Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacotheraputics > Pharm Final > Flashcards

Pharm Final Flashcards

1
Q

typical dosage of inhaled glucocortocoids for asthma treatment

A

200-400 mcg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the risk of treatment with amphotericin B

A

they are toxic, cause fever, chills, hypotension, anemia, thrombophlebitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

EC100

A

the concentration at which Emax is achieved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

antistaph penicillin

what are they used against

A

methicilin

cloxacin

nafcillin

oxacillin

staph infections except MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

G+ cocci to know

A

staph, strep, entero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the target INR for warfarin

A

2-3.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

goals of menopausal hormone support

A

reduce/prevent hot flashes

improve sleep to improve cognition and reduce depression

prevent bone loss

maintain healt of the GI system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

aminopenicillins (ampicillin, amoxicilin) are used on what

A

Otitis media

strep

UTI (where ther isk of resistant e coli is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the action of heparin

A

enhances the action of antithrombin III (inhibits activation of factor X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

strategy for dosing estrogen for HRT pills

A

start with a moderate dose that can be titrated up or down based on relief of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

typical methods of adminstration for corticosteroids

A

inhaled aerosol (most common)

oral or parenteral (emergency situation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

issues with fourth generation progestin contraception

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the method of action for IUDs

A

inflammatory response that blocks the passage of sperm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

possible etiology of COPD

A

¤Cigarette smoking (99%)

¤Other toxins (such as coal dust, silica)

¤Genetic (Cystic fibrosis, A-1antiproteinase (anti-trypsinase) deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F aminoglycosides are absorbed well in oral form

A

false, they are for parenteral use only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

amphotericin B is significantly effective against what bugs

A

Candida,

Histoplasma,

Cryptococcus,

Coccidioides,

Blastomyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

isoniaizd is bacteriostatic or cidal

A

both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

special contraindications for tetracycline

A

pregnancy and children under 9 due to dental enamal dysplasia and discoloration, growth inhibition, bone deformities

photosensitive, so wear sin screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dietary strategies to combat BPH

A

decreased fatty food intake

saw palmetto

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the prognosis of avtive TB

A

100% cure rate if the patient is compliant and the strain isnt resistant

without treatment only 35% of patients will live beyond 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what percent of TB is resistant to all 1st line drugs

A

10-15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

anti hep toxicity lamivudine

adefovir

entecavir

A

usually wel tolerated

renal toxic at high dose

renal toxic at usualy doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

describe in vitro immune enhancement

A

in cancers with a specific antigen, lymphocytes can be cultured with that antigen and reinfused to target those cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how long does it take for warfarin to have an effect

how should it be monitored

A

8-12 hours with no loading dose

prothrombin time ratio (INR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

at what point in using estrogen contraceptives is the risk of venous thrombosis minimal

A

2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

five classes of HIV drugs

A
  • I. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors
  • II. Nonnucleoside RT Inhibitors (“NNRTIs”)
  • III. Protease Inhibitors
  • IV. Fusion inhibitors
  • V. Integrase inhibitor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

folate deficiency is caused by what

A

diet (↓ fruits and veg)

↓absorption (sprue, drugs)

↑increased need (pregnancy, hemolytic anemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

T/F carbapenems are not cross reactive with penicillin/ceph allergies

A

false, they can be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

differentiate allergic asthma from idiosyncratic

A

allgeric asthma often has a personal of FHx of allergic disease and commonly present at an early age

idiosyncratic has no Hx, negative skin tests, normal serum IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

action of bezoyl peroxide for acne

what is it tpically paired with

A

opening skin pores with some intrinsic antibiotic effect

clindamycin or erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

T/F a culture needed to treat a UTI

A

false, culture is useful but you can start treatment without it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

cautionary statements of long acting beta2’s

A

not effective for acute attacks

15% of patients will not respond as predicted

increased mortality if used as the sole treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the advantage of arixta over lovenox

A

daily dosing

better at DVT prevention with equal prevention of thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is the bioavailibilty (f) of IV drugs

oral

how is this determined

A

100%

1-f

determined by comparing the AUC of oral to iv administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

cell wall active drugs are generally _____

protein synthesis inhibitors are usually _____

A

bacteriocidal

bacteriostatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what type of azole has the least impact one CYP

other benefits

A

fluconazole

good CNS penetration for fungal menigitis

Oral or IV

single dose treatment for vaginitis

low risk for hepatotoaxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

when can a patient be switched from lovenox to warfarin

A

INR > 2 for two consecutive days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what leukotriene is 1000x more potent than histamine

A

LLTD4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

compliance issues with iron supplements

A

GI upset very common

black stools

might need a creative dosing schedule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

why is dietary deficiency of vitamin B 12 rare

A

small daily needs with large stores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

common methods of estrogen replacement

A

estradiol (tablets, patch, spray)

conjugated estrogens

+ progesins (combipatch, prempro, fem HRT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

other than isoniazide and rifampin, what types of drugs are used against TB

A

fluoroquinolones, typically moxifloxacin and gatifloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

clinical pharmacokinetics

A

the application of PK princiles to the management of drug therapy in an individual patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

four beta lactam ABx

A

´Penicillins

´Cephalosporins

´Carbapenems

´Monobactams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

theraputic drug monitoring assumes what?

A

that decreasing the amount of a drug in the blood will decrease the amount at the receptor site and therefore decrease the effect of the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

two good glucocortcoid inhalers that have high compliance

A

¤Fluticasone (Flovent) or budesonide (Plumicort)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

types of emergency asthma therapy

A

1st line: beta2 inhlaers

subQ epi is useful

corticosteroid IV or oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

five determinants of distribution

A

chemical polarity

affinty for transport proteins

binding to tissue components or proteins

binding to blood components

volume of disstribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

typical drugs for UTI

A

bactrim

nitrofurantonin

2nd gen cephalosporins

amoxicilin

fluoroquinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what accelerates the action of antithrombin III

A

heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

why are most fixed dose/time drugs administered less than 5 half lives

A

so exponential elimination can’t eliminate all the drug so it will accumulate on the next dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

4th genetation cephalosporin to know

A

cefepime (esp against pseudomonas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

advantages of 5-alpha reductase inhibitors

A

treats BPH and male pattern baldness

can also lower prostate cancer risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

side effects of thiazide drugs

A

HYPOKALEMIA

postural hypotension

change in glucose tolerance

hypercalcemia, uricemia

hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

dapsone is useful against leprosy and what

adverse effects

A

pneumocystis

hemolysis
peripheral nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

amoxicillin with clavulanic acid = _____

ticarcillin + clavulanic acid = ____

A

augmentin

timentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what is the function of mineralocorticoid receptor antagonists

A

blocks the effect of aldosterone, preventing retention of NA and water, prevents excretetion of K and H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

duration and utility of long acting beta2’s

A

duration: 12 hours
utility: preventing recurrent acute attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what is the use of PD-1 blockade in cancer patients

A

allow cytotoxic t cells to recognize cancer cells and kil them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Cmin

A

the minimum plasma concentration that a drug achieves in a tested area after the drug has been adminstered and prior to the adminstration of a subsequent does

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

four factors that can alter drug absorption

A

sugery, food, drugs, disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

notable drug in lincomycin class

A

clindamyvcin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

T/F doxycycline is not affected by renal disease

A

true it is almost entirely metabolized in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

how does contraception block ovulation

what drugs use this method

A

suppression of FSH

steroid contraceptives, GnRH analogs (lupron)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

theraputic index

A

the range of doses at which a medication was effective in clinical trials for a median of participants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

describe the chemical process of a clot

A

fibrinogen is convered to thrombin by prothombin and then is converted to fibrin

plasmin starts to break the clot down into d-dimer and spllit fiborin products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is action of coumadin drugs

why is it still used today

A

interferes with the action of Vitamin K in clot formation

cheap, welll understood, reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

inpt treatment of prostatitis

out patient

A

IV ampicillina and aminoglycoside (gent)

cipro or other fluoroquinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

bioavailability (f)

A

the fraction of an adminstered dose of unchanged drugs that reaches the systemic circulation that characterizes the extent of absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

sulfonamides is a generic term for what

A

PABA analogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

typical pathogens for UTI

A

80-85% come from coliforms

15-20% from strep or enterococcus

hematogenous seeding is rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

reversal agents for fibrinolytics (streptokinase)

A

aminocaproic acid (amicar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

adverse effects associated with cephalosporin

A

allergic cross reactive with penicillin (3-5%)

1-2% allergic reaction with no pen allergy

can also cause bleeding due to anti vitamine K action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

causes of respiratory acidosis

A

respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

hitchhiker mutation

A

mutations found in cancerous cells that don’t necessarily contribute to the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

mortality related to estrogen use

A

MI

venous thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what is responsible to non-linear kinetics

A

phase I CYP enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

two primary systemic antifungal drugs

A
  • Amphotericin B (Amphotec, AmBisome)
  • Fluconazole (Diflucan)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

indications for the use of carbonic anhydrase inhibitors

A

open angle glaucoma

epilepsy

acute mountain sickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

contraindications for thrombolytics

A

<10days post op

serious GI bleed

HTN (diastolic >110)

pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

concentration at steady state for continuous infusion is proportional to what

A

the rate of infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

advantages of carbapenems

adverse effects

A

broad spectrum

expensive, nausea, diarrhea, can cause sz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

T/F it is possible to take OC continuously without time off for menstruation

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

two good glucocortcoid inhalers that have high compliance

A

¤Fluticasone (Flovent) or budesonide (Plumicort)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

choices for long acting reversible contraception (LARC)

A

injectable progestins

implantable progestins

IUDs

injectable GnRH analogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

two types of anti-inflammatory agents for the skin

A

topical corticosteroids and tar compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what a challenges are found with women over 35 and contraceptive use

A

they never want to quit, but if they are smoking or have HTN, DM, etc they need to stop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

types of emergency asthma therapy

A

1st line: beta2 inhlaers

subQ epi is useful

corticosteroid IV or oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

facts about voriconazole

A
  • Newer azole (trazole) antifungal agent
  • Indications:Candida septicemia, Invasive aspergillosis
  • Side effects:

Visual changes (blurred vision, increased light sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

risks of unopposed estrogen

how to fix this

A

endometrial hyperplasia and carcinoma

if there is a uterus you must add progestin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

vancomycin toxicity

A

´Nephrotoxicity

´Ototoxicity

´Flushing due to histamine release

´“Red Man Syndrome”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

why do 1st generation anti-histamines cause drowsiness

A

they can cross the blood brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

uses of leukotriene inhibitors in asthma treatment

A

lowered glucorticoid dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

pros and cons of chloramphenicol

A

excellent G+/G- coverage

causes bone marrow supression, neonatal toxicity (Gray baby syndrome), drug interaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what do we refer to as “latent TB”

A

TB in 90-95% of peole that is kept in check by the immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

what is the advange to factor X inhibitors in anticoagulation

what are the drawbacks

A

oral, no monitoring, no diet restriction

expensive, not easily reverible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

what is the action of alpha adrenergic agonists in treatment of allergic rhinitis

A

vasoconstriction to reduce hyperemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

how can cancer cells develop resistance to treatment

what can be done to prevent this

A

genetic mutations continue after malignant transformation

use the correct amount of the correct drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

other uses of quinolones

A
  • Gonorrhea (ciprofloxacin, ofloxacin)
  • Mycoplasma, ureaplasma, chlamydia
  • Legionella
  • Some mycobacteria (TB, avium)
  • Anaerobes (Avelox, Trovan)
  • Anthrax prophylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

what is the action of alkylating agents

three examples

what are three ADRs

A

damages the DNA in dividing cells

cyclophosphamide, ifosfamide

nausea, germ cell destructon, bone marrow suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

effect of beta-2 agonists

adverse drug reactions

A

bronchdilation

hyperglycema, tachycardia, poss HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

natural anticoagulants

A

antithrombin III

protein s and c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

what is 5-alpha reductase

A

the enzyme that converts T to DHT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

are aminocylcosides bacteriostatic or cidal

A

cidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

should HRT be used for every

A

no, focus on those with significant hot flashes for 3-5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

what type of autonomic receptor is found in the bladder sphincter

A

alpha receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

action of microtubule inhibitors

ADRs

A

interrupts mitotic spindle

bone marrow suppression, hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

T/F genetic backgroun of isoniazid can lead to slow of fast clearance

A

treu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

two examples of muscarinic receptor blockers used in asthma treatment

action

A

ipratropium, tiotrpoium

helps relieve bronchospasm, reduces airway secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

what is the goal of a bacteriocidal drug

A

to allow the immune system to catch up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

common uses for tyrosine kinase inhibitors

ADRs

A

leukemia, lung cancer, renal cell carcinoma

drug interactions, bone marrow suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

in drugs with first order elimination time required to reach concentration at steady state is dependent on what

