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USMLE Step 1 > Drugs > Flashcards

Drugs Flashcards

1
Q

Acetaminophen

A

Category: anti-inflammatory
MOA: analgesia, elevates pain threshold
Pharmacokinetics: slightly bound to plasma proteins; metabolized by CYPs to NAPQI
Use: treat mild-moderate pain, fever
Side effects: NAPQI buildup in overdose–> hepatotoxicity

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2
Q

Colchicine

A

Category: anti-inflammatory
MOA: inhibits microtubule assembly leading to inhibition of cell proliferation, chemotaxis, and activation
Use: treat acute gout flares or prevent chronic gout arthritis
Side effects: GI, electrolyte imbalance, bone marrow suppression, cytopenias

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3
Q

Etanercept

A

Category: Anti-inflammatory; TNF-a inhibitor
MOA: Monoclonal antibody; Inhibits TNF-α leads to reduced inflammation
Use: RA, etc
Side effects: hypersensitivity, infection risk, malignancy potential

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4
Q

Febuxostat

A

Category: anti-inflammatory
MOA: Inhibits xanthine oxidase leading to decreased production of uric acid
Use: long term tx of gout in patients with recurrent/ erosive gout

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5
Q

Fexofenadine

A

Category: anti-inflammatory, allergy/ asthma
MOA: Second generation H1 blocker, does not cross BBB
Use: urticaria and allergic rhinitis
Side effects: photosensitivity, allergic reaction, teratogenic

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6
Q

Second generation H1 blockers

A

Cetirizine
Fexofenadine
Loratadine

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7
Q

Indomethacin

A

Category: anti-inflammatory, NSAID
MOA: reversible, nonselective COX inhibitor–> decreased PGs and TxA2. Analgesic, antipyretic and anti-inflammatory effects
Uses: arthritis, gout, dysmenorrhea, PDA
Side effects: GI bleeds, ulcers; prolonged bleeding time, recurrent MI, increased BP

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8
Q

Loratadine

A

Category: anti-inflammatory, allergy/ asthma
MOA: Second generation H1 blocker, does not cross BBB
Use: urticaria and allergic rhinitis
Side effects: photosensitivity, allergic reaction, teratogenic

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9
Q

Misoprostol

A

Category: anti-inflammatory, GI
MOA: Synthetic PGE1 analog, inhibits GI acid secretion and increases secretion of mucin/ bicarb, increases mucosal blood flow
Uses: peptic ulcer disorders, reduce complications of NSAID treatment, abortion

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10
Q

Probenecid

A

Category: anti-inflammatory
MOA: uricosuric- increases uric acid excretion
Use: long term treatment of gout in patients with recurrent or erosive gout

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11
Q

Sumatriptan

A

Category: anti-inflammatory
MOA: triptan, 5-HT receptor agonist- causes vasoconstriction and reduces vascular inflammation
Use: migraine headaches
Precautions: coronary artery disease, stroke, arrhythmias, other serotonergic drugs

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12
Q

Allopurinol

A

Category: anti-inflammatory
MOA: inhibits xanthine oxidase –> decreased production of uric acid
Use: long term treatment of gout in patients with recurrent or erosive gout

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13
Q

Cimetidine

A

Category: GI
MOA: reversible competitive H2 antagonist, inhibits acid secretion on basolateral membrane of parietal cells
Use: duodenal ulcers, GERD
Side effects: drowsiness, diarrhea, headache, gynecomastia/ galactorrhea

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14
Q

H2 receptor antagonisst

A

Cimetidine
Famotidine
Nizatidine
Ranitidine

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15
Q

Diphenoxylate

A

Category: GI
MOA: stimulates u opioid receptor in the gut
Use: treat diarrhea, combined with atropine
Side effects: opioid toxicity at high doses

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16
Q

Esomeprazole

A

Category: GI
MOA: PPI, inhibits H/K-APTase proton pump of gastric parietal cells inhibiting acid secretion
Use: peptic ulcer disease, GERD
Side effects: nausea, diarrhea/ constipation, flatulence, drug interactions

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17
Q

Loperamide

A

Category: GI
MOA: stimulates u opioid receptor in the gut
Use: treat diarrhea

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18
Q

Metoclopramide

A

Category: GI
MOA: activates 5-HT4 receptors and acts as an antagonist at D2-dopamine receptors
Use: pro-motility agent, tx gastroparesis and acute ileus
Side effects: Parkinson’s like effects

