Pharm exam 2 Drugs, facts, EVERYTHING Flashcards
1
Q
Atropine
A
Muscarinic blocker. not very selective. week long duration! has minimal CNS effects. Good for pre–anesthesia. Tx cholinergic poisoning (but doesn’t help against nicotinic effects)
2
Q
MOA: steroid that Triggers production of specific proteins that reduce cell growth and proliferation
A
Prednisone
3
Q
__[drug]__ can interfere with penicillins and cephalosporins
A
Tetracyclines can interfere with penicillins and cephalosporins
4
Q
What drug goes through P450 metabolism
A
Vinblastine and Vincristine and
Docetaxel and Paclitaxel
(microtubule inhibitors)
5
Q
Bethanechol
A
Direct acting, agonist for ACh. More resistant to AChE
6
Q
Nm nicotinic receptors are on ___
A
Skeletal Muscle
7
Q
Which generation cephalosporin has NORMAL gram positive coverage with improved gram negative coverage (including some Pseudomonal coverage)?
A
5th generation (Ceftaroline) [end of the -line!]
8
Q
What is good for accurate refraction?
A
Homatropine or cyclopentolate
9
Q
Phenoxybenzamine
A
Non–selective alpha antagonists. IRREVERSIBLE. Greater affinity for alpha 1 over alpha 2. Used for pre–op treatment in cases of pheochromocytoma to control hypertension
10
Q
What does sypmathetic/parasympathetic activity do to the Kidney?
A
Sympathetic alters the secretion of renin. Parasympathetic does nothing
11
Q
Dactinomycin
A
Antibiotics – interfere with DNA between GC pair and interferes with RNA polymerase. sometimes combined with methotrexate. via IV. liver excretion. SENSITIZES PATIENT TO RADIATION. Bone marrow depression, Immunosuppression, Nausea, vomiting, diarrhea, stomatitis, alopecia,
12
Q
Which cephalosporin is good for people with renal deficiency?
A
Ceftriaxone (3rd generation) because drug is excreted through bile
13
Q
Carteolol
A
Non–selective beta antagonists with partial agonist effect
14
Q
Goserelin
A
Steroid Hormones and Antagonists ….. Steroid hormone that is GnRH analog. Tx prostate and breast cancer. Fewer side effects with treatment than estrogen
15
Q
What is Tx for hypertension?
A
Clonidine (Alpha 2 agonist)
16
Q
Which receptor is an “autoreceptor”?
A
Alpha 2
17
Q
What penicillins are taken IV or IM?
A
Ticarcillin, piperacillin, ampicillin + sulbactam, ticarcillin + clavulanic acid
18
Q
<p>Neostigmine</p>
A
<p>Intermediate Indirect acting, inhibits AChE. Reverses neuromuscular blockade produced during anesthesia. Used in myasthenia Gravis</p>
19
Q
Ceftazidime
A
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
20
Q
Why is a combination of drugs good for cancer treatment?
A
Provide maximal killing with tolerated toxicity, Effective against broad cell lines, May delay development of resistant cell lines. If use drugs with similar toxicities, dose of each must be reduced
21
Q
Doripenem
A
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
22
Q
Ertapenem
A
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
23
Q
Which antibiotic cancer drug is cell cycle specific?
A
Bleomycin
24
Q
Tx MRSA, skin infections
A
Daptomycin, Telavancin
25
Alprenolol
Beta–1 selective antagonists
26
Edrophonium (Tensilon)
Short Indirect acting, inhibits AChE. used for diagnosis of Myasthenia Gravis. also Reverses neuromuscular blockade produced during anesthesia
27
Cefdinir
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
28
What is the neurotransmitter and receptor of postganglionic sympathetics? Long or short?
Long, NE alpha/beta
29
What is the tissue target and actions for Alpha 2?
CNS and PNS nerve terminal (inhibits NT release). Also decreases aqueous production and increase uveoscleral outflow
30
What happens if the miotic pupil does not dilate with phenylephrine?
It's probably not Horner's syndrome, then
31
Terazosin
Alpha–1 antagonists
32
Which cephalosporin is excreted through the bile?
Ceftriaxone (3rd generation)
33
Meropenem
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
34
Which generation cephalosporin has diminished gram positive and improved gram negative coverage?
2nd generation (…Zil-or-Tin)
35
What happens when you activate Beta 1 receptors?
Affects HEART: higher bp, heart rate, increase contractility. Affects Kidney too (more renin > increase blood volume because more water)
36
What are the clinical uses of alpha antagonists?
For tumors that secrete NE, hypertension, Urinary obstruction (enlarged prostate), ED
37
Carmustine
Alkylating Agent. Alkylates DNA. Tx brain tumors (crosses CNS). via IV. Kidney excretion. AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis
38
What kind of receptor are the Alpha and beta receptors?
G-protein coupled receptors
39
5–fluorouracil
Antimetabolite – Thymidine analog that prevents DNA synthesis. Tx skin cancer. Through IV and topically. Excreted in the kidney/lungs. Can cause anorexia.
40
Which drug's adverse effect? : Pulmonary toxicity Alopecia Hypertrophic skin changes and hyperpigmentation Fever and chills
Bleomycin
41
Sildenafil
(Viagra) Type 5 Phosphodiesterase Inhibitors
42
Phenylephrine
Alpha–1 agonists. it's a Mydriatic (eye dilator) and OTC decongestant. Tx for Hypotension. also found in many OTC medications for congestion (local constriction) Used often for acute hypotension caused by severe hemorrhage, decreased blood volume, shock, etc. Diagnosis of Horner’s
43
What are the clinical uses of Cholinomimetics in the Eye?
Glaucoma (pilocarpine and carbachol are older treatments)
44
What do muscarinic blockers do to the eye?
They cause mydriasis (constrictor is inhibited), cause cycloplegia (ciliary muscle is inhibited), and reduce lacrimal secretion.
