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1_BOARDS > Pharm - Rami > Flashcards

Pharm - Rami Flashcards

1
Q

penicillin MOA

A

binds PBPs thereby blocking peptidoglycan cross linking

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2
Q

what 3 penicillins are more susceptible to beta lactamases?

A

penicillin, ampicillin, piperacillin

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3
Q

general side effect of penicillins

A

allergic reaction

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4
Q

side effect of penicillin

A

drug induced coombs positive hemolytic anemia

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5
Q

drugs that cause drug induced coombs positive hemolytic anemia

A

penicillin, alpha methyldopa, and cephalosporins

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6
Q

side effect of ampicillin/amoxicillin

A

non-allergenic skin rash

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7
Q

side effect of methicillin

A

interstitial nephritis

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8
Q

drugs that cause interstitial nephritis

A

methicillin, NSAIDs, furosemide (“buy meth in dollars instead of euros”)

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9
Q

what form is pen V given

A

oral

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10
Q

what form is pen G given

A

IV

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11
Q

aztreonam structure

A

monocyclic beta lactam ring

blocks peptidoglycan cross-linking as well

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12
Q

why give aztreonam

A

renally insufficient patient;

allergic to penicillin

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13
Q

side effect of aztreonam

A

elevated LFTs

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14
Q

imipenem side effect

A

seizures in renally impaired patients

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15
Q

what do you give with imipenem

A

cilastin - inhibits renal dihydropeptidase I (enzyme that inactivates drug in renal tubules)

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16
Q

antibiotic you do not want to give to renally insufficient patient that aztreonam might be great for

A

aminoglycosides

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17
Q

gen 1 cephalosporins

A

gram positive

CEFAZOLIN, CEPHALEXIN

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18
Q

gen 2 cephalosporins

A

gram positive, anaerobes, H flu

CEFACLOR, CEFUROXIME

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19
Q

gen 3 cephalosporins

A

gram negative

CEFTRIAXONE

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20
Q

gen 4 cephalosporins

A

gram positive and negative

pseudomonas, CEFEPIME

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21
Q

gen 5 cephalosporins

A

MRSA,

CEFTAROLINE

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22
Q

cephalosporin side effects

A

hypersensitivity reaction (10% of patients with penicillin allergy with be allergic),
disulfiram-like reaction,
nephrotoxicity

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23
Q

drugs that cause disulfiram like reactions

A

“Sorry pals, can’t go mingle”

1st gen sulfonylureas, 
procarbazine, 
cephalosporins,
griseofulvin.
metronidazole
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24
Q

50S inhibitors

A 
"50 cent - I'm a CMLC"
chloramphenicol,
macrolides, 
linezolid,
clindamycin,
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25
Q

30S inhibitors

A

aminoglycosides,

tetracyclines

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26
Q

chloramphenicol MOA

A

reversibly binds 50S to inhibit peptidyl transferase

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27
Q

clindamycin MOA

A

inhibits formation of initiation complex

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28
Q

aminoglycosides MOA

A

inhibits formation of initiation complex and causes mRNA misreading

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29
Q

tetracyclines MOA

A

blocks AMINOACYL tRNA from binding to the ribosome

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30
Q

chloramphenicol side effects

A

aplastic anemia,
gray baby syndrome (vomiting, flaccidity, gray skin hue, shock in newborns due to lack of UDP-glucuronyl transferase in liver)

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31
Q

drugs that cause aplastic anemia

A 
"Cant Make New Blood Cells Properly"
(carbamazepine,
methimazole,
NSAIDs,
benzene,
chloramphenicol,
PTU)
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32
Q

side effects of macrolides

erythromycin, clarithromycin, azithromycin

A

acute cholestatic hepatitis (jaundice)

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33
Q

uses of clindamycin

A

anaerobic infections above the diaphragm

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34
Q

side effects of clindamycin

A

pseudomembranous colitis (c. diff)

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35
Q

linezolid treats…

A

VRE, MRSA

VRE: vancomycin resistant enterococcus

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36
Q

uses of metronidazole

A

anaerobic infections below the diaphragm

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37
Q

side effects of aminoglycosides

A

nephrotoxicity (especially with cephalosporin),
ototoxicity (especially with loop diuretic),
teratogenicity

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38
Q

aminoglycosides are ineffective against…

A

anaerobes because they require oxygen to be taken up into bacterial cells

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39
Q

tetracycline side effects

A

teeth discoloration, bone deformity in kids, fanconi syndrome (aminoaciduria, phosphaturia, acidosis, glycosuria), photosensitivity

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40
Q

how is doxycycline eliminated

A

fecally –>

so it can be used in renally insufficient patients

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41
Q

uses of demeclocycline

A

treats SIADH (competitive antagonist at V2 receptor)

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42
Q

name all of the anti mycobacterial agents

A 
rifampin, 
isoniazid
pyrazinamide
ethambutol
dapsone
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43
Q

rifampin MOA

A

inhibits bacterial DNA-dependent RNA polymerase

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44
Q

side effects of rifampin

A

orange urine, hepatitis

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45
Q

isoniazid MOA

A

inhibits synthesis of mycolic acids

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46
Q

side effects of isoniazid

A

peripheral neuropathy (due to Vitamin B6 depletion),
G6PD-hemolytic anemia,
drug induced lupus,
hepatitis

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47
Q

dapsone MOA

A

PABA antagonist, inhibits folic acid synthesis

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48
Q

dapsone side effects

A

G6PD hemolytic anemia

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49
Q

ethambutol MOA

A

inhibits mycobacterial arabinosyl transferase

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50
Q

ethambutol side effects

A

retrobulbar neuritis (decreased visual acuity and red green color blindness)

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51
Q

pyrazinamide side effects

A

hepatotoxicity,

hyperuricemia (gout)

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52
Q

drugs that are hepatotoxic

A

“Patron is FIRSt fun, then hepatotoxic”

pyrazinamide,
fibrates,
isoniazid,
rifampin,
statins,
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53
Q

drugs that cause SLE like syndrome

A

“Having lupus is Mega SHIPP-E”

methyldopa,
sulfa,
hydralazine,
isoniazid,
procainamide,
phenytoin,
etanercept
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54
Q

drugs that cause hyperuricemia/gout

A

“Painful Tophi in Feet Need Care”

pyrazinamide,
thiazide,
furosemide,
niacin,
cyclosporine
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55
Q

drugs that cause G6PD hemolytic anemia

A

“Hemolysis IS D PAIN”

isoniazid,
sulfonamides,
dapsone,
primaquine,
aspirin,
ibuprofen,
nitrofurantoin
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56
Q

isoniazid causes peripheral neuropathy because…

A

it depletes the body of vitamin B6

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57
Q

trimethoprim- sulfamethoxazole MOA

A

DNA synthesis disruption
trimeth - blocks dihydrofolate reductase
sulfameth - blocks dihydropteroate synthase

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58
Q

bactrim (TMP-SMX) side effects

A

stevens johnson syndrome,
hemolytic anemia,
kernicterus in newborns,
(BAK)

