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Drugs Flashcards

1
Q

Dextromethorphan

A

opioid cough suppressant commonly used w/ expectorant guaifenesin

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2
Q

loperamide

A

opioid for diarrhea

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3
Q

diphenoxylate

A

opioid for diarrhea

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4
Q

Vesamicol

A

inhibits synthesis of ACh

inhibits choline-acetyl transferase

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5
Q

Hemicholinium

A

inhibits co-transporter of choline + Na into the neuron to make ACh

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6
Q

black widow spider toxin

A

stimulates release of ACh into synaptic cleft

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7
Q

Botulinium

A

causes flaccid paralysis

inhibits release of ACh into synaptic cleft

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8
Q

Metyrosine

A

inhibits tyrosine hydroxylase

Tyrosine –> L-Dopa

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9
Q

Reserpine

A

inhibits NE packaging into vesicles (for release by nerves)

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10
Q

what drugs inhibit reuptake of NE?

A

cocaine

TCAs

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11
Q

what is dopamine metabolized to?

A

HVA = homovanillic acid

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12
Q

what is NE metabolized to?

A

VMA = vanillylmandelic acid

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13
Q

what is EPI metabolized to?

A

metanephrine

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14
Q

bretylium

A

inhibits NE release

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15
Q

guanethylene

A

inhibits NE release

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16
Q

ephedrine

A

facilitate NE release into synapse

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17
Q

tyramine

A

facilitate NE release into synapse

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18
Q

amphetamines

A

facilitate NE release into synapse

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19
Q

angiotensin 2

A

facilitate NE release into synapse

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20
Q

what do you give for organophosphate poisoning?

A

pralidoxime

atropine

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21
Q

Fomepizole

A

inhibits alcohol dehydrogenase
ethanol –> acetaldehyde
use for methanol or ethylene glycol poisoning

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22
Q

Disulfiram

A

inhibits acetaldehyde dehydrogenase
acetaldehyde –> acetate
used to treat alcoholism

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23
Q

inhibits P450

A 
CRACK AMIGOS
Ciprofloxacin
Ritonavir
Amiodarone
Cimetidine
Ketoconazole
Acute Alcohol
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides
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24
Q