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19
Q

Asparaginase

A

Category: cancer
MOA: catalyzes hydrolysis of asparagine to aspartic acid
Use: treat ALL and some mast cell tumors
Side effects: allergy, coagulopathy

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20
Q

Bleomycin

A

Category: cancer
MOA: causes DNA damage by intercalating into DNA and cleaving bonds, causing double strand breaks
Use: Hodgkins, lymphoma, testicular cancers
Side effects: interstitial pneumonia and fibrosis

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21
Q

Cisplatin

A

Category: cancer
MOA: causes DNA damage, generates eletrophilic intermediates that target N7 or O6 position and form DNA interstrand and intrastrand crosslinking–> inhibition of replication
Use: treatment of ovarian and testicular cancer
Side effects: Nephrotoxicity, neurotoxicity, ototoxicity

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22
Q

Doxorubicin

A

Category: cancer
MOA: causes DNA damage through superoxide anion, hydroxyl radical forming DNA strand breaks
Use: antitumor antibiotic, common in combo therapy
Side effects: cardiac toxicity

23
Q

Flutamide

A

Category: cancer, endocrine
MOA: competitive inhibitor of androgens
Use: virilization in women, precocious puberty in boys, prostate cancer
Side effects: feminization of men

24
Q

Vincristine

A

Category: cancer
MOA: Inhibits tubulin polymerization; leads to inhibition of microtubule polymerization; Cell cycle specific (M phase)
Use: cancer
Side effects: peripheral neurotoxicity