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59
Q

sulfa drugs

A

“Popular FACTSSS”

probenecid,
furosemide,
acetazolamide,
celecoxib,
thiazides,
sulfonamide antibiotics,
sulfasalazine,
sulfonylureas
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60
Q

fluoroquinolones MOA

A

inhibits bacterial DNA topoisomerase II –>

DNA strand breaks –> cell death

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61
Q

fluoroquinolones side effects

A

tendonitis,
tendon rupture,
contraindicated in pregnant women and kids (damages cartilage)

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62
Q

fluoroquinolones coverage

A

gram negative

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63
Q

vancomycin MOA

A

binds D-ala D-ala, inhibits transglycosylase, weakens cell wall and causes cell lysis

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64
Q

vancomycin uses

A

MRSA, C. diff pseudomembranous colitis orally

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65
Q

side effects of vancomycin

A

“NOT” + red man

nephrotoxicity,
ototoxicity,
thrombophlebitis,
and red man syndrome

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66
Q

side effects of metronidazole

A

metallic taste,

disulfiram-like rxn

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67
Q

nucleoside reverse transcriptase inhibitors

A

zidovudine,
didanosine,
lamivudine,
abacavir

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68
Q

non nucleoside reverse transcriptase inhibitors

A

nevirapine,
efavirenz,
delavirdine

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69
Q

NRTI side effects

A

zidovudine - megaloblastic anemia

didanosine - pancreatitis

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70
Q

NNRTI side effects

A

efavirenz - CNS disturbances

nevirapine - stevens johnson syndrome, hepatitis

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71
Q

what NRTI is used on pregnant women?

A

zidovudine

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72
Q

what is the suffix of the protease inhibitors

A

-navir

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73
Q

MOA of protease inhibitors

A

inhibit HIV protease enzyme

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74
Q

side effects of protease inhibitors

A

altered distribution of fat (buffalo hump, increased truncal obesity), insulin resistance = hyperlipidemia, neuropathy

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75
Q

what disease causes buffalo hump

A

cushing syndrome (increased cortisol)

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76
Q

what drug besides protease inhibitors leads to fat redistribution

A

glucocorticoids (fat PIG)

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77
Q

acyclovir MOA

A

phosphorylated by viral thymidine kinase into analog of dGTP (inhibits DNA synthesis)

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78
Q

acyclovir side effects

A

neurotoxicity (tremor, delirium),

nephrotoxicity

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79
Q

ganciclovir MOA

A

inhibit CMV DNA polymerase,
especially useful for CMV retinitis

“I Gan Ci”

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80
Q

amantidine MOA

A

binds M2 surface protein on influenza A, blocking uncoating of viral RNA,
can also stimulate release of dopamine from neurons of nigra striatum

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81
Q

amantidine side effect

A

CNS symptoms

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82
Q

zanamivir MOA

A

inhibits neuraminidase,

treats influenza A and B

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83
Q

ribavirin MOA

A

inhibits viral RNA polymerase –> inhibits viral replication

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84
Q

ribavirin side effect

A

teratogenicity

Contraindicated in pregnancy, and in renally insufficient patients

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85
Q

amphotericin MOA

A

tears holes,
binds ergosterol,
alters permeability of fungal cell membrane,
leads to cell death

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86
Q

amphotericin side effects

A

“Ampho-Terrible”

infusion related reaction,
nephrotoxicity

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87
Q

does amphotericin cross the BBB

A

no

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88
Q

flucytosine MOA

A

inhibits thymidylate synthease - inhibits fungal DNA and RNA synthesis

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89
Q

flucytosine side effect

A

bone marrow suppression

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90
Q

caspofungin MOA

A

inhibits B(1,3)-D-glucan synthase

β(1,3)-d-glucan is an essential component of the fungal cell wall

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91
Q

griseofulvin MOA

A

interferes with microtubule formation and inhibits fungal cell replication

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92
Q

name an allylamine and the enzyme it blocks

A

terbinafine,
blocks squalene epoxidase,

tx: onychomycosis

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93
Q

what enzyme do azoles block

A

lanosterol 14 alpha demethylase

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94
Q

ketoconazole, miconazole, clotrimazole side effect

A

gynecomastia (because they disrupt gonadal and adrenal steroid synthesis)

can be used to treat cushing syndrome because of this

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95
Q

quinine side effects

A

cinchonism (tinnitus, headache, dizziness, nausea)
coombs positive hemolytic anemia
fetal toxicity

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96
Q

mefloquine side effect

A

mental status change

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97
Q

primaquine side effects

A

G6PD hemolytic anemia,

fetal toxicity

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98
Q

alpha 1 receptor secondary messenger

A

PLC,
increased IP3 and DAG –>
increased intracellular calcium

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99
Q

alpha 2 and D2 secondary messenger

A

Gi - inhibition of AC leads to decreased cAMP

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100
Q

beta 1 and 2 and D1 secondary messenger

A

Gs - AC activation leading to increased cAMP

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101
Q

direct sympathomimetics - uses

A

emergency shock,
anaphylaxis
(fast decrease in BP)

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102
Q

epinephrine - receptors

A

alpha agonist at high doses,

beta agonist at low doses

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103
Q

uses of epinephrine

A

anaphylaxis,

bronchospasm

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104
Q

epinephrine SE

A

hypertension,

pulmonary edema

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105
Q

norepinephrine - receptors

A

alpha 1, alpha 2, beta 1 (increased contractility)

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106
Q

dopamine - receptors

A

alpha agonist at high doses
beta agonist at low doses
D1 agonist at even lower doses

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107
Q

dobutamine - receptors

A

beta 1 agonist

selective = B for BRAT

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108
Q

uses of dobutamine

A

cardiac stress test,

cardiogenic shock

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109
Q

side effect of dobutamine

A

hypotension (via rebound)

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110
Q

direct sympathomimetics

A

“Duplicate sympathetic END point”

dobutamine,
epinephrine,
norepinephrine,
dopamine

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111
Q

indirect sympathomimetics - stimulate the release of…

A

direct sympathomimetics

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112
Q

ephedrine stimulates release of…

A

norepinephrine,

also stimulates beta 2 receptors and the CNS

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113
Q

effect of ephedrine

A 
increased contractility (same as NE),
bronchodilation (beta 2)
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114
Q

uses of ephedrine

A

nasal decongestant (pseudoephedrine),
athletic enhancement drug
(since it is a CNS stimulant)

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115
Q

cocaine MOA

A

blocks Na/K ATPase pump responsible for reuptake of NE, serotonin, and dopamine

results in euphoria, vasoconstriction

also blocks voltage-gated Na channels
results in anesthesia

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116
Q

cocaine side effects

A

hypertension,
cardiac ischemia,
cardiac arrhythmias

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117
Q

indirect sympathomimetics

A

amphetamines,
cocaine,
ephedrine

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118
Q

use of phenylephrine

A

mydriasis (eye exam)

“would you like me to dilate your Pupils?”

