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STEP 1 RECALL > Drugs/ Pharm > Flashcards

Drugs/ Pharm Flashcards

1
Q

Cromolyn sodium

A

Inhibits mast cell degranulation, preventing the release of chemical mediators of asthma

For prophylaxis of asthma attacks

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2
Q

Ondansetron (Zofran)

A

5- HT3 receptor (serotonin) antagonists, highly effective at preventing vomiting , especially for chemo patients

Block vagus nerve mediated nausea AND block vomit center in the CTZ of the medulla

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3
Q

N- acetylcysteine (NAC)

A

A mucolytic agent, used for acetominophen overdose

Other uses:

  • Protect kidneys in pts with renal insufficiency who need IV contrast
  • mucolytic in Flu, bronchitis, cystic fibrosis
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4
Q

Leucovorin (Folinic acid)

A

Treatment of methotrexate overdose

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5
Q

Filgrastim

A

A G-CSF (granulocyte colony stim factor) analog used to stimulate granulocytes after myelosuppressive chemotherapy

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6
Q

Octreotide

A

Somatostatin analog (use for Growth Hormone adenoma) suppresses the anterior pituitary response to GHRH to stop release of GH

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7
Q

Bromocriptine

A

Dopamine agonist– suppresses prolactin (used in pts with a prolactinoma )

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8
Q

Argatroban – mechanism, use ?

A

direct thrombin inhibitor, used for Heparin Induced Thrombocytopenia (HIT syndrome) and other times when you need to prevent clotting

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9
Q

best diabetes med for a pregnant woman?

A

Insulin

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10
Q

a drug to both decrease the risk of bone fracture and decrs breast cancer risk in woman

A

a SERM (ie: Raloxifene) –> estrogen agonist at the bone and antagonist at the breast

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11
Q

list the P450 inhibitors:

A

“Florida Grapefruits Can Inhibit Some Key Enzymes”

Fluoroquinolones (Cipro, Levaquin....) 
Grapefruit juice
Cimetidine
Isoniazid
Sulfonamides
Ketoconazole (& other -azoles)
Ethanol (alcohol abuse)

also, Macrolides, Amiodarone & Ritonavir (MAR)

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12
Q

Enfuvirtide

A

binds to gp41 on the HIV cell & prevents fusion & penetration into the host cell

“you can’t get “en -fu” there”

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13
Q

vitamin that helps Psoriasis?

A

vitamin D (sunlight or creams like Calcipotriene)

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14
Q

Abciximab mechanism , use?

A

monoclinal AB that targets the gpIIb/IIIa and inhibits platelet aggregation

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15
Q

a drug with a high MW, highly bound to plasma protein, highly charged & hydrophilic –> will it have a high or low Vd?

A

Low volume of distribution –> all those characteristics trap the drug in the plasma compartment

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16
Q

best treatment for ingestion of Rat Poison?

A

1st line is to give FFP, then slower acting vitamin K

rat poison is usually coumadin / warfarin & FFP contains all the clotting factors you need to immediately help the bleeding

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17
Q

Nitrates can cause a reflex tachycardia and hypotension with a subsequent release of catecholamines–> this adverse effect can be prevented by co-administering what type of drug?

A

a beta blocker –> decreases HR and also blocks the effects of the catecholamines

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18
Q

What are the Class 1 anti-arrhythmics?

A

Class 1A = “Double Quarter Pounder”
((Disopyramide, Quinidine, Procainamide))

Class 1B = “Lettuce, Tomato, Mayo”
((Lidocaine, Tocainide, Mexilitine))

Class 1C = “More Fries Please”
((Moricizine, Flecainide, Propafenone))

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19
Q

Why do patients taking nitrates need to have a ‘nitrate free interval’ every day?

A

To prevent tolerance

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20
Q

Which type of drug has been shown to be beneficial for preventing the myocardial remodeling of heart failure as well as lower BP?

A

ACE inhibitors

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21
Q

What is the mechanism of Nitrates?

