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Pharmacology > Heart Failure, Diuretics, Hyperlipidemia, Allergy, Asthma, Anemia, Coagulation > Flashcards

Heart Failure, Diuretics, Hyperlipidemia, Allergy, Asthma, Anemia, Coagulation Flashcards

1
Q

cardiac glycoside, inhibits Na/K ATPase, increases intracellular Ca, increasing cardiac contractility

A

digoxin

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2
Q

visual changes (yellow halos in vision)

A

digoxin

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3
Q

arrhythmogenesis in digoxin increased by

A

hypokalemia, hypomagnesemia, hypercalcemia

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4
Q

drugs with narrow therapeutic index

A

warfarin, aminoglycosides, lithium, ampho B, carbamazepine, phenobarbital, phenytoin, vanco, theophylline, digoxin (WALA na Cyang PaPa! VasTeD na!)

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5
Q

DOC antiarrhythmic drug in digitalis toxicity

A

lidocaine

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6
Q

digoxin antibodies

A

Fab fragments; Digibind

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7
Q

first line therapy for both systolic and diastolic failure

A

furosemide

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8
Q

aldosterone antagonist

A

eplerenone

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9
Q

first-line drugs for chronic heart failure, decrease ventricular remodeling (cardioprotective)

A

ARBs/ACEIs

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10
Q

reduce progression of CHRONIC heart failure, may be detrimental if systolic dysfunction is marked in acute failure

A

Carvedilol, Labetalol, Metoprolol

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11
Q

iminarone, milrinone

A

phosphodiesterase inhibitor

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12
Q

associated with increased morbidity and mortality in chronic heart failure

A

phosphodiesterase inhibitor

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13
Q

vasodilators for acute severe failure with congestion

A

nitroprusside or nitroglycerin

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14
Q

shown to reduce mortality in African-Americans with CHF

A

hydralazine, ISDN

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15
Q

class of drugs w/o value in CHF

A

CCB

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16
Q

improved survival in cases of heart failure

A

ACEIs, beta-blockers, aldosterone antagonists (ABA buhay ka pa!)

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17
Q

prolonged QT interval, polymorphic Vtach

A

Torsades de Pointes

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18
Q

anti-arrhythmics class 1; phase

A

sodium channel blockers; phase 0

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19
Q

anti-arrhythmics class 2; phase

A

beta-adrenoceptor blockers; phase 4

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20
Q

anti-arrhythmics class 3; phase

A

potassium channel blockers, phase 3

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21
Q

anti-arrhythmics class 4

A

calcium channel blockers

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22
Q

more selective anti-arrhythmic drug group (specific) with significant effects on ISCHEMIC tissue but negligible effects on NORMAL cells

A

group 1B

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23
Q

selectively depress tissue that are frequently depolarizing

A

use dependent anti-arrhythmic

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24
Q

selectively depress tissue that are relatively depolarized during rest

A

state dependent anti-arrhythmic

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25
Q

anti-arrhythmic which cuts across all classes, most efficacious, for refractory arrhythmia, causes microcrystalline deposits in cornea and skin, thyroid dysfunction, paresthesia, tremors, pulmonary fibrosis

A

amiodarone/ dronedarone

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26
Q

class 1a antiarrhythmic. lupus-like syndrome

A

procainamide

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27
Q

class 1a antiarrhythmic. marked antimuscarinic effects (atropine toxicity symptoms)

A

disopyramide

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28
Q

class 1a antiarrhythmic also used in malaria; but may cause torsades, cinchonism (headache, vertigo, tinnitus), autoimmune reactions (ITP), GI upset, reduced clearance of digoxin

A

quinidine

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29
Q

treatment of class 1A overdose: reverses drug-induced arrhythmias

A

sodium lactate

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30
Q

treatment of class 1A overdose: reverses drug-induced arrhythmias

A

pressor sympathomimetics

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31
Q

class 1b antiarrhythmic DOC for post MI ventricular arrhythmias, digoxin-induced arrhythmias; SE: CNS stimulation, agranulocytosis

