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USMLE > Drugs not in LANGE flashcards > Flashcards

Drugs not in LANGE flashcards

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USMLE® Step 1 flashcards
1
Q

Raltegravir, Elvitegravir

A

Integrase inhibitors – HIV drug

Inhibit HIV genome integration into host cell chromes by reversibly inhibiting HIV integrate

Toxicity: Increases creatine Kinase

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2
Q

Enfuvirtide

A

HIV drug
Binds gp41 – inhibits viral entry

Toxicity – skin reactions at site of injection
+ epenseive

  • reserved for any drug resistant HIV strains
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3
Q

Maraviroc

A

HIV drug
Binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120

The problem: obviously can only be used in patients with functional CCR-5 receptor

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4
Q

Anidulafungin
Caspofungin
Micafungin

A

class: Echinocandins Antifungals

Mechanism: inhibit cell wall synthesis by inhibiting synthesis of beta-glucan

Clinical use: invasive aspergillosis, Candida

Toxicity = GI upset, flushing (via histamine release)

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5
Q

what are the 5 drug classes that can be used to treat glaucoma?

A 
alpha agonists
Beta blockers
Cholinomimetics
diuretics 
Prostaglandins (PGF-2)
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6
Q

What is the treatment for diverticulitis?

A

Metronidazole (anaerobes)

Fluoroquinolones (gram neg) or TMP-SMX

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7
Q

Cinacalcet

A

mechanism: Sensitizes Ca2+- sensing receptor (CaSR) in parathyroid

Clinical use: hypercalcemia due to primary or secondary hyperparathyroidism

Toxicity = hypocalcemia

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8
Q

Drugs that cause methemoglobinemia

A

Recall the methemoglobin – Fe3+ state (oxidized)

Nitrates 
Antimalarial drugs ( Primaqine, Chloroquine)
Dapsone
Sulfonamides
Local anesthetics ( Lidocaine)
metoclopimide
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9
Q

Drugs that can cause a long QT (cardiac)

A

ABCDE

anti-Arrythmics ( Ia, III)
AntiBiotics (macrolides)
Anti "C"ycotics (haloperidol)
Anti Depressants ( TCAs)
Anti Emetics (ondansetron)
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10
Q

How do you treat Torsades de pointes

A

Magnesium sulfate

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11
Q

How do you treat Wolff-Parkinson-White syndrome?

A 
Procainamide
- avoid beta blockers or calcium channel blockers ( can use class IA/C... others block AV node and facilitate passage through the accessory pathway.----> SVT
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12
Q

How do you treat atrial fibrillation?

A

Class IC or III anti-arrythmetics

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13
Q

What is the preferred treatment for atrial flutter?

A

catheter ablation

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14
Q

How do you treat an acute heart attack

A
  1. ABC
  2. MONA – morphine, O2 (if hypoxic), Nitroglycerine, Aspirin)
  3. Beta-blocker (but not if there is a sign of heart failure)
  4. Statin
  5. Anti-platelet – Clopidogrel/ticagrelor
  6. Anti-coagulant– heparin and enoxaparin
  7. K+> 4, Mg >2
  8. STEMI – CATH/ Fibrinolysis
  9. NSTEMI – Cath
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15
Q

What drugs decrease the oxygen demand of the heart?

A
  1. Beta blockers (decrease contractility & HR)
  2. Nitrates (decrease preload)
  3. ACE/ ARB ( decrease afterlood)
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16
Q

treatment for hair-pulling disorder (Trichotillomania)

A

Fluoxetine (SSRI) or Clomipramine (TCA)

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17
Q

Atomoxetine ( Strattera)

A

Norepinephrine reuptake inhibitor (SNRI)

ADHD - attention deficit hyperactivity disorder

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18
Q

Dextroamphetamine

A

(aka Adderall)

CNS stimulants
Cause release of catecholamines at the synaptic cleft

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19
Q

How do you treat intractable tics? (Tourette syndrome)

A

Behavioral therapy
Fluphenazine
Pimozide
Tetrabenzaine

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20
Q

Treatment of Bulimia Nervosa

A

(SSRI) Fluoxetine + psychotherapy

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21
Q

what is the treatment for DTs (Delirium Tremens)