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119
Q

phenylephrine MOA

A

alpha 1 agonist

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120
Q

midodrine MOA

A

alpha 1 agonist

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121
Q

midodrine uses

A

used in patients with advanced hepatic disease,
orthostatic hypotension

Think: Me go faint & M1dodr1ne

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122
Q

side effect of midodrine

A

supine hypertension

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123
Q

clonidine uses

A

treats hypertension by inhibiting release of sympathetic neurotransmitters

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124
Q

clonidine side effect

A

rebound hypertension if withdrawn quickly

Think: “Clonidine clones itself” - goes from treating HTN to causing it!

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125
Q

clonidine MOA

A

alpha 2 agonist

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126
Q

isoproterenol uses

A

treats torsades de pointes (long QT) - given with magnesium for this,
can also treat cardiac arrest/heart block

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127
Q

isoproterenol MOA

A

beta 1 and 2 agonist

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128
Q

fenoldopam use

A

produces renal vasodilation for severe hypertension

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129
Q

albuterol uses

A 
produces bronchodilation (treats asthma),
treats hyperkalemia by causing transcellular shift of K into the cell
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130
Q

beta 2 agonists

A

“Beta 2 agonist needed for SAT-induced asthma!”

salmeterol,
albuterol,
terbutaline,

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131
Q

salmeterol uses

A

long acting treatment for COPD and asthma;
used with inhaled corticosteroids

analogue of albuterol

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132
Q

terbutaline MOA

A

beta 2 agonist;
relaxes smooth muscle in lungs and uterus
by directly-acting on the receptor

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133
Q

terbutaline use

A

delay preterm labor by reducing uterine contractions

Think: “TERM-butaline”

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134
Q

side effects of terbutaline

A

tachycardia,

tremor

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135
Q

methyldopa MOA

A

alpha 2 agonist

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136
Q

methyldopa uses

A

treats moderate hypertension

using adrenergic neurotransmitters

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137
Q

methyldopa side effects

A

positive coombs test,

orthostatic hypotension

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138
Q

phenoxybenzamine MOA

A

irreversible alpha receptor antagonist

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139
Q

phenoxybenzamine side effect

A

inhibition of ejaculation

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140
Q

phenoxybenzamine use

A

treats pheochromocytoma

both are 16 letters

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141
Q

phentolamine MOA

A

SHORT-ACTING

reversible alpha receptor antagonist

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142
Q

phentolamine use

A

diagnose pheochromocytoma

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143
Q

prazosin (-zosin) and tamulosin MOA

A

selective alpha 1 antagonist

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144
Q

prazosin (-zosin) and tamulosin uses

A

decrease prostatic and bladder neck contraction,
decrease blood pressure,
treatment for hypertension and BPH

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145
Q

prazosin (-zosin) and tamulosin side effect

A

first dose syncope (severe orthostatic hypotension –> syncope)

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146
Q

timolol MOA

A

beta 1 and 2 antagonist

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147
Q

timolol uses

A

ophthalmic solution - decreases aqueous humor secretion;

used to treat glaucoma

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148
Q

pindolol MOA

A

weak beta receptor agonist,
beta receptor antagonist,
intrinsic sympathomimetic properties

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149
Q

pindolol uses

A

treats: HTN, bradycardia

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150
Q

propranolol MOA

A

beta 1 and 2 antagonist

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151
Q

propranolol uses

A

tachycardia associated with hyperthyroidism and chronic migraines

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152
Q

side effects of propranolol

A 
bronchoconstriction,
fasting hypoglycemia (decreased glycogenolysis)
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153
Q

esmolol MOA

A

short acting beta 1 antagonist

“es small” = short acting

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154
Q

esmolol uses

A

treats critically ill patients with arrhythmias, hypertension, and MI

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155
Q

carvedilol MOA

A

alpha 1 and beta receptor blocker

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156
Q

carvedilol uses

A

decreases HR and contractility;
bronchoconstriction,
treats CHF (given with ACEi and diuretics),
treats hypertension

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157
Q

metoprolol MOA

A

selective beta 1 antagonist

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158
Q

metoprolol uses

A

decreases HR and contractility,

treats hypertension, tachycardias, CAD, especially in patients with diabetes

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159
Q

M1 and M3 receptors

A

Gq (increased IP3 and DAG –> increased intracellular calcium)

(same mechanism as alpha1 from adrenergics)

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160
Q

M2 receptor

A

Gi (AC is inhibited –> decreased cAMP),
also an increase in K+ conductance

same mechanism as alpha2 from adrenergics

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161
Q

Nm and Nn

A

activation of Na/K channels

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162
Q

pilocarpine and carbachol uses

A

applied topically to eye (ophthalmic solution);
treats glaucoma;

Think: piloCRYpine and CRYbachol

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163
Q

pilocarpine/carbachol MOA

A

M3 muscarinic agonist

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164
Q

methacholine uses

A

bronchial challenge test (inhalation);

diagnoses asthma

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165
Q

methacholine MOA

A

smooth muscle contraction of bronchi,

M1, M2, M3 muscarinic agonist (*use targets M3)

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166
Q

methacholine side effects

A

bradycardia, hypotension;

minimally seen because it is inhaled

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167
Q

bethanechol MOA

A

M2, M3 agonist (use related to M3)

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168
Q

bethanechol uses

A

promotes urination,

treats neurogenic ileus (urinary retention), especially postpartum or postop

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169
Q

bethanechol side effect

A

diarrhea

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170
Q

M3 agonists (3 of them)

A

pilocarpine,
methacholine,
bethanechol

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171
Q

atropine MOA

A

competitive M1-M3 antagonist

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172
Q

atropine use

A

antidote for cholinesterase inhibitor poisoning (nerve gas, insecticide)

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173
Q

treatment for atropine poisoning

A

physostigmine

cholinesterase inhibitor

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174
Q

atropine side effects

A

characteristic of muscarinic block:

hyperthermia (flushing),
decreased salivation,
cycloplegia (blurred vision),
psychosis,
tachycardia
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175
Q

tropicamide and homatropine uses

A

ophthalmic solutions,
retinal examinations,
temporary cycloplegia and mydriasis

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176
Q

tropicamide and homatropine MOA

A

atropine analogs,

antimuscarinic M1-M3

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177
Q

benztropine MOA

A 
M1-M3 antagonist,
M1 receptors (brain) in corpus striatum (PD)
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178
Q

benztropine use

A

treats parkinson’s by improving tremor and rigidity;

no effect on bradykinesia

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179
Q

benztropine contraindication

A

patients with glaucoma

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180
Q

scopolamine MOA

A

competitive M1-M3 antagonist;

action at MI for usage

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181
Q

scopolamine use

A

treats motion sickness,
crosses BBB to interact between vestibular ear and vomiting center of brain

think: “scopukeamine”

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182
Q

ipratropium MOA

A

M3 receptor antagonist

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183
Q

ipratropium uses

A

inhaled form causes bronchodilation;
treats COPD and asthma

(especially in those who are unable to take adrenergic agents)

think: “i pray to breathe”

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184
Q

oxybutynin MOA

A

M1-M3 receptor antagonist (action at M3)

