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Drugs Step 1 > Drugs Step 1 > Flashcards

Drugs Step 1 Flashcards

1
Q

Chlorthalidone

A

most potent thiazide diuretic

Inhibit Na/Cl transporters in distal convoluted tubule

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2
Q

Torsemide

A

Loop diuretic

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3
Q

Ethacrynic acid

A

Loop diuretic

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4
Q

Loop vs. Thiazide diuretics

A

Loop: cause Hypokalemia + hypocalcemia
Thiadize: hyponatremia + hypercalcemia + hypokalemia

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5
Q

Beta-lactam + rash & fever few weeks later…also high creatinine level?

A 
Acute interstitial nephritis
 - see eosinophils
 - involves renal interstitium
   - edema + leukocyte infiltration
(also happen w/ sulfas, rifampin, diuretics, quinolone antibiotics)
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6
Q

How treat GBS in pregnant mom?

A

At weeks 35-37 culture, then if + give perinatal penicillin (or ampicillin)

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7
Q

Toxicity of aggressive diuresis with osmotic diuretics?

A

Mannitol - given to reduce ICP

- toxicity = pulmonary edema

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8
Q

Vasopressin

A

Acts LATE - medullary segment of collecting duct
- acts on V1 and V2
V1: vasoconstriction + prostaglandin release
V2: antidiuretic response
- increased plasma osmolarity causes ADH release
- saves water
- increase urea reabsorption

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9
Q

Abciximab

A
  • binds glycoprotein GP IIb/IIIa on platelets – prevents binding of fibrinogen which links platelets in a platelet plug
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10
Q

Streptokinase

A

Thrombolytic

  • converts plasminogen to plasmin
  • cleaves fibrin & breaks down clots
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11
Q

Aspirin

A

Irreversibly inhibits COX-1

- inhibit thromboxane A2

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12
Q

Eptifibatide

Tirofiban

A

Both have “fib” = fibrinogen

- bind IIa/IIIb and prevent fibrinogen from causing platelet aggregation

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13
Q

Clopidogrel

A

Block ADP receptor

  • when ADP receptor binds ADP, causes IIa/IIIb to be expressed on platelet surface
  • so blocks IIb/IIIa expression
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14
Q

Ticlopidine
Ticagrelor
Prasugrel

A

Block ADP receptor (like clopidogrel)

  • when ADP receptor binds ADP, causes IIa/IIIb to be expressed on platelet surface
  • so blocks IIb/IIIa expression
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15
Q

Enoxaparin

A

Low molecular weight heparin

- inhibits factor Xa

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16
Q

Infliximab

A

TNF-a antibody

  • manage RA
  • treat Ankylosing spondylitis
  • Crohn’s
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17
Q

Abciximab

A

Antibody against GP IIb/IIIa

  • blocks final step in platelet aggregation
  • give during angioplasty in pt w/ ACS
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18
Q

Vincristine

A

Interferes w/ microtubule formation

  • inhibits MT polymerization after binding beta-tubulin
  • no mitotic spindle
  • chromosomes can’t align/segregate
  • M-phase specific agents
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19
Q

Vitamin K Injection

A

Needed by newborns after birth

  • clotting factor activation via carboxylation
  • needed to prevent bleeding complications
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20
Q

Hydroxyurea

A

Increases hemoglobin F synthesis

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21
Q

Antimalarial drugs

A

Instigators of G6PD deficiency

- Heinz bodies

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22
Q

Nevirapine

A

NNRTI

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23
Q

Zidovudine & Emtricitabine

A

NRTI

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24
Q

TMP-SMX

A

Induce G6PD deficiency (X-linked)

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25
Q

Morphine

A

Binds mu receptors, GPCR, cause K+ efflux out of the cells = hyper polarization

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26
Q

St. John’s Wort

A

Induces hepatic CYP450 enzymes

- increases warfarin metabolism – decreased warfarin drug levels

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27
Q

Narrow spectrum anticonvulsants

A

Phenytoin
Carbamazepine
Gabapentin
Phenobarbital

28
Q

Broad spectrum anticonvulsants

A

Valproic acid
Topiramate
Lamotrigine
Levetiracetam

29
Q

Status Epilepticus

A

Treat w/ Benzodiazepines

- enhanced postsynaptic chloride influx

30
Q

Blurred vision, flushed skin, pupils dilated, dry oral mucosa

A

Jimson Weed poisoning – Gardner’s mydriasis – treat w/ physostigmine

31
Q

Isoniazid

A

Chemically similar to pyridoxine (B6)

  • cause B6 deficiency
  • GABA deficiency
32
Q

Diphenhydramine

A

1st generation antihistamine

  • block histamine
  • block acetylcholine (anti-cholinergic)
33
Q

Rifampin

A

P450 inducer – lower phenytoin levels

34
Q

Amitryptyline

A

TCA: inhibits NE & 5-HT reuptake
- anticholinergic effects
(dry mouth, constipation, urinary retention)