A

half life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

three types of nasal corticosteroids

A

¨Beclomethasone (Beconase, Vancenase)

¨Fluticasone (Flonase)

¨Flunisolide (Nasalide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

multistep theory of oncogensis

A

there must be an activated oncogene and a deactivated or overwhelmed tumor suppressor gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

symptoms of acute prostatitis

A

—Fever is common

—Perineal, sacral, suprapubic pain/discomfort

—Irritative voiding symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

what is the most powerful antipseudomonal penicillin

A

piperacillin

used in intrabdominal infections but is susceptible to beta lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

toxicity related to aldosterone antagonsists

A

hyperkalemia

antiandrogenic effects (gynecomastia, ↓hirsuitism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

how do you decide to use bacteriostatic vs cidal

A

healthy patients can use either, but immunocompromised patients bacteriocidal agents should be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

what determines the pharmacodynamic effect of a drug

A

the relationship between drug concentration and at the site of action and the effect

time course and intensity of theraputic and adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

four types of fungal pathology

A

superifical infection

pulmonary infections

CNS infections

systemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

pharmacodynamics

A

the study of what the drug does to the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

driver mutations

A

oncogenic mutations that drive the cancer process, tend to be the same in the same types of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

why is vancomysin important

A

because it works for most bacteria and is controlled to prevent resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

asthma

A

chronic pulmonary disorder characterized by episodic reversible airflow obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

what will a superfincetion of C diff cause

A

pseudomembranous colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

nonbeta lactams

A

´Vancomycin (Vancocin)

´Bacitracin (ointment, Neosporin, Polysporin)

´Fosfomycin (Monurol): UTI treatment

´Cycloserine (Seromycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

what is the advantage of Alpha 1 blockers (tamsulosin, silodosin) over alpha 1 and 2 blockers (doxazosin, terazosin)

A

alpha 1 blockers will only work on the prostate and bladder

alpha 1 and 2 wil work on vascular smooth muscle as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

systemic antifungals new to market, only IV use, inhibits fungal cell walls

A

echinocandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

three types of non-cyclic OCs

A

seasonale (7 placebos that give 3 periods)

seasonique (only one period at the end)

Lybrel (no periods, continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

how does gonadotropin based male contraception work

what is the failure rate

A

testosterone enanthate/undeconoate injections to suppress FSH and cause azosperima or oligospermia

2-3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

side effects related to estrogen oral contraceptives

progestin

A

breast tenderness, nausea, fluid retention

dysphoria, breast tenderness, oily skin, fat gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

describe VEGF therayo for cancer therapy

A

inhibits the BRAF gene, improves outcomes in melanoma, colon, lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

most common genetic cause of hypercoagulability

what does it do

A

abnormal factor V (Leiden)

factor V Leiden cannot be inactivated by protein C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

T/F many drugs have pH dependant absorption

A

false, many are altered by pH but not many are absorbed into the blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

T/F abx are always needed for cystitis and pyelonephritis

A

false, they are usually necessary for cystitis but always for pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

two main types of asthma

which is more prevalent

A

allergic and idosyncratic

allergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

useful combination in the treatment of allergic rhinitis

A

¨Inhaled glucocorticoids as main preventative

¨Cromolyn/nedocromil added if needed to keep steroid dose low

¨Inhaled antihistamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

how do phase II enzymes create polor compounds

A

add a functional group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

where is most Na reaborbed in euvolemia

expanded volume

dehydration

A

proximal tubule

less in the proximal tubule, increases Na excretion to urine

significant increase in Na reabsorption in PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

outpatient devices for inhalation treatment of asthma

A

metered dose inhalers

dry powder inhaler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

methods for reducing bronchospasm assocaited with asthma

A

relax bronchial smooth muscle by stimulating Beta2 sympathetic receptors

block parasympathetic muscarinic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

concerns related to injectable progestins

A

CV/lipid concerns

probably bone loss (Low E2)

female sexual dysfunction from low androgens and dysphoria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

common respiratory viruses

A

FLu A and B

RSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

DEA drug schedule class III

A

less abuse potential than I and II, all have accepted medical uses (codeine, steroids, marinol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

parasite drug to know

A

metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

causes of metabolic acidosis

A

renal failure

ketoacidosis

ingestion of acid (aspirin overdose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

ADRs with tazarotene

A

<20% of body surface is treated

can be teratogenic

also photosensitizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

what challenges are there in prescribing OCs to women under 30

A

there are compliance issues due to side effects

the side effects don’t outweigh the risk of getting pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

how is lupron used in chemo

A

down regulation of FSH receptors produces low androgen levesl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Anti-IgE Monoclonal Antibody treatment for asthma

why is it saved for difficult cases

A

¨Omalizumab (Xolair)

it is costly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

factors affecting prognosis of cancer

A

cancer type

differentiation

staging at Dx

age

quality of medical care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

G+ bacilli

A

bacilus anthracis, clostridium diptheria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

LMW heparin preparations

A

enoxaprin (lovenox)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

significant differences between chronic and acute prostatitis

A

chronic prostatitis is more common in ment between 40-60

no fever with chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

five examples of times when theraputic drug monitoring is not needed

A

clinical outcome is unrelated to dose or plasma concentration

dosage does not need to individual

the pharmacological effects can be clinically quantified

the relationship between concentration and effect remains unestablished

drugs with a wide theraputic range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

excretion

A

the process by which a body ultimately eliminates a partent drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

treatment strategies for BPH

A

—Observation

—Herbs, dietary

—Medical treatment

—Surgical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

anti hep interereon toxicity

A
  • Neuropsychiatric: Contraindicated in psychosis, depression
  • Flu-like syndromes
  • Marrow suppression
  • Hepatic toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

action of methenamine

can it be used against proteus?

what is their main use

A

converts formaldehyde to acid in urine

proteus can split urea and neutralize the acid

only against uncomplication LUTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

indications for heparin use

A

prophylaxis (surgery, ICU)

theraputic (DVT, PE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

what is the most common use of sulfonamidea

A

UTIs (co-trimoxazole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

pathophysiological hallmarts of COPD

A

¤Airflow obstruction

¤Alveolar dilation and destruction

¤Airway infection (chronic and acute)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

typical UA results with UTI

A

cloudy or bloody

increased WBCs, bacturia, RBCs

casts = pyelonephtitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

four penicillin types

A

natural

anti staphyolococcal

extended spectrum

anti pseudomona;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

isoniazid toxicity

A

peripheral neuritis

heptatis (linked to age and ETOH)

drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

treatment of allergic conjunctivitis

A

systemic antihistamines work

topical is better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

anti flu drugs

A

amantidine and rimantidine prophylaxis against flu A

neuraminase inhibitors (Inhaled Zanamivir, oral.parenteral oseltamivir)

ribavirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

what is the effect of blood flow on instestinal absorption

A

more absorption happens because there is more blood flow, specifically in lipoholic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

facts about herpes simplex

A

teratogenic in early pregnancy

potentially fatal in new borns

severe infection possible with immunocompromised patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

T/F erythromycin are safe for kids and pregnancy

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

when would an abnormal bacteria or fungus be suspected for a UTI

A

indwelling catheter

bed ridden

immunosuppresedd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

anti pseudomonal penicllin

A

´Carbenicillin (Geocillin)

´Mezocillin (Mezlin)

´Piperacillin (Pipracil)

´Ticarcillin (Ticar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

most common tetracycline complaint

A

gastric distress, but that can be combated by taking it with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

what are 2nd generation quinolines used for

examples

A
  • Expanded gram negative coverage
  • Atypical coverage (chlamydia, mycoplasma)
  • Some gram + coverage

norfloxicin, ciprofloxicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

clincal causes of decreased half life (reasons to increase dose)

A

increased hepatic blood flow

decreased protein binding

increased metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

less common ADRs with alpha receptor blockers

A

CYP interaction

ejaculatory dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

function of loop diuretics

A

blocks tubule reabsorption of Na

significantly increases Na+ and Cl-

venous dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

anti CMV agents

A
  • Ganciclovir (Cytovene)
  • Cidofovir (Vistide)
  • Foscarnet (Foscavir)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Nonnucleoside RT Inhibitors

A
  • Nevirapine (Viramune)
  • Delavirdine (Rescriptor)
  • Efavirenz (Sustiva)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

when is cromolyn the first line treatment of asthma

A

mild to moderate cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

clinical causes of increased half life (reason to reduce dose)

A

decreased blood flow to liver and kidneys

decreased renal function that lowers elimination

decreased metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

treatments safe for asthma and pregnancy

A

¤Beta 2 agonists

¤Glucocorticoids

¤Cromolyn

¤Ipratropium, tiotropium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

diruetic drug classes

A

carbonic anhydrase inhibitors

osmotic agents

thiaizide and thiazide-like agents

loop agents

potassium sparing

ADH antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

what is the risk of introducing substances that act against non-mammalian metabolism

A

there will be an allergic event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

types of inhaled antihistamines

benefit of use

A

¨Azelastine nasal spray (Astelin)

¨With fluticasone: Dymista

¨Risks of sedation seem very low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

what inhibits absorption of tetracylcline

A

dairy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

rules for thrombolytic therapy

A

sooner is better

its not always effective

can cause hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

when might fluoroquinolones be contraindicated due to risk factors

A

when a person is at risk for tendon rupture due to age >60 or steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

notable 1st generation quniolines

A

nalidixic acid, used for UTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

Emin

A

the minimum concentration below which no effect is observed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

health risks associated with menopause HRT

A

cardiovascular risk

breast cancer risk increase

probably no help in cognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

main mycobacterium pathogens

A

tuberculosis, mycobacterium bovis, mycobacterium leprae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

indications for thrombolytics

A

DVT, PE, ischemic stroke, clotted shunts/catheters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

how can penicillins be used to fight beta lactam producing bacteria

A

add a beta lactamase inhibitor (clavulanic acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

T/F most patients will benefit from some level of corticosteroid therapy for asthma

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

integrase inhibitors

A
  • Raltegravir (Isentress)
  • No interference by CYP450 inhibitors or inducers
  • Generally well tolerated
  • Headache, nausea, diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

three inhaled glucocorticoids

A

¨Flunisolide (Aerobid)

¨Budesonide (Plumicort)

¨Fluticasone (Flovent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

three factors that can alter metabolism or elimination of a drug

A

genetic differences in the number and/or function of phase 1 and/or 2 enzymes

drugs or xenobiotics

diesese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

cautionary statements of long acting beta2’s

A

not effective for acute attacks

15% of patients will not respond as predicted

increased mortality if used as the sole treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

types of inhaled antihistamines

benefit of use

A

¨Azelastine nasal spray (Astelin)

¨With fluticasone: Dymista

¨Risks of sedation seem very low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

causes of ED

A

medical disorders (vascular compromise, DM, androgen insufficiency)

iatrogenic (ADRs from HTNdrugs, sequela from surgery)

pysch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

ingeneral how much of an aersol asthma medication is inhaled vs swallowed

A

2-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
204
Q

derivatives of atropine used as anticholinergic/muscarinic drugs in management of secretions in asthma

side effects

A

¨Ipratropium (Atrovent), ¨Tioptropium (Spiriva)

urinary retention, constipation, glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
205
Q

two types of vaginal estrogen creams

what are they used for

A

estradiol and conjugated estrogens

treatment of vaginal atrophy (dysparenunia, urinary incontinence/urgency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
206
Q

T/F most patients will benefit from some level of corticosteroid therapy for asthma

