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Drugs Flashcards

1
Q

Heparin affects what clotting factors

A

II (Prothrombin) and X (Stuart-Factor)

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2
Q

It binds to antithrombin III to increase activity

A

Heparin

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3
Q

Antidote for Heparin

A

Protamine sulfate

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4
Q

What clotting factors does warfarin affect?

A

Vit K-dependent: II (prothrombin), VII (Stable factor), IX (Christmas factor, X (Stuart factor)

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5
Q

Antidote for warfarin

A

Vitamin K

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6
Q

Treatment for tic douloureux

A

Carbamazepine (Tegretol)

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7
Q

Antiepileptic drugs (2)

A

Benzodiazepine - diazepam
Diphenylhydantoin - phenytoin

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8
Q

Drug contraindicated for hyperthyroidism

A

Epinephrine. May cause thyroid storm

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9
Q

Drugs for hyperthyroidism

A

Propythiouracil (PTU)
Methimazole

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10
Q

Drug for hypothyroidism

A

Levothyroxine (synthethic thyroxine)

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11
Q

tx for anaphylaxis

A

epi
adult dose: 0.5mL of 1:1000 or 0.5mg of epi
pedia dose: 0.01mg/kg (max dose 0.3mg)

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12
Q

Vancomycin side effect

A

Red man syndrome

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13
Q

Tx for TB

A

RIPES / StRIPE

Rifampicin
Isoniazid (1st line, most hepatotoxic)
Pyrizinamide
Ethambutol
Streptomycin (ototoxic)

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14
Q

Tx for hansen’s disease

A

Aka leprosy (Mycobacterium leprae)

Rifampin + dapsone (sulfone/sulfonamide)

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15
Q

content of artificial tears and artificial saliva

A

artificial tears - hydroxypropyl cellulose
artificial saliva - hydroxymethyl cellulose

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16
Q

tx for sjogren’s syndrome

A
  1. immunosuppressant drugs such as
    -cyclosporine,
    -corticosteroids (also an anti-inflammatory)
  2. cholinergic drugs (parasympathomimetic agents) - pilocarpine
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17
Q

tx for toxicities

A

activated charcoal
syrup of ipecac
gastric lavage (deposit then aspirate)
cathartics (laxative)

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18
Q

most important liver microsomal enzyme because it metabolizes most drugs

A

cytochrome p450

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19
Q

plasma enzyme important for metabolizing drugs

A

plasma pseudocholinesterase metabolizes esters and succinylcholine

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20
Q

bypasses metabolism stage of pharmacokinetics? bypass absorption?

A

bypass absorption - IV route
bypass metabolism - nitrous oxide

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21
Q

double i na anes but ester?
amide na sa both sa liver and plasma namemetabolize?

A

piperocaine - ester
articaine - amide but sa both metabolized

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22
Q

Tx for amoebiasis

A

Antiprotozoal and antibiotics

Co-trimoxazole (bactrim) - trimethoprim + sulfamethoxazole
Or
Metronidazole (anaerobes only)

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23
Q

Tx for malaria

A

Doxycycline
Quinine analog (mefloquine)
Primaquine
Chloroquine

“#1clean queen”

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24
Q

Tx for angina pectoris

A

Nitrates.

Nitroglycerin (sublingual)
Amyl nitrate (inhalation drug)

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25
Q

antibiotic prophylaxis (recommended dose)

A

30-60mins before invasive procedure
Amoxicillin (oral and parenteral) - 2g (Adult), 50mg/kg (child)
ampicillin (parenteral) - 2g (A), 50mg/kg (C)
cefalexin (oral and parenteral) - 2g (A), 50mg/kg (C)
azithromycin and clarithromycin (oral and parenteral) - 500mg (A), 15mg/kg (C)
*clindamycin (oral and parenteral) - 600mg (A), 20mg/kg (C)

*not recommended according to ADA 2021

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26
Q

Time required for a drug to reduce half of its initial value

A

Half-life

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27
Q

Rate at which the active drug is removed from the body

A

Clearance rate

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28
Q

Differentiate zero-order kinetics and first-order kinetics

A

Zero-order = clearance rate is constant and is not dependent on concentration of drug in plasma fluid

First-order = clearance rate is dependent on the concentration of drug. Half life ang constant

Drugs that follow zero-order have higher chance to accumulate in the body

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29
Q

Amount of drug eliminated is dependent on the concentration of drug in the plasma fluid

A

First-order kinetics

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30
Q

Amount of drug eliminated is constant and not dependent on the concentration of drug in the plasma fluid

A

Zero-order kinetics

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31
Q

Free-floating drugs in the plasma fluid?
Drugs attached to plasma protein?