A

lidocaine, mexiletine, phenytoin, tocainamide causes agranulocytosis

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32
Q

mnemonic for class 1a antiarrhythmics

A

I am the queen who proclaimed diso’s pyramids (quinidine, procainamide, disopyramide)

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33
Q

mnemonic for class 1b antiarrhythmics

A

I buy mexican tacos from lily (mexiletene, tocainide, lidocaine)

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34
Q

mnemonic for drugs that can cause agranulocytosis

A

agranulocytosis! CCCAPPIT (clozapine, cotri, colchicine, aminopyrine, phenylbutazone, PTU, indomethacin, tocainide)

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35
Q

class of antiarrhythmics that can be proarrhythmic, used as last resort for refractory arrhythmias

A

class 1c antiarrhythmics

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36
Q

class 1c antiarrhythmic, highest risk for Torsades, contraindicated for post MI arrhythmias

A

flecainide, propafenone, encainide, moricizine

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37
Q

mnemonic for class 1c antiarrhythmics

A

chicken ay pagkain for enrico mmm(propafenone, flecainamide, encainide, moricizine)

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38
Q

antiarrhythmic of choice for WPW

A

procainamide, amiodarone

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39
Q

antiarrhythmic of choice for acute ventricular arrhythmias, esp. post-MI, atrial arrhythmia due to digitalis

A

class 1b antiarrhythmic

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40
Q

nonselective B-blockers

A

propranolol, timolol

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41
Q

B1-selective B-blockers

A

Bet ko mag-ace sa ateneo si Esme (betaxolol, acebutolol, atenolol, esmolol, metoprolol)

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42
Q

B blockers with intrinsic sympathomimetic activity (partial agonist)

A

pindolol, acebutolol

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43
Q

B blocker lacking local anes effect, can be used for glaucoma

A

timolol, betaxolol

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44
Q

B blocker with low lipid solubility

A

atenolol

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45
Q

shortest and longest acting B blocker

A

esmolol, nadolol

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46
Q

B blocker with combined a and b blockade

A

carvedilol, labetalol

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47
Q

B blocker used for pheochromocytoma

A

labetalol

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48
Q

in CHF, this class 2 antiarrhythmic reduces progression and decreases incidence of potentially fatal arrhythmias

A

propranolol

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49
Q

B blocker for SVT, acute perioperative and thyrotoxic arrhythmias

A

esmolol

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50
Q

B blocker anti-arrhythmic with Class 3 properties

A

sotalol

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51
Q

anti-arrhythmic class with highest propensity to cause Torsades, prolongs AP duration increasing QT interval

A

Class 3

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52
Q

class 3 antiarrhythmic examples

A

AIDS (amiodarone, ibutilide, dofetilide, dronedarone, sotalol)

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53
Q

ECG morphology in class 4 antiarrhythmics

A

prolonged PR interval

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54
Q

type of CCB which are proarrhythmic; evokes compensatory sympathetic discharge

A

dihydropyridine CCBs

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55
Q

examples of class 4 antiarrhythmics; MC side effect

A

verapamil, diltiazem; flushing

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56
Q

miscellaneous antiarrhyhtmic; DOC for paroxysmal supraventricular tachycardia; SE: flushing, affects K channels prolonging hyperpolarization, reduces Ca channels

A

adenosine

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57
Q

ions with depressant effects on digitalis-induced arrhythmias

A

K, Mg (can be effective in Torsades)

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58
Q

carbonic anhydrase inhibitor acts on _____; example

A

PCT; acetazolamide, dorzolamide, brinzolamide, dichlorophenamide, methazolamide

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59
Q

uses of acetazolamide

A

diuretic, glaucoma, mountain sickness

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60
Q

NAGMA mnemonic

A

HARDUP (hyperalimentation, acetazolamide, RTA, diarrhea, ureteral diversion, pancreatic fistula)

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61
Q

loop diuretic toxicities mnemonic

A

OH DANG (ototoxicity-with aminoglycosides, hypoK, dehydration, allergy to sulfa, nephritis, gout-hyperuricemia)

