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Block 3 Review Flashcards

1
Q

mechanism of action of amphotericin B

A

creates pores in cell membrane

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2
Q

how is toxicity of amphotericin B reduced

A

liposomal preparation
slow infusion rate

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3
Q

adverse effect of amphotericin B

A

nephrotoxicity

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4
Q

what antifungal crosses BBB and achieves good CSF

A

flucytosine

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5
Q

flucytosine mechanism of action

A

inhibition of thymidylate synthetase

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6
Q

azole mechanism of action

A

inhibition of 14alpha demethylase

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7
Q

ketoconazole mechanism of action

A

inhibition of microsomal enzymes

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8
Q

adverse effects of ketoconazole

A

endocrine effects (blocks androgen receptors)
disulfiram-like reaction

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9
Q

effect of good CSF permeability of fluconazole

A

useful in meningitis

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10
Q

fluconazole is mainly useful in __

A

candidal cystitis/candiduria
mucocutaneous candidiasis

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11
Q

posaconazole use

A

prophylactic for fungal infection in chemotherapy

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12
Q

echinocandins mechanism of action

A

inhibition of 1,3-beta glucan synthesis

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13
Q

capsofungin (echinocandin) use

A

disseminated and mucocutaneous candida infection

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14
Q

griseofulvin mechanism of action

A

binds to microtubules and prevents spindle formation, inhibition of fungal mitosis

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15
Q

griseofulvin adverse effect

A

disulfiram like reaction

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16
Q

terbinafine mechanism of action

A

inhibition of squalene epoxidase

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17
Q

terbinafine main use

A

onchomycosis

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18
Q

metronidazole mechanism of action

A

inhibition of DNA, RNA, and proteins by creating free radicals

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19
Q

uses of metronidazole and tinidazole

A

amebiasis
giardiasis
trich. vag.

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20
Q

metronidazole adverse reaction

A

peripheral neuropathy
disulfiram like reaction

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21
Q

iodoquinol treats what types of infections

A

luminal amebicide

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22
Q

amebic liver disease drug

A

chloroquine

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23
Q

adverse effect of emetine

A

cardiotoxicity

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24
Q

drug for asymptomatic E. histolytica cyst carriers

A

paromomycin/iodoquinol

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25
Q

drug for mild-severe intestinal amoebiasis E. histolytica

A

metronidazole/tinidazole with paromomycin/iodoquinol

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26
Q

drug for amebic liver abscess

A

metronidazole/tinidazole with chloroquine+paromomycin

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27
Q

DOC for t. gondii toxoplasmosis

A

pyrimethamine+sulfadiazine

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28
Q

DOC in pregnancy for toxoplasmosis T. gondii instead of pyrimethamine+sulfadiazine

A

spiramycin

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29
Q

DOC for early T. brucei/W. African trypanosomiasis

A

pentamidine

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30
Q

DOC for advanced E. African trypanosomiasis

A

melarsoprol

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31
Q

adverse reaction of melarsoprol

A

fatal reactive encephalopathy

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32
Q

drug for early or late W. African trypanosomiasis

A

flexinidazole

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33
Q

DOC for blood schizonticide anti-malarial

A

chloroquine

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34
Q

DOC for tissue schizonticide radial cure of P. ovale and P. vivax

A

primaquine/tafenoquine

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35
Q

DOC for malarial prophylactic

A

chloroquine

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36
Q

DOC for malaria in chloroquine reistant areas

A

mefloquine

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37
Q

DOC for malaria in multi drug resistant area

A

doxycycline

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38
Q

chloroquine mechanism of action

A

inhibition of heme polymerase

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39
Q

mechanism of chloroquine resistance

A

mutation of PfCRT gene–>decrease in efflux of the drug from the parasite

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40
Q

chloroquine adverse effect

A

visual disturbance (retinal damage)

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41
Q

drug of choice in chloroquine resistant and multidrug resistant P. falciparum

A

Artesunate

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42
Q

quinine adverse effect

A

cinchonism (tinnitus, vertigo)

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43
Q

mefloquine adverse effects

A

psychosis
seizures

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44
Q

pyrimethamine+sulfadoxine adverse reaction

A

megaloblastic anemia

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45
Q

artemisinin mechanism of action

A

production of free radicals

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46
Q

primaquine+tafenoquine adverse reaction

A

hemolysis in G6PD deficient

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47
Q

drug for visceral, mucocutaneous, and cutaneous leishmaniasis

A

sodium stibogluconate

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48
Q

albendazole, pyrantel palmoate, ivermectin, praziquantal, and diethylcarbamezine (DEC) are all what kind of drugs

A

antihelmintic

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49
Q

albendazole mechanism of action

A

inhibition of microtubule synthesis
inhibition of glucose uptake

*both lead to paralysis of the parasite

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50
Q

DOC for hydatid cystic disease, cysticercosis, and neurocysticercosis

A

albendazole

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51
Q

mechanism of action of pyrantel palmoate

A

enhance release of ACh
inhibit AChE
depolarize neuromuscular blocker

*produces spastic paralysis

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52
Q

DOC for onchocerca volvulus (river blindness) and strongyloidiasis

A

ivermectin

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53
Q

ivermectin adverse reaction

A

Mazotti-like reaction (an allergic reaction to dying microfilariae)

