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Pharm - Rami Pt 2 Flashcards

1
Q

bisphosphonates uses

A

osteoporosis,
paget disease,
hypercalcemic bone metastasis

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2
Q

side effect of bisphosphonates

A

osteonecrosis of jaw (rare)

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3
Q

paget disease (osteitis deformans) first sign and hallmark

A

first sign: increased ALP,

hallmark: ivory vertebra

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4
Q

cushing’s syndrome

A

increased cortisol levels

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5
Q

cushing’s disease

A

increased cortisol levels due to overactive ACTH

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6
Q

dexamethasone suppression test

A

increases cortisol which should cause negative feedback

in cushing’s disease negative feedback will not happen so cortisol levels will remain high

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7
Q

colchicine MOA

A

induces microtubular polymerization by binding tubulin,

decreased migration of leukocytes (less inflammatory response)

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8
Q

colchicine use

A

acute gout attacks (also use NSAIDs like indomethacin or naproxen)

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9
Q

colchicine side effect

A

diarrhea

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10
Q

probenecid MOA

A

decreases reabsorption of uric acid in PCT by blocking active transport of uric acid

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11
Q

probenecid use

A

prevention of further gouty attacks (prophylaxis)

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12
Q

probenecid side effect

A

inhibition of renal excretion of penicillin and NSAIDs

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13
Q

allopurinol use

A

prevention of further gouty attacks (prophylaxis)

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14
Q

allopurinol MOA

A

inhibits xanthine oxidase (stops conversion of xanthine to uric acid)

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15
Q

allopurinol side effects

A

hypersensitivity reaction,

decreased metabolism of 6-mercaptopurine and azathioprine

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16
Q

orlistat MOA

A 
inhibits lipase (decreased intestinal fat absorption),
anti-obesity drug
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17
Q

orlistat side effects

A

steatorrhea
fecal incontinence,
decreased absorption of fat soluble vitamins

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18
Q

sibutramine MOA

A

serotonin, NE, and dopamine reuptake inhibitor,

anti-obesity drug

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19
Q

sibutramine side effect

A

sexual dysfunction

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20
Q

fen-phen (phentermine) MOA

A

increased catecholamine release in brain

anti-obesity drug

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21
Q

fen-phen (phentermine) side effects

A

increased risk of valvular disease and pulmonary hypertension,
withdrawn from market

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22
Q

flutamide MOA

A

competitive antagonist at androgen receptor,

decreases growth effects of testosterone on prostate

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23
Q

flutamide use

A

prostate cancer treatment

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24
Q

flutamide needs to always be given with what other drug and why?

A

leuprolide,

counteract increase LH levels caused by lower testosterone

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25
Q

flutamide side effects

A

gynecomastia,

LFTs

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26
Q

finasteride MOA

A

inhibits 5 alpha reductase (inhibits conversion of testosterone to DHT which stimulates prostate gland growth)

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27
Q

finasteride uses

A

BPH,
prostate cancer,
early male pattern baldness

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28
Q

finasteride side effects

A

decreased libido,

erectile dysfunction

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29
Q

leuprolide (naferelin and goserelin) MOA

A

GnRH agonist

eventual desensitization and downregulation of GnRH leads to decreased LH and decreased testosterone

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30
Q

leuprolide side effects

A

impotence,

hot flashes

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31
Q

leuprolide uses

A

metastatic prostate cancer,
leiomyomas,
infertility (given in pulsatile fashion)

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32
Q

danazol MOA

A

agonist at androgen and progesterone receptors,
decreased LH and FSH secretion
increases levels of C1 esterase inhibitor

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33
Q

danazol uses

A

endometriosis,

hereditary angioedema

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34
Q

danazol side effects

A

androgenic side effects in women (masculinization, hirsutism, acne)

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35
Q

clomiphene MOA

A

partial agonist at estrogen receptors in the pituitary gland,
decreases normal feedback inhibition
increases LH and FSH secretion

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36
Q

clomiphene use

A

infertility in patients with ovulatory dysfunction (polycystic ovary syndrome)

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37
Q

clomiphene side effects

A 
hot flashes,
abdominal discomfort,
multiple pregnancies (10%)
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38
Q

anastrazole MOA

A 
inhibits aromatase (decreases conversion of androgens to estrogens),
results in decreased estradiol levels
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39
Q

anastrazole side effects

A

osteoporosis,
increased CV events,
hyperlipidemia

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40
Q

tamoxifen MOA

A

competitive estrogen receptor antagonist;

minimizes growth effect of estrogen

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41
Q

tamoxifen most effective in

A

postmenopausal women

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42
Q

tamoxifen side effects

A

increased risk of endometrial cancer,
increased risk of thromboembolism,
hot flashes

