Block 3 Review Flashcards
1
Q
mechanism of action of amphotericin B
A
creates pores in cell membrane
2
Q
how is toxicity of amphotericin B reduced
A
liposomal preparation
slow infusion rate
3
Q
adverse effect of amphotericin B
A
nephrotoxicity
4
Q
what antifungal crosses BBB and achieves good CSF
A
flucytosine
5
Q
flucytosine mechanism of action
A
inhibition of thymidylate synthetase
6
Q
azole mechanism of action
A
inhibition of 14alpha demethylase
7
Q
ketoconazole mechanism of action
A
inhibition of microsomal enzymes
8
Q
adverse effects of ketoconazole
A
endocrine effects (blocks androgen receptors)
disulfiram-like reaction
9
Q
effect of good CSF permeability of fluconazole
A
useful in meningitis
10
Q
fluconazole is mainly useful in __
A
candidal cystitis/candiduria
mucocutaneous candidiasis
11
Q
posaconazole use
A
prophylactic for fungal infection in chemotherapy
12
Q
echinocandins mechanism of action
A
inhibition of 1,3-beta glucan synthesis
13
Q
capsofungin (echinocandin) use
A
disseminated and mucocutaneous candida infection
14
Q
griseofulvin mechanism of action
A
binds to microtubules and prevents spindle formation, inhibition of fungal mitosis
15
Q
griseofulvin adverse effect
A
disulfiram like reaction
16
Q
terbinafine mechanism of action
A
inhibition of squalene epoxidase
17
Q
terbinafine main use
A
onchomycosis
18
Q
metronidazole mechanism of action
A
inhibition of DNA, RNA, and proteins by creating free radicals
19
Q
uses of metronidazole and tinidazole
A
amebiasis
giardiasis
trich. vag.
20
Q
metronidazole adverse reaction
A
peripheral neuropathy
disulfiram like reaction
21
Q
iodoquinol treats what types of infections
A
luminal amebicide
22
Q
amebic liver disease drug
A
chloroquine
23
Q
adverse effect of emetine
A
cardiotoxicity
24
Q
drug for asymptomatic E. histolytica cyst carriers
A
paromomycin/iodoquinol
25
drug for mild-severe intestinal amoebiasis E. histolytica
metronidazole/tinidazole with paromomycin/iodoquinol
26
drug for amebic liver abscess
metronidazole/tinidazole with chloroquine+paromomycin
27
DOC for t. gondii toxoplasmosis
pyrimethamine+sulfadiazine
28
DOC in pregnancy for toxoplasmosis T. gondii instead of pyrimethamine+sulfadiazine
spiramycin
29
DOC for early T. brucei/W. African trypanosomiasis
pentamidine
30
DOC for advanced E. African trypanosomiasis
melarsoprol
31
adverse reaction of melarsoprol
fatal reactive encephalopathy
32
drug for early or late W. African trypanosomiasis
flexinidazole
33
DOC for blood schizonticide anti-malarial
chloroquine
34
DOC for tissue schizonticide radial cure of P. ovale and P. vivax
primaquine/tafenoquine
35
DOC for malarial prophylactic
chloroquine
36
DOC for malaria in chloroquine reistant areas
mefloquine
37
DOC for malaria in multi drug resistant area
doxycycline
38
chloroquine mechanism of action
inhibition of heme polymerase
39
mechanism of chloroquine resistance
mutation of PfCRT gene-->decrease in efflux of the drug from the parasite
40
chloroquine adverse effect
visual disturbance (retinal damage)
41
drug of choice in chloroquine resistant and multidrug resistant P. falciparum
Artesunate
42
quinine adverse effect
cinchonism (tinnitus, vertigo)
43
mefloquine adverse effects
psychosis
seizures
44
pyrimethamine+sulfadoxine adverse reaction
megaloblastic anemia
45
artemisinin mechanism of action
production of free radicals
46
primaquine+tafenoquine adverse reaction
hemolysis in G6PD deficient
47
drug for visceral, mucocutaneous, and cutaneous leishmaniasis
sodium stibogluconate
48
albendazole, pyrantel palmoate, ivermectin, praziquantal, and diethylcarbamezine (DEC) are all what kind of drugs
antihelmintic
49
albendazole mechanism of action
inhibition of microtubule synthesis
inhibition of glucose uptake
*both lead to paralysis of the parasite
50
DOC for hydatid cystic disease, cysticercosis, and neurocysticercosis
albendazole
51
mechanism of action of pyrantel palmoate
enhance release of ACh
inhibit AChE
depolarize neuromuscular blocker
*produces spastic paralysis
52
DOC for onchocerca volvulus (river blindness) and strongyloidiasis
ivermectin
53
ivermectin adverse reaction
Mazotti-like reaction (an allergic reaction to dying microfilariae)
54
DOC for filariasis and tropical eosinophilia