A

Free-ionized drug
Bound drug (reservoir of free-ionized)

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32
Q

Phenomenon of drug metabolism whereby the concentration of orally taken drugs is reduced before reaching the systemic circulation

A

First-pass effect

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33
Q

Branch of pharmacology concerned with effects of drugs and the mechanism of their action

A

Pharmacodynamics

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34
Q

Branch of pharmacology concerned with movements of drugs within the body

A

Pharmacokinetics (ADME)

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35
Q

It is the accumulation of drug because it cannot be excreted by the body

A

Cumulation

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36
Q

Drugs contraindicated for glaucoma

A

Diazepam and anticholinergic drugs

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37
Q

Study of damage to fetus during development?
Study of drug dosage?

A

Teratology - damage
Posology - dosage

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38
Q

Common teratogenic drugs and their effects

A
  1. Phenytoin (anti seizure)
  2. Thalidomide (anti cancer) - shortened limbs
  3. Tetracycline (antibiotic) - teeth stain (intrinsic), altered bone growth
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39
Q

Amount of drug that reaches the circulatory system after administration

A

Bioavailability

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40
Q

Drug pH that influence absorption

A

Drug must be weak acids (pH 6) or weak bases (pH 8) = more lipid soluble

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41
Q

Influences bioavailability

A

Drug solubility
Route
First-pass effect

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42
Q

dosage of drug needed to produce an effect

A

potency

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43
Q

refers to the effect of a drug

A

efficacy

*a drug can be more potent but less efficacious (fentanyl is more potent that morphine)

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44
Q

maximum effect of a drug where no effect is added even though drug dose is increased

A

maximal effect

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45
Q

a ratio that measures the relative safety of a drug

A

therapeutic index
TI = LD50/ED50 or TI = TD50/ED50

LD50 - median lethal dose (kill 50% of population)
TD50 - median toxic dose
ED50 - median effective dose (dose that is effective to 50% of population)

higher TI means safer drug

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46
Q

targets of drug action

A
  1. receptors
    ex. narcotics ➡️ opioid receptors (mu, kappa, delta)
    pilocarpine ➡️ muscarinic receptors
    epinephrine ➡️ adrenergic receptors
  2. enzymes
    ex. MAO inhibitor ➡️ monoamine oxidase
    anti-cholinesterase ➡️ acetyl-cholinesterase
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47
Q

ability of drug to bind to its target site

A

affinity

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48
Q

Ability of drug to procude an effect after binding to its target site

A

intrinsic activity

*all drugs have affinity but NOT all drugs gave intrinsic activity

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49
Q

full agonist vs antagonist vs partial agonist

A

FA - elicits maximal response by activating all or a portion of the receptors (ex. Pilocarpine)
antagonist - with affinity but no intrinsic activity (belladona alkaloids - atropine and scopolamine aka hyoscine butylbromide)
partial agonist - with affinity but lesser intrinsic activity; produces less maximal response even all the receptors are occupied (acts as agonist and antagonist)

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50
Q

clark’s occupational theory vs paton’s rate theory

A

clark - drug effect is proportional to the number of receptors occupied
paton - drug effect is proportional to the rate at which drug and receptor combine

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51
Q

types of sedation

A
  1. minimal (conscious) - relieves anxiety
  2. moderate (depressed consciousness) - can still respond to external stimuli
  3. deep (depressed consciousness) - only responds to painful and repeated stimuli
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52
Q