45
AE:
| Fever, chills, phlebitis at injection site, flushing and/or shock if rapid infusion (can pretreat with anti-histamine)
Vancomycin
46
What can cause Crystalline retinopathy and other vision probs?
Tamoxifen
47
What can regenerate AChE?
Pralidoxime
48
Bleomycin
Antibiotics – scission of DNA. Tx testicular cancer. Via subcutaneous, IM, or IV. Kidney excretion. can cause Pulmonary toxicity Alopecia Hypertrophic skin changes and hyperpigmentation Fever and chills
49
Nilutamide
Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogen. Tx prostate cancer. via oral administration. Kidney excretes. NILUTAMIDE CAN CAUSE VISUAL PROBLEMS
50
Brimonidine
(Alphagan–P) Alpha–2 agonists. Tx of glaucoma
51
Scopolamine
Muscarinic blocker. Good for seasickness but can cause drowsiness and amnesia. used for pre–anesthesia.
52
What is good treatment of Uveitis
Homatropine or Cyclopentolate
53
What drugs gind guanine in DNA to form cross links?
Cisplatin, Carboplatin, Oxaliplatin
54
What will be lower than the other? MIC or MBC?
MIC is a lower concentration than MBC
55
What can treat COPD and Asthma?
Ipratropium or Tiotropium
56
Which drugs can cause anorexia?
5-fluorouracil and 6-mercaptopurine
57
Norepinephrine
non–selective Alpha/beta agonist. Little effect on Beta 2 receptors Used often for acute hypotension caused by severe hemorrhage, decreased blood volume, shock, etc.
58
What receptor stimulates the iris dilator muscle?
Alpha 1
59
Where are the nonsteroidal antiandrogens drugs (anti-cancer)?
Flutamide, Nilutamide (can cause visual problems) Bicalutamide
60
Ipratropium (Atrovent)
Muscarinic blocker. Tx COPD and Asthma
61
What happens when you apply Direct-Acting Cholinoceptor Stimulants to the respiratory system?
Contraction of bronchial smooth muscle: Bronchoconstriction. Stimulation of bronchial glands: Increase mucous secretion. This would be bad for an asthma patient
62
Echothiophate
Long indirect actin, inhibits AChE
63
Carbachol
Direct acting, agonist for ACh. more resistant to AChE. Older treatment for glaucoma
64
What is effect of an Indirect Acting Cholinomimetic on the respiratory tract?
Basically the same as direct.
Contraction of bronchial smooth muscle: Bronchoconstriction. Stimulation of bronchial glands: Increase mucous secretion. This would be bad for an asthma patient
65
Which "steroid hormone and antagonists" are actually steroids? Which are not steroids?
STEROIDS:
66
What is MIC?
Minimum Inhibitory Concentration: Lowest concentration of antibiotic that inhibits bacterial growth. Clinically obtainable antibiotic concentration must be greater than the MIC.
67
Which alkylating agent transforms into an active metabolite?
Dacarbazine
68
What drug Tx enterocolitis?
Oral Vancomycin
69
What are some problems associated with chemotherapy?
Resistance, multidrug resistance, toxicity
70
Do Adrenergic receptors desensitize?
They are non-desensitizing
71
What does Beta-lactamse inhibitors do?
They bind and inactivate penicillinases allowing combined drugs to work.
72
AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis
Carmustine, Lomustine
73
What happens when you apply Direct-Acting Cholinoceptor Stimulants to the heart and blood vessels?
Hyperpolarization of the SA and AV node (decreases AP and contractility), blood vessels release NO from endothelial cells to cause vasodilation
74
What is the tissue target and actions for Alpha 1?
Vascular smooth muscle (contraction), pupillary dilator muscle (contraction -- dilation), and heart (increase force of contraction)
75
Atenolol
Beta–1 selective antagonists
76
Which drug has this MoA: Inhibits DNA polymerase. Also can be incorporated into cellular DNA
Cytarabine
77
Daptomycin
Other" antibiotic. induces rapid depolarization of cell membrane. tx gram positive, skin infections. Inactivated by pulmonary surfactants
78
Labetalol
Non–selective beta antagonists with partial alpha–1 antagonist activity. Can be used in hypertensive emergency
79
Cefixime
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
80
Penbutolol
Non–selective beta antagonists with partial agonist effect
81
AE: Severe reactions have been fatal: Must infuse slowly. Hypotension, bronchospasm, and angioedema; Chills and fever after first infusion; Cardiac arrhythmias; You don't see nausea vomiting hair falling out
Rituximab
82
Which antibiotic cancer drug can cause irreversible cardiotoxicity?
Doxorubicin
83
Bicalutamide
Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogens. Tx prostate cancer. via oral administration. Kidney excretes.
84
Telavancin
Other" antibiotic. inhibits cell wall. tx gram positive. (also MRSA). Tx skin infections. Taste disturbances, nausea, vomiting, insomnia, foamy urine, NOT to be used during pregnancy Caution in cardiac conditions"
85
Which drugs can cause buildup of uric acid in the urine?
Vinblastine and Vincristine (microtubule inhibitors)
86
Is tamoxifen cell-cycle specific or not?
Tamoxifen is NOT cell-cycle specific
87
Doxorubicin
Antibiotics – induces cytotoxicity and free radicals. must be given IV. Red urine and dark red veins because of extravasation.
88
Doxazosin
Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate. Doxazosin has longer half–life
89
Interferons
Recombinant DNA via bacteria, activation of macrophages and suppression of cell proliferation. Alpha– primarily leukocytic Beta– produced by CT fibroblasts Gamma– produced by T–lymphocytes
90
What is the mechanism of MRSA resistance?
Altered PBPs (penicillin binding proteins) for reduced drug affinity.
91
What drug can cause foamy urine?
