DRUGs miscellaneous Flashcards
what drug is a pyrophosphate analog and what does it treat?
foscarnet and it treats CMV and HIV because it inhibits both DNA polymerase in herpes and Reverse transcriptase in HIV. It does not need intracellular activation. This drug is also good to give if the patient already suffers from thrombocytopenia
What drug is a guanine nucleoside analogue used for CMV retinitis but requires intracellular conversion?
ganciclovir
What drug is a nucleoside analog that needs to be converted to a triphosphate form intracellular to work against herpes dna polymerase?
acyclovir
What drug is a cytosine analog, and Nucleoside reverse transcriptase inhibitor ?
Lamuvidine
What drug does not need intracellular activation, is a siliac acid analogue and inhibitor of neuroaminidase?
oseltamivir for influenza A and B
What drug inhibits the nonstructural protein NS5B an RNA dependent RNA polymerase needed for hepatic C virus replication that requires intracellular activation?
sofosbuvir
What drugs can commonly cause gout?
diuretics like furosemide hydrochlorothiazide
What is the 1st line for syphillis?
penicillin G benzathine
Vitamin K gamma carboxylation is respobsible for what factors?
10,9,7,2 and protein C and S
what can inhibit Vitamin K gamma carboxylation?
warfarin
What drug is an endothelin antagonist used for pulmonary arterial hypertension?
bosentan
patient has TB and takes a drug that caused neurotoxicty what vitamin do you give patient?
pyridoxine (B6)
what Tb drug stops acid-fastness?
isoniazid- mycolic acid inhibitor
What TB drug acts by halting DNA depenent RNA polymerase, causing a halting of bacterial protein synthesis?
Rifampin
What are the AE of rifampin?
GI effect, rash, red orange body fluids, cytopenia
What TB drug causes inhibition of arabinosyl transferase and the AE is optic neuropathy?
ethambutol
What drug is a cardiac glycoside used to treat A-fib and systolic HF?
digoxin
How is digoxin cleared and how does this effect how it is used?
renal, reduce dose in elderly because of a renal decrease in clearance due to aging
What are the AE of digoxin?
Gi issues and yellow vision
what is the purpose of giving both primaquine and chloroquine to someone with P.Vivax or Ovale?
chloroquine- intraerythrocyte stage
primaquine- dormant hepatic stage to ensure eradication and prevent relapse
drugs that cause hemorrhagic cystitis
cyclophosphamide or ifosfamide
what treats hemorrhagic cystitis due to cyclophosphamide or ifosfamide
mesna ( a sulfhydral that binds to toxin acrolein), aggressive hydration, bladder irrigation
What drug is an antagonist of neprilysin and increases ANP and BNP?
sacubitril..
this is beneficial for HF because it promotes natuiresis ( release of sodium and water), and increases vasodilation
what is the purpose of giving both primaquine and chloroquine to someone with P.Vivax or Ovale?
chloroquine- intraerythrocyte stage
primaquine- dormant hepatic stage to ensure eradication and prevent relapse
Pt has meningitis with tumbling motility high lymphocytes and gram + rod what is the best treatment?
ampicillin/ listeria meningitis
Treatment for cryptococcus neoformans meningitis?
amphothecerin B and fluconazole
inhibits integration of viral DNA into host genome via integrase
raltegravir
what opioid can precipitate withdrawal in long-term opioid users?
buprenorphine ( opioid partial agonist)
acts as antagonist when other opioids are present
what opioid can precipitate withdrawal in long-term opioid users?
buprenorphine ( opioid partial agonist)
acts as antagonist when other opioids are present
what drug treats post-menopausal osteoporosis?
raloxifene
Warfarin is used to treat atrial fibrillation, DVT, and pulmonary thromboembolism. AKA it is a long term anti-coagulant it inhibits the carboxylation of vitamin K dependent coagulation factors 10,9,7,2 protein C and S. what should be monitored when taking this treatment?
PT and INR
what is monitored when treating with UFH
APTT
______ should be used as emergency use against warfarin bleeding complication
Fresh frozen plasma if not emergency Vit K
______ should be used as emergency use against warfarin bleeding complication
Fresh frozen plasma if not emergency Vit K
What drug inhibits topoisomerase II/ DNA gyrase responsible for the negative supercoils done in DNA unwinding?
fluoroquinolone, ciprofloxacin “ floxacins”
which NSAID is less likely to cause GI toxicity?
celecoxib because it only inhibits COX2, and COX1 and 2 are inhibited by ibuprofen, indomethacin, and naproxen.
