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Pharm: Final Flashcards

1
Q

Antidote: Aspirin poisoning

A

IV NaHCO3

Hemodialysis

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2
Q

Antidote: Acetaminophen toxicitiy

A

N-acetylcysteine (increased glutathione)

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3
Q

Antidote: Amphetamine poisoning

A

Ammounium Cl (acidify the urine)
HTN: phentolamine, nitroprsuside
Tachycardia: Propranolol, Esmolol
Seizures: Benzos

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4
Q

Antidote: Anti-cholinergics

A

Physostigmine (NOT TCA)

Benzo/Anti-psychotic

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5
Q

Antidote: Beta-blocker

A

Glucagon (increased cAMP)

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6
Q

Antidote: CCB

A

Calcium, glucagon, epi

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7
Q

Antidote: TCA

A

Epi, NaHCO3 (not physostigmine)

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8
Q

Antidote: MAOI

A

Phentolamine, labetolol

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9
Q

Neuroleptic malignant syndrome vs. Serotonin syndrome

A

Neuroleptic – OD on anti-psychotic: FEVER (CPK, lead pipe rigidity, unstable vitals)
Serotonin: myoclonus, hyperreflexia

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10
Q

Antidote: Serotonin Syndrome

A

Cyproheptadine, benzo

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11
Q

Antidote: Neuroleptic malignant syndrome

A

Bromocriptine, Dantrolene

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12
Q

Antidote: Opioid

A

Naloxone, Nalmefine

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13
Q

Antidote: CO

A

RA, 100% O2, Hyperbaric O2

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14
Q

Antidote: ETOH acute intoxication

A

Thiamine, dextrose, electrolytes

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15
Q

Antidote: Methanol, ethylene glycol

A

EOTH, Fomepizole

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16
Q

Antidote: OP or Carbamate

A

Atropine, Pralidoxime

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17
Q

Antidote: Rodenticide (Warfarin)

A

Vitamin K, FFP

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18
Q

Antidote: Cyanide

A
  1. Amyl nitrate, Na nitrate

2. Thiosulfate

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19
Q

Antidote: Lead, Arsenic, Mercury

A

EDTA, succimer, dimercaprol

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20
Q

S/S Lead vs. Arsenic vs. Mercury

A

Lead: cognitive/neuro (wrist drop)
Arsenic: Rice water stool/rain drop keratosis
Mercury: Mad as a hatter

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21
Q

Antidote: Fe

A

Deferoxamine

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22
Q

Fatal withdrawal syndromes (3)

A

ETOH, Benzos, Barbs

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23
Q

FDA approved drugs for ETOH addiction “craving”

A
  1. Disulfram: aversion (aldehyde DH) (aversion)
  2. Naltrexone: opiod antagonist (Craving)
  3. Acamprosate: NMDA antagonist (relapse)
    (Not Topiramate)
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24
Q