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43
Q

raloxifene MOA

A

like tamoxifen but mixed estrogen agonist/antagonist effects

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44
Q

raloxifene uses

A

treats osteoporosis and reduces risk of breast cancer without increased risk of endometrial cancer

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45
Q

breast cancer drugs

A

anastrazole,
tamoxifen,
raloxifene

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46
Q

oral contraceptive pills

A

made of a mix of synthetic estrogens and progestins

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47
Q

progestins

A

decrease GnRH release,
decrease FSH and LH levels,
inhibit follicular development and absence of ovulation

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48
Q

oral contraceptive pill side effect

A

increased risk of thromboembolism especially in women > 35

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49
Q

emergency contraception

A

high doses of synthetic progestins (up to 72 hours)

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50
Q

mifepristone MOA

A

competitive antagonist of progesterone receptor;

abortifacient at high doses

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51
Q

octreotide MOA

A

synthetic analog of somatostatin hormone;

inhibits release of many hormones

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52
Q

octreotide uses

A

treats many endocrine disorders (zollinger ellison syndrome, carcinoid syndrome, acromegaly)

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53
Q

oxytocin MOA/uses

A

made by posterior pituitary,
stimulates uterine contraction to induce labor,
stimulates breast milk let down,
controls post partum uterine hemorrhage

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54
Q

vasopressin released from

A

posterior pituitary

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55
Q

V1 receptor (vasopressin)

A

vasoconstriction

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56
Q

V2 receptor (vasopressin)

A

increase permeability to water in collecting ducts

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57
Q

V3 receptor (vasopressin)

A

increase factor 8 activity

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58
Q

vasopressin uses

A

central diabetes insipidus,
septic shock,
cardiac arrest

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59
Q

vasopressin side effect

A

hyponatremia

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60
Q

omeprazole (-prazole) MOA

A

proton pump inhibitor,

irreversibly inhibits H/K pump on parietal cells

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61
Q

ranitidine MOA

A

H2 receptor blocker,

reversibly blocks binding of histamine to H2 receptor on parietal cells

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62
Q

ranitidine uses

A

GERD, PUD

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63
Q

ranitidine side effect

A

gynecomastia

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64
Q

antacids MOA

A

weak bases acting to reduce acidity

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65
Q

antacids use

A

GERD

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66
Q

side effects of antacids

A

AlOH - constipation,
MgOH - diarrhea,
calcium carbonate - hypercalcemia, milk-alkali syndrome,
sodium bicarbonate - flatulence, metabolic alkalosis

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67
Q

ondansetron MOA

A

blocks 5-HT3 receptors present in chemoreceptor trigger zone in brainstem (part of vomiting reflex pathway)

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68
Q

promethazine MOA

A

blocks H1 receptor,

decreases GI motility

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69
Q

promethazine side effets

A 
blurry vision,
dry mouth (histaminergic block)
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70
Q

metoclopramide MOA

A

blocks D2 dopamine receptors present in chemoreceptor trigger zone in medulla (part of vomiting reflex pathway)

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71
Q

metoclopramide uses

A

treats diabetic gastroparesis (stimulates intestinal motility),
anti-emetic

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72
Q

anti-emetics

A

metoclopramide,
ondansetron,
promethazine

think: “get an anti-emetic or we’ll need a MOP”

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73
Q

ursodiol MOA

A

decreases incidence of cholesterol gallstones by:

  1. inhibits HMG-CoA reductase
  2. decreasing intestinal reabsorption of cholesterol
  3. inhibits secretion of cholesterol into bile
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74
Q

ursodiol uses

A

primary biliary cirrhosis,

cholesterol gallstones

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75
Q

sulfasalazine MOA

A

metabolized by bacteria in colon to sulfapyridine and 5-ASA,

5-ASA –> anti inflammatory

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76
Q

sulfasalazine uses

A

inflammatory bowel disease,

RA/juvenile arthritis

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77
Q

anti-diarrheals

A

diphenoxylate,

loperamide

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78
Q

anti-diarrheal MOA

A

bind opioid receptors in intestine leading to inhibition of ACh release,
decreases gut peristalsis

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79
Q

anthracyclines

A

doxorubicin,
daunorubicin,
idarubicin

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80
Q

anthracyclines MOA

A

block DNA and RNA synthesis,
produce oxygen free radicals,
disrupt fluid and ion transport,
DAMAGE DNA

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81
Q

use of doxorubicin

A

solid tumors and hematologic malignancies (leukemia, lymphoma, myeloma)

think: “DEOXYRIBOSEin” to remember you’re damaging DNA

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82
Q

daunorubicin uses

A 
acute leukemia (AML, ALL, CML)
neuroblastoma

think: “does in daun on you at ALL?”

