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Pharmacology > Pharm cards 1 > Flashcards

Pharm cards 1 Flashcards

1
Q

cladribine

A

mech:

pruine analog -> multiple mechs (eg inhbition of dna polymerase, dna strand breaks)

hairy cell leukemia

myelosupression
nephrotxic
neurotoxcity

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2
Q

dactinomycin (actinomycin d)

A

antitumor

intercalates dna
inhibits rna polymerase

wilms tumor, ewing sarcoma, rhabdomyosarcoma, used for childhood tumors.

myelosupression

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3
Q

bevacizumab

A

mab agaisnt vegf, inhbiting angiogenesis.

solid tumors (colon renal cell carcinoma)

hemmorhage, blood clots, and impaired wood healing

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4
Q

rituximab

A

monoclonal antibody against cd20. found on most b cell neoplasms

non hodgkin lymphoma, cll, itp, RA

increased risk of PML

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5
Q

Vemurafenib

A

small molecule inhbitor of BRAF oncogene in + melanomas. for v600e mutation.

metastatic melanoma

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6
Q

tumor lysis syndrome

A

emergency, most often in treatment of leukemias/lymphomas.

hyperkalemia and hyperphosphatemia, increased phosphate causes decreased calcium. increased nucelec acid breakdown -> hyperuricemia -> AKI

treat with agressive hydration, allopurinol, rasburicase.

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7
Q

rasburicase

A

recombinant uricase -> uric acid to allantoid

use in prevention and treatment of tumor lysis syndrome

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8
Q

idarucizumab

A

mab against dabigatran

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9
Q

tranexamic acid

A

inhibits fibrin breakdown

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10
Q

alemtuzumab

A

mab to cd52

cll and ms

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11
Q

daclizumab

A

cd25 (part of il2 receptor)

relapsing MS

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12
Q

natalizumab

A

a4 integrin (involved in WBC adhesion)

MS and chron disease

Risk of PML in patients with JC virus

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13
Q

ustekinumab

A

il-12/il-23

psorisasis, psoriatic arthritis

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14
Q

ranibizumab, bevacizumab

A

vegf

neovascular age related macular degeneration, proliferative diabetic retinopathy, and macular edema

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15
Q

alirocumab

A

pcsk9 inhibitor

decrease decrease decrease / increase / decrease

inactivated ldl receptor degradation, increased ldl removed from blood

myalagias, delirium, dementia, other neurocognitive defects

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16
Q

evolucumab

A

pcsk9 inhibitor

decrease decrease decrease / increase / decrease

inactivated ldl receptor degradation, increased ldl removed from blood

myalagias, delirium, dementia, other neurocognitive defects

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17
Q

ivabradine

A

antiarrythymic

selective inhibition of funny na channels. prolongs phase 4. decreases sa node firing. negative chronotrope without inotrope. reduces o2 requirement.

chronic stable angina in people who cant take b blockers. chronic HF with reduced ejection fraction.

luminous phenomana/visual brightness, hypertension, bradycardia

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18
Q

cefazolin

A

1st cephalo

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19
Q

cephalexin

A

1st cephalo

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20
Q

cefaclor

A

2nd cepha

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21
Q

cefoxitin

A

2nd cepha

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22
Q

cefuroxime

A

2nd cepha

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23
Q

ceftriaxone

A

3rd cepha

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24
Q

cefotaxime

A

3rd cepha

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25
Q

cefpodoxime

A

3rd cepha

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26
Q

ceftazidime

A

3rd cepha

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27
Q

cefepime

A

4th cepha

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28
Q

ceftaroline

A

5th cepha

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29
Q

aminoglycoside resistance and mech

A

irreversible inhibition of inititation complex by binding 30s. mrna misreading. block translocation.

bacterial transferases inactivtion drug by acetylation, phosphorylation, or adenylation.

methylation of ribosomes.

modification of 30s genes makes resistant

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30
Q

tetracycline mech and resistance

A

bind to 30s and prevent attachement of aminoacyl trna.

