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USLME Kiss my ass and pray > MOA pharm > Flashcards

MOA pharm Flashcards

1
Q

Digoxin

A

direct inhibition of Na/K ATPase

  • > indirect inhibition of Na/Ca exchanger/ antiporter
  • > increased Ca and contractility
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2
Q

Sucrafate

A

Binds to ulcer base providing PHYSICAL barrier, allowing HCO3 secretion to reestablish

  • Bismuth also in this class
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3
Q

Misoprostol

A

PGE1 analog,
increases production of gastric mucous barrier and decreases acid production

Also used in : cervical ripening/labor inducing, maintaining PDA

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4
Q

Alteplase

A

tPA
directly aid in conversion of plasminogen to plasmin
->plasmin cleaves thrombin and fibrin clots

Also: reteplase and tenecteplase

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5
Q

Chloroquine

A

1st line antimalarial unless resistant

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6
Q

Methfloquine

A

2nd line antimalaria

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7
Q

Primaquine

A

Added to antimalrial treatment if Vivax or Ovale is suspected

Tx - hypnozoite

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8
Q

Atovaquone

A

Antimalarial for those allergic to chloroquine, often given w/ primaquine

Also for babesia

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9
Q

Clavulanic Acid/Clavulanate

A

beta lactamase inhibitor

given w/ amoxicillin or ticacillin

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10
Q

Sulbactam

A

beta lactamase inhibitor

given w/ ampicillin

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11
Q

Tazobactum

A

beta lactamse inhibitor

given w/ piperacillin

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12
Q

Lidocaine

A

blocks preferentially active voltage gated Na channels on the inner side of the channel -> local anesthetic

Amide

penetrated membrane uncharged then binds in charged form - problem w/ infected acidic tissue

may be given w/ vasoconstrictor to potentiate action

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13
Q

Mepivacaine

A

Amide
Na channel blocker -> local anesthetic
~lidocaine

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14
Q

bupivacaine

A

Amide

Na channel Blocker -> local anesthetic

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15
Q

Procaine

A

Ester

Na Channel Blocker -> local anesthetic

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16
Q

Tetracaine

A

Ester

Na Channel Blocker ->local anesthetic

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17
Q

Cimetidine

A

Reversible H2 blocker -> lower H secretion from parietal cell

Peptic Ulcer, Gastritis, mild refflux

Also: -‘dines
Ranitidine
Famotidine
Nizatidine

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18
Q

D penicillamine

A

Chelates copper - wilson’s disease

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19
Q

Terazosin

A

alpha 1 antagonist

  • for BPH and HTN
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20
Q

Tamsulosin

A

selective alpha 1 antagonist

  • BPH alone
    vs. Terazosin - nonselective
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21
Q

Vinblastine

A

alkaloid that binds to tubulin in M phase

Blocks polymerization of microtubules so mitotic spindles cannot form

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22
Q

Vincristine

A

alkaloid that bind to tubulin in M phase,

Blocks polymerization of microtubules so mitotic spindle cannot form

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23
Q

Paclitaxel

A

hyper stabilizes polymerized microtubules so mitotic spindle cannot break down

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24
Q

5 fluororuacil

A

Pyrimidine analog that complexes w/ folic acid

Inhibits thymidate synthase -> less dTMP ad less DNA

SE: myelosuppression and photosynth

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25
Q

Methotrexate

A

Folic acid analog

Inhibits dihydrofolate reductase -> less dTMP -> less DNA and protein synth

SE: myelosuppression, macrovescular FA liver disease, teratogenic

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26
Q

Azathioprine

A

Purine analog ->less de novo purine Synth

Activated HGPRT

toxicity w/ allopurinol due to metabolization w/ xanthine oxidase

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27
Q

6 mercaptopurine

A

Purine analog -> less de novo purine Synth

Activated by HGPRT

toxicity w/ Allopurinol due to metabolization w/ xanthine oxidase

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28
Q

6 thioguanine

A

Purine analog -> less de novo Purine synth

Activated by HGPRT

toxicity w/ Allopurinol due to metabolization w/ xanthine oxidase

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29
Q

Cytarabine

A

Pyrimidine analog

inhibits DNA polymerase

SE: Thrombocytopenia, megaloblastic anemia

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30
Q

Sumatriptan

A

5 HT 1D/1B agonists inducing vasoconstriction

used in migraine w or w/out aura

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31
Q

Odansetron

A

5HT 3 block for antiemetic function

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32
Q

Trazadone

A

inhibits serotonin reuptake

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33
Q

Maprotiline

A

Blocks NE Reuptake

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34
Q

Mirtazapine

A

alpha 2 antagonist -> increase NE and serotonin

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35
Q

Buproprion

A

increases NE and dopamine via unknown mech

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36
Q

Bromocriptine

A

dopamine agonists (prolactinoma)

Parkinsons
ergot - vasoconstrictor

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37
Q

Cabergoline

A

dopamine agonist (Prolactinoma)

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38
Q

octreotide

A

Somatostatin analog - GH cell adenoma

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39
Q

Demeclocycline

A

Ab used to induce impaired renal response to ADH

Used for SIADH

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40
Q

Propylthiouracil

A

Blocks peroxidase in hyperthyroidism

Also blocks peripheral conversion of T4 to active T3

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41
Q

phenoxybenzamine

A

irreversible alpha blocker

prior to surgical removal of pheo

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42
Q

Docusate

A

aniionic surfactant - reduces surface tension allowing water and lipid to penetrate the stool

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43
Q

Clopidogrel

A

inhibit platelet aggregation by irreversible blocking ADP receptors.

Inhibit fibrinogen receptor binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen

also: ticlopidine, ticagrelor, parasugrel

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44
Q

Ticlopidine

A

inhibit platelet aggregation by irreversible blocking ADP receptors.

Inhibit fibrinogen receptor binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen

  • Worry about neutropenia
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45
Q

Dimercarpol

A

chelator for arsenic, mercury and Pb

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46
Q

EDTA

A

Effective chelator of divalent and trivalent cations -> Na CaEDTA to avoid hypocalcemia

binds to mercury and lead

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47
Q

Cyclosporin

A

Binds to cyclophilins -> blocking of differentiation and activation of T cells by inhibiting calcineuron, preventing the production go IL2

Nephrotoxic, HTN, hyperlipidemia, gingival hyperplasia, hirsutism

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48
Q

Tacrolimus

A

binds to FK binding proteins -> inhibiting calcineurn and secretion of Il2

Nephrotoxic and HTN

NO gingival hyperplasia vs cyclosporin

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49
Q

Sirolimus

A

Binds to FKBP12 -> inhibits mTor, inhibits T cell proliferation in RESPONSE to IL2
(vs production in Tacrolimus and Cyclosporin)

NO nephrotoxicity

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50
Q

Azathioprine

A

antimetabolite precursor of 6 mercaptopurine

  • interferes w/ metabolism and synthesis of nucleic acid (purine antimetabolite)
  • toxic to lymphocytes

Bone marrow suppression, worry w/ allopurinol blocking metabolism and increased side effects

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51
Q

Muromonab CD3

A

Antcolonal antibody binding to CD3 of T cells - no signal transduction,, good for kidneys

Cytokine and hypersensitivity reaction

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52
Q

Phytonadione

A

Vitamin K analog - Warfarin overdose

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53
Q

Amphotericin B

A

Binds ergosterol - forming pores and allowing electrolyte leakage

-serious systemic mycoses

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54
Q

Nystatin

A

Binds ergosterol - forming pores and allowing electrolyte leakage

Topical though due to toxic systemic use- thrush and diaper rash/vaginal cndidiasis

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55
Q

fluconazole

A

inhibit fungal sterol (ergosterol synthesisi) by inhibiting P450 enzyme that converts lanosterol to ergosterol

Also Ketoconazole, clotimazole, miconazole, itraconazole, voriconazole

  • gyenectomastia seen - inhibits 1st step desmolase in making testosterone
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56
Q

Flucytosine

A

Inhibits DNA nadn RNA biosynth by converting to 5 flurouracil by cytosine deaminase

  • Systemic fungal infections- meningitis -> cryptococcus
  • wary of bone marrow suppression (HIV)
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57
Q

Caspofungin

A

inhibits cell wall synth by inhibiting synthesis of beta glucan

  • micafungin as well
  • Invasive aspergillosis and Candida
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58
Q

