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Drugs Flashcards

1
Q

What happens to Calcium in Thiazide Diuretics? Name One

other uses of Thiazide diuretics

A

Block NaCl symporter in DCT = increased excretion of NA, Cl, H2O

THEREFORE=> Increase Calcium Reabsorption from Nephron, Use in Nephrolithiasis (excess Ca in urine).

Hydrochlorothiazide

Edema due to CHF, renal disease, liver disease

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2
Q

Side Effects of Thiazide Diuretics

A

Hypokalemia, Hypomagnesmia, sometimes hypercalemia/Hyponatremia

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3
Q

What kind of Drug is Mannitol?

How does it work?

SE?

A

OSMOTIC DIURETIC

increasing plasma or tubular fluid osmolality- extraction of waterof water from the interstitial space into the vascular or tubular lumen with diuresis.

Pulmonary edema

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4
Q

What steriod does Spirinolactone act on? functions as what type of drug?

A

Aldosterone Antagonist= Mild Diuretic, K+ sparing diuretic.

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5
Q

What side effect of Spirinolactone is seen in 10% of patients? What property of the drug yields this efffect.

A

Steroid side effect gives rise to Gynecomastia ~10%

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6
Q

What drug does Eplenerone act like? how is it different?

A

Spirinolactone (both Aldosterone antagonist), LESS ENDOCRINE EFFECTS

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7
Q

Triameterene is what kind of drug? MOA?

A

K+ sparing diuretic, Blocks NA Channels in distal tubule/collecting duct. => Na and Fluid excretion

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8
Q

t1/2=?

A

(Vd x 0.70)/CL

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9
Q

Mu Opiod receptor activation includes 4 secondary messenger pathways

A

inhibition of adenylyl cyclase
inhibition of calcium conductance
inhibition of transmitter release
activation of Potassium channel efflux

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10
Q

Potassium efflux at the post synaptic neuron will cause what?

which drug does this?

A

efflux=> hyperpolarization of postsynapic neurons and termination of pain transmission

MORPHINE

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11
Q

p450 Inducers

A 
Barbiturates 
phenytoin
rifampin 
carbamazepine
griseofulvin
chronic alchohol
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12
Q

p450 inhibitors

A 
Isoniazid, 
cimetidine
amiodarone
TMP-SMX
macrolides
azole antifungals + omeprazole
grapefruit juic
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13
Q

What type of drugs decrease warfarin’s efficacy?

which would inhibit warfarins metabolism- too much bleeding?

A

p450 inducers

p450 inhibitors

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14
Q

N-acetylcysteine MOA? whats it used in?

A

cleaves disulfide bonds within mucus glycoproteinns and loosens thich sputum

Used in CF treatment

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15
Q

Rare side effect of Ticlipidine and how it presents

A

NEUTROPENIA

fever
mouth ulcers

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16
Q

(for each # below) name Antiplatelet drug and how it:

1) Blocks formation of ligands
2) Block interaction of ligands with receptors on platelets
3) Interfere with intracellular signaling

A

1) Aspirin- decr. TXA2 formation
2) Clopidogrel/Ticlopidine- ADP Antagonists
3) Cilostazol/Diyrimidamole- Incr. cAMP by decr. phosphodiesterase activity

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17
Q

Anticholinergic toxicity symptoms?

drugs that cause this?

A 
Fever
dryness (mucosal/axilary)
cutaneous flushing
mydriasis
delerium

Atropine, TCA’s (amytriptyline)

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18
Q

Antibiotics that disrupt cell wall synthesis

A

Penicillins
cephalosporins
vancomycin

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19
Q

Loop diuretics MOA?

used in?

SEs?

A

inhibit NAK2Cl symporter in the ascending loop of henle to block Na and Cl transport and increase NA Cl and fluid excretion.

used in pulmonary edema, venous and pulmonary congestion secondary to CHF
peripheral edema

Hypokalemia, hypomagnesmia, hypocalcemia

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20
Q

Loop Diuretics- name 3 & SE?

A

furosemide
bumetanide
torsemide

Hypokalemia, hypomagnesimia, hypocalcemia, ototoxicity

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21
Q

Thiazide diuretics- name 2 & SE?

A

Chlorthalidone
hydrochlorothiazide

Hypokalemia, hyponatremia, hyperuricemia, hypercalcemia

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22
Q

Potassium sparing diuretics- name 2 & SE?