decreasd uptake or increased efflux by plasmid encoded transport pumps

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31
Q

chloramphenicol

A

blocks peptidyl transferase at 50s

plasmid encoded acetyltransferase inactivated the drug

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32
Q

clindamycin

A

blocks peptide transfer (translocation) at 50s

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33
Q

linezolid

A

inhibition of protein synthesis by binding to the 23s of the 50s subunits and preventing formation of the initiation complex

point mutation of the ribosomal RNA

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34
Q

macrolide

A

inhibits protein synthesis bly blocking translocation by binding to the 23s rrna of the 50s.

methylation of the 23s rrna

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35
Q

von hippel lindau

A

3

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36
Q

renal cell carcinoma

A

3

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37
Q

pkd2

A

4

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38
Q

achondroplasia

A

4

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39
Q

hemochromatosis

A

6

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40
Q

willams syndrome

A

7

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41
Q

cystic fibrosis

A

7

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42
Q

fridierich ataxia

A

9

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43
Q

wilson disease

A

13

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44
Q

rb1

A

13

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45
Q

brca2

A

13

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46
Q

prader willi

A

15

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47
Q

angelman syndrome

A

15

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48
Q

marfan syndrome

A

15

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49
Q

brca1

A

17

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50
Q

p53

A

17

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51
Q

hairy cell leukemia

A

adult males. mature b cell tumor. cells have filamentous hair like projections. “fuzzy”

marrow fibrosis. dry tap. pancytopenia and splenomegaly.

trap

treat with cladribine and pentostatin (purine antimetabolite)

no lymphadenoapthy. accumulate in red pulp.

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52
Q

adult t cell leukemia/lymphoma

A

adults

mature cd4 t cells

caused by htlv-1 which is associated with IV drug abuse

rash (infiltration) generalized lymphadenopathy. hepatosplenomegaly, lytic lesions (punched out) with hypercalcemia.

most common in the japan west africa and carribbean

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53
Q

mycosis fungiodes

A

adults

mature cd4 cells

infiltrate the skin producing rash, plagues, and nodules. aggreates of neoplastic cells called pautrier microabscesses.

can spread to blood producing sezary syndrome (t cell leukemia)
- lymphocytes with cerebriform nuclei are seen on blood smear.

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54
Q

langerhans cell histocytosis

A

langerhans cells are dendritic cells found in the skin
derived from bone marrow monocytes
present to naive t cells

birbeck granules (tennis racke) granules. cd1a+ and s100+ (mesodermal origin).

letterer-siwe disease

  • malignant
  • skin rash and cystic skeletal defects in infant less than 2
  • multiple organs involved and rapidly fatal

eosinophilic granuloma

  • benign proliferation in the bone
  • adolescent with patholgic fracture
  • biopsy shows langerhans cells with mixed inflammation including eosinophils

hand-schuller-christian disease

  • malignant
  • scalp rash, lytic skull lesions, diabetes insipidus, and exopthalmos in a child

FA

presents in child as lytic bone lestions and skin rash or reccurent otitis media with a mass involing the mastoid process. cells are fxnnly immature and do not present antigens

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55
Q

MAC prophylaxis and treatment

A

azithromycin, rifabutin for prophylaxis

hiv prophylaxis < 50 azithromycin or clarithromycin

Treatment

azithromycin or clarithromycin + ethambutol
can add rifabutin or ciprofloxacin

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56
Q

M laprea treatment

A

long term treatment with dapson and rifampin for tuberculoid form. Add clofazimine for lepromatous form