Terbinafine

A

inhibits fungal enzyme squalene epoxidase

Rx for dematophytes

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59
Q

Griseofulvin

A

Interferes w/ microtubule function

Oral Rx for superficial infection - dematophytes

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60
Q

thiazolininediones

A

pioglitazone and rosiglitazone

increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription factor

-lowers serum glucose and lowers tryglycerides and C reactive protein levels and increases HDL

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61
Q

pioglitazone

A

increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription factor

-lowers serum glucose and lowers tryglycerides and C reactive protein levels and increases HDL

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62
Q

rosiglitazone

A

increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription factor

-lowers serum glucose and lowers tryglycerides and C reactive protein levels and increases HDL

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63
Q

flumazenil

A

competitive benzodiazapine antagonist

-blocking the action of GABA

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64
Q

Pralidoxime

A

acetylcolinesterase reactivater post organophosphorus actylecholinesterase activity

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65
Q

febuxostat

A

inhibits xanthine oxidase

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66
Q

cetirizine

A

2nd generation H1 blocker for allergy

less sedation, less anti muscarinic effects

-also loratadine and fexofenadine

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67
Q

demeclocycline

A

anti-ADH for SIADH Rx

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68
Q

lepirudin

A

inhibits thrombin, derivative of hirudin

Alternative to heparin for HIT
-bivalirudin as well

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69
Q

Bivalirudin

A

inhibits thrombin, derivative of hirudin

Alternative to heparin for HIT
-lepirudin as well

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70
Q

Atropine

A

competitive muscarinic antagonist

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71
Q

Bethanechol

A

cholinergic Agonist - postop illeus and urinary retention

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72
Q

Carbachol

A

cholinergic agonist - glaucoma

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73
Q

pilocarpine

A

cholinergic agonist - induce sweating, tears and saliva

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74
Q

methacholine

A

cholinergic agonist - asthma test

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75
Q

edrophonium

A

anti cholinesterase activity (short) - Dx myasthenia gravis

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76
Q

pyridiostigmine

A

Anticholinesterase activity (long) - Rx for myasthenia gravis

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77
Q

neostigmine

A

Anticholinesterase activity - neuromuscular blockade reverse (non depolarizing) and myasthenia gravis

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78
Q

physiostigmine

A

anti cholinesterase activity - Atropine antidote

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79
Q

donepezil

A

anticholinesterse activity - alzheimers

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80
Q

rivastigmine

A

anti cholinesterase activity - alzheimers

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81
Q

galantamine

A

anti cholinesterase activity - alzheimers

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82
Q

ecothiophate

A

anti cholinesterase activity - open angle glaucoma

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83
Q

homatropine

A

antimuscarinic- eye dialation

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84
Q

tropicamide

A

antimuscarinic - eye dialation

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85
Q

cyclopentolate

A

antimuscarinic - eye dialation

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86
Q

Benztropine

A

anti muscarinic

-Parkinsons disease has excess cholinergic activity and this blocks the rigidity and tremor somewhat, little w/ bradykinesia

CNS effects

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87
Q

Scopolamine

A

Anti muscarinic - motion sickness and decreased salivation (ICU)

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88
Q

ipratropium

A

Antimuscarinic - COPD/asthma

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89
Q

tiotropium

A

antimuscarinic - COPD/asthma

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90
Q

Oxybutynin

A

antimuscarinic - COPD/asthma

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91
Q

Toterodine

A

Antimuscarinic - urge incontinence

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92
Q

Darfenacin

A

Antimuscarinic - urge incontinence

also solifenacin

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93
Q

Trospium

A

antimuscarinic - urge incontinence

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94
Q

Epinephrine

A

alpha 1 and 2 and Beta 1 and 2 - anaphylaxis and hypotension; asthma maybe

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95
Q

norepinephrine

A

alpha 1 and 2 beta 1;

uses for hypotension - septic shock, worry about kidneys

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96
Q

Isoprotenerol

A

beta 1 and 2

no real clinical use - maybe torsades and bradycardias

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97
Q

Dopamine

A

alpha 1 and 2 at high does
beta 1 and 2 and med doses
dopamine 1 and 2 at low does
- dopamine receptors in the blood vessels and kidney

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98
Q

Dobutamine

A

beta 1 > beta 2
Used in heart failure
Chemical stress test
DoBETAm1ne

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99
Q

Phenylephrine

A

direct alpha 1 and 2
myodriatic
rhinitis - > vasoconstriction (nasal decongestant)

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100
Q

levabuterol

A

B2 > B1 - used in acute asthma, more selective for beta 2 than albuterol

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101
Q

salmeterol

A

B2 > B1 - used in long term asmtha

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102
Q

Terbutaline

A

B2>B1 - given sub Q and used as a tocolytic and asthma

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103
Q

Clonadine

A

alpha 2 agonist - lowers blood pressure, worry of rebound HTN

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104
Q

Amphetamine

A

releases stored NE (catecholamines)

- narcolepsy, obesity, ADHD

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105
Q

Ephedrine

A

releases stored NE (catecholamines)

-nasal decongestion, urinary incontence

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106
Q

Cocaine

A

blocks reuptake of NE - > vasoconstriction

  • never give with Beta blockade
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107
Q

pindolol

A

weak beta 1 and agonists -> antagonist

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108
Q

acebutolol

A

weak beta 1 and agonists -> antagonist

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109
Q

esmolol

A

selective beta 1 blocker

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110
Q

atenolol

A

selective beta 1 blocker

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111
Q

metoprolol

A

selective beta 1 blocker

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112
Q

propranolol

A

nonselective beta blocker - NOT for COPD

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113
Q

timolol

A

nonselective beta blocker - glaucoma

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114
Q

nadolol

A

nonselective beta blocker - NOT for COPD

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115
Q

labetolol

A

alpha1 and beta 1 antagonist

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116
Q

carvediol

A

alpha1 and beta 1 antagonist

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117
Q

Clomipramine

A

TCA used in OCD

May also use an SSRI- fluoxetine

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118
Q

Riframpin MOA?

A

inhibits DNA dependent RNA polymerase

Used in TB, leprosy and meningococcal (H influenza B prophylaxis)

Orange body fluids - TB Rx and chemoprophylaxis for H influenza contact

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119
Q

Probenecid

A

inhibits uric acid absorption

Gout medication

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120
Q

Quinidine

A

Class 1a anti arrhythmic

- phase 0 of myocytes, blocking Na channels -> increased ERP

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121
Q

Procainamide

A

Class 1a anti arrhythmic

- phase 0 of myocytes, blocking Na channels -> increased ERP

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122
Q

Disopyramide

A

Class 1a anti arrhythmic

- phase 0 of myocytes, blocking Na channels -> increased ERP

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123
Q

Lidocaine

A

Class 1b anti arrhythmic

- phase 0 of myocytes, blocking Na channels -> increased ERP

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124
Q

Mexiletine

A

Class 1b anti arrhythmic

- phase 0 of myocytes, blocking Na channels -> increased ERP

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125
Q

tocainide

A

Class 1b anti arrhythmic

- phase 0 of myocytes, blocking Na channels -> increased ERP

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126
Q

Flecanide

A 
class 1c anti arrhythmic
 phase 0 of myocytes, blocking Na channels -> increased ERP
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127
Q

Propafenone

A 
class 1c anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP
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128
Q

Amiodarone

A 
class III anti arrhythmic
-phase 3 of myocytes, blocking K channels increasing ERP
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129
Q

Ibutilide

A

Class III Antiarrythmic

-phase 3 of myocytes, blocking K channels increasing ERP

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130
Q

Dofetilide

A

Class III anti arrhythmic

-phase 3 of myocytes, blocking K channels increasing ERP

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131
Q

Sotalol

A

Class III antiarrythmic

-phase 3 of myocytes, blocking K channels increasing ERP

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132
Q

verapamil

A

Class IV Antiarrhythmic
-phase 0 of nodes, blocking Ca channels increasing ERP

preferentially acts on heart w/ diltiazem

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133
Q

Dilatiazem

A

Class IV anti arrhythmic

-phase 0 of nodes, blocking Ca channels increasing ERP

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134
Q

Adenosine

A

decreases K out of the cell -> hyper polarization and also decreases Ca channel opening at the nodes -> AV node block