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
207
Q

how is EPO used in cancer treatment

A

helps prevent anemia in the presence of bone marrow suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

obstructive BPH symptoms

A

—Decreased force & caliber of urine stream

—Difficulty initiating flow (“hesitancy”)

—Sensation of incomplete emptying

—Double voiding (2nd void within 2 hours)

—Straining to urinate

—Post-void dribbling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
209
Q

Protease Inhibitors

A
  • Saquinavir (Invirase)
  • Ritonavir (Norvir)
  • Ritonavir/lopinavir (Kaletra)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
210
Q

G- cocci

A

neiseria gonnorhoeoa, meningitides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
211
Q

issues with fourth generation progestin use

A

blocks to effect of aldosterone that prevents fluid retention but increases the risk of hyperkalemia

drospirenone seems to increase thrombosis risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
212
Q

five possible treatments of hot flashes

A

estrogen (high efficacy)

SSRI (moderate to good)

gabapentin (moderate)

progestin (moderate)

clonidine (some help)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

PDE-5 inhibitor examples

A

sildenafil (PRN)

tadalafil (daily)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

which method of treating bronchospams is associated with asthma is more effective

A

beta2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
215
Q

limitation of nitrofurantoin

common issue

rare complications

A

only useful against UTI caused by non-resistant E Coli

brown urine

pneumonitis/fibrosis, peripheral nephtitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
216
Q

monobactum to know

A

azetronam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
217
Q

Cmax

what pharmacokinetic concept is characterized byt his

A

maximum concentration, the max serum concentration the drug achieves in a specific test area after the drug has been administered

extent of absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
218
Q

evidence for airway inflammation as the primary underlying cause of asthma

A

increased inflammatory cells (eosinophils, basophils, etc) on bronchial washings and lung biopsy even when assymptomatc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
219
Q

linear kinetics

what is the proportion of concentration to eliminate in linear kinetics

A

first order kinetics, where a constant fraction of drug is cleared per unit of time

1:1, increase concentration increase elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
220
Q

short acting beta2 onset

duration

benefits

A

1-5 minutes

2-6 hours

bronchodilation with minimal anti-inflammatory effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
221
Q

three types of urinary antiseptics

A

methenamine

nitrofuratoin

nitrofurantoin monohydrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
222
Q

why is inhibition of folate a good method to kill bacteria

A

folate is needed to make DNA

humans are able to take in folate but bacteria need to convert it from other substances

if we can block conversion the bacteria will die and spare our cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
223
Q

toxicicty to penicilin

A

hypersensitivity (rash, angioedema, anaphylaxsis)

diarrhea

nephritis (exp mthicillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
224
Q

two examples of muscarinic receptor blockers used in asthma treatment

action

A

ipratropium, tiotrpoium

helps relieve bronchospasm, reduces airway secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
225
Q

treatment of an acute thrombic event

A

thrombolysis

anticoagulation

thrombectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
226
Q

psoriasis defined

females <>=males?

symptoms

A

chronic relapsing skin disorder

no bias

itching, joint inflammation, depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
227
Q

antiprostaglandin approach to anticoagulation

A

asipirin to prevent CVD

can cause GI bleeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
228
Q

what is the function of cromolyn

A

stabilizes mast cells to prevent antigen induced broncospasm but has no bronchdilating properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

Tmax

A

time to max concentration, the time after adminstration when the maximum plasma concentration is reached

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
230
Q

what types of cells are most susceptible to cytotoxic chemo

A

rapidly dividing cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
231
Q

three ingredients of triple abx ointment

A

neomycin, bacitracin, polymyxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
232
Q

adverse drug reactions related to corticosteroid treatment of asthma

A

pituitary-adrenal suppression >1600 micrograms/day

bone loss

hyperglycemia significant >1000mcg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
233
Q

duration and utility of long acting beta2’s

A

duration: 12 hours
utility: preventing recurrent acute attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
234
Q

what causes airflow obstruction in asthma

A

smooth muscle contraction, vascular congestion, edema, thick sputum

brought on by airway inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
235
Q

why is HTN related to estrogen contraception not as common anymore

A

because pills used to be much high dose and the risk of HTN is dose dependany

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
236
Q

fluoroquinoline toxicity

A

GI distress

CNS symptoms

liver toxicity

photosensitivity

generally well tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
237
Q

T/F luminal membrane postassium sparing diuretics are very effective

A

false, they are not very effective and are usually combined with thiazides or loops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
238
Q

how is the FDA safe in pregnancy list changing as of 2015

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
239
Q

toxicity with oxazolindnones

A

hematologic toxicity from thrombocytopenia

inhibit monoamine oxidase (parkinsons treatment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
240
Q

drug interactions with AZT

A

•Cimetidine, indomethacin, lorazepam, acetoaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
241
Q

what is the action of alpha adrenergic agonists in treatment of allergic rhinitis

A

vasoconstriction to reduce hyperemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
242
Q

distribution

A

how a drug is disseminated through out the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
243
Q

reactive hyperemia

A

after 2 or three days of alpha adrenergic use your nose will swell up due to compensatory mechcanisms activated in response to ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
244
Q

DEA drug schedule class V

A

lowest abuse potential (low dose codeine, opium, pregabalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
245
Q

natural penicillin is used against what

A

Gram + except staph

syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
246
Q

what constitutes a narrow theraputic window

A

if the difference between ED50 and TD50 is 2x or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
247
Q

irritative symptoms of BPH

A

—Urgency

—Frequency

—Nocturnal voiding

—All due to bladder pressure changes from partial outflow tract obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
248
Q

what is the advantage of ketolides over macrolides

one example of a ketolide

A

broader spectrum of action with less antibacterial resistance

telithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
249
Q

what is the value of ABx use in COPD treatment

A

they are valuble to prevent acute flare of bronchitis but have dubious value in long term treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
250
Q

beta-1 agonist effects from Beta-2 crossover

A

HTN, tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
251
Q

absorption

A

how fast a drug is absorbed into the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
252
Q

enzymes that peform metabolic elimination

A

blood esterases

phase I enzymes (oxidative, reduction, hydrolysis)

phase II (conjugative enzymes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
253
Q

how can the autonomic influences of the destrusor muscle be modified

A

cholinergic drugs can cause urgency and frequency

anitcholinergics will cause urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
254
Q

two factor X inhibitors

A

rivaroxaban (xarelto) and apixaban(eliquis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
255
Q

rhinitis treatment strategies

A

avoid allegerns

desensitize the immune system

prevent mast cell degranulation

block histamine

reduce nasopharyngeal hyperemia

block/reduce inflammtion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
256
Q

when are oral corticosteroids used in asthma treatment

dose?

goal?

taper?

A

in severe attacks

40-60 mg prednisone/day 5-10days or 1mg/kg/day

prevent hospitalization

not if the course lasts less than 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
257
Q

what is oral terbinifine used for

how long is the treatment

what must be monitored

A

onychomycosis

3-6mo

can be liver toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
258
Q

treatment strategies for asthma

A

reduce inflammation

increase airway diameter

improve airway secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
259
Q

inhibition of carbonic anhydrase causes what

A

alkaline urine

metabolic acidosis

minimal sodium loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
260
Q

non linear kinetics

A

drug elimination is disproportionate to dose (2x concentration leads +/- 2x change in concentration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
261
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
262
Q

asthma treatment principles

A

preventing inflammation is key

use Beta-2 agoninsts for acute episodes

prevent recurrence with anti-inflammatories and long actings Beta-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
263
Q

clearnace (CL, Cl, Cl/f)

A

a measure of the volume of plasma from which drug is removed per time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
264
Q

theraputic range

A

the concentration of a drug, typically in plasma, where efficacy is maximized and the risk of toxicity is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
265
Q

T/F use of diuretics can completely eliminate Na from the body

A

false, the body will eventually reach a new equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
266
Q

typical ADR of methotrexate

A

bone marrow suppression, mucosal ulcers, hepatotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
267
Q

what is one method to reach steady state concentration faster

A

adminster a loading dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
268
Q

types of implantable progestins

side effects

A

implanon, nexplanon

risks and side effects similar to progestins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
269
Q

diuretic combinations

A

loop+thiazide (useful in pts who are refractory to loop diuretics)

loop/thiazide + potassium sparing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
270
Q

why do 1st generation anti-histamines cause drowsiness

A

they can cross the blood brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
271
Q

what should be done when prescribing warfarin or with a patient who is on warfarin

A

check for drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
272
Q

what is the function of leukotriene inhibitors

A

decrease action to prevent bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
273
Q

ingeneral how much of an aersol asthma medication is inhaled vs swallowed

A

2-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
274
Q

three types of nasal corticosteroids

A

¨Beclomethasone (Beconase, Vancenase)

¨Fluticasone (Flonase)

¨Flunisolide (Nasalide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
275
Q

possible use of aromatase inhibiors in BPH treatment

A

might able to improve the estrogen/test ratio in overweight men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
276
Q

causes of chronic prostatitis

A

very few are due to low grade infections

some are due to atypical infections

the majority are due to non-pecific inflammtion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
277
Q

2nd generation antihisamines

are 1sts or 2nd gen better

A

Loratadine (Claritin), cetirizine (Zirtek), Fexofenadine (Allegra)

2nd gens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
278
Q

what happens to drug concetration with muliple drug injections

A

plasam concentration increases until Css is reached

some of the drug will be eliminated

some will remain leading to accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
279
Q

rifampin + pyrazinamide will result in what adverse effect

A

liver toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
280
Q

cystitis symptoms

A

irritative voiding symptoms (frequency, urgency, pain)

hematura

fever (commonly in kids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
281
Q

disadvantages of oral administration

A

lag time to reach plasma

plasma concentration is influenced by absorption and elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
282
Q

tetracyclines are most often used in what setting

A

outpatient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
283
Q

what are retinoids made of

what are they used for

A

vitamin A derivatives

acne and psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
284
Q

what is the value of ABx use in COPD treatment

A

they are valuble to prevent acute flare of bronchitis but have dubious value in long term treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
285
Q

what is the function of clinically useful diuretics

why do they work

A

causes an increased secretion of Na

water follows Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
286
Q

what is the major complication of CMV

A

can infect fetus

causes retinitis and encephalitis in immunocompromised pateints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
287
Q

what is the important clinical challenge for HIV

A

how do we lengthen the HIV latent phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
288
Q

what two values are equal at Tmax

what pharmacokinetic concept is characterized by this

A

when the rate of absorption = rate of elimination

the rate of absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
289
Q

what is the issue with in vitro lymphcyte training

A

it doesn’t add much to life span an costs a lot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
290
Q

what is the action of theophylline

A

inhibits phosphodiesterase to decrease muscarinic receptor function

some anti-inflammatory effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
291
Q

proteinuria is usually = what

A

renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
292
Q

T/F mineralocorticoid rececptor agonists can prevent cardiac remodeling

T/F they are typically not used as a sole medication

A

true, maybe

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
293
Q

sterptogramin use

two types, with use

A

bacteriocideal against most organsisms

quinupristin and dalfopristin (synercid), vancomycin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
294
Q

typical topical azoles

A

miconazole

clotrimazole

295
Q

why might BPH symptoms spontaneously remit

A

lifesyle changes or ↓androgens

296
Q

ADRs with coumadin

A

hemorrhage

fetotoxic

multiple drug interactions

dietary restrictions

297
Q

adverse drug reactions related to corticosteroid treatment of asthma

A

pituitary-adrenal suppression >1600 micrograms/day

bone loss

hyperglycemia significant >1000mcg/day

298
Q

steroid components of contraceptives:

estrogens

progestins

A

estrogens: ethinyl estradiol (most common), estradiol valerate, mestranol
progestins: >8 forms, 21 carbon deriviatives, 19-notestosterone dervitives, estranes, gonanes

299
Q

what are the advantages of combined estrogen/progestin OC

what is the function of progestin

estrogen

A

highly effective

progestin blocks ovulation and makes cervical unimplantable

estrogen controls uterine bleeding with a 3 weeks on, 1 wk off

300
Q

carbonic anhydrase

A

enzyme responsible for splitting H+ off H2CO3 or synthesizing H2O and CO2 f

301
Q

advantages of OC

A

reduced quantity and duration of menstrual bleeding

reduced dysmenorrhea

predictable periods or no periods

reduced risk of uterine and ovarian cancer

302
Q

two leukotriene receptor agonists

5-lipooxygenase inhibitor

A

¤Zafirucast (Accolate)

¤Montelukast (Singulair)

¤Zileuton (Zyflo)

303
Q

evidence for airway inflammation as the primary underlying cause of asthma

A

increased inflammatory cells (eosinophils, basophils, etc) on bronchial washings and lung biopsy even when assymptomatc

304
Q

antagonistic drugs with penicillin

A

bacteriostatic agents will decrease the effective ness of bacteriocidals, so macrolides and tetracyclines dont work with penicillin

305
Q

adverse effects of leukotriene inhibitos

A

liver toxicity (esp zilueton) that requires peroidic liver enzyme testing

306
Q

how can the same drug be bacteriocidal and bacteriostatic

A

at a low dose it might just kill enough microbes to keep the net colony growth to zero

a higher dose might kill all the colonies faster than they can be replaced

307
Q

usual treatment for Vit B 12 deficienct

A

IM injections daily, then weekly, then monthly

OR massive oral doses

308
Q

what is the choke point between the intrinsic and extrinsic pathways for clotting

A

factor x or thrombin

309
Q

two main symptoms of chronic bronchitis

A

¤Chronic productive cough

¤Mucopurulent sputum

310
Q

what is the main phase I enzyme

A

cytochrome P450

311
Q

what type of drugs will pass into the ICF

how will it effect Vd

A

low molecular weight and lipophilic drugs

the Vd will equal about 60% of body weight

312
Q

100% necessity for retinoid therapy

A

must be on oral contraceptives because they cause birth defects

313
Q

when are oral corticosteroids used in asthma treatment

dose?

goal?

taper?