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83
Q

idarubicin use

A

AML

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84
Q

side effects of anthracyclines

A

cardiac toxicity,

give dexrazoxane to decrease free radicals (less damage to myocytes)

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85
Q

ages for ALL, CLL, AML, CML

A

ALL - child,
CLL - over 60,
AML - 65,
CML - 45-85

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86
Q

dactinomycin MOA

A

antibiotic derived antineoplastic agent,
inhibits DNA dependent RNA polymerase,
only antineoplastic agent that interferes with RNA synthesis

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87
Q

dactinomycin uses

A

wilms tumor,
ewing sarcoma,
used with methotrexate to treat, gestational choriocarcinoma

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88
Q

dactinomycin side effects

A

bone marrow suppression,

“radiation recall” - patients with previous radiation may have skin abnormalities

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89
Q

similar drug to dactinomycin used to treat testicular cancers and Paget disease of bone?

A

plicamycin

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90
Q

bleomycin MOA

A

triggers formation of oxygen free radicals

DAMAGES DNA

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91
Q

bleomycin use

A

testicular tumors

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92
Q

bleomycin side effects

A

pulmonary fibrosis,
anaphylaxis,
bone marrow suppression is rare

think: “patients on bleo have trouble blowing air”

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93
Q

MOA of all alkylating agents

A

damage DNA by cross linking DNA strands

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94
Q

busulfan use

A

CML (philadelphia chromosome)

think: “take the bus to Philly (CML)”

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95
Q

busulfan side effects

A

pulmonary fibrosis,
adrenal insufficiency,
hyperpigmentation,
seizures

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96
Q

nitrosoureas (carmustine, streptozocin) uses

A 
brain tumors (glioblastoma) - one of the few agents that cross the BBB
streptozocin also used for insulinomas
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97
Q

nitrosoureas side effects

A

nephrotoxocity,

pulmonary fibrosis

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98
Q

cisplatin and carboplatin use

A

GU tumors

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99
Q

carboplatin and cisplatin side effects

A

nephrotoxicity (give amifostine to scavenge free radicals),
ototoxicity,
neurotoxicity

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100
Q

cyclophosphamide uses

A

treats solid and hematologic malignancies
also suppresses B and T cell function (along with cross linking DNA) - used as immunosuppressive drug to treat RA, SLE, Wegener granulomatosis, nephrotic syndrome

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101
Q

cyclophosphamide side effects

A 
hemorrhagic cystitis (accumulation of metabolite acrolein in urine),
bone marrow suppression
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102
Q

mechlorethamine use

A

part of MOPP - treats hodgkin lymphoma

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103
Q

procarbazine uses

A

part of MOPP,
hodgkin lymphoma,
brain tumors

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104
Q

patients should avoid what when taking procarbazine?

A

tyramine,

metabolite of procarbazine inhibits MAO

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105
Q

MOPP protocol

A

mechlorethamine,
vincristine (oncovin),
procarbazine,
prednisone

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106
Q

methotrexate MOA

A

inhibits dihydrofolate reductase (transforms folic acid to active form FH4 - precursor for thymidylate formation)
decreased DNA synthesis

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107
Q

methotrexate uses

A

variety of cancers
immunosuppressant used for RA, crohn’s, scleroderma, psoriasis
abortifacient when given with prostaglandin

108
Q

methotrexate side effects

A 
teratogen,
pulmonary toxicity,
bone marrow suppression,
hepatotoxicity,
nephrotoxicity,
mucositis
109
Q

leucovorin (folinic acid)

A

given with methotrexate to minimized bone marrow suppression due to lack of folate coenzymes,
bypases inhibited enzyme to provide folate supply

110
Q

6-mercaptopurine MOA

A

converted to thio-IMP by HGPRT (purine salvage pathway),
thio-IMP acts as purine analog and inhibits purine synthesis,
thio-IMP also converted to thio-GTP which destabilizes DNA and RNA

111
Q

6-mercaptopurine uses

A

leukemias (ALL),
nonhodgkin lymphoma,
immunosuppressant - inflammatory bowel disease, psoriasis

112
Q

6-mercaptopurine is metabolized by what enzyme and is therefore contraindicated with what drug?