Used for SVT

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135
Q

Entanercept

A

TNF alpha inhibitor - differs from monoclonal antibody in that it is and TNP alpha pseudo receptor and IgG Fc fusion protein

decoy receptor

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136
Q

Infliximab

A

TNF alpha inhibitor

monoclonal Ab

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137
Q

adalimumab

A

TNF alpha inhibitor

monoclonal antibody

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138
Q

Golimumab

A

TNF alpha inhibitor

monoclonal antibody

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139
Q

Certoluzumab

A

TNF alpha inhibitor

monoclonal antibody

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140
Q

Prodenacid

A

increases uric acid secretion by blocking reabsorption in the proximal tubule

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141
Q

colchicine

A

stabilizes tubulin and inhibits polymerization leading to inhibition of leukocyte chemotaxis in acute gout exacerbation

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142
Q

allopurinol

A

xanthine oxidase inhibitor

- chronic use only for gout

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143
Q

febuxostat

A

xanthine oxidase inhibitor

- chronic use only for gout

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144
Q

finasteride

A

blocks 5 alpha reductase converting testosterone to DHT

  • BPH and male pattern baldness
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145
Q

flutamide

A

anti androgen receptor (competitive antagonist) used in prostate cancer

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146
Q

ketoconazole - endocrine

A

(antifungal) inhibits steroid synthesis vis blocking 17, desmolase -> less testosterone and less hirutism in polycystic kidney disease

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147
Q

sprinolactone -endocrine

A

inhibits steroid binding leading to decreased hirutism due to androgens in polycystic kidney disease

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148
Q

Cyclophosphamide

A

Covalently x linked DNA at Guanine N7

  • requires bioactivation by liver
  • hemorragic cystitis
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149
Q

sildenafil

A

inhibits phosphodiesterase 5 -> increase in cGMP - > smooth muscle relaxation -> vasodialtion

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150
Q

vardenafil

A

inhibits phosphodiesterase 5 -> increase in cGMP - > smooth muscle relaxation -> vasodialtion

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151
Q

tadafenil

A

inhibits phosphodiesterase 5 -> increase in cGMP - > smooth muscle relaxation -> vasodialtion

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152
Q

Leuprolide

A

GnRH agonist (early flare)

used for infertility - pulsitile

continuous: (chemical menopause) -> down regulates FSH and LH release
- prostate CA,
- precocious puberty,
- uterine fibroids
- endometriosus

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153
Q

Clomiphene

A

partial estrogen agonist in hypothalamus
- stimulates receptors but not enough to cause a negative feedback like normal estrogen -> increase of LH and FSH

induce pregnancy

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154
Q

Letrozole

A

aromatase inhibitor -> decreased peripheral androgen conversion

  • postmenopausal ER positive breast CA
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155
Q

Anastrozole

A

aromatase inhibitor -> decreased peripheral androgen conversion

-postmenopausal ER positive breast CA

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156
Q

Amitriptyline

A

Block reuptake of NE and serotonin (biogenic amines)
-TCA

  • Anticholinergic
  • Sedation
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157
Q

Imipramine

A

Block reuptake of NE and serotonin (biogenic amines)
-TCA

  • Anticholinergic
  • Sedation
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158
Q

Desipramine

A

Block reuptake of NE and serotonin (biogenic amines)
-TCA

  • Anticholinergic
  • Sedation
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159
Q

Clomipramine

A

Block reuptake of NE and serotonin (biogenic amines)
-TCA

  • Anticholinergic
  • Sedation
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160
Q

doxepin

A
  • Odd end of a TCA
    Block reuptake of NE and serotonin (Biogenic amines)
    -TCA
  • Anticholinergic
  • Sedation
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161
Q

Nortriptyline

A

Block reuptake of NE and serotonin (biogenic amines)
-TCA

  • Anticholinergic
  • Sedation
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162
Q

lovastatin

A

statins in general

inhibit conversion of HMG Co A to mevalonate

also secondarily increases LDL receptors to the cell surface for cells to take in LDL and lowering levels (decreases LDL mainly)

  • rhabdomyolysis and hepatotoxicity
  • myalgia,
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163
Q

Niacin

A

inhibits lipolysis in adipose tissue
reduces VLDL secretion

Flushed face concerns w/ hypoglycemia and hyperuricemia

itchy

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164
Q

Cholestryramine

A

Prevents intestinal reabsorption of bile acids
-decreases LDL mainly

unique in that it binds to C dif toxin from other bile acid resins

colestipol, colesevelam

GI discomfort and gallstones

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165
Q

colestipol

A

Prevents intestinal reabsorption of bile acids
decreases LDL mainly

GI discomfort and gallstones

Cholestryamine, Colesevelam

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166
Q

colesevelam

A

Prevents intestinal reabsorption of bile acids
Decreases LDL mainly

GI discomfort and gallstones

Cholestryramine, colestipol

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167
Q

ezetimibe

A

prevent cholesterol reabsorption at the small intestine brush border

Decreases LDL

Rarely may have increased liver enzymes, 2nd line to a statin
Diarrhea

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168
Q

gemfibrozil

A

fibrate

Upregulates LPL to increase tryglyceride clearance

May have RUQ pain w/ gallstones

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169
Q

clofibrate

A

fibrate

Upregulates LPL to increase tryglyceride clearance,
-activate peroxisome proliferator activated receptor alpha (PPAR alpha)

May have RUQ pain w/ gallstones

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170
Q

Mifepristone

A

competitive inhibitor of progesterone -> abortion

heave bleeding and GI/ Nausea experienced

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171
Q

Sulfonamides(sulfamethoxazole)

A

works on the first step of folate synthesis acting as a PABA antimetabolite blocking dihydropteroate synthase

-bacterialstatic

gram +/- UTIs, GIs, PCP prophylaxis

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172
Q

Trimethoprim

A

works on the second step of folate synthesis by blocking dihydrofolate reductase (methotrexate also acts here in humans)

Rx- supplemental folinic acid - leucovorin rescue

UTIs, GIs use

worry of anemia

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173
Q

Ciprofloxacin

A

Floroquinolones

inhibit DNA gyrase (topoisomerase II) and topo IV

bactericidal
not to be taken antacids/supplements (Ca, Fe, Mg)

Gram - rods, UTIs and GI, including pseudomonas, tessera and some gram +

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174
Q

levofloxacin

A

Floroquinolones - 3rd gen

inhibit DNA gyrase (topoisomerase II) and topo IV

bactericidal
not to be taken antacids/supplements (Ca, Fe, Mg)

Gram - rods, UTIs and GI, including pseudomonas, tessera and some gram +

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175
Q

moxifloxacin

A

Floroquinolones - 4th gen

inhibit DNA gyrase (topoisomerase II) and topo IV

bactericidal
not to be taken antacids/supplements (Ca, Fe, Mg)

Gram - rods, UTIs and GI, including pseudomonas, tessera and some gram +

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176
Q

metronidazole

A

forms free radicals that damage bacterial DNA

GET GAP on the Metro
Giardia
Entamoeba
Trichomona
Gardenella
Anaerobes
h Pylori

didsulfiram reaction

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177
Q

Nitrofurantoin

A

bactericidal
reduced by bacterial proteins to reactive intermediates that inactivates bacterial ribosomes

Used for UTIs

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178
Q

Isoniazid

A

decreases synth of mycolic acids.

bacterial catalase (KatG) needed to convert INH to active metabolite

Give w/ pyridoxine (B6) to prevent neurotoxicity

  • lupes
  • hepatotoxicity
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179
Q

Pyridoxine

A

vitamin B6

prevent neurotoxicity w/ INH

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180
Q

Rifampin Rs (4)

A

RnA polymerase inhibitor

Revs up microsomal p450
(increase warfarin and be wary of birth control)

Red/orange body fluids

Rapid resistance if used alone

-minor hepatic toxicity

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181
Q

Pyrazinamide

A

TB medication that acts by inhibiting my colic acid production by blocking mycobacterial pyrazinamidase -> decreased FA synth

effective in acidic pH of phagolysosomes

worry of

  • hyperuricemia*
  • hepatotoxicity
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182
Q

Ethambutol

A

decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

Worry of
-red/green colorblindness - optic neuropathy

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183
Q

Aldesleukin

A

IL2 analog given to encourage T cells in fighting renal cell carcinoma and metastatic melanoma