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185
Q

oxybutynin uses

A

treats urinary incontinence and hyperhidrosis

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186
Q

cholinesterase inhibitors (anticholinesterases) have what effects

A

parasympathetic/muscarinic,

increased ACh

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187
Q

neostigmine MOA

A

reversibly inhibits acetylcholinesterase,

increased stimulation of nicotinic and muscarinic receptors

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188
Q

does neostigmine cross the BBB

A

no

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189
Q

neostigmine uses

A

treats myasthenia gravis,

overcomes nondepolarizing neuromuscular blockade (caused by pancuronium or vecuronium)

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190
Q

physostigmine MOA

A

reversibly inhibits Acetylcholinesterase

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191
Q

does physostigmine cross BBB

A

yes - used as antidote for atropine overdose

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192
Q

uses of physostigmine

A

antidote for atropine overdose,

ophthalmic solution - treats glaucoma

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193
Q

edrophonium and pyridostigmine MOA

A

reversibly inhibit Acetycholinesterase –>

increased stimulation of both nicotinic and muscarinic receptors

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194
Q

edrophonium use

A

diagnosis of myasthenia gravis (short acting)

think: “a drop lasts a moment, but a stigma lasts forever”

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195
Q

pyridostigmine use

A

treats myasthenia gravis (long acting)

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196
Q

tacrine MOA

A

reversibly inhibits AChE –>

increased stimulation of both nicotinic and muscarinic receptors

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197
Q

tacrine use

A

treats alzheimers

Think: “Tacrine (taking) care of Alzheimer’s patients”

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198
Q

tacrine side effect

A

hepatotoxicity

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199
Q

drugs similar to tacrine

A

Think: “Tacrine RDG”

rivastigmine,
donezepil,
galantamine,

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200
Q

echothiophate MOA

A

inhibits AChE by covalently binding to the enzyme –>

increased stimulation of both nicotinic and muscarinic receptors

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201
Q

drugs similar to echothiophate

A

isoflurophate,
malathion,
parathion

think: “echothiophate - IMP”

202
Q

echothiophate and isoflurophate use

A 
ophthalmic ointments,
treat glaucoma (M3)
203
Q

side effects of echothiophate

A

seizures, bradycardia, flaccid paralysis, and muscarinic activation SEs

due to persistent nicotinic activation resulting in NM blockade - depolarizing)

204
Q

echothiophate overdose treatment

A

atropine,

pralidozime

205
Q

pralidoxime MOA

A

cholinesterase reactivator,
reverses cholinesterase inhibitor binding to AChE

(so it opposes acetylcholinesterase inhibitors)

206
Q

pralidoxime effects are similar to what other drug

A

atropine

207
Q

pralidoxime uses

A

used with atropine to treat nerve gas or organophosphate poisoning,
treats overdose of neostigmine or pyridostigmine

208
Q

hexamethonium, mecamylamine, trimethphan MOA

A

competitive inhibition of Nn receptors on postsynaptic neurons of autonomic ganglia,
block outflow to sympathetic and parasympathetic neurons,
anti-nicotinic

209
Q

hexamethonium use

A

treats hypertensive emergencies

210
Q

hexamethonium side effect

A

hypotension

211
Q

how long does it take for antidepressants to work

A

3-4 weeks

212
Q

SSRIs

A 
fluoxetine,
fluvoxamine,
paroxetine,
escitalopram,
citalopram,
sertraline

Think: “Fun Fabulous PECS”

213
Q

SSRI uses

A

treat depression and OCD

214
Q

SSRI side effect

A

sexual dysfunction

215
Q

SSRIs and MAOIs cannot be given together due to

A

serotonin syndrome - changes in mental status, muscle stiffness, autonomic instability, hyperthermia

216
Q

fluoxetine inhibits what enzyme

A

cytochrome P450

217
Q

TCAs

A

Think: “ANTI-Depressant”

amitriptyline,
nortriptyline,
trazodone (tetracyclic anti depressant or SARI),
imipramine,
doxepin
218
Q

TCA MOA

A

block norepinephrine and serotonin reuptake,

also inhibit muscarinic, histamine, and alpha adrenergic receptors (side effects)

219
Q

TCA uses

A

treats depression, enuresis (bed wetting), chronic pain syndromes

220
Q

given together, TCAs and MAOIs cause

A

seizures

221
Q

trazodone use

A

insomnia

think: “trazodone makes you zone out”

222
Q

trazodone side effect

A

priapism

prolonged erection

223
Q

amitriptyline use

A

neuropathic pain

think: “am i tripping?”

224
Q

imipramine use

A

enuresis

think: “promise me to stop wetting the bed”

225
Q

buproprion use

A

smoking cessation,

anti-depressant

226
Q

histamine blockade

A

sedation

227
Q

adrenergic blockade

A

postural hypotension, cardiac arrhythmias

228
Q

muscarinic blockade

A

urinary retention,
blurred vision,
constipation,
dry mouth

229
Q

heterocyclic anti depressants

A

nefazodone,
venlafaxine,
mitrazapine,
maprotiline

think: “NVM, Man”

230
Q

nefazodone, venlafaxine, maprotiline MOA

A

block reuptake of norepinephrine and serotonin

231
Q

mirtazapine MOA

A

inhibits activation at alpha 2 adrenergic receptors and at 5HT2 receptors,
increases release of NE and serotonin

232
Q

mirtazapine side effects

A

sedation,
increased appetite,
weight gain

233
Q

venlafaxine side effects

A

elevated BP and HR

234
Q

MAOIs

A

tranylcypromine,
isocarboxazid,
phenelizine

think: “MAO TIP”

235
Q

MAOa

A

NE and serotonin

236
Q

MAOb

A

dopamine

237
Q

MAOI use

A

atypical depression

238
Q

side effect of MAOI

A

cheese effect:
MAO metabolizes tyramine- increased tyramine stimulates release of epi and NE
causes hypertensive crisis (HA, HTN, cardiac arrhythmias)

avoid tyramine-containing foods

239
Q

selegiline MOA and use

A

MAOI for MAOb (dopamine),
treats parkinsons with levodopa,
and major depressive disorder

240
Q

lithium use

A

bipolar disorder

241
Q

lithium side effects

A

tremor,
hypothyroidism,
nephrogenic diabetes insipidus (ADH antagonism),
teratogen

242
Q

drugs that cause hypothyroidism

A

lithium,
amiodarone,
sulfonamide

think: “LASs with hypothyroidism”

243
Q

drugs that cause nephrogenic diabetes insipidus

A

lithium,

demeclocycline

244
Q

typical antipsychotics MOA

A

block dopamine D2 receptors,

inhibit histamine, cholinergic, and alpha adrenergic receptors

245
Q

typical antipsychotics

A

fluphenazine,
thioridazine,
chlorpromazine,
haloperidol

think: “antipsychotics For Typical, Crazy, Humans”

246
Q

typical antipsychotics side effects

A

galactorrhea and amenorrhea (due to hyperprolactinemia),
neuroleptic malignant syndrome,
blockade symptoms,
extrapyramidal side effects

think: typicals treat tourette’s syndrome

247
Q

typical antipsychotics are effective against

A

positive symptoms

248
Q

antidote for neuroleptic malignant syndrome

A

dantrolene (muscle relaxant)

249
Q

atypical antipsychotics

A 
olanzapine,
clozapine,
quetiapine,
risperidone,
aripiprazole,
ziprasidone,

think: (its) ATYPICAL (for) OLd CLOSets (to) QUIETly RISPER (from) A (to) Z.

