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STEP 1 High Yield > High yield Drugs/Side effects > Flashcards

High yield Drugs/Side effects Flashcards

1
Q

Anti-Cholinergic Side effects and Drugs that Cause Anti-cholinergic toxicity

A

Hot as hare (no sweat), Dry as a bone (no lacrimation, very thirsty), red as a beet ( flushing), Blind as a bat (blurry), AMS (psychosis, Hallucinations, agitation, delirium)

Drugs:
Anticholinergics- atropine, scopolamine (motion sickness), oxybutynin (overactive bladder tx)

Antihistamines- Diphenhydramine, hydroxyzine
Antipsychotics - chlorpromazine, olanzapine
Antispasmodics- Hyocyamine, dicyclomine
Cyclic Anti Depressants- Amitryptyline, desipramine

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2
Q

Cyclosporine

A

Calcineurin Inhibitor
-binds cyclophilin
Blocks T-cell activation and Prevent IL2 transcription

use: Transplant rejection and Rheumatoid

HIGH YIELD:
NEPHROTOXIC- use Sirolimus (prevents IL2 response)
can also cause gingival hyperplasia

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3
Q

Tacrolimus

A

Calcineurin inhibitor
-binds FK506 binding protein, blocking T-cell activation and PREVENTING IL2 TRANSCRIPTION

use: Transplant rejection

toxicity- NEPHROTOXIC (use sirolimus) same as cyclosporine but increased risk for neurotoxicity and diabetes.

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4
Q

Sirolimus (rapamycin)

A

mTOR inhibitor, binds FKBP.
- Blocks T-cell activation and B-cell differentiation via
DECREASING T- CELL RESPONSE IL2

use: Kidney Transplant rejection (dont use tacrolimus or cyclosporine)

Toxicity- Pancytopenia, insulin resistance

synergistic with cyclosporine

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5
Q

Daclizumab + Basiliximab

A

monoclonal antibodies BLOCKS IL2 RECEPTOR (CD-25)

use: kidney transplant rejection

Side effects: edema and HTN, tremor

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6
Q

Azathioprine

A
  • anti-metabolite
  • precursor of 6-Mercaptopurine
  • PURINE analog

Both block de-novo purine synthesis, activated by HGPRT.

  • Inhibits lymphocyte proliferation by blocking nucleotide synthesis.

Uses: Transplant rejection, Crohns, RA,

effects: Leukopenia, anemia, thrombocytopenia

6MP is degraded by xanthine oxidase
- Pts taking Allopurinol or Febuxostat (XO inhibitor) are at increased risk for toxicity.

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7
Q

Mycophenolate

A
  • reversibly inhibits IMP dehydrogenase preventing B and T cell PURINE synthesis.
    use: Transplant rejection and lupus nephritis.

less nephrotoxic and neurotoxic, can cause pancytopenia.

ASSOCIATED WITH INVASIVE CMV INFECTION

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8
Q

FILGRASTIM

A

G-CSF
Recombinant cytokine
recovery of bone marrow

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9
Q

SARGRAMOSTIM

A

GM-CSF
Recombinant cytokine
recovery of bone marrow

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10
Q

IFN-alpha

A

used recombinant for Hep B and C, kaposi and malignant melanoma

Also part of innate host defense
released by multiple cells (monocytes, B-cells, NK cells)
-synthesized from virally infected cells and act locally on uninfected cells – priming for viral defense
- halting protein synthesis in cells
- RNAase degrades all RNA in the cell
- Protein Kinase R -inactivates EIF-2 blocking translation

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11
Q

IFN- Beta

A

used recombinant for MS

Also same innate host defense as IFN Alpha

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12
Q

Corticosteroids

A

Phospholipase A2 inhibitor

Inhibit NF-kB supress B and T cell function by decreasing transcription of cytokines.
Induces apoptosis of T-Lymphocytes

Used for rapid relief of RA patiens and for Proptosis in Hyperthyroid patients.

Cataracts
Ulcers
Striae
Hirsutis
Infection
Necrosis of Femoral head
Glucose Increase
Osteoporosis
Immune supression
Depression/Delerium
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13
Q

Rituximab

A 
Anti-CD20 - 
used for B-cells
- Non-hodgkin lymphoma
- CLL
- RA
- ITP

Increases risk for PML (progressive multifocal leukoencephalopathy)

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14
Q

Alemtuzumab

A

Anti- CD52

CLL and MS

aLYMtuzumab= LYMphocytic leukemia

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15
Q

Bevacizumab

A

Anti-VEGF

Colorectal cancer, RCC
can also be used for Wet age related macular degeneration

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16
Q

Ranibizumab

A

Anti -VEGF

used for age related macular degeneration

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17
Q

Cetuximab

A

anti-EGFR
monoclonal antibody
Stage IV colorectal cancer also Lung adenocarcinoma

