BONE.SMOOTHM.ANTIMICROB Flashcards

1
Q

Available bisphosphonates

A

Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid

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2
Q

MOA of Bisphosphonates

A

Inhibits osteoclast bone resorption

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3
Q

Uses of bisphosphonates

A

Osteoporosis, Paget’s disease, and osteolytic bone lesions, and hypercalcemia from malignancy

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4
Q

Major SE of bisphosphonates

A

Chemical esophagitis

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5
Q

Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia

A

Etidronate

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6
Q

Used for prevention of postmenopausal osteoporosis in women

A

Calcium reguators Bisphosphonates: alendronate, risedronate, ibandronate, Estrogen (HRT-Hormone replacement therapy)

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7
Q

Increase bone density, also being tested for breast CA tx.

A

Raloxifene (SERM-selective estrogen receptor modulator)

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8
Q

Used intranasally and decreases bone resorption

A

Calcitonin (salmon prep)

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9
Q

Used especially in postmenopausal women, dosage should be 1500 mg

A

Calcium

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10
Q

Vitamin given with calcium to ensure proper absorption

A

Vitamin D

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11
Q

Disease caused by excess ergot alkaloids

A

St. Anthony’s Fire

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12
Q

A class of endogenous substances that include histamine, serotonin, prostaglandins, and vasoactive peptides that work in autocrine or paracrine manner

A

Autacoids

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13
Q

Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea

A

Zollinger-Ellison Syndrome

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14
Q

Drug that causes contraction of the uterus

A

Oxytocin

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15
Q

Distribution of histamine receptors H1, H2, and H3

A

Smooth muscle and mast cells; stomach, heart, and mast cells; nerve endings, CNS respectively

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16
Q

1st generation antihistamine that is highly sedating

A

Diphendydramine

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17
Q

1st generation antihistamine that is least sedating

A

Chlorpheniramine

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18
Q

2nd generation antihistamines

A

Fexofenadine, loratadine, and cetirizine

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19
Q

Generation of antihistamine that has the most CNS effects

A

First generation due to being more lipid-soluble

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20
Q

Major indication for H1 receptor antagonist

A

Use in IgE mediated allergic reaction (allergic rhinitis, urticaria)

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21
Q

Antihistamine that is indicated for allergies, motion sickness, and insomnia

A

Diphenhydramine

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22
Q

H1 antagonist used in motion sickness

A

Dimenhydrinate and other 1st generation

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23
Q

Most common side effect of 1st generation antihistamines

A

Sedation, anticholinergic

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24
Q

H2 blocker that causes the most interactions with other drugs

A

Cimetidine

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25
Q

Clinical use for H2 blockers

A

Acid reflux disease, duodenal ulcer and peptic ulcer disease

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26
Q

Receptors for serotonin (5HT-1) are located

A

Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance

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27
Q

Triptan available in parenteral and nasal formulation

A

Sumatriptan

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28
Q

H1 blocker that is also a serotonin antagonist

A

Cyproheptadine

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29
Q

5HT2 antagonist mediate synaptic excitation in the CNS and smooth muscle contraction

A

Ketanserin, cyproheptadine, and ergot alkaloids (partial agonist of alpha and serotonin receptors)

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30
Q

Agents for reduction of postpartum bleeding

A

Oxytocin and ergonovine

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31
Q

Agents used in treatment of carcinoid tumor

A

Cyproheptadine

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32
Q

5HT-3 antagonist used in chemotherapeutic induced

A

Ondansetron, granisetron, dolasetron and palonosetron

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33
Q

5ht-3 antagonist that has been MOST associated with QRS and QTc prolongation and should not be used in patients with heart disease

A

Dolasetron

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34
Q

Drug used in ergot alkaloids overdose, ischemia and gangrene

A

Nitroprusside

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35
Q

Reason ergot alkaloids are contraindicated in pregnancy

A

Uterine contractions

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36
Q

SE of ergot alkaloids

A

Hallucinations resembling psychosis

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37
Q

Ergot alkaloid used as an illicit drug

A

LSD

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38
Q

Dopamine agonist used in hyperprolactinemia

A

Bromocriptine

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39
Q

Peptide causing increased capillary permeability and edema

A

Bradykinin and histamine

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40
Q

Mediator of tissue pain, edema, inactivated by ACE, and may be a contributing factor to the development of angioedema