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57
Q

haloperidol

A

high potency typical

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58
Q

pimozide

A

typical not specified

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59
Q

trifluoperazine

A

high potency typical

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60
Q

fluphenazine

A

high potency typical

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61
Q

thioridazine

A

low potency antipsychotic

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62
Q

chlorpromazine

A

low potency antipsychotic

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63
Q

aripiprazole

A

atypical

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64
Q

asenapine

A

atypical

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65
Q

clozapine

A

atypical

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66
Q

olanzapine

A

atypical

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67
Q

quetiapine

A

atypical

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68
Q

iloperidone

A

atypical

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69
Q

paliperidone

A

atypical

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70
Q

risperidone

A

atypical

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71
Q

lurasidone

A

atypical

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72
Q

ziprazidone

A

atypical

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73
Q

fluoxetine

A

ssri

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74
Q

fluvoxamine

A

ssri

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75
Q

paroxetine

A

ssri

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76
Q

sertraline

A

ssri

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77
Q

escitalopram

A

ssri

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78
Q

citalopram

A

ssri

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79
Q

venlafaxine

A

snri

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80
Q

desvelafaxine

A

snri

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81
Q

duloxetine

A

snri

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82
Q

levomilnacipram

A

snri

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83
Q

milnacipram

A

snri

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84
Q

amitriptyline

A

tca

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85
Q

nortriptyline

A

2nd tca

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86
Q

imipramine

A

tca

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87
Q

desipramine

A

tca 2nd

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88
Q

clomipramine

A

tca

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89
Q

doxepin

A

tca

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90
Q

amoxapine

A

tca

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91
Q

truncus arteriosus

A

ascending aorta and pulmonary trunk

92
Q

bulbus cordis

A

smooth parts (outflow track) of the left and right ventricles

93
Q

endocardial cushions

A

atrial septum, membranous interventricular septum, av and semilunar valves

94
Q

primitive atrium

A

trabeculated (left and right atria)

95
Q

primitive ventricle

A

trabeculated part of the left and right ventricle

96
Q

primitive pulmonary vein

A

smooth part of the left atrium

97
Q

left horn of the senous venosis

A

coronary sinus

98
Q

right horn of the sinus venosus

A

smooth part of right atrium

99
Q

right common cardinal vein and right anterior cardinal vein

A

svc

100
Q

endocarditis dental prevention high risk

A

amoxicillin

101
Q

gonorrhea exposure

A

cetriaxone

102
Q

reccurent utis

A

tmp smx

103
Q

meningicoccal exposure

A

ceftriaxone, ciprofloxacin, rifampin

104
Q

pregnant women with strep b

A

intrapartum penniciln g or ampicillin

105
Q

prevention of gonogoccal conjuncitivits in newborn

A

erythromycin ointment on eyes

106
Q

prevention of postsurgical infection due to s aureus

A

cefazolin

107
Q

prophylaxis of strep pharyngitis in child with prior rhematic fever

A

penicillin g or oral penicillin v

108
Q

exposure to syphhils

A

benzathine penicillin g

109
Q

cd4 less than 200 prophylaxis

A

use tmp smx for pneumocystis

110
Q

cd4 less than 100 prohylaxis

A

tmp and smx for pneumocystis and toxoplasmosis

111
Q

cd4 less than 50 prophylaxis

A

use azithromycin or clarithromycin for MAC

112
Q

mrsa treatment

A

vancomycin, daptomycin, linezolid, tigecycline, cefaroline, doxycycline

113
Q

vre treatment

A

linezolid, streptogamins (quinupristin, dalfopristin) - bind to 50s, i added (daptomycin, linezolid, tigecycline)

114
Q

multidrug resistant p aeruginosa

A

polymixins B and E(colistin)

115
Q

multidrug resistant acinetobacter baumannii

A

polymixins B and E(colistin)

116
Q

azole for histoplasma, coccidioides, blastomyces

A

itraconazole

117
Q

topical azole for fungal infections of skin

A

coltrimazole and miconazole

118
Q

asperigillus infection

A

voriconazole (also works agaisnt some candida)

serious aspergillus use isavuconazole

119
Q

mucorales infection

A

amphoterricin

isavuconazole

120
Q

terbinafine side effects

A

gi upset, headaches, hepatotoxicity, tast disturbance

121
Q

-fungins

A

echinodins

122
Q

echinodins side effects

A

gi upset, flushing (by histamine release)