A

Triamterene
spironolactone - decrease morbidity in CHF pts

Hyperkalemia,
Spirinolactone: gynecomastia, anti-androgen effects

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23
Q

Carbonic anhydrase inhibitors name 1 and side effects?

A

acetazolamide

Somnolence, paresthesias, urine alkalinization, dehydration, hypokalemia, hyponatremia, Metabolic acidosis

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24
Q

Osmotic diuretics name one and side effects?

A

Mannitol

Hypernatremia, pulmonary edema

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25
Gram+ Catalase- Optochin Resistant? Optochin Sensitive? What hemolysis are these bugs?
Strep. Viridans Strep. Pneumoniae alpha hemolytic
26
Gram+ Catalase- Bacitracin Resistant? Bacitracin Sensitive? What type of hemolysis are these bugs?
Strep. Agalactiae Strep. pyogenes B-hemolytic
27
Gram+ Catalase- Grow bile & 6.5% NaCl? Growth and Bile but not 6.5% NaCl? hemolysis?
Enterococci E.Faecium Noneterococci S. Bovis None
28
How do carbonic anhydrase inhibitors work? where else is carbonic anhydrase present & what else do inhibitors treat?
Inhibit carbonic anhydrase which effectively blocks NaHCO3 and water reabsorption in the proximal tubule's resulting in urinary bicarbonate wasting ``` Eyes- open/closed angle glaucoma; DECR. Aquous humor prod. Pancreas G.I. tract CNS Red blood cells ```
29
What is foscarnet and how is it used?
Pyrophosphate analog that can chelate calcium. Promotes nephrotoxic renal magnesium wasting = >hypocalcemia hypomagnesemia
30
Indication for ganciclovir? Main side effect?
First line for cytomegalovirus induced retinitis Severe neutropenia; contraindicated in HIV patients on zidovudine
31
Treatment options for cytomegalovirus induced retinitis? (3)
Ganciclovir foscarnet cidofovir
32
Acute organ rejection occurs how long after transplantation? What is it mechanism?
Within weeks Primarily mediated by host T lymphocytes that act against donor MHC antigens => mononuclear infiltrate and reduced function
33
Hyper acute graft rejection MOA?
Preformed antibodies against graft ABO antigens
34
Chronic graft rejection process?
Host B cells sensitization against graft MHC antigens as well as host T-cell sensitization to graft MHC antigens
35
Graft versus host disease MOA? prevention?
Graft T-cell sensitization against host MHC antigens Washing the donor cells with antithymocyte immunoglobulin to remove donor T lymphocytes
36
Pathological findings ofmembranous glomerulopathy? (3) LM, IF, Stain Most common cause of membranous glomerulopathy?
Diffuse increased thickness of GBM without increased cellularity Light Microscopy granular deposits on IF spike &dome appearance on methenamine silver stain IDIOPATHIC 85% ALSO: DM, tumors, SLE, penicillamine NSAIDs hepB hepC malaria syphilis
37
Where does chloramphenicol act on? Name (3) side effects?
50 S ribosomal subunits Myelosuppression = >anemia Aplastic anemia
38
What stabilizes mast cells?
Cromolyn
39
Acute asthma exacerbation treatment? ` which cardiac physiologic the finding is seen?
Beta adrenergic agonist produce relaxation of bronchial smooth muscle (via beta-2 adrenergic receptor stimulation) = >increases intracellular cAMP concentrate Pulses paradoxes
40
What side effects and the heart can be seen with succinylcholine administration?
Potassium release and life-threatening arrhythmias/hyperkalemia in (Burns, myopathies, crush injuries, denervated injuries)
41
When and how is dantrolene used?
` muscle relaxant used in malignant hyperthermia. ` ask on ryonidine receptors and SR and prevents release of calcium into the cytoplasm of muscle fibers
42
Where and how does baclofen work?
Muscle relaxant that ask on GABA B receptors at level of spinal
43
Which two drugs when used in combination increase the risk for gallstone formation?
Gemfibrozil and cholesteamine
44
How little why does hypospadia's occur in males?
` incomplete fusion of urethral folds, and abnormal opening of the urethra proximal to the glans penis along the ventral Staft of the penis
45
Hyper problems of thiazide diuretics Hypo problems of thiazide diuretics
Hyperuricemia, hypercalcemia, hyperglycemia, hyperlipidemia Hypokalemia, hypotension
46