A

xanthine oxidase,

allopurinol

113
Q

6-mercaptopurine side effect

A

bone marrow suppression

114
Q

azathioprine MOA

A

analog of 6-MP, gets converted into 6-MP within the cell –>

used as immunosuppressant in autoimmune diseases such as SLE, IBD, RA, ITP, and MS

think: “Azathioprine is an analogue of mercaptopurine”

115
Q

5-FU MOA

A

converted to 5-fdUMP which inhibits thymidylate synthase

disrupts DNA synthesis

116
Q

5-FU uses

A

adenocarcinomas (ex. colon)

117
Q

5-FU side effects

A

bone marrow suppression,
photosensitivity,
anorexia,
oral ulcerations

118
Q

cytarabine MOA

A

converted to araCTP which competitively inhibits DNA polymerase and DNA synthesis

119
Q

cytarabine uses

A

AML,

lymphomas

120
Q

cytarabine side effects

A

bone marrow suppression,

pancytopenia (decreased RBC, WBC, and platelets)

121
Q

etoposide MOA

A

inhibits topoisomerase II,

DNA strand breakage

122
Q

etoposide uses and side effect

A

small cell lung carcinoma,
other solid tumors,
hematologic malignancies

SE: bone marrow suppression

123
Q

vincristine and vinblastine MOA

A

bind to tubulin and depolymerize the mitotic spindle

124
Q

vincristine uses

A

ALL,

lymphomas (MOPP)

125
Q

vincristine side effects

A

peripheral neuropathy,

myelosuppression is rare

126
Q

vinblastine uses

A

testicular cancer,

lymphomas

127
Q

vinblastine side effect

A

bone marrow suppression

think: vinblastine causes bone marrow suppression

128
Q

paclitaxel MOA

A

binds tubulin and stabilizes and polymerizes the mitotic spindle

think: “paclitaxel polymerizes”

129
Q

paclitaxel uses

A

ovarian and breast cancer

coats coronary artery stents to prevent restenosis

130
Q

paclitaxel uses

A

ovarian and breast cancer,

coats coronary artery stents to prevent restenosis

131
Q

paclitaxel side effects

A

hypersensitivity (rash),
neurotoxicity,
bone marrow suppression

132
Q

rituximab side effects

A

infusion reaction,

acute renal failure

133
Q

hydroxyurea MOA

A

inhibits ribonucleotide reductase leading to decreased DNA synthesis

134
Q

hydroxyurea uses

A

CML,
melanoma,
sickle cell

135
Q

trastuzumab MOA

A

monoclonal antibody against HER2/neu (erb-B2) receptor which is overexpressed in 1/3 of breast cancers

136
Q

trastuzumab use

A

breast cancer

137
Q

trastuzumab side effects

A

cardiac toxicity,

neutropenia

138
Q

imatinib MOA

A

competitive inhibitor of tyrosine kinase enzymes in abl, c-kit, and PDGF-R (all genes for cellular growth)

139
Q

imatinib uses

A

CML (bcr-abl)

GIST (c-kit)

140
Q

imatinib side effects

A

fluid retention (edema),
rash,
heart failure

141
Q

rituxumab MOA

A

monoclonal antibody against CD20 found on B cells,

induces B cell lysis upon binding

142
Q

rituximab uses & side effect

A

non hodgkin lymphoma,
CLL,
RA

SE: infusion reaction, acute renal failure

143
Q

drug similar to infliximab

A

adalimumab

144
Q

aspirin uses

A

anti pyretic,
anti inflammatory,
anti platelet,
analgesic

145
Q

aspirin side effect

A

reye’s syndrome (fatty liver) in kids with viral infection

146
Q

celecoxib MOA

A

irreversibe inhibitor of COX2,

decreased prostaglandins

147
Q

celecoxib uses

A

RA, OA, reduce colonic polyps in patients with FAP

148
Q

celecoxib side effects

A

GI upset,
interstitial nephritis,
increased risk of thrombosis

149
Q

NSAID MOA

A

reversible inhibitor of COX 1 and 2

decreased prostaglandins

150
Q

zero order kinetics

A

eliminated at constant rate over time

aspirin, phenytoin, alcohol

151
Q

side effects of NSAIDs

A

GI bleeding,

interstitial nephritis

152
Q

acetaminophen MOA

A

reversibly inhibits COX 1 and 2,
decreased prostaglandins in CNS
(not as much peripherally)