123
Q

griseofulvin

A

teratogenic, carcinogenic, confusion, headaches, disulfarim like reaction, increase cyp and warfarin metabolism

124
Q

toxoplasmosis treatment

A

pyrimethamine + sulfadiazine

125
Q

t cruzi

A

benznidazole or nifurtimox; crusing in my benz with a fur coat on

126
Q

leshminiasis

A

amphotericin b (localized cutaneous) or sodium stibogluconate (sever diffuse cutaneous and visceral)

127
Q

antimite/louse therapy

A

permethrin (neuronal membrane deplorization via na channels)

malathion (acetylcholinesterase inhibitor)

lindane (blocks gaba channels -> neurotoxicity)

used to treat scabies (sarco scabiei) and live (pediculus and pthirus)

treat Pesky Mites and Lice with PML because they NAG you

scabies: permethin cream, washing/drying all clothing/bedding, treat close contacts
lice: pyrethoids, malathion, or ivermectin lotion, and nit combing. children can attend school and treated at home

128
Q

malaria treatments

A

use choloroquine for sensitive species (dont use for falciparum, resistance too common)

if resistant use:

mefloquine, atovaquone/proguanil

Treat falciparum with:

artemether/lumefantrine or atovaquone/proguanil

for life threatening use:

use IV quinidine in US (quinine elsewhere) or artesunate

for p vivax/ovale

add primaquine for hypnozoite

129
Q

chloroquine (hydrozychloroquine)

A

blocks plasmodium heme polymerase which turns heme into hemozoin. heme accumulates and is toxic.

resistance due to membrane pump that reduces intracellular concentrations

retinopathy; pruitis (especially in dark skinned people)

130
Q

adenoma

A

benign of the epithelium

131
Q

adenocarcinoma

A

malignant of epithelium

132
Q

leiomyoma

A

benign smooth muscle

133
Q

leiomyosarcoma

A

malignant smooth muscle

134
Q

rhabdomyoma

A

benign striated

135
Q

rhabdomyosarcoma

A

malignant striated

136
Q

three most common cancers

A

basal > squamos > > melanoma (skin)

137
Q

men cancer incidence

A

prostate, lung, colon/rectum

138
Q

men cancer mortality

A

lung, prostate, colon/rectum

139
Q

women cancer incidence

A

breast, lung, colon/rectum

140
Q

women cancer mortality

A

lung, breast, colon/rectum

141
Q

children cancer incidence/mortality (0 to 14)

A

leukemia. brain and CNS, neuroblastoma

142
Q

four carcinomas with hematogenous spread

A

renal, hepatocellular, follicular of thyroid, choriocarcinoma

143
Q

cytokeratin/keratin

A

epithelial

144
Q

vimentin

A

mesenchymal tissue (eg fibroblasts, endothelial cells, macrophages)

mesenchymal tumors and others (eg endometrial carcinoma, renal cell carcinoma, meningioma)

145
Q

desmin

A

muscle tumors (eg rhabdomyosarcoma)

146
Q

gfap

A

neuroglia (astrocytes, schwann cells, oligodendrocytes)

eg astrocytoma, glioblastoma

147
Q

neurofilaments

A

neurons

148
Q

empiric meningitis treatment

A

ceftriaxone and vancomycin (add ampicillin if listeria suspected)

149
Q

viral causes of meningitis

A

enterviruses (especiialy coxsackie), hsv-2 (hsv-1 = encephalitis), hiv, wnv (also causes encephalitis), vzv

150
Q

infections causing brain abscess

A

most commonly viridans group or s aureus. if dental extraction or infection, oral anerobes commonly involved.

multiple abscesses are usually from bactermia, single lesions from contigous sites: otitis media and mastoiditis -> temporal lobe. sinusitis or dental infection -> frontal lobe

151
Q

distal renal tubular acidosis causes (type 1)

