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Step 1 Andre > Meds > Flashcards

Meds Flashcards

1
Q

finasteride

A

5-alpha-reductase inhibitor that decreases local conversion of TT to DHT in prostate –> shrinks prostate

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2
Q

phenylpehrine

A

alpha-agonist w/alpha-1 selectivity … sympathomimetic

-

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3
Q

alpha-1 adrenergic agonist examples (4)

A

methoxamine
methylnorepinephrine
phenylephrine
midodrine

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4
Q

alpha-1 adrenergic mechanism and outcomes

A

PLC stimulation –> PIP2, IN3, DAG, Ca

  • smooth muscle contraction
  • vasoconstriction (pressors)
  • mydriasis
  • glycogenolysis and gluconeogenesis
  • Na reabsorption
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5
Q

alpha-2 adrenergic agonist examples

A

clonidine
guanfacine
methyldopa
guanethidine

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6
Q

alpha-2 mechanism and outcomes

A

inhibits adenylyl cyclase
sympatholytic

  • inhibit insulin release
  • induce glucagon release
  • contract sphincters
  • increased thrombocyte aggregation
  • presynaptic inhibition of NE in CNS
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7
Q

beta-1 agonist ex

A

dobutamine
xamoterol
denopamine

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8
Q

beta-1 agonist mechanism

A

adeneylyl cyclase activation (cAMP increase)

  • increase HR, conduction velocity, and contractility
  • increase renin from JGA
  • increase ghrelin from stomach
  • ## lipolysis in adipose
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9
Q

beta-2 agonist ex

A
  • salbutamol
  • salmeterol
  • isoproterenol
  • terbutaline
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10
Q

Short acting benzos (time and ex) (3)

A

< 10hrs

  1. alprazolam
  2. triazolam
  3. oxazepam
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11
Q

medium acting benzos (t and ex) (3)

A

10-20hrs

  1. estazolam
  2. lorazepam
  3. temazepam
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12
Q

long acting benzos (t and ex) (4)

A

days

  1. diazepam
  2. chlordiazepoxide
  3. clorazepate
  4. flurazepam
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13
Q

class Ia anti-arrhytmic (3)

A
  1. disopyramide
  2. quinidine
  3. procainamide

(Double Quarter Pounder)

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14
Q

class Ib anti-arrhthmic (3)

A
  1. lidocaine
  2. tocainide
  3. mexiletine

(Lettuce, Tomatoes, Mayo)

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15
Q

class Ic anti-arrythmic (2)

A
  1. moricizine
  2. flecainide
  3. propafenone

(More Fries Please)

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16
Q

class IV anti-arrythmic (2)

A
  1. dilt

2. verapamil

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17
Q

class II anti-arrythmic (4)

A
  1. metoprolol
  2. propranolol
  3. atenolol
  4. carvedilol
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18
Q

class III anti-arrythmic (4)

A
  1. amio
  2. sotalol
  3. dofetilide
  4. ibutilide
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19
Q

zodivudine (ZDV) aka azidothymidine (AZT)

A

NRTI

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20
Q

ganciclovir

A

antiviral med that treats CMV by acting as a dGTP competitive inhibitor

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21
Q

Metformin

A
  • increases glycolysis
  • decrease GI glucuose absorption
  • decrease gluconeogenesis
  • lactic acidosis

absolutely contraindicated in pts with renal failure or any other situations that may precipitate lactic acidosis:

  1. liver dysfunction
  2. chf
  3. alcoholism
  4. sepsis

b/c heart, liver, and kidneys use lactate to metabolize ATP

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22
Q

chlorpromazine eye ADR

A

corneal deposits

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23
Q

thioridazine eye ADRs

A

retinal deposits resembling retinitis pigmentosa

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24
Q

zipradisone ADRs

A
  • prolonged QT
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25
Q

olanzapine ADRs

A
  • WT gain
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26
Q

clozapine ADRs

A
  • agranulocytosis

- seizures

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27
Q

Physostigmine

A

AchE inhibitor peripherally and centrally (can cross BBB)

used to counteract atropine’s mucarininc cholinergic blockade

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28
Q

atropine

A

muscarinic cholinergic blockade

can be used to reverse muscarinic effects of organophosphate toxicity

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29
Q

xanthine oxidase inhibitor

A

allopurinol

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30
Q

uricosuric drugs

A

probenecid
sulfinpyrazone
-long term serum uric acid lowering therapy
- need good renal function

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31
Q

ergonovine

A

ergot alkaloid that constricts vascular smooth muscle by stimulating both alpha-adrenergic and serotonergic receptors

