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Step 1 Review > Associations in Pharm > Flashcards

Associations in Pharm Flashcards

1
Q

Drug Reaction:

hot flashes

A

Tamoxifen

Clomiphene

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2
Q

Drug Reaction:

hyperglycemia

A

“Taking Pills Necessitates Having Blood Checked”:

Tacrolimus, Protease inhibitors, Niacin, HCTZ, B-blockers, Corticosteroids

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3
Q

Drug Reaction:

Hypothyroidism

A

Lithium
Amiodarone
Sulfonamides

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4
Q

Drug Reaction:

Acute cholestatic hepatitis, jaundice

A

Erythromycin

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5
Q

Drug Reaction:

Diarrhea

A

“Might Excite Colon on Accident”:

Metformin, Erythromycin, Colchicine, Orlistat, Acarbose

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6
Q

Drug Reaction:

Focal to massive hepatic necrosis

A

Liver “HAVAc”:

Halothane, Amanita phalloides, Valproic acid, Acetaminophens

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7
Q

Drug Reaction:

Hepatitis

A

INH

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8
Q

Drug Reaction:

Pancreatitis

A

“Drugs Causing A Violent Abdominal Distress”:

Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (furosemide, HCTZ)

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9
Q

Drug Reaction:

Pseudomembranous colitis

A

Clindamycin
Ampicillin
Cephalosporins
(Abx predispose to superinfection by drug-resistant C. diff)

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10
Q

Drug Reaction:

Agranulocytosis

A

“Drugs CCCrush Myeloblasts and Promyelocytes”

Dapsone, Clozapine, Carbamazepine, Colchicine, Methimazole, Propylothiouracil

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11
Q

Drug Reaction:

Aplastic anemia

A

“Can’t Make New Blood Cells Properly”:

Carbamazepine, Methimazole, NSAIDs, Benzene, Chlorpromazine, Propylothiouracil

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12
Q

Drug Reaction:

Direct Coombs-positive hemolytic anemia

A

Methyldopa

Penicillin

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13
Q

Drug Reaction:

Gray baby syndrome

A

Chloramphenicol (Abx - protein synthesis inh)

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14
Q

Drug Reaction:

Hemolysis in G6PD

A

“Hemolysis IS D PAIN”:

INH, Sulfonamides, Dapsone, Primaquine, Aspirin, Ibuprofen, Nitrodurantoin

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15
Q

Drug Reaction:

Megaloblastic anemia

A

“Having a BLAST with PMS”:

Phenytoin, Methotrexate, Sulfa drugs

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16
Q

Drug Reaction:

Thrombocytopenia

A

Heparin

Cimetidine

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17
Q

Drug Reaction:

Thrombotic complications

A

OPCs

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18
Q

Drug Reaction:

Fat redistribution

A

“Fat PIG”:

Protease Inhibitors, Glucocorticoids

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19
Q

Drug Reaction:

Gingival hyperplasia

A

Phenytoin
Verapamil
Cyclosporine
Nifedipine

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20
Q

Drug Reaction:

Hyperuricemia

A

“Painful Tophi and Feet Need Care”:

Pyrazinamide, Thiazides, Furosemide, Niacin, Cyclosporine

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21
Q

Drug Reaction:

Myopathy

A

Fibrates, Niacin, Colchicine, Hydroxychloroquinolone, Interferon-alpha, Penicillamine, Statins, Glucocorticoids

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22
Q

Drug Reaction:

Osteoporosis

A

Corticosteroids

Heparin

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23
Q

Drug Reaction:

Photosensitivity

A

“SAT For Photo”:

Sulfonamides, Amiodarone, Tetracyclines, 5-FU

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24
Q

Drug Reaction:

Rash/SJS

A

“Steven Johnson has epileptic Allergy to Sulfa drugs and Penicillin”:
Anti-epileptic drugs*, Allopurinol, Sulfa drugs, Penicillin
*Including: ethosuximide, carbamazepine, lamotrigine, phenytoin, phenobarbital

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25
Q

Drug Reaction:

SLE-like syndrome

A

Having lupus is “SHIPP-E”:

Sulfa drugs, Hydralazine, INH, Procainamide, Phenytoin, Etanercept

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26
Q

Drug Reaction:

