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STEP2 > Pharm > Flashcards

Pharm Flashcards

1
Q

Hydroxycholoroquine s/e

A

Retinal toxicity

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2
Q

Methotrexate s/e*

A

Macrocytic anemia ==> pancytopenia

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3
Q

Cyclophosphamide s/e*

A

Hemorrhagic cystitis & bladder cancer (2/2 acrolein metabolite ==> take MESNA)
Myelosuppression

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4
Q

Digitalis / digoxin interactions, s/e*

A

Verapamil increases digoxin levels

GI upset (common!) 
Hyperkalemia 2/2 displacing K+ binding sites
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5
Q

Carbonic anhydrase inhibitor name, mechanism, s/e

A

Acetazolamide

Block CA @ proximal limb ==> block Na+ reabsorption & H+ secretion ==> increase Na+/H20 excretion

Metabolic acidosis
Sulfa allergy

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6
Q

Osmotic agent names, mechanism, s/e

A

Mannitol, urea

Pull fluid into tubules

Backfire: anuria, pulmonary edema

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7
Q

Loop diuretic names, mechanism, s/e*

A

Furosemide, -ides, ethacrynic acid

Block Na/K/2Cl transport @ ascending Henle ==> increase Na/H20 excretion

Ototoxicity
Sulfa allergy (except ethacrynic)
Metabolic alkalosis (2/2 increased DCT Na+ increases HCO3 reabsorption)*
Hypokalemia (2/2 increase Na/K exchange @ DCT)*
Hypocalcemia ==> calcium stones

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8
Q

Thiazide names, mechanism, s/e*

A

-thiazides

Block DCT Na/Cl cotransporter & activate Ca transporter ==> increase Na/H20 excretion

Pancreatitis
Hypercalcemia
Hyponatremia
Sulfa allergy (except ethacrynic)
Metabolic alkalosis (2/2 increased DCT Na+ increases HCO3 reabsorption)
Hypokalemia* (2/2 increase Na/K exchange @ DCT)

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9
Q

K+ sparing diuretic names, mechanism, s/e*

A

Spironolactone: block aldosterone receptor ==> block ENAC (Na+ reabsorption) /ROM-K (K+ secretion) exchange

Triamterene/amiloride: block ENAC channel

Hyperkalemia*
Metabolic acidosis
Antiandrogenic effects (gynecomastia)
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10
Q

IV acyclovir risk, tx*

A

Supersaturation & crystallization in DCT ==> renal failure

Aggressive hydration

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11
Q

Anticholinergic meds, s/e*

A

Diphenhydramine
Amitryptiline

Urinary retention 2/2 detrussor inability to contract & urinary sphincter inability to relax

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12
Q

Rifampin s/e*

A

Red-orange discoloration of body fluids

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13
Q

Metformin mechanism, s/e, contraindications*

A

Inhibits hepatic gluconeogenesis
Increases peripheral insulin sensitivity

Weight neutral
GI upset

Elderly > 80 y/o
Renal, hepatic, or heart failure patients
Renal failure ==> worsens lactic acidosis*
Sepsis

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14
Q

Cyclosporin mechanism, s/e**

A

IL-2 transcription inhibitor, especially lymphocytes

Nephrotoxic: azotemia, hyperkalemia, hyperuricemia, hypertension
Neurotoxic: tremor, seizure
Gingival hypertropy & hirsuitism
Malignancy, infection, GI intolerance, hyperglycemia

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15
Q

Tacrolimus mechanism, s/e**

A

IL-2 transcription inhibitor

*Same as cyclosporin except no hirsuitism or gingival hypertrophy
Nephrotoxic
Neurotoxic
Diarrhea & glucose intolerance

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16
Q

Azathioprine mechanism, s/e**

A

Inhibits purine synthesis

Diarrhea
Hepatotoxicity
Leukopenia

17
Q

Mycophenolate mechanism, s/e**

A

Inhibits purine synthesis

MARROW SUPPRESSION

18
Q

ACE-inhibitor mechanism, s/e*

A

___

Angioedema: perioral, periorbital etc. ==> can occur ANYTIME, not just upon starting meds

19
Q

Tetracyclines names, mechanisms, s/e*

A

Photosensitivity

20
Q

Rosiglitazone, piaglitazone name, mechanism, s/e, contraindications*

A

TZD

Increase insulin sensitivity

Weight gain
Hepatotoxicity
Bone loss

Contraindicated in heart failure patients

21
Q

Levothyroxine name, mechanism, interactions*

A

L-thyroxine

Oral estrogen: increases thyroxine binding globulin (TBG), thus more T4 is bound requiring increased level of levothyroxine
Pregnancy: increases thyroxine binding globulin ==> requires increased levothyroxine

22
Q

Sildinafil mechanism, contraindications*

A

Phosphodiesterase inhibitor

Give >4 hours apart with alpha-blocker (doxazosin) to avoid hypotension
Do not give with nitrates
Do not give with priapism conditions (sickle cell)
Erythromycin and cimetidine prolong it

23
Q

Methimazole and propylthiouracil s/e*

A

Rare but serious: agranulocytosis ==> discontinue if any fever / sore throat ==> permanently discontinue if WBC<1000

24
Q

Sulfonylurea names, mechanism, s/e, contraindications*

A

Weight gain

Hypoglycemia

25
Q

Beta-2 agonists names, mechanisms

A

Albuterol: short acting bronchial smooth muscle relaxation
Salmeterol: long acting bronchial smooth muscle relaxation

26
Q

Muscarinic antagonists names, mechanism

A

Ipratroprium: blocks muscarinic bronchoconstriction

27
Q

Cromolyn mechanism

A

Blocks vasoactive MAST cell release

28
Q

Antileukotriene names

A

Zileuton

Monteleukast

29
Q

Amiodarone s/e*

A

Interstitial lung disease

30
Q

Heparin mechanism

A

Bind and enhance antithrombin 3

31
Q

Warfarin mechanism

A

Inhibit vitamin K dependent clotting factors 2, 7, 9, 10

32
Q

Unfractionated heparin alternatives (e.g. enoxaparin etc.) contraindication*

A

Renal failure

GFR < 30

33
Q

Glucorticoid s/e*

A

Neutrophilia 2/2 increasing marginalization

Leukopenia & eosinophilopenia

34
Q

Theophylline toxicity signs*

A

TRIAD, 2/2 cirrhosis, illness, or competing drugs
CNS stimulation: headache, seizure
GI upset
Cardiac: arrhythmia

STEP2 (16 decks)

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