153
Q

acetaminophen uses

A

analgesia,
anti pyretic,
minimal anti inflammatory effects,
used in kids who need aspirin to avoid, Reye’s syndrome

154
Q

P450 substrates

A

Always Think When Outdoors

anti-epileptics,
theophylline,
warfarin,
OCPs

155
Q

zileuton MOA

A

inhibits 5-lipoxygenase,

decreases levels of leukotriene B4

156
Q

zileuton use

A

prevention of asthma

157
Q

zileuton SE

A

eosinophilic vasculitis

158
Q

zafirlukast (montelukast) MOA

A

reversible inhibitor of cysteinyl leukotriene-I receptor
decreases leukotriene C4, D4, and E4 which are bronchoconstrictors and mucus secretors

think: “ZafirLUKast inhibits LEUKotrienes”

159
Q

zafirlukast use

A

prevention of asthma

160
Q

zafirlukast SE

A

eosinophilic vasculitis

161
Q

cromolyn

A

inhaled anti inflammatory used to prevent asthma exacerbations,
inhibits release of histamine from mast cells

162
Q

cyclosporine MOA

A

inhibits calcineurin which normally activates IL-2,

IL-2 production decreased

163
Q

cyclosporine uses

A

immunosuppressant in transplant patients,
graft vs host disease,
RA

164
Q

cyclosporine side effects

A

nephrotoxicity,
hepatotoxicity,
hyperglycemia

165
Q

tacrolimus uses

A

immunosuppressant in transplant patients,

crohn’s disease

166
Q

tacrolimus SE

A

increased risk of infection

167
Q

sirolimus

A

immunosuppressant used in transplant patients,

inhibits mTOR

168
Q

interferon B (produced by fibroblasts) use

A

multiple sclerosis

169
Q

interferon gamma (produced by CD4 T cells) use

A

chronic granulomatous disease

170
Q

etanercept uses

A

autoimmune diseases (RA)

171
Q

gold salts use

A

rheumatoid arthritis

172
Q

infliximab MOA

A

chimeric antibody,

inhibits TNFa binding

173
Q

infliximab uses

A

autoimmune diseases - RA, IBD, psoriasis

think: “infliximab: inflammatory bowel disease”

174
Q

thalidomide MOA

A

decreases TNFa,

not well understood

175
Q

thalidomide uses

A

erythema nodosum leprae,

multiple myeloma

176
Q

thalidomide SE

A

sedation,
increased risk of DVT,
teratogen (causing phocomelia - shortening/absence of limbs)

177
Q

alprastadil use

A

prostaglandin used to treat erectile dysfunction

think: “alprastaDYl - erectile DYsfunction”

178
Q

misoprostol uses

A

prostaglandin used to treat gastric ulcers (increases mucosal protecton),
abortifacient when given with methotrexate

think: “misoprostol increases mucosal protection”

179
Q

latanoprost use

A

prostaglandin used to treat chronic glaucoma

think: latanoprost - lens

180
Q

diphenhydramine (1st gen histamine blockers) uses

A

urticaria and other allergic reactions

motion sickness

181
Q

promethazine use

A

anti-emetic

182
Q

meclizine uses

A

vertigo,

motion sickness

183
Q

1st gen histamine blockers SE

A

sedation,

anti cholinergic effects (dry mouth, blurry vision)

184
Q

2nd generation histamine blockers

A

fexofenadine (allegra),
loratadine,
cetirizine

185
Q

2nd gen histamine blockers (fexofenadine) uses

A

allergic rhinitis (seasonal allergies)

186
Q

2nd gen histamine blockers do not cause what?