250
Q

atypical antipsychotic MOA

A

blocks serotonin and dopamine receptors

251
Q

side effects of atypical antipsychotics

A

mild weight gain,

parkinsonism

252
Q

atypical antipsychotics treat what symptoms

A

positive and negative

253
Q

clozapine side effects

A

leukopenia,

agranulocytosis

254
Q

drugs that cause agranulocytosis

A 
ganciclovir,
clozapine,
carbamazepine,
colchicine,
methimazole,
PTU

think: “Gangs CCCrush Myeloblasts and Promyelocytes”

255
Q

benzodiazepines (-lam, -pam, chlordiazepoxide) MOA

A

enhances GABAa activity, increased chloride ion influx, hyperpolarization, decreased CNS neuronal activity

256
Q

benzo uses

A

anxiety, seizures, status epilepticus, alcohol withdrawal,

midazolam and diazepam are anesthetics

257
Q

treatment for benzo overdose

A

flumazenil

competitive antagonist of benzodiazepines

258
Q

barbiturates uses

A

thiopental - induction of anesthesia,

phenobarbital - management of seizures, treats neonatal hyperbilirubinemia

259
Q

CC: crigler najjar syndrome

A

congenital syndrome where babies have difficulty conjugating bilirubin;
jaundice, encephalopathy

260
Q

zolpidem use

A

short term tx for insomnia

think: “Zolpidem for Zzz”

261
Q

zolpidem MOA

A

binds GABAa like benzos

262
Q

zolpidem side effects

A

mild anterograde amnesia,

hallucinations

263
Q

phenytoin MOA

A

decrease flow of Na and Ca ions

264
Q

phenytoin uses

A

anti-epileptic,
partial seizures,
status epilepticus,

265
Q

phenytoin side effects

A

nystagmus,
gingival hyperplasia,
drug-induced lupus,
teratogen (fetal hydantoin syndrome)

266
Q

drugs that cause drug induced lupus (SHIPP-E)

A 
sulfa,
hydralazine,
isoniazid,
procainamide,
phenytoin,
etanercept
267
Q

lamotrigine MOA

A

blocks fast voltage activated Na channels;

anti-epileptic

268
Q

lamotrigine side effect

A

stevens johnson syndrome

269
Q

drugs that cause stevens johnson syndrome

A

sulfa,
penicillin,
allopurinol,
lamotrigine

270
Q

valproic acid uses

A

mania,

seizures

271
Q

valproic acid side effects

A

hepatotoxic,

teratogen (neural tube defects)

272
Q

ethosuximide use

A

treats absence seizures

think: “it sux to be absent”
MOA: is not well-understood

273
Q

carbamazepine MOA

A

inhibits flow of Na ions

274
Q

carbamazepine uses

A

first line for simple seizures, complex partial seizures, generalized tonic-clonic seizures (grand mal),
treats trigeminal neuralgia

275
Q

topiramate uses

A

migraines, seizures

think: “top of head hurts”

276
Q

topiramate MOA

A

inhibits Na ion flow

277
Q

tiagabine MOA

A

inhibits reuptake of GABA

278
Q

tiagabine use

A

partial seizures as adjunct tx

279
Q

vigabatrin MOA

A

irreversibly inhibts GABA transaminase

280
Q

vigabatrin uses

A

infantile spasm in kids,
refractory complex partial seizures

think: “Vi-GABA-trin - “Visual” - “GABA transaminase”

281
Q

side effects of vigabatrin

A

visual field constriction, visual loss in 30% of patients

282
Q

levetiracetam uses

A

anti-epileptic, treats neuropathic pain

283
Q

side effects of levetiracetam

A

drowsiness, depression

284
Q

succinylcholine MOA

A

depolarizing neuromuscular blocker, competes with ACh to reversibly bind to nicotinic receptors
continuous depolarization at NMJ leads to fasciculations and eventual desensitization (NM blockade)

285
Q

succinylcholine antidote

A

physostigmine

cholinesterase inhibitor

286
Q

succinylcholine use

A

muscle paralysis for endotracheal intubation

287
Q

succinylcholine contraindicated with halothane because

A

malignant hyperthermia (antidote = dantrolene)

288
Q

pancuronium MOA

A

non-depolarizing neuromuscular blocker,
does not activate nicotinic receptor but just blocks ACh binding to it,
no skeletal muscle contraction can occur

289
Q

pancuronium antidote

A

neostigmine

cholinesterase inhibitors

290
Q

pancuronium use

A

adjunct to general anesthesia induction

291
Q

ester local anesthetics duration of action

A

shorter than amides

292
Q

side effects of local anesthetics

A

seizures

293
Q

general inhaled anesthetics (-fluranes and halothane) uses

A

GA induction and maintenance

294
Q

inhaled general anesthetic side effects

A

myocardial/respiratory depression,
halothane - fulminant hepatic necrosis,
methoxyflurane/enflurane - nephrotoxic

295
Q

drugs that cause fulminant hepatic necrosis (HAVAc)

A

halothane,
amanita phalloides (death cap mushroom),
valproic acid,
acetaminophen

think: “Liver HAVAc”

296
Q

bupivacaine side effects

A

myocardial depression,

hypotension

297
Q

IV general anesthetics

A 
propofol,
etomidate,
ketamine,
benzos,
barbiturates
298
Q

propofol uses and side effect

A

induction and maintenance of GA
conscious sedation;

hypotension

299
Q

etomidate MOA and use

A

prolongs GABA activity;

induction of anesthesia and conscious sedation

300
Q

ketamine MOA and side effects

A

NMDA receptor antagonist; decrease neuronal conduction

hallucinations, cardiac and resp depression

301
Q

uses of codeine and dextromethorphan

A

cough suppressant

302
Q

butorphanol

A

opioid agonist and antagonist (mixed)

treats pain, manages migraines via intranasal formulation

303
Q

tramadol

A

opioid agonist,
moderate to severe pain,
side effect is seizures

304
Q

dantrolene MOA

A

inhibits calcium release from SR of myocytes to relax muscle –>
muscle relaxants

305
Q

dantrolene uses

A

malignant hyperthermia;

neuroleptic malignant syndrome

306
Q

dantrolene side effect

A

hepatotoxic

307
Q

levodopa crosses the BBB and then becomes

A

dopamine

308
Q

levodopa use

A

first line tx for parkinsonism

309
Q

levodopa side effects

A

dyskinesia, cardiac arrhythmias

310
Q

levodopa is given with

A

carbidopa,

carbidopa inhibits dopa-decarboxylase peripherally so levodopa can act on the brain

311
Q

sumatriptan MOA

A

stimulates presynaptic serotonin receptors –> inhibits vasodilation and inflammation of dura

312
Q

sumatriptan uses

A

treats migraines and cluster headaches

313
Q

sumatriptan side effect

A

coronary vasospasm (CI in CAD patients)