A

in severe attacks

40-60 mg prednisone/day 5-10days or 1mg/kg/day

prevent hospitalization

not if the course lasts less than 14 days

314
Q

asthma treatment principles

A

preventing inflammation is key

use Beta-2 agoninsts for acute episodes

prevent recurrence with anti-inflammatories and long actings Beta-2

315
Q

inhibitors of folate metabolism

A

sulfonamide

trimethoprim

co-trimoxazole

316
Q

Drug A and Drug B both occupy 100% of receptors but Drug B has less intrinsic activity

which will have a higher efficacy

A

Drug A

317
Q

common systemic fungal pathogens

A
  • Candida albicans
  • Histoplasma capsulatum
  • Coccidioides immitis
  • Blastomyces dermatitidis
  • Cryptococcus neoformans
  • Pneumocystis jirovecii (formerly: P. carninii)
318
Q

benefits of the azole drugs

A

fungistatics effective for superficial and systemic infections

teratogenic when given systemically in high doses

CYP3A4-5 inhibition leading to ADR

319
Q

most important loop diuretic

A

furosemide (lasix)(

320
Q

how is the theraputic index expressed

A

as the range between the median effective dose (ED50) and the median toxic dose (TD50)

321
Q

trends in worldwide contraception, what is used most

A

sterilization 20%

IUD 15%

oral 8%

condom 5%

322
Q

what is the goal of corticosteroid treatment for asthma

A

to reduce underlying inflammation related to chronic asthma

323
Q

T/F OC does not effect future fertility

A

true

324
Q

what is the rationale of chemotherapy in cancer treatment

A

because cancer cells are genetically fragile and rapidly dividing they are susceptble to chemo, allowing therapy to kill the tumor without killing the patient

325
Q

seven classes of drugs that are common candidates for theraputic drug monitoring

A

cardiovasculars

antibacterials

anti-depressants or psychotics

antiepileptics

antifungals

antineoplastics

immunosuppresives

326
Q

factors affecting absorption

A

pH

gastric emptying

blood flow

intestinal surface area

intestinal transport

transport proteins

intestinal CYP

327
Q

beta-1 agonist effects from Beta-2 crossover

A

HTN, tachycardia

328
Q

why are elderly men at higher risk for UTI

A

atrophy of urinal muscosa

BPH

329
Q

what issues are found with triphasic OCs

A

some individuals will have menstrual migrains and PMS

330
Q

excretion

A

how rapidly the drug is eliminated from the body usually through urine, feces

331
Q

lipid changes associated with progestin

A

Triglycerides and LDL go up, HDL goes down

332
Q

which method of treating bronchospams is associated with asthma is more effective

A

beta2 agonists

333
Q

two common anti herpes drugs

A

acyclovir

valacyclovir

334
Q

pramoxine for dermal itching

A

topical anesthetic, not going to fix the issue!

can be used with hydrocortisone

may cause burning

335
Q

sprichetes

A

treponema pallidum

336
Q

ADRs with NI

A

zanamivir: air way irritation, dangersous with people with asthma or COPD
oseltamivir: GI upset, cramps, nausea, fixed taken with food

337
Q

what issues are associated with vaginal ring contraceptive use

A

the ring can fall out

if the ring isn’t inserted on day 1 after the break it can cause failure

338
Q

what is needed to use the dry powder inhalers

A

a good inspiratory effort, because inspiration is what breaks up the powder

339
Q

weaknesses on cancer cells that can be exploited by chemo

A

outgrows blood supply

decreased ability to repair themselves

multiple mutations

most cancers have unique antigens

340
Q

synergistic drugs with penicillins

A

aminoglycosides, but can be mixed in the same vial

341
Q

what is the major risk of metronidazole

A
  • Disulfiram (Antabuse)-like reaction possible
  • Avoid ethanol
342
Q

horseshoe kidney

A

kidneys are linked and wrap around the aorta

343
Q

what is the function of leukotriene inhibitors

A

decrease action to prevent bronchoconstriction

344
Q

important safety rule regarding folate and B12 for anemia

A

NEVER prescribe folate for megaloblastic anemia UNLESS you are sure the patient’s B-12 level is normal

345
Q

what types of contraception are considered (SC) steroid contraception

A

oral

patches

nuvaring

intramuscular

progestin IUD

346
Q

factors that impact bioavailiblity

A

diet, physiology, first pass, genetics, age

347
Q

what is the function of PDE-5 inhibitors in treating ED

A

limits the action of phosphodiesterase, increasing duration of nitric oxide effect

nitric oxide increases blood flow to corpus cavernosum

348
Q

renal compensation of acidosis

alkalosis

A

acidosis: HCO3 is retained, H+ is excreted
alkalosis: HCO3 is secreted, H+ is retained

349
Q

how is letrozole or armidex used in chemo

A

anti aromatases, used to prevent breast cancer

350
Q

complications of hypokalemia

A

muscle weakness

muscle soreness

heart arrhytmia

death

351
Q

progestine blockers for emergency contraception uses

mirepristone

ulipristal

A

will terminate a pregnancy before 7 wks; contraception; used to treat cushings

352
Q

thrush prevention in corticosteroid treatment of asthma

treatment

A

use a spacer to catch larger particles that would deposit in the mouth

rinse mouth with water after dose

nystatin

353
Q

how long does injected male contraception take to work

what are the draw backs

A

8-12 weeks to reach 90% azoospermia

requires frequent follow up for injections and semen analysis

354
Q

DEA drug schedule class IV

A

low potential for abuse, accepted medical uses (benzodiazepines, phenobarbitol)

355
Q

why does long term corticosteroid therapy cause adrenal suppression

A

because the pituitary-adrenal axis takes time to adjust when corticosteroid therapy is disonctinued

356
Q

types of human herpes viruses

A
  • HHV 1 & 2: herpes simplex (HSV) types 1 & 2
  • HHV 3: Varicella-zoster virus (VZV)
  • HHV 4: Epstein-Barr virus (EBV)
  • HHV 5: Cytomegalovirus (CMV)
  • HHV 6 & 7: Roseolovirus
  • HHV 8: Kaposi Sarcoma associated HV (KSHV)
357
Q

wqhat are 4th generation quinolones used for

examples

A
  • gram + and anaerobic coverage
  • Less useful against atypicals

moxifloxacin

358
Q

signficant ADRs with PDE-5 inhibitors

most common

other

A

priapism (contraindicates with organic nitrates)

headache, flushing, nasal congestion

color vison, hearing loss

359
Q

¨Ipratropium (Atrovent) and Tioptropium (Spiriva) are synergistic with what other asthma treatments

A

beta 2 inhalers (ipratropium + albuterol)

360
Q

non-steroid anti-inflammatory choices

A

leukotriene inhibitors

cromolyn

anti-IgE monoclonal antibodies

361
Q

four basic criteria for theraputic drug monitoring

A

good correlation between concentration and effect

drug posses a narrow theraputic range

there is a defined theraputic range

significant interpatient variabilty in plasma concentration

362
Q

what are the most common routes for excretion of drugs

other routes

how are most polar drugs eliminated

A

biliary and renal

lungs, skin

through the kidneys

363
Q

how likley is breakthrough bleeding to occur with OC use

what should you do if this occurs

A

5-30% in the first two cycles

warn them ahead of time, reassure them

change to a different pill with more estradiol or add a short course of extra extrogen

364
Q

what are nasal glucoortcoids used for in treating allergic rhinitis

how often are they dosed

how long will it take to get effective

what is their most effecitve use

A

block or reduce inflammation

1-2x daily

1-2 wks

most effective for seasonal allergic rhinitis

365
Q

what might cause loss of intrinsic factor leading to anemia

A

pernicious anemia, gastric surgery, gastric atophy

366
Q

how is the pharmacodynamic effect of a drug measured

A

physiologic (HR, RR, LOC, analgesia)

laboratory (change in cholesterol)

367
Q

T/F aminoglycosides are usualyl used alone and are effect against G+ infections

A

false, they are almost always used with a specific G+ agent (cilin or cephalosporin) and work well against G-

368
Q

three tetracylcines to know

A

tetracycline

doxycycline

minocyclin

369
Q

Protease Toxicity

A
  • Common:
  • Diarrhea, Nausea, fatigue, headache
370
Q

regulators of sodium homeostasis

A

Hypothalamus/pituitary: ADH

Baroreceptors in the atria: Atrial natrietic peptide

sympathetic nervos system

RAAS

371
Q

anti hepatitis drugs

A

interferon alfa-2a

ribvirin

ledipasvir + sofosbuvir

372
Q

typical superficial antifungal agents

A
  • Clotrimazole (Lotrimin)
  • Miconazole (Monistat)
  • Econazole (Spectazole)
  • Nystatin (Mycostatin)
  • Grieseofulvin (Grifulvin)
373
Q

ADRs with calcipotriene

A

hypercalcemia, but rare

374
Q

what is the risk with treatment for refludan

A

since it comes from leechs it can cause an allergic reaction

375
Q

four targets of ABx action

A

cell wall synthesis

protein synthesis

nucleic acid synthesis

inhibitor of folate biosynthesis (inhibitors of metabolism)

376
Q

types of antimetabolite chemo drugs

A

folic acid analogs (methotrexate)

purine analogs (mercaptopurine)

pyrimidine (flurouracil)

377
Q

what is the advantage of immune therapy

A

it has targeted treatment against specific mutations in cancer cells that uses that patients own immune system

378
Q

what are 3rd generation quinolines used for

examples

A
  • Expanded gram negative coverage
  • Atypical coverage (chlamydia, mycoplasma)
  • better G+ coverage than 2nd gen

levofloxacin

379
Q

advantages of continuous infusion

A

rate of entry is constant

results of drug accumulation until steady state is reached

380
Q

COPD treatment strategies are preventing new damange and improve airways

how to improve airways

A

¤Bronchodilators

¤Glucocorticoids

¤Other anti-inflammatory drugs (leukotriene inhibitors)

¤Improve or reduce airway mucus (Respiratory therapy, Drugs such as ipratropium (Atrovent))

381
Q

descrive fusion or entry inhibitors

A
  • Enfuvirtide (Fuzeon); Maraviroc (Selzentry)
  • Part of multi-drug strategy
  • Problems:
  • Rash, injection reaction, hypersensitivity
  • Eosinophilia
  • Hepatotoxicity (maraviroc)
382
Q

what is the best use for amantidine/rimantidine

A

symptomatic treatment in the first 24-48 hrs

prevention

383
Q

most important carbonic anhydrase inhibitor

what is this most used for

what does it do

A

acetazolamide (diamox)

acute mountain sickness

speeds acclimation process and treats symptoms

384
Q

wht causes psoriasis

A

rapid turnover of skin cells

385
Q

causes of vitamin b 12 deficient anemia

A

diet deficient

loss of intrisic factor

386
Q

what types of drugs will tend to stay dissolved in plasma

what will be the effect on Vd? why

A

drugs witha high molecular weight and/or have a high affinity for transport proteins

it will have a high concentration in blood so Vd will be low, about 4L

387
Q

causes of respiratory alkalosis

A

hyper ventillation

388
Q

what is the action of topoisomerase

commonly used for what?

