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MD Pharmacology > Kaplan-5 > Flashcards

Kaplan-5 Flashcards

1
Q

How do we treat community acquired MRSA?

A

Clindamycin and TMP-SMX

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2
Q

what H-2 inhibitor causes gynecomastia and why?

A

Cimitidine is a P-450 inhibitor which causes reduction of androgens leading to gynecomestia and decreased libido.

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3
Q

What is the only NSAIDs that does not cause renal dysfunction?

A

Sulindac, It is a prodrug, the only NSAIDs that does not affect renal PGs.

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4
Q

What enzyme does allopurinol blocks?

A

Xanthine oxidase.

Allopurinol will be converted by Xanthine oxidase to Alloxanthine and then it will be blocked by this metabolite. (suicide inhibitor)

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5
Q

What is the interaction between allopurinol and azithioprine?

A

Azathioprine—HGPRT—-6MP (active)—–XO—- Inactive 6MP.

Allopurinol inhibits Xanthine oxidase, which converts 6-MP to its inactive form. Hence if a pt. is being treated for gout then it will cause severe toxic levels of 6-MP.

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6
Q

What drug inhibits the secretion of weak acid drugs such as penicillin, cephalosporins, and fluroquinolones?

A

Probenecid.

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7
Q

What is the enzyme blocked by glucocorticoids?

A

Phospholipase A2 (PLA2) leading to a decrease in PGs and LTs.

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8
Q

What causes oropharyngeal candidiasis as SE?

What can use to prevent this?

Treated with?

A

Inhaled glucocorticoids. To prevent this, pts use spacers or gargling. If they developed oral candidiasis its treated with nystatin. (Switch and gargle)

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9
Q

What is the antidote for Heparin?

A

Protamine sulfate, it is a chemical antagonist, fast onset.

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10
Q

What is the enzyme blocked by Warfarin?

A

Vitamin K epoxide reductase

Decreased hepatic synthesis of vitamin K- dependent factors II, VII, Ix, X (coumarins prevent gamma carboxylation by inhibiting vitamin k epoxide reductase, no effect on factors already present) Takes about 10 days to work.

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11
Q

What is biggest contraindicated medication for a pt. with a UTI and on Warfarin?

A

Sulfonamides. Warfarin is 98% bound to albumin, and sulfonamides displace warfarin and can lead to toxicity and death.

Treat pts. with ampicillin instead.

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12
Q

What are the direct inhibitors of thrombin/

A

Argatroban / Dabigatran / Bivalirudin used in atrial fib, doesn’t require PT monitoring.

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13
Q

What are the factor Xa inhibitor?

A

“Xabans” Rivaroxaban, does not require monitoring of PT and INR. Used to prevent DVTs after knee/hip surgery; prevention of stroke and systemic embolism in non-valvular atrial fibrillation.

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14
Q

What is the drug that will inhibit ADP on platelets? what will it lead to? SE?

A

Clopidogrel (Plavix) inhibits ADP on platelet decreasing the expression of GP IIB/IIIA receptor. Hence it works as antiplatelet drug, which prevents aggregation.

SE: Hemorrhage, leukopenia and thrombocytopenic purpura (TTP)

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15
Q

What do we use to prevent TIA , or post-MI pts that are ASA hypersensitive?

A

Clopidogrel, blocks ADP receptors on platelets, decreasing activation.

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16
Q

What drug do we use in acute coronary syndrome or post angioplasty?

A

Abciximab, which is a glycoprotein IIb/IIIa receptors antagonists— decrease aggregation by preventing cross-linking reaction. This drug is never used chronically.

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17
Q

What are the glucose dependent insulin release drugs? Why are they significant?

A

Thiazolidinendiones: Pio/rita/rosiglitazone.
Metformin
Repaglinide: stimulates insulin release from beta cells.
Exenatide: Increases (GLP-1)
Sitagliptin: inhibits DPP-4 which breaksdown GLP-1

These drugs are significant because they do not produce hypoglycemia. Only good for type II diabetics.

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18
Q

What is the MOA of Acarbose?

A

Acarbose: Inhibits alpha-glucosidase enzyme in brush border of small intestine , which inhibits the conversion of starch to glucose, hence decrease demand for insulin.

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19
Q

What is the MOA of Anastrozole?

A

It inhibits aromatase enzyme activity. Given to post-menopausal women.

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20
Q

What is the main difference between tamoxifen and raloxifene?

A

they are both estrogen receptor agonist (bone) and antagonist in breast BUT raloxifene differs in that it is an antagonist in endometrium , while tamoxifen is an agonist increasing the risk for endometrial cancer.

21
Q

What is the only anti contraceptive progestin that has no androgenic activity?

What are the other two androgenic drugs?

A

Desogestrel, no androgenic activity.

