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Buzzwords 2 Flashcards

1
Q

MOA - bind cyclophilin, inhibit calcineurin -> prevent IL-2 transcription -> block T-cell activation

A

Cyclosporine

MOA

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2
Q

MOA - bind FK506 binding protein (FKBP), inhibit calcineurin -> prevent IL-2 transcription -> block T-cell activation

A

Tacrolimus (FK506)

MOA

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3
Q

MOA - binds FKBP, inhibits mTOR -> prevent

response to IL-2 -> block T-cell activation and B-cell differentiation

A

Sirolimus (rapamycin)

MOA

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4
Q

Compare the AE of cyclosporin, tacrolimus, and sirolimus.

A

Cyclosporine and tacrolimus both cause nephrotoxicity. Sirolimus does NOT.

Cyclosporine causes gingival hyperplasia and hirsutism. Tacrolimus does NOT.

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5
Q

Which drug is synergistic with Cyclosporine?

A

Sirolimus

Synergistic with what drug?

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6
Q

MOA - Ab against IL-2 receptor

A

Basiliximab

MOA

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7
Q

MOA - reversible inhibition of IMP dehydrogenase -> prevents purine synthesis in B and T cells

A

Mycophenolate mofetil

MOA

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8
Q

Immunosuppressant associated with invasive CMV infection

A

Mycophenolate mofetil

Unique association

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9
Q

MOA of corticosteroids

A

Inhibit NFKB (pro-inflammatory transcription factor) -> suppress both B and T cell function by decreasing transcription of cytokines; also induces T cell apoptosis

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10
Q

What recombinant cytokine may be used to treat anemia, especially in renal failure?

A

EPO

Epoietin alfa (EPO analog)

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11
Q

What recombinant cytokines may be used to treat leukopenia and recovery granulocyte and monocyte counts?

A

Colony stimulating factors

Filgrastim (G-CSF) and Sargramostim (GM-CSF)

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12
Q

What recombinant cytokines may be used to treat AI thrombocytopenia?

A

Thrombopoietin

Romiplostim (TPO analog)
Eltrombopag (TPO receptor antagonist)

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13
Q

Name of recombinant IL-2?

A

Aldesleukin

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14
Q

Uses of IL-2?

A

RCC, metastatic melanoma

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15
Q

Uses of IFN-alpha?

A

Chronic hepatitis C (not first line) and B, RCC

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16
Q

Use of IFN-beta?

A

MS

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17
Q

Rx - CGD?

A

IFN-gamma

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18
Q

Alemtuzumab - target?

A

CD52

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19
Q

Bevacizumab - target?

A

VEGF

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20
Q

Cetuximab - target?

A

EGFR

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21
Q

Rituximab - target?

A

CD20

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22
Q

Trastuzumab - target?

A

HER2

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23
Q

Adalimumab - target?

A

Soluble TNF-alpha

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24
Q

Certolizumab - target?

A

Soluble TNF-alpha

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25
Q

Golimumab - target?

A

Soluble TNF-alpha

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26
Q

Infliximab - target?

A

Soluble TNF-alpha

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27
Q

Daclizumab - target?

A

CD25 (part of IL-2 receptor)

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28
Q

Eculizumab - target?

A

C5 (complement)

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29
Q

Natalizumab - target?

A

Alpha-4-integrin (plays a role in WBC adhesion)

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30
Q

Ustekinumab - target?

A

IL-12/IL-23

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31
Q

Abciximab - target?

A

GP 2b/3a

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32
Q

Denosumab - target?

A

RANKL

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33
Q

Digoxin immune Fab - target?

A

Digoxin

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34
Q

Omalizumab - target?

A

IgE

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35
Q

Palivizumab - target?

A

RSV F protein

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36
Q

Important use of bevacizumab?

A

Colorectal cancer

also RCC, non-small cell lung cancer, neovascular-related eye problems

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37
Q

Important use of cetuximab?

A

Stage IV colorectal cancer

also head and neck cancer

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38
Q

Important uses of trastuzumab?

A

Breast cancer and gastric cancer

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39
Q

Why does it make sense that rituximab is used for cancers like B-cell NH lymphoma and CLL?

A

Anti-CD20 (found on B cells)

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40
Q

How is etanercept different from soluble TNF-alpha antibodies?

A

It is a decoy TNF-alpha receptor, not a monoclonal Ab

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41
Q

Important use of daclizumab?

A

Relapsing MS

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42
Q

Important use of eculizumab?

A

Paroxysmal nocturnal hemoglobinuria

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43
Q

Antiplatelet agent for prevention of ischemic complications in patients undergoing percutaneous coronary intervention?

A

Abciximab (anti-GP2b3a)

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44
Q

Important use of Denosumab?

A

Osteoporosis (inhibits osteoclast maturation by mimicking OPG)

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45
Q

Important use of Omalizumab?

A

Refractory allergic asthma (prevents IgE binding to Fc-E-receptor)

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46
Q

Important use for Palivizumab?

A

RSV prophylaxis for high-risk infants

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47
Q

Which two immunosuppressants are specifically used to prevent KIDNEY transplant rejection?

A

Sirolimus

Basiliximab

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48
Q

Med used instead of aspirin to avoid Reye syndrome in children with a viral infection?

A

Acetaminophen

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49
Q

Aspirin toxicity - early vs. late effects on pH?

A

Early - respiratory alkalosis

Late - mixed metabolic acidosis-respiratory alkalosis

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50
Q

MOA - reversibly inhibits dihydroorotate dehydrogenase, preventing pyrimidine synthesis -> suppress T-cell proliferation

A

Leflunomide

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51
Q

MOA - bisphosphonates?

A

Pyrophosphate analogs that bind hydroxyapatite in bone, inhibiting osteoclast activity

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52
Q

AE - esophagitis (if taken orally, patient should sit upright for 30 minutes)

A

Bisphosphonates

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53
Q

AE - osteonecrosis of the jaw

A

Bisphosphonates

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54
Q

MOA - recombinant PTH analog used to increase osteoblastic activity when administered in a pulsatile fashion

A

Teriparatide

55
Q

Compare the effects of bisphosphonates vs. teriparatide.

A

Bisphosphonates are anti-resorptive

Teriparatide is pro-bone growth

56
Q

AE - increased risk of osteosarcoma?

A

Teriparatide (thus contraindicated in Paget disease or unexplained ALP elevation)

57
Q

Compare acetaminophen, aspirin, celecoxib, and NSAIDs regarding MOA.

A

Anti-pyretic: acetaminophen, intermediate dose aspirin, NSAIDs (NOT celecoxib)

Analgesic - all (intermediate dose aspirin)

Anti-platelet - only low-dose aspirin

Anti-inflammatory - all (high-dose aspirin) EXCEPT acetaminophen

58
Q

Arachadonic acid pathway

A
  1. Membrane phospholipids -> arachidonic acid (via phospholipase A2)
    2a. Arachidonic acid -> 5-HPETE -> Leukotrienes via 5-lipoxygenase
    2b. Arachidonic acid -> cyclic endoperoxides -> prostacyclin, prostaglandins, and thromboxane via COX1 and COX2
59
Q

Effect of glucocorticoids on arachidonic acid pathway

A
  1. Inhibit Phospholipase A2

2. Activate IKB -> inhibits NF-kappa B (thus inhibiting its activating effect on COX2)

60
Q

Compare COX1 and COX2.

A

COX1 - constitutive, found in GI, kidney, platelets, endothelium

COX2 - inflammatory sites only, temporal

61
Q

Compare TXA2 and PGs.

A

TXA2 - clotting, vasoconstriction

PGs - prevent clotting, vasodilation

62
Q

MOA - inhibits reabsorption of uric acid in proximal convoluted tubule

A

Probenecid

63
Q

MOA - allopurinol

A

Competitive inhibitor of XO -> decreased conversion of hypoxanthine and xanthine to urate

64
Q

Which drugs does allopurinol increase the concentration of?

A

Azathioprine and 6-MP

65
Q

MOA - recombinant uricase catalyzing uric acid to allantoin (more water-soluble)

A

Pegloticase

66
Q

MOA - inhibits XO

A

Febuxostat

67
Q

Rx - chronic gout (preventive)

A

Probenecid
Allopurinol*
Pegloticase
Febuxostat*

(Prevent a Painful Flare)

[Also colchicine]

68
Q

Rx - acute gout

A

NSAIDs (any)
Glucocorticoids
Colchicine

69
Q

MOA - binds and stabilizes tubulin -> inhibits microtubule polymerization -> impairs neutrophil chemotaxis and degranulation

70
Q

First line treatment for status epilepticus?