Ultra-short acting barbiturates

A

Methohexital and Thiopental

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53
Q

Short-acting barbiturates

A

secobarbital and pentobarbital
used for insomnia

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54
Q

intermediate acting barbiturates

A

amobarbital and butabarbital
used for insomnia

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55
Q

long acting barbiturates

A

phenobarbital, mephobarbital and primidone

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56
Q

used for induction of general anesthesia

A

Sedative
**ultra-short acting barbiturates **(thiopental, methohexital)

anticonvulsants/antiseizures
Benzodiazepines (non-barbiturate sedative) ex. Midazolam (most common), diazepam, lorazepam (short-acting)

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57
Q

barbiturates vs non-barbiturates

A

barbs - more potent, with barbaric acid
non - barbs - less potent, without barbaric acid

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58
Q

common sedative drug used in pediatric patients

A

Chloral hydrate (non-barbiturates)

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59
Q

non-barbiturate drug that is an anxiolytic but also an antihistamine and anti-cholinergic

A

diphenhydramine

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60
Q

mechanism of action of sedatives (barbiturates and non-barbiturates)

A
  1. affects reticular activating system (RAS)
  2. activates GABA receptors (gamma amino butyric acid) - inhibition of the different parts of CNS
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61
Q

most common inhibitory neurotransmitter

A

gamma amino butyric acid

Other inhibitory: glycine, serotonin, dopamine

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62
Q

Sedative-hypnotics drug uses

A

sedation
induction of G.A.
insomnia
anti-seizure and anti-anxiety

does not produce analgesia

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63
Q

adverse effects of sedatives

A

drug dependence
stimulates prophyrin production (porphyrism)
respiratory depression - death
coma

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64
Q

drug interaction of sedatives

A

increases activity of Liver microsomal enzymes (cp450 = faster metabolism)
increase activity of Coumarin-related agents
*precaution to combine with other CNS depressants

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65
Q

drug interaction of sedatives

A

increases activity of Liver microsomal enzymes (cp450 = faster metabolism)
increase activity of Coumarin-related agents
*precaution to combine with other CNS depressants

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66
Q

common anti-convulsant/anti-seizure drugs

A

benzodiazepines
phenytoin/ diphenylhydantoin / dilantin
carbamazepine / tegretol
valproic acid
barbiturates

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67
Q

anti seizure drug that is also anti-arrhythmic

A

phenytoin/ diphenyldantoin / dilantin

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68
Q

anti-seizure drug that is also a treatment of tic douloureux

A

carbamazepine

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69
Q

mechanism of action of anti-convulsants/anti-seizures

A

activates GABA receptors

like the sedatives

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70
Q

mechanism of action of anti-convulsants/anti-seizures

A

activates GABA receptors

like the sedatives

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71
Q

drug uses of anti-seizures

A

anti-convulsant/anti-seizure or anti-epileptic
anti-anxiety (benzos)
induction of anes (benzos)
insomnia

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72
Q

adverse effects of anti-seizures/anti-epileptic

A

severe sedation
paradoxical excitement (benzos, nitrous oxide)
drug dependence
respiratory depression
gingival hyperplasia (phenytoin / diphenylhydantoin/ dilantin)

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73
Q

drug interaction: anti-seizures

A

precaution to combine with other CNS depressants

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74
Q

diazepam is slowly and poorly absorbed in what route of admin?

A

intramuscular route

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75
Q

drugs with anticholinergic effects but are not generally anticholinergics?? secondary effect lang nila yun

A

DiTriBeAM
Diphenhydramine
Tricyclic antidepressants
benzodiazepines
antipsychotic agents
meperidine (narcotic)

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76
Q

drug interaction types

A
  1. synergistic 1 +1 > 2 (CNS depressants - SNAB)
  2. additive 1 + 1 = 2 (nsaids and corticosteroids)
  3. antagonistic 1 + 1 = 0 (narcotic and naloxone)
  4. potentiation 1 +0 = 2 (paracet and caffeine)
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77
Q

CNS depressants

A

sedative -hypnotics
narcotics
alcohol
benzodiazepine

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78
Q

Tx for herpes zoster

A

Aka shingles from VZV

Acyclovir

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79
Q

Mechanism of action of narcotics

A

Acts on opioid receptors (mu kappa delta) in:
-limbic system: emotion
-area postrema: n/v (medulla)
-solitary nuclei: gag reflex etc (medulla)
-substantia gelatinosa of rolando: “gate”

80
Q

Endogenous opioids produced by our body

A

Enkephalins and endorphines

81
Q

What is lomotil a combination of?