A

release NO –> increase cGMP–> vasodilates (veins&raquo_space; arteries) – cause a decrease in PRELOAD –> decrs cardiac work

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22
Q

Side effects of IV infused adenosine?

A

flushing, burning in the chest, SOB (Adenosin is the drug of choice for a supravenricular tachycardia)

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23
Q

Where are Beta 1 receptors found?

A

cardiac tissue & renal JG cells

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24
Q

Effects of anthracyclines (Doxo- & Daunorubicin) on the heart?

A

form free radicals in the myocardium and cause dilated cardiomyopathy

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25
Q

What is the bioavailability of a drug administered IV?

A

1 (100%)

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26
Q

Formula for Maintenance Dose?

A

MD = steady state plasma concentration X Clearance / Bioavailability (1 if given IV)

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27
Q

Formula for half life?

A

Vd x 0.7 / Clearance

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28
Q

Formula for Loading dose?

A

Vd x Steady state plasma concen / (Bioavailability fraction)

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29
Q

Where do the K+ sparing diuretics work in the nephron?

A

at the Collecting duct

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30
Q

What are the Class 3 anti-arrhythmics?? (they block K+ efflux / block phase 3 repol , prolonging the QT interval)

A

“K+ IS BAD”

Ibutilide
Sotalol
Bretylium
Amiodarone
Dofetilide

all put you at risk for Torsades!

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31
Q

Most common side effects of Verapamil?

A

Constipation, gingival hyperplasia, bradycardia and heart block!

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32
Q

What antihypertensive drugs are also protective against diabetic nephropathy?

A

ACE inhibitors

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33
Q

First line for hypertension treatment in pregnant women?

A

Hydralazine & Methyldopa

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34
Q

Hydralazine mechanism

A

direct vasodilator (incrs cGMP —>smooth muscle relaxation and vasodilation (esp in arterioles therby reducing AFTERLOAD)

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35
Q

Side effects of Hydralazine

A

Reflex tachycardia, Lupus like syndrome, N,V, HA…

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36
Q

Calcium channel blockers that are more specific for cardiac than smooth muscle

A

Verapamil, Diltiazem (Nifedipine is more vessel selective)

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37
Q

Treatments for Malignant HTN?

A

Nitroprusside
Fendolopam
Diazoxide

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38
Q

Best drugs for lowering LDL?

A

Statins (HMG-Coa reductase inhibitors)

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39
Q

Best drugs for increasing HDL?

A

Niacin (reduces VLDL secretion into blood)

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40
Q

Best for lowering Trigs?

A

Fibrates (upregulate LPL)

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41
Q

Adverse effect of fibrates and statins (worse when given together)

A

Myopathy (rhabdomyolysis, myositis…)

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42
Q

Lipid lowering drug with side effects of flushing, hyperglycemia, hyperuricemia (gout exacerbation)

A

Niacin (flushing can be decreased by taking ASA)

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43
Q

Patients HATE these lipid lowering drugs b/c they taste bad and cause GI upset

A

Bile acid resins (cholestyramine) – they prevent the liver from reabsorbing bile acids

44
Q

Drug for heart failure that inhibits the Na/K ATPase and Na/Ca exchanger, therby increasing intracellular Calcium and increasing contractility

A

DIGOXIN (used for CHF, also helpful for afib because it stimulates the vagus nerve)

45
Q

Treatment for Torsades and dig toxicity

46
Q

Class 1 antiarrhythmics block_______ channels

A

Sodium channels (the phase 0 inward Na+ current in the ventricles) – also prolong phase 3 & prolog the AP (class 1A the most, 1C next and 1B the least)

47
Q

Class II antiarrhythmics block_______

A

these are Beta blockers – block Beta receptors and decrs cAMP, decr Ca++ in the cell, decrs the slope of phase 4 at the nodes

48
Q

Which drugs can treat arrhythmia but have the side effect of masking signs of hypoglycemia?

