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comlex > Pharm > Flashcards

Pharm Flashcards

1
Q

propanolol

A

non-selective b-blocker SI: hyperlipidemia, 1st degree heart block

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2
Q

cabergoline

A

dopamine agonist used to treat prolactinoma. ALT: bromocriptine, quinagolide

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3
Q

amifostine

A

cytoprotective free-radical scavenger. given to CA pts receiving platinum based chemo

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4
Q

cisplatin

A

platinum containing chemo, creates reactive oxygen which forms DNA crosslinks. SI: NEPHRO TOXIC. use amifostine to prevent damage.

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5
Q

allopurinol and drug interactions

A

Xanthanine oxidase inhibitor. prevents the production of uric acid. interacts with 6-mp which needs to be reduced

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6
Q

octreotide

A

synthetic somatostatin. inhibits secretion of many hormones. used to treat carcinoid sx.

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7
Q

hydroxyzine

A

nonselective antihistmine. etoh withdrawal, anxiety, n/v, puritis

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8
Q

Prazosin, terozosin, doxazosin

A

(-zosin)
Alpha 1 Selective Antagonist
Used to treate HTN and urinary retention in BPH
Toxicity= 1st dose orthostatic hypotension, dizziness, headaches

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9
Q

Alpha 2 Selective Antagonist

A

Mirtazapine
Treats depression
Toxicity= sedation, increased serum choletrol and increased appetite

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10
Q

B1 Selective Anatagonist

A 
Acebutolol (partial agonist)
Betaxolol
Esmolol (short acting)
Atenolol
Metoprolol

*these are good for patients with co-morbid pulmonary disease

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11
Q

Partial Beta Agonist

A

Pindolol

Acebutolol

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12
Q

Non-Selective B Antagonist

A

Propanolol
Timolol
Nadolol
Pindolol (partial agonist)

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13
Q

Non-selective alpha and beta antagonists

vasodilatory

A

Carvedilol

Labetolol

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14
Q

Atropine

A

Muscarinic Antagonist
used for glaucoma and bradycardia
others: Homatropine, Tropicamide

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15
Q

Benztropine

A

Muscarinic Antagonist

Parkinson’s

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16
Q

MOA, Use, ADRs, and Mechanism of Resistance

A

MOA: blocks viral penetration/uncoating (M2 protein) and causes release of dopamine from intact nerve terminals
Use: prophylaxis of Influenza A and Parkinson’s
ADRs: Ataxia, dizziness, slurred speech
Resistance: mutated M2 protein (90% of Flu A is resistant)

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17
Q

Scopolamine

A

Muscarinic Antagonist

Motion sickness

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18
Q

Ipratropium

A

Muscarinic Antagonist

Asthma, COPD

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19
Q

Oxybutinin

A

Muscarinic Antagonist
bladder spasms/urgency
Other: Glycopyrrolate

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20
Q

Methscopolamine

A

Muscarinic Antagonist
Peptic ulcers
Others: pirenzepine, propatheline

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21
Q

Pheoxybenzamine

A

Non-selective alpha blocker
(irreversible) used for Pheos before surgical removal.
Toxicity= orthostatic hypotension, reflex tachy

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22
Q

Phentolamine

A

Non-selective alpha blocker
(reversible) used for people taking MAO-I that ate tyrosine rich foods
Toxicity= orthostatic hypotension, reflex tachy

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23
Q

P450 Inducers

A

Quinidine, Barbituates, St. John’s Wort, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Chronic alcohol use

“Queen Barb Steals Phen-phen, and Refuses Greasy Carbs CHRONICally”

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24
Q

P450 Inhibitors

A

Macrolides, Amioderone, Grapefruit juice, Isoniazid, Cimentidine, Ritoniavir, Acute alcohol abuse, Cirpflozacin, Ketoconazole, Sulfonamides.

MAGIC RACKS

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25
Q

5 Antimetobolites (chemo agents)

A

Methotrexate, 5FU, 6-Mercatopurine, 6-Thioguanine, and Cytarabine

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26
Q

Methotrexate

A

MOA: Folic Acid analog that inhibits dihyrdrofolate reductase
Use: Leukemia, lymphoma, choriocarcinoma, sarcoma, abortions, ectopic pregancy, RA, psoriasis
ADR: myelosupression (reversible with leucovorin), macrovesicular fatty liver change, mucositis, teratogenic

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27
Q

5-Fluoruricil

A

MOA: Pyrimidine analog bioactivated to 5F-dUMP, which covalently complexes folic acid, inhibiting Thymidylate synthase ultimately decreasing protein synthesis
Use: colon cancer, solid tumors, basal cell (topical)
ADR: myelosupression (not reversible with leucovorin), photosensitivity