Treatment for ETOH withdrawal

A
  1. LTM benzos: diazepam, chlordiazepoxide

2. Intermediate: Lorazepam, oxazepam (elderly or liver failure)

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25
Treatment for benzo & barb withdrawal
Diazepam
26
MOA of methylxanthines: caffeine, theophylline, theobromine
Block pre-synaptic adenosine receptors | Adenosine inhibits NE release
27
Treatment of cocaine dependence
SSRI
28
3 approved treatments for nicotine addiction
1. NRT therapy 2. Bupropion 3. Varenicline (partial agnoist at nicotine R)
29
S/S opioid withdrawal | Treatment of opioid intoxication & long term post-detox
* Dysphoria, lacrimation, rhinorhhea, yawning 1. Long-acting opioid agonist (methadone, bupenorphine) 2. Adrenergic agonist (Clonidine, lofexidine) Post-detox: Naltrexone
30
Therapeutic effects of dronabinol
* CB-1, brain; CB-2 immune cells Anorexia/AIDS N+V/Ca CTX
31
Pinpoint pupils in an agitated patient
PCP | * Parenteral Benzo
32
MDMA releases...
Serotonin
33
LSD "bad trips" treated with
Diazepam
34
Local anesthetics: AE bipivacaine
Cardiotoxic
35
Local anesthetics: AE prilocaine
MethHb (metabolite o-toludine)
36
Among the local anesthetics, who are the PABA derivatives (sulfa): amides or esters?
Esters
37
Short vs. Medium vs. LTM local anesthetics
Short: procaine, chlorprocaine Medium: lidocaine, mepivacaine, prilocaine Long: Tetracaine, Bupivacaine, Etiodocaine, Ropivacaine
38
Management of local anesthetic induced convulsions
O2, IV diazepam, Barbs, Succs
39
Echinacea
Colds
40
Ephedra
Spinal anesthesia
41
Garlic
Anti-cholesterol
42
Ginko/Ginsing
Dementia
43
Milk thistle
Hepatotoxicity
44
St. John's Wort
Depression
45
Saw Palmetto
BPH
46
CoQ
Parkinson's; statin-induced myopathy
47
Glucosamine
OA
48
Black cohosh
PMS
49
Kava
Relaxation
50
Difference between cationic and uncharged portion of a local anesthetic?
Cationic: Most active at the receptor Uncharged: Penetration of membrane
51
The 3 major constituents of a local anesthetic:
1. Lipophilic (Aromatic group) 2. Intermediate chain (Ester or Amide) 3. Ionizable group (Tertiary amine)
52
Spinal epinepherine alpha-2 receptor inhibits the release of: AE's
Substance P | AE: delayed wound healing, tissue edema, necrosis
53
Relationship between liposolubility and potency of a local anesthetic.
Proportional
54
To prevent CNS convulsions when using a local anesthetic...
Pre-medicate with benzo
55
The only local anesthetic that does not cause vasodilation
Cocaine
56
To manage CV AE's of local anesthetics
IVF, pressors
57
To manage convulsions AE's of local anesthetics
O2, diazepam, barbs, succys
58
The difference in metabolism of ester and amide local anesthetics
Esters: Tissue and plasma pseudocholinesterase Amides: P450
59
Major classes of NMJ antagonists and examples of each class
Benzylisoquinolones: Mivacurium, Cisatracurium, Atracurium, Tubocurarine Ammonio-steroids: PAncuronium, Rocuronium, Vocuronium
60
Major AE's of the benzylquinolones vs. the ammonio-steroid NMJ blockers
Benzyl: hypotension 2/2 histamine release; ganglionic blockade Ammonio: tachycardia and M2 blocker
61
The only benzylisoquinolone NMJ blocker that doesn't cause histamine release
Cisatracurium (because it forms less laudunosine metabolite) than does atracurium
62
The major benzylisoquinolone NMJ blocker that causes ganglionic blockade
Tubocurine
63
The major ammoniosteroid NMJ blocker that causes M2 blockade and tachycardia
Pancuronium
64
The 3 skeletal muscle relaxants whose levels must be modified for patients in renal failure