A

Class 2 antiarrhythmics (B-blockers) –> treat overdose with glucagon

49
Q

Class III antiarrhythmics block_______

A

K+ channels – they block the K+ efflux, prolong phase 3 repol and prolong the QT interval ((*risk for Torsades))

50
Q

Amiodarone adverse effects

A

pulmonary fibrosis, hepatotoxicity, thyroid problems ((always check LFTs, PFTs and TFTs) –also blue/gray skin discolor, constipation, bradycardia , heart block

51
Q

Why would you not give an opiod analgesic for a person in pain from gallbladder problems?

A

b/c opiods cause contraction of the smooth muscles in the Sphincter of Oddi –> increases pressure in the bile duct & GB and can lead to biliary colic pain

*Mepiridine doesn’t cause much contraction & is the one to use for GB & panc pain….

52
Q

mechanism of Zidovudine (for HIV)

A

nucleoside RT inhibitor, comp binds to RT and is incorporated into the viral genome as a Thymidine analog

-AZT doesn’t have a 3’ -OH group so phosphodiester bond formation is impossible

53
Q

an acute extrapyramidal symptom (like dystonia) after taking a drug for psychiatric disorder –> which receptor was most likely being antagonized by the drug?

A

Dopamine (D2) receptors

  • EPS are a result of an imbalance btw the D2 and Muscarinic receptors in the nigrostriatal tract
  • they usually balance each other out – so block one & you get symptoms
54
Q

the one type of renal stone that is radiolucent (does NOT show up on XRAY)

A

Uric Acid stone

55
Q

what mediates the flushing side effects on Niacin?

A

Prostaglandins

-hence you can prevent it with Aspirin

56
Q

What is the mechanism of the TB drug that can cause optic neuritis as a side effect?

A

Ethambutol –> inhibits carbohydrate polymerization & thus peptidoglycan synthesis

57
Q

What is the mechanism of Isoniazid?

A

inhibits Mycolic acid synthesis

58
Q

Which TB drug directly inhibits bacterial RNA synthesis and can turn your tears, sweat & other secretions red/ orange?

59
Q

drug for treating HTN & BPH at the same

A

alpha-1 blocker

60
Q

these drugs bind to PPAR-gamma and decrease Insulin-resistance , increase adiponectin

61
Q

severe HTN causes what changes to kidney arterioles?

A

onion-like concentric thickening of arteriolar walls

62
Q

Conditions associated w/ avascular necrosis of the femoral head

A

1- Sickle cell
2- Vasculitis / Lupus
3- Steroids / Alcoholism

63
Q

What causes the hypercalcemia in sarcoidosis?

A

macrophages cause increased extrarenal formation of active Vitamin D

64
Q

A pt on antithyroid meds (PTU or Methimazole) — what complication should you look out for?

A

Agranulocytosis (white count < 500)

65
Q

Drug to give a patient who is having trouble voiding after surgery

A

Bethanechol (muscarinic agonist)

66
Q

these drug classes function by irreversibly binding to penicillin-binding-proteins like transpeptidases…

A

Penicillins & Cephalosporins

67
Q

What is the 1st area of the brain damaged / most susceptible to global cerebral ischemia?

A

the hippocampus

68
Q

Rathke’s pouch comes from what embryologic layer?

A

Surface ectoderm

69
Q

Low AFP on a triple screen of a pregnant woman might indicate….

A

Down’s syndrome

70
Q

Rank the different kinds of “bruises” from smallest to largest

A

petechiae ( 1cm)

71
Q

prevention for MAC in an HIV + pt

A

weekly Azithromycin

72
Q

side effects of Caspofungin

A

flushing & GI upset

73
Q

mechanism of Amphotericin B & Nystatin

A

“tears” holes in Ergosterol membranes

74
Q

What fungal pneumonia can be stained w/ mucicarmine stain?

A

Cryptococcus neoformans

75
Q

What drug is used for asthma challenge test

A

methacholine

76
Q

Side effects of -azoles?

A

Inhibits hormone synthesis (androgens) , can cause gynecomastia in men, hepatotoxicity

77
Q

What is the most common form of Cryptococcus neoformans infection?