A

Benzodiazepines

71
Q

First line treatment for prophylaxis of recurrent status epilepticus

72
Q

What is the only other drug indicated for status epilepticus?

A

Phenobarbitol

73
Q

First line treatment for epilepsy in babies?

A

Phenobarbitol

74
Q

First line treatment for seizures in eclampsia? Other option?

A

MgSO4; benzodiazepines

75
Q

Most epilepsy drugs can be used to treat partial (focal) seizures. Which drug is commonly used? Which drugs are NOT indicated?

A

Common - carbamazepine

NOT indicated - benzos, ethosuximide

76
Q

Most epilepsy drugs can be used to treat tonic-clonic seizures. Which drugs are commonly used? Which drugs are NOT indicated?

A

Common - valproic acid, phenytoin

NOT indicated - benzos, ethosuximide, gabapentin, tiagabine, topiramate, vigabatrin

77
Q

First line treatment - trigeminal neuralgia?

A

Carbamazepine

78
Q

Which drug is commonly used to treat absence seizures? What are two other alternatives?

A

Common - ethosuximide

Other - lamotrigine, VPA

79
Q

Which epilepsy drugs affect (generally increase) GABA action?

A
  1. Benzodiazepines
  2. Phenobarbitol
  3. Tiagabine (inhibits reuptake)
  4. Topiramate
  5. Valproic acid
  6. Vigabatrin
80
Q

Which epilepsy drugs increase GABA by inhibiting GABA transaminase? Which of these is irreversible?

A

Valproic acid, vigabatrin (irreversible)

81
Q

Which epilepsy drugs act by blocking calcium channels?

A

Ethosuximide (thalamic T-type channels)

Gabapentin (high-voltage)

82
Q

Which epilepsy drugs inhibit Na+ channels?

A 
Carbamazepine
Lamotrigine (also inhibits release of glutamate)
Phenytoin
Topiramate
Valproic acid
83
Q

Epilepsy drug with AE - permanent visual loss?

A

Vigabatrin

84
Q

Patients on which epilepsy drug should have their LFTs monitored?

85
Q

Compare MOA of barbiturates and benzodiazepines.

A

Both facilitate GABA-A action

Barbiturates - increase duration of chloride channel opening

Benzos - increased frequency of chloride channelingn opening

86
Q

Short-acting benzos with a higher addictive potential?

A

ATOM (Alprazolam, Triazolam, Oxazepam, Midazolam)

87
Q

Benzos with minimal first pass metabolism (can be used in elderly, patients with liver disease0?

A

LOT (Lorazepam, Oxazepam, Temazepam)

88
Q

Rx - OD of benzodiazepines?

A

Flumazenil

Also reverses effects of non-benzo hypnotics

89
Q

MOA - melatonin receptor agonist, binds MT1 nd MT2 in suprachiasmatic nucleus

90
Q

Which insomnia medication has no risk of dependence?

A

Ramelteon

Suvorexant has “no or low” dependence

91
Q

MOA - hypocretin (orexin) receptor antagonist

A

Suvorexant

92
Q

MOA - bind BZ1 subtype of the GABA receptor

A

Zolpidem, Zaleplon, Eszopiclone

93
Q

Drugs used to treat Parkinson disease?

A 
Bromocriptine
Amantadine
Levodopa (w/carbidopa)
Selegiline (and COMT inhibitors)
Antimuscarinics

BALSA

94
Q

MOA - dopamine agonist (ergot and non-ergot)?

A

Ergot - bromocriptine

Non-ergot - pramipexole, ropinirole

95
Q

MOA - increased dopamine availability via increased release and decreased reuptake?

A

Amantadine

96
Q

MOA - prevent dopamine breakdown?

A

Selegiline (inhibit MAO-B)

Entacapone (inhibit central COMT)

97
Q

Anti-muscarinics used in Parkinson disease to curb excess cholinergic activity?

A

Benztropine
Trihexyphenidyl

(Improves tremor and rigidity, little effect on bradykinesia)

98
Q

Rx - increase survival in ALS?

A

Riluzole (decreases neuron glutamate excitotoxicity)

99
Q

Rx - Huntington chorea and tardive dyskinesia?

A

VMAT inhibitors (tetrabenazine, reserpine)

100
Q

AChE inhibitors used to treat AD?

A

Donepezil, rivastigmine, galantamine

101
Q

NMDA receptor antagonist used to treat AD?