What type of muscle side effects are seen in hypo-lipid to make drugs especially statins?
Myopathy, elevated serum creatine kinase activity
47
Name a drug that causes neural tube defects during pregnancy and how it does list?
Valproate, inhibits intestinal full like acid absorption
48
What is oral isotretinoin used for and how does it work?
Severe acne, inhibits follicular epidermal keratinization
49
What drug is used for alopecia areata?
Topical corticosteroids
50
Which drug and how does it treat male pattern baldness?
Finasteride | 5 – a – reductase inhibitor
51
Seizure causing drugs? (5)
``` Bupropion Clozapine Isoniazid (if given without pyroxidine) Ciprofloxacin imipenem (abx) ```
52
``` HLA class I: HLA class II: ```
B27 | DR, DP , DQ
53
how does hemicholinium work?
Blocks choline uptake by presynaptic neurons preventing acetylcholine synthesis through depletion of intracellular choline
54
Action of vesimicol?
Non-competitively blocks the vesicular acetylcholine transporter preventing acetylcholine from entering the secretory vesicles in the presynaptic nerve terminal
55
Another name for tight junctions? at which location do they act as protection from chemical
zona occludens @ BBB
56
Where are desmosomes located?
In the Stratham Spinosum layer of the skin; function as anchors holding adjoining cells together
57
Where are hemidesmosomes located What disease are associated with this function?
basal layer of epithelial cells to basement membrane bullous pemphigoid junctional epidermolysis bullosa
58
Location and purpose of intermediate junctions?
Service epithelial cells below tight junctions | assist and cell to cell adhesion
59
Description of gap cells and how they are formed?
Channels between cells that allow free exchange of solute and fluid. Typically form by connexin proteins
60
Olanzapine is which kind of antipsychotic? which receptors do they affect? Clozapine is also used in the same manner as olanzapine to achieve which affect?
atypical antipsychotic=> block D2C and 5-HT2 receptors. Mood Stabilizing.
61
side effects of cloazapine ? what test would you have done with this drug?
Agranulocytosis Leukopenia CBC
62
which drug combo is an extended spectrum penicillin and a Beta Lactamase inhibitor? What is it effective against? name 2
.Piperacillin--Tazobactam Gram+ Gram- and anaerobics including P.Aeruginosa and Bacteroides fragilis
63
What is CIpro effective against?
Gram- rods and bacilli Legionella & P. Aeurginosa
64
what is ceftriaxone effective against?
``` Gram - Bacilli H. Influenza Klebsiella Serratia Neisseria ```
65
what is Azithromycin effective against?
Chlamydia, Mycoplasma, H. Influenza, Morraxella
66
what is Vanco effective against?
S. Aureus, S.epi, C.Diff
67
Main treatment for Cryptococcal Meningitis?
amphotericinB & Flucytosine
68
What is the second most common cause of neonatal meningtis (GBS =1) ? what produces its virulence?
E.Coli Capsule (K-1 antigen)
69
how does lithium cause nephrogenic diabetes insipidus?
antagonizes the action of vasopressin on the principle cells of the collecting duct system
70
how does tetracycline use in pregancy affect the infant? 2
bone growth retardation | Discoloration of deciduous teeth
71
What is the first line treatment of Essential tremors?
Nonspecific beta adrenergic antagonists propranolol
72
How do Sulfonylureas work (MOA)? Name 4...
Incr. Insulin rls by inhibiting K+ Channel ``` Tolbutamide Chorpropamide Glyburide Glipizide Tolzamide/Glimepiride/Nateglinide ```
73
SE of Sulfonylurea
Hypoglycemia | Disulfram-like effects
74
1st Gen Antihistamines name 2 side effects (3 Anti's)
Chlorpheneramine Diphenhydramine AntiMuscarinic AntiAdrenergic Antiserotenergic side effects
75
Alpha glucosidase inhibitor- name 2? MOA? SE?
Acarbose Miglitol inhibit BrushBorder enzymes=> decreases carbs abosrbed leading to decr. amount of glucose SE: incr. flatulence,
76
Aromatase inhibitors
anastrozole letrozole exemestane
77
DOC for Listeria? what is this bug not sensitive to
Ampicillin Cephalosporins
78
MOA of GLP-1 Analogues Name 2
incr. cAMP=> 1) incr. insulin secretion 2) decr. glucagon release Exenatide Liraglutide

UWORLD QuestionQuestions (12 decks)

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