1. Cisatrcurium 2. Tubocurine 3. Pancuronium
65
How do you overcome the effects of the non-depolarizing blockers?
Neostigmine/Edrophonium | Also consider: atopine, glycopyrrolate to prevent bradycardia
66
What worries would you have with skeletal muscle relaxants for the following patients: Myasthenia gravis, advanced age, burns, UMN disease
MG: enhanced blockade Age: decreased clearance Burns/UMN: resistant to blockade 2/2 proliferation of extra-junctional receptors
67
How is atracurium broken down? Any concerns?
Broken down by hydrolysis; laudanosine metabolite can cause hypotension and seizures (Cisatracurium is a better alternative)
68
How is mivacurium broken down?
Butylcholinesterase (similar to succys)
69
Which ammoniosteroid has a rapid onset (similar to succys)
Rocuronium
70
3 important drug interactions that can enhance the effect of NM blockade
1. Inhaled anesthetics 2. Aminoglycosides 3. Tetracyclines
71
The major electrolyte disturbance that must be monitored while using succys is: * Thus, succys is contraindicated in patients with these conditions:
Hyperkalemia | * Malignant hyperthermia, skeletal myopathy, burn, polytrauma, UMN injury
72
What are some major AE's of the use of succys?
Bradycardia (prevent with atropine), histamine release, muscle pain, hyperkalemia, increased IOP, increased intragastric pressure
73
Malignant hyperthermia is treated with
Dantrolene
74
Acute spasmolytic agent
Cyclobenzaprine (strong anti-muscarinic); can cause sedation/confusion
75
Chronic skeletal muscle spasmolytics
1. Dantrolene (ryanodine R blocker) | 2. Botox: cerebral palsy
76
Skeletal muscle spasmolytic for cerebral palsy
Botox
77
CNS skeletal muscle spasmolytics
``` GABA-A: Diazepam GABA-B: Baclofen [works through Gi] GABA A+B: Progabide Increased GABA: Gabapentin Alpha-2 Ag: Tizanidine Glycine Decreased glutamate: Idioclamide, Rilozole ```
78
The 4 IV general anesthetics
1. Barbituates (thiopental, methohexital) 2. Propofol 3. Ketamine 4. Etomidate
79
How does methohexital terminate its action (IV general anesthetic)
Redistribution from the brain
80
Among the IV general anesthetics, which one increased ICP?
Ketamine
81
Which IV general anesthetic provides analgesia: Propofol, Ketamine, Etomidate
Ketamine
82
Which IV general anesthetic is an anti-emetic?
Propofol
83
Which IV general anesthetic blocks NMDA receptors and can cause "emergence" dissociative anesthesia?
Ketamine
84
Which IV general anesthetic is given to patients with increased CV risk? What is the major AE?
Etomidate (decreased steroidgenesis)
85
What are the major AE's of thipental and methogexital as general anesthetics?
Apnea, cough, chest wall spasm, laryngospasm, bronchospasm
86
Why might you consider using an anti-muscarinic, i.e. Scopalamine as an adjuvant to a general anesthetic?
Decreased salivation, decreased bronchial secretions, protect heart from bradycardia
87
Describe the neuroleptic-opioid combo. What agent is then used for anesthesia?
Neuroleptic: droperidol Opioid: fentanyl Anesthetic: N2O
88
AE halothane
Hepatitis
89
AE methoxyflurane
Nephrotoxicity
90
The inheritance pattern of malignant hyperthermia
AD
91
2 drugs that can cause malignant hyperthermia
Succys, Halothane
92
Neuroleptic means
Anti-psychotic
93
How does one test for malignant hyperthermia?
Caffeine-halothane test: muscle sample removed, measure contraction, add halothane
94
Which inhalational anesthetic can cause megaloblastic anemia?
N20: can cause a decrease in methionine synthase | * Think poorly ventilated dental suite