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28
Q

6-Mercaptopurine

A

MOA: Purine (thiol) analog, decreasing denovo purine synthesis. Activated by HGPRTase and inactivated by Xanthanine Oxidase
Use: Leukemias, Lymphomas (not CLL or Hodgkins)
ADR: bone marrow, GI, Liver

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29
Q

Which chemo agent has increased toxicity if given with allopurinol

A

6-Mercaptopurine

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30
Q

6-Thioguanine

A

MOA: same as 6-MP
Use: ALL
ADRs: bone marrow depression, liver
*can be given with allopurinol

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31
Q

Cytarabine

A

MOA: Pyrimidine analog causing inhbtion of DNA polymerase
Use: AML, ALL, high-grade Hodgkins
ADRs: leukopenia, thrombocytopenia, megaloblastic anemia

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32
Q

Antimetabolites are specific for which stage of the cell cycle

A

S phase

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33
Q

Anti-tumor Antibiotics

A

Dactinomycin, Doxorubicin, Bleomycin, Etopside

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34
Q

Alkylating Agents

A

Cyclophosphamide, ifosfamide, nitrosoureas, busulfan

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35
Q

Cyclophosphamide

A

covelently X-link DNA at guanine N-7. requires activation by liver
Use: non-hodgkins, breast, ovarian cancers, and immunosupresasnt
ADRs: myelosuppression, hemorrhagic cystitis

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36
Q

Drug used to prevent homeorrhagic cystitis caused by Cyclophosphamide

A

Mesna

37
Q

Nitrosoureas

Carmustine, Lomustine, Semustine, Streptozocin

A

MOA: requires bioactivation, able to cross blood brain barrier and enter CNS
Use: brain tumors (including glioblastoma multiforme)
ADRs: CNS toxicity (dizzy, ataxia)

38
Q

Busulfan

A

Alkylates DNA
Use: CML and to ablate bone marrow before bone marrow transplant
ADR: pulmonary fibrosis, and hyperpigmentation

39
Q

Microtubule Inhibitors

A

Vincristine, vinblastine, Paclitaxel, and other Taxols

Taget tubulin

40
Q

Vincristine/ Vinblastine

A

MOA: alkaloids bind to tubulin in Mphase and block polymerization of microtubles so the mitotic spindle cannot form
Use: hodgkin’s, Wilm’s tumor, choriocarcinoma, ALL
ADR: neurtoxicity (areflexia, peripheral, neuritis) and paralytic ileus- Vincristine
Vinblastine- blasts bone marrow

41
Q

Paclitaxel

A

Hyperstabilizes polyermized mictorbules in M phase so the mitotic spindle can’t break down
use: Ovarian and breast cancer
ADR: myelosuppression and hypersensitivity

42
Q

Cisplatin

A

Cross-links DNA
Use: Testicular, bladder, ovary, and lung carcinomas
ADR: Nephrotoxicty and acoustic nerve damage

43
Q

Chemo agent that causes acoustic nerve damage

A

Cisplatin

44
Q

How to prevent Cisplatin nephrotoxicity

A

give with Amifostine (free radical scavenger) and clhoride diuresis

45
Q

Hydroxyurea

A

inhibits ribonucleotide reducatase, thus DNA synthesis
Use: melanoma, CML. sickle cell (increases HbF)
ADRs: bone marrow suppression, GI upset

46
Q

Prednisone as a chemo agent

A

may trigger apoptosis and may even work on non-dividing cells

47
Q

Most common glucocorticoid in cancer chemotherapy

A

Prednisone

48
Q

Tamoxifen/ Raloxifene

A

SERMs- receptor antagonists in breast and bone.

used for breast cancer and can prevent osteoporosis

49
Q

ADR of Tamoxifen

A

may increase risk of endometrial cancer bc it has partial estrogen agonist effects there.

50
Q

Drug used for Metastatic Breast Cancer

A

Trastuzumab (monoclonal antibody against HER-2 (erb-B2))

Can cause cardiotoxcity

51
Q

Tyrosine kinase inhibitor for philadelphia chromosome bcr-abl

A

Imatinib (gleevac)

52
Q

Rituximab

A

monoclonal antibody against CD20, found on most Bcell lymphomas
Used for non-hodgkins, and RA

53
Q

eplernone

A

TX of Conn’s syndrome (hyperaldosteronism). similar to spirinolactone but with less side effects

54
Q

pentazocine

A

opiod Mu partial agonist and weak antagoist. used to decrease addition to opiods. can cause withdrawl in addicts.