A

meningitis

78
Q

What side effect do Gangcyclovir & Zidovudine have in common?

A

Neutropenia / bone marrow suppression

79
Q

how do Beta blockers help in treatment of thyrotoxicosis?

A

1- reduce heart rate , anxiety

2- decrs the rate of peripheral conversion of T4 to T3

80
Q

Mechanism of Trimethoprim

A

inhibits DHFR

same as methotrexate

81
Q

pt with recent episodes of thrombophlebitis that involve multiple sites

A

migratory thrombophlebitis (think CANCER)

-“Trousseau’s syndrome” –> especially adenocarcinomas of the pancreas, colon, or lung

82
Q

lipid lowering drug that can cause INCREASED trigs

A

bile acid resins

83
Q

Nitroprusside is metabolized to _________ & ______ so there is potential for toxicity

A

Cyanide and N.O

84
Q

antidote for Cyanide toxicity

A

Sulfur (in the form of Sodium Thiosulfate)

85
Q

which ACHe inhibitor can cross the BBB

A

Physostigmine – can reverse Atropine toxicity

86
Q

this anatomical defect is necessary for pyelonephritis to develop

A

Vesico-ureteral reflux

87
Q

Atropine can worsen _________ and is therefore contraindicated in pt’s with this eye problem

A

Glaucoma

  • Atropine causes Mydriasis, can worsen narrowing of anterior chamber angle
88
Q

long acting alpha-blocker commonly used for Pheochromocytomas

A

Phenoxybenzamine

89
Q

highly sedating anti-depressant that can cause priapism

90
Q

mechanism of Pioglitazone

A

a TZD – binds to PPAR-gamma to modify transcription , increases Adiponectin, therby decrs insulin resistance

91
Q

corticosteroids cause an increase in which type of white blood cell?

A

Neutrophils (a result of demargination of neutrophils that were attached to vessel walls)

-they cause a decrs in all other WBC’s

92
Q

1st line tx for Simple & Complex Partial seizures

A

Carbamazepine

93
Q

Tx for Myoclonic Seizures (type of generalized seizure, arrhythmic jerking movements)

A

Valproic acid

94
Q

1st line tx for Generalized Tonic Clonic seizures

A

Phenytoin (then Carbamazepine & Valproate)

95
Q

Drugs that can cause a Disulfiram like reaction

A

I Died when I “MET that PRO SURFer at a Certain C-store”

  • Metronidazole
  • Procainamide
  • Sulfonureas (1st gen)
  • Certain Cephalosporins
96
Q

Antipsychotic drug that you must beware of Agranulocytosis…

A

Clozapine (hides granulocytes in the ‘closet’)

97
Q

you can develop tolerance to all of the effects of Opiods EXCEPT:

A

Constipation & Miosis

98
Q

drug most associated w/ Neuroleptic malignant syndrome

A

Haloperidol

99
Q

Oxycodone overdose would cause your pupils to ________

A

constrict (it is semisynthetic Opioid)

100
Q

SSRI’s (like Paroxetine) can be used to treat premature ejaculation b/c _____

A

they cause anorgasmia as a side effect!

101
Q

primarily used to treat spasticity/ UMN symptoms

A

Baclofen – activates GABA at muscle spindle

102
Q

carbonic anhydrase inhibitor that is used to treat glaucoma, seizures, pseudotumor cerebri, altitude sickness, cystinuria, heart failure (diuretic) ..

A

Acetazolamide

103
Q

mechanism of Acetazolamide

A

block Carbonic Anhydrase at the PCT

-interferes with bicarbonate (HCO3-) reabsorption in the kidneys, thereby re-acidifying the blood (and thus alkalinizing the urine).

104
Q

mechanism of the atypical antipsychotic Aripriprazole

A

Partial agonist at dopamine receptors

105
Q

Mechanism of Montelukast

A

blocks the leukotriene receptors

STEP 1 RECALL (12 decks)

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