Medroxyprogesterone / Norethindrome

22
Q

What is the MOA of Flutamide? and usage?

A

Flutamide is an androgen receptor antagonist - tx AR+ prostate CA

23
Q

What is the MOA of Leuprolide? what does it treats?

A

GnRH analog, continuous, suppresses release of LH/FSH, treats AR+ prostate CA

24
Q

What enzyme does finasteride blocks?

A

5-alpha reducatase, inhibits the production of DHT and its used to treat BPH and male patter baldness.

25
Q

Which 5a-reductase inhibitor is the most teratogenic?

A

Finasteride

26
Q

What are the similities and differences between PTU and methimazole?

A

Methimazole and PTU block inhibit Peroxidase; but only PTU inhibits 5’deiodinase, hence only one useful for thyroid storm.

PTU is safer in pregnancy, both will cross the placenta but PTU is safer because is highly protein bound.

27
Q

When do we use Potassium iodide plus Iodine?

A

Potassium iodide plus iodine is only used preoperatively to decrease gland size, fragility, and vascularity.

28
Q

What is the DOC for acromegaly, carcinoid and secretory GI tumors?

A

Octreotide

29
Q

What is the MOA of Demeclocycline?

A

It uncouples Gs from V-2 receptor and makes the kidneys unresponsive. Thus it is used in the treatment of SIADH.

30
Q

What are the “Dronates” and what are their MOA?

A

Bisphosphonates.

Stabilize hydroxyapaptite bone structure and induce osteoblasts to secrete inhibitors of osteoclasts, decreases bone resorption , and decreased osteoporosis.

31
Q

What are the uses for biphosphonates?

A

Paget’s disease
Post-menopausal osteoporosis (Alendronate)
GC-induced osteoporosis (Alendronate)

Pts. need to sit or stand, can’t lay down.
SE: Gi distress / Esophageal ulcers.

32
Q

What are the anticancer cells that act at the M phase?

A

Vinblastine, Vincristine, Paclitaxel

33
Q

What are the S Phase specific cancer drugs?

A

6-mercaptopurine / 5-fluorouracil / Methotrexate / Hydroxyurea / 6-thioguanine

34
Q

Cyclosphosphamide / Cisplatin / Procarbazine MOA?

A

Alkylating agents (cross-linking DNA strands)

35
Q

Which alkylating agent produces leukemia after tx?

A

Procarbazine. It is commonly used for the tx of Hodgkin.

36
Q

What is the SE of Doxorubicin?

A

BMS and Cardiomyopathy

Doxorubicin is an intercalator, forms free radicals, inhibits topoisomerase

37
Q

What is the MOA of Leucovorin?

A

Leucovorin is a folic acid rescue drug with high dose Metothrexate (MTX). Rescues normal cells while cancer cells get killed.

MTX inhibits DHF reductase, used to tx RA.

38
Q

What is the MOA of 5-FU?

A

Pyrimidine antimetabolite (S-phase) bioactivated to inhibit thymidylate synthetase.

39
Q

What is the ab against ErbB2 (HER2/neu) that help treat breast cancer?

A

Trastuzumab

40
Q

What is the drug that targets VEGF-A

A

Bevacizumab

41
Q

What anitcancer drug causes pulmonary fibrosis and pneumonitis as side effects?

A

Bleomycin

42
Q

What drug causes hemorrhagic cystitis

A

Cyclophosphomide

Treatment : Mesna tx cyclophosphomide

43
Q

What is the MOA of Cyclosporine ? Tx for?

A

Binds to cyclophilin lead to inhibition of calcineurin (cytoplasmic phosphatase) which leads to a decrease activation of T-cell transcription factor: IL-2/ IL-3 and IFN gamma.

DOC for organ or tissue transplantation. Tacrolimus used alternatively to cylcosporine in renal and liver transplants.

SE: gingival hyperplasia and nephrotoxicity

44
Q

What is the treatment for carbon monoxide intoxication?

A

Hyperbaric oxygen and decontamination.

45
Q

Comma, pinpoint pupils, markedly depressed respiration, decreased BP, decreased HR and lethargy — Signifies overdose of what?

A

Opioids , treated with Naloxone

46
Q

Confusion, lethargy, hyperventilation, hyperthermia, dehydration, hypokalemia, acidosis—- signifies overdose of what?

A

Aspirin. Control hyperthermia NaHCO3 to correct acidosis and increase renal elimination, hemodialysis .

47
Q

Myoclonus will be present in Malignant Hyperthermia or SSRIs overdose?

A

SSRIs. it will present with agitation, confusion, hallucination, muscle rigidity, hyperthermia, increased HR/BP, seizures and myoclonus.

48
Q

What drug causes wrist drop and foot drop?

A

Vincristine

MD Pharmacology (7 decks)

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