A

Diphenoxylate (opioid)
Atrophine (anti-cholinergic/decreases GI motility)

82
Q

Drug effects of narcotics

A

Analgesia
Sedation
Euphoria
Dysphoria
Anti-tussive
Drug dependence
Nausea
Respiratory depression

83
Q

Morphine Triad (overdose)

A

Myosis (pin point pupils)
Coma
Respiratory depression

84
Q

Drugs combined to induce neuroleptic analgesia

A

Neuroleptic analgesia (amnestic and analgesic state)

Butyrophenone (Droperidol) and Fentanyl
(Forget BUTY DROgs)
*Neuroleptic agents are your hallucinogens, major tranquilizers, or anti-psychotics.

85
Q

Non-scheduled narcotic agent

A

Tramadol

86
Q

Aka heroin

A

Diacetylmorphine (narcotic)

87
Q

Antagonist of narcotics

A

Naloxone
Naltrexone

88
Q

Antagonist of benzodiazepines

A

Flumazenil

89
Q

Which narcotic agents are converted by the body into CNS stimulant

A

Meperidine -normeperidine
Propoxyphene -norpropoxyphene

90
Q

Acute tolerance to drugs

A

Tachyphylaxis

91
Q

Drugs used for general anesthesia

A

Ketamine
Propofol
Etomidate
(Eto Protulugin Keta)
Induction: ultrashort acting barbiturates and benzos (midazolam, diazepam, lorazepam)
Inhalation drugs: halothane, desflurane

92
Q

Used for dissociative anesthesia

A

Ketamine

93
Q

Most commonly used sedative drug in dentistry

A

Midazolam (benzodiazepines)

94
Q

Differentiate target of narcotic analgesic and non-narcotic analgesics

A

Narcotic - blocks pain in CNS
Non-narcotic - blocks pain primarily in the PNS

95
Q

Mechanism of action of non-narcotic analgesics

A

Inhibit activity of cyclooxygenase

96
Q

Explain prostaglandin production

A

Arachidonic acid –cox1(pns)> thromboxane A2 (platelet aggregation) and prostaglandin (gastric protection)
—-
Arachidonic acid –cox2(cns)> prostaglandins (fever, pain, headache)
—-
Arachidonic acid –cox2(pns)> prostaglandins (pain, inflammation), prostacyclin (inflammation) both are vasodilators which increase renal blood flow

97
Q

Acetaminophen action

A

Centrally acting cox2 inhibitor
Weak peripherally acting cox1 and cox2 inhibitor

98
Q

NSAIDS mechanism of action

A

Inhibits cox1 and cox2 (peripheral and central)

99
Q

Drug interactions of nsaids

A

Enhance effects of warfarin
Nsaid + nsaid = exacerbated effects
Nsaid + paracetamol = synergistic

100
Q

Other name for paracetamol

A

Acetaminophen
APAP (a-pam aminophenol)

101
Q

Nsaids drug examples

A

Ibuprofen, mefenamic acid, naproxen, aspirin, diclofenac, piroxicam, indomethacin, sulindac, nabumetone, ketorolac, tolmetin, oxaprozin, flurbiprofen, ketoprofen, diflunisal, etodolac, cox2 inhibitors

102
Q

Selective cox 2 inhibitors

A

Etoricoxib
Celecoxib
Lumiracoxib
Valdecoxib and rofecoxib (banned)

High cardiovascular risk
No or lessened GI irritation

103
Q

Mechanism of action of aspirin

A

Irreversibly inhibits platelet COX1

*Blood thinner
*Acetyl salicylic acid (ASA)
*Aspirin and ibuprofen are least toxic than other nsaids

104
Q

An NSAID safest for patients at high risk for GI bleeding but higher risk for cardiovascular toxicity

A

Celecoxib (+omeprazole)

105
Q

Nsaids for patients with renal insufficiency

A

Nonacetylated salicylates
Magnesium choline salicylate
Sodium salicylate
Salicyl salicylate