95
Which inhalational anesthetic increases ICP the least?
N2O | * Ketamine is the only IV that increases ICP
96
Which inhalational anesthetics are pungent and can thus induce bronchospasm?
Isoflurane, Desflurane
97
Which inhalational anesthetics decrease cardiac contractility and thus CO? Also, these can increase the sensitivity of myocardium to catecholamines, and thus induce ventricular arrhythmias.
Halothane, Enflurane
98
Which inhalational anesthetics are good to use in patients with impaired cardiac function?
Isoflurane, Desflurane, Sevoflurane
99
Which inhalational anesthetic can cause tonic-clonic seizures?
Enflurane
100
The sequence of events for GETA.
1. IV induction agent 2. Inhalational anesthetic 3. Analgesia 4. NM blocker
101
MAC is _________
Quantal dose response
102
The more soluble the inhalational anesthetic, the faster/slower onset?
Slower onset
103
MOA of inhalational anesthetics
+: GABA-A, glycine | -: Nicotinic
104
The faster the ventilation rate, the faster/slower dose of the inhaled anesthetic
Faster
105
Inhaled anesthetics increase/decrease brain perfusion and increase/decrease minute ventilation.
Increase brain perfusion | Decrease minute ventilation
106
AE Valproate
Hepatotoxicity (decreases P450)
107
AE Phenytoin
Diplopia, ataxia, gingival, hirsuitism, Zero-order kinetics
108
AE Carbamazepine
Aplastic anemia, rash
109
AE Vigabatrin
Decreased vision
110
Valproate in pregnancy can cause
NTD (anti-folate)
111
Anti-epilepsy drugs in pregnancy can cause...
Newborn hemorrhagic disease
112
Treatment: Absence seizure
Ethosuximide
113
Treatment myoclonic seizure
Valproate (Topiramiate, Leve)
114
Treatment for atonic (generally refractory)
Valproate, Lamotrigine
115
Treatment infantile spasm (non-febrile)
Corticotropin, GC, Vigabatrin
116
Treatment febrile convulsion > 15 minutes
IV or PR diazepam
117
Treatment of breakthrough seizure
PR diazepam
118
Treatment of drug-induced seizure
Diazepam/Loraezepam, Phenobarbital
119
Formulary for status epilepticus
1. Lorazepam 2. Phenytoin 3. Phenobarbital 4. GETA
120
Major AE of anti-epileptic drug OD
Respiratory depression
121
Anti-epileptic inducers
Phenytoin, Phenobarbital, Carbamazepine
122
Tiagabin vs. Vigabatrin
Tia: prevents re-uptake of GABA Viga: Prevents degradation of GABA
123
Epilepsy: Na-channel blocker
Phenytoin, Carbamazepine, Lamotrigine, Zonisamide | Phenobarbital, Valproate, Topiramate
124
Epilepsy: Ca-channel blocker (t-type)
Ethosuximide, Valproate
125
Synaptic vesicle GP2 anti-epilepsy drug (Ca+)
Levetiracetam
126
3 major CI of dopamine precursor therapy for Parkinson's
1. Anti-psychotics 2. Arrhythmias 3. Acute glaucoma
127
Drug used to treat end-of dose akinesia of levodopa
Apomorphine
128
AE of apomorphine
Emetogenic, QT prolongation
129
AE Bromocriptine
Pulmonary infiltrates, fibrosis, megaloblastic, digital vasospasm
130
AE Pramipexole, Ropinirole
Somnelesnce (better for younger patients)
131
How is rotigotine applied (anti-Parkinson's)
Transdermal
132
MAOI's for Parkinson's
Deprenyl: inhibit COMTb | Rasagiline inhibit dopa dc; activation COMT
133
AE Tolcapone
Fulminant hepatotoxicity
134
AE Amantadine
Livedo reticularis; seizure/CHF = CI
135
Major anti-muscarinic used for Parkinson's treatment | Major AE?
Benztropine (can cause hallucinations, delirum)
136
COMT inhibitors for Parkinson's (Central & Peripheral)
Central: Tolcapone Peripheral: Entacopone, Tolcapone
137
Used for acute treatment of GAD or as an adjunct with an SSRI being titrated (then tapered)
