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Pharm Formulas > Cleanup > Flashcards

Cleanup Flashcards

1
Q

Inhaled corticosteroids

A

Fluticasone, budesonide

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2
Q

Long lasting beta 2 agonists for asthma

A

Salmeterol, formoterol

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3
Q

Theophylline need

A

Inhibition of bronchodilation by inhibiting phosphodiesterase and increasing cAMP, narrow therapeutic window

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4
Q

Clomiphene

A

Antagoinst of estrogen receptors in hypothalamus preventing the normal feedback inhibition and leading to increased release of LH and FSH from the pituitary which stimulates ovulation

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5
Q

Tamoxifen

A

Estrogen antagonist at breast and an agonist at bone and uterus; increases risk of thromboembolic events and endometrial cancer

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6
Q

Raloxifene

A

Antagonist at breast, uterus; agonist at bone; increased risk of thromboembolic events but no increased risk of endometrial cancer; used to treat osteoporosis

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7
Q

Aromatase inhibitors

A

Anastrozole, letrozole, exemastane

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8
Q

Mechanism of aromatoase inhibitors and use

A
  • Mech: Inhibit peripheral conversion of androgens to estrogen
  • Use: ER + breast cancer in post menopausal women
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9
Q

Minoxidil side effects

A

Used as an arteriolar vasodilator; causes androgenic alopecia, severe hypertension

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10
Q

Finasteride

A

5 alpha reductase inhibitor used for BPH and male pattern baldness

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11
Q

Flutamidre

A

Nonsteroidal competitive inhibitor at androgen receptors. Used for prostate carcinoma

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12
Q

Ketoconazole

A

Inhibits steroid synthesis

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13
Q

Spironolactone

A

Inhibits steroid binding

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14
Q

Side effects of ketoconazole and spironolactone

A

Gynecomastia and amenorrhea

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15
Q

Epinephrine and brimonidine uses for glaucoma

A
  • Epi is alpha 1, briomidine is alpha 2
  • Decreased aqueous huumor synthesis via vasoconstriction (epi)
  • Decreased aqueous humor synthesis (brimonidine)
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16
Q

TImolol, betaxolol, carteolol

A

Decreased aqueous humor synthesis

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17
Q

tazolamide

A

Decreased aqueous humor synthesis via inhibition of carbonic anhydrase

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18
Q

Bimatoprost and latanoprost for glaucoma

A

Increased outflow of aqueous humor via decreased resistance to flow therough uveoscleral pathway; can cause darkening of the iris, eyelash growth

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19
Q

When does dressler syndrome occur

A

Occurs several weeks after MI. Autoimmune phenomenon resulting in fibrinous pericarditis

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20
Q

Ivabradine mech and AE

A
  • Mech: Selective inhibition of funny sodium channels prolonging the slow depolarization phase and decreased SA node firing and a negative chronotropic effect
  • AE: Luminous phenomena/visual brightness, hypertension, bradycardia
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21
Q

Terbinafine AE

A

GI upset, headaches, hepatotoxicity, taste disturbance

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22
Q

Which 3rd gen cephalosporin can kill pseudomonas

A

Ceftazidime

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23
Q

Which cephalosporin can cover pseudomonas

A

Cefepime

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24
Q

Antiviral drugs NRTIs

A
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25
Q

NNRTIs

A

END

  • Efavirenz
  • Nevirapine
  • Delavirdine
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26
Q

Protease inhibitor AE

A

Hyperglycemia, lipodystrophy, GI intolerance

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27
Q

Metformin mechanism

A

Decreased gluconeogenesis, increased glycolysis, increased peripheral glucose uptake

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28
Q

What is cilostazol and dipyridamole used for?

A

Intermittent claudication, coronary vasodilation, prevention of stroke or TIAs

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29
Q

What kind of hallucinations are a common feature of medical illness rather than psuchiatric

A

Visual; auditory is usually psychiatric

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30
Q

Membranous nephropathy has what kind of appearance on microscopy?