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184
Q

Erythropoeitin

A

Given to encourage RBC production with Renal failure leading to anemia

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185
Q

Filgrastim

A

GM-CSF ~ IL3

recovery of Bone marrow

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186
Q

sargramostim

A

GM-CSF ~ IL3

recovery of bone marrow

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187
Q

alpha interferon (exogenous)

A

Ramp up antiviral set _> ribonuclease activation

given to fight off Hep A and C, kaposis, leukemiasm malignant melanoma, hairy cell leukemia and genital warts

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188
Q

gamma interferon (exogenous)

A

given for chronic granulomatous disease to stimulate macrophages deficient in NADPH oxidase

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189
Q

Oprelvekin

A

~IL11

Used for thrombocytopenia

190
Q

Thrombopoietin

A

Used to thrombocytopenia

191
Q

Daclizumab

A

Binds to CD25, the IL 2 receptors in activated T cells for immune suppression

192
Q

Mycophenolate mofetil

A

immune suppressor that inhibits purine synthesis through blocking IMP dehydrogenase (inosinemonophosphate dehydrogenase)
-> decrease guanine synthesis

Increase of lymphoma risk, teratogen

193
Q

Thalidomide

A

immune suppressor that is historically important as a teratogen (phocomelia- limb agenisis)

Also used in immune suppression: anti-angiogenic

MOA- affects TNF alpha

194
Q

Abciximab

A

Glycoprotein IIb/IIIa monoclonal antibody that is anti platelet,

Used post anioplasty and prevent cardiac ischemia in unstable angina

195
Q

trastuzumab

A

HER/erb 2 neu receptor blocker in over expressing positive breast cancer

196
Q

Rituximab

A

CD 20 monoclonal antibody that attacks B cells in non-hodgkin’s lymphoma

197
Q

Omalizumab

A

IgE monocolonal antibody that is used in severe asthma relief,

Expensive

198
Q

Tetrabenazine

A

inhibits DA release

used in huntingtons

199
Q

pramipexole

A

dopamine receptor agonist
- Parkinsons

~Ropinirole, bromocriptine

200
Q

ropinirole

A

dopamine receptor agonist
- Parkinsons

~Pramipexole, bromocriptine

201
Q

Amantadine

A

Increases DA release in Parkinsons

used to be an antiviral

202
Q

Levoadopa

A

dopamine precursor (L-DOPA) that is converted to Dopamine after crossing the BBB by dopamine decarboxylase

Given w/ carbidopa

Has tolerance- where it wears off and akinesia sets in

203
Q

Carbidopa

A

simemet -blocks peripheral conversion of L Dopa to Dopamine minimizing SE of HTN, arrhythmia, hallucinations, psychosis

Given w/ levodopa

204
Q

Selegiline

A

selective MAO typeB inhibitor blocking the breakdown of dopamine in Parkinsons

205
Q

Entacapone

A

COMT inhibitor preventing L dopa degradation increasing availability of DA

~tolcapone

206
Q

tolcapone

A

COMT inhibitor preventing L dopa degradation increasing availability of DA

~entacapone

207
Q

riluzole

A

decreases presynaptic glutamate release in ALS

208
Q

Memantine

A

NMDA receptor antagonist -> decreased levels of excitotoxity
-Glutamate receptor

Helps with alzheimers

209
Q

Ondansetron

A

5HT3 antagonist used to block nausea post chemo, pregnant and post op

210
Q

Omeprazole

A

Irreversible binds to the K/H ATPase in the stomach blocking H production

Used for Peptic ulcers, gastritis, Zollinger ellison, GERD

211
Q

Bismuth

A

binds to ulcer base providing a physical barrier allowing the HCO3 secretion to reestablish pH gradient

Promotes healing

212
Q

Misoprostol

A

PgE1 analog that is used in increased production of HCO3 and decreased gastric acid secretion

also increases uterine tone -> abortifant

213
Q

Aluminum hydroxide

A

Antiacid that leads to constipation and hypokalemia and hypophosphatemia

214
Q

Magnesium hydroxide

A

Antiacid that leads to diarrhea and hypokalemia

magnesium relaxes smooth muscles in general body wide

215
Q

Calcium carbonate

A

Antiacid that leads to hypercalcemia (rebound acid secretion) and hypokalemia

216
Q

Metoclopramide

A

Decreases D2 stim as an antagonists and stimulates 5HT4

Helps w/ gastroparesis - post surgical or diabetic

217
Q

Mesalamine

A

5 ASA - activated in the colon by bacterial cleavage

218
Q

Sulfasalazine

A

5 ASA - activated in the colon by bacterial cleavage

219
Q

Ursodiol

A

natural bile acid that decreases synthesis of cholesterol in the liver and changes the composition of bile in the gallbladder

Delays progression in primary biliary cirrosis

220
Q

bosentan

A

decreases pulmonary hypertension by competitively antagonizing endothelian receptor type 1

221
Q

ambriesentan

A

decreases pulmonary hypertension by competitively antagonizing endothelian receptor type 1

222
Q

etoposide

A

inhibits topo II -> increase in DNA degradation

223
Q

teniposide

A

inhibitys topo II -> increase DNA degradation

224
Q

Cisplatin

A

cross links DNA

Toxicity -> nephrotoxic, acuoustic nerve damage -amifostine prevents

225
Q

carboplatin

A

cross links DNA

Toxicity -> nephrotoxic, acoustic nerve damage
-amifostine prevents

226
Q

levabuterol

A

beta 2 agonists for acute Asthma attack

- less beta 1 spill than albuterol

227
Q

Theophylline

A

inhibits phosphodiesterase thereby decreasing cAMP hydrolysis and causing bronchodialation

narrow TI -> cardiotoxic, neurotoxic, metabolized by p 450

228
Q

Ipatropium

A

blocks M3 muscarinic receptor leading to bronchodialation - More for COPD

blocks vagal stimuation in general -> smooth muscle dialalation

229
Q

Tiatropium

A

blocks M3 muscarinic receptor leading to bronchodialation - more for COPD

blocks vagal stimuation in general -> smooth muscle dialalation

230
Q

fluticasone

A

inhaled steroid that blocks production of cytokines and TNF alpha by inactivating NF kappaB (transcription factor)

Used for chronic prophylactic asthma management

beclomethazone, budesinode

231
Q

Beclomethasone

A

inhaled steroid that blocks production of cytokines and TNF alpha by inactivating NF kappaB (transcription factor)

Used for chronic prophylactic asthma management

-budesinode, fluticasone

232
Q

budesinode

A

inhaled steroid that blocks production of cytokines and TNF alpha by inactivating NF kappaB (transcription factor)

Used for chronic prophylactic asthma management

-beclomethazone, fluticasone

233
Q

Montelukast

A

blocks leukotriene receptors -> asthma, especially w/ allergic rhinits

234
Q

zafirlukast

A

blocks leukotriene receptors-> asthma, especially w/ allergic rhinits

235
Q

Zileuton

A

5 lipoxygenase pathway inhibitor blocking the formation leukotirenes

236
Q

Cromolyn

A

blocks the mast cell release of mediators. Used prophylactically for asthma
- not to common anymore

237
Q

Guaifenesin

A

expectorant - thins respiratory secretions

238
Q

n acetylcystine(3)

A

acetaminophen overdose
expectorant - especially w/ mucous plugs in CF patients
Prophylactic protection of kidney function from contrast

239
Q

diphenhydramine

A

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

  • be wary of: sedation(enters CNS), antimuscarinic, and anti alpha adrenergic
240
Q

demenhydrinate

A

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

  • be wary of: sedation(enters CNS), antimuscarinic, and anti alpha adrenergic
241
Q

chlorpheniramine

A

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

  • be wary of: sedation(enters CNS), antimuscarinic, and anti alpha adrenergic
242
Q

loratidine

A

H1 antagonist - 2nd gen

Used for allergy, less sedating

243
Q

fexofenazine

A

H1 antagonist - 2nd gen

Used for allergy, less sedating

244
Q

cetirizine

A

H1 antagonist - 2nd gen

Used for allergy, less sedating

245
Q

desloratidine

A

H1 antagonist - 2nd gen

Used for allergy, less sedating

246
Q

hydroxizine

A

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

  • be wary of: VERY sedating (enters CNS),
    antimuscarinic, and anti alpha adrenergic
247
Q

meclizine

A

Antihistamine used for vertigo

248
Q

Promethazine

A

antihistamine used for N/V

249
Q

cyproheptadine

A

antihistamine used as an appetite stimulant

250
Q

Dextromethorphan

A

derivative of morphine that antagonizes the NMDA glutamate receptor

used as a cough suppressant

mas mild opiod effect in excess

251
Q

Pseudophederine

A

sympathomimetic alpha agonist used in nonprescription nasal decongestants

constricts dilated arterioles -> decreased airway resistance

  • some CNS stimulation and anxiety
  • phenylephrine is another
252
Q

Minoxidil

A

opens K channels and hyper polarizes smooth muscles -> relaxation of vascular smooth muscle