Telavancin
92
Name MOA: Forms a stable complex with DNA Intercalates into double helix between G-C base pairs Interferes with RNA polymerase and hinders DNA synthesis
Dactinomycin
93
What are the long-acting organophosphates? Where are they distributed?
Echothiophate, Malathion, Parathion, Sarin. All are distributed to CNS except echothiophate
94
Which adregergic receptors lead to a blood pressure decrease?
Alpha 2, Beta 2
95
Cephalexin (Keflex)
1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney. Tx eye (lid) infections. tx pharyngitis
96
What is Tx for cardiac arrest?
Isoproterenol, Epinephrine
97
What do muscarinic blockers do to the GI tract?
Decrease salivation, production of stomach acid, smooth muscle tone and propulsive movements
98
What is the short-acting Indirect Acting Cholinomimetic? How does it work?
Edrophonium. Forms reversible bond with the enzyme. Not actually a substrate for ACh-esterase
99
What happens when you activate Beta 2 receptors?
Bronchodilation, elevates blood glucose (via glycogen breakdown) and increases glucagon secretion from pancreas. Also decreases blood glucose vis insulin. Relaxes smooth ciliary muscle to decrease accommodation.
100
Tx MRSA, infection blepharitis, corneal ulcers…
Bacitracin ("other')
101
What is good for seasickness?
Scopolamine and other muscarinic blockers
102
If you're allergic to penicillin, what else can you not take?
Other beta-lactams like Cephalosporins. Nor Augmentin
103
Nafcillin
Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph. High toxicity, causes interstitial nephritis Used only to identify MRSA.
104
Tiotropium (Spiriva)
Muscarinic blocker. Tx COPD and Asthma
105
Which generation cephalosporin has further diminished gram positive coverage with improved gram negative coverage and FULL coverage against Pseudomonas?
4th generation (cefepime) [4th gen is almost -prime time!]
106
Prednisone
Steroid Hormones and Antagonists ….. Steroid hormone that reduces cell growth and proliferation. Tx lymphomas and induces remission. Via oral, excreted urine. Predispose patient to infection, Hyperglycemia, Cataract formation, increased IOP, Osteoporosis, Mood changes: hyper and happy
107
Isoproterenol
Non–selective beta agonist. Tx cardiac arrest (w/ epinephrine)
108
What are the common adverse side effects of cancer treatment?
Severe vomiting, Bone marrow suppression, Alopecia, Myelosuppression (patient prone to infection)
109
Cevimeline
Direct acting, agonist for ACh. Used in Sjogren's syndrome (for salivation)
110
What generation of cephalosporins are ok to use with people allergic to penicillin?
3rd, 4th, 5th.
111
Metaproterenol
Beta–2 agonists. Tx Asthma
112
What are some AE to penicillins?
Hypersensitivity. Diarrhea, nephritis (esp. with methicillin), neurotoxicity, hematologic toxicity (decreased coagulation).
113
What is the distribution and elimination of muscarinic blockers?
Most are widely distributed through CNS. They are eliminated via the kidney.
114
What drug stops VEGF from stimulating new blood vessels?
Bevacizumab
115
Which antibiotic is safe during pregnancy?
Bacitracin ("other")
116
Parathion
Long indirect actin, inhibits AChE
117
Oxaliplatin
Platinum coordinating complex, IV administration. Little penetration to CSF. Renal excretion. forms cross–links in guanine. Mild nausea, myelosuppression
118
Which drug has this MoA: Pyrimidine analog Forms a molecular complex that deprives the cell of thymidine (DNA synthesis stops)
5-fluorouracil
119
Vincristine
Microtubule Inhibitors–halts anaphase. IV injection. Metabolism by the P450 system. Excretion via bile and feces. hyperuricemia (buildup of uric acid in the urine) Nausea, vomiting, diarrhea, alopecia. Phlebtis or cellulitis if extravasation occurs.
120
What are side effects unique to cholinesterase inhibitors?
Miosis, Salivation, Sweating, and Muscle weakness. Both direct and indirect have Bronchial constriction, Vomiting, Diarrhea, Convulsions,
121
What can cause vasoconstriction?
Alpha agonists (Epi, Phenylephrine, Tetrahydrozoline)
122
How are Monoclonal antibodies administered.
NOT orally! IV
123
Which antimetabolite is given orally?
6-mercaptopurine (and Methotrexate can be oral)
124
Cefoxitin
2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney.
125
What is a Pharmacologic Sanctuary?
A place where some tumor cells can “hide” in tissues where chemotherapeutic agents cannot enter. Radiation "finds" these tumors
126
Ampicillin
Aminopenicillins. tx Gram (+). limited gram (–) coverage Considered extended spectrum. via only oral.
127
What does a selective receptor mean?
It can become non-selective at high concentration
128
What drug class would be bad for an asthma patient?
Direct and indirect acting cholinoceptor stimulant, Timolol (beta blocker)
129
Nadolol
Non–selective beta antagonists. Long duration of action
130
Cefprozil
2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney.
131
What do muscarinic blockers do to the urinary tract and sweat glands?
Slows voiding. Reduces sweating
132
Methotrexate
Antimetabolite – Prevents folic acid conversion to THF leading to decreased DNA/ protein materials. Thymidine depletion is most prominent. Low doses Tx inflammatory diseases (Rheumatoid arthritis, crohn disease). via oral, IM, IV. intrathecal for CNS. Avoid in pregnancy. can lead to crystalluria
133
Which antibiotic type is often combined with penicillinase inhibitor?
Aminopenicillins (like ampicillin and amoxicillin)
134
What is effect of an Indirect Acting Cholinomimetic on the Eye?
Basically the same as direct. Contraction of iris sphincter (miosis), ciliary muscle (accommodation), and opening of trabecular meshwork (lower IOP)
135
What classes of antibiotics show Time-dependent killing?
