drugs

Question 1

How to distinguish between the two classes of local anesthetics

• esters
• amides

Answer 1

Amides: two i’s

Esters: one or no i’s

Question 2

Side effects of antimuscarinics

Answer 2

Red as a beet: flushing w/ decreased sweating
Dry as a bone: dry skin and mucous membranes
Blind as a bat: mydriasis w/ loss of accommodation
Mad as a hatter: delirium
Hot as a hare: hyperthermia
-constipation and urinary retention

Question 3

Location of where antiemetics work

-what drugs are used

Answer 3

Vagal afferents -> Chemoreceptor trigger zones in area postrema located in the floor of the fourth ventricle

Drugs:

• DA antagonist: metoclopramide
• 5-HT3 antagonist: “setrons”

Question 4

Muscarinic agonist SE

Answer 4

DUMBBELSS

• diarrhea
• urination
• miosis (constriction of the pupil)
• bronchospasm
• bradycardia
• excitation of CNS and skeletal ms
• Lacrimation
• Sweating
• Salivation

Question 5

MOA of the only drug available that will help prolong ALS pts life

Answer 5

Riluzole: glutamate release inhibitor, glutamate receptor blocker, and Na channel blocker

Question 6

Pt on antidepressants is brought to ER w/ diaphoresis, severe HA, and tachycardia

• was watching football, drinking a beer and eating pizza when it started
• VS: increased pulse and BP

What class of drugs was he on?

Answer 6

Monoamine oxidase inhibitors =

• was eating tyramine containing foods: cheese and beer
  
  • tyramine will enter synaptic terminals and displace massive amounts of NE from them -> sympathetic crisis

MOA: phenelzine, tranylcypromine, isocarboxazid

Question 7

TCA used to tx OCD

Answer 7

Clomipramine

Question 8

45 y/o female presents w/

• severe upper quadrant abdominal pain and nausea after eating fatty meals
• cholangiogram shows no stones in biliary duct
• increased AST and ALT on labs
• US: hepatomegaly but not abnml in biliary tree

History of tx w/ what anesthetic would cause these SE?

Answer 8

Halothane -> causes hepatitits

Question 9

Binds to IL-2 receptor on activated T-cells

Answer 9

Basiliximab

-kidney transplant rejection prophylaxis

Question 10

Inhibits T cell proliferation by binding to serine-threonine kinase mTOR

Answer 10

Sirolimus

-kidney transplant rejection prophylaxis

Question 11

Inhibits calcineurin mediated transcription of IL-2

Answer 11

Tacrolimus

-kidney, heart, and liver transplant rejection

Question 12

What cases red man syndrome (maculopapular rash) on pts being tx w/ vancomycin

Answer 12

D/t infusion rate being too rapid