Induce P450

A 
Guinness, Coronas and PBRS induce chronic alcoholism
Griseofulvin
Carbamazepine
Phenytoin
Barbiturates
Rifampin
St. John's Wart
Chronic Alcoholism
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25
what drugs cause a disulfiram-like reaction?
``` metronidazole cephalosporins (cefotetan, cefamandole, cefoperazone) 1st gen sulfonylureas = tolbutamide ```
26
what chronic CHF drugs improve survival?
ACE inhibitors (prevent Ang 1 --> Ang 2) ARBs (inhibit Ang 2 receptors) Aldosterone antagonists (inhibit mineralocorticoid recept) B-blockers (block B1 adrenergic)
27
What chronic CHF drugs relieve symptoms?
Diuretics vasodilators digoxin
28
Treatment for Acute CHF
NO LIP Nitrates = dilate veins = low preload Oxygen Loop diuretics = use for pulmonary edema* Inotrops Positioning = sit up = blood pools in legs
29
what drugs cause agranulocytosis?
``` methimazole PTU clozapine carbamazepine colchicine ```
30
what drugs cause osteoporosis?
corticosteroids | heparin
31
what drugs cause pulmonary fibrosis?
bleomycin busulfan amiodarone
32
what drugs cause gynecomastia?
``` Some Drugs Create Awesome Knockers Spironolactone Digitalis Cimetidine chronic Alcohol Ketoconazole + Marijuana ```
33
what drugs cause photosensitivity?
SAT for a photo Sulfonamides Amiodarone Tetracycline
34
what drugs cause drug-induced Lupus?
``` SHIPP Sulfonamides Hydralazine Isoniazid Procainamide Phenytoin ```
35
what's the MOA of giving N-acetylcystine for acetaminophen OD?
regenerates glutathione
36
name antiarrythmic drug class: quinidine
``` Class 1A Double Quarter Pounder Disopyramide Quinidine Procainamide ```
37
name antiarrythmic drug class: procainamide
``` Class 1A Double Quarter Pounder Disopyramide Quinidine Procainamide ```
38
name antiarrythmic drug class: dispyramide
``` Class 1A Double Quarter Pounder Disopyramide Quinidine Procainamide ```
39
name antiarrythmic drug class: lidocaine
``` Class 1B Mayo Lettuce Tomato Mexiletine Lidocaine Tocainide ```
40
name antiarrythmic drug class: mexiletine
``` Class 1B Mayo Lettuce Tomato Mexiletine Lidocaine Tocainide ```
41
name antiarrythmic drug class: tocainide
``` Class 1B Mayo Lettuce Tomato Mexiletine Lidocaine Tocainide ```
42
name antiarrythmic drug class: flecainide
Class 1C Fries Please Flecainide Propafenone
43
name antiarrythmic drug class: propafenone
Class 1C Fries Please Flecainide Propafenone
44
name antiarrythmic drug class: Amiodarone
``` Class 3 = K channel blockers AIDS Amiodarone Ibutilide Dofetilide Satalol ```
45
name antiarrythmic drug class: Ibutilide
``` Class 3 = K channel blockers AIDS Amiodarone Ibutilide Dofetilide Satalol ```
46
name antiarrythmic drug class: Dofetilide
``` Class 3 = K channel blockers AIDS Amiodarone Ibutilide Dofetilide Satalol ```
47
name antiarrythmic drug class: Satalol
``` Class 3 = K channel blockers AIDS Amiodarone Ibutilide Dofetilide Satalol ```
48
name antiarrythmic drug class: Verapamil
Class 4 = CCB
49
name antiarrythmic drug class: diltiazem
Class 4 = CCB
50
S/E of Quinidine?
Cinchonism = HA, dizziness, tinnitus thrombocytopenia torsades de pointes
51
S/E of Amiodarone
toxicity: lungs --> PFT thyroid --> TFT liver --> LFT
52
flutamide
non-steroidal competitive inhibitor of androgens at the testosterone RECEPTOR use = prostate carcinoma
53
finasteride
5-a-reductase inhibitor | use = BPH, promotes hair growth in men
54
ketoconazole
inhibits testis production of testosterone | inhibits 17,20-desmolase
55
spironolactone
inhibits androgen binding at androgen RECEPTOR | inhibits testis PRODUCTION of testosterone
56
what drugs have zero-order elimination?
"PEA" is round like a 0 Phenytoin Ethanol Asprin
57
cyclosporine: MOA, toxicity
binds CYCLOPHILINS --> inhibits calcineurin --> prevents IL-2 production --> can't develop T cells toxicity = HTN, nephrotoxicity