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62
Q

____ decrease the efficacy of loop diuretics by inhibiting ______

A

NSAIDs (also decrease effect of thiazides), prostaglandins

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63
Q

Loop diuretics act on _____ at the ____; examples

A

Na-K-2Cl transporter; TAL, furosemide, bumetanide, torsemide, ethacrynic acid

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64
Q

thiazides act on___ transporter at the ____; examples

A

Na-Cl carrier; DCT; HCTZ, (padapain, itali, lasunin) indapamide, chlorthalidone,metolazone

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65
Q

Thiazide diuretic effects

A

HyperGLUC (gylcemia, lipidemia, uricemia, calcemia)

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66
Q

thiazides act on___ transporter at the ____; examples

A

Na-Cl carrier; DCT; HCTZ, (padapain, itali, lasunin) indapamide, chlorthalidone,metolazone

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67
Q

Thiazide diuretic effects

A

HyperGLUC (gylcemia, lipidemia, uricemia, calcemia)

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68
Q

primary site of acidification of urine; last site of Na reabsorption and K secretion

A

cortical collecting duct

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69
Q

use of spironolactone

A

hyperaldosteronism (Conn’s syndrome), hypertension, heart failure, hypokalemia

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70
Q

SE of spironolactone

A

gynecomastia, hyperchloremic metabolic acidosis, BPH

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71
Q

advantages of spironolactone (specifically eplerenone)

A

reduces progression of DM nephropathy, reduces mortality post-MI

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72
Q

mnemonic for K-sparing diuretics

A

The K STAEs with K-sparing diuretics (spironolactone, triamterene, amiloride, eplerenone)

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73
Q

drugs causing gynecomastia

A

Some drugs create awesome knockers (spironolactone, digoxin, cimetidine, alcohol, ketoconazole)

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74
Q

SE of amiloride

A

kidney stones, acute renal failure (with indomethacin)

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75
Q

mannitol is used for

A

rhabdomyolysis, hemolysis, inc ICP, acute glaucoma

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76
Q

osmotic diuretics

A

mannitol, glycerin, isosorbide, urea

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77
Q

ADH agonists act on ___ receptors at the _______;example

A

V1 and V2 ADH receptors; medullary collecting duct, ADH, desmopressin

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78
Q

ADH, desmopressin used for

A

central DI, nocturnal enuresis, hemophilia, von Willebrand’s dse

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79
Q

ADH antagonists act on ___ receptors at the _______;example

A

V1a and V2 ADH receptors; medullary collecting duct, conivaptan, tolvaptan, lixivaptan, demeclocycline, lithium

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80
Q

Conivaptan is used for

A

SIADH, hyponatremia

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81
Q

Conivaptan may cause

A

nephrogenic DI, renal failure, bone and teeth abnormalities

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82
Q

short acting benzodiazepines w/mnemonic

A

bro, try mo etox! (brotizolam, triazolam, midazolam, etizolam, oxazepam)

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83
Q

benzodiazepines cause ____ amnesia and ____ sedation

A

anterograde; unwanted daytime sedation

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84
Q

midazolam causes rebound _____

A

insomnia/anxiety

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85
Q

benzodiazepines increase the ____ of chloride channel opening while barbiturates incease the ______; which has more dependence liability?

A

frequency, duration; barbiturates

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86
Q

part of brain responsible for anterograde amnesia; retrograde

A

hippocampus (HATER), thalamus

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87
Q

intermediate acting benzodiazepines w/mnemonic

A

si ACE NaTaLo (alprazolam, clonazepam, estazolam, nitrazepam, lormetazepam, lorazepam, temazepam)

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88
Q

abnormal sleep pattern from benzodiazepine use?

