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PHARM Flashcards

1
Q

Cyclosporine-Tacroglimus -> Clinical Use

3

A
  • Reduce acute transplant rejection
  • Psoriasis
  • Rheumatoid Arthritis
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2
Q

Calcineurin Inhibitors

2

A
  • -Cyclosporine

- Tacrolimus

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3
Q

Cyclosporine-Mechanism

A
  • Binds cyclophilin
  • Blocks T cell activation
  • Prevents IL-2 transcription
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4
Q

Tacrolimus-Mechanism

A
  • Binds FK506 binding protein

- inhibition of IL-2 transcription

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5
Q

Binds FK506 binding protein

A

Tacrolimus-Mechanism

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6
Q

Side effects-Cyclosporine

A
  • Nephrotoxicity
  • Neurotoxicity
  • Gingival hyperplasia
  • Hirsutism
  • Hypertension
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7
Q

Side effects-Tacrolimus

A
  • ↑ risk of neurotoxicity compared to cyclosporine
  • ↑ risk of diabetes
  • -Nephrotoxicity
  • -Hypertension
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8
Q

mycophenolate mofetil-MOA

A

inosine monophosphate dehydrogenase inhibitor->By inhibiting de novo guanosine nucleotide synthesis, T and B lymphocyte proliferation is disrupted.

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9
Q

mycophenolate mofetil-Side effect

A

Bone marrow suppression

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10
Q

used in patients who cannot tolerate calcineurin inhibitors due to the frequency of neurotoxicity and nephrotoxicity.

A

mycophenolate mofetil

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11
Q

sirolimus-side effect

A

Delayed wound healing

hepatic artery thrombosis, hyperlipidemia, and dermatologic complications.

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12
Q

sirolimus-MOA

A

blocks signal transduction at the IL-2 receptor

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13
Q

anti-CD3 antigen complex monoclonal antibody-Side effect

A

associated with viral or other infectious reactivation, such as reactivation of tuberculosis or viral hepatitis

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14
Q

Skin thinning is a very common side effect associated with

A

steroids

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15
Q

Amides -> Anesthetics

A

lidocaine, mepivacaine, prilocaine, bupivacaine, etidocaine, and ropivacaine and levobupivacaine
_tienen una i antes del -caine

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16
Q

Esters -> Anesthetics

A

chloroprocaine, procaine, and tetracaine

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17
Q

serotonin syndrome->

A

SSRIs, SNRIs, TCAs,tramadol, ondansetron, triptans, MDMA, and dextromethorphan

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18
Q

Aminoglycosides

A 
Amikacin
Gentamicin
Neomycin
Tobramycin
Streptomycin
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19
Q

Binds to aminoacyl site of 16S rRNA (part of 30S subunit) → misreading of genetic code and inhibition of translocation

A

Aminoglycosides

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20
Q

Mechanism of Bacterial Resistance-> Inactivation of drug via acetylation, adenylation, or phosphorylation by bacterial transferase enzymes

A

Aminoglycosides

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21
Q

Adverse Effects->Aminoglycosides

A

Nephrotoxicity (acute tubular necrosis)
Ototoxicity (vestibular and/or cochlear damage, potentiated by loop diuretics)
Neuromuscular blockade (contraindicated in myasthenia gravis)
Teratogenic

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22
Q

PX with an acute cerebrovascular accident (CVA)

Tx

A

-Alteplase (also called tissue plasminogen activator or tPA)->increasing fibrin’s affinity for endogenous plasminogen-> increased activation of plasmin

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23
Q

inhibits vitamin K-dependent carboxylation of factors II, VII, IX, and X.