102
Q

Which types of anesthetics have rapid induction and recovery?

A

Decreased blood solubility

103
Q

Minimal alveolar concentration?

A

[inhaled asthetic] required to prevent 50% of subjects from moving in response to a noxious stimulus

104
Q

Why does N2O (nitrous oxide) have fast induction and low potency?

A

Decreased blood solubility

Decreased lipid solubility

105
Q

Fever and severe muscle contractions induced by inhaled anesthetics or succinylcholine

A

Malignant hyperthermia

106
Q

Rx - malignant hyperthermia?

A

Dantrolene

107
Q

Which IV anesthetic decreases cerebral blood flow?Which increases it?

A

Decrease - thiopental

Increase - ketamine

108
Q

Which three drugs are used to treat glaucoma by decreasing aqueous humor synthesis?

A
  1. Beta-blockers (timolol, betaxolol, carteolol)
  2. Alpha-agonists (epinephrine, apraclonidine, brimonidine)
  3. Diuretics (acetazolamide)
109
Q

Which 2 drugs are used to treat glaucoma by increasing outflow of aqueous humor?

A

Prostaglandins (decreased resistance of flow thru uveoscleral pathway)

M3 cholinomimetics (direct - pilocarpine, carbachol, indirect - physostigmine, echothiophate) (contraction of ciliary muscle, opening of trabecular meshwork)

110
Q

Which glaucoma drug is CONTRAindicated in closed-angle glaucoma?

A

Alpha-1 agonists (cause mydriasis)

111
Q

AE (glaucoma drug) - browning of iris + eyelash growth

A

Prostaglandins

112
Q

Rx - acute angle closure glaucoma

A

Pilocarpine

113
Q

H2 blocker with lots of AE effects

A

Cimetidine (CYP450 inhibitor, anti-androgenic, cross BBB, cross placenta, decrease excretion of creatinine)

114
Q

Which antacid causes constipation? Which causes diarrhea?

A

Constipation - aluminum hydroxide

Diarrhea - magnesium hydroxide

115
Q

Drug used for prevention of NSAID-induced peptic ulcers?

A

Misoprostol (PGE1 analog)

116
Q

MOA - combination of sulfapyridine (antibacterial) and 5-aminosalicyclic acid (anti-inflamatory), activated by colonic bacteria?

A

Sulfasalazine

117
Q

Indication - sulfasalazine?

A

UC, Crohn disease (colitis component)

118
Q

List the 2 bulk-forming laxatives.

A

Psyillium, methylcellulose

119
Q

List the 4 osmotic laxatives.

A

Mg hydroxide, Mg citrate, polyethylene glycol, lactulose

120
Q

How is lactulose, an osmotic laxative, also used to treat hepatic encephalopathy?

A

Gut flora degrade it into metabolites (lactic and acetic acid) that promote nitrogen excretion

121
Q

1 stimulant laxative

A

Senna (stimulates enteric nerves)

122
Q

AE - melanosis coli

123
Q

1 emollient

124
Q

List the 3 first generation H1 blockers.

A

Diphenhydramine
Dimenhydrinate
Chlorpheniramine

125
Q

List the 4 second generation H1 blockers.

A

Loratadine
Fexofenadine
Desloratadine
Cetirizine

126
Q

Major differences between first and second generation H1 blockers?

A

1st - used for allergy, motion sickness, and sleep aid

2nd - used for allergy only

1st - sedation, antimuscarinic, and anti-alpha-adrenergic effects
2nd - less sedating (less entry into CNS)

127
Q

MOA - expectorant that things respiratory secretions, but does not suppress cough reflex

A

Guaifenesin

128
Q

MOA - mucolytic that disrupts disulfide bonds, used in COPD and CF

129
Q

MOA - anti-tussive that antagonizes NMDA glutamate receptors

A

Dextromethorphan

130
Q

List the 2 alpha-adrenergic agonists used as nasal decongestants

A

Pseudoephedrine, phenylephrine

131
Q

List 3 drugs that can treat pulmonary hypertension.

A
  1. Endothelin receptor antagonists
  2. PDE5 inhibitors
  3. Prostacyclin analogs
132
Q

First line treatment for chronic asthma

A

Inhaled corticosteroids (fluticasone, budesonide)

133
Q

Indication - prevention of bronchospasm (NOT acute bronchodilation)

A

Mast cell stabilizers (cromolyn, nedocromil)

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