A

decreased REM sleep

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89
Q

long-acting benzodiazepines

A

diazepam, quazepam, chlorazepate, chlordiazepoxide, flurazepam, flunitrazepam

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90
Q

special use of long-acting benzodiazepines

A

alcohol withdrawal

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91
Q

benzodiazepine used as a date-rape drug

A

flunitrazepam

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92
Q

benzodiazepines w/ longest half-life

A

chlordiazepoxide (longest spelling)

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93
Q

date-rape drugs

A

alcohol, flunitrazepam, gamma hydroxybutyrate

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94
Q

DOC for status epilepticus

A

lorazepam, diazepam

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95
Q

benzodiazepine also used for bipolar disorder

A

clonazepam

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96
Q

toxic dose of benzodiazepines; treatment

A

1000x therapeutic dose; flumazenil

97
Q

with flumazenil, ____ and ____ may occur when administered in Pts who take both TCAs and benzodiazepines

A

seizures and arrhythmia

98
Q

ultrashort acting barbiturates

A

may taya tayo (methohexital, thiamylal, thiopental)

99
Q

thiopental

A

ultrashort acting (tayo agad!), acute intermittent porphyria, used for inc ICP

100
Q

cyp450 inducers mnemonic

A

ethel booba takes phen-phen and refuses greasy carb shakes (ethanol, barbiturates, phenytoin, rifampicin, griseofulvin, carbamazepine, st. john’s wort/ smoking)

101
Q

short and intermediate-acting barbiturates

A

pentobarbital (and all other barbitals except pheno and mephobarbital)

102
Q

long-acting barbiturates

A

phenobarbital, mephobarbital, primidone

103
Q

special use of long-acting barbiturates

A

hyperbilirubinemias (Gilbert syndrome)

104
Q

enzyme deficient in acute intermittent porphyria

A

hmb synthase (porphobilinogen deaminase)

105
Q

acts like benzodiazepine, used for sleep disorders only, effects reversed with___

A

zolpidem; flumazenil

106
Q

partial agonist of 5-HT1a receptors and possibly D2 receptors used for generalized anxiety disorder

A

buspirone

107
Q

enzyme used to metabolize low to moderate doses of ethanol

A

alcohol dehydrogenase

108
Q

enzyme used to metabolize ethanol at blood levels higher than 100mg/dl

A

microsomal ethanol oxidizing system

109
Q

blood alcohol concentration causing sedation, “high”, slow reaction times

A

50-100mg/dL

110
Q

blood alcohol concentration causing impairment of drivinig ability

A

60-80mg/dL

111
Q

blood alcohol concentration causing emesis, stupor

A

200-300mg/dL

112
Q

blood alcohol concentration causing coma

A

300-400mg/dL

113
Q

MC neurologic abnormality in chronic alcoholics

A

peripheral neuropathy

114
Q

syndrome characterized by ataxia, confusion, paralysis of EOM; dreaded emergency of alcohol intoxication

A

Wernicke-Korsakoff syndrome (Weird ACO- ataxia, confusion, ophthalmoplegia; Korsakoff- confabulation, hallucination, amnesia)

115
Q

Wernicke-Korsakoff syndrome: vitamin deficiency, CT scan findings

A

thamine; hemorrhagic necrosis of mamillary bodies

116
Q

most catastrophic symptom of sedative-hypnotic withdrawal

A

rebound suicide

117
Q

alcohol increases incidence of _____ cardiomyopathy; doxorubicin increases incidence of _____

A

reversible dilated; irreversible dilated

118
Q

level of alcohol consumption increasing HDL levels

A

10-15 mg/dL

119
Q

mental retardation, growth deficiencies, microcephaly, midfacial underdevelopment associated with heavy consumption of alcohol during T1 of pregnancy

A

fetal alcohol syndrome

120
Q

microorganism associated with alcohol-induced infection

A

Klebsiella pneumoniae (currant jelly sputum)

121
Q

HAD-48

A

delirium tremens (hallucinations, autonomic instability, delirium, 48-72 hours postdiscontinuation of alcohol)

122
Q

scale used to monitor patients who are possibly having alcohol withdrawal

A

CIWA- Clinical institute withdrawal for alcohol

123
Q

benzodiazepine with less complex metabolism for pts with compromised liver function exhibiting alcohol withdrawal