diethylcarbamazine (DEC)
55
diethylcarbamazine (DEC) mechanism of action
modifies surface area proteins making them more prone to host cell apoptosis
56
praziquantel is the drug of choice for __ and __
flukes (trematodes)
cestodes (tapeworms)
57
what is administered after use of niclosamide
laxative
58
unfractionated heparin mechanism of action
binds and activates antithrombin III which then inactivates factor IIa and Xa
59
low molecular weight heparin mechanism of action
binds and activates antithrombin III which then in activates factor Xa
60
how is unfractionated heparin monitored
PTT
61
when is unfractionated heparin preferred over low molecular weight heparin
acute conditions due to its rapid onset
*ex: unstable angine, MI
62
when is low molecular weight heparin preferred over unfractionated heparin
to prevent a DVT or PE during prolonged bed rest, surgery, or fracture
63
how can excessive bleeding with heparin activity be reversed
use of protamine sulfate
64
adverse effects of heparin
heparin induced thrombocytopenia (HIT)
inhibition of aldosterone synthesis
osteoporosis
65
what occurs in heparin induced thrombocytopenia (HIT)
heparin, platelet factor 4, and Ab immune complex reduce the number of platelets
66
what is the mechanism of action of fondaparinux
inhibition of factor Xa by antithrombin III
67
warfarin mechanism of actions
inhibition of vitamin K epoxide reductase-->inhibition of synthesis of vitamin K clotting factors and protein C+S
68
how is warfarin monitored
PT or international normalized ratio (INR)
69
warfarin adverse reaction
skin necrosis
70
how is excess bleeding with warfarin reduced
IV administration of vitamin K
71
what type of drug is dabigatran
direct acting oral thrombin inhibitor
72
what type of drug is rivaroxaban
direct acting oral factor Xa inhibitor
73
rivaroxaban is used for treatment of what
PE, DVT, atrial fibrillation
74
andexanet alpha use
reversal of life threatening bleeding due to a factor Xa inhibitor
75
drug for non-valvular Afib
dabigatran
76
fibrinolytic drugs mechanism of action
converts plasminogen to plasmin
plasmin degrades fibrin and fibrinogen causing clot dissolution
77
drug for use in acute ischemic stroke
recombinant t-PA
78
aspirin mechanism of action
inhibition of COX-1
79
ticagrelor and cangrelor are both what class of drugs
antiplatelet
80
dipyridamole mechanism of action
inhibition of phosphodiesterase
inhibition of inactivation of cAMP
81
opioid analgesics mechanism of action
inhibition of pain transmitting neurons (ascending pain pathway) and activation of descending pain modulating pathway
82
morphine is metabolized to M6G and M3G. what is M3G adverse effect
seizures
83
adverse reactions of opioid analgesics
respiratory depression
pinpoint pupils
CTZ center stimulation
orthostatic hypotension
constipation
84
what drug is used in dyspnea in pulmonary edema
IV morphine
85
meperidine effect
antimuscarinic-->tachycardia
86
pentazocine effect
stimulate sympathetic NS
87
what opioid drug is preferred over morphine for labor pain
meperidine
88
what opioid is used for shivering
meperidine
89
triad of acute opioid poisoning
pinpoint pupils
respiratory depression
coma
90
treatment for opioid poisoning
naloxone
91
drug used for opioid withdrawal and detoxification symptoms
buprenorphine with naloxone
92
opioid analgesic contradictions
head injury
undiagnosed abdominal pain
during labor
93
__ is used as substitution therapy of opioid dependence patients
methadone
94
effect of meperidine use with MOA
serotonin syndrome
95
tramadol mechanism of action
inhibition of reuptake of NE and serotonin
96
use of tramadol
post-operative pain
97
difference between naloxone and naltrexone in terms of duration of action
naloxone- short half life
naltrexone- long half life
98
migraine prophylaxis drugs
methylprednisolone
onabotulinumtoxin A
99
triptan action
terminate acute attack of migraine
100
triptan mechanism of action
inhibition of vasodilating neurotransmitters
5-HT receptor agonists
101
adverse effect of triptan migraine drugs
coronary vasospasm
102
DOC for acute migraine attacks
sumatriptan
103
addictive drugs act on what system
mesolimbic dopamine
104
symptoms of nicotine withdrawal
