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dr taher classes HK > CVS 7 > Flashcards

CVS 7 Flashcards

1
Q

zero order kinetics drugs

A 
WATTP
Warfarin 
Aspirin
Theophyline
Tolbutamide ( first gen sulfonylurea)
Phenytoin
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2
Q

failure of therapy caused by enzyme inducer or inhibitors

A

INDUCER

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3
Q

list of enzyme inducers

A

My New GPRS Cell Phone
Modanifil —- increase DA (narcolepsy ADHD)
Nevirapine —– NNRTI
Griseofulvin —– microtubules
Phenytoin —– Na in heart and brain
Rifampin —— Rna polym II
Smoking/ St john wart ——— increase 5HT
Carbamezapine (na-) and CHRONIC alcohol
Phenobarbital —— GABA duration cl- channels

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4
Q

what is the eukaryotic RNA polymerase inhibitor

A

Amantina phelloides death cap mushroom

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5
Q

most common types of RNA

A

R rna—— I
M rna—— II
T rna —— III

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6
Q

CYP 450 inhibitors 3A4 most common type

A 
Sodium valproate  Na - / gaba transaminase -/ t  typ ca
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Acute alcohol / avirs / amiodarone ( 5' deiodinase)
Chloramphenicol / cipro/ clarythro
Erythromycin
Sulfa --------- dehypteroate synthase
C
Omeprazole
Metronidazole
Grapefruit juice
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7
Q

tiagabine MOA

A

blocks reabsp of GABA

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8
Q

Gabapentin

A

acts on GABA receptors +ve

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9
Q

vigabatrin

A

gaba transaminase inhibitor
GABA doesnt break down —– increase levels of GABA

for infantile spasms

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10
Q

sodium valproate

A

gaba transaminase inhibitor
Na channels inhib
t type calcium channels

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11
Q

pregabalin

A

increases releae of GABA

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12
Q

Chemical mediators are divided into CELLULAR AND PLASMA

what are the plasma ones?

A

made in liver
complement
kinin
clotting

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13
Q

Cellular chemical mediators

A

PREFORMED
hsitamine
serotonin
lysosomal enzymes

FRESHLY FORMED
prostaglandins
leukotreines
cytokines
nitric oxide PAF
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14
Q

TLR CD 14

A

Gram negative endotoxin

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15
Q

cytokines and mast cells degenerate to make

A

hsitamines

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16
Q

how do steroids function

A

induce lipocortin —– breaks PLP to AA

innactivating NF-κB
NF-κB is the transcription factor that induces the production of TNF-α and other inflammatory agents

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17
Q

antibodies against PLP A2

the enzyme that breaks PLP to AA

A

membranous nephropathy

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18
Q

lipoxigenase inhibiotor drug

A

zileuton

highly hepatotoxic

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19
Q

blocks leukotreine receptors

A

zafirleukast moteleukast

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20
Q

Prostacyclin PGI2 function and drug name

A

inhibits platelet agg
EPOPROSTENOL
ILOPROST

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21
Q

Prostaglandins PGE1

A

decrease vascular tone

ALPROSTADIL

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22
Q

PGE2

A

increase uterine tone
pain
pyrexia
DINOPROSTONE

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23
Q

PGF2 alpha

A

increase uterine tone

CARBOPROST

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24
Q

Thromboxane 2

A

increase platelet agg
increase vascular tone
ASPIRIN ihibits this

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25
Q

LOX pathway makes LTB4 and LTC D E 4

A

LTB4 —– neutrophil chemotaxis

LTC D E 4 —— vasodialation and increase bronchial tone

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26
Q

chemotactic agents include

A 
LTB4 
IL 8 
C5a
Kallikrenin 
formyl methionine
27
Q

what are the physiological functions of COX 1

A

gastric mucose protection
increase renal perfusion
platelett aggregation

28
Q

COX 2 has physiological and pathological functions

A

PHYSIOLOGICAL
increase renal perf
vasodialation
tissue repair

PATHOLOGICAL
increase pain sensitivity
inflammation

29
Q

asprin induced asthma mechanism

A

blocks COX 1 2 …. shifts towards LOX —— LTC D E 4 increase and case bronchospams

30
Q

drugs that inhibit mast cell degranulation

A

cromolyn
nedocromil
ketotifen

31
Q

igE INDEPENDENT mast cell degranulation

A

morphine opiods
Vancomycin
Radiocontrast

histamine bradykinin released —- localised swelling and urticaria

32
Q

what activates teh classical pathway

A

IgG and IgM

33
Q

C3 derivatives

A

C3a —— anaphylotoxin

C3b —– opsonin IgG

34
Q

what are the three pathways of complement cascade

A

classical —- IgM IgG
lecithin——- mannose binding lecithin C4
alternate—– spontaneous C3

35
Q

c1 c2 c4 c3 ——-

A

c5b6-9– MAC

mac is cytotoxic

36
Q

mac can also bind to self cells like RBC and WBC but normally what blocks this?