(Ca channels stay closed, less contraction)

Used in HTN and topical hair loss (hypertichosis is S Fx)

253
Q

Nifedipine

A

blocks voltage dependent L type Ca channels of smooth muscle and thereby reduce muscle contractility preventing formation of Ca Calmodulin complex

-> HTN

Also amlodipine

254
Q

Hydralazine

A

increases cGMP directly -> increase myosin phosphatase activity and less myosin phophorylated -> smooth muscle relaxation

reduces after load by preferentially dilating arterioles

Co -administered w/ beta blocker frequently to prevent reflex tachy

255
Q

Nitroprusside

A

short acting increases cGMP via direct release of NO (activates guanylyl cyclase); leads to increased myosin phosphatase activity

Risk of cyanide poisoning

Used for malignant HTN

256
Q

Captopril

A

ACE inhibitor

inhibits angiotension II formation

  • > decreased vasoconstriction
  • > decreased aldosterone (less Na and fluid retention)

used for HTN and CHF and diabetic renal disease

Concern w. cough, andioedema, teratogen, creatine increase and hyperkalemia

257
Q

enalapril

A

ACE inhibitor

inhibits angiotension II formation

  • > decreased vasoconstriction
  • > decreased aldosterone (less Na and fluid retention)

used for HTN and CHF and diabetic renal disease

Concern w. cough, andioedema, teratogen, creatine increase and hyperkalemia

258
Q

Losartan

A

ARB

blocks angitenision II effect on its receptor leading to less aldosterone and decreased vasoconstriction

  • used in HTN and CHF and post mI and diabetic renal disease

No Cough Sideeffect

Still have angioedema and teratogen,

259
Q

Aliskern

A

renin inhibitor
- used for HTN, old drug

Causes hyperkalemia and renalinsufficency,

NOT for pregnancy, CHF, MI

260
Q

Omega 3 FA

A

decreases tryglycerides

261
Q

morphine

A

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

262
Q

fentanyl

A

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

263
Q

heroin

A

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

264
Q

Methadone

A

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

265
Q

meperidine

A

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

266
Q

Penicillin G - 3 MOA

A

IV - bactericidal

binds penicillin binding proteins preventing wall formation

binds to transpeptidase preventing cross linking

Increase autolytic enzymes

syphilis

267
Q

Penicillin V - 3 MOA

A

Oral - bactericidal

binds penicillin binding proteins preventing wall formation

binds to transpeptidase preventing cross linking

Increase autolytic enzymes

268
Q

Oxacillin

A

narrow spectrum

w/ naficillin, dicloxacilin

penicillinase resistant blocking degradtion

Used for MSSA; not MRSA

269
Q

naficillin

A

narrow spectrum

w/ oxacillin, dicloxacilin

penicillinase resistant blocking degradtion

Used for MSSA; not MRSA

270
Q

dicloxacilin

A

narrow spectrum - same 3 MOA as penicillin

w/ naficillin, oxacillin

penicillinase resistant blocking degradtion

Used for MSSA; not MRSA

271
Q

Ampicillin

A

IV mainly
same 3 MOA of penicillin but wider spec

Gram +

HELPSS
Haemophilus
E Coli
Listeria
Proteus mirabilis
Salmonella
Shigella

ampicillin rash w/ EBV
-neonatal infect/ URI/UTI

272
Q

Amoxicillin

A

Oral - given w/ clavulanic acid
same 3 MOA of penicillin but wider spec

Gram +

HELPSS
Haemophilus
E Coli
Listeria
Proteus mirabilis
Salmonella
Shigella

ampicillin rash w/ EBV
-neonatal infect/ URI/UTI

273
Q

Ticarcillin

A

antipseuedomonal penicillin

274
Q

piperacillin

A

antipseuedomonal penicillin

275
Q

carbenicillin

A

antipseuedomonal penicillin

276
Q

Clavulanic acide

A

beta lactamase inhibitor

given w/ amoxicillin and ticarcillin

277
Q

Sulbactam

A

beta lactamase inhibitor

given w/ ampicillin

278
Q

Tazobactam

A

beta lactamase inhibitor

given w/ piperacillin

279
Q

cefazolin

A

1st gen cephalosporin

gram + and PEcK

Proteus mirabilis
E Coli
Klebiella

280
Q

cephalexin

A

1st gen ceph

gram + and PEcK

Proteus mirabilis
E Coli
Klebiella

281
Q

cefoxitin

A

2nd gen ceph
gram + and HEN PEcKS

Haemophilus
Enterobacter
nesseiria (not gon)
Proteus mirabilis
E Coli
Klebsiella
Serratia
282
Q

cefaclor

A

2nd gen ceph
gram + and HENS PEcK

Haemophilus
Enterobacter
nesseiria (not gon)
Serratia
Proteus mirabilis
E Coli
Klebsiella
283
Q

cefuroxime

A

2nd gen ceph

gram + and HENS PEcK

Haemophilus
Enterobacter
nesseiria (not gon)
Serratia
Proteus mirabilis
E Coli
Klebsiella
284
Q

cefprozile

A

2nd gen ceph

gram + and HENS PEcK

Haemophilus
Enterobacter
nesseiria (not gon)
Serratia
Proteus mirabilis
E Coli
Klebsiella
Serratia
285
Q

ceftriaxone

A

3rd gen ceph

only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria ****
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia
286
Q

ceftiazidime

A

3rd gen ceph
ANTIPSEUDOMONIAL

only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria 
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia
287
Q

cefotaxime

A

3rd gen ceph
only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria 
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia
288
Q

cefdinir

A

3rd gen ceph
only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria 
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia
289
Q

cefepime

A

4th gen ceph

BIG GUN - wide spectrum
antipseudomonial and gram + again

290
Q

Aztreonam

A

Cell wall inhibitor that binds to PBP3

prevents peptidoglycan cross linking in gram - only

monobactum resistant to beta lactamase as well

291
Q

Imipenem

A

Carbapenem that binds to penicillin binding proteins inhibiting cell wall synthesis

Broad spectrum covering everything except MRSA

CNS toxicity (seizures); GI; Skin Rash

Given w/ Cilastatin to decrease renal breakdown (inactivates renal dehydropeptidase)

292
Q

Cilastatin

A

given w/ imipenem to block renal breakdown of the drug via blocking renal dehydropeptidase I

293
Q

Meropenam

A

Carbapenem that binds to penicillin binding proteins inhibiting cell wall synthesis

Broad spectrum covering everything except MRSA

CNS toxicity (seizures); GI; Skin Rash

294
Q

Vancomycin

A

binds to D-ala D-ala moitey to inhibit cell wall synthesis in Gram + peptidoglycan polymerization

MRSA, enterococci, and oral 2nd line for C Dif

bactericidal

NOTs
Nephrotoxic
Ototoxic
thrombophelbitis

Red man syndrome

295
Q

Gentamicin(3)

A

aminoglycoside

inhibits formation of initiation complex- binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

296
Q

Neomycin (3)

A

aminoglycoside

inhibits formation of initiation complex- binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal -severe gram (-)

297
Q

Streptomycin (3)

A

aminoglycoside

inhibits formation of initiation complex - binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

298
Q

Tobramycin (3)

A

aminoglycoside

inhibits formation of initiation complex - binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

299
Q

Amikacin (3)

A

aminoglycoside -

inhibits formation of initiation complex - binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

300
Q

Tetracycline

A

Bacteriostatic- tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins
VACUUM The BedRoom

301
Q

doxycycline

A

Bacteriostatic - tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins
VACUUM The BedRoom