A

Peaks 2-4 days after last drink

Benzodiazepines

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22
Q

What is used to treat alcoholic hallucinations

A

visual hallucination 12-48 hours after last drink

Long-acting benzodiazepines
chloridazepoxide, lorazepam, diazepam

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23
Q

Drug for Lyme disease or Rocky Moutain Spotted fever

A

Tetracyclines

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24
Q

Used to treat Giardia lamblia

A

Metronidazole

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25
Q

Treatment for gram negative rods in patients with renal insufficiency

A

Meropenem/ imipenem with TMPX, Dapsone then Pentamiine

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26
Q

Propholaxis in Aids patients against P. jirovecii pneumonia

A

Cilastatin

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27
Q

Used as prophylaxis against TB

A

Isoniazid

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28
Q

Which antibiotics are safe during pregnancy

A 
Penicillins and aminopenicillins
Piperacillin
Cephalosporins
Macrolides (erythromycin, azithromycin)
Metronidazole (after 1st trimester)
Nitrofurantoin
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29
Q

which medication inhibits dihydrofolate reductase

A

Enzymes plays role in pyrimidine synthesis

Methotrexate, Trimethoprim, pyrimethamine

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30
Q

which drug inhibits thymidylate synthase

A

Enzymes plays role in pyrimidine synthesis

5-FU

5- Fluorouracil

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31
Q

Inhibits nosine monophosphate dehydrogenase

A

Mycophenolate, Ribavirin

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32
Q

Inhibits PRPP amidotransferase

A

6-Mercaptopurine (6-MP) and it’s prodrug azathioprine

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33
Q

Etoposide

A

Inhibits eukaryotic topoisomerase

Treats cancer of the testicles and small cell lung cancer in combination with other medicines.

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34
Q

Alpha-amanitin

A

Toxin

Found in Amanita phalloids (death cap mushrooms) and it inhibits RNA polymerase II (eukaryotes – recall prokaryotes only have 1 polymerase). Can cause SEVERE HEPATOTOXICITY if ingested.

35
Q

Drugs that cause Disulfiram-like reactions

A

Metronidazole
Certain cephalosporins
Procarbazine (Hodgkin lymphoma)
1st generation sulfonylureas (tolbutamide)

36
Q

Who are the low potency neuroleptics?

A

Chlorpromazine, Thioridazine

37
Q

Who are the high potency neuroleptics?

A 
Haloperidol
Fluphenazine
Loxapine
Thiothixene
Trifluoperazine
38
Q

Who are the atypical antipsychotics?

A 
olanzapine
quetiapine
Risperidone
apipiprazole
clozapine
39
Q

Methylphenidate
Dextroamphetamine
Methamphentamine

  • mechanism
  • clinical use?
  • toxicity?
A

Atypical antidepressant

Stimulates release of norepinephrine and dopamine into synaptic cleft

ADHD, narcolepsy, apetite control

toxicity: sedation, increase appetite, weight gain, dry mouth

40
Q

Trazodone

  • mechanism
  • clinical use?
  • toxicity
A

Atypical antidepressant

blocks 5-HT2 and alpha-1 adrenergic receptors

Primarly used for insomnia (works well with SSRIs and increases REM sleep)

Toxicity: sedation, nausea, PRIAPISM (painful persistent penile erection), postural hypotension

41
Q

Bupropion

  • mechanism
  • clinical use?
  • toxicity
A

Atypical antidepressant

increases NE and dopamine by inhibiting its uptake

Smoking cessation

Toxicity: stimulant effects (tachycardia, insomnia) – dont take drug before going to sleep
- headaches, seizures in anorexic or bulimic patients

benefit: NO SEXUAL SIDE EFFECTS

42
Q

Nitrofuration

mechanism
Indication
SE

A

mechanism: bacteriocidal
Reduced by bacterial proteins to a reactive intermediate that inactivates bacterial ribosomes
* has to be in presence of bacteria to be active

Indication: UTI cystitis by E.coli or staph saprophyticus

SE: rarely nausea, HA, diarrhea

Safe in pregnancy

43
Q

why should beta blockers not be used during cocaine intoxication

A

beta blockers can lead to severe hypertension from unopposed alpha 1 activation

44
Q

How do you treat nephrogenic diabetes insipidus

A

Hydrochlorothiazide
Amiloride (lithium toxicity)
Indomethacin

45
Q

Who are the short acting benzodiazepines?

A

“ATOM”

Alprazolam
Triazolam
Oxazepam
Midazolam

46
Q

What are the drugs associated with Nephrotoxicity/ototoxicity

A

Vancomycin
Aminoglycosides
Loop diuretics
Cisplatin and Carboplatin

47
Q

Mnemonic for treating testicular cancer:

A

“Eradicate ball cancer”

Etoposide
Bleomycin
Cisplatin

Or:

Etoposide
Ifosfamide
Cisplatin

48
Q

Brimonidine

what is it used for?
receptor it targets?

mechanism?
Side Effects:

A

Glaucoma drug – FA 494
(alpha 2)

  • decreases aqueous humor synthesis

Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular parities

49
Q

Beta blockers that can be used in glaucoma?

A

Timolol, betaxolol, carteolol – Beta blockers

Decrease aqueous humor synthesis

No pupillary or vision changes

50
Q

Mnemonic to see if beta blockers are specific for B1 or are non selective:

A

A- M selective against B1

N to Z is non selective

Carvedilol and labetalol are nonselective alpha and beta antagonists.

