SVT), and hypertension-related angina.

• Caution: Sinus bradycardia, AV block, asthma, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, impotence, bradycardia, heart failure (HF).

• Class III (Amiodarone):

  • Treats ventricular arrhythmias.
  • Caution: Liver toxicity, heart failure (HF), arrhythmias, cardiac arrest, discolored skin.

• Nitrates (Nitroglycerin):

  • Treats acute angina and prevention.
  • Caution: Headache, nausea, hypotension, tachycardia.

Anti-Seizures

• Hydantoins (Phenytoin):
  • Treats tonic-clonic seizures and epilepsy.
  • Caution: Liver toxicity, sinus bradycardia, atrioventricular (AV) block, central nervous system (CNS) effects, leukopenia, thrombocytopenia, bradycardia, cardiac arrest, liver failure, dermatitis, swollen lymph nodes, gingival enlargement, nystagmus.
• Benzodiazepines + Barbituates:
  • Long-term seizure treatement
  • Same warnings as above.
• Succinimides (Ethosuximide):
  • Treats absence seizures.
  • N/V, central nervous system (CNS) symptoms, and skin reactions (SJS).
• Other (Valproic Acid):
  • Treats myoclonic, absence, and focal seizure types.
  • Warning: Hepatotoxicity, drug rash with eosinophilia and systemic symptoms (DRESS), central nervous system (CNS) effects, birth defects.
• Other (Carbamazepine):
  • Treats generalized and focal seizures.
  • Caution: Dermatological reactions, staggering gait, nystagmus, double vision, pancytopenia.

Anti-Parkinsonism

• Dopaminergics (Carbidopa + Levodopa):
  • Parkinson's disease.
  • Tachycardia, hallucinations, agitation, orthostatic hypotension, nausea, vomiting, malignant melanoma, dark/red/brown urine, sweating.
• Anticholinergics (Benztropine):
  • Added to drug regimens to manage extrapyramidal symptoms (EPS).
  • Sedation, dry mouth, ↑ risk for confusion, disorientation, constipation.

Muscle Relaxants

• Centrally Acting (Baclofen):
  • Treats musculoskeletal acute pain conditions and spinal cord injuries.
• Direct Acting (Dantrolene):
  • Treats spasticity in peripheral muscles, related to neuromuscular disease. Seizers, central nervous system (CNS) depression, GI upset, hepatitis, anaphylaxis, aplastic anemia, heart failure (HF).

PAIN - Opioids

• Opioids Agonist (Morphine):
  • Moderate to severe pain management, end-of-life care.
  • Caution: Respiratory depression, GI issues, neurologic effects, overdose, constipation.
• Opioid Antagonists (Naloxone):
  • Emergency reversal of opioid-induced respiratory depression, alcohol dependence.
  • Caution: CNS stimulation.
• Anti-Migraine:
  • Ergot Derivatives (Ergotamine):
    • Prevention and treatment of vascular headaches and peripheral vascular disease (PVD)
    • Caution: Pregnancy, CAD, elderly patients, renal/hepatic effects, CNS, GI, and CV complications.
  • Triptans (Sumatriptan):
    • Acute migraine management and cluster headaches.
    • Caution: Pregnancy, coronary artery disease (CAD), elderly patients, renal/hepatic effects, CNS, GI, and CV complications.

NERVOUS - General/Local Anasthetics

• Nonbarbituate General Anasthetic (Midazolam):
  • Preoperative sedation and general anesthesia/ICU intubation.
  • Caution: Respiratory distress and arrest.
• NB General Anasthetic (Propofol):
  • Short-procedure sedation
  • Caution: Localized burning, bradycardia, hypotension, pulmonary edema.
• Anasthetic Gas (Nitrous Oxide):
  • Rapid-acting anesthesia for dental procedures.
  • Caution: Hypoxia.
• Antianxiety/Analgesic (Succinylcholine):
  • Used to paralyze during surgery.

BLOOD GLUCOSE

• Rapid-acting (Lispro) + Aspart:
  • Right before meals, bolus insulin.
  • Onset: 15-30 minutes, peak 0.5-3 hours, duration 3-5 hours.
• Short-acting (Regular):
  • 30-60 minutes before meals, IV treatment for DKA (diabetic ketoacidosis)/hyperkalemia.
    • Onset: 30 minute-1 hour, peak 1-5 hour(2-4hour), duration 6-10 hours
• Intermediate-acting (NPH):
  • Half-day/overnight coverage.
  • Onset: 1-2 hours, peak 4-14 hours, duration 14-24 hours.
• Long-acting (Glargine/Detemir):
  • Full-day coverage
  • Onset 1-4 hr, peak none, duration 24 hr.

Oral Antidiabetics

• Sulfonylureas (Glipizide):
  • Combination therapy for type II diabetes with diet to manage.
  • Caution: Diabetic ketoacidosis (DKA).
• Biguanides (Metformin):
  • Combination treatment for type II diabetes with diet and exercise. -Caution: Do not take with IV contrast MRI/CT, hypoglycemia, lactic acidosis.

ENDOCRINE

• Posterior Pituitary (Desmopressin):
  • Treats diabetes insipidus, von Willebrand disease, and hemophilia.
  • Fluid retention, dry mouth, flushing, and nausea.
• Adrenal Cortical Agents (Prednisone):
  • Treats adrenal cortical insufficiency, inflammatory disorders, hypercalcemia, hematological disease, ulcerative colitis, and multiple sclerosis.
  • Caution: Infection risk. Vertigo, hypotension, shock, fluid/sodium retention, weight gain, delirium.
• Thyroid/Parathyroid Agents (Levothyroxine):
  • Thyroid hormone replacement therapy in hypothyroidism.
  • Tremors, nausea, vomiting, tachycardia, HF, arrhythmia, hyperthyroidism.
• Antithyroid Agents (Methimazole):
  • Treats hyperthyroidism.
  • Caution: Nausea, vomiting, liver toxicity, nephritis, bone marrow suppression, vertigo.

REPRO - Female

• Estrogens (Estradiol):

  • Menopause symptoms, osteoporosis prevention, and some types of cancer.
  • Caution: Allergies, pregnancy, atypical vaginal bleeding, and hepatic dysfunction.

• Progestins (Norethindrone Acetate):

  • Treating conditions such as amenorrhea. - Caution: Epilepsy, migraines, and (sometimes) asthma/CV/renal issues

• Estrogen Receptor Modulators (Raloxifene):

  • Prevent/treat postmenopausal osteoporosis, decrease risk for breast cancer. -Caution: Venous thromboembolism, hot flashes, vaginal bleeding, pulmonary embolism

REPRO - Male

• Androgens (Testosterone):
  • Replacement therapy for hypogonadism and delayed puberty.
  • Caution: Liver function, cardiovascular (CV) disease, sleep disorders, androgenic effects, hepatitis, hypoestrogenic effects.

Fertility Drugs

• Clomiphene:
  • Helps with ovarian issues.
  • Caution: Thromboembolic disease, respiratory disease, flushing, multiple pregnancies, breast tenderness, ovarian enlargement.
• Oxytocin:
  • Induces/improves uterine contractions
  • Caution: Mothers with previous C-section, water intoxication, arrythmias, uterine rupture, hypotension, fetal bradycardia

Erectile Dysfunction

• Sildenafil:
  • Treats erectile dysfunction (ED).
  • Caution: Erectile dysfunction, pulmonary arterial hypertension (PAH), bleeding disorders, nitroglycerin, urinary tract infections (UTIs), headache, hearing loss, hypotension.