58
tacrolimus: MOA, toxicity
binds FK-BINDING PROTEIN (FKBP) --> inhibits calcineurin --> prevents IL-2 PRODUCTION--> can't develop T cells
59
sirolimus: MOA
binds FKBP-12 --> inhibits mTOR -> inhibits T cell RESPONSE TO IL-2
60
Azathioprine: MOA
precursor to 6-MP --> metabolized by xanthine oxidase to 6-MP --> can't make nucleic acids --> BM suppression allopurinol increases toxicity of azathioprine + 6-MP
61
Muromonab-CD3 (OKT3): MOA
binds CD3 on T cells --> messes w/ T cell signal transduction
62
Mycophenolate: MOA
inhibits IMP-Dehydrogenase --> prevents synthesis of GUANINE --> no cell replication --> no B/T cell growth
63
Daclizumab: MOA
binds CD25 = IL-2 receptor | blocks IL-2 receptor on T cells
64
thalidomide: MOA
affects TNF-a, teratogen for pregnancy
65
How do you treat H. Pylori?
triple therapy: PPI + clarithromycin + amoxicillin/metronidazole quad: PPI + bismuth + metronidazole + tetracycline
66
Metoclopramide: MOA?
inhibits D2 receptors stimulates Serotonin receptors helps GI move = antiemetic + gastroprokinetic
67
what drug regimen is used to treat TB?
``` RIPE Rifampin Isoniazid Pyrazinamide Ethambutol ```
68
treatment for diverticulitis
metronidazole + | either fluoroquinolone or TMP-SMX
69
Treatment for methemoglobinemia?
Methylene Blue Vitamin C Cimetidine (works slowly)
70
Treatment for cyanide poisoning?
- nitrites (Fe 2+ --> Fe 3+) which binds cyanide | - thiosulfate (binds this cyanide --> thiocyanate --> excreted in urine)
71
what drugs cause methemoglobinemia?
``` Nitrates/nitrites antimalarial = primaquine, chloraquin dapsone sulfonamides local anesthetic = lidocaine metoclopramide ```
72
what are the 3 anti-TNF drugs?
Etanercept = not AB, TNF inhibitor (decoy) Infliximab Adalimumab
73
what HTN drugs are good for pregnant women?
``` Hypertensive Moms Love Nifedipine Hydralazine Methyldopa Labetalol Nifedipine ```
74
HMG-CoA Reductase: S/E, MOA
hepatotoxicity, rhabdomyolysis | inhibit HMG-CoA --> mevalonate
75
niacin: S/E, MOA
inhibits lipolysis in adipose tissue reduces hepatic VLDL secretion into circulation flushed face, hyperglycemia, hyperuricemia
76
Cholestyramine, Colestipol, Colesevelam: MOA, SE
bile acid resins prevent intestinal absorption of bile acids liver must use cholesterol to make more decreases absorption of fat soluble vitamins Cholesterol gallstones Cholestyramine --> binds C. Diff toxin
77
Ezetimibe: MOA, S/E
Cholesterol Absorption Blockers prevent cholesterol reabsorption at small intestine brush border rare increase in LFTs, diarrhea
78
Gemefibrozil, Clofibrate, benzafibrate, fenofibrate: MOA, SE
Fibrates upregulate LPL --> increase TG clearance Myositis, hepatotoxicity, cholesterol gallstones
79
what are the clinical uses for ampicillin and amoxicillin? Which has a greater oral bioavailablity?
``` extended spectrum penicillin HEELPSS H. Influenza E.coli Enterococci Listeria Proteus Mirabilis Salmonella Shigella ```
80
name beta-lactamase inhibitors, when do you use them?
CAST Clavulanic Acid Sulbactam Tazobactam often added to penicillin AB to protect the AB from destruction by b-lactamase (penicillinase)
81
when do you use ticarcillin and piperacillin?
``` antipseudomonals MOA = same as penicillin use = psudonomas + gram - rods susceptible to penicillinase use w/ clavulanic acid toxicity = hypersensitivity rxns ```
82
What do first gen cephalosporins kill? what are the drugs?
PEcK Proteus mirabilis E.Coli Klebsiella cefazolin cephalexin
83
What do second gen cephalosporins kill? what are the drugs?
``` HENs PEcK Haemophilus influenza Enterobacter aerogenes Neisseria Serratia Marcescens Proteus mirabilis E.Coli Klebsiella ``` cefoxitin cefaclor cefuroxime
84
what do 3rd gen cephalosporins kill?
