May 21 wk8-F

Question 1

What drugs are used to maintain a sinus rhythm in patients with paroxysmal atrial fibrillation?

Answer 1

Class III antiarrhythmics

Amiodarone, Sotalol, Dofetilide

Question 2

What are the glycoproteins on platelets and what do they do?

Answer 2

GP-Ib: binds to vWF that has been exposed by damaged endothelium and activates the platelet to release ADP and TXA-2 and the platelet undergoes a conformational change that exposes GP-IIb/IIIa

GP-IIb/IIIa: binds fibrinogen that links between platelets and allow formation of the platelet plug as part of primary hemostasis

Question 3

What drug binds to GP IIb/IIIa on platelets to prevent formation of the platelet plug by fibrinogen cross-linking?

Answer 3

Abciximab

Used to treat unstable angina and ACS especially in patients undergoing percutaneous interventions

Question 4

What are two molecules released by activated platelets and what drugs inhibit this release?

Answer 4

ADP–Clopidogrel inhibits action by blocking P2Y12 on ADP receptors
TXA-2–inhibited by Aspirin

Question 5

What is Glanzmann Thrombasthenia?

Answer 5

AR disorder caused by defective or deficient GP-IIb/IIIa on platelets
Typically presents in childhood with mucocutaneous bleeding

Question 6

What are Argatroban and Dabigatran?

Answer 6

Direct thrombin inhibitors

Question 7

Heparin MOA

Answer 7

Potentiates effects of ATIII activity leading to inactivation of thrombin and factor Xa

Question 8

Features of serotonin syndrome

Answer 8

Abnormal mental status
Autonomic hyperactivity
Muscle rigidity
Hyperreflexia

Question 9

Which of the lipid lowering drugs has the greatest effect on Triglycerides?

Answer 9

Fibrates

These up-regulate LPL which breaks down TG’s into FFA’s that can be taken up by cells and stored in adipocytes

Question 10

Which of the lipid lowering drugs inhibits lipolysis in adipocytes and VLDL synthesis in the liver? What is a common SE?

Answer 10

Niacin (Vit B3)

Red, flushed face that can be decreased by NSAID’s or long-term use

Question 11

What is Leucovorin?

Answer 11

Folinic Acid

Used to prevent negative effects of Methotrexate

Question 12

How are allopurinol, xanthine oxidase and 6-mercaptopurine related?

Answer 12

6-mercaptopurine is an immune suppressant used for ALL and Crohn’s and UC. It is broken down by Xanthine Oxidase which is inhibited by Allopurinol as a treatment of gout to reduce the production of uric acid
Therefore, if a patient is on Allopurinol, they should not be given 6-Mercaptopurine.

Question 13

Cyclophosphamide

Answer 13

Chemotherapy drug
Mustard type drug that alkylates Guanine in DNA to cause intra and interstrand cross-links that prevent DNA replication
Requires activation by P450

Question 14

When is MESNA administered?

Answer 14

With Cyclophosphamide in treating cancer. It helps to prevent the hemorrhagic cystitis caused by Cyclophosphamide.

Question 15

What is Filgrastim?

Answer 15

Drug

Granulocyte Colony Stimulating Factor analog used to stimulate granulocytes in patients with neutropenia

Question 16

What are granulocytes?

Answer 16

Also known as PMN’s

These include Neutrophils, Eosinophils, Basophils, Mast cells

Question 17

What are Monocytes?

Answer 17

Mononuclear granular cells that differentiate into macrophages and dendritic cells when they migrate into the tissues

Question 18

Where does Mannitol exert its effects?

Answer 18

Proximal tubule and descending loop of Henle

Question 19

What are some SE’s of thiazide diuretics?

Answer 19

Hyperuricemia and Hypercalcemia

Question 20

What are some SE’s of Spironolactone?

Answer 20

Gynecomastia and antiandrogen effects

Question 21

Acetazolamide MOA

Answer 21

Carbonic Anhydrase inhibitor in the proximal tubule of the kidney used as a diuretic

Question 22

Amiloride MOA

Answer 22

Diuretic, blocks Na channels in the in the collecting duct

Spares K+

Question 23

Ethacrynic acid

Answer 23

Loop diuretic

Question 24

Which of the anti-diuretics increases the reabsorption of urea?

Answer 24

Vasopressin (ADH)

Question 25

What are Sx of atopic eczematous dermatitis?

Answer 25

Intraepidermal vesicles
Superficial epidermal hyperkeratosis causing scales
Epidermal hyperplasia (Acanthosis)
Chronic inflammatory infiltrate in the skin

Question 26

What SE’s would be expected with prolonged topical treatment with a corticosteroid?

Answer 26

Atrophy of the dermis and other cells in the skin

Drying, cracking, skin tightening, telangectasias

Question 27

Teratogenic effects of Warfarin

Answer 27

Depressed nasal bridge, epiphyseal stippling, nail hypoplasia, fetal bleeding

Question 28

Teratogenic effects of Lithium

Answer 28

Hypothyroidism in infant

Ebstein anomaly

Question 29

Teratogenic effects of ACE inhibitors

Answer 29

Renal agenesis and polyhydramnios

Question 30

Teratogenic effects of Valproate

Answer 30

Affects folic acid levels and therefore leads to neural tube defects