Midterm Drugs

Question 1

Ceftriaxone

Answer 1

MOA: binds PBP and blocks transpeptidation of peptidoglycan in bacterial cell walls

TU: MSSA and Strep plus some Gram - coverage

Question 2

Vancomycin

Answer 2

MOA: binds D-Ala-D-Ala to prevent NAM/NAG-peptide subunites into peptidoglycan, blocks transglycocylation

TU: broad Gram + coverage including MRSA, used in empiric Tx w/ ceftriaxone in endocarditis

Question 3

Penicillin G

Answer 3

MOA: bind PBP and blocks transpeptidation of peptidoglycan in bacterial cell walls

TU: strep (basically) and some other Gram + organisms

Question 4

Amoxicillin

Answer 4

MOA: amino-beta-lactam: binds PBP and blocks transpeptidation of peptidoglycan in bacterial cell walls

TU: strep and some Gram -

Other: given in conjunction w/ clavulinate

Question 5

Alteplase

Answer 5

MOA: tissue plasminogen activator (t-PA), activates plasminogen -> plasmin to break down clot

TU: ischemic stroke

Adverse: hemorrhage, usually contradicted in endocarditis

Question 6

Morphine

Answer 6

MOA: acts on mu receptors of neurons

TU: pain

Adverse: respiratory depression, constipation

Question 7

Nitroglycerine

Answer 7

MOA: guanylyl cyclase, increase cGMP, increased MLC phosphatase, increased MLC dephosphoylation, smooth muscle dilation (veins > arteries)

TU: angina, MI

Adverse: reflex tachycardia

Question 8

Clopidogrel

Answer 8

MOA: ADP-receptor antagonist, inhibits platelet activation

TU: post-MI anticoagulation

Adverse: hemorrhage

Question 9

Heparin

Answer 9

MOA: increases activity of antithrombin III, inhibits thrombin, blocks conversion of fibrinogen -> fibrin, stops/slows thrombus formation

TU: acute anticoagulation, MI

Adverse: hemorrhage

Question 10

Eptifibatide

Answer 10

MOA: Factor IIb/IIIa receptor inhibitor on activated platelets and inhibits binding of fibrinogen

TU: post-MI anticoagulation therapy

Question 11

Aspirin

Answer 11

MOA: irreversibly binds COX1/2 on platelets, blocks thromboxane A2 formation -> inhibits platelet aggregation

TU: MI

Question 12

Statins

Answer 12

MOA: inhibit HMG-CoA reductase

TU: dyslipidemia

Question 13

Enalapril

Lisinopril

Answer 13

MOA: ACE inhibitor, decreased aldosterone release, decreased Na reabsorption in kidney, decreased blood volume and preload

TU: post MI management, chronic CHF

Adverse: cough, angioedema

Question 14

Metoprolol

Propranolol

Answer 14

MOA: metoprolol: β1 antagonist

propanolol: nonselective β1 and β2 antagonist

TU: post-MI management, chronic CHF

Question 15

Isosorbide

Answer 15

MOA: converted to nitro, same MOA

TU: same as nitro

Other: longer t_1/2 than nitro

Question 16

Hydralazine

Answer 16

MOA: same as nitro, but arteries > veins

TU: HTN during pregnancy

Question 17

Furosemide

Answer 17

MOA: NKCC symporter antagonist, decreases Na reabsorption and water reabsorption, decreased preload

TU: acute CHF

Question 18

Eplerenone

Spirinolactone

Answer 18

MOA: aldosterone receptor antagonist, decrease Na+ reabsorption and water reabsorption, decreased preload

Adverse: gynecomastia (spirinolactone) because of anti-adrenergic effects

Question 19

Digoxin

Answer 19

MOA: inhibits Na⁺/K⁺ ATPase, indirectly affects Na⁺/Ca2⁺ antiporter, increases intracellular Ca2⁺, increasing contractility in myocytes and prolonging phase 4 of pacemaker cells –> negative chronotrope

TU: acute CHF, refractory CHF

Question 20

Pargyline

Answer 20

MOA: monoamine oxidase inhibitor

TU: depression

Adverse: HTN

Question 21

Cocaine, Imipramine

Answer 21

MOA: block NE axoplasmic reuptake pump

TU: local anesthesia (cocaine), depression (imipramine)

Question 22

Tyramine, Amphetamine, Ephedrine

Answer 22

MOA: axoplasmic NE reuptake pump reversal

Question 23

Reserpine

Answer 23

MOA: blocks NE transport back into vesicles

Question 24

Guanethidine, Guanadrel

Answer 24

MOA: reversal of vesicular NE reuptake pumps