A

lorazepam

124
Q

opioid receptor antagonist used for tx of alcoholism

A

naltrexone

125
Q

NMDA receptor antagonist used for tx of alcoholism

A

acamprosate

126
Q

these inhibit aldehyde dehydrogenase causing hang-over like sx

A

disulfiram, (Clara took the Pre-Medical Test in the PM) chlorpropamide, cefoperazone, cefomandaole, cefotetan, procarbazine, metronidazole)

127
Q

distinct manifestation of methanol toxicity

A

visual dysfunction

128
Q

electrolyte disturbance of methanol toxicity

A

acidosis (due to accumulation of formaldehyde and formic acid)

129
Q

tx of methanol poisoning

A

ethanol, fomepizole (inhibitor of alcohol dehydrogenase)

130
Q

manifestation of ethylene glycol toxicity

A

HAGMA (due to accumulation of oxalic acid), renal damage

131
Q

tx of ethylene glycol poisoning

A

ethanol, fomepizole

132
Q

hyper___ is associated with a high incidence of acute pancreatitis

A

chylomicronemia

133
Q

MOA of statins

A

inhibit hepatic cholesterol synthesis by reversible competitive inhibition of Hmg-Coa reductase; liver compensates by increasing LDL receptors; plaque stabilization

134
Q

notable SE of statins; especially when used with ____

A

myopathy, rhabdomyolysis; fibrates

135
Q

MOA of resins

A

bind bile acids and prevent intestinal absorption, hepatic cholesterol is used to synthesize new bile acids, compensatory increase in LDL receptors

136
Q

resin example; mnemonic

A

ang cholet, colet, colet mo! BAR this from people with high TGs! (cholestyramine, colesevalam, colestipol)

137
Q

lipid-lowering drugs with GI SE

A

cholestyramine (BAR), sitosterol (sterol absorption blocker)

138
Q

given at bedtime because cholesterol synthesis predominantly occurs at night

A

statins

139
Q

notable SE of cholestyramine

A

GI sx, increases TG and VLDL

140
Q

MOA of ezetimibe

A

cholesterol absorption blockers, inhibit NPC1L1 transporter in jejunal enterocyte which mediates cholesterol and phytosterol uptake, compensatory increase in LDL receptors

141
Q

lipid lowering agent combination with synergistic LDL lowering effect but with increased hepatotoxicity.

A

statin + ezetimibe

142
Q

MOA of sitosterol

A

cholesterol analog which decreases intestinal absorption of cholesterol

143
Q

MOA of niacin

A

inhibits hormone sensitive lipase, reduces VLDL synthesis, increases clearance of VLDL by lipoprotein lipase, reduces catabolism of HDL, decreases fibrogen, increases tPA

144
Q

most effective agent for increasing HDL

A

niacin

145
Q

MC SE of niacin; reduced by

A

flushing; aspirin intake

146
Q

lipid lowering agent which must be avoided in Pts with PUD; potentiates effects of antihypertensives (vasodilators, ganglion blockers)

A

niacin

147
Q

drugs that cause flushing

A

(VANC) Vancomycin, adenocine, niacin, CCB

148
Q

MOA of fibrates

A

ligand for PPAR-alpha protein–>inc synthesis of lipoprotein lipase, stimulate fatty acid oxidation, decrease expression of apo-CIII–>impeding clearance of VLDL and increasing apo A1 and A2 which increases HDL

149
Q

DOC for hypertriglyceridemia/ high VLDL

A

fibrates

150
Q

SE of gemfibrozil

A

cholesterol gallstone, nausea, rashes, leukopenia, hemoconcentration

151
Q

best synergistic combination for hypercholesterolemia

A

statin + niacin (or ezetimibe but increased hepatotoxicity)

152
Q

combination of lipid lowering agents which increases risk of cholelithiasis

A

fibrates + resin

153
Q

endogenous molecules with powerful pharmacologic effects that do not fall into traditional autonomic groups

A

autacoids

154
Q

histamine is from what amino acid?