106
Q

Drug used to treat salicylism

A

sodium bicarbonate
Salicylism is associated with aspirin toxicity w/ sweating, drowsiness, hallucinations, convulsions, coma

107
Q

Toxic prodrug that is coverted to acetaminophen

A

Phenacetin

108
Q

Mechanism of action of synthetic glucocorticoids (corticosteroids)

A

Inhibits phospholipase a2

(No arachidonic acid)

109
Q

effects of corticosteroid drugs

A

Bronchodilators
Immunosuppressant
Anti-inflammatory
Antagonize vit D absorption (dec Calcium - bone resorption)
Adrenal insufficiency
Cushing’s syndrome

110
Q

Example corticosteroid drugs

A

Hydrocortisone
Prednisone
Prednisolone

**If with adrenal insufficiency, supplement before minor (x2) or major (x10) surgery.

111
Q

Mechanism of action of antipsychotic drugs/neuroleptic /hallucinogens/ major tranquilizers

A

Dopamine receptor antagonist

112
Q

Side effect seen in typical antipsychotic (first gen) not in atypical antipsychotics

A

Extra-pyramidal syndrome
-Tardive dyskinesia -involuntary repeated body movements usually involves the jaw, lips and tongue
-akathisia -uncontrollablr restlessness
-parkinson’s syndrome
-acute dystonic reaction -spastic retrocollis or torticollis

113
Q

1st antipsychotic drug:
Typical?
Atypical?

A

Typical: Chlorpromazine (phenothiazine derivative)
Atypical: clozapine

114
Q

Example of antipsychotic drugs

A

typical “people talking backwards”
1. Phenothiazine (chlorpromazine, fluphenazine)
2. Thioxanthene (thiothixene)
3. Butyrophenone (haloperidol, droperidol)
4. New (pimozide, molindone)

Atypical
1. Clozapine
2. Asenapine
3. Olanzapine
4. Quetiapine

115
Q

Used for acute phase and prevention of bipolar disorder

A

Lithium - 1st agent useful for bipolar disorder

Other drugs for bipolar:
Carbamazepine and valproic acid
Lamotrigine -prevent recurrence
Chlorpromazine, olanzapine, quietiapine
Olanzapine + fluoxetine
Tricyclic antidepressants

116
Q

Tricyclic antidepressants

A

Imipramine -prototype
Desipramine
Amitriptyline

117
Q

Examples of Antidepressants

A

Selective serotonin reuptake inhibitors (SSRI)
Serotonin-norepinephrine reuptake inhibitors (SNRI)
Tricyclic antidepressants (TCA)
Monoamine oxidase (MAO) inhibitors

118
Q

Antabuse agent used for patients with alcoholism

A

Disulfiram

119
Q

tx to accelerate closure of patent ductus arteriosus

A

Indomethacin (NSAID) -IV
Ibuprofen

ductus arteriosus to bypass lungs. connects aorta and pulmonary artery

120
Q

only nonacid NSAID available

A

Nabumetone

121
Q

Prodrug of salicylates? morphine? dopamine?

A

Aspirin

Remember:
Codeine to morphine
Levodopa to dopamine

122
Q

What receptors do dopamine, isoproterenol, norepi, epi adrenergic drugs act on?

A

Catecholamines (direct-acting)
Dopamine: A1, B1, B2 agonist
Isoprotetenol: B1, B2 agonist (primarily bronchodilation)
Norepinephrine: mainly A1, A2 agonist, weak B1 agonist, very weak B2 agonist or none
Epinephrine: most potent alpha agonist; B1, B2 agonist

123
Q

Drug of choice for severe allergies (anaphylactic shock)

A

Epinephrine

124
Q

Example of selective alpha-1 agonist

A

Phenylephrine (inc BP)
-a decongestant

125
Q

Example of alpha 2 agonist

A

Clonidine (Catapres)
Methyldopa

Tx for hypertension, decrease BP

126
Q

Selective alpha-1 and Beta-1 agonists

A

Dobutamine “DOBle Uno”