Tooth discoloration

A

Tetracyclines

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27
Q

Drug Reaction:

Tendonitis, tendon rupture, cartilage damage

A

Fluoroquinolones

28
Q

Drug Reaction:

Cinchonism

A

Quinidine, quinine

29
Q

Drug Reaction:

Parkinson-like syndrome

A

“cogwheel rigidity of ARM”:

Antipsychotics, Reserpine, Metoclopramide

30
Q

Drug Reaction:

Seizures

A

“with Seizures, I BITE My tongue”:

INH, Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide

31
Q

Drug Reaction:

Tardive dyskinesia

A

Antipsychotics

Metoclopramide

32
Q

Drug Reaction:

Diabetes insipidus

A

Lithium

Democlocycline

33
Q

Drug Reaction:

Fanconi syndrome

A

Expired tetracycline
*Fanconi syndrome = disease of proximal tubule in which substances are lost to urine instead of being reabsorbed (Glucose, aa, uric acid, phosphate, bicarb)

34
Q

Drug Reaction:

Hemorrhagic cystitis

A

Cyclophosphamide
Ifosfamide
*Prevent by co-administering with mesna

35
Q

Drug Reaction:

Interstitial nephritis

A

Methicillin
NSAIDs
Furosemide

36
Q

Drug Reaction:

SIADH

A

“Can’t Concentrate Serum Sodium”:

Carbamazepine, Cyclophosphamide, SSRIs

37
Q

Drug Reaction:

Dry cough

A

ACEIs - ACE also breaks down bradykinin; without it you get extra bradykinin and it can precipitate angioedema

38
Q

Drug Reaction:

Pulmonary fibrosis

A

“Breathing Air Badly from Medications”:

Bleomycin, Amiodarone, Busulfan, Methotrexate

39
Q

Drug Reaction:

Antimuscarinic

A

Atropine
TCAs
H1-blockers
Antipsychotics

40
Q

Drug Reaction:

Disulfiram-like rxn

A 
Metronidazole
Certain cephalosporins
Griseofulvin
Procarbazine
1st gen Sulfonylureas
41
Q

Drug Reaction:

Nephrotoxicity/Ototoxicity

A

Cisplatin
Aminoglycosides
Loop diuretics
Vancomycin

42
Q

CYP Inducers

A

“Chronic alcoholic Mona Steal Phen-Phen and Never Refuses Greasy Carbs”:
Chronic alcohol; Modafinil; St. John’s wort; Phenytoin; Phenobarbital; Nevirapine; Rifampin; Griseofulvin; Carbamazepine

43
Q

CYP Substrates

A

“Always, Always, Always, Always Think When Starting Others”:

AEDs, Antidepressants, Antipsychotics, Anesthetics, Theophylline, Warfarin, Statins, OCPs

44
Q

CYP Inhibitors

A

“A cute Gentleman Cipped Iced Grapefruit juice Quickly And Kept Munching on Soft Cinnamon Rolls”:
Acute alcohol abuse, Gemfibrozil, Ciprofloxacin, Isoniazid, Grapefruit juice, Quinidine, Amiodarone, Ketoconazole, Macrolides, Sulfonamides, Cimetidine, Ritonavir

45
Q

Sulfa drugs

A

“Popular FACTSSS”:
Probenacid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide abx, Sulfasalazine, Sulfonylureas

**Sulfa allergy: fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocytosis, urticaria. Symptoms range mild to severe.

46
Q

Mood stabilizers for treatment of Bipolar

A

Lithium
Carbamazepine
Valproate

47
Q

Lamotrigine

A

Anti-convulsant mood stabilizer for bipolar (esp. depressive episode)

48
Q

Anti-psychotics

A
  1. Typicals:
    High potency = “Try to Fly High”
    Trifluoperazine; Fluphenazine; Haloperidol
    Low potency = “Cheating Thieves are Low”
    Chlorpromazine; Thioridazine; Levomepromazine
  2. Atypicals:
    “Old Closets Quietly Risper from A to Z”
    Olanzapine; Clozapine; Quetiapine; Risperidone; A; Z
49
Q

Side effects of loop diuretics

A

(inhibit NaKCC)

  • higher doses/CKD - ototoxicity
  • hypokalemia, hypomagnesemia, hypocalcemia
50
Q

