Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE Step 1 > Drugs > Flashcards

Drugs Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What are the names of the antipsychotics (neuroleptics)?

A

Haloperidol + “azines”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the origin of EPS side effects with neuroleptics?

A

The D2 blockade results in an imbalance of muscarinic and dopaminergic signaling in the striatum (via M1 receptors); Rx with benztropine (anticholinergic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes side effects with low potency neuroleptics?

A

They have anticholinergic, antihistamine, and alpha-1 blockade effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the atypical antipsychotics?

A

Olanzapine, Clozapine, quietiapine, risperidone, aripiprazole, ziprasidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are “mood stabilizers” and what are they used for?

A

Lithium, Valproate, and Carbamazepine are mood stabilizers used in the treatment of manic episodes/bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Buspirone used for and why?

A

It is used for Generalized Anxiety Disorder; it does not have the hypnotic, euphoric, or addictive properties of other anxiolytics such as benzodiazepines or barbiturates. It does not interact with EtOH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a possible side effect when starting any depressant?

A

Mania!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can you identify the name of a TCA?

A

All TCAs end in “-iptyline” or “-ipramine” except for doxepin and amoxapine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the “Three C’s” of TCA toxicity?

A

Convulsions, Coma, Cardiotoxicity. These are all related to the anticholinergic properties of these drugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the names of the MAOIS?

A

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline, (MAO Takes Pride In Shanghai)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What side effects of Mirtazapine might be desirable in some patients?

A

Sedation in those with insomnia; appetite stimulation and weight gain in those with anorexia or in the elderly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Varenicline?

A

It is a partial agonist of the nicotinic receptor and it is used for smoking cessation. Helps to decrease cravings and blunts the pleasurable effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What nitrate is 100% orally bioavailable?

A

Isosorbide mononitrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What two drugs, when used with statins, increase the risk of Rhabdo?

A

Niacin and Fibrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What medication increases risk of gallstones with fibrates?

A

Bile acid resins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What electrolyte abnormality causes increased toxicity for all Class I antiarrhythmics?

A

Hyperkalemia!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the non-selective alpha and beta antagonists?

A

carvedilol and labetalol (not the different suffix than the standard -olol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is special about Nebivolol?

A

It is B1 selective and stimulates B3 leading to NO synthesis and vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What population of patients is beta blockers contraindicated in?

A

Cocaine users due to unopposed alpha1-mediated vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Ribavirin used for?

A

RSV and HepC, inhibits IMP dehydrogenase (no G)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Acyclovir, famiciclovir, and valacyclovir used for?

A

HSV/VZV only as it needs to be phosphorylated by viral thymidine kinase. No CMV effectivness. Low SFX profile, G analog. Famiciclovir is for VZV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Ganciclovir used for?

A

It is used against CMV (needs CMV viral kinase). G analog. More toxic to host enzymes and can cause leukopenia/neutropenia/thrombocytopenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is foscarnet used for?

A

Ganciclovir resistant CMV and acyclovir resistant HSV. Inhibits viral DNA polymerase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is cidofovir used for?

A

CMV and acyclovir-resistant HSV as it does not require phosphorylation by viral kinase. Nephrotoxic so co-administer with probenecid and IV saline.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What organisms are typically not covered by cephalosporins?

A

LAME = Listeria, Atypicals, MRSA, Enteroccoci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the clinical activity of Aztreonam?

A

GNR, no GP or anaerobic coverage. Good for penicillin allergic patients and those who can’t tolerate aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are carbapenems used for?

A

GPC, GNR, Anaerobes, but lots of side effects so not first line treatment (e.g. seizures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the mechanism of action of aminoglycosides?

A

They inhibit the formation of the initiation complex.

Note: cephalosporins increase nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the mechanism of action of tetracyclines?

A

They bind the 30S and inhibit attachment of aminoacyl-tRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the mechanism of action of macrolides?

A

They inhibit translocation at 50S

Use for atypicals and GPC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the mechanism of action of chloramphenicol?

A

Blocks peptidyltransferase activity at 50S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the mechanism of clindamycin?

A

Blocks peptide transfer (translocation) at 50S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the common ending of H2 blocker names?

A

“-dine”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What H2 blockers have the most side effects?