Increase BP, increase ♥️ contraction, and ♥️rate

127
Q

Example of selective beta-2 agonist

A

Albuterol (Salbutamol) Sabu2mol/Albu2rol
Terbutaline 2rbutaline

Ideal for asthma

128
Q

Indirect acting adrenergic drugs

A

*stimulates release of norepinephrine from adrenergic neuron

  1. Tyramine
  2. Mephentermine
  3. Amphetamine (derived from methamphetamine)
  4. Methylphenidate- (Ritalin) used as study drug

3 and 4 are classified as stimulants and used for ADHD pt

Ty MeMe Amp

129
Q

Example of mixed acting adrenergic drug

A

Ephedrine (used for obesity)

130
Q

Example of selective alpha 1-adrenergic antagonist

A

Prazosin - decrease BP

131
Q

Example of non-selective beta blocker

A

Propanolol (prototype of B blockers)

132
Q

interferes with the release and storage of norepinephrine in adrenergic neurons

A

adrenergic neuron blockers

affects both alpha and beta receptors but predominantly alpha receptors

133
Q

example of adrenergic neuron blocker and effect

A

guanethidine
reserpine (anti-hypertensive and anti psychotic)

*produced transient hypertension (increase BP)before lowering down the blood pressure (decrease BP)

134
Q

it is both an anti-hypertensive and anti-psychotic drug

A

reserpine - adrenergic neuron blocker

135
Q

drugs that promote functions of acetylcholine by activating directly the cholinergic receptors or by increasing Ach in synapse? classification?

A

CHOLINERGIC DRUGS
acetylcholine-like type - mimic Ach to activate receptor
anticholinesterase - binds to acetylcholinesterase to inhibit function

136
Q

example of acetylcholine -like type of cholinergic drugs

A

Pilocarpine - muscarinic agonist
muscarine - stimulates muscarinic receptors (mushroom)
nicotine - stimulates nicotinic receptors (nicotine plant)
carbachol - muscarinic and nicotinic agonist
bethanechol chloride - muscarinic agonist

BETH Punched Me Not CARmen

137
Q

example of anticholinesterase type of cholinergic drugs

A

neostigmine - for myasthenia gravis
pyridostigmine - for myasthenia gravis
physostigmine - for glaucoma, reversal agent of atropine

anti-enzyme = –stigmine aka carbamates

138
Q

reversal agent of atropine (muscarinic antagonist)

A

Physostigmine (anticholinesterase cholinergic drug)

139
Q

drugs that opposes the action of acetylcholine and their classification

A

Anticholinergics
A. MUSCARINIC ANTAGONIST (belladonna alkaloids: atropine, scopolamine hyoscine butylbromide/buscopan) - no intrinsic activity
B. NEUROMUSCULAR BLOCKERS (muscle paralysis/muscle relaxation)
b.1. Non-depolarizing type (Tubocurare: Pancuronium, mivocurium) blocks nicotinic receptors….can be reversed by anti-cholinesterase neostigmine and pyridostigmine
b.2. depolarizing type (Succinylcholine or suxamethonium) - contracts but no repolarization

140
Q

Drugs that inhibit the transmission of signals from preganglionic neurons to the postganglionic neurons of ANS

A

ganglionic blocking drugs (used for malignant hypertension)

141
Q

example of ganglionic blocking drugs

A

Hexamethonium (prototype)
Mecamylamine (for bloodless surgical field)

*lowers BP significantly, xerostomia, constipation, blurred vision

142
Q

example of selective beta 1 adrenergic blocker

A

(-olol)

metoprolol

143
Q

antiarrhythmic drugs - suppress abnormal rhythms of heart

A

quinidine
procainamide
propanolol -B blocker
lidocaine
phenytoin
amiodarone
verapamil -Ca channel blocker
adenosine

144
Q

cardiac glycosides

A

increase the force contraction of the heart
for patients with heart failure

DIGoxin
DIGitoxin

145
Q

Diuretics - drugs that increase urine output

A

increase urine output, decrease blood volume, decrease blood pressure

Benzothiazides (-thiazide) -inhibits Na reabsorption in distal tubules of nephron, drug of choice for mild hypertension
Loop diuretics (furosemide) -reabsortion in ascending loop, most potent diuretic agent

