PDA Block II

Question 1

Alprostadil

Answer 1

PGE1 analog - erection/ductus arteriosus

EP2/4 relax sm. muscle, vasc. dilation - cAMP

Question 2

Bimatoprost

Answer 2

PGF2α analog - Glaucoma, eyelash hypotrichosis (FP)

AE: Eye redness, itching, color change, inc. # lashes

Question 3

Carboprost

Answer 3

PGF2α analog - Termination of early pregnancy, control postpartum hemorrhage
FP: Uterine contraction
AE: Nausea, diarrhea, fever, uterine rupture

Question 4

Dinoprostone

Answer 4

PGE2 analog - Termination of early pregnancy (EP1/3) or cervical ripening (EP4)
AE: Nausea, diarrhea, fever, uterine rupture

Question 5

Epoprostenol

Answer 5

PGI2 analog - Primary pulmonary HTN (IV)
IP: Dilation of pulmonary artery vasc. sm. muscle - cAMP
AE: Nausea, headache, flushing, ixn w/ anti-HTN/anti-platelet

Question 6

Misoprostol

Answer 6

PGE1 analog - Prevent ulcers w/ NSAID use
Decrease H+, Inc. mucin and bicarb (EP3)
Inc. mucosal blood flow (EP2/4)
Contra: Pregnancy

Question 7

Etanercept

Answer 7

TNFα suicide inhib - receptor analog antibody

RA, Crohn’s disease

Question 8

Infliximab

Answer 8

TNFα inhibitor - monoclonal antibody

RA, Crohn’s disease

Question 9

Zafirlukast

Answer 9

Cys-LT blocker (CYP2C9)

Prophylaxis and chronic treatment of asthma - little AE

Question 10

Zileuton

Answer 10

5-LOX inhibitor (1A2, 2C9, 3A4)

Prophylaxis and chronic treatment of asthma

Question 11

Cortisol

Answer 11

Glucocorticoid (zona fasciculata/cortex)
Inc. blood sugar
AE: acute adrenal insufficiency, salt wasting, CV collapse, Cushing’s

Question 12

Dexamethasone

Answer 12

Potent glucocorticoid - anti-inflammatory/immunosuppressant effects
Inflam/AI conditions

Question 13

Prednisolone

Answer 13

Glucocorticoid - Inflam/AI
Some mineralicorticoid act.
Inflam/AI conditions, immunosupressive for organ transplants
Irr. binds GR

Question 14

Fludrocortisone

Answer 14

Potent mineralicorticoid - cerebral salt wasting, adrenal insufficiency (Aldosterone), orthostatic intolerance/tachycardia
AE: Na/H20 retention, HTN, hypokalemic

Question 15

Metyrapone

Answer 15

Diagnostic: Blocks 11-β hydroxylation - stops at deoxycortisol - should see inc in ACTH

Question 16

Mifeprisone

Answer 16

Progesterone comp antag: Termination of pregnancy

Glucocorticoid comp. antag: Cushings

Question 17

Drospirenone

Answer 17

Mineralicorticoid/Progesterone/Androgen Antagonist: HRT post-menopausal women
Diuretic blocks Na retaining effect of estrogen.
W/ Estrogen suppresses ovulation

Question 18

Cyclosporine

Answer 18

Prevents rejection of transplanted organs, some AI disease
Cyclophilin blocker - blocks NFAT for IL-2 production - blocks T helper fx/prolif/cytotoxicity
AE: Nephrotoxicity w/ high dose

Question 19

Azathioprine

Answer 19

Allograft rejections, AI disease, RI
Metabolized to 6-mercaptopurine - inhibits de novo and salvage purine syn.
AE: Bone marrow depression, GI and hepatic toxicity

Question 20

Cyclophosphamide

Answer 20

Alkylating agent - cross linked DNA kills replicating and non replicating cells
AI disease in combo - not effective in preventing graft rejection
Bone marrow depression

Question 21

Methotrexate

Answer 21

Inhibits DHF reductase - purine synthesis
AI disease
AE: Hepatic toxicity

Question 22

Mycophenolate Mofetil

Answer 22

Blocks IMP DH (no GMP) Lymphocyte selective - can’t use salvage pathway.
Prevent renal allograft rejection (w/ cyclosporine & corticosteroids) RI, Refractory psoriasis
AE: Infection, leukopenia, anemia
CI: Pregnancy

Question 23

Tacrolimus

Answer 23

Dec. IL-2 production (more potent than cyclosporine)
Binds FK binding protein - blocks cyclophilin and calcineurin
Prevent rejection of transplanted organs, some AI disease
**Less nephro and hepatotoxicity than cyclosporine

Question 24

Sirolimus

Answer 24

Inhibits T cell act/prolif downstream of IL-2: binds FKBP-12 - inhibits mTOR - Blocks G1->S transition
Prevent rejection of transplanted organs, some AI disease