A

Cimetidine and ranitidine. Both can decrease renal Cr excretion
Famotidine and nizatidine have fewer side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are side effects associated with long-term use of PPIs?

A

Hip fractures and hypomagnesemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the names of direct thrombin inhibitors?

A

Argatroban and bivalirudin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which ADP receptor inhibitor is associated with netropenia?

A

Ticlopidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are cilostazol and dipyridamole?

A

PDE inhibitors that inhibit platelet aggregation. Rx: intermitten claudication, prevention of stroke/TPA, angina prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are eptifibatide and tirofiban?

A

GP IIb/IIIa inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the log-kill hypothesis?

A

A given does of chemo kills the same fraction of cells regardless of tumor size. It accounts for better chemo results when tumor burden is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the difference between vinca alkaloids and paclitaxel?

A

Vinca Alkaloids - Inhibit microtubule formation

Taxanes - Inhibit microtubule dissasembly “It is taxing to Stay polymerized”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What compounds can be used for an overdose-rescue with 5-FU?

A

Uridine can be given (leucovorin is not effective)

43
Q

What tumors is Dactinomycin typically used for?

A

Childhood tumors = Wilm’s Tumor, Ewing’s Sarcoma, Rhabdomyosarcoma

44
Q

What is used to prevent cardiotoxicity from doxorubicin?

A

Dexrazoxane (iron chelating agent)

45
Q

What is used to prevent nehprotoxicity from cisplatin?

A

Amifostine (free radical scavenger) and chloride diuresis

46
Q

What enzyme is inhibited by irinotecan and topotecan?

A

topoisomerase I / DNA Gyrase

47
Q

What enzyme is inhibited by Etoposide and teniposide?

A

Topoisomerase II

48
Q

What is a key side effect of rituximab?

A

Increased risk of PML

49
Q

What are two key toxicities of bisphosphonates?

A

Corrosive esophagitis and osteonecrosis of the jaw

50
Q

What is the prefered glaucoma drug for emergencies?

A

Pilocarpine - opens trabecular meshwork

51
Q

What is the action of mu receptors?

A

Open K+ channels, Close Ca2+ channels

52
Q

What opioids are used for diarrhea?

A

Loperamide and Diphenoxylate

53
Q

What opioid receptor causes miosis?

A

Kappa Receptors

54
Q

Why is meperidine prefered in pancreatic and biliary pain?

A

Causes less contraction of the sphincter of odi

55
Q

What is Butorphanol used for?

A

Severe pain. Partial mu agaonist so causes less respiratory depression but can lead t withdrawal symptoms if on other opioids

56
Q

What is Tramadol used for?

A

Chronic pain. It is a weak opioid agonist. Inhibits 5-HT and NE reuptake

57
Q

What is the toxicity of Tramadol?

A

Seizures, Serotonin Syndrome

58
Q

What is first line treatment for Eclampsia seizures?

A

MgSO4

59
Q

What is the first line treatment for partial seizures?

A

Carbamazepine

60
Q

What are the kinetics of Phenytoin metabolism?

A

Zero-Order Kinetics

61
Q

What is first line treatment for trigeminal neuralgia?

A

Carbamazepine

62
Q

What seizure drug is associated with SIADH?

A

Carbamazepine

63
Q

What are second line treatments for absence seizures?

A

Valproic Acid and lamotrigine

64
Q

What two seizure drugs are only indicated for partial seizures?

A

Tiagabine (inhibits GABA reuptake) and Vigabatrin (inhibits GABA degradation)

65
Q

What three compounds all bind the GABAa receptor?

A

Benzos, barbs, EtOH

66
Q

What are the three short acting benzodiazepines?

A

Triazolam, Oxazepam, Midazolam

67
Q

What are the medium acting benzodiazepines?

A

Estazolam, Lorazepam, Temazepam

68
Q

What are the long-acting benzodiazepines?

A

Chlordiazepoxide, Clorazapam, Diazepam, Flurazepam

69
Q

What drug can reverse the effects of non-benzo hypnotics?

A

Flumazenil

70
Q

What non-inhaled drugs can cause malignant hyperthermia?

A

Succinylcholine

71
Q

What is the most commonly used drug for endoscopy?

A

Midazolam

72
Q

What receptor does Propofol work on?