A
  • IF: Granular as a result of immune complex deposition. Nephrotic presentation of SLE
  • LM: GBM thickening
  • EM: Spike and dome
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31
Q

Microscopic appearance of FSGS

A
  • LM: segmental sclerosis and hyalinosis
  • IF: can be positive for nonspecific focal deposits of IgM, C3, C1
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32
Q

Minimal change disease microscopic appearance

A
  • LM: Normal glomeruli
  • IF: negative
  • EM: effacement of foot processes
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33
Q

Diffuse proliferative glomerulonephritis appearance

A
  • LM: Wire looping of capillaries
  • EM: Subendothelial IgG based ICs often with C3 deposition
  • IF: Granular
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34
Q

Acute poststreptococcal glomerulonephritis appearance

A
  • LM: Glomeruli enlarged and hypercelllar
  • IF: Starry sky appearance due to IgG, IgM, C3 deposition
  • EM: Subepithelial immune complex humps
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35
Q

What stage of sleep occurs in sleep terror disorder?

A

N3 when the person is cannot move

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36
Q

How long does it take for buspar to take effect? How does it work?

A

Stimulates 5HT1A receptors; takes about 2 weeks to work

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37
Q

Osteosarcome

A
  • Common malignant bone tumor
  • Codmans triangle on sunburst pattern on x-ray
  • Aggressive, resect immediately
  • Metaphysis of long bones
  • Young and old bimodal distribution
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38
Q

Giant cell tumor is also known as….

A

Osteoclastoma

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39
Q
A
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40
Q

What occurs in antiphospholipid syndrome?

A

Anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, abortions and arterial thrombosis

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41
Q

What are the actions of acitominophen

A

Antipyretic, analgesic but NOT antinflammatory

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42
Q

NSAIDs are

A

Antipyretic, antiinflammatory, and analgesic

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43
Q

What must be present for the diagnosis of autism spectrum disorder to be made?

A

Childhood presentation. Repetitive ritualize behaviors, poor social interactions, social communication deficits, restricted interests

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44
Q

What is the definition of a hypomanic episode

A

Like a manic episode except mood disturbance is not severe enough to cause marked impairmetn in social and/or occupational functioning or to necessitte hospitalization

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45
Q

Membranoproliferative glomerulonephritis

A

Tram track appearance on MPAS stain and H&E stain due to GBM sl=plitting caused by mesangial ingrowth

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46
Q

Type II membranoproliferative glomerulonephritis

A

C3 nephrritiic factor causing a dense deposit disease

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47
Q

Most common tracheoesophageal fistula

A

COnnection of the distal end

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48
Q

Best way to shorten the duration of the flu?

A

Oseltamivir or zanamivir taken within 48 hours of onset

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49
Q

Adverse effects of foscarnet

A
  • Nephrotoxicity
  • Hyper or hypophosphatemia
  • Hypo or hypercalcemia
  • Hypokalemia
  • Hypomagnesmia
  • Seizures
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50
Q

Indinavir specifically AE

A

Nephropathy ,hematuria, thrombocytopenia

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51
Q
A
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52
Q

A wave cause

A

atrial contraction leading to a closed tricuspid valve bulging into the atrium

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53
Q

C wave cause

A

RV contraction against a closed tricuspid valve leading to bulding into the atrium

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54
Q

V wave cause

A

Increased right atrial pressure due to filling against a closed tricuspid valve

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55
Q

Y descent cause

A

RA emptying into RV. Prominent ni constrictive pericarditis and absent in cardiac tamponade

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56
Q

Class 1A uses

A

Both atrial and ventricular arrhythmias especially a reenty circuit and ectopic SVT and VT

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57
Q

Class 1C uses

A

SVTs including afib. Only a last resort

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58
Q

Class1B uses

A

Decreased AP duration for ischemic or depolarized purkinje and ventricular tissue

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59
Q

Hydralazine mech and sue

A
  • Increase cGMP leading to smooth muscle relaxation. Dilates arterioles more than veins to reduce afterload
  • Use: severe hyertension HF, safe during pregnancy
  • Usually coadministered with a beta blocker to prevent reflex tachycardia
60
Q

What are the reasons for the increased cortisol in cushing syndrome?

A
  • Exogenous corticosteroids decreasing ACTH and leading to bilateral atrophy
  • Adrenal adenoma, hyperplasia, or carcinoma causing decreased ACTH and atrophy of the uninvolved adrenal gland
  • ACTH secreting pituitary adenoma: increased ACTH and bilateral adrenal hyperplasia
61
Q

What is the reason for exopthalmos in graves disease?