146
Q

drug of choice for mild hypertension / mainstay of hypertensive therapy

A

benzothiazides - inhibit Na reabsorption in distal tubules of nephron

147
Q

most potent diuretic agent

A

loop diuretics (furosamide) - inhibits ION reabsorption in ascending loop

148
Q

antihypertensive drugs

A

diuretics
alpha 1 adrenergic blockers (-ozin)
alpha 2 adrenergic agonist (Clonidine)
beta blockers (non selective, selective b1 blocker)
beta blockers with alpha 1 blocker (-ilol and -alol) carvedilol
adrenergic blocking drugs
ACE inhibitors (-pril) captopril, accupril reduce peripheral resistance and blood volume
Angiotensin II receptor antagonist (-artan) losartan reduce peripheral resistance
calcium channel blockers (-dipine and -pamil) reduce peripheral resistance

149
Q

mechanism of action of antianginal drugs and examples

A

coronary artery dilators

nitroglycerin (sublingual)
amyl nitrate (inhalation)
Isosorbide dinitrate

150
Q

anticoagulants

A

aspirin
heparin
warfarin (coumadin)

coumarin - prototype

151
Q

differentiate bacteriostatic and bactericidal

A

bacteriostatic - inhibits bacterial growth by inhibiting metabolic pathways and bacterial division
bactericidal - kills bacteria by inhibiting formation of cell wall during cell division

antagonistic effect

152
Q

beta-lactam antibiotics and mode of action

A

penicillin
cephalosporin
monobactams
carbapenems - broadest spectrum

cell wall synthesis inhibitors / bactericidal others: glycopeptides (vancomycin), bacitracin, cycloserine (for tb)

153
Q

vancomycin is used for?

A

pseudomembranous colitis
methicillin-resistant staph areus

side effect: red man syndrome

154
Q

tx for pseudomembranous colitis

A

vancomycin
metronidazole

155
Q

Protein synthesis inhibitors

A

bacteriostatic

AT30MCC50
blocks 30s/50s ribosomal unit
Aminoglycosides -only one na bactericidal
Tetracycline Family
Macrolides (Azithromycin, Clarithromycin, Erythromycin)
Clindamycin (Lincosamide family with Lincomycin)
Chloramphenicol

156
Q

Adverse effects of chloramphenicol

A

*one of the last resort Abx due to high toxicity and adverse effects

hemolytic anemia
gray baby syndrome

157
Q

for pt allergic to penicillin

A

clindamycin (lincosamide)
macrolides (Azithromycin, Clarithromycin, Erythromycin)

158
Q

biosynthetic pathway inhibitors

A

bacteriostatic
Trimethoprim
sulfonamide - mimic PABA (vit b10)

bactericidal
fluroquinolones (-floxacin) -inhibit DNA gyrase, ciprofloxacin, levofloxacin

159
Q

co-trimoxazole (Bactrim) is a combination of?

A

trimethoprim + sulfamethoxazole

160
Q

common bacteriostatic drugs

A

bacterio STTECC tic

sulfonamide
trimethoprim
tetracycline
erythromycin (macrolides)
clindamycin
chloramphenicol

161
Q

Quinolones are derived from?

A

quinine

162
Q

differentiate penicillin G and penicillin VK

A

G - benzylpenicillin, parenteral, acid unstable
VK - phenoxymethyl penicillin, oral route, acid stable

163
Q

example of aminopenicillins? differentiate the two

A

amoxicillin - most common oral prophylactic antibiotics
ampicillin - parenteral

164
Q

widest broad spectrum penicillins

A

piperacillin
ticarcillin

anti-pseudomonas penicillin

165
Q

penicillinase-resistant penicillins

A

methicillin
nafcillin
cloxacillin
oxacillin
dicloxacillin

166
Q

Co-amoxiclav (augmentin) is a combination of?