ADR

A

blocks enzyme for DNA supercoiling

lung, ovarian, colorectal

bone marrow suppression

389
Q

two types of heparin

A

unfractionated and LMW

390
Q

rhinitis treatment strategies

A

avoid allegerns

desensitize the immune system

prevent mast cell degranulation

block histamine

reduce nasopharyngeal hyperemia

block/reduce inflammtion

391
Q

facts about ketoconazole

A
  • Broad spectrum antifungal
  • Best use: Histoplasmosis
  • Food impairs absorption, Coca-cola improves!
392
Q

sulfonamide choices for systemic disease

IBD

A

sulfamethoxazole

sulfisoxazole

sulfadizaine

sulfasalazine

393
Q

risk factors for pseudomembranous colitis

A

ABx use

hospitialization

PPI

394
Q

what is the function of 5-lipooxygenase

A

it converts arachadonic acid to leukotrienes

395
Q

treatment strategy for an acute thrombus

A

thombolysis

anticoagulation

thrombectomy

396
Q

when is cromolyn the first line treatment of asthma

A

mild to moderate cases

397
Q

what is telavancin used for

A

similar to daptomycin

reserved for mrsa

can prolong QT interval

interferes with some blood tests

398
Q

are contraceptive patches safe

A

yes, early studies show a higher risk of DVT and PE due to higher estradiol levels but recent studies don’t bear that out

399
Q

anti cmv toxicity

A

ganciclovir causes myelosuppression additive with HIV drugs

cidofovir causes renal toxicity

400
Q

what is a patient controlled adverse effect of short acting Beta2 treatment of asthma

A

patient mange deteriorating asthma due to progressive inflammation with more frequent doeses

401
Q

medical treatment of BPH

A

alphablockers

5-alpha reductase blockers

402
Q

primary Nucleoside/Nucleotide Reverse Transcriptase Inhibitors “NRTIs” drugs

A
  • Zidovudine (Retrovir, AZT)
  • Zalcitabine (Hivid, ddC)
  • Stavudine (Zerit, d4T)
403
Q

typical causes of iron deficient anemia

A

poor diet

increased need

chronch blood loss

404
Q

what is the advantage of PD-1 blockade

A

20-25 durable response rate, especially useful in difficult to treat cancers (renal cell, melanoma)

405
Q

four factors that can alter drug distribution

A

genetic differences in transport proteins

body composition

drugs

disease

406
Q

two important 1st gen cephalosporins

A

cefazolin, cephalexin

407
Q

what is the risk of putting patients on a drug regimine that is at the low end of the theraputic window

the high end

A

there won’t be an appreciable effect

they are at risk for complications

408
Q

two types of platinum corrdination complexes used in chemo

ADRs

A

cisplatin, carboplatin

severe nausea, ototoxicity

409
Q

Dx of UTI requires what

A

clinical suspcion + 100,000mL in voided samples or 1,000-10,000 in catheter samples

410
Q

how is COPD related to asthma

A

smoke damaged epithelium, leading to frequent infection, chronic inflammtion, and asthma like reactive airways

411
Q

what is the cheapest thrombolytic drug

A

streptokinase

412
Q

specific tactics of immune cancer therapy

A

prevent evasion of apoptosis

increased immune response

monoclonal antibodes against specific targets

413
Q

two long term complications of asthma

A

airway remodeling in response to chronic inflammation leading to gradual decline in pulmonary function

414
Q

macrolide toxicity

A

GI distress

drug interactions fomr CYP3A4 inhibitors

415
Q

Anti-IgE Monoclonal Antibody treatment for asthma

why is it saved for difficult cases

A

¨Omalizumab (Xolair)

it is costly

416
Q

methods of oral contraception adminstration

A

cyclic with a fixed dose or triphasic dose

continuous

417
Q

doxepin is a what?

what is its method of action

ADRs?

A

tricyclic antidepressant

not sure, possible antihistamine effect

drowsiness, exacerbate narrow angle glaucoma

418
Q

first pass metabolism

A

when the drug is metabolized in the intestine before going into the blood

419
Q

what is the action of interferon therapy in cancer treatment

notable ADRs

A

stimulation of NK cells

neuropsyciatric

420
Q

T/F osmotic diuretics are useful in decreasing blood volume and Na

A

false

421
Q

what is the mode of action of azelaic acid

common side effect

A

antibacterial and may ↓test conversion ot DHT

erythema and dryness

422
Q

adverse drug ractions with rifampin

A

generally well tolerated

commonly causes nausea and rash

CYP induction will interact with oral contraception, warfarin

423
Q

issues with non-cyclic OC use

A

more total hormone doses mean more exposure and cost

breakthrough bleeding

424
Q

luminal diuretic toxicity

A

GI upset

increase urinary calcium

hyperkalemia, especially with Ace inhibitors or NSAIDs

425
Q

PE and lab findings associated with acute prostatitis

A

enlarged and painful prostate

leukocytosis with left shift

UA with pyuria, bacturia, hematuria

positive cultures for G- bacteria

426
Q

what is the role of vitamin C in iron therapy

A

500mg taken with iron sulfate can help absorption

427
Q

anti hep toxicity ribavirin

A
  • Hemolytic anemia (10-20%)
  • Teratogenic in animals
428
Q

¨Ipratropium (Atrovent) and Tioptropium (Spiriva) are synergistic with what other asthma treatments

A

beta 2 inhalers (ipratropium + albuterol)

429
Q

how are lipophilic drugs typically exlcuded

A

they and their metabolites are eliminated through biliary, renal, or both after biotransformation

430
Q

red man syndrome

A

flushing diue to histamine release realted to vancomycin

431
Q

how is tamoxifen used in chemo

A

reduced risk of breast cancer recurrenct

432
Q

if a patient presents a medication for oral contraception called mestranol 1/50, what does the 1/50 mean

A

1 is the dose of progestin, 50 is to dose of estradiol

433
Q

where do most drugs fall on the FDA use in pregnancy list

A

category B and C

434
Q

drugs that can have a dangerous interaction with erythromycin due to CYP inhibition

A

astemizole

carbamazepine

warfarin

435
Q

deliniate where particles of varying sizes can be used in aerosol therapy fo asthma

>10 microns

1-5 microns

A

>10microns: mouth and oropharynx

1-5: smaller airways

<0.5: minimal deposition (in and out)

436
Q

what will increase risk of fungal disase

A

large exposure to pathogen

reduction in normal bacterial flora

immunosuppression (HIV, chemo, malnutrition)

437
Q

Emax

A

the concentration of a drug which will fully bind to all the available receptors and increasing dose will not increase effect

438
Q

what is the advantage to starting OC on the first sunday after a period

disadvantage

A

you will have your period on a monday or tuesday vs the weekend

you have to use condoms for the first month

439
Q

classes of antiviral drugs

A
  • Anti-Human Herpes Virus
  • Anti-hepatitis
  • Anti-influenza
  • Anti-retrovirus
440
Q

what is the time difference between symptomatic relief of BPH beteween alpha 1 blockers vs 5-alpha reductase inhibitors

A

7-10 days vs 6-12 months

441
Q

what are the functions of thiazide diuretics

A

inhibitors of Na/Cl symport in the tubule (increases Na/Cl excretion)

come inhibit carbonic anhydrase

some have a direct vascular effect

442
Q

T/F androgens are needed for BPH

A

true, specifically DHT

443
Q

two factors that will reduce OC efficacy

A

large body size and drug interactions

444
Q

useful combination in the treatment of allergic rhinitis

A

¨Inhaled glucocorticoids as main preventative

¨Cromolyn/nedocromil added if needed to keep steroid dose low

¨Inhaled antihistamine

445
Q

ADRs related to HER2 therapy

A

cardiac toxicity, especially between trastuzumab and doxorubicin

446
Q

side effects of 5 alpha reductase inhibitors

A

diminished libido

erectile dysfunction

gynecomastia

447
Q

are tetracylcines bacteriostatic or cida

A

static, but not against gram negative UTIs

448
Q

antibiotic strategies

A

employ a substances that attacks a non-mammalian part of the growth process

slow growth so the immune system gains the upper hand

employ agents to kill log order growth in immune compromised patients

449
Q

contraindications for methenamine

A

hepatic insufficiency

renal insufficiency

sulfa drugs

Upper UTI

450
Q

hallmark signs of bacterial chronic prostatitis

A

Urine and blood culture negative with leukocytes and bacteria in prostatic secretions

451
Q

goals of HSV 1 and 2 treatment

A
  • Shorten length and severity of primary infection
  • Prevent or abort recurrences
  • Life-saving in immunocompromised patients
452
Q

when would prostaglandin E analog be used to treat ED

example

fucntion

A

when pts can’t use PDE-5 inhibitors

alprostadil by urethral suppository or injection

probably relaxes corpus cavernosum smooth muscle

453
Q

pathophysiological hallmarts of COPD

A

¤Airflow obstruction

¤Alveolar dilation and destruction

¤Airway infection (chronic and acute)

454
Q

complications of a UTI

A

untreated cystitis can lead to pyelonephritis

poorly treated pyelonephritis can produce kidney damage

455
Q

anticoagulation strategies

A

block platelet function

inhibit thrombin directly

inhibit thrombin indirectly (vit K or ↑antithrombin III)

inhibit factor X

456
Q

T/F progestins are more effective than other OCs

issues related

A

false, they are slightly less effective

irregular bleeding, metabolic changes

457
Q

typical dosage of azithromycin

A

500mg on day one, 250mg on days 2-5

458
Q

what is a patient controlled adverse effect of short acting Beta2 treatment of asthma

A

patient mange deteriorating asthma due to progressive inflammation with more frequent doeses

459
Q

types of drugs used for acne

A

retinoids

benzoyl peroxide

azelaic acid

ABx

460
Q

effect of beta-2 agonists

adverse drug reactions

A

bronchdilation

hyperglycema, tachycardia, poss HTN

461
Q

drug tolerance

A

reduced effect from repeated exposure to the same concentration of a drug

462
Q

new approach to HIV treatment

A
  • Extract CD4 cells
  • Disable CCR5 by in vitro gene editing
  • Return the CD4 cells back to the patient
463
Q

when should iron supplements be avoided

A

men with normal diets

non-menstruating women with normal diets

464
Q

reactive hyperemia

A

after 2 or three days of alpha adrenergic use your nose will swell up due to compensatory mechcanisms activated in response to ischemia

465
Q

osmotic diuretics

primary uses

complications iwth use

A

Mannitol glycerin, isosorbide

acute renal failure, increased ICP

may worse pulmonary edema, not useful for anuria

466
Q

conditons related to Hep B and C

A

chronic infection

liver failure

hepatoma

467
Q

what is dabigatran (predexa) used for

what is the advantage over other drugs

issues

A

thombin inhibitor

better at preventing stroke and afib, no monitoring

non-reversible, more GI upset, expense

468
Q

what is the advantage of fixed time and dose regimens

what is the disadvantge

A

more convenient

results in fluctuating concentration

469
Q

what is used to reverse heparin

A

protamine sulfate

470
Q

off label use of PDE-5 inhibitors

A

BPH (tadalafil)

pulmonary HTN (sildenafil, tadalafil)

471
Q

T/F patients with pulmonary edema related to CHF will have almost immediate relief with lasix due to decreased heart workload