A

amphoterricin b, ibuprofen, congenital abnormalities (obstruction), autoimmune like sjorgrens and rheuematoid, ifosfamide, hypercalcuria for any reason, genetic

152
Q

proximal renal tubular acidosis (type 2)

A

fanconi or carbonic anhydrase inhibitor

153
Q

hyperkalemic renal tubular acidosis (type 4)

A

decreased aldosterone production (diabetic hyporenism, ace in, arbs, nsaids, heparin, cyclosporine, adrenal insufficiency) or aldosterone resistance (k sparing dieuretics, nephropathy due to obstruction, tmp smx)

154
Q

fanconi syndrome causes

A

heriditary causes - wilson disease, tyrsinemia, glycogen storage disorder, cystinosis

acquired - iscehmia, multiple myleoma, nephrotoxins/drugs (eg ifosfamide, cisplatin, tenofovir, expired tetracyclines), lead poisoning

155
Q

septic arthritis

A

s aureus, strep, and n gonorrhea are common causes. affected joint is swollen red and painful. synovial fluid purulent (greater than 50000 wbcs)

gonococcal ahtirtis - sti that presents as either purulent arthritis (eg knee) or triad of polyarthalgia, tenosynovitis (hand), dermatitis (eg pustules)

156
Q

molecules working on the parietal cells

A

ach, gastrin, histamine, somatostatin, prostaglandins

157
Q

parietal cell ach

A

m3 gq

158
Q

gastrin parietal cell

A

cckb gq

159
Q

histamine on parietal cell

A

h2 recep gs

160
Q

somatostain on parietal

A

gi

161
Q

prostaglandin on parietal

A

gi

162
Q

abacavir (ABC)

A

nrti hlab 5701

163
Q

didanosine (ddl)

A

nrti pancreatitis

164
Q

emtricitabine (ftc)

A

nrti macular rash on palms

165
Q

lamivudine

A

nrti

166
Q

stavudine (d4t)

A

nrti

167
Q

tenofovir (tdf)

A

nrti nucleotide

168
Q

zidovudine (zdv, formely azt)

A

nrti general prophylaxis and pregnancy, anemia

169
Q

delavirdine

A

nnrti ci in pregnancy

170
Q

efavirenz

A

nnrti cns symptoms and vivide dreams

171
Q

nevirapine

A

nnrti ci in pregnancy

172
Q

rilpivirine

A

nnrti

173
Q

indinavir

A

protease inhbitor. nephopathy and hematuria from stones of drug. thrombocytopenia

174
Q

autoclave

A

pressurized steam at greater than 120. may be sporicidal

175
Q

alcohols

A

denature proteins and disrupt cell membranes. not sporicidal

176
Q

chlorhexidine

A

denatures proteins and disrupts cell membranes. not sporicidal

177
Q

hydrogen peroxide

A

free radical oxidation. sporicidal.

178
Q

iodine and iodophors

A

halogenation of dna, rna, and proteins. may be sporicidal.

179
Q

c tetani treatment

A

prevent with vaccine. treat with antitoxin plus minus vaccine booster., diazepem (for muscle spasms), wound debridement.

180
Q

c diff treatment

A

often caused by clindamycin, ampicillin, associated with ppi use.

metronidazole or oral vancomycine. reccurent cases consider fidaxomicin, or fecal microbiota transplant.

181
Q

listeria monocytogenes treatment

A

ampicillin

182
Q

nocardia treatment

A

tmp smx

183
Q

actinomyces treatment

A

penicillin

184
Q

gonocci treatment

A

cetriaxone + (azithromycin or doxycyline) for chlamydia

erythromycin oitment prevents neonatal blindness

185
Q

menigocci treatment

A

rifampin, ciprofloxacin, ceftriaxone for prophylaxis of close contacts.

treat with ceftriaxone or penicillin g

186
Q

haemophilus influenza treatment

A

amoxicillin +/- claculanate for mucosal infections. ceftriaxone for meningitis. rifampin prophylaxis for close ocntacts.

