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Drugs Flashcards

1
Q

Finasteride MOA

A

5-alpha reductase inhibitor

Use for BPH

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2
Q

Tx of BPH:

A

Initial: alpha antag (terazosin, tamsulosin) relax sm mm in bladder neck/prostatic urethra

5 alpha reductase inhib (finasteride, dutasteride) to reduce large prostate volumes

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3
Q

Flutamide

A

Nonsteroidal competitive testosterone R antagonist

Use in prostate Ca

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4
Q

Cause pseudomembranous colitis:

A

aminopenicillins (ampicillin, amoxicillin), Clindamycin, cephalosporins

Tx: oral dose of vanco

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5
Q

First Gen Cephalosporins

A

Cephalexin, Cefazolin

Gram + cocci, PEK (Proteus, E. coli, Klebsiella pneumoniae)

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6
Q

Second Gen Cephalosporins (2A)

A

Cefaclor, Cefuroxime

Gram + cocci, HEN PEK (H. flu, Enterobacter, Neisseria)

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7
Q

Cephalosporins 2B

A

Cefotetan, Cefoxitin (Cephamycins)

Gram + cocci, HEN PEK, Anaerobes!!!

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8
Q

Third Gen Cephalosporins

A

Cefotaxime, Cefixime, Cefpodoxime, Ceftriaxone

Excellent Gram -, nosocomial G - infection resistant to other beta lactams

Ceftriaxone: Meningitis, gonorrhea

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9
Q

Unique 3rd Gen Cephalosporin

A

Ceftazadime

Less G +, good G -, Pseudomonas!

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10
Q

Fourth Gen Cephalosporin

A

Cefepime

Pseudomonas, G + great, G - great

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11
Q

Ceftaroline

A

broad G + and G -, MRSA

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12
Q

Atreonam

A

monobactam, binds PBP 3, resistant to beta lactamases

G - only, Pseudomonas

Use: penicillin allergy or renal unsuffic who can’t tol. aminoglycosides

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13
Q

Carbapenems

A

Doripenem, Imipenem, Meropenem, Ertapenem

Broad! G + cocci, G - rods, anaerobes
Ertapenem: no Acinetobacter, Pseudomonas, Enterococcus

Give Imipenem with Cilastatin - prevents inactivation in renal tubules

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14
Q

Carbapenem Side Effects

A

Seizures, GI, rash

Renal dose adjust

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15
Q

Vancomycin

A

inhibits peptidoglycan format. by binding D-ala D-ala
Gram + only! only resistant ones (MRSA, VRE)
Oral dose for C. dif

Resistance: D-ala D-lac modific

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16
Q

Vancomycin SEs

A

Red man syndrome (histamine mediated), Nephrotox, Ototox, Thrombophlebitis

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17
Q

Protein synth inhibitors that blocks A-site tRNA binding:

A

Tetracyclines (30S)

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18
Q

Protein synth inhibitors that block initiation complex formation:

A

Aminoglycosides (30S)

Also cause misreading of mRNA

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19
Q

Aminoglycosides SEs:

A

Nephrotoxic, Neuromuscular blockade, Ototoxic, Teratogen

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20
Q

Aminoglycoside names/uses:

A

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

Aerobes only!! MOA requires 02
G +: synergy with BLs
Severe G - rod infections, Pseudomonas

Resistance: bacterial transferase enzymes add side chain

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21
Q

Tetracycline SEs:

A

N/V/D, bind to growing teeth/bones, photosensitivity, contraindic in preg, chelate with divalent cations

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22
Q

Tetracycline names/uses:

A

Tetracycline, Doxycycline, Minocycline

Borrelia burgdorferi, M. pneumonia, Rickettsia, Chlamydia
(Atypical pneumonia, tick bites, chlamydia)

Resistance: efflux pumps, plasmid-encoded

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23
Q

Macrolides

A

Azithromycin, Clarithromycin, Erythromycin

Block translocation, bind 23S rRNA of 50S ribosome

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24
Q

HELP SES Bugs

A

Aminopenicillins: Ampicillin, Amoxicillin (better oral) (ESBLs)

Haemophilus influenza, E. coli, L. monocytogenes, Proteus mirabalis, Salmonella, Enterococci, Shigella

Give with Clavulanic acid/sulbactam: BLase inhibitors

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25
Q

Phenoxybenzamine

A

Noncompetitive, irreversible alpha antagonist

To manage Pheo Sx preop

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26
Q

Phentolamine

A

competitive, reversible alpha antag

Give to tx HTN crisis when withdraw clonidine or eat tyramine containing foods on MAO-I

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27
Q

Prazosin

A

Alpha-1 selective antagonist

used to treat HTN, BPH urinary Sx, PTSD

Also Terazosin, doxazosin, tamsulosin (selective @ prostate’s alspha-1A Rs)