A

true, lasix will cause vasodilation

472
Q

COPD treatment strategies are preventing new damange and improve airways

how to prevent new damage

A

reducing exposure to irritants

ABx to control infetion

473
Q

describe what makes triphasic OCs unique

A

estrogen and progestins vary during the cycle

mimics a normal cycle

474
Q

examples of long acting Beta2’s with glucocortcoids

A

¨Fluticasone + salmeterol (Advair)

¨Mometasone + formoterol (Dulera)

¨Budesonide + formoterol (Symbicort)

475
Q

consequences of hyponatremia

hypernatremia

A

hypotension, cardvascular collapse, death

hypertension, pulmonary edema, death

476
Q

efficacy is dependant on what

what is the assumption made when determining efficacy

A

the number of drug receptor complexes formed and the intrinsic activity of the drug

it assumes that all receptors are occupied and the drug is at Emax

477
Q

ABx most likely to produce a C diff superinfection

A

Clindamycin

amoxicillin, ampicillin

cephalosporin

fluoroquinolines

478
Q

adverse side effects of estrogen contraception

A

increased clotting (increased risk of DVT, MI, CVA)

activaion of RAA cycle (5% risk of HTN, poss fluid retention)

increase in cholestasis

increased risk of endometrial hyperplasia if not given with progestins

479
Q

two main types of asthma

which is more prevalent

A

allergic and idosyncratic

allergic

480
Q

new ABx class

what is it useful against

A

teixobactin

all G+, mycoplasma, mycobacterium

481
Q

what would indicate high clinical suspcion of UTI in peds

A

unexplained fever in female <5

482
Q

physologic factors that impact gastric emptying time

physiochemical factors

A

pH, baroreceptors

particle size

483
Q

why do macrolides cause GI distress

A

macrolides mimic the structure of a natural chemical called motilin that triggers peristalsis

484
Q

what is the action of granulocyte colony stimulating factors

one notable ADR

A

helps prevent neutropenia

can cause bone pain

485
Q

typical superficial fungal infections

A
  • Tinea pedis (athlete’s foot)
  • Tinea cruris (jock itch)
  • Tinea corporis (ringworm)
  • Onychomycosis (nail bed infection)
  • Vaginal infections (yeast infection)
  • Oral cavity infections (thrush)
486
Q

cautionary statements of using beta2 agonists in asthma treatment

A

frequen use may reduce effectiveness due to down regulation

bronchospasm may worse in some patients with long acting beta2

487
Q

how does a clinician know when to stop chemotreatment

A

Biochemical markers (HCG, CEA, PSA)

clinical markers (palpable nodes, imaging)

488
Q

1st generation antihistamines

drawbacks

A

Chlortrimeton, Benadryl

effective but cause drowsiness

489
Q

anti itching drugs

A

steroids

doxepin

pramoxine

490
Q

how to deal with breakthrough bleeding related to non-cyclic OC use

A

if its mild reassure that patient that all is well

persistent, withdraw treatment for 1 wk then resume

491
Q

absorption is characterized by what two things

A

rate and extent (how much)

492
Q

what is folate used for

what will low folate do to a fetus

A

essential cofactor for AAs, purines, DNA

↑ risk for ancephaly and spina bifida

493
Q

derivatives of atropine used as anticholinergic/muscarinic drugs in management of secretions in asthma

side effects

A

¨Ipratropium (Atrovent), ¨Tioptropium (Spiriva)

urinary retention, constipation, glaucoma

494
Q

common steroid contracptive doses:

estrogen

progestin

A

estrogen: 10-50mcg
progestin: 0.15-1mg

495
Q

strategy to block secretions in asthmatic patients

A

¨Decrease bronchial secretions with anticholinergic/ anti-muscarinic agents

496
Q

what type of bacteria are macrolides useful against

A

good against G+, useful against “Others” like chlamydia

weak against G-

497
Q

three SERMs and their uses

A

tamoxifen (nolvadex) breast cancer prevention and treatment

raloxifene (evista) osteoporosis

bazedoxifene (duavee) SERM + estrogen for HRT

498
Q

5th geneation cephalosporin to know

A

ceftaroline

only beta lactam useful against MRSA

499
Q

respiratory compensation of acidosis

alkalosis

A

acidosis: ventilation increases, takes away CO2, shifts the equation to CO2 and H2O
alkalosis: decreases ventilation, retains CO2, shifts equation to H and HCO3

500
Q

absolute vs relative bioavailbility

A

absolute is compared to IV

relative is set to an imaginary number because there is no IV formulation

501
Q

advantages of non-cyclic OCs

A

less dysmenorrhea and issues with endometriosis

fewer hormone flucuations lead to less premenstrual dysphoria and menstrual migranes

502
Q

non-selective ADH antagonists

A

lithium

demeclocycline

503
Q

what types of contraception are used most in developing nations

A

injectable contraceptives and IUDs

504
Q

what is the treatment for syphilis in the penicillin allergic patient

A

erythromycin

505
Q

long acting beta2s

A

¨Salmeterol (Servent)

¨

¨Formoterol (Foradil)

506
Q

examples of short acting beta 2 agonists

A

¨Albuterol (Proventil, Ventolin)

¨Metaproterenol (Alupent)

¨Terbutaline (Brethine, Bricanyl)

507
Q

Major Protease Drug Interactions

A
  • Quinidine
  • Ergots
  • Rifampin
  • Some benzodiazepines
  • Inhaled steroids
  • St. John’s wort
  • Many statins
  • Fentanyl
508
Q

1st generation antihistamines

drawbacks

A

Chlortrimeton, Benadryl

effective but cause drowsiness

509
Q

describe lymphocyte gene therapy

A

lymphocytes are removed and exposed to a retrovirus that will force expression of CD19nreceptors (b cells)

reinfused T cells will then go kill b cells (used for B cell leukemia/lymphoma)

510
Q

how do dietary factors influence gastric emptying

A

changing gastric pH and the caloric load

511
Q

main superficial fungal pathogens

A
  • Trichphyton
  • Microsporum
  • Epidermophyton
512
Q

where can OC patches NOT be placed

A

over bony prominences or on your breasts

513
Q

Anti-ADP approach to anticoagulation

drugs

primary use

side effects

A

plavix

adjunct to stent, used chronically to prevent MI or CVA

nausea, diarrhea, leukopenia

514
Q

blocking alpha 1 receptors leads to…

blocking alpha 2 leads to…

A

relaxation of the bladder sphincter

relaxation of the bladder and vascular smooth muscle, lowering BP

515
Q

general causes of anemia

A

nutritional deficiency (folate, iron, B12)

EPO ↓ (CKD)

hemolysis (genetic, drug induced, autoimmune)

bone marrow suppression (drugs, cancer, aplastic anemia)

516
Q

6 month regimen for TB treatment

A

first 2 months: isoniazid, rifampin, pyrazinamide, ethambutol

3-6 months: isoniazid, rifampin

517
Q

methods for reducing bronchospasm assocaited with asthma

A

relax bronchial smooth muscle by stimulating Beta2 sympathetic receptors

block parasympathetic muscarinic receptors

518
Q

Classes of Drugs

A

estrogens

SERMs

progestogens

progesterone agonist/antagonist

androgens

anti-androgens

519
Q

two instances where mannitol is particularly useful

how can you determine mannitol is a good therapy

A

acute renal failure due to hemoylsis or rhabdomyolysis

Mannitol IV increases urine flow, good response to test dose indicates it will work well

520
Q

risks of clindamycin

A

C diff

liver impairment

neutropenia

521
Q

COPD treatment strategies are preventing new damange and improve airways

how to prevent new damage

A

reducing exposure to irritants

ABx to control infetion

522
Q

Ke (elimation rate constant)

A

a secondary parameter that is mathmatically derived value describing the rate at which a drug is eliminated from the body

523
Q

how is COPD related to asthma

A

smoke damaged epithelium, leading to frequent infection, chronic inflammtion, and asthma like reactive airways

524
Q

strategies to combat repeat UTI

A

◦Hydrate well

◦Empty bladder before/after intercourse (IC)

◦Antibiotic before IC

◦Apply antibiotic ointment to urethral meatus before IC

◦Long term low dose antibiotic therapy

525
Q

iron toxicity in pediatrics can becaused by how many pills

what is the risk

A

>10

neocrotizing enteritis

526
Q

Nonnucleoside RT Inhibitors toxicity

A
  • Rash
  • Fever
  • Headache
  • Elevated Liver Enzymes
  • Epidermal Reactions
527
Q

uses for daptomycin

disadvantages

A

G+ coverave for resistant staph, strep, enterococcus

parenteral only, not useful in pneumonia, must stop statins

528
Q

where does most absorption happen

does pH affect this

A

in the small intestine because of large surface area and permeable membranes

529
Q

describe interferons

A

Immune cell produced cytokines which Are anti-viral and anti-neoplastic because They activate key immune system components:

  • Macrophages
  • Natural killer cells
  • Assist with antigen presentation to T cells
530
Q

Amantadine/Rimantadine

Minor ADRs

Major ADRs

caution

A

insomnia, dizziness, ataxia

hallucination, seizures

renal failure, sz

531
Q

what is the function of 5-lipooxygenase

A

it converts arachadonic acid to leukotrienes

532
Q

psoriasis treatment options

A

high potency topical steroids and tar

acitretin

tazarotene

calcipotriene

533
Q

what clindamycin used best against

A

anaerobes except C diff

534
Q

two main symptoms of emphysema

A

¤Shortness of breath (dyspnea) with exertion

¤Shortness of breath at rest

535
Q

types of goals of two asthma intervention

A

acute: relieave acute bronchspasm
chronic: reduce frquency of acute episodes

536
Q

chronic hemochromatosis can come from what

A

iron toxicity leading to organ failure

537
Q

are fluoroquinolines safe for pregnancy

A

no, they are Grade C but they should be avoided because they can damage growing cartilage

538
Q

drugs used to prevent IgE activation in the treatment of allerigc rhinitis

A

cromolyn nose spray before allergen exposure

omalizumab as an anti-IgE monoclonal antibody

539
Q

types of goals of two asthma intervention

A

acute: relieave acute bronchspasm
chronic: reduce frquency of acute episodes

540
Q

what is the most important determinant of cancer biology

A

cancer genomics, not organ of origin

541
Q

best treatment for chronic bacterial prostatitis

A

bactrim for 6-12 weeks

542
Q

DEA drug schedule class I

A

high abuve potential with no accepted medical use *heroin, LSD

543
Q

how is dexamethasone used in chemo

A

anti emesis, blocks hypersentivity reactions

544
Q

types of male contraceptives

A

permanent (vasectomy)

reversible (barrier contraception, gonadotropin suppression)

545
Q

most important thiaizide like diuretic

A

chlorthalidone

546
Q

macrolides to know

A

erythromycin

azithromycin

clarithromycin

thelthromycin

547
Q

treatments safe for asthma and pregnancy

A

¤Beta 2 agonists

¤Glucocorticoids

¤Cromolyn

¤Ipratropium, tiotropium

548
Q

examples of short acting beta 2 agonists

A

¨Albuterol (Proventil, Ventolin)

¨Metaproterenol (Alupent)

¨Terbutaline (Brethine, Bricanyl)

549
Q

typical dosage of inhaled glucocortocoids for asthma treatment

A

200-400 mcg/day

550
Q

sites of metabolic elimination

A

liver, GI, lungs, kidneys, skin

551
Q

contrinducations for sulfonamides

A

new borns (cause kernicterus)

late pregnancy (dtto)

antagonistic with methaminde

552
Q

long acting beta2s

A

¨Salmeterol (Servent)

¨

¨Formoterol (Foradil)

553
Q

adverse effects of leukotriene inhibitos

A

liver toxicity (esp zilueton) that requires peroidic liver enzyme testing

554
Q

macrolide derivative used against C diff

what is its mode of action

A

fidaxomicin

acts gainst bacterial DNA transcriptions

555
Q

what is the action of antibiotic chemo

one example

Three ADRs

A

disrupt DNA

dactinomycin

bone marrow suppression, cardiac toxicicity (adriamycin), pulmonary toxicity (blenoxane)