Benzos, i.e. alprazolam
138
Second line therapy for anxiety disorders (After SSRI + benzo)
Buspirone
139
Treatment of OCD (aside from SSRI's)
Clomipramine
140
SSRI treatment of choice for PTSD
Sertraline, Paroxetine
141
STM, Intermediate and LTM Benzodiazepines
STM: Triazolam, Oxazepam Intermediate: Alprazolam, Lorazepram, Temazepam LTM: Diazepam, Flurazepam
142
MOA benzodiazepines
Bind to GABA-A receptors in CNS (which is a Chloride channel) and hence decreases firing of neurons
143
Benzodiazepine antagonist
Flumazenil | * Reveres the CNS effects of benzodiazepines; can hasten recovery following use in anesthesia
144
Benzo: Anticonvulsant
Clonazepam
145
Benzo: Muscle relaxant (MS + Cerebral palsy)
Diazepam
146
Benzo: #1 drug for status epilepticus
Lorazepam
147
Benzo: Drug withdrawal (including ETOH)
Diazepam, Oxaxepam
148
T/F Benzodiazepines can cause paradoxical anxiety, irritibility, rage, depression and suicide
True
149
Benzodiazepine (BZD) vs. GABA | Which subunits are activated?
GABA: Alpha, beta Benzo: Alpha, gamma
150
Benzo's used for difficulty initiating sleep vs. maintaining sleep
Initiate: Triazolam, Temazepam Maintain: Flurazepam
151
Why are barbiturates inferior to benzos? What is the major lethal complication?
Because they also block glutamate and Na | - Respiratory depression; decreased activity of central Co2 chemoreceptor
152
These sedative-hypnotics are contraindicated in patients with porphyria
Barbituates
153
T/F Barbs are inducers
True
154
Which sedative-hypnotic can be used to treat hyperbilirubinemia and/or kernicterus in a child
N-phenobarbital
155
Which sedative-hypnotic is a good choice because of its lack of interaction with alcohol?
Buspirone (Partial 5-HT1 Ag)
156
Who are the non-benzodiazepine benzodiazepine receptor agonist?
Zolpidem, Zaleplon, Eszopiclone
157
Among the "z drugs" which one has the shortest t-1/2 and which one has the longest t-1/2
Shortest: Zolpidiem Longest: Eszopiclone
158
Ambien is which durg?
Zolpidiem
159
Which anti-histamine can be used as a sedative/hypnotic?
Hydroyzine
160
The MAOI's for depression include:
Tranylcypromine Isocarboxazid Phenelzine Selegiline
161
MAOI's are reversible/irreversible
Irreversible
162
Describe the underlying basis for the cheese reaction.
Tyramine is typically inactivated by MAO; hence using OTC cold medicines (i.e. pseudoephedrine) can lead to the cheese reaction
163
Who are the TCA's? Which ones have better AE profiles? Which one has the worst sexual side effects?
``` Amitryptiline *sex Clomipramine *Desipramine *Nortryptiline Imipramine ```
164
Who are the tetracyclic antidepressants? Do they block net or sert preferentially?
Amoxaprine, Maprotiline (net > sert)
165
Aside from blocking SERT & NET, what receptors iare blocked by TCA's?
Alpha-adrenergic, muscarinic, histamine, 5-HT
166
Who are the CYP inhibitors among the SSRI's?
Fluoxetine, Paroxetine, Fluvoxetine (all CYP) | Non-inhibitors: Sertraline, Escitopram, Citalopram
167
Drug of choice for bullemia
Fluoxetine
168
Drug of choice for PMDD
Fluoxetine, Sertraline
169
Which SSRI causes the most amount of weight gain?
Paroxetine
170
OD of SSRI can cause...
Seizure
171
Who are the SNRI's? What is the difference between them?
Venlafaxine: SERT > NE Duloxetine: SERT = NE
172
Which anti-depressant drugs are approved for the treatment of diabetic neuropathy and fibromyalgia?
Duloxetine
173
MOA of bupropion
NE, Dopamine | * OD = seizure
174
Who are the SARI's? Major AE's?
Nefazodone: hepatotoxicity Trazodone: priapism