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28
Q

Mirtazapine

A

Selective alpha-2 antagonist

Used to treat depression, causes sedation

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29
Q

Cause gingival hyperplasia: (4)

A

Phenytoin, verapamil, cyclosporine, nifedipine

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30
Q

Cause Myopathy:

A

Fibrates, niacin, colchicine, hydroxychloroquine, IFN-alpha, penicillamine, statins, glucocorticoids

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31
Q

Cause SLE-like syndrome:

A

Sulfa drugs, hydralazine, INH, Procainamide, Phenytoin, Etanercept

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32
Q

Cause SIADH:

A

Carbamazepine, cyclophosphamide, SSRIs

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33
Q

Cause Pulmonary fibrosis

A

Bleomycin, Amiodarone, Busulfan, Methotrexate

34
Q

Sulfa Drugs:

A

Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide ABs, Sulfasalazine, Sulfonylureas

PROfessional FACTSSS

May cause fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocyt, and urticaria in ppl w/ allergies

35
Q

Insulin release mediated by:

A

Decreased by alpha-2

Increased by beta-2

36
Q

Metronidazole Treats:

A

GET GAP on the Metro

Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes below belt (Bacteroides, C. dif), H. Pylori - triple ther with PPI and clarithromycin

37
Q

ABs to avoid during pregnancy:

A

SAFe Children Take Really Good Care

Sulfonamides, Aminoglycosides, FQs, Clarithromycin, Tetracyclines, Ribavirin, Griseofulvin, Chloramphenicol

38
Q

Opioid MOA

A

Open K channels, close Ca channels
Increase K efflux and Decrease Ca influx hyperpolarizes post syn neurons.

Inhibit release of ACh, NE, 5HT, glutamate, substance P

39
Q

Ethosuximide

A

DOC for absence seizures
Blocks thalamic T-type Ca chan

SE: GI, rash, SJS, HA, fatigue

40
Q

Benzos for Seizures

A

IV tx of status epilepticus (followed by IV Phenobarbital or fosphenytoin)
Also for eclampsia seizures (MgSO4 is DOC)

Diazepam/Lorazepam (longer DoA, preferred)

Increase GABAa action

41
Q

Phenytoin

A

Tonic-clonic and status epilep prophylaxis: 1st line, also used in partial

Na channel inactivation, zero order kinetics

SE: nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, periph neuropathy, megaloblastic anemia, teratogen, SLE like sindrome, SJS, osteopenia

CYP inducer

42
Q

Carbamazepine

A

partial, tonic clonic: 1st line

Increased Na chan inactivation

SE: diplopia, ataxia, blood dyscrasias, liver tox, teratogen, SIADH, SJS

CYP inducer

Also used for BPD and Trigeminal neuralgia

43
Q

Valproic acid

A

Tonic clonic: 1st line, also used in absence, partial, myoclonic seizures

Na chan inactivation, Increased GABA conc by inhib GABA transaminase

GI, hepatotox-can be fatal-monitor LFTs, tremor, wt gain. CONTRAINDIC in preg-NTDs

Also used for BPD

44
Q

Gabapentin

A

not 1st line, partial, tonic-clonic

Inhibits high-voltage-activated Ca chan

SE: sedation, ataxia

Also used for periph neuropathy, postherpetic neuralgia, migraine prophylaxis, BPD

45
Q

First Line Partial seizures:

A

Carbamazepine*, oxcarbazepine, valproate, lamotrigine, phenytoin

46
Q

First line generalized tonic clonic:

A

Carbamazepine, phenytoin, valproate, lamotrigine, oxcarbazepine

47
Q

Phenobarbital

A

1st line in Neonates! Other uses: partial, tonic clonic

Increases GABAa

SE: sedation, tolerance, dependence, cardioresp depression

CYP Inducer

48
Q

Topiramate

A

Blocks Na channels, increases GABA action

Partial, tonic clonic

Sedation, mental dulling, cidney stones, wt loss

also migraine prophylaxis

49
Q

Lamotrigine

A

Partial, tonic clonic, absence

Blocks voltage-gated Na chan

SE: SJS

Also used for depressive phase of BPD

50
Q

Levetiracetam

A

Partial, tonic-clonic

unknown MOA

51
Q

Tigabine

A

partial

Increased GABA by inhibiting reuptake

52
Q

Vigabatrin

A

partial

increases GABA by irreversibly inhibiting GABA transaminase

53
Q

Tx of serotonin syndrome:

A

cyproheptadine (5HT2 R antag)

54
Q

Which antiviral polymerase inhibitors do not require phosphorylation by cellular kinases?