556
Q

treatment strategies for asthma

A

reduce inflammation

increase airway diameter

improve airway secretions

557
Q

four facts about ketoconazole toxicity

A
  • Hepatic toxicity is possible
  • Strong inhibitor of gonadal and adrenal steroids:
  • Can not be given with Amphotericin B
  • Rarely used systemically in USA
558
Q

how is heparin therapy monitored

what is the goal

A

activated protamine titration (PTT)

goal is 2-2.5 x control

559
Q

what is the goal of extended spectrum penicillins

A

improve gram negative coverage

560
Q

differentiate between azole and prazole

A

azoles are antifungal

prazoles are PPIs

561
Q

flu treatment

A

vaccination

anti flu drugs

supportive care

562
Q

wht are vaptans

A

selective vasopressin receptor blockers

563
Q

two leukotriene receptor agonists

5-lipooxygenase inhibitor

A

¤Zafirucast (Accolate)

¤Montelukast (Singulair)

¤Zileuton (Zyflo)

564
Q

pyelonephritis symptoms

A

fever, nausea, vomiting, diarrhea

flank pain

with or without voiding symptoms

565
Q

cautionary statements of using beta2 agonists in asthma treatment

A

frequen use may reduce effectiveness due to down regulation

bronchospasm may worse in some patients with long acting beta2

566
Q

are anti herpes drugs commonly toxic

A

usually very well tolerated

acyclovir has been used constantly for 10 years with minimal ADR, can have transient renal function

famciclovir linked to cancer and testicle toxicity

567
Q

AUC (area under the curve)

what drugs will have a lower AUC

A

the area under a plasma concentration/time curve that reflect actually exposure to the drug

ones that are cleared rapidly

568
Q

metabolism

A

to what extent a drug is modified by enzymes in the body

569
Q

what two things will cause megaloblastic anemia

A

vit B and folic acid deficiency

570
Q

general strategies used to make contraceptives work

A

block sperm

block ovulation

block sperm access to the cervix

block sperm transit through the uterus

block fallopian tubes

block embryo implantation

571
Q

NRTI toxicity

A
  • Pancreatitis
  • Renal Impairment
  • Peripheral neuropathy
  • Bone marrow toxicity (esp. AZT)
  • Drug Interactions (esp. AZT)
572
Q

what causes pernicious anemia

DX by what

treatment consideration

A

intrinsic factor autoantibodes that ↓folate absorption

megaloblastic anemia and progressively declining neurologic function

treating the folate ↓ will fix anemia but not the the neuro issues

573
Q

macrolides are CYP3A4 inhibitors

why is that relevant

A

it stops many drugs from being broken down and can cause the circulating blood levels of some othe rmedications to increase to dangerous leveslk

574
Q

guidelines to decide which OC to use

A

match estrogen to body size

use 2nd, 3rd, 4th generation progestin

be familiar with 4-5 brands with different progestins

go with what the patient tells you

575
Q

metabolic elimination of a drug

A

the chemical modification of a drug to a more polar compound and facilitate clearance

576
Q

what is the advantage of LMW heparin

A

↓risk of thrombocytopenia or osteopenia

usually no monitoring needed

can be used at home

577
Q

what is the function of cromolyn

A

stabilizes mast cells to prevent antigen induced broncospasm but has no bronchdilating properties

578
Q

advantage of monobactum

what is it used for

A

relatively beta lactamase resistant, low allergic reaction potential with penicillin allergy

usually against enterobacter and other G-. not G +

579
Q

how does the renal system regulate pH

A

adding or taking away HCO3

580
Q

half-life (T1/2Beta)

what does this assume

A

the time required for a drug to fall to 50% of its current value

that the drug is eliminated linearly

581
Q

typical methods of adminstration for corticosteroids

A

inhaled aerosol (most common)

oral or parenteral (emergency situation)

582
Q

what is mupirocin used for

atabax

A

gram + (impetigo)

also impetigo

583
Q

two long term complications of asthma

A

airway remodeling in response to chronic inflammation leading to gradual decline in pulmonary function

584
Q

long and short acting alpha agonists used in the treatment of allergic rhinitis

A

¨Phenylephrine (Neosynephrine) - Short acting drops/spray

¨Oxymetazoline (Afrin) - Longer action (12 hours)

585
Q

what are nasal glucoortcoids used for in treating allergic rhinitis

how often are they dosed

how long will it take to get effective

what is their most effecitve use

A

block or reduce inflammation

1-2x daily

1-2 wks

most effective for seasonal allergic rhinitis

586
Q

factors that will trigger conversion from latent to active TB

A

HIV

corticosteroid therapy

chemo

immunosuppresive therapy

587
Q

2nd generation antihisamines

are 1sts or 2nd gen better

A

Loratadine (Claritin), cetirizine (Zirtek), Fexofenadine (Allegra)

2nd gens

588
Q

toxicity associated with streptogramins

A

arthralgia and myalgia

hyperbilirubinema

589
Q

why are obese men at increased risk to BPH

A

because they have higher levels of estradiol because they have more aromatase to convery T into E

590
Q

3rd genetation cephalosporin to remember

A

rocephin

591
Q

differentiate allergic asthma from idiosyncratic

A

allgeric asthma often has a personal of FHx of allergic disease and commonly present at an early age

idiosyncratic has no Hx, negative skin tests, normal serum IgE

592
Q

two groups of cell wall inhibitors

A

beta lactams

others

593
Q

why is prevention of bone marrow suppression important to chemotherapy

A

better bone marrow function increased tolerance to additional chemotherapy

594
Q

three factors to fight ABx resistance

A

long enough treatment

only use Abx when necessary

use a combination of Abx when needed

595
Q

Most important ADR for alpha1 blockers

how to prevent issue

A

orthostatic hypotension more common in volume/salt depleted patients

educate them on what is happening and give them their first dose in the office

596
Q

T/F nearly all asthma treatments can be used with COPD and are very effective

A

false, asthma treatment for COPD is less effective depending on how extensive the damage is

597
Q

five drugs with narrow theraputic windows

A

warfarin

lithium

digoxin

phenytoin

zidovudine

598
Q

aminoglycocide toxicity (2+1)

A

ototoxic

nephrotoxic

exacerbated by loop diurectics (furosimide/lasix or bumetanide/bumex)

599
Q

typical coliforms in UTI

A

enterobacter

escherichia

klebsiella

serratia

600
Q

what is the action of theophylline

A

inhibits phosphodiesterase to decrease muscarinic receptor function

some anti-inflammatory effect

601
Q

types of hep viruses

A

A B C D E

602
Q

EPO toxicity issues

A

increase viscosity can cause HTN or DVT

↑risk of CVA or MI with chronic don’t come

can ↓cancer surviability

603
Q

causes of metabolic alkalosis

A

prolonged vomiting

ingestion of large amounts of bicarbonate

604
Q

adverse drug reactions from cotrimoxazole

A

allergry (5%)

hemolytic anemia with G6PD deficienct

can cause aplastic anemia

605
Q

T/F Pregnancy is safer than usings OC

A

false, OC is much safer than pregnancy

606
Q

outpatient devices for inhalation treatment of asthma

A

metered dose inhalers

dry powder inhaler

607
Q

long and short acting alpha agonists used in the treatment of allergic rhinitis

A

¨Phenylephrine (Neosynephrine) - Short acting drops/spray

¨Oxymetazoline (Afrin) - Longer action (12 hours)

608
Q

thrush prevention in corticosteroid treatment of asthma

treatment

A

use a spacer to catch larger particles that would deposit in the mouth

rinse mouth with water after dose

nystatin

609
Q

T/F ledipasvir + sofosbuvir are well tolerated and cheap

A

false, they are well tolerated but wildly expensive

610
Q

how is fluid volume controlled

A

sodium

611
Q

how are theophyllines used in treatment of ashtma in kids

adults

A

kids: in place of inhaled glucocortcoids
adults: time release for nocturnal asthma

612
Q

issues with hyperkalemia

A

malaise

palpitation

muscle weakness

fatal arrhytmia

613
Q

typical causes of hay fever (allergic rhinitis)

A

¤Pollens, animal dander, dust, molds, etc.

¤Hyperemia, enhanced secretions

¤IgE involved in inflammatory cascade

¤Histamine & other mediators

614
Q

what is the goal of corticosteroid treatment for asthma

A

to reduce underlying inflammation related to chronic asthma

615
Q

what is HER2 therapy for breast cancer

A

monoclonal antibodies (herceptin) with or without (herceptin + mertansine) will attack cells with mutated human endothelial growth receptor, improving prognosis for HER2 cancer

616
Q

T/F selective alpha blockers are 100% selective

A

false, they can still cross react

617
Q

T/F period are necessary to maintain health

A

false, estrogen flucuaton is

618
Q

absolute contraindications for OC

A

smokers after age 35

undiagnosed breast tumors

undiagnosed vaginal bleeding

acute liver disease

history of DVT or hypercoagulation

619
Q

how are theophyllines used in treatment of ashtma in kids

adults

A

kids: in place of inhaled glucocortcoids
adults: time release for nocturnal asthma

620
Q

what type of drugs will stay dissolved in the extracellluar fluid

how will this effect Vd

A

drugs with low molecular weight that can pass through the capillary junctions into interstitial fluid but are too polar to cross the cell mambrane

Vd will be high, about the sum of the interstitial fluid (20% of body weight(

621
Q

why is ethinyl estradiol the most commonly used estrogenn for OC

A

because it is well absorbed orally

622
Q

fwhat is the action of fluoroquinolones

A

inhibits DNA synthesis

623
Q

tetracycline is especially useful against what

A

chlamydia

mycoplasma

rickettsia

cholera

anthrax

acne

624
Q

how is predinosne used in chemo

A

acute leukemia and lymphoma

625
Q

Treatment of UTI

A

fluids

vitamin C/cranberry juice

Abx

626
Q

what percent of pregnancy are the result of contraceptive failures

how many women miss 1 pill/mo

3/mo

when is it most dangerous to miss a pill

A

50%

50%

30%

at the beginning of a pill pack

627
Q

general guidelines to match estrogen to body size

A

15-20 mcg for small to average size women

30-35 mcg for larger women

628
Q

two types of potassium sparing diuretics

A

luminal membrane agents (triameterene)

mineralcorticoid antagonist (spirolactione)

629
Q

common brand name of co-trimoxazole (combination fo trimethoprim and sulfamethazone)

used for

A

bactrim

UTI
Prostatitis
adjunct to H flu, listeria, legionella

630
Q

possible issues with contraceptive patches

A

some patch adhesive reactions

less effective in women over 200lvs

631
Q

rate of IV infusion adminstration equation

A

rate of drug adminstration = steady state - rate of drug elimination

632
Q

why would you use vaginal vs oral estrogen

A

vaginal creams for vagina atrophy, orals for hot flashes

633
Q

EC50

A

the concentration at which 50% concentration is achieved

634
Q

two main symptoms of emphysema

A

¤Shortness of breath (dyspnea) with exertion

¤Shortness of breath at rest

635
Q

what skin conditions are coal tar used for

issues

A

psoriasis, lichenified dermatitis for anti-itch effect

messy, can be irritating

636
Q

what is the action of thrombolytic drugs

A

activates plasminogen to become plasmin

637
Q

FDA use in pregnancy ratings category A

B

C

D

X

A

controlled studies show no risk

no evidence of risk in humans but no controlled studies

risk cannot be ruled out OR animal studies show risk to fetus

positive evidence of risk but benefits may outweigh risks

contraindicated in pregnancy

638
Q

drugs that will have a dangerous interaction with chloramphenocol

A

chlorpropamide

phenytoin

tolbutamide

warfarin

639
Q

asthma

A

chronic pulmonary disorder characterized by episodic reversible airflow obstruction

640
Q

what is the best use for neuraminase inhibitors

how long will zanamavir and oseltamivir reduce symptoms

A

reduce symptoms when started <48hrs after onset

zanamavir 1-2 days

oseltamivir 0.5-4 days

641
Q

non beta lactam ABx that target cell walls

A

´Vancomycin

´Daptomycin

´Bacitracin

642
Q

Heparin Toxicity

A

hemorrhage

thrombocytopenia

osteopenia

643
Q

Why are estrogen contraceptives contraindicated for smokers over 35

A

there is a significant increased risk of MI compared to non-smokers

644
Q

when is vancomycin used

A

MRSA

enterococcus

clostridium (oral)

