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zABSITE 2019 - high yield comprehensive > 7. Medicines and Pharm > Flashcards

7. Medicines and Pharm Flashcards

1
Q

What drugs are bound by albumin

A

Warfarin and PCN are 90% bound

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2
Q

s/e of sulfonamide

A

Displace unconjugated bilirubin from albuin in newborns causing kernicterus

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3
Q

What drugs are stored in bone

A

Tetracycline

heavy metals

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4
Q

O order kinetics

A

Constant amount of drug is eliminated regardless of dose

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5
Q

1st order kinetics

A

drug eliminated proportional to dose

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6
Q

How long does it take a drug to reach steady state?

A

5 half lives

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7
Q

Volume of distribution

A

amount of drug in the body divided by amount of plasma/blood

- high VOD means high concentrations in vascular compartment (fatty tissue) compared to intravascular

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8
Q

Bioavailability

A

Fraction of unchanged drug reaching systemic circulation

  • 100% for IV
  • Oral usually less (PO cipro is 100%)
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9
Q

ED50

A

drug level at which desired effect occurs in 50%

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10
Q

LD50

A

drug level at which death occurs at 50%

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11
Q

Tachyphylaxis

A

Tolerance after only a few doses

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12
Q

Phase 1 metabolism

A

Demethylation, redox, hydroxylation

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13
Q

Phase 2 metabolism

A

Glucuronic acid and sulfates attached to form water soluble metabolite

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14
Q

P450 inhibitors

A 
Cimetidine
Isoniazid
Ketoconazole
Erythromycin
Cipro
Flagyl
Allopurinol
Verapamil
Amiodarons
MAOi
Disulfuram
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15
Q

P450 inducers

A 
Cruciform vegetables
ETOH
Cigarette smoke
Phenobarb
Barbiturates
Dilantin
Theophylline
Warfarin
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16
Q

Colchicine

A

MOA: Binds tubulin and inhibits chemotaxis of WBC
Use: Acute gout attack

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17
Q

Indomethacin

A

MOA: NSAID, reversible cinhibitor, blocks uric aox inhibitor, inhibit PG synthesis
Use: Acute gout attack

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18
Q

Allopurinol

A

MOA: XO inhibits, inhibits UA production from xanthine
Use: Chronic gout

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19
Q

Probenecid

A

MOA: increases renal secretion of UA
Use: Chronic gout

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20
Q

Cholestyramine

A

MOA: binds bile acids in gut forcing body to resyntheize using cholesterol
Use: lipid-lowering agent
S/E: binds vit K causing bleeding

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21
Q

Statis

A

MOA: HMG coa reductase inhibitors
Use: lipid-lowering agent
S/e: Liver dysfunction, rhabdo

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22
Q

Niacin

A

MOA: inhibits CE syntheesis
Use: lipid-lowering
s/e: flushing (tx with ASA)

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23
Q

Metoclopramide

A

Reglan
MOA: inhibits dopamine receptors
Use: increase gastric/gut motbility

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24
Q

Erythromycin

A

MOA: binds and activates motilin receptor
Use: increase gastric/gut mobility

25
Q

Alvimopan

A

MOA: anatongist to mu-opinoid receptor
Use: post op ileus

26
Q

Loperamide

A

MOA: mu-receptor agonist
Use: slows gut motility

27
Q

Lomotil

A

Dephnoxylate/atropine
MOA: opidoid receptor agonist
Use: slows gut motility

28
Q

Promethazine

A

Phenergan
MOA: inhibitos dopamine receptors
Use: anti-emetic
s/e: TD (Tx w/ diphenhydramine)