187
Q

legionella treatment

A

macrolide or quinolone

188
Q

pseudomonas treatment treatment

A

“campfire”

carbapenems
aminoglycosides
monobactams
polymyxins (polymixn b, colistin)
fluroquinolones (ciprofloxacin, levofluroquinolone)
thIRd and fourth gen cepahlospoins (eg ceftazidime, cefepime)
extended spectrum peniciilins (eg ticarcillin, piperacillin)

189
Q

salmonella typhi

A

ceftriaxone or fluroquinolones

190
Q

h pylori

A

amoxicillin (metronidazole if allergic) + clarythromycin + ppi (antibiotics cure pylori)

191
Q

lyme disease

A

doxycyline (1st line); amoxicillin and cefuroxime in pregnant women and children

utd says all work for early stage

192
Q

g vaginalis

A

metro or clindamycin

193
Q

chlamydiae

A

treatment: azithromycin (prefered because one time treatment) or doxycyline (+ceftriaxone)

lacks classic peptidoglycan due to reducde muramic acid so b lactams dont work

194
Q

m pneumonia

A

macrolides, doxycyline, or fluroquinionlens.

penicillin infeective since no cell wall

195
Q

candida

A

oral fluconazole/topical azole for vaginal.

nystatin, fluconazole, or capsofungin for oral/esophageal.

fluconazole, caspofungin, or amphoterricin b for systemic

196
Q

c neoformans

A

amphoterricin b + flucytosine followed by fluconzaole for meningitis

197
Q

mucor and rhizopus

A

surgical debridement and amphoterricin b

198
Q

PCP

A

tmp-smx, pentamidine (if sulfa allergy), dapsone (prophylaxis only), atovaquone. Start prophylaxis when cd4 less than 200

199
Q

sporothrix

A

itraconazole or k iodide

200
Q

giardia

A

metro

201
Q

e histolytica

A

metronidazole; paromomycin or iodoquinol for asymptomatic stool passers

202
Q

cryptosporidium

A

prevention by filtering city water supplies; nitazoxanide in immunocmopetent hosts

203
Q

toxoplasmosis

A

tmp smx prophylaxis

sulfadiazine + pyrimethamine

204
Q

n fowleri

A

amphoterrin b has been effective in a few

205
Q

t brucei

A

suramin for blood

melarsoprol for CNS

206
Q

babesia

A

atovaquone + azithromycin

207
Q

t cruzi

A

benznidazole or nifurtomox

curising in my benz with my fur coat

208
Q

l donovani

A

amphoterricn b (localized cutaneous)

sodium stibogluconate (severe diffuse cutaneous or visceral)

209
Q

t vaginalis

A

metronidazole for patient and partner (prophylaxis)

210
Q

enterobius vermiculuari (pin worm)

A

bendazoles (1st line)

pyrantel pamoate (pregnant)

211
Q

ascaris (giant roundworm)

A

bendazoles

212
Q

strongyloides (threadworm)

A

ivermectin or bendazoles

213
Q

ancyclostome/necator (hookworms)

A

bendazoles or pyrantel pamoate

214
Q

t spiralis

A

bendazoles

215
Q

trichuris trichiura (whipworm)

A

bendazoles

216
Q

toxocara canis

A

bendazoles

217
Q

onchocerca volvulus

A

ivermectin

218
Q

loa loa

A

diethylcarbamazine

219
Q

wuchereria bancrofti

A

diethylcarbamazine

220
Q

t solium

A

intestinal tapeworm - paziquantel

cystercercosis - praziquantel

neurocystercerci - albendazole

221
Q

d latum

A

praziquantel

222
Q

e granulosis

A

albendazole

223
Q

schistoma

A

praziquantel

224
Q

clonorchis

A

praziquantel

225
Q

rsv prophylaxis in premies

A

palivizumab

226
Q

postexposure prohylazin rabies

A

wound cleaning plus immunization with killed vaccine and rabies immunoglobin

Pharmacology (33 decks)

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