175
What is the MOA of the SARI's?
Block 5-HT reuptake and also antagonize the 5-HT2 receptor (which is responsible for a lot of AE's)
176
Why is Trazodone used as a hypnotic?
Because it preferentially blocks alpha-1 and H1 receptors
177
Which anti-depressant is used that antagonizes central alpha-2 presynaptic receptors, which also promotes the release of NE and dopamine and antagonizes 5-HT2, 3 receptors?
Mirtazapine
178
What is the major AE of Mirtazapine?
Weight gain
179
Which atypical anti-psychotics can be used for the treatment of depression?
Quetiapine, Ariprazole, Olanzapine
180
What is the MOA of Lithium?
Inositol depletion; hence decreased central adrenergic activity; no synthesis of PIP2
181
Can Lithium be used in pregnancy?
No
182
What drugs can be used for treatment of bipolar instead of Lithium?
Anti-epileptics: Valproate, Carbamazepine, Lamotrigine | Atypical antipsychotics: Olanzapine, Ariprazole, Quetipaine, Risperidone, Ziprasidone
183
MOA of classical anti-psychotics.
D2 blockers in the mesolimbic pathway
184
High potency classical anti-psychotics vs. low potency.
High potency: Haloperidol, Fluphenazine | Low: Thioridazine, Chlorpromazine
185
Who are the atypical antipsychotics?
Clozapine, Risperidone, Olanzapine, Quetiapine, Paliperidone, Ariprazole, Ziprasidone
186
Which atypical antipsychotic can cause agranulocytosis?
Clozapine
187
Which atypical antipsychotic has the least EPR AE's?
Clozapine
188
Which atypical antipsychotic can be used to treat Autism?
Risperidone
189
Which drugs can be used to treat neuroleptic malignant syndrome?
Dantrolene, bromocriptine
190
What is the way to treat tardive dyskinesia 2/2 atypical anti-psychotic use?
Discontinue drug, eliminate anti-cholinergics, add diazepam and swithch to clozapine
191
Which 2 anti-psychotics can cause seizures?
Chlorpromazine, | Clozapine
192
Are anti-muscarinics beneficial to deal with the AE's of anti-psychotics?
Yes
193
Can anti-psychotics cause hyperprolactinemia?
Yes
194
The atypical anti-psychotics are dual antagonists at:
5-HT2A, D2
195
Neuroleptic anesthesia is achieved with...
Droperidol, fentantl
196
Can clozapine be used in pregnancy
Yes (can cause hyperglycemia/weight gain)
197
3 drugs and 1 surgical option used for the treatment of hypercalcemia
1. Furosemide (with saline) 2. Bisphosphonates (-dronate) 3. Calcitonin (4. ) Parathyroidectomy
198
Patients with ESRD often have hyperphosphatemia. Which drug can be used as a phosphate binder in the guy?
Sevelamer
199
Drugs which can cause osteoporosis
1. CS 2. Lithium 3. ETOH 4. Heparin 5. Anastrazole
200
Drugs which can cause osteomalacia
1. Phenytoin | 2. Etidronate
201
Drugs which decrease PO4 excretion
Thiazides
202
Drugs which can cause hypomagnesiemia
PPI, AG, Chronic diarrhea, diuretics, ETOH
203
Treatment of malignant hypercalcemia
-dronate
204
AE of bisphosphonates (-dronates)
Erosive esophagitis | Osteomalacia, osteonecrosis, jaw fracture
205
Treatment of Paget's disease
Etidronate
206
RANKL inhibitor
Denosumab
207
AE of Denosumab
Reactivation of latent TB
208
Continuous administration vs. Pulsatile administration of Teriparatide
Pulsatile: new bone formation Continuous: bone resorption
209
Drug which increases Calcium sensing receptors (particularly useful in secondary hyperparathyroidism)
Cincalcet
210
Fluoride can be used to promote new bone synthesis. What is the way that this bone is described.
Dense, but brittle
211
Gallium nitrate MOA
Decreases bone resorption
212