51
Q

Carbachol

A

muscarnic and nicotinic receptor agonist.

M3 receptor

52
Q

Drugs that cause SLE

A 
Hydralazine
Procainamide
Isoniazid
Minocycline
Quinidine
53
Q

What is the treatment for Wilson’s disease

A

low ceruloplasmin

tx: penicillamine

54
Q

What is the anti protozoan therapy for toxoplasmosis

A

Pyrimethamine

55
Q

What is the anti-protozoan therapy for trypanosome brucei

A

suramin and melarsoprol

56
Q

What is the anti-protozoan therapy for T. cruzi

A

nifurtimox

57
Q

What is the anti-protozoan therapy for leishmaniasis

A

Sodium stibogluconate

58
Q

What are the anti-louse therapies

A

Permethrin (blocks Na+)–> neurotoxicity
Malathion (AchE i)
Lindane (blocks GABA) —> neurotoxicity

To treat Scabies and Pedicures and Pthirus (lice)

59
Q

who are the agents used as antihelminthic therapy

A

Mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel

60
Q

treatment of Von Willebrand disease

A

Desmopressin – analog of vasopressin/ADH – it is known that it increases vWF release from endothelial cells.

however, severe vWF deficiency will not respond to desmopressin

61
Q

what is the treatment for gestational diabetes if light exercise and diet have failed?

A

Insulin – does not cross the placenta

62
Q

how is hypoglycemia treated in medical setting vs. non medical setting

A

In medical setting – IV dextrose (glucose)

In non medical setting – intramuscular glucagon

63
Q

treatment of central DI?

A

Intranasal desmopressin acetate

Hydration

64
Q

Treatment for nephrogenic DI?

A
  • HCTZ (1st line) – causes patient to become dehydrated: makes PCT work harder and so it reabsorbs more water so that by the time filtrate hits distal tubal, it is already a little more concentrated
  • Indomethacin (blocks prostaglandin, decrease renal blood flow, inhibit urine output)
  • Amiloride ( blocks Na+ channels that lithium use to enter principle cell) – lithium induced DI.
  • hydration
65
Q

Treatment for SIADH?

A 
Fluid restriction
IV hypertonic saline (NaCl > 0.9%)
Conivaptan
Tolvaptan
Demeclocycline
66
Q

Drugs that can cause seizures

A
  • Bupropion (antidepressant – especially bolemic/ anorexic)
  • Clozapine (antipsychotic at high doses)
  • Isoniazide ( anti-TB, give pyridoxine)
  • Ciproflaxin (antibiotic)
  • Imipenem (antibiotic)
67
Q

treatment for ADHD?

- names and mechanism

A

stimulants : Methylphenidate, dextroamphetamine, methamphetamine

mechanism: increase catecholamines in the synaptic cleft, especially NE and Dopamine

68
Q

treatment for alcohol withdrawal

A

long-acting benzodiazepines

(chlordiazepoxide, lorazepam, diazepam_

69
Q

treatment for bipolar disorder

A
  • Lithium ( mood stabilizer)
  • Valproic acid
  • Atypical antipsyhcotics
70
Q

treatment for Bulimia

A

SSRIs

71
Q

treatment for Depression

A

SSRIs

72
Q

treatment for generalized anxiety disorder

A

SSRIs, SNRIs

73
Q

Treatment for obsessive compulsive disorder

A

SSRIs, clomipramine (tricyclic antidepressant - block reuptake of NE and 5-HT - serotonin)

74
Q

treatment of panic disorder

A

SSRIs
Venlafaxine (SNRI)
benzodiazepines

75
Q

treatment of PTSD

A

SSRIS

Venlafaxine (SNRI)

76
Q

treatment of Schizophrenia

A 
Atypical antipsychotics  
(olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone)
77
Q

Treatment for social phobias

A

SSRIs, beta-blockers

78
Q

Tourette Syndrome

A

Antipsychotics (fluphenazine, pimozide)
tetrabenazine
Clonidine

79
Q

drugs with antimuscarinic effects:

A 
Atropine
TCA
H1 antagonists
neuro-eleptics
Anti-parkinson meds

= flushing and myadriasis

80
Q

who are the mood stabilizers? Are they used in combination with anything else?

A

Lithium
Valproate ( Valproic Acid)
carbamazepine

Plus an atypical antisychotic (olanzapine)

81
Q

treatment for essential tremors

A

nonspecific beta-adrenergic antagonist (like propranolol)

essential tremor is believed to be inherited as an autosomal dominant

82
Q

Drug given for ALS

A

“Lou needed riLUzole”

Riluzole – decreases presynaptic glutamate release

83
Q

treatment for bedwetting

A

Desmopressin

84
Q

Treatment for night terrors and sleepwalking

A

benzodiazepines

USMLE (43 decks)

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