302
Q

demeclocycline

A

Bacteriostatic - tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins
VACUUM The BedRoom

MORE ADH Antagonist -> dieuretic in SIADH

303
Q

minocycline

A

Bacteriostatic - tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins

VACUUM The BedRoom

304
Q

Azithromycin

A

Macrolide - bacteriostatic

Binds to 23s unit of 50s subunit blocking translocation (macroslide) in protein synthesis

Prolonged QT, p450 inhib, cholestatic hep

PUS- atyp Pneumonia; URI; STD (chlamydia)
Resistance w/ methylation of the side

305
Q

Erythromycin

A

Macrolide - bacteriostatic

Binds to 23s unit of 50s subunit blocking translocation (macroslide) in protein synthesis

Prolonged QT, p450 inhib, cholestatic hep

PUS- atyp Pneumonia; URI; STD (chlamydia)
Resistance w/ methylation of the side

306
Q

Clarithromycin

A

Macrolide - bacteriostatic

Binds to 23s unit of 50s subunit blocking translocation (macroslide) in protein synthesis

Prolonged QT, p450 inhib, cholestatic hep

PUS- atyp Pneumonia; URI; STD (chlamydia)
Resistance w/ methylation of the side

307
Q

Chloramphenical

A

bacteriostatic

binds to 50s subunit blocking the peptidyltransferase (formation of peptide bond)

Old use - meningitis

ALOT of side effects
-gray baby, dose dependent aplastic anemia

308
Q

Clindamycin

A

bacteriostatic

Blocks peptide transfer (transpeptidation) at 50s ribosomal subunit

used in Anaerobes primary

Worry of C dif post use

309
Q

Quinupristin/dalfoprisitin

A

a streptogramin

Synthesized by Strep virginias
- binds to the 23S portion of the 50s ribosome,

Used for MRSA, VRE, staph and skin infections

SE- hepatoxicity, pseudomonas colitis, p450 inhibit

310
Q

polymyxin

A

cationic detergent (disrupts cell membranes)

Used for very serious gram - IV
-Neurotoxic and nephrotoxic

More likely used topical

311
Q

methylphenidate

A

ritalin

CNS stimulant that increases NE release

~dextroamphetamine

312
Q

dextroampthetamine

A

adderol

CNS stimulant that increases NE release

~ethyphenidate

313
Q

Atomoxetine

A

NE reuptake inhibitor

Strattera

used in adult ADHD

314
Q

Haloperidal

A

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

315
Q

fluphenazine

A

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

316
Q

trifluoperazine

A

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

317
Q

loxapine

A

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

318
Q

thiothixene

A

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

319
Q

thioridazine

A

typical antipsychotic - LP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX
more antimuscarinic 
- dry mouth, constipation
alpha1 block -> hypotenison
histamine block -> sedation
320
Q

Chlopromazine

A

typical antipsychotic - LP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX
more antimuscarinic 
- dry mouth, constipation
alpha1 block -> hypotenison
histamine block -> sedation
321
Q

Olanzaprine

A

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

UNIQUE- more concern w metabolic disorder and DM

322
Q

Clozapine

A

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

UNIQUE - agranulocytosis (weekly CBC checks)

323
Q

Quetiapine

A

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

UNIQUE - used for psychotic symptoms brought on due to parkinson medications, less side effect profile

324
Q

Risperadone

A

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

325
Q

Aripiprazole

A

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

326
Q

Fluoxetine

A

SSRI

concern w/ sexual dysfunction and serotonin syndrome
(MSC, neuromuscular abnormalities, autonomic instability)

useful in bulimia

327
Q

Paroxetine

A

SSRI

concern w/ sexual dysfunction and serotonin syndrome
MSC, neuromuscular abnormalities, autonomic instability

328
Q

Sertraline

A

SSRI

concern w/ sexual dysfunction and serotonin syndrome (MSC, neuromuscular abnormalities, autonomic instability)

329
Q

citalopram

A

SSRI

concern w/ sexual dysfunction and serotonin syndrome (MSC, neuromuscular abnormalities, autonomic instability)

330
Q

venlafaxine

A

SNRI

concern w/ stimulant effects and increased BP

331
Q

duloxetine

A

SNRI

also used for diabetic peripheral nueropathy and fibromyalgia

concern w/ stimulant effects and increased BP

332
Q

Amytriptyline

A

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

used for fibromyalgia mainly

333
Q

nortriptyline

A

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

334
Q

imipramine

A

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

Used for bedwetting

335
Q

clomipramine

A

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

Used in OCD

336
Q

doxepin

A

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

337
Q

tranylcypromine

A

MAOI - blocks the breakdown of NE, 5Ht and Dopamine

Concern w/ hypertensive crisis in the presence of tyramine and excess NE

338
Q

Phenelzine

A

MAOI - blocks the breakdown of NE, 5Ht and Dopamine

Concern w/ hypertensive crisis in the presence of tyramine and excess NE

339
Q

Isocarboxazid

A

MAOI - blocks the breakdown of NE, 5Ht and Dopamine

Concern w/ hypertensive crisis in the presence of tyramine and excess NE

340
Q

Buproprion

A

NDRI - blocks the reuptake of dopamine and NE, synergistic w/ SSRI

Useful in smoking cessation and NO sexual side effects

Concern w/ seizures in bulemics, some stimulant effects

341
Q

Mirtazapine

A

tetracyclic antidepressant that blocks alpha2
increasing the release of NE and 5 HT

also potent 5Ht2 and 5 Ht3 receptor antagonist

concern w/ sedation and weight gain (may be a good thing)
- dry mouth

342
Q

Trazodone

A

tetracyclic that blocks serotonin reuptake

Used primarily for insomnia

concern w/ priaprism and sedation

343
Q

Buspirone

A

Stimulates 5 HT1a receptors

Used in GAD

takes 2 weeks work

No real side effects, can be used w/ alcohol, non sedating or addictive

344
Q

Mannitol

A

osmotic diuertic -> increased vascular osmolarity and tubular fluid osmolarity (works in proximal tubule)

helps w/ shock, increased Intracranial pressure and as a diuretic, glaucoma

345
Q

acetazolamide

A

carbonic anhydrase inhibitor -> self limited NaHCO3 diuresis (works in the proximal tubule)

used in glaucoma, urinary alkalization, fix metabolic acidosis, altitude sickness

Worry of hyperchloremic metabolic alkalosis and SULFA allergy

346
Q

Furosimide

A

SULFA loop dieuretic

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

Ototoxic, Nephrotoxic, hypokalemia, dehyd, gout,

347
Q

toresemide

A

SULFA loop dieuretic

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

Ototoxic, Nephrotoxic, hypokalemia, dehyd, gout,

348
Q

bumetanide

A

SULFA loop dieuretic

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

Ototoxic, Nephrotoxic, hypokalemia, dehyd, gout,

349
Q

ethycrynic acide

A

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

NO SULFA ALLERGY

350
Q

Hydrochlothiazide

A

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

351
Q

metolazone

A

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

352
Q

chorthalidone

A

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

353
Q

chlorothiazide

A

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

354
Q

spironolactone

A

k sparing dieuretic - aldosterone receptor antagonist

also used in acne and polycystic kidney disease

tox- hyperkalemia and antiandrogen (worse than eplerenone)

355
Q

eplerenene

A

k sparing dieuretic - aldosterone receptor antagonist

toxicity - hyperkalemia

356
Q

amiloride

A

K sparing dieuretic - blocks Na channel

concern of hyperkalemia

357
Q

triamterene

A

K sparing dieuretic - blocks Na channel

concern of hyperkalemia

358
Q

Hydrocortisone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

~ cortisol

359
Q

prednisone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM
360
Q

triamcinolone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

Topical

361
Q

dexamethasone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

Used dexamethasone suppression test

362
Q

beclomethasone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

Inhaled for asthma

363
Q

fluticasone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

inhaled for asthma

364
Q

prednisolone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

IV

365
Q

methylpredisiolone

A

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox

  • iatagenic Cushing’s syndrome
  • Adrenal insufficiency
  • osteoprosisi
  • ulcers
  • DM