β-lactams, glycopeptides, macrolides, clindamycin, and linezolid
136
Docetaxel
Microtubule Inhibitors – binds to tubulin and makes too stable. via IV. P450 metabolism Biliary excretion. Neutropenia, peripheral neuropathy Docetaxel contraindicated in cardiac disease (can cause fluid retention) and is more potent than paclitaxel
137
Which cancer drug Sensitizes the patient to radiation (sun)?
Dactinomycin
138
Dobutamine
Beta–1 agonist
139
Which antibiotic is used to identify resistant strains of S. aureus?
Methicillin
140
What are the properties of Choline esters?
ACh, Carbachol, Bethanechol are hydrophilic (poorly absorbed), Carbachol and Bethanechol are more resistant to AChE --longer duration of action
141
What is Tx for chronic orthostatic hypotension?
Midodrine (Alpha 1 agonist)
142
Which cholinomimetric alkaloid can be absorbed across the skin?
Nicotine
143
What is the process of making NE?
Tyrosine > DOPA > Dopamine, which enters vesicles > NE via Dopamine β hydroxylase. NE is metabolized by MAO and diffused into surrounding tissue
144
Which Antibiotic cancer drugs can be given subcutaneously, IM, or IV?
Bleomycin
145
Clavulanic acid + amoxicillin (Augmentin)
β–lactamase Inhibitor + Antibiotic Combos. bindand inactivate penicillinases allowing combined drugs to work. Used in to treat many eye infections.
146
What cancer drug is a powerful blistering agent?
Mechlorethamine
147
AE: Severe vomiting, Nephrotoxicity, Ototoxicity
Cisplatin
148
Which is more potent:
| Docetaxel, Paclitaxel?
Docetaxel
149
What antibiotic should not be used during pregnancy?
Telavancin
150
What is Tx for acute hypotention?
Alpha agonists (NE, Phenylephrine)
151
Albuterol
Beta–2 agonists. Most commonly used asthma Rx
152
What antibiotic has no activity against gram (+)?
Monobactams
153
Flutamide
Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogens. Tx prostate cancer. via oral administration. Kidney excretes.
154
Tacrine
Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's (not as often as other options because of side effects)
155
Prazosin
Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate
156
Which ANS receptors are nicotinic?
All pre-ganglionic cells (and somatic skeletal muscle motor end plates)
157
Cefotaxime
3rd Gen Cephalosporins. GOOD CSF penetration. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
158
Which adrenergic receptors lead to an increase in heart contractility and heart rate?
Beta 1
159
Ceftaroline
5th Gen Cephalosporins. gram positive. improved gram negative. is active against S. aureus (including MRSA) and S. pneumoniae. elimination through Kidney.
160
What classes of antibiotics show concentration-dependent killing?
Aminoglycosides
161
Timolol (Timoptic)
Non–selective beta antagonists. Very effective when used topically to the eye, but do not prescribe for an asthmatic patient. Increased survival after heart attack
162
Which cephalosporin can penetrate the CSF well?
Cefotaxime (3rd generation)
163
Curing cancer results in about ___% of patients. Overall 5-year survival rate for cancer patients is
__%
10%. 65%
164
What is the tissue target and actions for Beta 2?
Respiratory, uterine, and vascular smooth muscle (Relaxes smooth muscle). Skeletal muscle (promotes K+ uptake)
165
Metoprolol
Beta–1 selective antagonists. Increased survival after MI
166
Apraclonidine
Alpha–2 agonists. Tx of glaucoma
167
What are the different ways drug resistance happens?
Spontaneous mutations (good, neutral, bad), DNA transfer (conjugation), altered protein expression
168
Which antibiotic is highly toxic, causing interstitial nephritis?
Methicillin [Penicillinase-Resistant Penicillin] (and Bacitracin ["other" category])
169
What cephalosporin is good for eye lid infections?
Cephalexin (1st generation)
170
Penicillins act against gram ____ bacteria
Penicillins act against gram positive bacteria
171
Are alkylating agents cell cycle specific or non-cell cycle specific?
Not cell-cycle specific
172
What adrenergic drugs are limited clinically?
Alpha 2 antagonists, but they are being used experimentally in diabetes and depression.
173
Letrozole
Nonsteroidal Aromatase inhibitors: decrease the production of estrogen. More potent selective. Do not need hydrocortisone supplement. does not predispose to endometrial cancer.
174
Which drug has this MoA: Inhibits the first step of purine-ring biosynthesis and blocks formation of AMP
6-thioguanine and 6-mercaptopurine
175
AE: Hot flashes, nausea, vomiting, skin rash; Potential to cause endometrial cancer, Crystalline retinopathy and other vision problems
Tamoxifen
176
What is effect of an Indirect Acting Cholinomimetic on the CNS?
Low concentrations: alerting response. High concentrations: convulsions
177
Which antibiotic type is often combined with other antibiotics? What should you do to avoid an inactive complex from forming between the two?
Penicillins. Never place in same infusion fluid because they can form an inactive complex
178
Esmolol
Beta–1 selective antagonists. Very short acting (Eskimos are short)
179
Propranolol
Non–selective beta antagonists. Increased survival after heart attack
180
Cefazolin
1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney. longer duration of action (penetrates bone!)
181
Nicotine
Direct acting, agonist for ACh. Can be absorbed through the skin.
182
Cefaclor
2nd Gen Cephalosporins. has diminished gram positive and improved gram negativecoverage. elimination through Kidney.
183
Aztreonam
Monobactams. only for gram negative! tx pseudomonas. it's a ring not fused to another ring. No cross reactivity with penicillin!
184
What kind of receptor is muscarinic?
g-protein.
185
What are side effects unique to Direct-Acting Muscarinic Stimulants?
Nausea, Frontal headache (from accommodation stimulated), Urinary urgency, Salivation, Sweating, and flushing of the skin (vasodilation) . Both direct and indirect have Bronchial constriction, Vomiting, Diarrhea, convulsions
186
What is used to treat lymphomas?