A

PIGA gene is responsible for formation of GPI ( glycosyl phosphatidyl inositol )
this makes DAF ( CD55) and MIRL ( CD59)

these prvent complent mediated desctruction

37
Q

paroxysmal nocturnal hemoglobinemia

A

normocytic anemia

at night because of shallow breathing—- retntion of CO2 — acidic ph activates ALTERNATIVE pathway

38
Q

PNH what can be seen in this condition

A

dark urine hemoglobinuria
decrease haptoglobin levels
hemosiderinuria

PLT microthrombi —- hepatic vein thrombosis— budd chiari

39
Q

hemosiderin laden macrophages can be seen in

A

heart failure

40
Q

what is the most common cause of budd chiari

A

polycythemia vera

41
Q

c1 esterase def

A

hereditary angioedema

42
Q

treatment for hereditary angioedema

A

DANAZOL

ECALLANTIDE

43
Q

which drugs to avoid in pts with HAE

A

ACEi

sacubitril

44
Q

If funny channels

A

IVABRIDINE

increases BP
visual brightness
bradycardia

45
Q

what is the function of neprilysin

A

breaks down ANP BNP and ang II

46
Q

what is the function of Ag II

A

increases aldosterone which increases Na and dec K+
constricts efferent arteriole
ADH secretion

47
Q

sacubitril must be given with ? and why

A

ARBS
because AgII levels also increase
ANP and AgII will work against each other

48
Q

what are teh side effects of sacubitril

A

decrease BP
hypokalemia
angioedema

49
Q

Captopril side effects

A 
Cough
Angioedema
Pregnancy CI ----- renal failure/ potter seq
Taste disturbance 
Orthostatic hypoT
Prodrugs (activate in liver)
RAS 
Increase K contraindication ( ACE i increases K)
Lowers ag II formation
50
Q

deficiency in C2 C4

A

risk of pyogenic infections and increase risk of AUTOIMMUNE disease

51
Q

def in C5-C9

A

increase risk of infection due to nisseria and txoplasma

52
Q

neprilysin breaks down

A

substance p and bradykinin
so when neprilysin is blocked by sacubitril these increase
substance p —- pain
bradykinin —- angioedema

53
Q

steps of leukocyte extravasation

A 
Margination
Rolling 
Adhesion 
Transmigration (DIAPEDESIS)
Chemotaxis
Opsonization
Phagocytosis
O2 dep killing
54
Q

Margination cell adhesion molecules include

vasculature and leukocyte

A

VASCULATURE
P selectin
E selectin
L selectin

LEUKOCYTE
sialyl lewis

55
Q

E L selectin

A

IL 1 TNF alpha

56
Q

P selectin

A

released from weibel palade bodies

57
Q

what else is secreted from weibel palade bodies

A

VWF

can be induced by desmopressin

58
Q

Adhesion molecules

vasculature and leukocytes

A

VASCULATURE
ICAM 1 CD54
VCAM 1 CD 106

LEUKOCYTES
CD 11/18 integrin

59
Q

what induces integrin

A

C5a

LTB4

60
Q

Transmigration diapedesis

vasculature and leukocytes

A

VASCULATURE
PECAM 1 CD31

LEUKOCYTES
PECAM 1

61
Q

Migration

A 
LTB4 
C5a
IL8
kallikrein
platelet activating factor
62
Q

CGD and the tests

A 
def in NADPH oxidase 
XLR
nitrobluetetrazolium test ---- blue test positive means no deficiency

DHR test —- O2 —> O2- requires NADPH oxidase
O2- is needed to convert DHR —> rhodamine

so in NADPH oxidase def no O2- is made hence no rhodamine made so INCREASE IN DHR

63
Q

organisms that can cause infection in CGD

A 
catalse +ve 
Cats Need PLACESS to Belch their Hairballs
Candida
Nocardia
Pseudomonas
Listeria
Aspergillus
Candida
E coli
Staph
Serratia
Burkolderia cepaciae
H.pylori
64
Q

O2 independent mechanism of killing

A

major basic protein
lactoferrin
lysozyme (tears /saliva)

dr taher classes HK (24 decks)

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