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32
Q

non-selective alpha blockers

A
  • phentolamine
  • tolazoline
  • trazodone
  • typical and atypical antipsychotics
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33
Q

alpha-1 blockers

A

tamsulosin
terazosin
alfuzosin
prazosin

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34
Q

alpha-2 blockers

A

mirtazapine
yohimbine
idazoxan
atipamezole

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35
Q

diphenoxylate

A

opiate anti-diarrheal
binds to mu opiate rec in GI to slow motility

ADR
bloating and mild sedation

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36
Q

kaolin-pectin and attapulgite

A

adsorbents that adsorb fluids, toxins, nutrients, and digestive juices to prevent diarrhea

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37
Q

bismuth subsalicylate

A

treat secretory diarrhea

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38
Q

doxazosin

A

alpha-1 blocker for HTN and urinary retention of BPH

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39
Q

Mebendazole

A

treats helminths

Enterobius vermicularis

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40
Q

Diethylcarbamazine

A

treats loa loa (loiasis

and wucherenia bancrofti (lymphatic filariasis infections

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41
Q

Ivermectin

A

treats strongyloides stercoralis and onchocerca volvulus (onchocerciasis)

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42
Q

Nifurtimox

A

treats trypanosomes like Chagas (trypanosoma cruzi)

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43
Q

Praziquantel

A

treats schistosoma (schitosomiasis) clonorchis sinesis (clonorchiasis) and paragoniimus westermani (paragonimiasis)

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44
Q

Milrinone

  1. mechanism
  2. some effects
A
  1. PDE3 inhibitor –> elevated cAMP

2. vasodilation, inotropic

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45
Q

Chlorpheniramine

A

1st gen antihistamine that blocks central and peripheral H1 receptors
can be sedating b/c easily crosses BBB

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46
Q

Loratadine

A

2nd gen antihistamine that can’t cross BBB so no sedations

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47
Q

Ranitidine

A

H2 receptor antagonist that inhibits gastric acid secretion

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48
Q

Phenytoin treats?

how?

A

grand mal (tonic-clonic) sz’s, partial sz’s, status epilepticus

by blocking VG-Na channels

49
Q

Phenytoin toxicitiy

A

cerebellum and vestibular system –> ataxia and nystagmus

50
Q

Phenytoin ADRs

A

1) gingival hyperplasia, hirsuitism

2) metagloblastic anemia (2/2 folic acid metabolism deF)

51
Q

Phenytoin and cyt p450

A

induces p450 –> increases metabolism and decreases blood level of many meds

52
Q

phenytoin and pregnancy

A

can cause fetal hydantoin syndrome

53
Q

Lithium toxicity

A

NMJ excitability (irregular coarse tremors, fascicular twitching, rigid motor agitation, ataxia)

  • Nephrogenic diabetes insipitus
  • hypothryoidism
  • cardiac conduction defects
54
Q

Prednisone ADRs (5)

A
  • hyperglycemia
  • wt gain
  • depression
  • fluid retention w/edema
  • osteoporosis
55
Q

cocaine mechanism

A

blocks re-uptake of NE, 5-HT, and Dopa into CNS

56
Q

Methimazole

1) mechanism
2) ADRs (3)

A

inhibits thyroid hormone synthesis by supprsesing iodination and couple of tyrosine

  • edema, rash, agranulocytosis
57
Q

cholinergic syndrome

A 
DUMBELS - muscarinic
Diarrhea and diarphoresis
Urination
Miosis
Bronchospasm and baradycardia
Emesis
Lacrimation
Salivation

muscle fasciculations and paralysis - nicotinic

58
Q

pralidoxime

A

reverses muscarinic and nicotinic effects of organophsphates by restoring cholineresterase from the bound toxin

59
Q

naloxone

  1. reverses what and how
  2. what receptors
  3. how soon does it work
  4. how long does it work
  5. vs. naltrexone
A
  1. opioid intoxication or overdose by acting as pure opioid receptor antagonist
  2. mu recetpors
  3. minutes
  4. 1-4 hours
  5. naloxone is shorter acting - better for emergencies
60
Q

Calcipotriene

  • what is it and how does it work
  • treats what
A
  • topical vit D analog that binds to vitD receptor, a nuclear TF that causes inhibition of keratinocyte proliferation and stimulates keratinocyte differentiation
  • also, inhibits T cell proliferation and other inflammatory mediators
  • psoriasis
61
Q

cyclosporine

  • mechanism
  • treats what
A
  • inhibits NFAT (nuclear factor of activated T cells) from entering nucleus –> impairs production of IL-2 –> therefore prevents activation of T cells
  • treats psoriasis among others
62
Q