A

amoxicillin (500mg) and clavulanic acid (125mg) (beta-lactamase inhibitor)

167
Q

Abx with disulfiram-like effects

A

cephalosporins

antabuse agent

1st gen: against gram +, narrower spectrum
5th gen: againts gram -, broader spectrum

168
Q

antifungals

A

amphotericin B - given IV
nystatin - for oral candidiasis
-azoles (ketonazole, fluconazole, miconazole)
griseofulvin - most potent anti fungal
flucytosine

169
Q

Adverse effect of tetracycline

A

Hepatotoxic
Photosensitivity
Resistance and superinfections
Tooth discoloration
Black hairy tongue

170
Q

Mnemonics for cephalosporin generations and exceptions??

A

1st - cefa
2nd - others
3rd - -one, -ime, -ir
4th - –pi–

Except:
2nd gen - cefuroxime, cefaclor

171
Q

MAO inhibitors should not be combined with?

A

Meperidine
SSRI
Ephedrine
Epinephrine

Because it can cause hyperpyrexia

172
Q

Relationship of opioiates and nsaids, estrogen TO acid-base balance

A

Opioiates - depress resp center - dec respi rate - increase pCO2 - resp acidosis

Nsaids/estrogen - stimulate resp center - inc respi rate - dec pCO2 - respi alkalosis

Remember: CO2 + water = carbonic ACID

173
Q

Acidic or basic: barbiturates? Opioiates? Local anes?

A

Barb - acidic
Op - basic
LA - basic

174
Q

Used as an eye drop to decrease pressure for patients with glaucoma

A

Pilocarpine (muscarinic agonist)

175
Q

Antiviral medication for hep C, RSV, hemorrhagic fever

A

Ribavirin aka tribavirin

176
Q

Drug of choice for cardiogenic shock

A

dobutamine, norepinephrine

177
Q

Proposed the gate control theory of pain

A

Melzack & Wall

178
Q

drug reaction of oxycodone and acetaminophen

A

synergistic

179
Q

first atypical antipsychotic drugs

A

clozapine

180
Q

first typical antipsychotic drugs

A

Chlorpromazine

181
Q
A
182
Q

Classes of antiarrhythmic drugs

A

Class I - sodium blockers (Lidocaine)
Class II - Beta blockers (olol)
Class III - potassium blockers (amiodarone)
Class IV - Ca-channel blocker (Verapamil, Nifedipine)

183
Q

Parent drug of warfarin

A

Dicoumarol

184
Q

Carbamates Moa

A

Carbamates are also known as anticholinesterase

“Stigmine”

Inhibits cholinesterase = more Ach in synapse

185
Q

drug that has 100% bioavailability even when given orally

A

chloramphenicol

186
Q

plasma protein binding of acidic drugs? basic drugs?

A

acidic - albumin
basic - alpha1 acid glycoprotein

187
Q

Drug metabolism under phase I and phase II?

A

Phase I: reduction, oxidation, hydroxylation (ex. cytochrome P450 or CYP)

Phase II: conjugation –adding another substance to make the drug more water soluble
(ex. glucuronidation, acetylation, sulfation, transferase enzymes)
remember: it is not in chronologic order kahit termed as phase I and phase II

188
Q

drugs that follow zero-order kinetics

A

TAPE
theophylline
aspirin
phenytoin
ethanol

189
Q

how to compute for onset when given the half-life?

A

t1/2 multiply by 4

4-5 na half lives = 94-97% will be eliminated and accumulated already

steady state: rate of accumulation is equal to the rate of elimination

190
Q

muscarinic receptors

A

M1 - neurons
M2 - cardiac
m3 - visceral organs except cardiac: “glandular”
m4 - neuron
m5 - neuron

191
Q

alpha non-selective agonist examples and uses

A

oxymetazoline
xylometazoline
–nasal decongestant (nasal spray)

192
Q

Organophosphates examples and action

A

Echotiopate
Malathion
Parathion
(insect repellants)
increases parasympathetic tone
acetylcholinesterase –» inc ACh in synapse -» overstimulation

DOC: IV atropine

193
Q

Irreversible alpha antagonist

A

Phenoxybenzamine

194
Q

Antifibrinolytic agent used for patients with coagulopathies

A

Aminocaproic acid

195
Q

Most potent and broad spectrum anti arrhythmic

A

Amiodarone (potassium channel blocker) class III

, .supercram (16 decks)

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