A

Bradykinin

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41
Q

Drug causing depletion of substance P (vasodilator)

A

Capsaicin

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42
Q

Prostaglandins that cause abortions

A

Prostaglandin E1 (misoprostol), PGE2, and PGF2alpha

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43
Q

Drug that selectively inhibits COX 2

A

Celecoxib

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44
Q

Inhibitor of lipoxygenase

A

Zileuton

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45
Q

Major SE of zileuton

A

Liver toxicity

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46
Q

Inhibitor of leukotrienes (LTD4) receptors and used in asthma

A

Zafirlukast and montelukast

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47
Q

Used in pediatrics to maintain patency of ductus arteriosis

A

PGE1 (Alprostadil)

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48
Q

Approved for use in severe pulmonary HTN

A

PGI2 (epoprostenol)

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49
Q

Prostaglandin used as 2nd line treatment of erectile dysfunction

A

PGE1 (Alprostadil)

50
Q

Irreversible, nonselective COX inhibitor

A

Aspirin (or other salicylates)

51
Q

Class of drugs that reversibly inhibit COX

A

NSAIDS

52
Q

Primary endogenous substrate for Nitric Oxidase Synthase

A

Arginine

53
Q

MOA and effect of nitric oxide

A

Stimulates cGMP which leads to vascular smooth muscle relaxation

54
Q

Long acting beta 2 agonist used in asthma

A

Salmeterol

55
Q

Muscarinic antagonist used in COPD

A

Ipratropium, tiotropium

56
Q

MOA action of cromolyn

A

Blocks opening of Cl channels to prevent mast cell degranulation

57
Q

Enzyme which theophylline inhibits

A

Phosphodiesterase

58
Q

Methylxanthine derivative used as a remedy for intermittent claudication

A

Pentoxifylline

59
Q

Antidote for severe CV toxicity of theophylline

A

Beta blockers

60
Q

MOA of corticosteroids

A

Induce lipocortins to

61
Q

SE of long term (>5 days) corticosteroid therapy and remedy

A

Adrenal suppression and weaning slowly, respectively

62
Q

MOA of fluoroquinolones

A

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV

63
Q

MOA of penicillin

A

Block cell wall synthesis by inhibiting transpeptidase and block peptidoglycan cross-linkage

64
Q

Drug used for MRSA

A

Vancomycin

65
Q

Vancomycin MOA

A

Binds D-Ala-D-Ala on murein monomers and prevent polymerization of the murein monomers

66
Q

Type of resistance found with vancomycin

A

Point mutation

67
Q

Meningitis prophylaxis in exposed patients

A

Rifampin

68
Q

Technique used to diagnose perianal itching, and the drug used to treat it

A

Scotch tape technique

69
Q

Two toxicities of aminoglycosides

A

nephro and ototoxicity

70
Q

Drug of choice for Legionnaires’ disease

A

Azithromycin (or macrolides)

71
Q

MOA of sulfonamides

A

Inhibit dihydropteroate synthase

72
Q

Penicillins active against penicillinase secreting bacteria

A

Methicillin, nafcillin, and dicloxacillin

73
Q

Cheap wide spectrum antibiotic DOC of otitis media

A

Amoxicillin

74
Q

Class of antibiotics that have 10% cross sensitivity with penicillins

A

Cephalosporins

75
Q

PCN active against pseudomonas

A

Carbenicillin, piperacillin and ticarcillin

76
Q

Antibiotic causing red-man syndrome, and prevention

A

Vancomycin, can be prevented by infusion

77
Q

Drug causes teeth discoloration

A

Tetracycline

78
Q

Mechanism of action of tetracycline

A

Decreases protein synthesis by binding to 30S ribosome and prevent binding of tRNA to A site