IV

366
Q

lispro

A

rapid acting insulin

367
Q

aspart

A

rapid acting insulin

368
Q

gluisine

A

rapid acting insulin

369
Q

regular insulin

A

regular acting insulin

370
Q

NPH

A

intermediate acting insulin

371
Q

Glargine

A

long acting insulin

372
Q

Determir

A

long acting insulin

373
Q

Metformin

A

decreases gluconeogenisis, increases glycolysis, increases peripheral glucose uptake

lowers LDL and triglycerides

Tox: lactic acidosis, contraindicated in renal failure

374
Q

glyburide

A

sulfonylureas

close K channel in the beta cell membrane -> depolarization of the cell-> triggering insulin release via Ca influx

risk of hypoglycemia, some weight gain

375
Q

glimepiride

A

sulfonylureas

close K channel in the beta cell membrane -> depolarization of the cell-> triggering insulin release via Ca influx

risk of hypoglycemia, some weight gain

376
Q

glipizide

A

sulfonylureas

close K channel in the beta cell membrane -> depolarization of the cell-> triggering insulin release via Ca influx

risk of hypoglycemia, some weight gain

377
Q

pioglitazone

A

increases insulin sensitivity by binding to PPAR-gamma nuclear TF which is responsible for regulating FA storage and glucose metabolism

-> increased response to insulin

Risk

  • Bladder CA
  • osteoperosis
  • hepatoxicity
  • weight gain/edema
  • Heart failure
378
Q

rosiglitazone

A

increases insulin sensitivity by binding to PPAR-gamma nuclear TF which is responsible for regulating FA storage and glucose metabolism

-> increased response to insulin

Risk

  • hepatotoxicity
  • weight gain/edema
  • Heart failure*
379
Q

acarbose

A

alpha glucosidase inhibitors

delays sugar hydrolysis and glucose absorption

  • thus passed in the stool
  • > less postprandial hyperglycemia

Toxicity: GI disturbance (diarrhea/flatulence)

380
Q

miglitol

A

alpha glucosidase inhibitors

delays sugar hydrolysis and glucose absorption

  • thus passed in the stool
  • > less postprandial hyperglycemia

Toxicity: GI disturbance (diarrhea/flatulence)

381
Q

pramlintide

A

amylin analog

acting as a amylin which is normally secreted w/ insulin that leads to depression of glucagon secretion and delaying gastric emptying

Used only in patients taking insulin (type I or Type II)
- injected after every meal

risk of hypoglycemia, nausea, diarrhea

382
Q

Exenatide

A

GLP 1 analog (an incretin)

analog of exendin which acts like GLP 1 ->

  • decreases glucagon secretion
  • increases insulin secretion
  • delays gastric emptying

do not use while on insulin

Risk of pancreatitis and N/V

383
Q

liraglutide

A

GLP 1 analog (an incretin)

analog of GLP 1 ->

  • decreases glucagon secretion
  • increases insulin secretion
  • delays gastric emptying

do not use while on insulin

Risk of pancreatitis and N/V

384
Q

Sitagliptin

A

inhibits dipeptidyl peptidase IV (DPP-IV) which affects glucagon like peptide (GLP-1)
-Normally DPP-IV breaks down GLP but this allows the incretin to remain

Prolongs insulin actions

  • decreases glucagon secretion
  • increases insulin secretion
  • delays gastric emptying
385
Q

heparin

A

cofactor for increasing the efficacy of antithrombin inhibiting the intrinsic pathway cascade

elevated PTT

worry of heparin induced thrombocytopenia ( binds to platelet factor 4 - IgG then binds and removes)

386
Q

enoxaparin

A

LMWH

acts more on factor Xa than inducing antithrombin

2-4x the half life, not easily reversible
does on weight

387
Q

dalteparin

A

LMWH

acts more on factor Xa than inducing antithrombin

2-4x the half life, not easily reversible
does on weight

388
Q

lepirudin

A

derivative of hirudin (leeches) and it inhibits thrombin via another mech (not inducing antithrombin)

alternative to heparin w/ HIT complications

389
Q

bivalirudin

A

derivative of hirudin (leeches) and it inhibits thrombin via another mech (not inducing antithrombin)

alternative to heparin w/ HIT complications

390
Q

desirudin

A

derivative of hirudin (leeches) and it inhibits thrombin via another mech (not inducing antithrombin)

alternative to heparin w/ HIT complications

391
Q

Fondaparinux

A

activates antithrombin and inhibits factor Xa

not the same as LWMH

392
Q

rivaroxaban

A

direct factor Xa inhibitor

393
Q

apixaban

A

direct factor Xa inhibitor

394
Q

Alteplase

A

thrombolytic

activates plasminogen ->plasmin to lyse clots

395
Q

streptokinase

A

thrombolytic

activates plasminogen ->plasmin to lyse clots

396
Q

reteplase

A

thrombolytic

activates plasminogen ->plasmin to lyse clots

397
Q

tenecteplase

A

thrombolytic

activates plasminogen ->plasmin to lyse clots

398
Q

Clopidogrel

A

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

399
Q

ticlopidine

A

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

Tox - neutropenia

400
Q

prasugrel

A

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

401
Q

ticagrelor

A

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

402
Q

Abciximab

A

binds to glycoproetien receptor IIb/IIIa directly inhibiting fibrinogen from binding preventing cross linking

403
Q

eptifibatide

A

binds to glycoproetien receptor IIb/IIIa directly inhibiting fibrinogen from binding preventing cross linking

404
Q

tirofiban

A

binds to glycoproetien receptor IIb/IIIa directly inhibiting fibrinogen from binding preventing cross linking

405
Q

Acyclovir

A

monophophorylated guanosine analog that is phosphorylated by HSV/VZV thyrimidine kinase

preferentially inhibits viral DNA polymerase

Used for HSV and VZV, weak EBV

valacyclovir is oral viral prodrug

406
Q

Famciclovir

A

acycyclic guanosine analog
prodrug of peniclovir

needs to be phosphorylated by thymidine kinase to work inhibit viral DNA polymerase in HSV and VZV

407
Q

ganciclovir

A

monophosphate formed by CMV viral kinase leads to active guanine analog that inserts itself in viral DNA via DNA polymerase, inhibiting it

valgancyclovir is oral viral prodrug

toxicity: bone marrow suppression and renal toxicity

408
Q

Foscarnet

A

Viral DNA polymerase inhibitor that does NOT require activation by a viral kinase

Used for CMV retinitis and acyclovir resistant HSV

Concern w/ Nephrotoxicity and anemia

409
Q

Zanamivir

A

inhibits influenza neurmainidase, blocking viral release

used in rx and prevention of influenza A and B
-need to be used w/in 24-48 hrs

410
Q

oseltamivir

A

inhibits influenza neuraminidase, blocking viral release

used in rx and prevention of influenza A and B
need to be used in 24-48hrs

411
Q

Ribavirin

A

inhibits synthesis of guanine nucleotides by competively inhibing IMP dehydrogenase

used in RSV (adults mainly), and hep C*

Toxicity : hemolytic anemia and teratogen

412
Q

maraviroc

A

CCR5 co-receptor antagonists,

Bonds to host cell co-receptor preventing HIV gp100 from binding and infusiion

413
Q

lopinovir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

414
Q

atazanivir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

  • nephrolithias convern
  • increased bilirubin
415
Q

darunavir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

416
Q

fosamprenavir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

417
Q

Saquinavir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

418
Q

ritonavir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

Especially used to BOOST other PI functions
*pancreatitis

419
Q

indinavir

A

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

*nephrolithias concern

420
Q

Tenofovir

A

NRTI - nucleotide vs nucleoside
- DOES NOT need phosphorylation from thrymidine kinase to work like other NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain

lactic acidosis

421
Q

Emtricitabine

A

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis

422
Q

Abacavir

A

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis
*life threatening hypersensitivity

423
Q

lamivudine

A

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis

424
Q

Zidovudine

A

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

-prophylactically given to moms peri-delivery if not on HAART prior

lactic acidosis

  • bone marrow suppression
  • anemia
425
Q

Didanosine

A

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis

  • Pancreatitis
  • hepatic steatosis
  • peripheral neuropathy
426
Q

Stavudine

A

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis

  • peripheral neuropathy
  • hepatic steastosis
427
Q

Nevirapine

A

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

428
Q

efavirenz

A

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

  • neuropsychiatric disorders
  • false + cannaboid
  • teratogenic
429
Q

delavirdine

A

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

430
Q

etravine

A

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

431
Q

rilpivirine

A

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

432
Q

Raltegravir

A

HIV viral integrase inhibitor, prevents the viral DNA from combing w/ host DNA

SFX : hypercholesterolemia, Nausea, vomitting, rash

433
Q

Enfuvirtide

A

HIV fusion inhibitor blocking gp41 binding and infection of a cell

injection site reaction and increased risk of bacterial pneumonia

434
Q

Griseofulvin

A

interferes w/ microtubule function, disrupts mitosis, deposits in keratin containing tissues