A

histidine

155
Q

enzymes metabolizing histamine

A

monoamine and diamine oxidase

156
Q

excess production of histamine detected by

A

imidazole acetic acid in urine

157
Q

classic demonstration of histamine effect

A

triple respones: wheal, flush, flare

158
Q

first generation H1 receptor antagonist examples

A

MINE and ZINE (diphenhydramine, chlorpheniramine, cyclizine, meclizine, promethazine)

159
Q

MOA of promethazine

A

competitive inhibition of peripheral and central H1 receptors+ alpha and M receptor, with anti-motion sickness effect

160
Q

SE of cyclizine

A

drowsiness

161
Q

2nd generation H1 receptor antagonist examples

A

cetirizine, loratadine, fexofenadine, desloratidine, terfenadine, astemizole

162
Q

MOA of astemizole

A

competitive inhibition of peripheral H1 receptors; no anti-motion sickness effect

163
Q

H2 receptor antagonist examples

A

ranitidine, famotidine, cimetidine, nizatidine

164
Q

serotonin is produced from aa

A

tryptophan (5-hydroxytryptamine)

165
Q

excess serotonin production is detected by ____ which is also a marker for

A

5-hydroxyindole acetic acid (5-HIAA); carcinoid tumor in GI tract

166
Q

MOA of sumtriptan; DOC for

A

5-HT ID receptor agonist (brain), causes vasoconstriction; acute migraine, cluster headache

167
Q

MOA of granisetron; DOC for

A

5-HT3 antagonist, blocks chemoreceptor trigger zone and enteric nervous system; chemo and postop vomiting

168
Q

DOC for irritable bowel disease which may cause constipation

A

alosetron

169
Q

5-HT3 antagonist wihich may cause QRS and QT prolongation

A

dolasetron

170
Q

produced from a fungus in wet or spoiled grain, partial agonists at alpha-adrenoceptors and 5-HT receptors

A

ergot alkaloids

171
Q

classification of ergot alkaloids with examples

A

vasoselective (ergotamine), uteroselective (ergonovine)

172
Q

MOA of ergotamine

A

partial agonist of 5-HT and alpha adrenoceptors causing marked smooth muscle contraction but blocks alpha agonist vasoconstriction, used for migraine and cluster headache (vasoselective)

173
Q

classification of methysergide; side effect

A

ergot alkaloids (vasoselective), retroperitoneal fibrosis

174
Q

antidote of ergotamine

A

nitroprusside

175
Q

MOA of ergonovine

A

partial agonist of 5-HT and alpha adrenoceptors causing marked smooth muscle contraction but blocks alpha agonist vasoconstriction, used for migraine and cluster headache (uteroselective)

176
Q

partial agonist of 5-HT and alpha adrenoceptors used for postpartum bleeding, migraine

A

ergonovine, methylergonovine (methergine)

177
Q

cyclooxygenase isoform found in normal physiologic processes

A

cox-1

178
Q

cyclooxygenase isoform found in inflammatory cells

A

cox-2

179
Q

endogenous fatty acid derivatives that are produced from arachidonic acid

A

eicosanoids

180
Q

prostaglandin E1 analogue used for PUD, prevention of NSAID-induced gastric mucosal injury and abortifacient

A

misoprostol/gemeprost

181
Q

SE of misoprostol

A

teratogenic (moebius sequence)

181
Q

prostaglandin E1 analogue used for maintenance of PDA, erectile dysfunction; notable SE

A

alprostadil; priapism

181
Q

prostaglandin E1 analogue used for maintenance of PDA, erectile dysfunction; notable SE

A

alprostadil; priapism

182
Q

prostaglandin E2 analogue used induction of labor(cervical ripening) and abortifacient

A

dinoprostone/sulprostone

182
Q

prostaglandin I2 analogue used for pulmonary HPN, reduced plt aggregation in dialysis

A

epoprostenol, beraptost, iloprost, treprostinil

182
Q

prostaglandin F2A analogue used for glaucoma, causes permanent eye color change

A

latanoprost, bimatoprost, ravoprost, unoprostone

182
Q

prostaglandin F2A analogue used for control of postpartum hemorrhage, abortifacient