Etanercept

- mechanism

A
  • binds TNF alpha
63
Q

pyridostigmine

  • mechanism
  • treats
A
  • cholinesterase inhibitor (globally)

- myasthenia gravis (but this only needs the nicotinic effect, so may have mAchR mediated ADRs)

64
Q

scopolamine

  • mechanism
  • another similar med
A
  • selective muscarinic AchR antagonist that reduces effects of global cholinesterase inhibitors
  • hyoscyamine
65
Q

pilocarpine

- mechanism

A

non-selective mAchR agonist

66
Q

ribavirin

  • mechanism
  • treats
A
  • nucleoside antimetabolite drug that interfers w/duplication of viral genetic material
  • chronic HCV and RSV
67
Q

raltegravir

  • mechanism
  • treats
A
  • integrase inhibitor that inhibits integration of viral DNA into host genome
  • HIV
68
Q

indinavir

  • mechanism
  • treats
A
  • inhibits viral protease activity

- HIV

69
Q

amantadine

  • mechanism
  • treats
A
  • prevents uncoating of influenza A virion after endocytosis

- influenza A

70
Q

enfuvirtide

  • mechanism
  • treats
A
  • prevents viral entry into target cell

- HIV fusion inhibitor

71
Q

inhaled anesthetics

  • leads to increase in blood flow to where?
  • decreases in what (4)
A

cerebral blood flow

    1. GFR
      1. RPF
      2. LVEF
      3. hepatic blood flow
72
Q

pentazocine

- mechanism

A

opioid marcotic w/partial agonist activity and weak antgaonist activity at mu receptors

73
Q

misoprostol

  • mechanism
  • used for (4)
A
  • PGE1 analog

- prevent gastric ulcers, treat missed miscarriages, induce labor, induce abortion

74
Q

What meds can cause Cushing Syndrome (2)

A
  • glucocorticoids

- HAART therapy

75
Q

What treats absence seizures

A

Ethosuximide

76
Q

Ethosuximide

  • mechanism
  • BM suppression?
A
  • blocks T-type CaCh in thalamic neurons

- NO

77
Q

Carbamazepine

  • mechanism
  • treats what
  • possible ADRs
A
  • blocks VG-NaCh in cortical neurons and stabilizes it in inactive state
  • simple/complex partial seizures; managing generalized tonic-clonics; mood stabilizer in BPD; treats trigeminal neuralgia
  • BM suppression; heptaotoxic (LFT check); ADH-secretion (SIAHD)
78
Q

Isoniazid chemically similar to what vitamin

- what does it do

A

B6 (pyridoxine)

- part of TB regiment, but it depletes B6

79
Q

What reverses TCA-associated cardiac abnormalities

A

Soidum bicarb

  • can correct QRS prologation
  • reverse HoTN
  • treat V-dysrhythmias
80
Q

which TB drug causes visual changes

  • what changes are they
  • how does it affect mycobacterium
  • how do to treat visual changes
A
  • Ethambutol
  • optic neuritis, color blindness, central scotoma
  • inhibits arabinosyl transferase, which is required for cell wall carbohydrate synthesis
  • discontinuation usually leads to improvement
81
Q

Primidone

  • what is it
  • what is it metabolzied to
A
  • antiepileptic

- phenobarbital and phenylethylmalonamide

82
Q

Three classes of antimetabolites

A
  1. Folate antagonist
  2. Purine analogs
  3. Pyrimidine analogs
83
Q

Folate antagonist (1)

A

methotrexate

84
Q

Purine analogs (3)

A
  1. 6-thiopurines (6-MP, 6-GP)
  2. fludarabine - CLL
  3. cladribine - HCL
85
Q

Pyrimidine analogs (4)

A
  1. 5-fluorouracil
  2. capecitabine
  3. cytarabine
  4. gemcitabine
86
Q

lomustine

  1. class
  2. mechanism
  3. activation
  4. CNS permeation?
A
  1. nitrosurea
  2. DNA alkylation and cross-bridge formation
  3. non-enzymatic hydroxylation in liver
  4. penetrates well 2/2 lipophilicity
87
Q

cisplatin

  1. class
  2. activation requirements
A
  1. platinum-tontaining chemo agent

2. needs to by hydrated in environments w/low chloride concentration

88
Q

MTX mechanism

A

folic acid analog that inhibits dihydrofolate reductase w/out metabolic conversion

89
Q

mercaptopurine

  1. class
  2. activated by
  3. inactivated by
A
  1. purine analog
  2. hypoxanthine-guanine phosphoribosyl transferase
  3. xanthien oxidase
90
Q

cladribine

  1. class
  2. resistant to?
  3. used for?
A
  1. purine analog
  2. resists degradation by adenosine deaminase
  3. hairy cell leukemia
91
Q

deferoxamine

  • what does it do
  • what is it antidote for
A
  • specific chelator of iron

- antidote for serious iron poisoning

92
Q

TCA toxicity treated by?

