Pharm 2 - Kaplan Flashcards
Statins…side effects
Myalgias Rhabdomyolysis (if increased [ ] or w/ Gemfibrozil)
Bile acid sequestrants…drugs?
Bad things?
When NOT to use?
Cholestipol, Cholestiramine
Increased VLDL and TGs
Malabsorption of lipid-soluble vitamins
Hyperglycemia
Hypertriglyceridemia
Niacin - MoA
Side effect? How to treat?
Inhibits VLDL synthesis
Flushing (aspirin)
Fibrates - MoA
Use?
Increase PPAR-alpha –> increased lipoprotein lipases
Hypertriglyceridemia
Ezetimibe - MoA
Prevents cholesterol absorption, decreasing LDL
Orlistat - MoA
Use?
Inhibits pancreatic lipase –> decreased TG breakdown
Weight loss
Only drugs besides Benzos that can be inhibited by Flumazenil
Why?
Zolpidem, Zaleplon
Also block the BZ1 receptor on the GABA-A receptor
Buspirone - MoA
Importance?
Problem?
Serotonin-1A receptor partial agonist
NO SEDATION (not GABA)
Slow onset (few weeks)
2 pathways to treating anxiety (w/ difference)
GABA agonists - FAST
Serotonin agonists - SLOW
2 pathways to treating sleep disorders
Melatonin agonists (Ramelteon) GABA agonists (Zolpidem, Zaleplon, BZs)
Ethylene glycol – metabolic byproducts
Damage?
Glycoaldehyde –> glycolic acid –> oxalic acid
Nephrotoxicity
Methanol – metabolic byproducts
Damage?
Formaldehyde –> formic acid
Ocular damage
Commonality between ethanol, methanol, and ethylene glycol
Cheap treatment for the later 2? Why?
All use alcohol dehydrogenase
Ethanol = greatest affinity for the enzyme
Fomepizole - MoA
Advantage?
What else might be needed?
Long-acting inhibitor of alcohol dehydrogenase
No formation of acetaldehyde –> no hangover S/S
Dialysis to get rid of the substance floating around
Disulfiram - MoA
Inhibitor of acetaldehyde dehydrogenase –> accumulation of acetaldehyde –> hangover symptoms
Drug that causes disulfiram effect
**Metronidazole (Chlorpropamide) (Griseofulvin)
Treatments for UTIs
Amoxicillin
Cephalosporins
Nitrofurantoin
TMP-SMX
Sirolimus…MoA
How does it differ from tacrolimus and cyclosporin?
Side effects?
Inhibits T-cells by binding mTOR (serine-threonine kinase)
Limited neuro and nephrotoxicity
Hypertriglyceridemia, hypercholesterolemia
Empiric treatment protocols for community acquired strep pneumonia (3)
If healthy – macrolide or doxycycline
If comorbidity – macrolide, PLUS fluoroquinolone or beta-lactam
If CURB-65 – fluoroquinolone, or beta-lactam + macrolide
Serotonin receptor…
- 1A partial agonist
- 1B/1D agonist
- 2 antagonist
- 3 antagonist
Buspirone (depression)
-triptans (migraine abortion)
Atypical antipsychotics, Cyproheptadine
-setrons (emesis)
Treatment of acute cholelithiasis (w/ MoA)
Ursodiol (ursodeoxycholic acid) – concentrates in bile, decreases bile cholesterol, hepatic cholesterol production, and cholesterol absorption
Famotidine - MoA
H2 antagonist –> decreased gastric acid secretion
Alosetron - MoA and Use
Adverse effect?
5-HT3 antagonist – diarrhea-predominant IBS
Ischemic colitis
Sulfasalazine - explain
Split by colon bacteria into 5-ASA and sulfapyridine
- 5-ASA = ulcerative colitis
- SP = rheumatoid arthritis
Mesalamine - MoA
5-ASA for Crohn’s Disease
MoA and Use for…
- Alprostadil
- Misoprostol
- Dinoprostone
- Epoprostenol
- Latanoprost
- Carboprost
A = PGE1 - vasodilation for ED M = PGE1 - cervical ripening and induction D = PGE2 - cervical ripening and induction E = PGI2 - vasodilation for pulmonary hypertension L = PGF2a - glaucoma C = PGF2a - uterine SM contraction for abortion and hemorrhage
Nitroprusside - side effects
Hypotension
Cyanide poisoning
Methemoglobin
ALS…
- Drugs for spasticity treatment?
- Drug for life prolongation?
Spasticity = Baclofen (GABA-B agonist), alpha-2 agonists
Life = Riluzole (glutamate and Na+ antagonist –> decreased excitatory toxicity)
Recently started a new drug…
- Fever
- Impaired autonomic stability
- Muscle rigidity and breakdown
- Myoglobinuria
- Altered mental status
Treatment?
Neuroleptic malignant syndrome (typical antipsychotics)
Dantrolene, Amantadine, or Bromocriptine
Treatment for hepatic encephalopathy
Lactulose – converted to lactic acid, causing acidotic colon and excretion of NH3 as NH4+
Rifamixin or Neomycin – destroy colonic urease-producing bacteria
Effects of glucocorticoids on calcium and bone
- Increase osteoclasts (bone breakdown)
- Decrease Ca++ channels in intestine
- Oppose Vitamin D
- Decrease reabsorption in kidney
Drug for inhibition of RSV
Palivizumab (anti-RSV fusion protein antibody)
Jarisch-Herxheimer reaction…treatment?
Explain
Anti-TNF drug (Infliximab)
Endotoxin –> direct macrophage activation –> IL-1, IL-6 (pyrogens), and TNF-alpha
2 functions of metoclopramide (w/ mechanisms)
- Anti-emetic (D2 antagonist in area postrema)
- Pro-motility (enhances response to acetylcholine in intestines)
How exactly do furosemide and digoxin interact?
Digoxin binds to the K+ binding place on the Na/K ATPase, thus as serum K+ decreases from furosemide, digoxin binds more easily
Acyclovir…MoA
Requires what?
Inhibits viral DNA polymerase
Phosphorylation by viral thymidine kinase (Herpes Helps) or by the host thymidine kinase (all other target viruses)
Drugs that can lead to hypertensive emergencies
Cocaine, Amphetamines, PCP, MAOIs, Triptans
Psychiatric
Hepatic
Neurologic
Ring around iris
Treatment?
Wilson’s disease (Copper accumulation)
Penicillamine, trientine (chelation)
Drugs that can cause disulfiram-like reaction
Metronidazole
Some cephalosporins
Griseofulvin
1st gen sulfonylureas