A

carboprost, bimatoprost, ravoprost, unoprostone

182
Q

prostaglandin F2A analogue used for glaucoma, causes permanent eye color change

A

latanoprost, bimatoprost, ravoprost, unoprostone

183
Q

major risk factor of asthma

A

atopy

190
Q

DOC for acute asthma attacks

A

SABA (Albuterol, salbutamol, levabuterol, terbutaline, metaprotenerol, pirbuterol, procaterol, fenoterol)

191
Q

Seretide

A

Salmeterol+Fluticasone

192
Q

Symbicort

A

Budesonide+Formoterol

193
Q

for asthma prophylaxis which increases asthma mortality when used alone; may precipitate arrhythmias

A

LABA (Formoterol, Salmeterol, Cleneterol Bambuterol)

194
Q

Ipatropium/Tiatropium MOA

A

muscarinic receptor antagonist preventing vagal-stimulated bronchoconstriction

195
Q

more effective and less toxic for patients with COPD

A

Iatropium

196
Q

drip used in status asthmaticus

A

aminophylline drip

197
Q

MOA of theophylline/aminophylline/ pentoxifylline; use; SE

A

methylxantine; phosphodiesterase inhibition, adenosine receptor antagonist; prophylaxis against nocturnal attackes; may cause tremors, seizure, narrow therapeutic window

198
Q

antidote in overdosage of B blockers

A

theophylline

199
Q

MOA of cromolyn;use; similar drugs

A

mast cell stabilizer;causes ca influx, release of leukotrienes, histamine, and other mediators; asthma prophylaxis (not for acute control); nedocromil, lodoxamide

200
Q

DOC for BA prophylaxis

A

ICS (fluticasone, beclomethasone, budesonide, ciclesonide, flunisolide, mometasone, triamcinolone)

201
Q

MOA of mometasone; SE

A

corticosteroid, inhibitase phospholipase A2; oral candidiasis, mild growth retardation

202
Q

can be used for severe refractory asthma (status asthmaticus)

A

IV hydrocortisone

203
Q

ICS with lowest systemic steroid toxicity

A

Ciclesonide

204
Q

MOA of zileuton; unique indication; SE

A

leukotriene synthesis inhibitor (specifically 5-lipoxygenase); BA prophylaxis, exercise, antigen and ASA-induced bronchospasm; elevation of liver enzymes

205
Q

MOA of montelukast, unique indication, rare SE

A

leukotriene synthesis inhibitor (specifically cysteinyl leukotriene-1 receptor for SRSA, antigen and ASA-induced bronchospasm; Churg-strauss syndrome, neuropsych effects

206
Q

MOA of omalizumab

A

anti-IgE antibody, binds IgE antibodies on mast cells; prophylaxis of severe, refractory asthma not responsive to other drugs

207
Q

oral iron supplement with lowest elemental iron (36mg)

A

ferrous gluconate

208
Q

oral iron supplement with highest elemental iron (106mg)

A

ferrous fumarate

209
Q

triad of hemochromatosis; aka; tx

A

cirrhosis, DM, skin pigmentation; bronze diabetes; phlebotomy, deferoxamine or deferasirox

210
Q

cause of megaloblastic anemia with neurologic defects; w/o neurologic defects

A

vitamin B12 deficiency; folic acid deficiency

211
Q

neurologic defects of Vit B12 deficiency

A

ataxic gait, impaired position and vibratory sense, spasticity

212
Q

reactions where vit B12 is essential

A

methylmalonyl CoA to succinyl CoA; homocysteine to methionine; folic acid metabolism, synthesis of deoxythmidylate (dTMP), a precursor for DNA synthesis

213
Q

administration of ____ to patients with vit B12 deficiency helps refill tetrahydrofolate pool and corrects anemia but not neurologic defects

A

folic acid

214
Q

vit B12 synthesis

A

cyanocobalamin, hydroxocobalamin

215
Q

MOA of folic acid; similar drugs

A

precursor of essential donor of methyl groups used for synthesis of aa, purines and DNA

