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Question 1

digoxin (MOA)

Answer 1

-NA/K ATPase inhibitor, leads to intracellular accumulation of Na, leads to inhibition of Na/Ca antiproton, leads to intracellular accumulation of Ca2+ –> positive inotropy

Question 2

hydrochlorothiazide (MOA, tx, possible complications)

Answer 2

• inhibits NaCl reuptake in proximal distal tubule
• decreases Ca2+ wasting (positive inotrope effects?)
• tx: HTN, CHF, ***nephrogenic diabetes insipidus
• SE: hyperglycemia, hyperlipidemia, hypercalcemia

Question 3

Tx for Lead poisoning (adults 2, kids 1)

Answer 3

• adults: dimercaprol and ethelynediamine tetraactic acid (EDTA)
• kids: succimer

Question 4

protamine sulfate

Answer 4

• tx for heparin overdose

- cation, binds negatively charged heparin, inactivating it

Question 5

hydroxyurea (MOA, tx)

Answer 5

• MOA: inhibits ribonucleotide reductase, preventing conversion of ribonucleotides to deoxyribonucleotides, effectively inhibiting DNA synthesis
• … because of this it can increase production of fetal hemoglobin (less likely to sickle)
• tx: sickle cell and essential thrombocytosis

Question 6

chelating agents (deferoxamine, dimercaprol, penacillamine, EDTA/succimer)

Answer 6

• deferoxamine: iron and aluminum
• dimercaprol: arsenic, mercury, gold
• penacillamine: lead and arsenic and COPPER (wilson’s dz)
• EDTA and succimer: lead

Question 7

filgrastim

Answer 7

• given to patients on myelosuppressive chemotherapy to help bone marrow recover
• also called granulocyte colony stimulating factor (G-CSF)

Question 8

ribavarin (MOA… leads to SE of hemolytic anemia, which has lab values of…)

Answer 8

• inhibits monophosphate dehydrogenase, effectively inhibiting nucleotide formation– leads to hemolytic anemia
• lab values: decreased hematocrit and haptoglobin, elevated lactate dehydrogenase and indirect bilirubin

Question 9

abciximab (MOA)

Answer 9

-binds to glycoprotein receptor IIa/IIIb, preventing fibrinogen from binding, interrupting platelet aggregation

Question 10

clopidogrel (MOA)

Answer 10

-inhibit ADP pathway involved in binding of fibrinogen to platelets

Question 11

leuprolide (MOA and tx, tricky)

Answer 11

• can act as either GnRH agonist (pulsatile) or antagonist (continuous) depending on administration
• used to treat infertility (agonist) and prostate cancer (antagonist)

Question 12

vincristine (MOA… tx…)

Answer 12

• microtubule inhibitor

- tx of hodgkin’s lymphoma

Question 13

ribavirin (MOA… tx… SE…)

Answer 13

• depletes intracellular stores of ATP
• given to chronic HCV, reduce fatigue and hepatic inflammation
• causes non-immune mediated hemolytic anemia

Question 14

all trans retinoid acid (MOA… tx…)

Answer 14

• induces differentiation of tumor cells

- PML t(15;17) often presents with DIC

Question 15

abciximab

Answer 15

-antibody against GP IIb/IIIa, prevents aggregation of platelets

Question 16

clopidogrel/ticlopidine (MOA)

Answer 16

-anti-platelet, works by inhibiting ADP which decreases platelet aggregation and GP IIb/IIIa expression

Question 17

immunosuppressants that act via IL-2 (one inhibits, one is a receptor antagonist)

Answer 17

• IL-2 is important in T lymphocyte activation
• cyclosporine… inhibitor, SE: renal tox
• daclizumab… monoclonal Ab, generally well tolerated

Question 18

side effect of cyclophosphamide and tx to prevent this side effect

Answer 18

• SE: hemorrhagic cystitis and myelosupression

- tx: Mensa, neutralizes metabolites in urine and prevents cystitis

Question 19

tx for severe neutropenia?

Answer 19

• G-CSF: granulocyte colony stimulating factor

- promotes maturation and differentiation of neutrophils

Question 20

reverse the effects of tPA with…

Answer 20

-aminocaproic acid

Question 21

celocoxib

Answer 21

-selective COX-2 inhibitor