Used in oral Rx for superficial infection (inhibits dermatophyes)

concern w/ teratogen, HA and increased p450 metabolism (rarely confusion)

435
Q

Terbinafine

A

inhibits fungal enzyme squalene epoxidase
(sqaulene -> lamosterol)

used for dermatophytes (onchomycosis esp)

Concerne w/ abnormal LFTs/hepatotoxicity and GI

436
Q

Amphoteracin B

A

binds to ergosterol and forms holes in fungal cell membrane

Serious systemic mycoses
-cryptococcal, blastomyces, coccidiodes, histoplasma, mucor

Concern w/ fever, chills, hypotension, nephrotoxicity * (supplement K and Mg w/ hypokalemia), arrythmias, aneima

437
Q

Nystatin

A

binds to ergosterol and forms holes in fungal cell membrane

Used topically b/c otherwise it is too toxic for use

thrush, diaper rash, vaginal candidiasis

438
Q

Fluconazole and other azoles

A

inhibits fungal sterol (elgosterol synth) by blocking p450 conversion of lamosterol -> ergosterol

local and lass serious systemic mycoses use

Fluconazole for chronic suppression of cryptococcal meningitis

concern w/

  • testosterone synth inhib (impotence and gynectomastia)
  • liver dysfunciton ( blocks p450 metab)
439
Q

Flucytosine

A

inhibits DNA/ RNA biosynthesis by converting to 5 fluorouracil by cytosine demaninase
-> nucleoside analog

used in systemic fungal infections, like cryptoccocal (w/ amphoteracin B)

concern w/ cone marrow suppression and GI

440
Q

Caspofungin

A

inhibits cell wall synthesis by inhibition synthesis of beta glucan
-> cell lysis and death

used in invasive aspergillus and candid

Concern w/ GI upset and flushing

441
Q

micafungin

A

inhibits cell wall synthesis by inhibition synthesis of beta glucan
-> cell lysis and death

used in invasive aspergillus and candid

Concern w/ GI upset and flushing

442
Q

Cyproheptadine

A

antihistamine w/ 5HT2 receptor antagonist

used in serotonin syndrome

443
Q

Methotrexate

A

folic acid analog that inhibits dihydrofolate reductase
(s phase)

inhibiting conversion of DHF back to THF -> less dTMP and ultimately less DNA

used in: ALL/AML, immune supp (RA, psoriasis), and Uterine path (ectopic, choriocarcinoma, hydradidiform mole)

Tox: myelosuppresion, fibrotic lung disease
teratogenic

give leucovorin

444
Q

leucovorin

A

folinic acid used in methotrexate rescue

445
Q

5 fluororacil

A

pyrimidine analog (S phase) that covalently complexes to folic acid, the complex then inhibits thymidylate synthase -> decreases dTMP and less DNA in general

used in colon and pancreatic CA
especially topically basal cell and actinic keratosis

Tox: myelosuppression and photosensitivity

446
Q

cytarabine

A

pyrimidine analog (s phase) -> inhibition of DNA polymerase

used in leukemia and lymphoma

concern w/ leukopenia

447
Q

6 mercaptopurine

A

purine (thiol analog) (s phase) -> less purine synthesis
blocks PRPP amidotransferase

used in leukemias

Metabolized xanthine oxidase -> increased toxicity w/ allopurinol ( myelosuppression and hepatotoxicity)

448
Q

6 thioguanine

A

purine (thiol analog) (s phase) -> less purine synthesis
blocks PRPP amidotransferase

used in leukemias

differs from 6 mercaptopurine in that it is not metabolized by xanthine oxidase

449
Q

Dactinomycin

A

antibiotic that intercalates DNA

used in Ewing sarcoma, rhabdomyosarcomas and Wilms

450
Q

Doxorubicin

A

(adriamycin) antibiotic that
1. generates free radicals
2. noncovalently intercalates in DNA -> DNA breaks

used in solid tumors

Risk of cardiotoxicity - rx w/ dexrazoxane

451
Q

Daunorubicin

A

antibiotic that

  1. generates free radicals
  2. noncovalently intercalates in DNA -> DNA breaks

used in solid tumors

Risk of cardiotoxicity - rx w/ dexrazoxane

452
Q

bleomycin

A

antibiotic that induces free radicals -> DNA strand breaks

Used in testicular CA and Hodgkins lymphoma

Pulmonary fibrosis toxicity

453
Q

cyclophosphamide

A

alkalating agent that covertly cross links DNA at Guanine N-7, needs bioactivation by liver

Uesd in

  1. Solid tumors
  2. Immune suppression : lupes nephritis and PAN

Toxicity: hemorragic cystits, Rx w/ Mensa
increased transitional cell CA risk

454
Q

Mensa

A

used in hemorragic cystitis caused by cyclophosphamide’s metabolite acrolein

455
Q

Nitrosourease (carmustine etc..)

A

alkylating agent used in brain tumors

Crossed the BBB

Concern w/ CNS toxicity - dizzy, ataxia

456
Q

Busulfan

A

alkylates DNA

used in CML

Concern w/ pulmonary fibrosis and hyperpigmentation

457
Q

ifosphamide

A

similar to cyclophosphamide

alkalating agent that covertly cross links DNA at Guanine N-7, needs bioactivation by liver

Used in testicular CA

458
Q

vincristine

A

binds to tubulin in the M phase to block polymerization so microtubules can’t form

used in: hodgkin lymphoma, wilma, ewing, choricarcinoma

Worry of: neurotoxicity and peripheral neuritis

459
Q

vinblastine

A

binds to tubulin in the M phase to block polymerization so microtubules can’t form

used in: hodgkin lymphoma, wilma, ewing, choricarcinoma

Worry of myelosuppression (Blasts bone marrow0

460
Q

Paclitaxel

A

hyperstabilize polymerized microtubules in the M phase so mitotic spindles cannot break down

used in ovarian and breast

worry of myelosuppression and hypersensitivity

461
Q

Cisplatin

A

cross links w/ DNA - damage

used in testicular, bladder, ovary cA

causes nephrotoxicity and acoustic nerve damage

462
Q

carboplatin

A

cross links w/ DNA - damage

used in testicular, bladder, ovary cA

causes nephrotoxicity and acoustic nerve damage

463
Q

oxaliplatin

A

cross links w/ DNA - damage

used in testicular, bladder, ovary cA

causes nephrotoxicity and acoustic nerve damage

464
Q

Etoposide

A

inhibits topoisomerase II -> unwinds supercoiling usually -> DNA degradation

Used in call cell Lung, prostate, and testicular CA

concern are usual w/ CA myelosup, GI and aloplecia

465
Q

teniposide

A

inhibits topoisomerase II -> unwinds supercoiling usually -> DNA degradation

Used in call cell Lung, prostate, and testicular CA

concern are usual w/ CA myelosup, GI and aloplecia

466
Q

Irinotecan

A

inhibits topoisomerase I

used in METS Colon Ca

467
Q

topotecan

A

inhibits topoisomerase I

used in
-small cell lung CA,
-ovarian CA
Cervical CA

468
Q

Hydroxyurea

A

inhibits ribonucleotide reductase -> decreased DNA synthesis in antineoplastic function

Increases HbF in sickle cell

469
Q

Prednisone antineoplastic MOA

A

may trigger apoptosis

used in CLL and NHL

worry of BAM CUSHINGOID

470
Q

Trastuzumab

A

monoclonal ab against her-2 Neu, a tyrosine kinase

needs to be her2 + breast CA

worry of cardiotoxicity

471
Q

Rituximab

A

monoclonal Ab against CD20, found on most B cell neoplasms

Used in Non hodgkin lymphoma, RA, phemigus vulgaris, ITP and vasculitis

472
Q

imatinib

A

enzyme inhibitor for chromosome bcr-abl tyrosine kinase

Used in CML (ALL and AML if positive)

USLME Kiss my ass and pray (33 decks)

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