55
Q

given hyperthyroidism

A

propothiouracil ( inhibits peroxidase in thyroid and peripheral) or methimazole only works in thyroid not peripherally (meth not safe in pregnancy)

56
Q

phenoxybenamine

A

used to treat pheochromocytoma, do you remember rule of 10’s?

57
Q

Drug used before a bone marrow transplant

A

Busulfan

58
Q

Drugs that can induce Lupus

A

HIP
Hydralizine
Iszoniazid
Procanimide

59
Q

Treatment for Absence Seizures

A

Ethosuximide

60
Q

Tx for closed/narrow angle glaucoma

A

pilocarpine

61
Q

Tx for CMV retinitis

A

Foscarnet

62
Q

1st line Treatment for Supraventricular Tachycardia

A

Adensoine

63
Q

Treatment for digoxin toxicity or torsades

A

Mg2+

64
Q

ADRs of Adenosine

A

Flushing, Hypotension, and Chest pain

65
Q

Ca2+ channel blockers Types, MOA, and ADRs

A

Dihydropyridine: Nifedipine, Amlodipine (peripheral)
MOA: lower bp
Nondihydropyiridine: Verapimil, Diltiazem (cardiac)
MOA: lower contractility of heart
ADRs: constipation, flsuhing, edema, CHF, AV block, sinus node depression

66
Q

ADR of Ibutilide

A

Torsades

67
Q

Do these 3 lab tests before starting Amioderone

A

Pulmonary, Liver, and Thyroid Function Tests

68
Q

MOA of Beta-Blockers and class of anti arrhythmic

A

decrease cAMP, decrease Ca2+ currents, supressing abnoraml pacemaker by decreasing the slope of phase 4 of the cardiac action potential
Class II

69
Q

Digoxin, class, MOA, use, toxicity, antidote

A

Cardiac Glycoside
MOA: direct inhibition of Na/K ATPase, leading to indirect inhibition of Na/Ca exchanger, increasing intracellular Ca thus increase in inotropy. Stimulates vagus nerve
Use: CHF (increase contractility) and A-Fib (decrease AV and SA node conduction)
Tox: cholinergic, increase PR, decrease QT, T wave inversion, hyperkalemia, arrhthmia, worsended by renal failure, hypokalemia, and quinidine, and hypercalcemia
Antidote: slowly normalize K, lidocaine, anti-dig Fab fragments, Mg2+

70
Q

How do meds reduce angina

A

decrease myocardial O2 consumption by decreasing bp, HR, ejection time, EDV, or Ionotropy

71
Q

Lipid Lowering Agent causing Vit A,D,E,& K deficiency

A

Bile Acid Resins (colestipol, colesevelan, cholestryramine)

72
Q

Target of tPA

A

Plasminogen

73
Q

Target of clopidogrel

A

ADP receptor of platelet cells- irreversible blockage

prevents gp IIb/IIIa expression thus inhibiting fibrinogen binding and platelet aggregation

74
Q

Target of Abciximab

A

glycoprotein IIb/IIIa receptors

75
Q

MOA of Warfin

A

interferes with normal synthesis of gamma carboxy of vitamin k dependent clotting factors

76
Q

MOA of Heparin

A

cofactor of antithrombin, decreasing thrombin and Xa

77
Q

Coagulation labs with Warfin

A

normal bleed time
nomral platelets
Increased PT (monitor)
Increased PTT

78
Q

Coagulation labs of Heparin

A

normal bleed time
nomral platelets
Increased PT
Increased PTT/INR (monitor)

79
Q

Seizure prophylaxis for pregnant women

A

Phenobarbital

80
Q

Use of Dantrolene

A

Malignant hyperthermia and neuroleptic malignant syndrome

81
Q

Treatment for Acute Status Epilepticus

A

Diazepam

82
Q

MOA of Bromocriptine

A

Dopomine Receptor agonsit

83
Q

Treatment for Chronic Pain

A

Tramadol

84
Q

Use of Benztropine in Parkinson’s

A

curbs excess cholinergic activity

85
Q

Used for induction of anesthesia

A

Thiopental

86
Q

Selegeline MOA and use

A

Used in parkinson’s, MAO-B inhibitor inhibits breakdown of dopamine and preferentially metabolizes NE and 5HT

87
Q

Chemo agent that causes Pulmonary Fibrosis

A

Bleomycin

88
Q

Chemo agent that can cause dilated cardiomyopathy

A

Doxorubicin

89
Q

Chemo agent that can cause hemorrhagic cystitis and what is used to prevent this side-effect

A

cyclophosphamide

use mesna to prevent

comlex (18 decks)

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