Prednisone, Rituximab
187
Which antibiotic is good against gram +, -, anerobes, and pseudomonas?
Carbapenems
188
What drug should not be given to people undergoing cataract surgery?
Tamsulosin because it can cause IFIS (Floppy iris syndrome)
189
What is effect of an Indirect Acting Cholinomimetic on the heart and vessels? What is the NET result?
Decrease heart rate and force of contraction (decrease in cardiac output and BP). Increase in vascular resistance (vasoconstriction causes increase in BP because of sympathetic ganglia stimulation). Net result is mild BP increase but high dose will cause BP to fall.
190
Tadalafil
(Cialis) Type 5 Phosphodiesterase Inhibitors
191
Nebivolol
Beta–1 selective antagonists
192
Which cephalosporin can cross BBB. Tx bronchitis / pneumonia in the elderly/immunocompromised?
Cefuroxime (2nd generation)
193
What is good for dilated fundus exam?
Tropicamide or Cyclopentolate
194
Cisplatin
Platinum coordinating complex, forms cross–links in guanine. IV administration. Little penetration to CSF Renal excretion. Severevomiting, Nephrotoxicity, Ototoxicity
195
Which nonsteroidal antiandrogens drug can cause visual problems?
Nilutamide can cause visual problems
196
What can cause chemical conjunctivitis at high doses?
Cytarabine (antimetabolite)
197
How do you test for Horner's syndrome?
Use phenylephrine. If it doesn’t dilate then it's probably not Horner's. then test with opthalmic cocaine: No dilation = postganglionic lesion. Dilation= preganglionic lesion.
198
What treats breast cancer?
First line treatment: Tamoxifen Aminoglutethimide, Anastrozole and Letrozole, Exemestane [all aromatase inhibitors]. For advanced breast cancer: Leuprolide and Goserelin [GnRH analogs]
199
What is MBC?
Lowest concentration of antibiotic that kills the bacteria
200
Which antimetabolite should be avoided in pregnancy ?
Methotrexate
201
What happens when you apply Direct-Acting Cholinoceptor Stimulants to the eye
Contraction of iris sphincter (miosis), ciliary muscle (accommodation), and opening of trabecular meshwork (lower IOP)
202
Which ANS receptors are muscarinic?
Only post-ganglionic receptors
203
Adult eye bacteria are mostly gram ___
Adult eye bacteria are mostly gram positive
204
What happens when you activate Alpha 2 receptors?
Reduces NE release from preganglionic neuron, reducing sympathetic effects. Insulin release is inhibited
205
Cefadroxil
1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney
206
What adrenergic receptor prevents urination?
Alpha 1
207
What is good against pseudomonas?
Kinda (3rd, 4th, 5th, cephalosporins) carbapenems, and monobactams (which is Aztreonam) Antipseudomonal Penicillins (think TiPi)
208
What should you NOT use in pneumonia because pulmonary surfactants deactivates?
Daptomycin
209
What's good for advanced breast cancer?
Leuprolide and Goserelin
210
What is the tissue target and actions for Beta 1?
Heart (increases force and rate of contraction)
211
Which receptor targets the Vascular smooth muscle, pupillary dilator muscle, and heart?
Alpha-1
212
Salmeterol
Beta–2 agonists
213
Tamsulosin
(Flomax) Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate. Tx enlarged prostate (BPH) but can cause Floppy iris syndrome in cataract surgery patients.
214
What receptor is only on the heart?
Beta 1
215
What are the clinical uses of Cholinomimetics in the GI/urinary tract?
Postpoperative atony, neurogenic bladder. Basically smooth muscle disorders where there is no obstruction. Pilocarpine and Cevimeline can increase salivary secretion in Sjogren's syndrome.
216
What is a treatment of testicular cancer?
Bleomycin with vineblastine or etoposie
217
What happens if the cocaine drops cause dilation?
Horner's syndrome is from preganglionic lesion
218
Pilocarpine
Direct acting, agonist for ACh. Older treatment for glaucoma. Used in Sjogren's syndrome (for salivation)
219
What is the neurotransmitter and receptor of postganglionic parasympathetics? Long or short?
Short, Ach muscarinic
220
What is the goal of chemotherapy?
Goal is to cause a lethal cytotoxic event or apoptosis in the cancer cell or arrest tumor’s progression
221
What is effect of an Indirect Acting Cholinomimetic on the NMJ?
prolong and intensify the actions of acetylcholine
222
Which generation cephalosporin has further diminished gram positive coverage with improved gram negative coverage (including some Pseudomonal coverage)?
3rd generation (many drugs)
223
AE of "other" cancer drugs: Mild nausea, myelosuppression
carboplatin and oxaliplatin
224
What receptor relaxes the smooth ciliary muscle?
Beta 2
225
Bacitracin (common ocular)
Other" antibiotic. Gram positive. similar to vancomycin. via TOPICAL. SAFE IN PREGNANCY. causes nephrotoxicity. Tx MRSA, infection blepharitis, corneal ulcers"
226
6–thioguanine
Antimetabolite – Inhibits the first step of purine–ring biosynthesis and blocks formation of AMP. Genetic counseling is recommended because some patients accumulate higher toxic metabolites. Don't use for maintenance therapy
227
cholinomimetric alkaloid are easily or hardly absorbed from administration sites?
cholinomimetric alkaloid are EASILY absorbed from administration sites?
228
What drugs bind to tubulin subunits and make microtubules more stable (cells are stuck in metaphase)
Docetaxel, Paclitaxel
229
What does sympathetic activity do to the blood vessels in skeletal muscle and in the skin?
Symp causes dilation in muscles but constriction in the skin
230
What are the adverse effects of Muscarinic blockers?
Mydriasis, Cycloplegia, Dry mouth, Tachycardia, Flushed skin, Agitation, Delirium, Elevated body temperature
231
What is still used to treat ED ouside US? What mechanism?