29
Q

Ondansetron

A

Zofran

MOA: Central acting ser rec inhibitor

30
Q

Omperazole

A

MOA: blocks H/K ATPase in he stomach parietal cells

31
Q

Cimetidine

A

MOA: H2 receptor blocker
Use: decrease stomach acid

32
Q

Ranitidine

A

MOA: H2 receptor blocker
Use: decrease stomach acid

33
Q

Octreotide

A

MOA: SS analgoue
Use: decrease gut secretions

34
Q

Digoxin

A

MOA: inhibits Na/K ATPase and increase Ca
Effects: Decreases AV node, inotrope
S/e: mesenteric ischemia, hypokalemia, yellow vision, arrythemia
- not cleared with dialysis

35
Q

Amiodarone

A

MOA: anti-arrythmic
Use: Acute atrial and ventrail arrythmia
s/e: pulmonary fibrosis, hypo/hyper thyroidism

36
Q

Mg

A

Use: torsades de pointes and ventricular tachycardia

37
Q

Adenosine

A

MOA: Interupts AV node

38
Q

ACEi

A

Inhibit ACE
Use: best single agent to improve survival with CHF
s/e: precipitate RF if RAS

39
Q

Beta blocker

A

MOA: block beta receptors
Use: best single agent to improve survival after MI
- reduce risk of MI and afib post op
S/e: don’t start a BB w/in 24h of surgery in a new user

40
Q

Atropine

A

MOA: Acetylcholine antagonist
Use: increases HR

41
Q

Metyrapone

A

MOA: Inhibits adrenal steroid synthesis
Use: Adrenocortical CA

42
Q

Aminoglutethimide

A

MOA: Inhibits adrenal steroid synthesis
Use: Adrenocortical CA

43
Q

Leuprolide

A

MOA: analogue of GnRH and LHRH that inhibits release of LH/FSH for pituitary (paradoxic effect)
Use: metastatic prostate CA

44
Q

Tamsulosin

A

MOA: alpha antagonist
Use: BPH

45
Q

NSAIDS

A

MOA: non selective cox inhibitor
S/E: inhibit PG synthesis and lead to less mucus and bicarb secretion and more acid production
- gastritis, ulcers, GI bleeding
- renal insufficiency 2/2 constriction of renal afferent arteriole

46
Q

Celeoxib

A

MOA: NSAID with selective cox2 inhibition
S/E
- fewer gi s/e
- increase r/o CV event

47
Q

Misoprostol

A

MOA: PGE1 derivative, protective PG sed to prevent peptic ulcer disease
- Use: patients on chronic NSAIDS

48
Q

Haldol

A

MOA: Inhibits dopa receptorts
Use: Anti-psychotic, agitation in elderly
- s/e: EPSx (tx w/ benadryl), qt prolongation

49
Q

Furosemide

A

MOA: loop diuretic

s/e: metabolic alk, hypoK, ototoxic

50
Q

Spironolactone

A

MOA: aldo inhibitor

s/e: metabolic acid, hyperK

51
Q

Infliximab

A 
Remicade
MOA: TNF-alpha Ab
Use: IBD
S/e: TB reactivation, CHF, new infection
- no effect on wound healing
52
Q

ASA poisoning

A

Sx: tinnitus, HA, n/v

  • Initially: respiratory alkalosis (increased ventilation)
  • Later: metabolic acidosis (compensation + drug effect)
53
Q

Gadolinium

A

S/E: nausea, acute renal failure, nephrogenic fibrosis

54
Q

Iondine contrast

A

S/e: nausea, dyspnea

55
Q

Tx for tylenol overdose

A

N-acetlycysteine

56
Q

S/e of ergot

A

Retroperitoneal fibrosis

Tx w/ prednisone

57
Q

Drugs not safe with pregnancy

A
  1. Methimazole: cretenism
  2. ACE-: congential malformation, RF
  3. Coumadin: CNS and skeletal defect (x BBB)
  4. ASA: Increase miscarriages
  5. Tylenol: Increase miscarriages
58
Q

s/e of Nitroprusside

A

Metabolized into NO and cyanide causing CN toxicity

tx: amyl nitrate

zABSITE 2019 - high yield comprehensive (12 decks)

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