Plicamycin, which is a cytotoxic anti-cancer agent can be used... AE's?
Cancer-related hypercalciuria | AE: TBO-penia, renal/hepatotoxicity
213
To counteract the effect of MgSO4 overdose, one can use...
Calcium gluconate
214
A topical treatment for psoriasis
Calcipotriene
215
D2/D3 | Ergo or Chole
Ergo: D2 Chole: D3
216
Sulfonurea drugs (first generation); describe half-lives
1. Tolbutamide (short half life) | 2. Chlorpropamide (long half life)
217
Sulfonurea drugs (second generation)
1. Glyburide (high incidence of hypoglycemia) 2. Glipizide 4. Glimepiride (can be dosed once daily)
218
Meglitinides
Repaglinide | Nateglinide: lower risk of hypoglycemia
219
AE's chlorpropamide
Hyperemic flush with ETOH, SIADH
220
What is the major benefit of the Meglitinides over the Sulfonurea drugs
Can be used for patients with sulfa allergy
221
What is the only biguanide? What is its MOA? What is the life threatening AE?
Metformin; activation AMP kinase; inhibits GNG Major AE: lactic acidosis, decreased B12 absorption CI: renal/hepatic/hypoxia/ETOH
222
What is the 3rd class of oral hypoglycemics?
TZD's: Pio & Ros-glitazone | * Decrease insulin resistance; agonist of PPAR-gamma; promotes insulin uptake
223
AE of TZD's
Fluid retention, weight gain, exacerbate CHF, liver function monitored
224
What is the 4th class of oral hypoglycemics? Major AE?
Alpha glucosidase inhibitors: Acarbose, Miglitolo | AE: LFT's monitor
225
What are the non-oral hypoglycemic agents?
1. Incretin analogue: Exenatide 2. Inihibtor of DPP-IV: Sitagliptin 3. Amylin analogue: Pramlintide 4. Bile acid sequestrant: Colesevelam
226
Major CI for Exenatide
Gastroparesis
227
Major AE Sitagliptin
Pancreatitis, hypersensitivity
228
T4/T3 | Levo vs. Liothyroxine
T4 = Levo * Treatment of Cretinism AE: hyperthyroidism, CYP induction
229
AE's propythiouracil and methimazole
PTU: Rash, anemia, liver toxicity, vasculitis Methimazole: teratogenic
230
Drugs that can be used to treat thyroid storm
Beta blocker, PTU, IV NaI, GC, amiodarone, radiocontrast
231
Drugs which prevent Na-I symport
Perchlorate, thiocyanate, pertechnetate
232
Drugs that can provoke HYPOthyroidism
Amiodarone, IFN, IL-2, Lithium, Goitrogens (cabbage, thiocyanate, cassava)
233
Drug used for intraoperative thyroid storm
Esmolol
234
AE Iodine & Iodine salts
Anaphylaxis, parotid/maxillary enlargement, brassy teeth
235
STM CS
All but triamcinolone & Dexamethosone
236
Intermediate CS
Triamcinolone
237
LTM CS
Dexamethosone
238
Topical CS
All but prednisone
239
Aerosolized CS
Triamcinolone, Beclomethasone
240
IM or IM/IV CS
IM: Triamcinolone | IM/IV: All but beclomethasone
241
PO CS
All
242
SST Analogue
Octreatide
243
GH Analogues (2)
Somatropin, Somatrem
244
Anti GH
Pegvisomant
245
ACTH Analogues (2)
Corticotropin, Cosyntropin
246
FSH/LH Analogues (4)
Menotropins, (Uro)Follitropin, Choriogonadotropin
247
GnRH Analogues (4)
Gonadorelin, Goserelin, Leuprolide, Nafarelin
248
Anti GnRH (2)
Cetrorelix, Ganirelix
249
Anti ADH
Conivaptan
250
Anti Oxytocin
Atosiban
251
Positive and Negative aldosterone analogues
+: Fludrocortisone | -: Spironolactone
252
Major adrenal hormone synthesis inhibitors (3)
Ketoconazole: Adrenal and gonadal synthesis inhibitors Aminoglutethamide: cholesterol --> pregnenolone Metyrapone: 11-hydroxylation inhibitor (Cushings/preg)
253
Negative GC & progesterone analogue
Mifepristone (GC + progesterone)
254
Cortisol's effect on PMN's vs Lymphocytes
Increased PMN, Decreased lymphocytes
255
Cortisol increases/decreased ICP
Increases
256
AE spironolactone