A

sedation,

do not cross BBB

187
Q

theophylline MOA

A

inhibits PDE,

bronchodilation

188
Q

theophylline uses

A

acute and chronic asthma

189
Q

theophylline SE

A

cardiac arrhythmias,

narrow therapeutic index

190
Q

guaifenesin

A

expectorant,
clears phlegm via stimulation of respiratory tract secretion flow,
secretion of less viscous mucous

191
Q

bosentan (-sentan drugs) MOA

A

competitively inhibits binding of endothelin-I to endothelin receptors

192
Q

bosentan use

A

treats pulmonary arterial hypertension

193
Q

bosentan side effects

A

hepatotoxicity,

teratogen

194
Q

antidote for ethanol

A

disulfiram

195
Q

antidotes for lead/arsenic

A

dimercaprol, penicillamine

196
Q

antidote for iron

A

deferoxamine

197
Q

antidote for CO

198
Q

first order kinetics

A

eliminated at rate proportional to serum concentration
fixed fraction eliminated over time
rate of elimination decreases as serum concentration decreases

199
Q

therapeutic index

A

area between therapeutic effect and toxic effect

200
Q

potency

A

amount of drug required to produce a certain response

201
Q

efficacy

A

maximal response that can be elicited by a drug

202
Q

P450 inducers

A

CHRONIC ALCOHOLics STeal PHEN-PHEN and Never Refuse Greasy Carbs

chronic alcohol use,
st. john's wort,
phenytoin,
phenobarbital,
nevirapine,
rifampin,
griseofulvin,
carbamazepine
203
Q

P450 substrates

A

Always Think When Outdoors

anti-epileptics,
theophylline,
warfarin,
OCPs

204
Q

P450 inhibitors

A

AAA RACKS IN GQ Magazine

acute alcohol abuse,
ritonavir,
amiodarone,
cimetidine,
ketoconazole,
sulfonamides,
isoniazid (INH),
grapefruit juice,
quinidine,
macrolides (except azithromycin)
205
Q

etoposide side effect

A

bone marrow suppression

206
Q

NSAID uses

A

anti pyretic,
anti inflammatory,
analgesic

207
Q

mycophenolate mofetil MOA

A

inhibits monophosphate dehydrogenase via B and T cells

208
Q

mycophenolate mofetil uses

A

immunosuppressant in transplant patients

autoimmune disorders

209
Q

interferon a (produced by leukocytes) uses

A

cancers (kaposi sarcoma)

chronic hep B and C

210
Q

etanercept MOA

A

inhibits binding of TNFa and TNFb to their receptors,

anti inflammatory

211
Q

infliximab uses

A

autoimmune diseases - RA, IBD, psoriasis

212
Q

thalidomide contraindication

A

pregnancy,

causes phocomelia - shortening or absence of limbs

213
Q

dinoprostone use

A

prostaglandin abortifacient

214
Q

first generation histamine blockers

A 
diphenhydramine,
promethazine,
meclizine,
hydroxyzine,
doxylamine
215
Q

fluconazole, itraconazole, voriconazole

side effects

A

less of an endocrine effect than the ketoconazole/miconazole/clotrimazole

216
Q

where is ergosterol found

A

ONLY in fungal cell membranes

217
Q

how to prevent red man syndrome?

A

co-administer with anti-histamines or at a slow infusion rate

218
Q

drugs that induce megaloblastic anemia

A

“You’re having a MEGA BLAST with PMS”

hydroxyurea,
phenytoin,
methotrexate,
sulfa drugs

219
Q

chlowRampheNICUl mnemonic

A

low RBCs = aplastic anemia,

infants with gray baby syndrome go to the NICU

220
Q

adrenergic agonists and antagonists are involved in…

A

activating the RECEPTOR, which essentially leads to the same effects as the mimetics

221
Q

fenoldapam MOA

A

D1 receptor agonist

222
Q

hyper(-emia) of any type indicates excess where?

A

in the BLOOD, not the cell

223
Q

is methyldopa active at dopamine receptors?

A

no! it’s active at alpha-2 receptors

224
Q

oxybutynin side effects

A

cholinergic blockade symptoms

225
Q

associate -stigmine with what kind of drug?