Yohimbine! It's alpha 2 antagonist that promotes NE release to increase sympathetic activation
232
Which drugs are the choline esters?
ACh, Carbachol, Bethanechol
233
Piperacillin
Antipseudomonal Penicillins. tx Gram (+). has good gram (–) coverage (considered extended spectrum). via IV or IM
234
Penicillin G
Natural Penicillins. tx Gram (+).Cannot be taken orally. Susceptible to inactivation by B–lactamases
235
Bevacizumab (Avastin)
Monoclonal antibody … Anti VEGF. Tx retinal neovascular diseases. Via IV.
236
Ceftizoxime
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
237
What do muscarinic blockers do to the lungs?
They cause Bronchodilation, a reduce secretions in lung
238
Tetrahydrozoline
(aka visine) Alpha–1 agonists. It sucks! Leads to rebound redness due to receptor desensitization Local constriction reduces red eye
239
What penicillins are taken orally?
penicillin V, amoxicillin, amoxicillin + clavulanic acid
240
Activation of what receptor causes bronchodilation?
Beta 2
241
Oxybutynin
Muscarinic blocker. Tx urinary urgency/bladder spasm.
242
Which cancer drug basically activates the immune system?
Interferons
243
What are some examples of prophylactic use of antibiotics?
Rheumatic heart disease, dental excretions, using before surgery, preventing HIV in fetus
244
Acetylcholine (Miochol)
Direct acting, agonist for ACh
245
Which drugs Bind to microtubule protein and prevent polymerization?
Vinblastine and Vincristine (microtubule inhibitors)
246
Which drug is only topical?
Bacitracin
247
AE: Constipation (all the rest are diarrhea), nausea, headache,
Daptomycin
248
Pyridostigmine
Intermediate Indirect acting, inhibits AChE. common long–term myasthenia gravis treatment.
249
Paclitaxel
Microtubule Inhibitors – binds to tubulin and makes too stable. via IV. P450 metabolism Biliary excretion. Neutropenia, peripheral neuropathy. Docetaxel is more potent than paclitaxel.
250
Acebutolol
Non–selective beta antagonists with partial agonist effect
251
What is Log kill?
The concept that destroying cancer cells follows first-order kinetics (that a steady dose kills a constant FRACTION of cells)
252
Why don't we use nicotinic blockers?
They are too non-specific and would cause major side-effects
253
What is the first line therapy for breast cancer?
Tamoxifen
254
Child eye bacteria are mostly gram ___
Child eye bacteria are mostly gram negative
255
Tamoxifen
Steroid Hormones and Antagonists.. Estrogen antagonist. First line treatment for breast cancer (and prophylactic). often given with leuprolide. Hot flashes, nausea, vomiting, skin rash; Potential to cause endometrial cancer; Crystalline retinopathy and other vision probs
256
Which antimetabolite is given topically for skin cancer and the prevention of scar formation?
5-fluorouracil
257
Dicyclomine
Muscarinic blocker
258
Which drugs are Cholinomimetric Alkaloids?
Pilocarpine, nicotine, muscarine
259
Nn nicotinic receptors are on ___
Neurons
260
Which non-selective alpha agonist can potentially be used for ED treatment (injection)?
Phentolamine
261
Dicloxacillin
Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph.
262
Physostigmine
Intermediate Indirect acting, inhibits AChE
263
How are penicillins excreted?
Most via kidneys
264
Phentolamine
Non–selective alpha antagonists. Causes cardiac stimulation via reduced peripheral resistance Used in an injection format for treatment of ED – may lead to orthostatic hypotension and fibrosis (eek!)
265
How are cephalosporins eliminated?
Through the kidney, except for ceftriaxone (3rd gen)
266
Formoterol
Beta–2 agonists
267
Which generation cephalosporin has gram positive coverage (including Staph aureus) and basic gram negative coverage
1st generation (...oxil lin xin)
268
What is the effect of activating muscarinic receptors of the GI tract?
Increased muscle tone and peristaltic activity
269
Yohimbine
Alpha–2 antagonist. Used to treat ED Still found in many OTCs/”nutritional supplements”
270
Sarin
Long indirect actin, inhibits AChE
271
Imipenem–cilastatin
Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.
272
What do muscarinic blockers do to the cardiovascular system?
Increase HR but no strong net effect
273
What can treat cholinergic poisoning?
Atropine (muscarinic blocker)
274
Ceftibuten
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
275
Which adrenergic receptors lead to a blood pressure increase?
Alpha 1, Beta 1 (but there is a reflex decreasein HR)
276
Leuprolide
Steroid Hormones and Antagonists ….. Steroid hormone that is GnRH analog. Tx prostate and breast cancer. Fewer side effects with treatment than estrogen
277
Which alkylating agent is given orally?
Lomustine
278
What receptor is on respiratory, uterine, and vascular smooth muscle and skeletal muscles?
Beta 2
279
What is the neurotransmitter and receptor of preganglionic sympathetics? Long or short?
Short, ACh nicotinic
280
What do nonsteroidal antiandrogens do?
Nonsteroidal antiandrogens that compete with natural hormone for the androgen receptor and prevent translocation of the hormone into the nucleus
281
Cefditoren
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
282
Betaxolol
Beta–1 selective antagonists. Also used as a glc tx
283
Ticarcillin
Antipseudomonal Penicillins. has good gram (–) coverage (considered extended spectrum). via IV or IM.
284
Which anti-metabolite is not used for maintenance therapy?
6-thioguanine
285
Which non-selective alpha antagonist has greater affinity for alpha 1 over alpha 2?
Phenoxybenzamine
286
What Tx for certain lymphomas and leukemias?
Rituximab
287
What drugs are mutagenic and carcinogenic?