A

so`dium bicarbonate

93
Q

how is acetaminophen detoxed in liver

A

cyt P450 metabolizes it to NAPQI that the liver puts through sulfation and glucuronide conjugation

94
Q

antidote for acetaminophen toxicity

- mechanism

A

NAC (N-acetyl cysteine)

- provides sulfhydryl groups

95
Q

polyethylene glycol

  • mechanism
  • other examples
A
  • osmotic laxative

- magnesium hydroxide (magnesium citrate)

96
Q

drug-induced lupus erythematous (5)

A
  1. hydralazine
  2. procainamide
  3. isoniazid
  4. minocycline
  5. quinidine
97
Q

findings for drug-induced lupus erythematous (4)

A
  1. new onset lupus sxs
  2. ANA and anti-histone antibodies
  3. anti-dsDNA rarely seen
  4. exposure to the drug
98
Q

halothane can cause?

how?

A

massive hepatic necrosis

  • halothane metabolite direct damage to liver
  • formation of autoantibodies to liver proteins
99
Q

what meds can cause coronary steal phenomenon

A

adenosine

dipyridamole

100
Q

shortest acting benzo

101
Q

what causes orthostatic hypotension and lightheadedness

A

blockade of alpha-1 adrenergic receptors

102
Q

extrapyramidal sxs

A

over-blockade of dopamine receptors 2/2 antipsychotics

103
Q

octeotride

  • what is it
  • mechanism
A
  • somatostatin

- potent inhibitor of GH, glucagon, and insulin

104
Q

common precipitating factors of G6PD deficiency anemia (4)

A
  1. infectins
  2. drugs (dapsone, antimalarials, sulfonamide abx (TMP-SMX)
  3. DKA
  4. favism
105
Q

hyroxyurea

  • what does it do
  • when is it used
A
  • increases fetal hemoglobin in an not understood way

- in pts with sickle cell anemia w/frequent pain crises

106
Q

clomiphene

  • mechanism
  • used for?
A
  • selective estrogen receptor modulator
  • prevents negative feedback inhibition of hypothalamus –> allows increased release of gonadtotropin (FSH, LH) –> aids in ovulation
107
Q

leflunomide inhibits?

A

dihydroorotate dehydrogenase … therefore, inhibits pyrimidine synthesis

108
Q

mycophenolate and ribavirin inhibit?

A

IMP dehydrogenase –> inhibits GMP synthesis during de novo purine synthesis

109
Q

hydroxyurea inhibits?

A

ribonucleotide reductase –> screws up de novo pyrimidine synthesis

110
Q

6-mercaptopurine (6-MP) inhibits?

A

de novo purine synthesis … stops it right at the beginning

111
Q

5-fluorouracil (5-FU) inhibits?

A

thymidylate synthase –> decreases dTMP formation –> inhibits de novo pyrimidine synthesis

112
Q

MTX, TMP, pyrimethamine inhibit what?

A

Dihydrofolate reductase –> decreases DHF conversion to THF which is needed for dTMP formation

113
Q

meds that act on microtubules (5)

A

“Microtubules Get Constructed Very Poorly”

  1. Mebendazole (anti-helminth)
  2. Griseofulvin (anti-fungal)
  3. Colchicine (anti-gout)
  4. Vincristine/Vinblastine (anti-cancer)
  5. Paclitaxel (anti-cancer)
114
Q

Fomepizole

  • inhibits what?
  • used for ?
A
  • inhibits alcohol dehydrogenase

- antidote for methanol or ethylene glycol poisoning

115
Q

disulfiram (Antabuse)

  • inhibits what?
  • used for?
A
  • acetaldehyde dehydrogenase, therefore excess acetaldehyde

- makes you feel more hungover w/alcohol, treats chronic alcoholism

116
Q

Clomifene

  • what is it
  • used for?
  • ADR
A
  • SERM (inhibits EstR’s in hypothalamus –> inhibits negative feedback) –> upregulation of HPA gonad axis
  • ovulation induction and reversal of anovulation
  • hot flush
117
Q

Tamoxifen

  • receptors
  • used for?
A
  • estrogen receptor antagonism in breast but agonism in endometrium
118
Q

Amiodarone toxicity

  • check what?
  • causes what?
A
  • LFTs, PFTs, TFTs
  • Transaminitis
  • Interstital lung disease
  • Hypo/Hyperthyroidism b/c Amiodarone ~ Throxine (T4)

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