Hyperkalemia, arrhythmias, gynecomastia, GIT/derm
257
Indications for spironolactone
Hyperaldosteronism, hirsuitism (Female = androgen antag)
258
Indications for mifepristone
Inoperable ectopic ACTH production tumor; adrenal cancer, RU486
259
Which CS can be used for cerebral edema?
Dexamethosone
260
Which CS can be used to stimulate fetal lungs
Dexamethosone
261
Acute adrenal insufficiency is treated with...
IV hydrocortisone and electrolyte repletion
262
Treatment of idiopathic orthostatic hypotension
Fludrocortisone
263
AE: Somatotropin and Somatrem in adults and children
Adults: Connective tissue, edema, myalgia Children: Scoliosis, hypothyroid, IC htn, Otitis Media (Turner's syndrome), DM, pancreatitis, gynecomastia
264
AE Pegvisomant
GH-R antagonist | * Gallstones, bradycardia, decreased B12
265
Who has a longer half life: bromocriptine or cabergoline
Cabergoline
266
HBA1C target
< 7%
267
FPG target
< 130
268
Post-prandial glucose target
< 180
269
Major AE of alpha-glucosidase inhibitors
Flatulence, diarrhea
270
Rapid, Short, Intermediate, Long acting insulin
Rapid: Lispro, Aspart, Glusine Short: Regular Intermediate: NPH Long: Glargine, Detemir
271
Which insulin preps are given just before a meal
Rapid-acting
272
Differentiate between continuous and pulsatile GnRH
Pulsitile: stimulate FSH, LH Continuous: hypogonadism (with a flare at 7 days)
273
AE of high dose cabergoline
Peripheral vasospasm, pulmonary infiltrates
274
Continuous administration of Goserelin, Leuprolide, Nafarelin can be used to treat: (M & F)
F: endometriosis, fibroids (with Fe) M: PRCA, precocious puberty, BRCA, PCOD
275
AE Goserelin, Leuprolide, Nafarelin
F: Menapause, Depression, Ovarian cysts, Osteoporosis M: Hot flush, edema, gynecomastia
276
Why might you use cetrorelix or ganirelix?
To prevent LH surge associated with ovarian hyperstimulation
277
V1R vs V2R
V1: vasoconstriction, IP3 V2: renal, cAMP
278
Treatment of infantile spasm
Cosyntropin (West syndrome)
279
AE oxytocin
Excessive contraction, ADH activation, hypotension
280
Which drug is used (not in the US) to prevent pre-term labor?
Atosiban
281
Desmopressin acts primarily at which receptors?
V2
282
Indications vasopressin
Esophageal varices, colonic diverticulitis
283
Indications desmopressin
Coagulopathy associated with hemophilia A, VW disease
284
OD of desmopressin can cause
Hyponatremia and seizure
285
Conivaptan is used to treat
Hyponatremia
286
The + progesterone agent with anti-androgen properties
Drospirinone (acne treatment), Norgestimate
287
Anti-progesterone drug that inhibits P450 and can be used to treat endometriosis and FCC breast
Danazol
288
AE Danazol
Abnormal LFT's and masculinizing effects
289
Full estrogen receptor antagonist
Fulvestrant
290
What is special about clomiphene when used to treat infertility?
It is an estrogen antagonist which prevents negative feedback inhibition
291
Aromatase inhibitors (steroidal and non-steroidal)
S: Exemestane NS: Rev: anastrazole, Letrozole
292
Which progesterone Ag can be used to treat acne?
Drospirinone
293
Which are the positive androgen agents?
Oxandrolone, Stanozol, Fluoxymestrone, Oxymetholone, Nandrolone
294
The androgen receptor antagonists
Flutamide, nulutamide, bicalutamide (can be use with leuprolide to prevent a PRCA flare)
295
5-alpha reductase inhibitor
Finasteride
296
What hormonal agent can be used for MTF transition (transgender)?
Cyproterone (androgen synthesis inhibitor)

Term 5 (9 decks)

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