A

GABA a

73
Q

Why do you need more anesthetic in infected tissues?

A

The tissue is acidic - charges alkaline anesthetics, can’t penetrate membrane

74
Q

What factor is more important in anesthetic action, fiber size or myelination?

A

Fiber size (small blocked before large)

75
Q

What are the two classes of local anesthetics?

A

Esters and Amides (have two I’s in the name)

76
Q

What local anesthetic has severe cardiotoxicity?

A

bupivicaine

77
Q

True or false, neuromuscular blocking drugs affect autonomic nicotinic receptors?

A

False

78
Q

What patients are particularly at risk for succinylcholine induced hyperkalemia?

A

Burn and Crush patients, and those with myopathies and denervation injuries (e.g. quadripalegics)

79
Q

When reversing a nondepolarizing blockade with neostigmine, why must atropine also be given?

A

To prevent overstimulation of muscarinic effects (e.g. bradycardia)

80
Q

What are the key components of Parkinson’s Treatment?

A

B - Bromocriptine/Other agonists
A - Amantadine
L - Levodopa/Carbidopa
S - Selegiline
C - COMT inhibitors (entacapone, tolcapone)
A - Antimuscarinics (benztropine, trihexyphenidyl)

81
Q

What can long term levodopa use lead to?

A

“On-Off Phenomenon” of dyskinesia following administration

82
Q

What are the key Alzheimer drugs?

A

Memantine (NMDA antagonist) and Donepezil (AChE inhibitor. Also galantamine or rivastigmine)

83
Q

What drug is tolterodine, fesoterodine, and trospium similar to?

A

Oxybutynin/Darifenacin/solifenacin (reduce bladder spasm)

84
Q

What is the result of blocking D2 receptors intracellularly?

A

Increased cAMP concentrations (recall D2 is a Gi coupled receptor)

85
Q

What is used to treat EPS symptoms from typical antipsychotics?

A

Benztropine or diphenhydramine (M1/H1 and H1 blocking agents)

86
Q

What side effects result from blocking histamine receptors in the brain?

A

Sedation

87
Q

Why do EPS symptoms occur with D2 blockers?

A

No D2 opposition of excitatory M1 in the striatum - treat with benztropine or diphehydramine

88
Q

What is the mnemonic for neuroleptic malignant syndrome?

A

FEVER = Fever, Encephalopathy, Vitals Unstable, Enzymes, Rigidity

89
Q

What are the side effects of Lithium?

A 
L - Lithium
M - Movement (tremor)
N - Nephrogenic DI
O - HypOthyroidism
P - Pregnancy Problems
90
Q

What receptor does buspirone act on?

A

5-HT 1a

91
Q

What receptor does metoclopramide act on?

A

D2 - antagonist
5-HT 3 - antagonist
5-HT 4 - agonist

92
Q

What are the symptoms of serotonin syndrome?

A 
Hyperthermia
Confusion
Myoclonus
CV collapse
Flushing/Diarrhea
Seizures
93
Q

What are the SNRIs?

A

Venlafaxine and Duloxetine

94
Q

What 3 antidepressents can cause SIADH?

A

MAOIs, SSRIs and TCAs

95
Q

Which TCAs have more anticholinergic effects?

A

Tertiary ones like amitryptiline compared to secondary (e.g. nortriptyline)

96
Q

What two opiates can cause serotonin syndrome?

A

Meperidine and Dextromethorphan

97
Q

What two receptors is mirtazapine an antagonist at?

A

5-HT2 and 5-HT3

98
Q

What receptor does trazodone block?

A

5-HT2 and alpha1. Use for insomnia

99
Q

What receptor does cyproheptadine act on?

A

5-HT2 antagonist

100
Q

What is the names of the 1st gen H1 blockers?

A

Diphenhydramine, dimenhydrinate, chlorpheniramine

101
Q

What are the names of the 2nd gen H1 blockers?

A

Loratadine, fexofenadine, desloratadine, cetirizine

102
Q

What is guaifenesin?

A

Expectorant, thins mucous

103
Q

What is tetrabenazine and what is it used for?

A

It is a VMAT inhibitor used with reserpine (also VMAT inhibitor) in HD

USMLE Step 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions