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Pharmacology 2 > Big Picture > Flashcards

Big Picture Flashcards

1
Q

Trade name doesn’t matter except with what drugs?

A

Antibiotics and combination diuretics

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2
Q

How are generic product approved?

A

similar absorption profile, similar systemic exposure, area under the curve, time to maximum concentration

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3
Q

What drugs should you use the trade name instead of generic versions?

A

Narrow TI drugs (Warfarin, and Theophylline)

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4
Q

What are biosimilar drugs?

A

generic biological agents

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5
Q

Monoclonal antibodies prefix?

A

unique name

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6
Q

Monoclonal antibodies substem (infix)?

A

target, related to action or use of antibody, or source

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7
Q

Monoclonal antibodies suffix?

A

-mab or -pab

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8
Q

Jimmy Carter was taken what monoclonal antibody for his brain cancer?

A

Pembrolizumab

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9
Q

How should epinephrine be administrated?

A

IM or SubQ, never IV

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10
Q

What does PCN treat?

A

Syphilis

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11
Q

What do you have to be careful with when using Metronidazole?

A

C. difficle

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12
Q

Precaution with Amp B dosing because it produces?

A

infusion related side effects

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13
Q

What are Amp B related side effects?

A

high fever, chills, hypotension, muscle spasm (cytokine release)

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14
Q

Amp B can cause nephrotoxicity over what gram?

A

4 gm

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15
Q

If verapamil is taken with GFJ what can happen to the patient?

A

hypotension

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16
Q

What is the link between digoxin and antibotics

A

p-glycoprotein inhibition

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17
Q

T/F Erythromycin can treat S. aureus infection?

A

False

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18
Q

What are the two isomers of Warfarin?

A

S isomer (active), R isomer

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19
Q

What enzyme is active in Warfarin S isomer?

A

1A2, 2C19

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20
Q

What enzyme is inactive in Warfarin R isomer?

A

3A4

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21
Q

What can inhibit/increase Warfarin?

A

fluconazole, amiodarone, metronidazole, sulfamethoxazole-trimethoprim

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22
Q

Which drugs are affected by GFJ?

A

CCB, statins

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23
Q

What is the food inhibits Warfarin action?

A

greeny leaf vegetables rich in Vitamin Ki

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24
Q

Which foods inhibit MAOI?

A

Tyramine rich foods: cheese, red wine, beers on tap, cured or smoked meats or fish, soy products (soup, bean curd, tofu), fava or broad beans

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25
Q

Foods that inhibit MAOI will cause what type of reaction?

A

Hypertensive crisis

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26
Q

Beta blockers can cause?

A

hypotension and bradycardia

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27
Q

What drugs go through phase II acetylation?

A

SHIP

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28
Q

Warfarin is sensitivity to what Vitamin K gene?

A

VKORC1

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29
Q

Inhibition of acetaldehyde metabolism causes what?

A

Disulfiram like reaction

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30
Q

What symptoms are seen in disulfiram like reaction?

A

N/V, flushing, tachycardia, headache, sweating

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31
Q

What CNS depressant can cause a disulfiram like reaction?

A

Alcohol

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32
Q

What classes of CPH can cause a disulfiram like reaction?

A

2G and 3G CPH

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33
Q

What is the difference between the 2G and 3G CPH?

A

the more you go down the more gram positive

the more you go up the more gram negative coverage

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34
Q

What antibody can cause a disulfiram like reaction?

A

Metronidazole

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35
Q

What two drugs can disrupt Vitamin K clotting factors?

A

CPH and Warfarin

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36
Q

What are Vitamin K clotting factors?

A

2, 7, 9, 10

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37
Q

What can cause hypoprothrombinemia

A

Warfarin and CPH

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38
Q

What is Therapeutic Index (TI)

A

Measurement of drug safety. Dose required for death in 50% of the animals. (LD50/ED50)

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39
Q

The higher the TI….

A

the safer the drug

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40
Q

The lower the TI…

A

the bad ass of the drug

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41
Q

What drugs can cause bleeding, bruising, bleeding gums?

A

anticoagulant, aspirin, NSAIDS

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42
Q

Undesirable oral thrush

A

glucocorticosteriods

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43
Q

Undesirable diarrhea, C. difficle

A

antibotics, Clindamycin

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44
Q

Undesirable GI ulceration

A

NSAIDS

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45
Q

Undesirable hair loss, alopecia, myelosupression

A

Anticancer drugs

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46
Q

Undesirable sedation, anticholinergic , CV toxicity

A

TCA: Amitriptyline

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47
Q

How do you monitor anticoagulants?

A

Bleeding time, PT, PTT, INR

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48
Q

How do you monitor statins?

A

Creatine kinase

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49
Q

How do you monitor drugs that cause SJS syndrome and Lupus like?

A

test dose, genetic testing

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50
Q

What medicines need genetic testing?

A

codiene, carbamezepine, Abacavir, Flucloxacillin, Allopurinol, SHIP

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51
Q

What causes cough?

A

ACEI

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52
Q

What causes headaches?

A

Leukotriene antagonist

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53
Q

What drugs are commonly asked to monitor for?

A

Corticosteroids, SSRIs, Benzo, Beta blockers

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54
Q

What is the biggest problem with corticosteroids?

A

adrenal crisis

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55
Q

What is the treatment for asthma?

A

long acting B2 agonist + inhaled steroid for prophylaxis

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56
Q

What undesirable side effect of inhaled corticosteroids?

A

oral candidiasis

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57
Q

How do you treat oral candidiasis due to corticosteroids?

A

rinse mouth and throat w/ water after use, then spit out

- spacer w/ mouthpiece

58
Q

What drugs can cause oral candidiasis?

A

Nystain
clotrim-
flucon-azole

59
Q

slowing healing to cuts and bruises suggests..

A

the pt is on a immunosuppressive

60
Q

What are some sde of long term corticosteroids use?

A 
increase appetite
weight gain
fluid retention
hyperglycemia
moon face 
Osteoporosis 
glaucoma, cataracts
61
Q

Whats the txt for osteoporosis?

A

calcium and vitamin D, biphosphonates

62
Q

When a patient stressful event is over what should be done to avoid adrenal crisis?

A

dose over several days to previous maintenance level. NO COLD TURKEY

63
Q

What are the sde of cholinomimetics?

A 
diarrhea
urination
miosis
bradycardia
bronchoconstriction
emesis
lacrimation
salivation
sweating
64
Q

What are the sde of anticholinergic?

A 
blurred vision
dry mouth
constipation
urinary retention
tachycardia
65
Q

What drugs can cause nystagmus?

A

phenytoin, carbamazepine, CNS depressants, ALCOHOL

66
Q

How do you test for nystagmus?

A

horizontal gaze nystagmus test (field sobriety test)

67
Q

What level of alcohol consumption can nystagmus occur?

A

low as 0.04%

68
Q

What drugs can cause visual, color changes, diplopia?

A

Voriconazole, anticholinergic, Ethambutol, digoxin

69
Q

Causes impaired night vision, and increase sensitivity to sunlight

A

Voriconazole

70
Q

Amiodarone causes what?

A

blue man syndrome

71
Q

Vancomycin causes what?

A

red man syndrome

72
Q

Rifampin causes what?

A

orange secretions

73
Q

Heparin causes what?

A

cytopenia induced antibody rxn

74
Q

FQ causes what?

A

tendinitis, tendon rupture, QT prolongation

75
Q

Metronidazole causes what?

A

disulfiram like rxn

76
Q

Amphotericin B causes what?

A

infusion rate rxn, hypotension, nephrotoxicity (4gm), histamine like rxn

77
Q

Phenytoin causes what?

A

gingival hyperplasia

78
Q

Clozapine causes what?

A

bone marrow effects, agranulocytosis

79
Q

What tumors are more responsive to Rx?

A

small tumors (high proliferating cell to non-diving cell)

80
Q

What does cancer therapy target?

A

signal transduction pathways that regulate cell proliferation and survival.

81
Q

Topoisomerase inhibitors

A

directly damage DNA

82
Q

Anthracyclines

A

directly damage DNA

83
Q

Antimetabolites

A

interferes w/ DNA precursors inhibits DNA synthesis

84
Q

Hormonal RX

A

influences hormone homeostasis

85
Q

Anti-tublin agents

A

blocks or promotes assembly of mircotubules

86
Q

Alkylating agents

A

directly damage DNA

87
Q

What drugs cause GI mucosa ulceration?

A

Methotrexate, 5-flurouracil, cisplatin

88
Q

What 4 rapidly diving cells do cancer drugs effect?

A

GI mucosa
Hair follicles
Ovary/ Testis
Bone Marrow

89
Q

When cancer cells target bone marrow it causes what common toxicity?

A

Myelosupression

90
Q

Best anti-emetics

A

5HT-3 antagonists, and NK1

91
Q

What is neutropenia?

A

<1,000/ul of neutrophils

92
Q

What is febrile neutropenia?

A

< 500/ul w/ fever

93
Q

What are signs of thrombocytopenia?

A

easing bruising, excessive gum bleeding

94
Q

What drugs can cause neurotoxicity?

A

alkylating agents, anti-tubuin: Vincristine, Vinblastine, taxanes

95
Q

What stimulates red cell formation?

A

erythropoietin

96
Q

What stimulates production of neutrophils?

A

filgrastim

97
Q

What stimulates production of platelets?

A

Oprelvekin (Il-11) and thrombopoietin

98
Q

What decrease MTX renal excretion?

A

NSAIDs, Sulfonamides, probenecid

99
Q

Accumulation of MTX can cause what?

A

crystalluria

100
Q

T/F Need to stay hydrated taking Methotrexate?

A

TRUE

101
Q

What can be used to “res-curable” cells from MTX admin?

A

Leucovorin (folinic acid)

102
Q

Ears toxicity?

A

cisplatin

103
Q

PNS toxicity?

A

Vincristine, Vinblastine

104
Q

Mouth toxicity?

A

MTX (secreted in saliva)
5-FU (deposited platinum in gums)
Imatinib (lichenoid rxn of buccal)
Adriamycin, Cyclophosphamide, 5-FU (salivary gland dysfunction)

105
Q

Heart toxicity?

A

doxorubicin

106
Q

Lung toxicity?

A

bleomycin, busulfan (high dose)

107
Q

Bladder toxicity?

A

ifosamide, cyclophosphamide

108
Q

Kidney toxicity?

A

cisplatin

109
Q

Antidote for ifosfamide?

A

Mesna

110
Q

Antidote for gout hyper-uricemia?

A

Allopurinol

111
Q

Why are chemotherapy often combined therapy?

A

produces additive or synergistic cytotoxicity

112
Q

What drugs can cause kidney nephrotoxicity?

A

Aminglycoside, Amp B, Cisplatin

113
Q

What drugs can cause tinnitus and hearing loss?

A

Aminglycoside, Vancomysin, Cisplatin, ETHACRYNIC ACID

114
Q

Orthostatic hypotension

A

alpha receptor antagonists

115
Q

Hot flashes

A

Tamoxifen

116
Q

Stevens Johnson syndrome

A

Abacavir, Sulfonamides, Carbamazepine, Phenytoin

117
Q

HLA-B1502

A

Carbamazepine

118
Q

Acne drug that causes teratogenic?

A

Accutane- Isotretinoin

119
Q

What antibody can still cause pregnancy?

A

Rifabutin

120
Q

Tooth discoloration, enamel hypoplasia, bone dysplasia

A

Tetracyclines

121
Q

Neonatal jaundice, hemolytic anemia

A

Sulfonamides (3rd trimester)

122
Q

Folate antagonist, C/I in 1st trimester

A

Trimethoprim

123
Q

Fetal otoxtoxicty

A

Aminglycosides

124
Q

Fetal cartilage damage

A

FQ

125
Q

Safe but C/I in 1st trimester

A

Metronidazole

126
Q

Only used for B. fragilis infection

A

Clindamycin

127
Q

Development of clef lip and palate

A

Benzo

128
Q

analgesic DOC for all trimesters

A

Acetaminophen

129
Q

What do nitroglycerin patches do?

A

prevent development of tolerance (Zopidem)

130
Q

Anatacids, milk, Ca2+

A

FQ

131
Q

Antidote for Warfarin?

A

Phytonadione, Factor IX, fresh plasma

132
Q

Antidote for Heparin

A

Protamine

133
Q

Antidote for Dabigatran

A

Idarucizumab

134
Q

Antidote for thrombolytic

A

alteplase

135
Q

Antidote for Benzo

A

Flumenazil

136
Q

Antidote for Digoxin

A

Digibind, DigFab

137
Q

Antidote for Acetaminophen

A

N-acetylcysteine (within 8-10hrs)

138
Q

Antidote for hypoglycemia

A

glucagon

139
Q

Antidote for cyclophosphamide

A

Mesna

140
Q

When is hemodialysis useful?

A

When the drug is confined to the plasma

141
Q

Antidote for opioid?

A

Narcone

142
Q

Unique property of Clozapine?

A

its a potent agonist causing salivation and a antagonist causing anticholinergic

Pharmacology 2 (9 decks)

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