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18
Q

Trastuzumab

A

Anti- HER2/Neu tyrosine kinase receptor

used for breast cancer

19
Q

Adalimumab

Infliximab

A

Soluble TNF- alpha inhibitor
monoclonal antibody

Crohns, RA, psoriasis, Ankylosing spondylitis

Check for TB first

20
Q

Etanercept

A

Fusion protein for TNF-alpha and IgG1
Acts as a decoy receptor

RA, psoriasis

Check for TB first

21
Q

Teriparitide

A

Recombinant PTH increases osteoblastic activity

22
Q

VermurRAFenib

A

BRAF + oncogene in metastatic melanoma

used for V600E mutated BRAF

23
Q

Imatinib

A

Tyrosine Kinase inhibitor of BCR-ABL (t 9;22 - CML or B-ALL) and C-KIT inhibitor in GI tumors

24
Q

Erlotinib + Gefitinib

A

EGFR tyrosine kinase inhibitor

NON-SMALL cell lung cancer.

25
Q

Eculizumab

A

Complement protein C5 monoclon antibody - used in paroxysmal nocturnal hemoglobinuria ( no DAF to protect)

26
Q

Omalizumab

A

IgE inhibitor for severe asthma, prevents IGE binding

27
Q

Palivisumab

A

RSV prophylaxis

28
Q

Abciximab

A

antibody agains platelet glycoproteins IIB/IIIA

anti-platelet agent to prevent complications in patients undergoing PCI

29
Q

Natalizumab

A

alpha- 4 integrin inhibitor preventing WBC adhesion.

30
Q

Cisplatin/Carboplatin

A

cross link DNA
Testicular Bladder and lung carcinoma

Nephrotoxic and Ototoxic

Prevent nephrotoxicity with AMIFOSTINE (free radical scavenger)

31
Q

Etoposide and Teniposide

A

inhibitor of Topoisomerase II – Increase DNA degradation

- blocks the sealing of strand breaks.

32
Q

Irinotecan and Topotecan

A

Inhibits Topoisomerase I - preventing DNA unwinding
Colon Cancer- Irinotecan
Small Cell - Topotecan

33
Q

Hydroxyurea

A

inhibits ribonucleotide reductase- Decreases DNA synthesis (S specific phase)

Blocks Purine AND Pyrimidine synthesis

Melanoma CML, Sickle Cell (increases HbF)

34
Q

Cladribine

A

Purine Analog- dna polymerase inhibitor and dna breaks

Used for Hairy cell leukemia

Myelosupression, nephrotoxic, neurotoxic

35
Q

Cytarabine

A

Pyrimidine analog- inhibits DNA polymerase.

use for Leukemias

Can cause PanCYTopenia

36
Q

5- Fluorouracil

A
  • Pyrimidine analog activated to 5-FdUMP
  • Covalently complexes folic acid,
  • Inhibits THYMIDYLATE SYNTHASE (decreases DNA synthesis)

Effects enhanced by Leucovorin (folinic acid) can worsen myelosupression

37
Q

Methotrexate

A

folic acid analog, that competitively inhibits dihydrofolate reductase (decreases DNA synthesis)

INHIBITS PYRIMIDINE SYNTHESIS

Uses:
Cancer: leukemias (ALL), lymphomas, choriocarcinoma
Non-cancer: 1st line for RA, IBD, ectopic preg, medical abortion (with misoprostol)

Myelosupression reversed by Leucovorin (folinic acid)

Mucositis, hepatotoxic, pulmonary fibrosis.

38
Q

Bleomycin

A

Anti-tumor
Free radical formation- DNA Strand Breaks.

Pulmonary fibrosis - skin hyperpigmentation

39
Q

Dactinomycin

A

intercalates DNA

Used for WIlms, Ewing sarcoma, rhabdomyosarcoma, (childhood tumors)

40
Q

Demeclocyclin

A

Used to treat SIADH, by inducing nephrogenic DI

41
Q

Doxorubicin/Danorubicin

A

Generates free radicals intercalates DNA

Cardiotoxic- dilated cardiomyopthy

Dexrazoxane - iron chelator to prevent cardiotoxicity - prevents Fe2+ free radical damage

42
Q

Ribavirin

A

inhibits inosine monophosphate dehydrogenase

used for Hepatitis C and RSV in adults

(palivisumab prophylaxis in high risk babies)

43
Q

Leflunomide

A

Inhibits Dihydroorotate dehydrogenase- inhibits pyrimidine synthesis

STEP 1 High Yield (4 decks)

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