Alkylating agents
288
Amoxicillin
Aminopenicillins. tx Gram (+). limited gram (–) coverage Considered extended spectrum. via only oral. Almost completely absorbed. COMBINE WITH CLAVULANIC ACID FOR AWESOMENESS
289
What is Tx for asthma?
Albuterol, Metaproterenol, Terbutaline
290
What does a specific receptor mean?
Specific means it will stay specific regardless of concentration
291
Anastrozole
Nonsteroidal Aromatase inhibitors: decrease the production of estrogen. More potent selective. Do not need hydrocortisone supplement. does not predispose to endometrial cancer.
292
Which antibiotic cancer drug can make red urine and dark red veins?
Doxorubicin
293
Malathion
Long indirect actin, inhibits AChE
294
6–mercaptopurine
Antimetabolite– Inhibits the first step of purine–ring biosynthesis. Given orally in spite of lower bioavailability. Bone marrow depression Anorexia, nausea, can cause JAUNDICE
295
What is the mechanism of Type 5 Phosphodiesterase inhibitors?
It inhibits PDE5 to allow for more cGMP (causes vasodilation). Muscarinic ACh > Nitric Oxide > cGMP.
296
Methicillin
Penicillinase–Resistant Penicillins. tx Gram (+).
297
Exemestane
Steroidal inhibitor of aromatase. Tx Breast cancer. Via oral.
298
Retuximab
Monoclonal antibody … Induce cell–mediated cytotoxicity. Tx Lymphomas and Leukemias. Via IV. Severe rxns have been fatal, must be infused slowly. Hypotension, bronchospasm and angioedema. Chills and fever after first infusion. Cardiac arrhythmia. You don't see nausea vomitinghair falling out
299
Cefuroxime
2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney. can cross BBB. Tx bronchitis / pneumonia in the elderly/immunocompromised
300
What are beta blockers used for clinically?
Hypertension, Ischemic heart disease by regulating heart beat and decreasing O2 demand, Cardiac arrhythmias, Heart failure, Glaucoma, Hyperthyroidism, migraines, tremors and stage fright/anxiety
301
Donepezil
Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's
302
Tropicamide
Muscarinic blocker. shortest duration (6 hours). Good for dilated fundus exam, uveitis treatment
303
Homatropine
Muscarinic blocker. Second longest effect (1–3 days). Good for accurate refraction, uveitis treatment
304
What generation cephalosporin is active against S. aureus (including MRSA) and S. pneumoniae
5th generation (Ceftaroline) [end of the -line!]
305
Which receptors are rapid on/off and desensitize to constant activation?
Nicotinic receptors
306
Aminoglutethimide
Nonsteroidal Aromatase inhibitor. Tx breast cancer. Also inhibits hydrocortisone synthesis, given with hydrocortisone.
307
Which antibiotic cancer drug goes through extensive liver metabolism?
Doxorubicin.
308
Which drugs are analogs of gonadotrophin releasing hormone?
Leuprolide and Goserelin
309
What are the effects of Beta blockers on the cardiovascular system?
Decrease in blood pressure in patients with hypertension (decrease in renin release), Slow atrioventricular conduction (Decrease heart rate and cardiac output). Can have an acute effect of increasing BP via the blocking of B2 mediated vasodilation
310
Where are alpha 2 receptors located?
On the presynaptic membrane. They are "autoreceptors"
311
Penicillin V
Natural Penicillins. tx Gram (+).CAN be taken orally. Susceptible to inactivation by B–lactamases
312
Which cancer drug treats melanoma?
Dacarbazine
313
Oxacillin
Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph.
314
Dacarbazine
Alkylating Agents. Attacks nucleophilic groups in DNA. Tx melanoma. via IV. Nausea and vomiting, myelosuppression, hepatotoxicity
315
AE: Severe nausea and vomiting Severe bone marrow depression Latent viral infections due to immunosuppression Patient will be very susceptible to infection. Must use caution.
Mechlorethamine
316
Tx MRSA, infection blepharitis, corneal ulcers
Bacitracin
317
What drug induces cell-mediated cytotoxicity and must be infused slowly?
Rituximab
318
What can be used for Alzheimer's treatment?
Tacrine (not used as often due to side effects), Donepezil, Galantamine, Rivastigmine
319
What cephalosporin is good for gonorrhea?
Ceftriaxone (3rd generation)
320
What are common steroid effects?
Predispose patient to infection, Hyperglycemia, Cataract formation, increased IOP, Osteoporosis, Mood changes: hyper and happy
321
What happens when you apply Direct-Acting Cholinoceptor Stimulants to the NMJ?
Causes depolarization followed by depolarization blockade
322
Vardenafil
(Levitra) Type 5 Phosphodiesterase Inhibitors
323
Carvedilol
Non–selective beta antagonists with partial alpha–1 antagonist activity
324
What is the MoA of penicillins?
The beta lactam causes autolysis by forming covalent bonds to the Penicillin binding proteins
325
Cytarabine
Antimetabolite – interferes with DNA polymerase. Given IV, excreted in the Kidneys. high doses can induce chemical conjunctivitis.
326
Which cancer drug is hardly excreted?
Mechlorethamine
327
Antibiotics have what kind of toxicity?
Relative, so the concentration of drug must be carefully controlled to avoid damage to the host
328
Which alkylating agent can penetrate the CNS?
Carmustine, Lomustine
329
Cefpodoxime
3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.
330
Vancomycin
Other" antibiotic. Inhibits cell wall synthesis. mostly topical because oral = nephrotoxicity. via slow IV. elim via kidneys. tx MRSA, tx enterocolitis (oral). Fever, chills, phlebitis at injection site, flushing and/or shock if rapid infusion (can pretreat with anti–histamine)"
331
Which adrenergic drug is effective in topical administration to the eye?
Timolol
332
What are the steps of ACh production and use?