A

cholinesterase inhibitors –> cholinergic effects

226
Q

CC: status epilepticus

A

single seizure lasting more than 5 minutes

think: “Phive minutes”, or 2 seizures within 5 minutes

227
Q

CC: fetal hydantoin syndrome,

define, and caused by which drug

A

sxs incl: cleft lip/palate,
microcephaly,
mental retardation

caused by PHENYTOIN

228
Q

CC: trigeminal neuralgia

define and tx

A

chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain

tx with Carbamazepine

229
Q

ester anesthetic agents

A

procaine,
cocaine,
tetracaine,
benzocaine

230
Q

amide anesthetic agents

A

bupivacaine and lidocaine

231
Q

CC: malignant hyperthermia

A

hyperthermia,
tachycardia,
acidosis,
muscle breakdown

232
Q

CC: neuroleptic malignant syndrome

A

hyperthermia,
mental status change,
muscle breakdown,
autonomic instability

233
Q

opioids: drugs

A 
meperidine,
fentanyl,
dextromethorphan,
morphine, 
codeine, 
oxycodone,
hydrocodone,
hydromorphone,
heroin
234
Q

opioids MOA

A

bind opioid receptors –> hyperpolarization of neural cells via Ca2+ and K+ ion channels

235
Q

opioids use

A

pain control,
cough suppressant (codeine and dextromethorphan),
diarrhea (diphenoxylate, an analogue of meperidine),
acute pulmonary edema (morphine: reduces anxiety and cardiac preload)

236
Q

opioids issues

A

dependence issues,

methadone helps ease withdrawal symptoms

237
Q

opioid overdose tx

A

naloxone and naltrexone are opioid receptor antagonists that treat overdoses

238
Q

smoking cessation agents

A

buproprion,

varenicline

239
Q

calcium channel blockers (CCBs) use

A

cause vascular smooth muscle relaxation; tx HTN and angina

drugs are verapamil and diltiazem

240
Q

what are the class II anti-arrhythmic agents?

A

beta-blockers (propranolol, carvedilol, metoprolol)

241
Q

osmotic diuretics

A

isosorbide,
mannitol,
urea,
glycerin

think: “I MUG”

242
Q

loop diuretics

A

furosemide,
bumetanide,
ethacrynic acid,
torsemide

think: “lasix for loop diuretics”, “loop earrings for earthacrynic acid”

243
Q

thiazide diuretics

A

-thiazide,
-thalidone,
metolazone,
indapamide

think: “D in thiazide for DCT”

244
Q

K+ sparing diuretics

A

aldosterone receptor antagonists (spironolactone, eplerenone),
na+ channel blockers (triamterene, amiloride)

245
Q

anti-coagulants

A 
heparin,
warfarin,
direct thrombin inhibitors (argatroban),
fondaparinux,
rivaroxaban
246
Q

anti-platelet agents

A 
clopidogrel,
abciximab,
acetylsalicylic acid,
prasugrel,
cilastazol,
dipyridamole
247
Q

other hematologic agents

A

fibrinolytic agents (streptokinase),
aminocaproic acid,
synthetic erythropoietin

248
Q

heparin: test to monitor

A

PTT, for intrinsic pathway

249
Q

warfarin: test to monitor

A

PT, for extrinsic pathway

250
Q

direct thrombin inhibitors (argatroban): test to monitor

251
Q

rivaroxaban MOA

A

inhibits both the intrinsic and extrinsic coagulation cascade

252
Q

fondaparinux side effect

253
Q

lead/arsenic poisoning antidote

A

dimercaprol, penicillamine

254
Q

first-generation histamine blockers

A 
diphenhydramine,
promethazine, 
meclizine, 
hydroxyzine, 
doxylamine
255
Q

dinoprostone MOA and use

A

prostaglandin,

use: abortifacient

256
Q

infliximab side effect

A

increased susceptibility to infection

257
Q

eTaNercept MOA

A

inhibits the binding of TNF-alpha and TNF-beta molecules to their receptors = anti-inflammatory effects

258
Q

interferon-alpha (produced by leukocytes) use

A

cancers (kaposi’s sarcoma),

chronic hepatitis B and C

259
Q

mycophenolate mofetil MOA

A

inhibits monophosphate dehydrogenase via B and T lymphocytes

260
Q

mycophenolate mofetil uses

A

immunosuppressant in transplant patients;

also used to treat autoimmune disorders

261
Q

tacrolimus MOA

A

inhibits calcineurin via binding to FKBP-12 = IL-2 production is decreased

262
Q

acetaminophen side effect

A

fatal hepatotoxicity with overdose,

give acetylcysteine for antidote

263
Q

NSAIDs

A

ibuprofen,
naproxen,
indomethacin,
diclofenac

264
Q

NSAIDs MOA

A

reversible inhibitor of COX-1 and 2 = decreased prostaglandins

265
Q

NSAIDs side effects

A

GI bleeding,
interstitial nephritis

does NOT have anti-platelet effects

1_BOARDS (14 decks)

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