79
Q

Drug that causes gray baby syndrome and aplastic anemia

A

Chloramphenicol

80
Q

Drug notorious for causing pseudomembranous colitis

A

Clindamycin

81
Q

Drug of choice for tx of pseudomembranous colitis

A

Metronidazole

82
Q

Treatment of resistant pseudomembranous colitis

A

ORAL vancomycin

83
Q

Anemia caused by trimethoprim

A

Megaloblastic anemia

84
Q

Reason fluoroquinolones are contraindicated in children and pregnancy

A

Cartilage damage

85
Q

DOC for giardia, bacterial vaginosis, pseudomembranous colitis, and trichomonas

A

Metronidazole

86
Q

Treatment for TB patients (think RIPE)

A

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

87
Q

Metronidazole SE if given with alcohol

A

Disulfiram-like reaction

88
Q

Common side effect of Rifampin

A

Orange urine discoloration

89
Q

MOA of nystatin

A

Bind ergosterol in fungal cell membrane

90
Q

Neurotoxicity with isoniazid (INH) prevented by

A

Administration of Vit. B6 (pyridoxine)

91
Q

Toxicity of amphotericin

A

Nephrotoxicity

92
Q

SE seen only in men with administration of ketoconazole

A

Gynecomastia

93
Q

Topical DOC in impetigo

A

Topical mupirocin (Bactroban)

94
Q

DOC for influenza A and B

A

Oseltamivir or Zanamivir

95
Q

DOC for RSV

A

Ribavirin

96
Q

DOC for CMV retinitis

A

Ganciclovir

97
Q

SE for ganciclovir

A

Myelosuppression

98
Q

Anti-viral agents associated with Stephen Johnson syndrome

A

Nevirapine, amprenavir

99
Q

HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism

A

Protease inhibitors

100
Q

Antivirals that are teratogens

A

Delavirdine, efavirenz, and ribavirin

101
Q

Antivirals associated with neutropenia

A

Ganciclovir, zidovudine, saquinavir, interferon

102
Q

HIV med used to reduce transmission during birth

A

AZT (zidovudine)

103
Q

Drug used for African sleeping sickness

A

Suramin

104
Q

Drug used in Chagas disease

A

Nifurtimox

105
Q

Cephalosporins able to cross the BBB

A

Cefixime (2nd) and 3rd generation

106
Q

DOC for N. gonorrhea

A

Ceftriaxone

107
Q

Cephalosporins that cause kernicterus in neonates

A

Ceftriaxone or cefuroxime

108
Q

SE of INH

A

Peripheral neuritis and hepatitis

109
Q

Aminoglycoside that is least ototoxic

A

Streptomycin

110
Q

Drug used in exoerythrocytic cycle of malaria

A

Primaquine

111
Q

Oral antibiotic of choice for moderate inflammatory acne

A

Minocycline

112
Q

Drug of choice for leprosy

A

Dapsone

113
Q

DOC for herpes and its MOA

A

Acyclovir; activated by viral thymidine kinase, results in inhibition of viral DNA replication

114
Q

Anti-bacterials that cause hemolysis in G6PD-deficient patients

A

Sulfonamides

115
Q

Mechanism of action of macrolides (erythromycin, clarithromycin)

A

Inhibit protein synthesis by binding to domain V of 23S rRNA of 50S ribosome subunit

116
Q

Antibacterials for optimal treatment of acute uncomplicated cystitis

A

Nitrofurantoin, trimethoprim-sulfamethoxazole, fosfomycin

117
Q

Antibacterials for optimal treatment of acute pyelonephritis

A

Fluoroquinolones (ciprofloxacin, levofloxacin), trimethoprim-sulfamethoxazole

118
Q

Lactam that can be used in PCN allergic patients

A

Aztreonam

119
Q

SE of imipenem

A

Seizures

120
Q

Anti-viral with a dose limiting toxicity of pancreatitis

A

Didanosine (ddI)