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Pharm Exam 4 2024 complete update A+ graded study guide

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Pharm Exam 4 2024 complete update A+ graded study guide MOA acetaminophen - not clear - weak COX1/COX2 inhibitor - activation of descending serotonergic inhibitory pathways - antipyretic effects via inhibitory effects on hypothalamic "thermostat" adverse effects tylenol ...

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  • January 1, 2024
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Pharm Exam 4 2024 complete update A+
graded study guide




MOA acetaminophen - not clear
- weak COX1/COX2 inhibitor
- activation of descending serotonergic inhibitory pathways
- antipyretic effects via inhibitory effects on hypothalamic "thermostat"

adverse effects tylenol- skin rash/allergy
- hemolytic uremia
- methemoglobinemia
- hepatotoxicity (>4g/day, >15g lethal)

early signs hepatotoxicity tylenol nausea, vomiting, diarrhea, abdominal pain, dizziness,
excitement, disorientation

contraindications acetaminophen? - long term use during pregnancy associated with ADHD
- severe inflammatory pain (not best to give)
- severe hepatic disease

MOA salicylates (acetylsalicylic acid, aspirin) inhibits COX which inhibits the synthesis of
prostaglandins
- antipyretic, analgesic, anti-platelet properties

side effects salicylates- CNS: tinnitus, aseptic meningitis, HA, dizziness
- CV: fluid retention, HTN, edema, MI, CHF
- GI: abdominal pain, dyspepsia
- hematologic: thrombocytopenia, neutropenia, aplastic anemia
- hepatic: abnormal LFTs, liver failure
- pulm: asthma
- skin: rash, pruritis
- renal: renal failure/insufficiency, hyperkalemia, proteinuria

indications salicylates - pain relief, anti-inflammatory
- rheumatic disease arthritis

, - primary prevention of atherosclerotic CV disease

contraindiciations salicylates - pregnancy
- allergy
- children (Reyes syndrome)
- hemophilia/bleeding disorders

MOA NSAIDs inhibits prostaglandin biosynthesis via inhibition of COX isoenzymes
(COX1/COX2)

side effects NSAIDs - similar to aspirin
- can precipitate asthma/anaphylactoid reactions
- reversible platelet inhibition
- hepatotoxicity
- CV risk
- people with PUD history should be tested for H.Pylori
- monitor renal function

indications NSAIDs? - pain (more effective than tylenol)
- fever
- colon cancer prevention
- PDA closure
- stabilize menstrual bleeding

contraindications NSAIDs? - hx of PUD
- renal insufficiency
- CHF

opioids MOA?** depends on receptor type **

inhibits dorsal horn pain transmission neurons
- inhibits release of excitatory NTs inhibition of pain processing in dorsal horn of the spinal cord

side effects opioids? analgesia, cough suppression, diarrhea, dyspnea, opioid abuse disorder

biliary colic, urinary retention, renal impairment, prolonged labor, hypogonadism, pruritis,
impaired immunity, tooth decay

contraindications opioids? - renal impairment (be careful)
- drug interactions! (codeine, 3A4 substrates, 2D6 substrates)

MOA TCAs? block the reuptake of serotonin/norepi

block peripheral sodium channels, histamine, alpha 1 receptors, muscarinic receptors

side effects TCAs dry. mouth, weight gain, dizziness, tremor, urinary retention, confusion,
sedation

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