A

Foscarnet (for CMV retinitis in AIDS or resistant HSV/VZV)
Cidofovir (preferentially inhib viral DNA pol, CMV in immunocomp, resistant HSV)
Tenofovir (only NRTI that doesn’t require phosphorylation)
all the NNRTIs (Efavirenz, Nevirapine, Delaviridine - bind RT)

55
Q

Drugs that prolong QT:

A

Some Risky Meds Can Prolong QT:

Sotalol
Risperidone
Macrolides
Chloroquine
Protease Inhibitors (-navir)
Quinidine
Thiazides
Ziprasidone
56
Q

Meds that may cause seizures

A

Bupropion (antidepressant), clozapine (APD), Isoniazid (if given without pyridoxine), ciprofloxacin, imipenem

57
Q

First Gen Antihistamines:

A

Diphenhydramine, dimenhydrinate, chlorpheniramine
H1 blockers
Uses: allergy, motion sickness, sleep aid
SEs: Anti-HAM

58
Q

2nd gen antihistamines:

A

Loratadine, fenoxfenadine, desloratadine, cetirizine

Allergy

Less sedating

59
Q

H2 blockers:

A

Cimetidine, ranitidine, famotidine, nizatidine

reversibly block H2 Rs to decrease H+ sec by parietal cells

Uses: peptic ulcer, gastritis, mild reflux

Cimetidine is Potent CYP INHIBITOR, also anti-androgenic effects, can cross BBB and placenta

Cimetidine and ranitidine decr renal creatinine excretion

60
Q

PPIs

A

Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole

Irrevers inhib H+/K+ ATPase in stomach parietal cells

Uses: peptic ulcer, gastritis, reflux, ZES

61
Q

Cilostazol

A

PDE 3 Inhibitor, increases cAMP in platelets, inhibiting platelet agg, also vasodilates

Dipyridamole does same thing

Can use for claudication

Watch out, can cause coronary steal b/c vasodilate

62
Q

Tx for methemoglobinemia:

A

IV methylene blue

helps reduce Fe3+ back to 2+

(can be caused by nitrates/sulfa drugs)

63
Q

Tx of atrial flutter:

A

Conversion to sinus rhythm: class 1A, 1C, or 3

Rate control: beta block or Ca chan blocker

64
Q

Tx for Diptheria:

A

DT antitoxin (passive immunity) GIVE FIRST
Penicillin/erythromycin
DPT vaccine

65
Q

Listeria tx

A

ampicillin in infants/immunocomp/elderly

66
Q

Actinomyces tx:

A

Penicillin
G+ anaerobe, branching filamentous oral flora
oral/facial abscesses that drain through sinus tracts

67
Q

Tx for nocardia:

A

Sulfonamides
G + aerobe, filamentous branching, weak acid fast, in soil
Pulm infections in immunocomp and cutaneous infections after trauma

68
Q

MAC prophylaxis

A

Azithromycin
disseminated non-TB dz in AIDS
grows at high temps

69
Q

Mycobacterium leprae tx:

A

Lepromatous (Th2 response): Dapsone, rifampin, clofazimine for 2-5 years

Tuberculoid (Th1 response): Dapsone and rifampin 6 mo

70
Q

Hydralazine

A

increases cGMP, vasodilates arterioles > veins
Reduces afterload
First line for HTN in pregnancy w/ methyldoa

SE: causes reflex tachycardia, can give with beta blocker
lupus-like syndrome, fluid retention, nausea, headache, angina

71
Q

Hypertensive emergency tx:

A

nitroprusside, nicardipine, clevidipine, labetalol, fenoldopam

Nitroprusside: increases cGMP via direct release of NO, short acting
-SE: cyanide toxicity! releases cyanide, tx w/ sodium thiosulfate

Fenoldopam: D1 agonist - coronary, peripheral, renal, and splanchnic vasodilation –> decr BP and incr natriuresis
-improves renal perfusion

72
Q

H. flu mucosal infection tx:

A

amox +/- clav

73
Q

H. flu meningitis tx/prophylaxis:

A

Tx: ceftriaxone, rifampin prophylaxis in close contacts

74
Q

Meningococcus treatment:

A

ceftriaxone or penicillin G

Prophylaxis: rifampin, cipro, or ceftriaxone in close contacts

75
Q

Legionella treatment

A

macrolide or quinolone

76
Q

Pseudomonas tx:

A

Aminoglycoside plus ESBL (piperacillin, ticarcillin, cefepime, imipenem, meropenem)

77
Q

Lyme dz tx:

A

doxycycline, ceftriaxone

78
Q

Rickettsial dz tx:

A

Doxycycline

79
Q

Mycoplasma pneumoniae tx:

A

macrolide, doxy, or FQ

80
Q

cardioselective beta blockers

A

atenolol, acebutolol, betaxolol, esmolol, metoprolol

81
Q

beta blockers for MI:

A

metoprolol, carvedilol, bisoprolol - decrease mortality

82
Q

Partial beta agonists:

A

Pindolol, Acebutolol

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