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54
Q

DOC for filariasis and tropical eosinophilia

A

diethylcarbamazine (DEC)

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55
Q

diethylcarbamazine (DEC) mechanism of action

A

modifies surface area proteins making them more prone to host cell apoptosis

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56
Q

praziquantel is the drug of choice for __ and __

A

flukes (trematodes)
cestodes (tapeworms)

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57
Q

what is administered after use of niclosamide

A

laxative

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58
Q

unfractionated heparin mechanism of action

A

binds and activates antithrombin III which then inactivates factor IIa and Xa

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59
Q

low molecular weight heparin mechanism of action

A

binds and activates antithrombin III which then in activates factor Xa

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60
Q

how is unfractionated heparin monitored

A

PTT

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61
Q

when is unfractionated heparin preferred over low molecular weight heparin

A

acute conditions due to its rapid onset

*ex: unstable angine, MI

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62
Q

when is low molecular weight heparin preferred over unfractionated heparin

A

to prevent a DVT or PE during prolonged bed rest, surgery, or fracture

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63
Q

how can excessive bleeding with heparin activity be reversed

A

use of protamine sulfate

64
Q

adverse effects of heparin

A

heparin induced thrombocytopenia (HIT)
inhibition of aldosterone synthesis
osteoporosis

65
Q

what occurs in heparin induced thrombocytopenia (HIT)

A

heparin, platelet factor 4, and Ab immune complex reduce the number of platelets

66
Q

what is the mechanism of action of fondaparinux

A

inhibition of factor Xa by antithrombin III

67
Q

warfarin mechanism of actions

A

inhibition of vitamin K epoxide reductase–>inhibition of synthesis of vitamin K clotting factors and protein C+S

68
Q

how is warfarin monitored

A

PT or international normalized ratio (INR)

69
Q

warfarin adverse reaction

A

skin necrosis

70
Q

how is excess bleeding with warfarin reduced

A

IV administration of vitamin K

71
Q

what type of drug is dabigatran

A

direct acting oral thrombin inhibitor

72
Q

what type of drug is rivaroxaban

A

direct acting oral factor Xa inhibitor

73
Q

rivaroxaban is used for treatment of what

A

PE, DVT, atrial fibrillation

74
Q

andexanet alpha use

A

reversal of life threatening bleeding due to a factor Xa inhibitor

75
Q

drug for non-valvular Afib

A

dabigatran

76
Q

fibrinolytic drugs mechanism of action

A

converts plasminogen to plasmin
plasmin degrades fibrin and fibrinogen causing clot dissolution

77
Q

drug for use in acute ischemic stroke

A

recombinant t-PA

78
Q

aspirin mechanism of action

A

inhibition of COX-1

79
Q

ticagrelor and cangrelor are both what class of drugs

A

antiplatelet

80
Q

dipyridamole mechanism of action

A

inhibition of phosphodiesterase
inhibition of inactivation of cAMP

81
Q

opioid analgesics mechanism of action

A

inhibition of pain transmitting neurons (ascending pain pathway) and activation of descending pain modulating pathway

82
Q

morphine is metabolized to M6G and M3G. what is M3G adverse effect

83
Q

adverse reactions of opioid analgesics

A

respiratory depression
pinpoint pupils
CTZ center stimulation
orthostatic hypotension
constipation