35
Q

Azathioprine

A

Allopurinol blocks Xanthine Oxidase which results in increased conversion of Azathioprine to 6-MP.
This allows more 6-MP to be incorporated into cellular DNA – get bone marrow suppression

36
Q

Celecoxib

A

Specific COX-2 inhibitor

- less blessing

37
Q

Omeprazole

A

Risk of osteoporosis & hip fracture

Possibly due to decreased Ca++ absorption

38
Q

Methotrexate

A 
#1 for Moderate to severe Rheumatoid Arthritis
SE: painful mouth ulcers + hepatotoxicity
39
Q

Alendronate

A

Bisphosphonate

  • similar structure to pyrophosphate
  • disrupt osteoclast function
    • binds to hydroxyapatite binding sites
40
Q

Chronic use of prednisone

A

Osteoporosis

41
Q

Risedronate

A

Inhibits mature osteoclast-mediated bone resorption

42
Q

Thiazide diuretics

A

Increase distal tubular reabsorption of filtered Ca++

43
Q

Sulfonylureas

  • glipizide
  • glyburide
  • glimepiride
A

Glipizide – short acting
Glyburide – long acting
Glimepiride – long acting

44
Q

Niacin

A

Decreases TG and VLDL

Cause gouty arthritis

45
Q

Varenicline

A

Partial agonist of a4b2 nicotinic ACh receptor

- causes only limited release of dopamine

46
Q

Inhaled glucocorticoids

A

Can cause oropharyngeal candidacies

- use spacer & rinse mouth

47
Q

Amiodarone SE

A

PFT’s, LFT’s, and TFT’s
Pulmonary fibrosis
Hepatotoxicity
Hypo/hyper-thryoidism

48
Q

Fluticasone

A

Asthma - Corticosteroid - inactivate NFkB

- especially decreased TNF-a

49
Q

Budesonide

A

Asthma - Corticosteroid - inactivate NFkB

- especially decreased TNF-a

50
Q

Omalizumab

A

anti-IgE – Asthma drug

- used in allergic asthma resistant to inhaled steroids and LABA

51
Q

Theophylline

A

Asthma - bronchodilation via PDE inhibition
- increase cAMP
Narrow TI = cardio/neurotoxic…blocks adenosine (P450)

52
Q

Bosentan

A

Treat PAH; antagonist endothelin-1 receptors

  • decreased pulmonary vascular resistance
  • give while waiting for lung transplant
53
Q

Allopurinol

A

Can cause stevens-johnson syndrome

- fever, bullae, sloughing, necrosis, DEATH

54
Q

Amiodarone SE

A 
Check PFT, LFT, TFT
 - QT prolongation, TdP, heart block
 - Interstitial pneumonitis
 - Hypo/Hyper-thyroidism
 - Elevated Transaminases - Liver
\+++ blue-gray skin discoloration
55
Q

Propylthiouracil

Methimazole SE’s

A

Agranulocytosis
- pt comes in w/ fever, sore throat, oral ulcerations
GET CBCwdiff

56
Q

Pioglitazone

A

Thiazolidinedione TZD

  • binds PPAR-g and this complex
  • binds transcription regulatory sequence of genes
  • *increases insulin sensitivity (increases adiponectin)
57
Q

Anastrozole

A

Aromatase inhibitor

58
Q

Letrozole

A

Aromatase inhibitor

59
Q

Exemestane

A

Aromatase inhibitor

60
Q

Cholestyramine

A 
Bind bile acids -- shit them out
Liver has to make more bile acids
 - this increases LDL cholesterol uptake
 - reduces LDL blood levels
SE: increase TG
61
Q

Propranolol

A

Inhibits NE & Epi compensatory rxn to hypoglycemia
- block b2 block gluconeogenesis
- block glycogenolysis & lipolysis
Don’t use nonselective beta blockers in diabetics
Reduce the awareness of hypoglycemia in diabetics

62
Q

Repaglinide

A 
Meglitinide
 - closes ATP K+ channel
 - depolarizes cell
 - induces L-type Ca++ channel opening
      - insulin release
Short acting
63
Q

Sildenafil

A

Can’t give with nitrates – double SM relaxation

- deadly hypotension

64
Q

OCP Use SE

A

Hepatic adenoma

65
Q

Tamoxifen & Raloxifen SE’s

A

Increase risk of thromboembolic events
Tamoxifen - increased risk endometrial cancer
Raloxifen - used for osteoporosis; does not cause endo ca

66
Q

Anastrozole

A

Aromatase inhibitors used in POSTMENOPAUSAL women with ER+ breast cancer

67
Q

Disulfiram-like reaction

A

Metronidazole when combined w/ alcohol

Drugs Step 1 (5 decks)

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