A

Warfarin

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24
Q

inhibit cyclooxygenase

A

Aspirin, ibuprofen, and naproxen

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25
direct inhibitor of thrombin
Argatroban
26
propagates a patient’s endogenous antithrombin, which inhibits thrombin and activated factor X
Heparin
27
Medication for type II diabetes that should be avoided in patients with heart failure, due to the risk of fluid retention.
Thiazolidinediones (TZDs) -> (pioglitazone, rosiglitazone)-> | Activation of peroxisome proliferator-activated receptor gamma in adipocytes
28
Activation of peroxisome proliferator-activated receptor gamma in adipocytes to promote adipogenesis and fatty acid uptake and increase insulin-dependent glucose uptake.
Thiazolidinediones (TZDs) -> (pioglitazone, rosiglitazone)
29
Contraindications->Thiazolidinediones
``` Heart failure Fluid overload Active liver disease Bladder cancer Type 1 diabetes Pregnancy Macular edema ```
30
Inhibition of α-glucosidases
acarbose
31
oral antidiabetic agent that can cause diarrhea and gastrointestinal upset.
acarbose
32
work via inhibition of dipeptidyl peptidase IV, which normally functions to break down incretins (such as GIP and GLP-1) responsible for increased insulin synthesis/release and decreased glucagon release
Gliptins such as sitagliptin
33
works primarily via inhibition of hepatic gluconeogenesis->Increase insulin sensitivity
Metformin
34
also contraindicated in decompensated CHF and Renal failure, this is due to an increased risk of lactic acidosis
Metformin
35
work via stimulation of insulin release from the pancreas
Sulfonylureas
36
Side effects include hypoglycemia and weight gain (DM tx)
Sulfonylureas
37
Stimulation of glucose-dependent insulin release
GLP-1 agonists
38
Liraglutide Semaglutide Dulaglutide
GLP-1 agonists
39
DPP-4 normally degrades glucagon-like peptide-1 (GLP-1) | DPP-4 inhibitors therefore prevent degradation of GLP-1
DPP-4 inhibitors
40
DPP-4 inhibitors
Sitagliptin Saxagliptin Linagliptin
41
SGLT-2 inhibitors
Canagliflozin | Empagliflozin
42
expressed in the proximal tubule and mediates reabsorption of approximately 90 percent of the filtered glucose load
SGLT-2
43
Sulfonylureas
Glyburide Glipizide Tolbutamide Chlorpropamide
44
hookworm infection -> first-line therapy
inhibition of microtubule synthesis | **albendazole or mebendazole
45
treatment of pinworm, roundworm, and hookworm.
Depolarizing neuromuscular blockade * modulates the GABAergic system to induce a neuromuscular blockade in the helminth * *Pyrantel pamoate
46
treatment of strongyloidiasis
influx of Cl- ions leading to hyperpolarization of the helminth cell membranes. (Ivermectin)
47
modulates the nitric oxide and cyclooxygenase inflammatory pathways to increase the helminth's susceptibility to phagocytosis
Diethylcarbamazine | -> treatment of filariasis
48
treatment of schistosomiasis
an influx of Ca++ ions, leading to muscle spasm and paralysis of the helminth ->Praziquantel
49
Cardiac Glycoside | 1
(Digoxin)
50
Adverse Effects-> Digoxin
``` AV block Arrhythmias Blurry yellow vision Cholinergic: Diarrhea,Nausea,Vomiting Hyperkalemia ```
51
Atrial fibrillation->Decreases conduction at AV node | Heart failure-> Increases contractility
> Digoxin
52
``` Direct inhibition of Na+/K+ ATPase Indirect inhibition of Na+/Ca2+ exchanger ↑ Ca2+ concentration Increases Inotropy Stimulates Vagus nerve ↓ Heart rate ```
Digoxin
53
Risk Factors for toxicity -> Drugs that displace Digoxin from tissue-binding sites (3)
- >Amiodarone - >Quinidine - >Verapamil
54
Risk Factors for toxicity->digoxin
Hypokalemia Renal failure (digoxina se extreta por el rinon) ↓ Excretion
55