84
Q

what drug is used in dyspnea in pulmonary edema

A

IV morphine

85
Q

meperidine effect

A

antimuscarinic–>tachycardia

86
Q

pentazocine effect

A

stimulate sympathetic NS

87
Q

what opioid drug is preferred over morphine for labor pain

A

meperidine

88
Q

what opioid is used for shivering

A

meperidine

89
Q

triad of acute opioid poisoning

A

pinpoint pupils
respiratory depression
coma

90
Q

treatment for opioid poisoning

91
Q

drug used for opioid withdrawal and detoxification symptoms

A

buprenorphine with naloxone

92
Q

opioid analgesic contradictions

A

head injury
undiagnosed abdominal pain
during labor

93
Q

__ is used as substitution therapy of opioid dependence patients

94
Q

effect of meperidine use with MOA

A

serotonin syndrome

95
Q

tramadol mechanism of action

A

inhibition of reuptake of NE and serotonin

96
Q

use of tramadol

A

post-operative pain

97
Q

difference between naloxone and naltrexone in terms of duration of action

A

naloxone- short half life
naltrexone- long half life

98
Q

migraine prophylaxis drugs

A

methylprednisolone
onabotulinumtoxin A

99
Q

triptan action

A

terminate acute attack of migraine

100
Q

triptan mechanism of action

A

inhibition of vasodilating neurotransmitters
5-HT receptor agonists

101
Q

adverse effect of triptan migraine drugs

A

coronary vasospasm

102
Q

DOC for acute migraine attacks

A

sumatriptan

103
Q

addictive drugs act on what system

A

mesolimbic dopamine

104
Q

symptoms of nicotine withdrawal

A

irritability
anxiety
restlessness
difficulty concentrating
HA
insomnia

105
Q

nicotine treatment to reduce craving and assist in symptoms of withdrawal

A

bupropion and clonidine

106
Q

amphetamine mechanism of action

A

increase the release of NE, dopamine, and serotonin

107
Q

chronic use of phencyclidine (PCP) effects

A

delusions
hallucinations

108
Q

symptoms of LSD usage

A

impaired rational decision

109
Q

dronabinol and nabilone are what class of drug

A

cannabinoides

110
Q

dronabinol and nabilone can be used as a __ stimulant

111
Q

what type of drug is phenytoin

A

antiepileptic

112
Q

pharmokinetics of phenytoin

A

at low plasma concentration= 1st order kinetics
at higher therapeutic concentration= 0 order kinetics

113
Q

adverse effects of phenytoin

A

ataxia, nystagmus, diplopia, vertigo
gingival hyperplasia
hirsutism

114
Q

carbamazepine mechanism of action

A

prolongs inactivatd state of Na+ channels

115
Q

what antiepileptic drug can be used for maniac depressive psychosis

A

carbamazepine

116
Q

adverse effects of carbamazepine

A

agranulocytosis
spina bifida if taken during pregnancy
Steven Johnson syndrome

117
Q

what allele is at increased risk of Steven Johnson syndrome

118
Q

sodium valproate antiepileptic mechanism of action

A

blocks T type Ca2+ channels
inhibits GABA transaminase
prolongs inactivation of Na+ channel

119
Q

adverse effects of sodium valproate

A

hepatotoxicity
pancreatitis
spina bifida if taken during pregnancy

120
Q

a mutation in what gene increases the risk of developing fatal sodium valproate hepatotoxicity

121
Q

what type of drug is ethosuxmide

A

anticonvulsant

122
Q

ethosuximide mechanism of action

A

inhibition of T-type Ca2+ channels in thalamocortical neurons

123
Q

ethosuximide is used for what type of seizures

A

absence (especially in kids)

124
Q

what type of drug is lamotrigine

A

anti-convulsant

125
Q

lamotrigine mechanism of action

A

blocks Na+ and Ca2+ channels

126
Q

adverse effect of lamotrigine

A

Steven Johnson syndrome

127
Q

what type of drug is topiramate

A

anticonvulsant

128
Q

adverse effects of topiramate

A

loss of appetite weight loss
cognitive impairment

129
Q

what type of drug is levetiracetam

A

antiepileptic

130
Q

levetiracetam mechanism of action

A

reduces the release of glutamate

131
Q

gabapentin and pregabalin use

A

antiepileptic

132
Q

gabapentin and pregabalin mechanism of action

A

binds to alpha2delta subunit of P/Q type Ca2+ channel decreasing the release of glutamate

133
Q

besides seizures, gabapentin and pregabalin can be used for __

A

neuropathic pain

134
Q

felbamate use

A

anticonvulsant

135
Q

felbamate mechanism of action

A

blocks NMDA receptors

136
Q

vigabatrin mechanism of action

A

irreversible inhibitor of GABA transaminase

137
Q

use of vigabatrin

A

infantile spasm (West syndrome)

138
Q

vigabatrin adverse effect

A

retinal damage

139
Q

tiagabine mechanism of action

A

blocks uptake of GABA into presynaptic neurons

140
Q

zonisamide adverse effects

A

inhibition of carbonic anhydrase

141
Q

zonisamide adverse effect

A

Steven Johnson syndrome

142
Q

drug of choice for status epilepticus

A

benzodiazepines (diazepam or lorazepam)

143
Q

if benzodiazepines don’t work for status epilepticus, what is the next drug of choice

A

fosphenytoin

144
Q

benzodiazepines preferred in the elderly

A

lorazepam
oxazepam
temazepam

145
Q

why are lorazepam, oxazepam, and temazepam benzodiazepines preferred in the elderly

A

they have no 1st phase metabolism

146
Q

adverse effects of benzodiazepines

A

daytime drowsiness
respiratory depression

147
Q

benzodiazepine respiratory depression is exacerbated in patients with ___

A

obstructive sleep apnea

148
Q

do short or long acting benzodiazepines cause more abrupt and sever

149
Q

what drug class can cause floppy baby syndrome

A

benzodiazepines

150
Q

drug used for benzodiazepine toxicity

A

flumazenil

151
Q

Z drug (zolpidem, zaleplon, zopiclone) mechanism of action

A

act on BZ1 receptor (GABA A receptor)

152
Q

main use of Z drugs instead of benzodiazepines

A

treat insomnia

153
Q

barbiturates mechanism of action

A

increase duration of GABA A gated chloride channel opening

154
Q

benzodiazepines or barbiturates to treat neonatal jaundice

A

barbiturates

155
Q

barbiturate use contraindicated in __

A

acute intermittent porphyria

156
Q

treatment for acute barbiturate poisoning

A

forced alkaline diuresis

157
Q

buspirone drug class

A

anti-anxiety

Pharmacology (16 decks)

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