A

Thyroid stimulating immunoglobulin stimulates TSH receptors on the thyroid BUT also the dermal fibroblasts leading to the pretibial myxedema seen early, but also the infiltration of activated T cells into the retroorbital space which stimulate fibroblasts whic deposit GAGs

62
Q

What occurs in larson syndrome

A

Defective growth hormone receptors and decreased linear growth. Increased GH is seen and decreased IGF1. Short height, small head circumference, saddle nose and prominent forehead

63
Q

Mech and use of cyclobenzaprine

A
  • Mech: Structurally related to TCAs, similar antichoniergic side effects, centrally acting skeletal muscle relaxant
  • Use: Muscle spasm
64
Q

Baclofen

A

GABAb receptor activator in the spinal cord eliminating muscle spasms and helping with MS

65
Q

What is the main difference between tamoxifen and raloxifene

A

Tamoxifen has increased risk of endometrial cancer

66
Q
A
67
Q

What do macrolides treat

A
  • Atypical pneumonia (mycoplasma, chlamydia, legionella)
  • STIs (Chlamydia)
  • Gram + cocci (streptococcal infections in patients allergic to penicillin)
  • Pertussis
68
Q

AE of macrolides

A

MACRO

  • Motility issues (diarrhea)
  • Arrhythmia (QT)
  • Chloestatic hepatitis
  • Rash
  • eOsinophilia
69
Q

Flucytosine mech

A
  • Inhibits DNA and RNA biosynthesis by conversion to 5FU by cytosine deaminase
  • Treats sustemic fungal infections in combination with Amphotericin B
70
Q

What does mitral or tricuspid regurg sound like?

A

Holosystolic blowing murmur

  • Mitral radiates to the axilla
  • Tricuspid is loudest in the tricuspid area
71
Q

Best antiarrhythmic to give post MI

A

1B

72
Q

What are the beta blockers in class II

A

Metoprolol, propranolol, esmolol, atenolol, timolol, carvedilol

73
Q

Which beta blocker can cause:

  • Dyslipidemia:
  • Vasospasm
A
  • Dyslipidemia: Metoprolol
  • Vasospasm: Propranolol
74
Q

Fludrocortisone

A

Aldosterone analog with little to no glucocorticoid effects used for mineralocorticoid replacement in primary insufficiencyt

75
Q

Wilson disease details

A
  • AR
  • ATPase copper transporter on chromosome 13
  • Decreased copper excretion of ble and incorporation into apoceruloplasmin
  • Copper accumulates in liver brain cornea and kidneys
76
Q

What is the cause of primary hemochromatosis

A

Increased intestinal iron absorption

77
Q
A
78
Q

SLE drugs

A

SHIPP-E

  • Sulfa drugs
  • Hydralazine
  • Isoniazid
  • Procainamide
  • Phenytoin
  • Etanercept
79
Q

Drugs that cause coombs positive hemolytic anemia

A

Methyldopa, penicillin

80
Q

What is the symptoms of whipple disease?

A
  • PAS+ foamy macrophages
  • Cardiac symptoms
  • ARthralgias
  • Neurologic symptoms common
81
Q

Waht are the symptoms of hemochromatosis as it progresses?

A
  • Cirrhosis
  • diabetes mellitus
  • skin pigmentation
  • Restrictive cardiomyopathy, dilated cardiomyoathy,
  • hypoghonadism
  • arthropathy
  • HCC
82
Q

Triad of Multiple sclerosis

A

Scanning speech

Intentino tremor and Internuclear opthalmoplegia

Nystagmus

83
Q

Tramadol mechanism and side effects

A
  • Mech: K opioid receptor agonist and mu agonist to produce analgesia
  • Can cause withdawal symptoms if patient is also take full agonist
  • Overdose not easily reversed
84
Q

Pentazocine

A
  • Mech: K agonist and mu weak antagonist or partial agonist
  • AE: Can cause withdrawal if patient is taking full antagoinst
85
Q

Names of nondepolarizing NMJ blockers

A

Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium (CUR in name)

86
Q

How do you reverse a nondepolarizing NMJ drug?