216
Q

agonist of erythropoietin receptors; SE; associated with blood doping

A

epoietin alfa, darbepoietin alfa, methoxypolyethylene glycol-epoietin beta

217
Q

myeloid growth factor; indication; SE

A

G-CSF, sargramostim (GM-CSF), Pegfilgrastim; neutropenia associated w/chemo, myelodysplasia, aplastic anemia, mobilization of peripheral blood cells for hematopoietic stem cell transplantation; bone pain

218
Q

megakaryocyte growth factor; indication; SE

A

oprelvekin (IL-11) or thrombopoietin; prevention of thrombocytopenia in pts under chemo for nonmyeloid cancer; fluid accumulation, transient atrial arrhythmias

219
Q

local autocoid factors responsible for vasoconstriction

A

TXA2, endothelin

220
Q

causes platelet aggregation

A

adenosine diphosphate, serotonin (also causes vasoconstriction)

221
Q

net result of coagulation pathways

A

prothrombin activator

222
Q

arterial vs venous thrombosis

A

red and platelet rich; fibrin-rich

223
Q

MOA of ASA; toxic dose, lethal dose, SE (regarding aerobic metab), associated syndrome

A

nonselective, irreversible cox1 and 2 inhibitor, reduces platelet production of TXA2; 150mg/kg; 500mg/kg; uncoupler of oxidative phosphorylation; Reye syndrome

224
Q

indication for ASA in pedia

A

RF, Kawasaki dse, JRA

225
Q

triad of aspirin hypersensitivity

A

SAMTER triad (asthma, aspirin sensitivity, nasal polyps)

226
Q

salicylate intoxication acid-base abnormality in children; adults

A

HAGMA; respi alkalosis with HAGMA (lactic acidosis due to anaerobic metab)

227
Q

MOA of abciximab; similar drugs; similar to this congenital deficiency

A

interferes with gpIIB/IIIa binding to fibrinogen; eptifibatide, tirofiban; Glanzmann’s thrombastenia

228
Q

MOA of clopidogrel; similar drugs; SE

A

irreversibly inhibits binding of ADP to platelet receptors; ticlopidine, prasugel; TTP (more with ticlopidine)

229
Q

inhibits phosphodiesterase III and inc cAMP in plt and BVs, used for prophylaxis in cardiac valve displacement; similar drug used for intermittent claudication (but contraindicated in heart failure)

A

dipyridamole; cilostazol

230
Q

heparin is a (direct/indirect) thrombin inhibitor; activates ______, which complexes with Factors _____; most popular SE; monitor using; antidote

A

indirect; antithrombin III; IIa, IXa and Xa; heparin-induced thrombocytopenia; PTT; protamine

231
Q

enoxaparin is a (direct/indirect) thrombin inhibitor; activates ______, which complexes with Factor _____; monitoring; antidote

A

indirect; antithrombin III; Xa; does NOT require PTT monitoring; protamine only partially effective

232
Q

derived from saliva of medicinal leech

A

lepirudin

233
Q

MOA of lepirudin; indication; monitoring; antidote

A

direct thrombin inhibitorl; binds to thrombin’s active site; HIT; PTT; no reversal agent

234
Q

Warfarin is a (direct/indirect) thrombin inhibitor; activates ______; most popular SE; CI; monitor using; antidote

A

direct; vitamin K epoxide reductase (responsible for carboxylation of vit K dependent clotting factors [1972, protein C and S]); warfarin induced skin necrosis; pregnancy; PT; vit K (slow), FFP (fast)

235
Q

MOA of alteplase, special note, allergy observed with ____, antidote

A

fibrinolytic, tPA analog; loses effectiveness on 2nd use; streptokinase; aminocaproic acid

236
Q

MOA of aminocaproic acid; similar drug; CI (2)

A

competetive inhibitor of plasminogen activator; tranexamic acid; DIC and GU bleeding

237
Q

names of vit K1, 2, 3; CI; among these, which must never be used as tx due to ineffectiveness?

A

phytonadione, menaquinone, menadione; severe infusion reaction when administered too fast (dyspnea, chest and back pain); vit K2

238
Q

MOA of desmopressin

A

vasopressin V2 agonist; increases

FVIII activity for Hemophilia A, vW disease

Pharmacology (7 decks)

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