Opioids

A

OP3/mu opioid receptor agonists, which modifies pain and slows GI motility

Alfentanil, Fentanyl, Sufentanil, Remifentanil
Codeine, Tramadol (5HT and NE reuptake inh), Hydrocodone, Hydromorphone, Oxycodone, Oxymorphone, Methadone, Meperidine, Morphine

Diphenoxylate, Loperamide - opioid anti-diarrheal agent

51
Q

TCAs

A

Amitriptyline
Nortriptyline
Imipramine
Desipramine

52
Q

Anticonvulsants

A

Gabapentin, Pregabalin - inhibits neuronal excitement by preventing Ca ch. migration to surface to hypersensitize the cell to pain signals

Lamotrigine - blocks Na Ch function
Carbamazepine - blocks Na channel function, esp. in trigeminal nucleus

53
Q

Opiate antagonists

A

Methylnaltrexone

Bind tightly, slowly release (for withdrawal tx): Naloxone, Naltrexone, Buprenorphine

54
Q

Opiate withdrawal symptoms and treatment

A

Peaks at 3-4d, lasts 7-10d

Sx: agitation, diaphoresis, increased lacrimation, piloerection, dilated pupils; also MSK pain in back, joints, abdomen; N/V

Tx: outpatient - clonidine (anti-SNS sx), inpatient - methadone

55
Q

Dopamine - peripheral effects

A

low doses - D1R in renal vessels and VD, inc. GFR

higher doses - B1Rs in cardiac muscle, inc. contractility, pulse pressure, and SBP

56
Q

How to clinically differentiate between acute Hep B and Hep C infections?

A

Hep C is usually asymptomatic; may get some cryoglobulinemia manifested on the skin in chronic infection.
Acute Hep B will manifest fever/fatigue, skin rash (urticarial), joint pain, hepatomegaly, and elevated ALT/AST.
Hep B transmitted sexually, parenterically, or vertically.
Hep C transmitted usually by IV drugs, not usually sexually.

57
Q

Why can’t you use monotherapy on TB?

A

rapid emergence of resistance

58
Q

Major side effects of Amiodarone

A

Cardiac - brady, heart block, pro-arrhythmia, QTP, Torsades
Pulm - fibrosis
Endocrine - Hypo/hyperthyroid (it’s 40% iodine by weight)
GI - elevated LFTs, hepatitis
Ocular - corneal deposits, optic neuropathy
Dermatologic - blue-gray discoloration
Neuro - peripheral neruopathy

59
Q

Teratogenicity of valproate

A

neural tube defects - it inhibits the absorption of folic acid

60
Q

How to treat hepatic encephalopathy?

A

*Remember it’s caused by hyperammonemia from liver failure (cirrhosis) to convert ammonia to urea; will see AMS and asterixis

Rifaximin - alters intestinal flora in order to decrease intraluminal ammonia production
Lactulose - increases conversion of ammonia to ammonium ion

61
Q

HLA-B57:01 has strong association with what drug hypersensitivity reaction?

A

Abacavir - NRTI for HIV

It’s a Type 4 HSN consisting of fever, malaise, GI sx, and delayed rash

62
Q

What kind of drugs are preferentially eliminated by the liver?

A

Drugs that are lipophilic and have a high volume of distribution
Lipophilicity kind of informs volume of distribution - easily crosses membranes

*Lipophilic is good to get into the liver because it can cross HC membrane and fits easily into bile to be excreted; bad in kidneys because it will easily go back into the tubular cells from the lumen

63
Q

When to use MAOIs?

A

For patient with the Atypical subtype of major depression, characterized most by mood reactivity, plus leaden paralysis, rejection sensitivity, and increased sleep and appetite.
MAOIs aren’t really used for anything else anymore (except atypical and refractory major depression) because of the side effect profile.

64
Q

First line treatment for Generalized Anxiety Disorder?

A

SSRIs - Citalopram

*Don’t use BZDs because of the risk of dependence/tolerance and rebound toxicity with discontinuation

65
Q

Mu opioid receptors - MOA

A

GPCRs that regulate K conductance

When opioids bind, they increase K efflux which hyperpolarizes the cell and terminated pain transmission

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