Cefriaxone --> Meningitis + gonorrhea Cefotaxime Ceftazidime --> pseudomonas serious gram(-) resistant to other beta-lactams
85
what do 4th gen cephalosporins kill?
Cefepime ---> pseudomonas and G+ organisms
86
what are cephalosporins NOT good at covering?
``` LAME bacteria Listeria Atypicals (mycoplasma chlamydia) MRSA Enterococci ```
87
what antibiotics bind at 30S? 50S?
buy AT 30, CCELL at 50 30 Aminoglycosides Tetracycline ``` 50 Chloramphenicol Clindamycin Erythromycin (macrolides) Lincomycin Linezolid Streptogramins ```
88
furosemide toxicities
``` OH DANG Ototoxicity Hypokalemia Dehydration Allergy (sulfa) Nephritis (interstitial) Gout ```
89
thiazide toxicities
``` hyperGLUC hyperGlycemia hyperLipidemia hyperUricemia hyperCalcemia ``` sulfa allergy hypoKalemic metabolic acidosis hyponatremia
90
treatment for central DI
desmopressin
91
treatment for nephrogenic DI
HCTZ, indomethacin, amiloride
92
treatment for lithium-induced DI
amiloride
93
what drugs inhibit Complex 1 in the ETC?
Rotenone
94
what drugs inhibit Complex 3 in the ETC?
Antimycin A
95
what drugs inhibit complex 4 in the ETC?
CN | CO
96
what drugs inhibit ATPase in the ETC?
Oligomycin A
97
what drugs are uncoupling agents in the ETC?
Asprin thermogenin 2,4-DNP
98
what HIV drug binds to gp41? gp120?
``` gp41 = enfuvirtide gp120 = maraviroc (doesn't bind to gp120 directly but binds to CCR5 on the macrophage) ```
99
what are the S/E of HIV protease inhibitors? "-navir"
``` hyperglycemia GI lipodystrophy nephropathy hematuria (indinavir) ```
100
amphotericin B: MOA, S/E
binds ergosterol --> forms membrane pores --> leakage of electrolytes used for serious, systemic mycoses S/E: "shake and bake", NEPHROTOXICITY
101
nystatin: MOA
systemic mycoses infections | binds ergosterol --> forms membrane pores --> leakage of electrolytes
102
azoles: MOA, S/E
inhibits fungal sterol (ergosterol) synthesis by inhibiting the P-450 enzyme that converts lanosterol to ergosterol hepatic toxicity, increases liver enzymes
103
flucytosine: MOA, S/E
inhibits DNA--> RNA biosynthesis by conversion to 5-FU by cytosine deaminase note: 5-FU blocks thymidylate synthase that converts dUMP--> dTMP S/E = BM suppression
104
caspofungin, micafungin: MOA, S/E
inhibits cell wall synthesis by inhibiting the synthesis of b-glucan S/E: GI, flushing (by histamine release)
105
terbinafine: MOA, S/E
inhibits fungal enzyme squalene epoxidase --> decreases ergosterol synthesis S/E = LFTs, vision
106
griseofulvin: MOA, S/E
``` MOA = interferes w/ microtubule formation --> disrupts mitosis, deposits in keratin-containing tissues (nails) S/E = P450 inducer --> watch out for oral contraceptives ```
107
Methotrexate: MOA, rescue, S/E
``` MOA = folic acid analog inhibits dihydrofolate reductase --> less dTMP --> less DNA and protein syn rescue = leucovorin for myelosuppression S/E = myelosuppression, fatty liver ```
108
5-FU: MOA, rescue
``` MOA = pyrimidine analog --> activated to 5F-dUMP --> covalently binds to folic acid --> complex inhibits thymidylate synthase --> less dTMP --> less DNA and protein syn rescue = thymidine for myelosuppression ```
109
cytarabine: MOA
pyrimidine analog --> inhibition of DNA polymerase
110
6-mercaptopurine Azathioprine 6-thioguanine
purine (thiol) analogs --> less de novo purine synthesis | activated by HGPRT
111
cyclophosphamide | Ifosfamide
DNA alkylating agent at guanine N-7 S/E = HEMORRHAGIC CYSTITIS (due to toxic metabolite acrolein, prevented w/ mesna) -TCC of bladder -requires bioactivation in liver
112
Nitrosoureas (carmustine, iomustine, semustine, streptozocin): MOA, use
Cross BBB --> CNA | used for brain tumors (GBM)
113
Busulfan: MOA, use, S/E
``` MOA = alkylates DNA Use = CML S/E = pulmonary fibrosis ```
114