314
Q

memantine MOA

A

NMDA antagonist

315
Q

memantine use

A

moderate to severe alzheimers

316
Q

buproprion MOA

A

inhibits reuptake of NE and dopamine,

nicotinic antagonist

317
Q

buproprion side effects

A

psychosis, seizures, dry mouth

318
Q

varenicline MOA

A

partial agonist and antagonist (mixed) at a4B2 nicotinic ACh receptors in the brain

319
Q

varenicline use and side effect

A

smoking cessation,

suicidal ideation

320
Q

pregabalin (lyrica) uses

A

treats neuropathic pain and fibromyalgia

321
Q

gabapentin (neurontin) MOA

A

GABA analog

322
Q

gabapentin uses

A

treats postherpetic neuralgia, neuropathic pain, partial seizures

323
Q

gabapentin side effect

A

peripheral edema

324
Q

buspirone MOA

A

acts on 5-HT1a as partial agonist

325
Q

buspirone use

A

treats anxiety when used with SSRIs

326
Q

goals of treating systolic heart failure

A

increase contractility - inotropes (dobutamine, milrinone), digoxin,
optimize HR - beta blockers,
optimize preload - diuretics, venodilators,
reduce afterload - arteriolar vasodilators, mixed vasodilators

327
Q

which phases of the cardiac myocyte action potential are missing from the SA node action potential?

A

phase 1 and 2

328
Q

cardiac myocyte depolarizaton occurs with what ion

A

Na

329
Q

SA node depolarization occurs with what ion

A

Ca

330
Q

class IA anti arrhythmics

A

disopyramide,
quinidine,
procainamide

think: “Double Quarter Pounder”

331
Q

class IA anti arrhythmic MOA

A

block activated Na channels (phase 0 depol prolonged, phase 3 repol prolonged)
prolonged QT interval

332
Q

class IB anti arrhythmics

A

lidocaine,
tocainide,
mexiletine

think: “lettuce tomato mayo”

333
Q

class IB anti arrhythmic MOA

A

block activated and inactivated Na channels (phase 3 repol shortened along with AP)
shortened QT interval

334
Q

class IC anti arrhythmics

A

encainide,
flecainide,
propafenone

think: “extra fries please!”

335
Q

class IC anti arrhythmic MOA

A

block flow of Na inside;

phase 0 depol prolonged

336
Q

class III anti arrhythmics

A 
bretylium
--
amiodarone,
ibutilide,
dofetilide,
sotalol

think: “Band-AIDS”

337
Q

class III anti arrhythmic MOA

A

block flow of K channels out;
phase 3 repol prolonged (and AP)
prolonged QT interval

338
Q

class IV anti arrhythmics

A

verapamil,

diltiazem

339
Q

class IV anti arrhythmic MOA

A

block voltage gates Ca channels in SA and AV nodes;

slow phase 4 spontaneous depolarization

340
Q

class I, 3, 4 - assoc. ions

A 
class I - Na,
class III - K,
class IV - Ca
341
Q

class IA anti arrhythmic uses

A

WPW syndrome,
a fib,
v tach

342
Q

class IB anti arrhythmic uses

A

v tach,

v fib

343
Q

class IC anti arrhythmic uses

A

supraventricular arrythmias (a fib)

344
Q

class III anti arrhythmic uses

A

-tilides –> atrial arrhythmias,

sotalol and amiodarone –> atrial and ventricular arrhythmias

345
Q

class IV anti arrhythmic uses

A 
supraventricular tachycardia (a fib),
also treat hypertension and angina
346
Q

quinidine side effect

A

cinchonism (vertigo, headache, tinnitus, psychosis)

class IA anti-arrhythmic

347
Q

procainamide side effect

A

drug induced lupus

class IA anti-arrhythmic

348
Q

disopyramide side effects

A

urinary retention,
double vision,
constipation

class IA anti-arrhythmic

349
Q

amiodarone side effects

A 
pulmonary fibrosis,
hepatotoxicity,
thyroid dysfunction,
cardiac arrhythmias,
ataxia,
photosensitivity

class III anti-arrhythmic; but has class I-IV actions

350
Q

class IA and class III common side effect

A

torsades de pointes (prolonged QT interval, type of v tach)

351
Q

how to treat torsades de pointes

A

isoproterenol and magnesium

352
Q

adenosine use

A

anti arrhythmic used for cardiac stress testing

353
Q

potassium uses

A

anti arrhythmic,
suppresses ectopic pacemakers,
treats digoxin toxicity

354
Q

magnesium uses

A

anti arrhythmic,

treats torsades de pointes and digoxin toxicity

355
Q

nitroglycerin use

A

treats angina

356
Q

nitroglycerin MOA

A

–> becomes nitric oxide –>
smooth muscle relaxation of veins,
decreases preload (venous return)

357
Q

nitroglycerin side effect

A

hypotension

358
Q

nitroprusside MOA

A

mixed vasodilator,
smooth muscle relaxation of peripheral veins and arteries,
decreased preload (venous return) and afterload (blood pressure)

359
Q

use of nitroprusside

A

treats hypertensive crisis

360
Q

side effect of nitroprusside

A

cyanide toxicity (adminster nitroprusside IV)

361
Q

uses of ACEi and ARBs

A

treat hypertension and CHF,

treat and prevent diabetic nephropathy

362
Q

side effects of ACEi

A

cough,
angioedema

due to increased active bradykinin levels, while ARBs do not, since they simply block the angiotensin II receptor without inhibiting ACE

363
Q

hydralazine MOA

A

direct relaxation of arteriolar smooth muscle;

arteriolar vasodilators

364
Q

uses of hydralazine

A

hypertension,
heart failure,
decreases afterload,
first line treatment of hypertension in pregnancy

365
Q

side effect of hydralazine

A

drug induced lupus

366
Q

minoxidil MOA and use

A

arteriolar vasodilators,
anti hypertensive agent,
opens K channels in smooth muscle,
also used for hair growth

367
Q

CCB use

A

treats hypertension,

verapamil and diltiazem treat supraventricular tachycardia

368
Q

CCBs

A 
nifedipine,
diltiazem,
verapamil,
amlodipine,
nicardipine

think: “ND VAN”
May need CCBs after eating at the ND VAN

369
Q

side effect of amlodipine

A

peripheral edema

370
Q

side effects of CCBs

A

hypotension,

heart block

371
Q

carbonic anhydrase inhibitor

A

acetazolamide

372
Q

osmotic diuretics

A

glycerin,
mannitol,
urea,
isosorbide

think: “GUMI”

373
Q

loop diuretics

A

furosemide,
bumetanide,
ethacrynic acid
torsemide

think: “F BEaTs”

374
Q

thiazide diuretics

A

metolazone,
indapamide,
thiazide,
thalidone

think: “MITT”

375
Q

K sparing diuretics

A

aldosterone receptor antagonists- spironolactone, eplerenone,
Na channel blockers - triamterene, amiloride

376
Q

carbonic anhydrase inhibitors act at which part of the nephron

A

PCT

think: “PaCeTazolamide”

377
Q

osmotic diuretics act at which part of the nephron

A

thin descending loop of henle

think: “osmosis jones is a tall, thin man (mannitol)”