irritability
anxiety
restlessness
difficulty concentrating
HA
insomnia
105
nicotine treatment to reduce craving and assist in symptoms of withdrawal
bupropion and clonidine
106
amphetamine mechanism of action
increase the release of NE, dopamine, and serotonin
107
chronic use of phencyclidine (PCP) effects
delusions
hallucinations
108
symptoms of LSD usage
impaired rational decision
109
dronabinol and nabilone are what class of drug
cannabinoides
110
dronabinol and nabilone can be used as a __ stimulant
appetite
111
what type of drug is phenytoin
antiepileptic
112
pharmokinetics of phenytoin
at low plasma concentration= 1st order kinetics
at higher therapeutic concentration= 0 order kinetics
113
adverse effects of phenytoin
ataxia, nystagmus, diplopia, vertigo
gingival hyperplasia
hirsutism
114
carbamazepine mechanism of action
prolongs inactivatd state of Na+ channels
115
what antiepileptic drug can be used for maniac depressive psychosis
carbamazepine
116
adverse effects of carbamazepine
agranulocytosis
spina bifida if taken during pregnancy
Steven Johnson syndrome
117
what allele is at increased risk of Steven Johnson syndrome
HLA 15:02
118
sodium valproate antiepileptic mechanism of action
blocks T type Ca2+ channels
inhibits GABA transaminase
prolongs inactivation of Na+ channel
119
adverse effects of sodium valproate
hepatotoxicity
pancreatitis
spina bifida if taken during pregnancy
120
a mutation in what gene increases the risk of developing fatal sodium valproate hepatotoxicity
POLG
121
what type of drug is ethosuxmide
anticonvulsant
122
ethosuximide mechanism of action
inhibition of T-type Ca2+ channels in thalamocortical neurons
123
ethosuximide is used for what type of seizures
absence (especially in kids)
124
what type of drug is lamotrigine
anti-convulsant
125
lamotrigine mechanism of action
blocks Na+ and Ca2+ channels
126
adverse effect of lamotrigine
Steven Johnson syndrome
127
what type of drug is topiramate
anticonvulsant
128
adverse effects of topiramate
loss of appetite weight loss
cognitive impairment
129
what type of drug is levetiracetam
antiepileptic
130
levetiracetam mechanism of action
reduces the release of glutamate
131
gabapentin and pregabalin use
antiepileptic
132
gabapentin and pregabalin mechanism of action
binds to alpha2delta subunit of P/Q type Ca2+ channel decreasing the release of glutamate
133
besides seizures, gabapentin and pregabalin can be used for __
neuropathic pain
134
felbamate use
anticonvulsant
135
felbamate mechanism of action
blocks NMDA receptors
136
vigabatrin mechanism of action
irreversible inhibitor of GABA transaminase
137
use of vigabatrin
infantile spasm (West syndrome)
138
vigabatrin adverse effect
retinal damage
139
tiagabine mechanism of action
blocks uptake of GABA into presynaptic neurons
140
zonisamide adverse effects
inhibition of carbonic anhydrase
141
zonisamide adverse effect
Steven Johnson syndrome
142
drug of choice for status epilepticus
benzodiazepines (diazepam or lorazepam)
143
if benzodiazepines don't work for status epilepticus, what is the next drug of choice
fosphenytoin
144
benzodiazepines preferred in the elderly
lorazepam
oxazepam
temazepam
145
why are lorazepam, oxazepam, and temazepam benzodiazepines preferred in the elderly
they have no 1st phase metabolism
146
adverse effects of benzodiazepines
daytime drowsiness
respiratory depression
147
benzodiazepine respiratory depression is exacerbated in patients with ___
obstructive sleep apnea
148
do short or long acting benzodiazepines cause more abrupt and sever
short
149
what drug class can cause floppy baby syndrome
benzodiazepines
150
drug used for benzodiazepine toxicity
flumazenil
151
Z drug (zolpidem, zaleplon, zopiclone) mechanism of action
act on BZ1 receptor (GABA A receptor)
152
main use of Z drugs instead of benzodiazepines
treat insomnia
153
barbiturates mechanism of action
increase duration of GABA A gated chloride channel opening
154
benzodiazepines or barbiturates to treat neonatal jaundice
barbiturates
155
barbiturate use contraindicated in __
acute intermittent porphyria
156
treatment for acute barbiturate poisoning
forced alkaline diuresis
157
buspirone drug class
anti-anxiety