A

Neostigmine given with atropine to prevent muscarinic side effects, edrophonium, other cholinesterase inhibitors

87
Q

MAOIs

A

Tranylcypromine, phenelzine, isocarboxazid, selegiline

88
Q

How long do you wait after stopping MAO inhibitors before starting serotonergic drugs or stopping dietary restrictions

A

2 weeks

89
Q
A
90
Q

First generation antihistamines

A

Diphenhydramine, dimenhydrinate, chlorpheniramine

91
Q

Second generation antihistamines

A

Loratidine, fexofenadine, desloratadine, cetrizine

92
Q

Adverse effects seen in antihistamines

A

Sedation, antimuscarinic, anti-alpha adrenergic

93
Q

Anticholinergic side effects

A

Blind as a bat (dilation), mad as a hatter, hot as a hare, red as a beet

94
Q

1B antipsychotics

A

Lidocaine, MexileTine

95
Q

What are the two retroviruses

A
96
Q

What are the two retroviruses

A

HTLV and HIV

97
Q

Danazol

A

Synthetic androgen that acts as partial agonist at androgen receptors for treataing endometriosis and hereditary angioedema

98
Q

Ceftaroline covers

A

Listeria, MRSA, E faecalis, but not Pseudomonas

99
Q

When do you want to use rifabutin instead of rifampin?

A

When youre also using a protease inhibitor

100
Q

Use of alpha methyldopa

A

Hypertension in pregnancy, but can cause coombs + hemolysis, SLE like syndrome

101
Q

Atropine overdose drug

A

Physostigmine

102
Q

Pyridostigmene use

A

Gets RID of MG myasthenia gravis

103
Q

Neostigmene

A

Urinary retention, myasthenia gravis, reversal of NMJ blockade, doesnt cross CNS

104
Q
A
105
Q

Which diabetic drugs are weighy neutral

A

Gliptans

106
Q

What diabetes drugs cause weight gain?

A

Sulfonylureas, glitazones, meglitinindes

107
Q

Which glomerular disease has IgG, IgM and C3 deposits?

A

Acute poststreptococcal glomerulonephritis

108
Q

Deposits seen in focal segmental glomerulosclerosis

A

IgM, C3 and C1

109
Q

Which lung tumor produces PTHrP

A

Squamous cell

110
Q

Small cell lung cancer is marked by

A

Neuroendocrine kulchitsky cells, chromogranin A, neuron specific enolase

111
Q

Turner syndrome

A

CLOWNS

  • Coarctation of aorta
  • Lymphedema
  • Ovarian streaks
  • Webbed neck
  • Nips Spread out
  • Short
  • ALSO CYSTIC HYRGOMA
  • DECREASED ESTROGEN LEADS TO INCREASED LH AND FSH
112
Q

Klinefelter syndrome

A

KLINEF

  • Kryptochidism
  • Leydig hyeprtrophy
  • Increased gonadotrophs
  • Negative chromatic
  • Elongeated legs
  • Failure of secondary sex characterstics
113
Q

features of 46 XX DSD

A
  • Ovaries present, but external genitalia virilized or ambiguous due to excessive or inappropriate exposure to androgenic steroids during early gestation
114
Q

46XY DSD

A
  • Testes present but external genitalia are female or ambiguous most common form is androgen insensitivity syndrome
115
Q

Androgen insensitivity syndrome

A

Defect in androgen leading to a normal appearing femal with femal external genitalia with scant pubic hair, a rudimentary vagina, uterus and fallopian tubes absent

116
Q

Aromatase deficiency

A

Inability to synthesize estrogens from androge leading to masculinization of an XX female and increased testosterone and androstenedione

117
Q
A
118
Q

What is toxic multinodular goiter

A

Focal patches of hyperfunctioning follicular cells distendd with colloid working independently of TSH. Hot nodules rarely malignant

119
Q

Bedwetting treatment

A

Oral desmopressin

120
Q

Order of nerve blockade of local anesthetics

A

Small myelinated then small unmyelinated then large myelinated then large unmyelinated

121
Q

In an alkalilne environment, will an acidic anesthetic be able to penetrate?