378
Q

carbonic anhydrase inhibitors MOA

A

inhibit carbonic anhydrase,
less bicarbonate reabsorbed,
more Na lost in tubular lumen,

carbonic anhydrase also in the eye - involved in production of aqueous humor

379
Q

carbonic anhydrase inhibitors uses

A

treats glaucoma,
alkalinize the urine,
prophylaxis for high altitude sickness

380
Q

uses of osmotic diuretics

A

decrease intracranial or intraocular pressure

381
Q

uses of loop diuretics

A

for volume overload states,
hypertension,
hypercalcemia (excretes calcium)

382
Q

uses of thiazide diuretics

A

first line for hypertension,
nephrogenic diabetes insipidus,
recurrent kidney calcium stones (spares calcium) - decreased excretion of calcium

383
Q

MOA of K sparing diuretics

A

Na channel blockers - spare K by specifically blocking Na channels;
aldosterone receptor antagonists - competitive

384
Q

carbonic anhydrase inhibitor side effects

A

hyperchloremic metabolic acidosis,
hypokalemia,
neuropathy,
sulfa allergy

385
Q

osmotic diuretics side effects

A

pulmonary edema,

contraindicated in CHF patients

386
Q

loop diuretic side effects

A

ototoxicity,
hyperuricemia,
sulfa allergy (give ethacrynic acid instead),
hypokalemia

387
Q

thiazide diuretics side effects

A 
hyperuricemia,
hypokalemia,
hyperglycemia,
hyperlipidemia,
hypercalcemia,
metabolic alkalosis,
hypersensitivity reactions
388
Q

Na channel blocker K sparing diuretic side effect

A

hyperkalemia

389
Q

aldosterone receptor antagonist K sparing diuretic side effects

A

hyperkalemia,

gynecomastia (anti- androgen effect with spironolactone)

390
Q

phosphodiesterase inhibitors

A

sildenafil (viagra),

milrinone

391
Q

sildenafil MOA

A

selectively inhibits cGMP-specific PDE type 5 found in corpus cavernosum of the penis and smooth muscle of pulmonary vasculature

think: “sildenafive for type 5”

392
Q

sildenafil uses

A

treats erectile dysfunction and pulmonary arterial hypertension

393
Q

milrinone MOA

A

inhibits PDE type 3 (increased cAMP, open calcium channels, increased contractility)

394
Q

milrinone use

A

treats acute decompensated heart failure

395
Q

side effects of milrinone

A

nausea, thrombocytopenia

396
Q

nesiritide MOA

A

synthetic human B type natriuretic peptide (hBNP),

binds guanylate cyclase - increased cGMP, smooth muscle relaxation, reduced preload and afterload

397
Q

nesiritide use

A

treats acute decompensated heart failure

398
Q

nesiritide side effect

A

hypotension

399
Q

digoxin (cardiac glycoside - others are digitoxin and ouabain) MOA

A

inhibits Na/K pump - increased intracellular Na, decreased activity of Na/Ca exchanger, increased intracellular Ca, increased contractility

400
Q

digoxin use

A

treats heart failure

401
Q

digoxin side effects

A

GI upset,
blurry, yellow vision,
ECG changes (prolonged PR, decreased QT, ST segment scooping, T wave inversion),
increase in parasympathetic flow

402
Q

digoxin side effects are made worse by:

A

hypokalemia (digoxin and K compete for binding site to ATPase),
quinidine (displaces digoxin from binding sites on albumin and increases serum levels of digoxin)

403
Q

heparin MOA

A

activates antithrombin III,
short half life,
rapid onset

404
Q

LMWHs (low molecular weight heparin)

(enoxaparin, dalteparin) duration of action

A

longer than heparin,

need less frequent dosing

405
Q

warfarin MOA

A

inhibits vitamin K dependent g-carboxylation of factors 2, 7, 9, 10, protein C and protein S;
long half life,
slow onset

406
Q

direct thrombin inhibitors (argatroban) MOA

A

directly inhibit thrombin

-rudin, -gatroban, & -gatran

407
Q

fondaparinux MOA

A

accelerate selective action of antithrombin III by inhibiting factor Xa

408
Q

does fondaparinux have HIT has a side effect?

Heparin Induced Thrombocytopenia (HIT)

A

no

because Fondaparinux is selective –> doesn’t have HIT as a side-effect

409
Q

rivaroxaban MOA

A

direct inhibition of factor Xa

410
Q

what do you give to a patient that is allergic to heparin?

A

fondaparinux or rivaroxaban

411
Q

heparin uses

A

acute DVT,

pulmonary embolism

412
Q

warfarin use

A

chronic anticoagulation

413
Q

direct thrombin inhibitors (argatroban) uses

A

acute and chronic anticoagulation

414
Q

argatroban use

A

treats HIT

415
Q

bivalirudin use

A

treats acute coronary syndromes during cardiac catheterization

can be used by patients allergic to heparin

416
Q

fondaparinux uses

A

acute DVT,

pulmonary embolism

417
Q

rivaroxaban uses

A

DVT prophylaxis,
prevent thromboembolism in patients with A Fib

can be used by patients allergic to heparin

418
Q

heparin side effects

A

bleeding (give protamine sulfate),

HIT

419
Q

warfarin side effects

A

bleeding,

teratogen

420
Q

aspirin MOA

A

irreversibly inhibits COX 1 and 2 to decrease prostaglandin synthesis –>

TXA2 inhibition provides decreased platelet aggregation

421
Q

clopidogrel/prasurgel MOA

A

irreversibly inhibits binding of ADP to platelet P2Y receptor, blocking ADP mediated platelet aggregation;
no fibrinogen interaction with platelets so no platelet plug

422
Q

cilostazol MOA

A

inhibits cAMP phosphodiesterase III;
inhibits TXA2 which decreases platelet aggregation

prasugrel is the same

423
Q

dipyridamole MOA

A

inhibits uptake of adenosine into platelets,
inhibits platelet aggregation and thrombus formation
promotes vasodilation,
inhibits cGMP PDE

424
Q

abciximab MOA

A

binds GP IIb/IIIa receptor complex,
inhibits binding of fibrinogen and vWF to the receptor
no platelet aggregation

think: “ABC it’s easy as GP-2,3”

425
Q

aspirin overdose can lead to

A

respiratory or metabolic acidosis (must alkalinize urine to promote excretion - give sodium bicarbonate)

426
Q

ticagrelor MOA

A

reversible allosteric inhibitor of P2Y12 receptor,

no platelet plug

427
Q

aspirin indications

A 
many uses,
pain,
fever,
antiplatelet,
antiinflammatory
428
Q

clopidrogel uses

A

acute coronary syndrome (with aspirin),
patients undergoing placement of a coronary stent

prasugrel is the same

429
Q

cilostazol use

A

claudication

430
Q

dipyridamole uses

A

cardiac stress test,

used with aspirin for stroke prevention

431
Q

abciximab use

A

acute coronary syndrome

432
Q

aspirin side effects

A

bleeding in GI tract,
gastric ulcers/gastritis,
reye’s syndrome (fatal liver failure in kids with viral infections),
tinnitus