COX1 has GI mucousal protectivity
COX 1 (constitutive)- GI mucous protection, increase renal percussion, platelet aggregation. COX2 ( inducible)- vasodilaiton
______ should be used as emergency use against warfarin bleeding complication
Fresh frozen plasma if not emergency Vit K
what is the AE of loop diuretics?
hypokalemia, hypomagnesemia, ototoxicity, and cause metabolic alkalosis
which NSAID is less likely to cause GI toxicity?
celecoxib because it only inhibits COX2, and COX1 and 2 are inhibited by ibuprofen, indomethacin, and naproxen.
COX1 has GI mucousal protectivity
What do you prescribe for a 3 Hz spike wave, absence seizure?
ethosuxomide
what is the AE of loop diuretics?
hypokalemia, hypomagnesemia, ototoxicity, and cause metabolic alkalosis
what is a function of mannitol ? and AE?
decreases cerebral edema, and can cause pulmonary edema and HF. it decreases sodium and water reabsorption by PCT
Drug used to treat bradycardia with acute chest pain diaphoresis and nausea?
atropine ( anticholinergic)
AE- mydriasis, narrowing of anterior chamber, diminished aqueous humor, can cause angle closure glaucoma ( unilateral eye pain plus halos)
What drug instead of methimazole must you give pregnant woman their first trimester if they have hyperthyroidism?
PTU ( they both inhibit TPO but PTU also inhibits peripheral conversation of T4-T3)
drug used for lice
permethrin and ivermectin
Drug used to treat bradycardia with acute chest pain diaphoresis and nausea?
atropine ( anticholinergic)
AE- mydriasis, narrowing of anterior chamber, diminished aqueous humor, can cause angle closure glaucoma ( unilateral eye pain plus halos)
What drug is a phosphodiesterase inhibitor used for patient with Peripheral vascular disease that has pain walking?
what should be given in unison to prevent coronary heart disease and stroke?
cilostazol ( it reduces platelet aggregation and vasodilator) decreases claudication symptoms
aspirin or clopidogrel ( anti platelet)
drug used for lice
permethrin and ivermectin
Drug to close PDA
indomethacin
drug to treat cyanotic baby before surgery?
prostaglandins
bile acid sequestrates, decrease enterohepatic circulation of bile acids, aka liver pulls cholesterol out of blood to convert it to more bile acid decreases serum LDL
colestipol, cholestyramine, colesvelam
inhibits absorption of cholesterol through the small bowel wall at brush border
ezetimibe
upregulated lipoprotein lipase and decreased VLDL, increasing TGA clearance out of blood, activate PARR, decreases recurrent risk of pancreatitis, and increase HDL ( for elevated triglycerides and LDL)
fibrates, gemfibrozil fenofibrates
reversible inhibition of HMG-CoA reductase, increase of LDL receptors
statins ( increase HMG coa Mrna synthesis)
pancreatic lipase inhibitor
orlistat ( treats obesity)
AE fat soluble vitamin def and steatorrhea
PCSK9 inhibitors, enzyme breaks down LDL receptors
evolocumab and alirocumab
digoxin tox treatment
normalize potassium ( it is low), give anti-digoxin Fab fragments, give Mg
Tx for beta blocker overdose
glucagon
patient has confusion after sodium nitropruisde was administered what was caysed
cyanide toxicity
dopamine 1 receptor agonist that dilates both afferent and efferent arterioles to maintain renal perfusion in hypertensive emergency
fenoldopam
Furosemide is used to unload fluid in pts with dyspnea in HF or peripheral edema what is used if that didnt work?
spironolactone
for HF what is the order of meds?
ace inh, beta blocker then spironolactone
what is an AE of the NSAID naproxen?
fluid retention/edema due to renal retention of sodium
how to treat a fib
rate control first then rhythm,
rate- beta blocker or verapamil ( if beta needs to be avoided)
rhythm- flecainide ( or amiodarone)
AE of fibrates
cholesterol gallstones. Elevations in liver enzymes from hepatotoxicity and myositis are also possible adverse effects.
what are the two things beta blockers do that benefit hypertension
reduce myocardial contractility and HR and inhibit renin release
what antiarrhythmics affect the PR interval?
beta blockers and calcium channel blockers+ amiodarone
which antiarrhythmics affect qrs interval?
sodium channel blockers + amiodarone except lidocaine
which antiarrhythmics affect QT interval
K+ channel inhibitors ( dofetilide, sotalol + amiodarone