25
Paclitaxel
Category: cancer MOA: causes mitotic arrest and cell death; inhibits tubulin and microtubule polymerization by destabilizing tubules. cell cycle specific- M phase Use: cancer Side effects: myelosuppressio, hypersensitivity
26
Trastuzumab
Category: cancer MOA: blocks HER2 function, reduced cell proliferation/ increased apoptosis Use: HER2+ metastatic breast cancer
27
Cetuximab
Category: cancer MOA: monoclonal antibody against EGFR, reduces cell proliferation/ increases apoptosis Use: colon cancer
28
Gefitinib
Category: cancer MOA: small molecule inhibitor of HER1/EGFR tyrosine kinase Use: non-small cell lung cancer
29
Bevaczumab
Category: cancer MOA: blocks VEGF receptor function leading to reduced blood supply to tumor Use: renal cell carcinoma
30
Sunitinib
Category: cancer MOA: ATP competitive inhibitor of VEGF receptor tyrosine kinase activity Use: renal cell carcinoma Side effects: cardiac toxicity
31
Methotrexate
Category: cancer MOA: inhibits dihydrofolate reductase leading to inhibition of purine biosynthesis, inability of DNA synthesis Use: leukemia, lymphoma, head/neck, breast cancers
32
5-FU
Category: cancer MOA: inhibits DNA synthesis by inhibiting thymidylate syntehsis, depletion of dTTP pool use: combo with leucovorin for cancer
33
Lisinopril
Category: cardiovascular, anti-hypertensive MOA: reversible, competitive antagonist of ACE--> vasodilation, lower blood pressure Uses: HTN, +/- diuretics; heart failure; post MI; good for preserving renal function in diabeteics Side effects: angioedema, cough, rash, postural hypotension, hyperkalemia Similar drugs: captopril, ramipril, fosinopril
34
Clonidine
Category: cardiovascular MOA: antagonist at a2 receptors results in inhibition of sympathetic tone Use: mainly HTN, others include opioid withdrawal, vascular headaches, Tourette's Side effects: orthostatic hypotension, GI upset, xerostomia
35
Clopidogrel
Category: anti-platelet MOA: irreversible ADP inhibitor; inhibits ADP induced platelet aggregation Use: treat or prevent arterial thrombosis Side effects: thrombocytopenia, neutropenia, inhibits CYPs
36
Digoxin
Category: cardiovascular MOA: Blocks Na/K ATPase: increased Na+ decreases the efficiency of Na/Ca exchanger, Ca is retained in the cytoplasm leading to increased contractile force Use: CHF, atrial flutter, atrial fibrillation, AVNRT Side effects: AV block, sinus bradycardia, Ca overload
37
Diltiazem
Category: anti-arrhythmia MOA: L-type Ca channel antagonist, decreased phase 4 in SA leading to decreased automaticity and heart rate Use: atrial flutter, atrial fibrillation, AVRT, AVNTR, atrial tachycardia Side effects: dizziness, hypotension, bradycardia, constipation
38
Dobutamine
Category: cardiovascular, heart failure MOA: activates B1 adrenergic receptors leading to increased cardiac contractility; activates B2 adrenergic receptors in vascular smooth muscle resulting in vasodilation and reduced afterload Use: acute heart failure
39
Unfractionated heparin
Category: anti-thrombic MOA: binds to antithrombin III leading to inhibition of thrombin and factor Xa Use: treat or prevent venous thrombosis Side effects: bleeding, heparin induced thrombocytopenia. Monitor with aPTT Neutralize with protamine sulfate
40
Low molecular weight heparin
Category: anti-thrombic MOA: binds to antithrombin III leading to inhibition of thrombin and factor Xa Use: treat or prevent venous thrombosis Side effects: bleeding and thrombocytopenia (less than unfractionated), hypersensitivity Monitoring: none Neutralize with protamine sulfate
41
Fondaparinux
``` Category: anti-thrombic MOA: binds to antithrombin III leading to inhibition of factor Xa Use: treat or prevent venous thrombosis Side effects: bleeding, hypersensitivity No antidote, must give FFP ```
42
Hydralazine
Category: cardiovascular, anti-hypertensive MOA: directly relaxes arterial vascular smooth muscle- activates gated potassium channels on vascular smooth muscle leading to vasodilation; dilates renal vessels. Effects mediated by prostaglandin release Triggers baroreflex resulting in tachycardia and vasoconstriction, best given w/ B blocker Side effects: flushing, headache, reflex tachycardia, lupus like dz
43
Losartan
Category: cardiovascular, anti-hypertensive MOA: reversible competitive inhibitor of angiotensin receptors, inhibits ang II at target organ resulting in vasodilation, reduced pressure, increased salt excretion Use: HTN +/- diuretic, good for diabetics to preserve renal function, heart failure, post-MI Side effects: hyperkalemia, renal impairment
44
Why do ARBs eliminate the cough seen with ACEs?
No cough or angioedema because bradykinin is unchanged
45
Nifedipine
Category: cardiovascular, anti-hypertensive MOA: CCB- antagonist at L-type calcium channels, blocks calcium influx thus preventing smooth muscle contraction. Selective for arterial smooht muscle Use: chronic HTN, hypertensive emergency Side effects: reflex tachycardia, palpitations, facial flushing, headache, postural hypotension, gum hypertrophy
46
List three dihydropyridine CCBs
amlodipine nifedipine nimodipine
47
List two non-dihydropyridine CCBs
diltiazem | verapamil
48
Nitroglycerin
Category: cardiovascular, heart failure MOA: Converted to NO resulting in relaxation of vascular smooth muscle; Causes primarily venous dilation and thus reduced end diastolic volume Use: chronic heart failure
49
Quinidine
Category: anti-arrhythmia MOA: type I anti-arrhythmic, blocks the fast inward sodium current (INa), use dependent block Side effects: thrombocytopenia, granulomatous hepatitis, myasthenia gravis, and torsades de pointes, CYP inhibitor
50
Verapamil
Category: cardiovascular MOA: non-dihydropyrinide CCB, use dependent AV block and dilates arterial vascular smooth muscle Use: HTN, arrhythmia Side effects: bradycardia, hart block, postural hypotension, GERD
51
Warfarin
Category: anti- thrombotic MOA: inhibits vitamin K dependent gamma carboxylation of factors VII, IX, X, and II. Use: treat or prevent venous thrombosis Side effects: bleeding, fetal toxicity, skin necrosis Monitor with PT/INR
52
Aspirin
Category: anti-platelet MOA: irreversible nonselective COX inhibitor, leads to decreased prostaglandins and TxA2 leading to anti-platelet and cardioprotective effects Use: NSAID, treatment or prevention of arterial thrombosis Side effects: bleeding, bruising, tinnitus, gastritis, potentiates other anti-platelet durgs
53
Propranolol
Category: cardiovascular MOA: competitive nonselective B adrenergic receptor antagonist--> decrease in HR, CO, BP Use: HTN, angina, tachycardia, acute MI Side effects: bradycardia, NVD, cold hands and feet

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