433
Q

ticlopidine side effects

A

bleeding,
neutropenia,
thrombocytopenic purpura

434
Q

prasugrel side effect

A

thrombocytopenic purpura

435
Q

cilostazol side effects

A

headache,

palpitations

436
Q

dipyridamole side effects

A

hypotension,

hepatotoxicity

437
Q

abciximab side effects

A

bleeding,
thrombocytopenia,
diffuse alveolar hemorrhage

438
Q

fibrinolytic agents

A

streptokinase,
urokinase,
alteplase,
reteplase

439
Q

fibrinolytic agents MOA

A

promote conversion of plasminogen to plasmin

440
Q

fibrinolytic agents indications

A

massive pulmonary embolism,
stroke,
acute MI,

most effective when given early on

441
Q

fibrinolytic agents side effect

A

bleeding

442
Q

aminocaproic acid (tranexamic acid) MOA

A

inhibits plasminogen activation,
inhibition of fibrinolysis,
promotes clotting

443
Q

aminocaproic acid use

A

treats bleeding

444
Q

aminocaproic acid side effect

A

thrombosis

445
Q

synthetic erythropoietin (epoetin, darbepoetin) MOA

A

stimulates bone marrow to enhance erythroid proliferation and differentiation,
increases hematocrit

446
Q

epoetin use

A

treats anemia

447
Q

epoetin side effects

A

CV events and thrombotic complications,

teratogen

448
Q

epoetin contraindications

A

renal patients

449
Q

how is insulin secreted?

A 
glucose enters cell,
metabolizes to ATP,
ATP binds K channel and closes it so K cannot flow out of the cell,
depolarization,
calcium release intracellularly,
promotes exocytosis of insulin
450
Q

thiazolidinediones (-glitazone) MOA

A

bind to PPAR-g which upregulates genes that lead to decrease in insulin resistance

451
Q

rosiglitazone side effect

A

heart attacks

452
Q

troglitazone side effect

A

liver damage

453
Q

pioglitazone side effect

A

bladder cancer

454
Q

thiazolidinediones (-glitazone) general side effects

A

edema, hypoglycemia

455
Q

sulfonylureas MOA

A

inhibit K channel on beta cells

456
Q

chlorpropamide side effect

A

disulfiram like reaction with alcohol

457
Q

sulfonylurea general side effect

A

hypoglycemia

458
Q

contraindication for sulfonylureas

A

pregnancy

459
Q

1st generation sulfonylureas

A

chlorpropamide,
tolbutamide,
tolazamide

460
Q

2nd generation sulfonylureas

A

glyburide,

glipizide

461
Q

3rd generation sulfonylureas

A

glimepiride

think: M3

462
Q

alpha glucosidase inhibitors (acarbose and miglitol) MOA

A

inhibt alpha glucosidase which breaks down carbs into monosaccharides for absorption (no more absorption of glucose)

463
Q

acarbose and miglitol side effects

A

GI upset (flatulence, diarrhea)

464
Q

metformin uses

A

diabetes,

treats polycystic ovarian syndrome (PCOS)

465
Q

does metformin cause hypoglycemia?

A

no

466
Q

metformin side effects

A

GI upset,

lactic acidosis

467
Q

metformin contraindication

A

renal patients (this is how it is excreted)

468
Q

metformin MOA

A

inhibits hepatic gluconeogenesis and helps make beta cells work better

(improves insulin sensitivity)

469
Q

meglitinides (-glinide) - ex. repaglinide MOA

A

bind K channel (different channel from sulfonylureas but same effect essentially)

470
Q

meglitinides side effects

A

weight gain,

hypoglycemia

471
Q

DPP-4 inhibitors (sitagliptin, saxagliptin) MOA

A

DPP-4 degrades GLP-1,
GLP-1 increases insulin and decreases glucagon secretion,
inhibition of DPP-4 allows for more GLP-1 action

472
Q

DPP-4 inhibitors side effect

A

nausea/vomiting

473
Q

GLP-1 analogs (exenatide, liraglutide) MOA

A

mimic GLP-1 –> increase insulin and decrease glucagon secretion

474
Q

GLP-1 analog side effects

A

pancreatitis,
hypoglycemia,
weight loss

475
Q

bile acid resins

A

cholestyramine,
colestipol,
colesevelam

476
Q

bile acid resins MOA

A

inhibit reabsorption of bile acids in jejunum and ileum,

decreases LDL levels

477
Q

bile acid resins side effects

A

GI upset,

decreased fat soluble vitamin absorption (ADEK) and folic acid

478
Q

statins MOA

A

HMG-coA reductase inhibitors,

decrease total cholesterol and LDL levels

479
Q

statins side effects

A

myopathy,

abnormal LFTs

480
Q

niacin MOA

A

increases HDL levels

481
Q

niacin side effects

A

flushing (give aspirin to decrease),

hyperuricemia

482
Q

fibrates (gemfibrozil, -fibrates) MOA

A

stimulates lipoprotein lipase (breaks down TG into VLDL and chylomicrons which are then removed from circulation),
decreases TG levels

483
Q

fibrates side effect

A

gallstone formation

484
Q

ezetimibe MOA

A

decreases absorption of cholesterol in small intestine,

decreases serum LDL

485
Q

ezetimibe use

A

adjunct for hypercholesterolemia

486
Q

ezetimibe side effects

A

steatorrhea (diarrhea),
myalgia,
elevated LFT

487
Q

levothyroxine MOA

A

synthetic T4

think: “LeFOURthyroxine”

488
Q

levothyroxine uses

A

hypothyroidism,

goiters (thyroid cancer) by suppressing TSH secretion

489
Q

PTU and methamizole MOA

A

inhibit thyroid peroxidase,

inhibition of thyroid hormone synthesis and peripheral conversion of T4 to T3

490
Q

PTU and methamizole use

A

hyperthyroidism

491
Q

PTU and methamizole side effects

A

hepatotoxicity,
rash,
methamizole also is teratogen

492
Q

symptoms of hyperthyroidism

A

tachycardia,
weight loss,
diarrhea

493
Q

symptoms of hypothyroidism

A

bradycardia,
weight gain,
constipation

494
Q

where is T4 secreted from?

A

follicular cells of the thyroid gland

495
Q

prednisone (synthetic corticosteroid) MOA

A

synthetic glucocorticoids that mimic the action of endogenous glucocorticoids

496
Q

prednisone uses

A 
adrenocortical insufficiency,
IBD,
allergic reactions,
SLE, RA,
diagnosis of cushing's syndrome,
immunosuppression in organ transplants
497
Q

prednisone side effects

A

symptoms of cushing syndrome (osteoporosis, hyperglycemia, fat redistribution - buffalo hump and moon facies),
impaired wound healing

498
Q

how do we diagnose cushing’s syndrome?

A

dexamethasone suppression test

499
Q

beclomethasone use

A

inhaled corticosteroid used to treat chronic asthma

think: “B for Bronchial asthma and Beclomethasone”

500
Q

bisphosphonates (-onate) - ex. alendronate MOA

A

decrease osteoclastic bone reabsorption

1_BOARDS (14 decks)

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