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Step 1 DIT > 3. Pharm Basics > Flashcards

3. Pharm Basics Flashcards

1
Q

What drug regenerates acetylcholinesterases after organophosphate poisoning?

A

Pralidoxime

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2
Q

Which anticholinesterases are used in the treatment of Alzheimer disease? (3)

A
  • donepezil
  • galantamine
  • rivastigmine
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3
Q

Which of the muscarinic antagonists can be used to improve FEV1 in a patient with COPD? (2)

A
  • ipratropium

- tiotropium

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4
Q

What anticholinergics are used in the treatment of urge-type urinary incontinence? (4)

A
  1. oxybutynin
  2. tolterodine
  3. darifenacin, solifenacin
  4. trospium

On The Darn Toilet

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5
Q

In what patient populations is atropine contraindicated? (5)

A
  1. BPH (alrdy have problems with urinary retention)
  2. hyperthermia
  3. acute angle glaucoma
  4. elderly (delirium)
  5. GI obstruction/ ileus
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6
Q

What medications have anticholinergic side effects? (4)

A
  1. first generation H1 blockers (ex. diphenhydramine)
  2. neuroleptics
  3. TCA
  4. amantadine (anti-parkinson)
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7
Q

Which receptors are stimulated by clonidine?

A

alpha-2

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8
Q

Which receptors are stimulated by dopamine?

A

low –> dopamine receptor
med –> B1, B2
high –> a1, a2

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9
Q

Which receptors are stimulated by phenylephrine

A

a1 > a2

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10
Q

Which receptors are stimulated by albuterol

A

b2 > b1

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11
Q

Which receptors are stimulated by NE

A

a1 > a2 > b1

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12
Q

Which receptors are stimulated by isoproterenol

A

b1 = b2

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13
Q

Which receptors are stimulated by epi

A

b1, b2, a1, a2

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14
Q

Which receptors are stimulated by dobutamine

A

b1 > b2

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15
Q

Which receptors are stimulated by terbutaline

A

b2 > b1

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16
Q

Which sympathomimetic is given as a nebulizer for asthma?

A
  • albuterol, levalbuterol
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17
Q

Which sympathomimetic is drug of choice for anaphylaxis?

A

epi

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18
Q

Which sympathomimetic is the most common first line agent for pts in septic shock

A

NE

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19
Q

Which sympathomimetic is given subQ for asthma?

A

terbutaline

  • also used for tocolysis (decreasing uterine tone)
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20
Q

Which sympathomimetic is used by ENT to vasoconstrict nasal vessels?

A
  • phenylephrine

- (cocaine)

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21
Q

Which selective a-blocker has less effect on blood pressure?

A

tamsulosin

selective for alpha-1A,D which is just on prostate. doesn’t affect vascular alpha-1B receptor

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22
Q

What are the common side effects of b-blockers? (3)

which pt population should use caution when taking b-blockers?

A

SE:
1. bronchospasm (asthma, COPD) - esp with non-selective b-blockers (which can block b2 –> bronchoconstriction)

  1. lower blood glucose (diabetics; may mask symptoms of hypoglycemia)
  2. brady, AV block (careful w/ CHF)
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23
Q

Which 3 enzymes are required to convert phenylalanie to dopamine?

A
  • phenylalanine hydroxylase (low in PKU)
  • tyrosine hydroxylase
  • dopamine decarboxylase
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24
Q

A patient develops paralysis after being bitten by a black widow spider. Is this a spastic or flaccid paralysis? What other autonomic symptoms might be seen?

A
  • spastic [stimulates release of ACh at NMJ]

- salivation, diaphoresis, lacrimation (excess ACh)

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25
Q

what substances inhibit the reuptake of NE? (2)

A

cocaine

TCA

26
Q

What substances stimulate the release of NE from neurons? (4)

A

calcium (normal release)
amphetamine
ephedrine
tyramine

27
Q

Outline the pathway by which stimulation of a Gs receptor activates protein kinase A

A

Gs –> adenylyl cyclase –> converts ATP to cAMP –> PKA

28
Q

What effect will a reversible competitive antagonist have on Vmax and Km?

A 
Vmax unchanged (no change in efficacy) 
Km increased (decreased potency)
29
Q

Drug A has therapeutic index of 10:1 while drug B has TI of 2:1. Which drug would be considered safer?