Digoxin toxicity is characterized by electrocardiogram changes including
increased PR interval decreased QT interval scooping of the ST segment T-wave inversion
56
selectively blocking the binding of angiotensin II to AT1 receptors
Losartan
57
alpha-1 receptor blocker and works by selectively blocking the alpha-1 receptors
Prazosin
58
Prazosin ->Uses
benign prostate hyperplasia, PTSD, and hypertension treatment
59
Prazosin-> secondary effects
Side effects include 1st dose orthostatic hypotension, dizziness, and headaches.
60
β-blocker that decreases SA and AV nodal activity by decreasing cAMP and Ca2+ currents
Metoprolol
61
Metoprolol-> side effects
impotence, exacerbation of COPD and asthma, bradycardia, and masking of hypoglycemia.
62
vasodilation of vascular smooth muscles with increased cGMP
Nitroglycerin
63
Nitroglycerin-> Side effects
reflex tachycardia, hypotension, flushing, and headaches
64
angiotensin-converting enzyme inhibitor and works by inhibiting ACE and decreasing ATII
Lisinopril
65
Side effects ->Lisinopril
angioedema, cough, hyperkalemia, and hypotension
66
Inhibit calcium ion channel
Calcium channel blockers
67
Antianginal therapy-> β-blockers + Nitrates
Blood Pressure ↓ | Myocardial O2 consumption ↓↓
68
Antianginal therapy-> Nitrates
``` Blood Pressure↓ Contractility ↑ Ejection time↓ End-Diastolic volume↓ Heart rate↑ Myocardial O2 consumption↓ ```
69
Antianginal therapy-> β-blockers
``` Blood Pressure↓ Contractility ↓ Ejection time↑ End-Diastolic volume - Heart rate↓ Myocardial O2 consumption↓ ```
70
Tx for a flare of her Crohn's disease in pregnant
Antibodies against tumor necrosis factor (TNF) α -> infliximab
71
increased risk using infliximab
tuberculosis reactivation, patients should get a purified protein derivative (PPD) test
72
purine analogue and inhibits purine nucleotide synthesis and metabolism
6-mercaptopurine
73
inhibits dihydrofolate reductase. It also inhibits purine synthesis and decreases the production of inflammatory cytokines
Methotrexate (MTX)
74
Tx elevated intracranial pressure (ICP) ICP ≥ 20 mm
mannitol -> causes osmotic diuresis and increased urine output ** may cause (or worsen) pulmonary edema (due to rapid increase i the vascular hydrostatic pressure)
75
Tx for SIADH
Demeclocycline is an ADH antagonist
76
Tx for DI
Desmopressin is a synthetic version of ADH and can be used to treat central diabetes insipidus (DI).
77
first-line therapy for patients that present with decompensated heart failure
Furosemide -> loop diuretic
78
should not be used in cases of elevated ICP
Glucocorticoids->unless the elevation is due to malignancy
79
Contraindications Mannitol
- Anuria | - Heart failure
80
Contraindications -> Spironolactone
- Addison disease (chronic adrenal insufficiency) | - Hyperkalemia
81
Contraindications -> Thiazide diuretics
Gout (thiazides reduce the clearance of uric acid since they compete for the same transporter) Hypokalemia Hypotension Sulfa allergy
82
Contraindications ->Loop diuretics
``` Hyperuricemia Sulfa allergies (ethacrynic acid is the only loop diuretic that can be used in a patient with a sulfa allergy) ```
83
Contraindications >Acetazolamide
Sulfa allergy | Nephrolithiasis (acetazolamide promotes calcium phosphate stone formation)
84
chronic graft-versus-host disease (GVHD)
Skin is the most commonly affected organ in chronic GVHD, and skin findings are usually classified as lichen planus-like or sclerotic.
85
prophylactic agent for the prevention of chronic GVHD
methotrexate + leucovorin *Administering leucovorin (folinic acid) along with methotrexate can reduce the likelihood and severity of methotrexate adverse effects

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