1 Choline enters and 2 combines with Acetyl CoA through Choline acetyltransferase. 3 Ach put in vesicles. 4 AP causes Ca++ to enter the axon > 5 vesicle fuses with axon terminal. 6 ACh eventually gets broken down by AChE. 7 Choline gets recycled
333
Which drugs contain a benzene ring with ethylamine side chain?
Sympathomimetic
334
What happens if the cocaine drops do not cause dilation?
Horner's syndrome is from postganglionic lesion
335
What is the distribution of penicillins?
All cross the placenta but NOT teratogenic. Penetration to bone or CSF insufficient unless inflammation is also present. Prostate levels are insufficient. Excretion for most via the kidneys
336
Midodrine
Alpha–1 agonists. Tx orthostatichypotension (it helps get blood to the heart)
337
Vinblastine
Microtubule Inhibitors–halts anaphase. IV injection. Metabolism by the P450 system. Excretion via bile and feces. hyperuricemia (buildup of uric acid in the urine) Nausea, vomiting, diarrhea, alopecia. Phlebtis or cellulitis if extravasation occurs
338
Which antimetabolite is used in low doses to treat inflammatory diseases: severe psoriasis, rheumatoid arthritis, crohn disease?
Methotrexate
339
What is good against MRSA?
Vancomycin, Bacitracin, Ceftaroline (5th) (kinda Telavancin, kinda Daptomycin)
340
Which cholinomimetric alkaloid is toxic?
Muscarine
341
Lomustine
Alkylating Agents. Alkylates DNA. Tx brain tumors (crosses CNS). via oral. Kidney excretion. AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis
342
Which drug has this MoA:
| Prevents folic acid conversion to THF leading to decreased DNA/ protein materials
Methotrexate
343
What are the ocular side effects of type 5 Phosphodiesterase inhibitors?
Mild impairment of color vision, Blurry vision, Increased risk of ischemia
344
Which cancer drugs tend to have fewer adverse effects?
Monoclonal antibodies because they can be directed at specific targets.
345
Carboplatin
Platinum coordinating complex, IV admistration. Little penetration to CSF. Renal excretion. forms cross–links in guanine. Mild nausea, myelosuppression
346
Which drug is an estrogen antagonist?
Tamoxifen
347
Cyclopentolate
Muscarinic blocker. short duration (1 day). Good for accurate refraction, dilated fundus exam, uveitis treatment
348
Cefepime
4th Gen Cephalosporins. has furtherdiminished gram positive coverage with improved gram negative coverage and FULL coverage against Pseudomonas. elimination through Kidney.
349
Galantamine
Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's
350
What are the side effects of beta blockers?
Increased airway resistance in the respiratory tract – CAUTION IN USE WITH AN ASTHMATIC PATIENT! Impair recovery from hypoglycemia; Increase VLDL and decrease HDL, Bradycardia, Mild sedation or depression, Cardiac decompensation, Caution in use in high cholesterol and diabetic patients!
351
Rivastigmine
Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's
352
Clonidine
Alpha–2 agonists. Tx high blood pressure.
353
Terbutaline
Beta–2 agonists. Tx long–term asthma
354
MoA: induces rapid depolarization of cell membrane.
Daptomycin
355
Which drugs help increase survival after a heart attack?
Propranolol (Beta blocker), Timolol (beta blocker), Metoprolol (Beta 1 blocker)
356
How can bacteria have resistance against penicillins?
Bacteria can make beta-lactamase to hydrolyze the beta-lactam ring, use an efflux pump to lower permeability, and alter PBPs (penicillin binding proteins) for reduced drug affinity.
357
Which cancer drugs are aromatase inhibitors?
Aminoglutethimide, Anastrozole and Letrozole, Exemestane
358
Mechlorethamine
Alkylating Agent. Cross links between guanine bases in DNA Causes strand breakage and the occasional miscoding mutations. Very unstable blistering agent. Via IV. almost no drug is excreted. Severe nausea and vomiting Severe bone marrow depression Latent viral infections due to immunosuppression Patient will be very susceptible to infection. Must use caution.
359
Pindolol
Non–selective beta antagonists with partial agonist effect
360
What Tx for prostate cancer?
Flutamide, Nilutamide (can cause visual problems) Bicalutamide [all nonsteroidal antiandrogens]. Also
Leuprolide and Goserelin
361
Varenicline (Chantix)
Direct acting, agonist for ACh
362
Ceftriaxone
3rd Gen Cephalosporins. Tx gonorrhea. BILE excretion
further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal).
363
What does a long postantibiotic effect allow?
A long PAE allows for infrequent dosing (once a day, for example)
364
What antibiotic has no cross reactivity with penicillin?
Aztreonam (Monobactams)
365
What is good for myasthenia gravis?
Indirect acting Cholinomimetic (Edrophonium for diagnosis, pyridostigmine for treatment and neostigmine)
366
What are the 3 properties of antibiotics that have significant influence?
Concentration-dependent killing, Time-dependent killing, post-antibioitc effect.
367
Vomiting and diarrhea are uncommon for which anticancer drug?
Docetaxel and Paclitaxel
368
What do adrenoceptor antagonists do (heart, and other effects)
They block vasoconstriction, lowering blood pressure. This can result in orthostatic hypotension and reflex tachycardia. They also cause pupil constriction, cause nasal stuffiness, and increase urine flow
369
What is the neurotransmitter and receptor of preganglionic parasympathetics? Long or short?
Long, Ach nicotinic
370
Pralidoxime
Reactivates AChE
371
What can produce a fever in younger patients?
Muscarinic blockers
372
What was developed as a mustard gas during WWI
Mechlorethamine
373
What can treat urinary urgency or bladder spasm?
Oxybutynin (Muscarinic blocker)
374
What happens when you activate Alpha 1 receptors?
Vasoconstriction in skin increases blood pressure, Iris dilator muscle dilates pupil, urine retention, slows GI tract (but contracts sphincters)