A

Drug A

30
Q

Which hepatic phase of metabolism is lost first by geriatric patients? Which phase is mediated by cytochrome p450

A

both phase 1

31
Q

What medication inhibits acetaldehyde dehydrogenase?

A

disulfiram

32
Q

what medication inhibits alcohol dehydrogenase?

A

fomepizole

33
Q

What are the 7 inducers of cytochrome p450?

A 
Griseofulvin
Carbamazepine
Phenytoin
Barbiturate
Rifampin
St. John's Worts 
Chronic alcoholism
34
Q

What are the 11 inhibitors of cytochrome p450?

A 
Cimetidine 
Ritonavir (protease inhibitor) 
Amiodarone 
Ciprofloxacin 
Ketoconazole 
Acute alcohol
Macrolides 
Isoniazid 
Grapefruit juice
Omeprazole 
Sulfonamides
35
Q

Which medication overdose can be treated with sodium bicarb?

A

aspirin (weak acid)

36
Q

Which medication OD can be treated with ammonium chloride?

A

amphetamines (weak base)

37
Q

What medication causes cardiotoxicity and bone marrow suppression? (2)

A
  • doxorubicin
  • daunorubicin
    (anti-cancer drugs)
    –> can cause dilated cardiomyopathy
38
Q

An African-American man who goes to Africa develops anemia after taking ppx medicine for primary disease prevention. In what enzyme is this patient deficient?

A

G6PD deficiency

- primaquine (malaria ppx)

39
Q

A 65 yo male pt taking multiple medications presents with gynecomastia. Which meds can be responsible for this? (2 major ones)

A
  • spironolactone
  • ketoconazole
Spironolactone 
THC (marijuana) 
Alcohol (chronic use) 
Cimetidine 
Ketoconazole 
Estrogen
Digoxin
40
Q

A patient presents with tinnitus, dizziness, HA, and vision changes. What drug is causing these symptoms? (2)

A
  • quinidine (class 1A anti-arrhythmic)
  • quinine

[cinchonism]

41
Q

What medications are known for causing drug-induced lupus?

A 
Sulfonamides
Hydralazine
Isoniazid
Phenytoin
Procainamide
42
Q

What is the antidote to acetaminophen?

A

N-acetylcysteine (replenishes glutathione)

43
Q

What is the antidote to salicylates?

A

sodium bicarb, dialysis

**note: aspirin OD can lead to tinnitus

44
Q

What is the antidote to amphetamines?

A

ammonium chloride

45
Q

What is the antidote to anticholinesterases, organophosphates

A

atropine, pralidoxime

46
Q

What is the antidote to antimuscarinic, anticholinergic agents?

A

physostigmine

47
Q

What is the antidote to digoxin?

A

anti-dig Fab fragments

- K+ and Mg2+ optimization

48
Q

What is the antidote to iron?

A

deferoxamine

  • fe-
  • *note: iron OD –> abd pain, hematemesis, melena, lethargy
49
Q

What is the antidote to lead?

A

EDTA
dimercaprol
succimer
penicillamine

**note: lead OD –> dev delay, non-spec GI symptoms

50
Q

What is the antidote to mercury, arsenic, gold

A

dimercaprol (BAL)
succimer

-merc-

51
Q

What is the antidote to copper, arsenic, gold

A

penicillamine

-copper pennies-

52
Q

What is the antidote to carbon monoxide?

A

100% O2

53
Q

What is the antidote to methemoglobin?

A

methylene blue, vitamin C

-meth-

54
Q

What is the antidote to cyanide

A

nitrite + thiosulfate, hydroxocobalamine

55
Q

What is the antidote to methanol, ethylene glycol (antifreeze)

A

fomepizole (inhibits alcohol dehydrogenase)

can also give ethanol, dialysis

56
Q

What is the antidote to benzo?

A

flumazenil

*be careful with rapid correction b/c can cause seizures

57
Q

What is the antidote to TCA

A

sodium bicarb

58
Q

What is the antidote to heparin?

A

protamine sulfate

-prot- (proton…hydrogen…H for heparin)

59
Q

What is the antidote to t-PA, streptokinase?

A

aminocaproic acid

60
Q

What is the antidote to theophylline

A

beta-blocker

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