Doxorubicin, Daunorubicin: MOA, S/E, rescue
``` MOA = generate free radicals --> intercalates DNA S/E = dilated cardiomyopathy, alopecia, myelosuppression rescue = dexrazoxane = iron-chelating agent ```
115
dactinomycin: MOA, use
intercalates DNA wilms tumor, ewing sarcoma, rhabdomyosarcoma children ACT out --> dACTinomycin
116
bleomycin: MOA, S/E, use
generate free radicals -> fragments DNA pulmonary fibrosis used to treat testicular cancer
117
Oseltamivir
brand name = Tamiflu sialic acid analogue that inhibits neuraminidases of influenza A and B viruses used for prevention and early Rx of influenza infection
118
etoposide: MOA, S/E
inhibits Topoisomerase 2 alopecia GI irritation myelosuppression
119
Cisplatin: S/E, MOA
crosslinks DNA | ototoxic --> damages hair cells --> high freq hearing loss
120
treatment for calcium stones?
thiazides save calcium | citrate
121
miravoc
``` HIV drug inhibits gp120 (binds to CD4) ```
122
xenfuvirtide
``` HIV drug inhibits gp41 (fusion/entry) ```
123
metformin: MOA, S/E
MOA = decreases liver gluconeogenesis, increases glycolysis, increases peripheral glucose uptake (insulin sensitivity) S/E = lactic acidosis; do NOT use w/ renal failure
124
sulfonylureas "-ide": MOA, S/E 1st gen = tolbutamide, chlorpropamide 2nd gen = glyburide, glimepiride, glipizide
MOA = close K channel in b-cell --> depolarizes --> Ca --> release insulin S/E = 1st gen have disulfiram-like effects= inhibits acetaldehyde dehydrogenase.
125
glitazones/thiazolidinediones (TZD): MOA, S/E pioglitaxone rosiglitazone
binds PPAR-gamma --> gene transcription --> insulin sensitivity + adiponectin S/E: hepatotoxicity, heart failure (worsen CHF) metabolized in the liver = good for renal failure pts
126
a-glucosidase inhibitors: MOA, S/E acarbose miglitol
inhibit intestinal brush-border a-glucosidases S/E = GI, don't use in pts w/ cirrhosis or IBD
127
amylin analog = pramlintide: MOA, S/E
decreases glucagon | s/e = hypoglycemia, N/D
128
GLP-1 = exenatide, liraglutide: MOA, S/E
increase insulin decrease glucagon release S/E = pancreatitis, N/V
129
DPP-4 = "-gliptin": MOA, S/E
increase insulin decrease glucagon release S/E = mild urinary and respiratory infections
130
lepirudin bivalirudin hirudin argatroban
inhibits thrombin, used by leeches | used as an alternative therapy for patients with heparin-induced thrombocytopenia (IgG against heparin-PF4)
131
``` thrombolytics: Alteplase (tPA) reteplase (rPA) tenecteplase (TNK-tPA) MOA, PT/PTT/Platelet count, toxicity rx? ```
convert plasminogen --> plasmin increases PT and PTT no change in platelet count treat toxicity w/ aminocaproic acid
132
asprin | MOA, PT/PTT/bleeding time
blocks COX-1/2 by covalent acetylation no change in PT, PTT increased bleeding time
133
Clopidogrel
block ADP receptors on platelets
134
ticlopoidine
block ADP receptors on platelets | toxicity = neutropenia
135
prasugrel
block ADP receptors on platelets
136
ticagrelor
block ADP receptors on platelets
137
cilostazol
PDE 3 inhibitor --> increases cAMP in platelets --> inhibits platelet aggregation VASODILATORS
138
dipyridamole
PDE 3 inhibitor --> increases cAMP in platelets --> inhibits platelet aggregation VASODILATORS
139
abciximab
binds GP 2b/3a on activated platelets --> prevents aggregation
140
eptifibatide
binds GP 2b/3a on activated platelets --> prevents aggregation
141
tirofiban
binds GP 2b/3a on activated platelets --> prevents aggregation
142
pergolide
ergot dopamine agonist - bromocriptine - pergolide
143
pramipexole
nonergot dopamine agonists - pramipexole - ropinirole
144
ropinirole
nonergot dopamine agonists - pramipexole - ropinirole
145
filgrastim
G-CSF analog --> more granulocytes, used after myelosuppressive chemotherapy

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