A

No it will need a higher concentration to achieve effect

122
Q

SAME

A

Symptom of apparent mineralocorticoid excess

  • Deficincy in 11 beta hydroxysteroid dehydrogenase which normally converts cortisol to cortisone.
  • Excess cortisol in theses cells from enzyme deficiency leads to hypertension, hypokalemia, and metabolic alkalosis with LOW ALDOSTERONE LEVELS
  • Comes from glycyrrhetinic acid (licorice)
123
Q

Licorice disease

A

Hypokalemia, metabolic alkalosis, low aldosterone, SAME

124
Q

Meglitinides mechanism

A

Stimulate insulin release by binding to K+ channels on beta cell membranes (similar to sulfonylureas but at a different site

125
Q

What is the mechanism of glitazones?

A

Increased insuln sensitivity in peripheral tissue by binding to the PPAR-y transcription regulator

126
Q

Fibrates mechanism

A
  • Upregulate LPL leading to clearance of triglycerides
  • Activates PPAR-alpha to induce synthesis of HDL
127
Q

PCSK9 inhibitors mechanism

A

Inactivation of LDL degradation increasing the amount of LDL removed from the blood

128
Q

Staples of hypertension treatment regardless of what it is paired with

A
  • Diuretics (commonly thiazides)
  • ACE/ARBs
  • Calcium channel blockers
129
Q

MUST BE GIVEN to hypertension patients with diabetes

A

ACE inhibitors or ARBs

130
Q

What are the side effects seen with nonDHPs

A

AV block, cardiac depression, hyperprolactinemia, constipation

131
Q

What are the effects of nitrates on

  • :End diastolic volume:
  • Blood pressure:
  • Contractility:
  • HR:
  • Ejection time
  • MVO2
A
  • :End diastolic volume: decreased
  • Blood pressure: decreased
  • Contractility: no effect
  • HR: increased (reflex)
  • Ejection time: Decreasd
  • MVO2: Decreased
132
Q

Effects of beta ablockers on:

  • :End diastolic volume:
  • Blood pressure:
  • Contractility:
  • HR:
  • Ejection time
  • MVO2
A
  • :End diastolic volume: no effect or increased
  • Blood pressure: decreased
  • Contractility: decreased
  • HR: decreased
  • Ejection time: increased
  • MVO2: decreased
133
Q

Effects of nitrates and beta blockers on

  • :End diastolic volume:
  • Blood pressure:
  • Contractility:
  • HR:
  • Ejection time
  • MVO2
A
  • :End diastolic volume: no effect or decreased
  • Blood pressure: decrease
  • Contractility: no effect
  • HR: no effect
  • Ejection time no effect
  • MVO2: decreased
134
Q

Beta 1 selective blockers

A

acebutolol, atenolol, betaxolol, bisoprolol, esmolol, metoprolol (first half of the alphabet)

135
Q

Nonselective beta blockers

A

nadalol, pindolol, propranolol, timolol (second half of the alphabet)

136
Q

Cidofovir use and AE

A
  • Inhibits DNA polymerase and does not require phosphorylation
  • CMV retinitis in immunocompromised patients
  • HSV resistant to acyclovir
  • AE: nephrotoxicity
137
Q

How is shigella and yersinia distinguished between salmonella and proteus

A

H2S production on TSI agar

138
Q

Symptoms of babesiosis

A

fever and hemolytic anemia in the northeastern united states as a result of a bite from the ixodes tick

139
Q

Cardiac myxomas are usually composed of

A

Gelatinous material, myxoma cells immersed in glycosaminoglycans

140
Q

Ranolazine mech

A
  • Inhibit late phase of sodium current recuding diastolic wall tension and oxygen consumption
  • AE: Can cause constpiation, dizziness, headache, nausea, QT prolongation
141
Q

Adenosine mechanism

A

Increased k+ out of cells leading to hyperpolarization and decreasing AV nodal conduction

142
Q
A
143
Q

What is seen in SIADH?

A

Excessive water retention, euvolemic hyponatremia with combined urinary Na+ excretion. Urine osmolality>serum osmolality

144
Q

How does the body respond to SIADH

A

Dedcreasing aldosterone and increasing ANP and BNP, leading to euvolemic hyponatremia.

145
Q
A

Pharm Formulas (10 decks)

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