645
Q

2 21 carbon progestin choices

how many 19-nortestosterone progestins are there

A

provera, progesterone

four generations with over dozens of choices

646
Q

ADRs of acitretin

A

no blood donation, requires 3 years to clear system

no alcohol (liver toxic)

647
Q

what determines a drugs half life

A

clearance and Vd

648
Q

side effects related to injectable progestin contraception

A

bleeding, weight gain, dysphoria

649
Q

epidermal reactions assocaited with NNRTIs

A
  • Toxic Epidermal Necrolysis
  • Stevens-Johnson Syndrome
650
Q

total clearance

A

the exponential effect of hepatic, biliary, and urinary elimination to decrease plasma concentration

651
Q

two factors that effect the chemical polarity and partitioning of a drug as it relates to distribution

A

lipophilicity (increases permability through lipid bilayers)

particle size (influences how the body handles the drug)

652
Q

functions of osmotic diuretics

A

increase tubule osmolality

increase renal ultrafiltrate

increase urine flow

preferential to water but electrolytes are also lost

653
Q

what leukotriene is 1000x more potent than histamine

A

LLTD4

654
Q

three methods for reversing warfarin

A

vitamin K, FFP, prothrombin concentrats

655
Q

what is the coverage of oxazolidinones

common type and what it is used for

A

works well against G+, G-, anaerobes, aerobes

linezolid, used against vancomsycin resistant bugs

656
Q

COPD treatment strategies are preventing new damange and improve airways

how to improve airways

A

¤Bronchodilators

¤Glucocorticoids

¤Other anti-inflammatory drugs (leukotriene inhibitors)

¤Improve or reduce airway mucus (Respiratory therapy, Drugs such as ipratropium (Atrovent))

657
Q

ciclopirox is good for what

A

in lotion its good for tinea

in nail polish its good for onychomycosis

658
Q

how is potency determined

A

testing two drugs in the same patient or pool of patients and comparing their EC50 to find which requires a lower concentration

659
Q

most common presentation of thrombosis

A

MI, ischemic stroke, DVT

660
Q

T/F tetracycline has anti-inflammatory effect

A

true, which makes it useful in acne treatment

661
Q

theraputic drug monitoring

A

using an assay to determine drug concentrations in plasma then using that concentration to develop safe and effective drug protocols

662
Q

5-alpha reductase inhibiors

A

dutasteride

finasteride

663
Q

types of protein inhibiting ABx to know

A

tetracyclines

aminoglycosides

macrolides

664
Q

HIV treatment strategies

A
  • Inhibit Reverse Transcriptase (RT)
  • Inhibit Viral Protein Production
  • Prevent viral entry into cell
  • Prevent integration of HIV into host DNA
  • Prevent/Treat Opportunistic Infections
665
Q

is there an advantage to used in progestin on a daily vs cyclic schedule

A

no, in fact you take a lower total dose with continuous scheduling

666
Q

T/F the boundaries for the theraputic range of a drug are absolulte

A

false

667
Q

what is the benefit of giving a SERMs with estrogen for HRT

A

blocks estrogen receptors in the breast and uterus so there is no need for progestin

668
Q

how is estrogen used in chemo

A

prostate cancer

669
Q

DEA drug schedule class II

A

high potential for abuse, some medical indications with high restrictions (morphine, cocaine, oxycodone)

670
Q

three inhaled glucocorticoids

A

¨Flunisolide (Aerobid)

¨Budesonide (Plumicort)

¨Fluticasone (Flovent)

671
Q

gram- bacilli

A

e coli, proteus, enterobacter, salmonema

672
Q

pharmacokinetics

four parts

A

the study of what the body does to a drug

absorption, distribution, metabolism, excretion

673
Q

drugs used to prevent IgE activation in the treatment of allerigc rhinitis

A

cromolyn nose spray before allergen exposure

omalizumab as an anti-IgE monoclonal antibody

674
Q

autoinduction

A

adminsration of a drug causes a increase in metabolism that requires an increased amount of the drug to get the same effect

675
Q

three notable aminoglycosides

A

amikacin, gentamicin, tobramycin

676
Q

what are cephalosporins used for

A

treating mainly gram + with some gram - coverage depending on generation

677
Q

typical causes of hay fever (allergic rhinitis)

A

¤Pollens, animal dander, dust, molds, etc.

¤Hyperemia, enhanced secretions

¤IgE involved in inflammatory cascade

¤Histamine & other mediators

678
Q

deliniate where particles of varying sizes can be used in aerosol therapy fo asthma

>10 microns

1-5 microns

A

>10microns: mouth and oropharynx

1-5: smaller airways

<0.5: minimal deposition (in and out)

679
Q

two main symptoms of chronic bronchitis

A

¤Chronic productive cough

¤Mucopurulent sputum

680
Q

what is needed to use the dry powder inhalers

A

a good inspiratory effort, because inspiration is what breaks up the powder

681
Q

differentiate between chronic bronchitis and emphysema

A

chronic bronchitis is caused by airway obstruction that destroys alveoli

emphysema is cause by alveolary loss that least to air way obstruction

682
Q

common treatment for the prevention of MI

A

clipidogrel (plavix) + aspirin (↑risk for GI bleeds, but relatively small)

683
Q

treatment for iron deficient anemia

A

ferrous sulfate

ferrous glucaonate

IM or IV iron

684
Q

differentiate between chronic bronchitis and emphysema

A

chronic bronchitis is caused by airway obstruction that destroys alveoli

emphysema is cause by alveolary loss that least to air way obstruction

685
Q

general guidelines for retinoid use in acne

A

8-12 weeks to max benefit

may make acne look worse to start

avoid mucous membranes and eyes

use sunscreen after treatment ↑risk of skin cancer

686
Q

ADRs related to isoretinoin

A

chapped lips

dry skin

nose bleeds

dry eyes

687
Q

how does the respiratory system regulate pH

A

by adding or taking away CO2

688
Q

if contraception starts on cycle day 1 or 2, when will they take effect

what if you start whenever you want

A

contraception starts immediately

restart with a new pack after the first period and use condoms until the second pack

689
Q

examples of long acting Beta2’s with glucocortcoids

A

¨Fluticasone + salmeterol (Advair)

¨Mometasone + formoterol (Dulera)

¨Budesonide + formoterol (Symbicort)

690
Q

why does pH effect absorption

A

most drugs are weak bases

691
Q

acid fast bacteria

A

mycobacterium tuberculosis, bovis, leprae

692
Q

what causes airflow obstruction in asthma

A

smooth muscle contraction, vascular congestion, edema, thick sputum

brought on by airway inflammation

693
Q

uses of leukotriene inhibitors in asthma treatment

A

lowered glucorticoid dose

694
Q

what is the last resort for iron deficient anemia

why should you refer

A

parenteral

anaphylaxsis risk warrants refereal

695
Q

why do we have phase I and phase II of elimination

A

because often phase one will produce a metabolite that will be processes against in phase II

696
Q

concentration at steady is inversely proportional to what

A

clearance

697
Q

drug interactions associated with decreasd OC efficacy

A

st johns wort

some anti convulsants

anti fungal agents

698
Q

issues related to progestin contraception

A

lipid changes

some are androgenic

can cause dysphoria

699
Q

what type of drugs can have a Vd in excess of total body water

how is that possible

A

non-polar, unionized drugs

suggests tissue distribution

700
Q

analgesics for cystitis

useed for

side effection

A

pryridium

pain relief for the first 1-2 days of UTI

orange urine, 10% incidence of GI upset

701
Q

treatment for leprosy

A

dapsone, colfazamine, rifampin

702
Q

three thiazide drugs

A

hydrochlorothiazide

benzathiazide

bendroflumethazide

703
Q

possible etiology of COPD

A

¤Cigarette smoking (99%)

¤Other toxins (such as coal dust, silica)

¤Genetic (Cystic fibrosis, A-1antiproteinase (anti-trypsinase) deficiency)

704
Q

what happens that makes missing OC pills risky

A

follicular development is still happening, if the pill isn’t resumed fast enough the follicle may survive and they may ovulate

705
Q

examples of thromblytic agents

what is their universal method of adminstration

A

streptokinase, urokinase, etc

all given IV

706
Q

T/F nearly all asthma treatments can be used with COPD and are very effective

A

false, asthma treatment for COPD is less effective depending on how extensive the damage is

707
Q

Abx for acne treatment

A

systemic: tetracycline or erythromycin
topical: clindamycin, erythromycin, metronidazole

708
Q

heparin induced thrombocytopenia type II

what is the reactive measure for this

A

Two types, Type II is an immunte related drop in platelets that leads to thombosis

immediately stop thrombin and start something else

709
Q

what determines the EC50/potency of a drug

A

affinity for receptors and the number of receptors available

710
Q

why does HIT cause thrombosis with thrombocytopenia

A

because all the platelets are being take up by clots

711
Q

why are GnRH analogs not used to for contraception

A

because it would cause an extreme loss of estrogen and put women at risk for heart disease and osteoporosis if they aren’t added back

712
Q

four pillars of cancer treatment

A

surgery

chemo

radiation

immunetherapy

713
Q

antiplatelet approaches for anticoagulation

A

block prostaglandin

inhibit ADP pathway

block IIb/IIIa platelet receptors

714
Q

new standard of care for chronic hep C

A

ledipasivr + sofosbuvir

previously was interferon + ribavirin

715
Q

how does plan B prevent or dely ovulation

A

disrupting follicle growth or blunting the LH surge

716
Q

T/F a more potent drug (lower EC50) will have a longer effect

A

false

717
Q

tetracycline derivative that can be used against resistant staph and strep in IV formuation

adverse effects?

A

tigecycline

similar to tetracycline with more nausea and vomitting

718
Q

drug efficacy

A

the relationship between concentration and dose that takes into account the maximum effect that a drug can have regardless of dose

719
Q

short acting beta2 onset

duration

benefits

A

1-5 minutes

2-6 hours

bronchodilation with minimal anti-inflammatory effects

720
Q

importnt 1st line TB drugs

A

isoniazid

rifamycins

721
Q

volume of distribtion (Vd)

equation

A

the theoretical volume that would be necessary the contain the total amount of an adminstered drug at the same concentration observed in blood plasma

Vd = (amount of drug in body)/(concentration at time zero)

722
Q

low potency topical steroid

intermiediate

high

highest

A

triamcinolone

hydrocortisone

desoximetasone

clobetasol

723
Q

non-steroid anti-inflammatory choices

A

leukotriene inhibitors

cromolyn

anti-IgE monoclonal antibodies

724
Q

why does long term corticosteroid therapy cause adrenal suppression

A

because the pituitary-adrenal axis takes time to adjust when corticosteroid therapy is disonctinued

725
Q

two common extended spectrum penicillins

common probelms

A

ampicilin (oral and parenteral)

amoxicilin (oral only)

rash

726
Q

ADRs of loop diuretics

A

ototoxicity (deafness, vertigo, usually reversible)

excessive fluid and Na loss (hypotension, postural hypotension)

loss of electrolytes (K, Cl, Ca, Mg)

727
Q

three amphotericin B formulations

most important

A

Cholesteryl sulfate complex, Lipid complex, Lipsomal

liposomal

•Reduces toxicity, particularly renal

728
Q

treatment of allergic conjunctivitis

A

systemic antihistamines work

topical is better

729
Q

variation on steroid transdermal absorption based on region

A

high: face, scalp, armpits, groind
medium: chest, back, abdomen
low: hand, feet, arms, legs

730
Q

kinetic homogeneity

A

a predictable relationship between plasma drug concentration and concentration at the receptor site where the drug produces its pharmacologic effect

731
Q

strategy to block secretions in asthmatic patients

A

¨Decrease bronchial secretions with anticholinergic/ anti-muscarinic agents

732
Q

eight indications for theraputic drug monitoring

A

low theraputic index

poorly defined clinical end point

non-adherence

theraputic failure

drugs with saturable metabolism

wide variation in drug metabolism

major organ failure

prevention of ADE

733
Q

new standard for when to initiate HIV treatment

A

at first diagnosis

Pharmacotheraputics (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions