Brainscape's Knowledge GenomeTM

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


See full index

USMLE > Pharm USMLE > Flashcards

Pharm USMLE Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

28 year old chemist presents with MPTP exposure

What NT is depleted?

A

Dopamine

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

Woman taking tetracycline exhibits photosensitivity

What are the clinical manifestations?

A

Rash on sun-exposed regions of body

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

Nondiabetic patient presents with hypoglycemia but low levels of C peptide

What is the diagnosis

A

Surreptitious insulin injection

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

African American male who goes to Africa develops hemolytic anemia after taking malaria prophylaxis

What is the enzyme defficiency

A

Glucose 6 phosphate dehydrogenase

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

27 year old female with history of psychiatric illness now has urinary retention due to neuroleptic

What do you treat it with?

A

Bethanechol

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

Farmer presents with dyspnea, salivation, miosis, diarrhea, cramping and blurry vision

What caused this and what is the mechanism

A

Insecticide poisoning, inhibition of acetylcholinesterase

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

Patient with recent kidney transplant is on cyclosporine for immunosuppresion, he requires antifungal agent for candidiasis

What antifungal drug would result in cyclosporine toxicity?

A

Ketoconazole

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

Man on several medications including antidepressants and antihypertensives, has mydriasis and becomes constipated

What is the cause of symptoms?

A

TCA

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

55 year old postmenopausal woman on tamoxifen therapy

What is she at increased risk of acquiring?

A

Endometrial carcinoma

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

Woman on MAO inhibitor has hypertensive crisis after meal

What did she ingest?

A

Tyramine (wine or cheese)

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

After taking clindamycin, patient develops toxic megacolon and diarrhea

What is the mechanism of diarrhea?

A

Clostridium difficile overgrowth

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

Man starts a medication for hyperlipidemia. He then develops rash, pruritus and GI upset

What drug was it?

A

Niacin

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

Patient is on carbamazepine

What routine workup should be done?

A

LFT’s

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

23 year old female who is on rifampin for TB prophylaxis and on birth control (estrogen) gets pregnant

Why?

A

Rifampin augments estrogen metabolism in liver rendering it less effective

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

Patient develops cough and must discontinue captopril

WHat is a good replacement drug and why doesnt it have the same side effects?

A

Losartan - an angiotensin II receptor antagonist, does not increase bradykinin as captopril does

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

Relates the amount of drug in the body to plasma concentration

A

Vd - volume of distribution

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

Formule for volume of distribution

A

Vd = amount of drug in the body/plasma drug concentration

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

Vd of plasma protein-bound drugs can be altered by what disease?

A

Liver and kidney

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

Relates the rate of elimination to plasma concentration

A

CLEARANCE

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

Formula for clearance

A

Cl = rate of elimination of drug/plasma drug concentration

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

The time required to change the amount of drug in the body by 1/2 during elimination (or during constant infusion) is called _

A

Half life T1/2

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

After 1 half life concentration of drug equals _ %

A

50%

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

After 2 half lifes concentration of drug equals_

A

75%

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

A drug infused at constant rate reaches about _ % of steady state after 4 T1/2

A

94

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

Formula for T1/2

A

T1/2 = 0.7 * Vd/CL

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

Loading dose formula

A

Loading dose = Cp * Vd/F

Cp= target plasma concentration

F = bioavailibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Formula for maintenance dose

A

Cp * CL / F

Cp = target plasma concentration

F = bioavailibility

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

In patients with impaired renal or hepatic function, the loading dose decreases, increases or remains unchanged?

Maintenance dose?

A

Loading dose remains unchanged

Maintenance dose decreases

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

Rate of elimination is constant (constant amount of drug is eliminated per unit time) - what order elimination?

What happens to target plasma concentration?

A

Zero order elimination

Target plasma concentration decreases linearly with time

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

Rate of elimination is proportional to drug concentration (constant fraction of drug eliminated per unit time) - what order elimination?

What happens to target plasma concentration?

A

First order elimination

Cp decreases exponentially with time

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

Give examples of drugs with zero order elimination

A

Ethanol

Phenytoin

Aspirin (at high or toxic concentration)

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

Phase I metabolism (reduction, oxidation, hydrolysis) yields _ metabolites (often still active)

A

Slightly polar, water soluble

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

What phase of metabolism associated with cytochrome P450

A

Phase I

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

What phase of metabolism associated with conjugation

A

Phase iI

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

Phase II metabolism (acetylation, glucoronidation, sulfation) yields _ metanolites (renally excreted)

A

Very polar, inactive

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

Geriatric patients lose which phase of metabolism first?

A

Phase I

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

Is it safe? Pharmacokinetics? - which phase of clinical testing of the drug

A

Phase I

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

Does it work in patients?- which phase of clinical testing of the drug

A

Phase II

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

Does it work? Double blind - which phase of clinical testing of the drug

A

Phase III

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

What happens in phase IV of clinical testing of the drug

A

Postmarketing surveillance

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

A competitive antagonist shifts agonist curve where?

A

To the right

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

A noncompetitive antagonist (irreversible) shifts agonist curve where?

A

Downward

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

Name antibiotics that block cell wall synthesis by inhibition of peptidoglycan cross linking

A

Penicillin

Ampicillin

Ticarcillin

Pipercarcillin

Imipenem

Aztreonam

Cephalosporins

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

Name antibiotics that block peptidoglycan synthesis

A

Bacitracin

Vancomycin

Cycloserine

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

Name antibiotics that block protein synthesis at 50S ribosomal unit

A

Chloramphenicol

Erythromycin/macrolides

Lincomycin

Clindamycin

Streptogramins (quinupristin, dalfopristin)

Linezolid

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

Name antibiotics that block protein synthesis at 30S ribosomal unit

A

Aminoglycosides

Tetracyclines

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

Name antibiotics that block nucleotide synthesis

A

Sulfonamides

Trimethoprim

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

Name antibiotics that block DNA topoisomerase

A

Quinolones

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

Name antibiotic that blocks mRNA synthesis

A

Rifampin

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

Name bactericidal antibiotics

A

Penicillin

Cephalosporins

Vancomycin

Aminoglycosides

Fluoroquinolones

Metronidazole

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

Name drugs that disrupt bacterial/fungal cell membrane

A

Polymyxins

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

Name drugs that disrupt fungal cell membranes

A

Amphotericin B

Nystatin

Flucoconazole/azoles

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

Oral form of penicillin is called _

IV form?

A

Penicillin V

Penicillin G

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

Mechanism of penicillin

A
  • Binds penicillin binding proteins
  • Blocks transpeptidase cross linking of cell walls
  • Activates autolytic enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

This antibiotic is bactericidal for gram positive cocci, gram positive rods, gram negative cocci and spirochetes. Not penicillinase resistant

A

PENICILLIN

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

Toxicity of penicillin

A

Hypersensitivity reactions

Hemolytic anemia

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

Methicillin, nafcillin, dicloxacillin - mechanism of action?

Narrow or broad action?

Penicillinase resistant or not?

A

Same as penicillin

Narrow action

Penicillinase resistant because of bulkier R groups

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

Methcillin, nafcillin and dicloxacillin are clinically used for treatment of what bug?

A

S. aureus

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

Methicillin toxicity

A

Interstitial nephritis

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

Methcillin, nafcillin, dicloxacillin toxicity

A

Hypersensitivity reactions

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

Ampicillin, Amoxicillin- mechanism of action

Penicillinase sensitive or resistant?

Spectrum narrow or wide?

A

SAME AS PENICILLIN

Wide spectrum

Penicillinase sensitive

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

Ampicillin, amoxicillin can be combined with _ to enhance spectrum

A

Clavulinic acid

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

Which has greater oral bioavailibility - amoxicillin or ampicillin

A

AmOxicillin has greater Oral bioavailibility

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

Name antibiotics that are extended-spectrum penicillins - against certain gram positive and gram negative rods

Name rods

A

HELPS kill enterococci - H influenzae, E.coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, enterococci

Ampicillin, amoxicillin

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

Toxicity for ampicillin and amoxicillin

A

Hypersensitivity reactions, ampicillin rash, pseudomembranous colitis

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

Mechanism for carbenicillin, pipercillin, ticarcillin

Spectrum?

A

Same as penicillin, extended spectrum

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

Name penicillins used for treatment of Pseudomonas, and gram negative rods

Is it penicillinase resistant or sensitive

Can it be used with clavulinic acid

A

Carbencillin, Piperacillin, Ticarcillin

Penicillinase sensitive

Use with clavulinic acid

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

Toxicity for carbencillin, piperacillin, ticarcillin

A

Hypersensitivity reactions

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

Beta lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases, bactericidal

A

CEPHALOSPORINS

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

Which cephalosporins target gram positive cocci + Proteus , E. coli,Klebsiella

A

1st generation

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

Which cephalosporins target gram positive cocci + H. flu, Enterobacter, Neisseria, Proteus, E coli Klebsiella, Serratia

A

2nd generation

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

Which cephalosporins target serious gram negative infections resitant to other beta lactams, meningitis (most penetrate BBB) - give examples

A

3d generation - ceftazidime, ceftriaxone

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

3d generation cephalosporin used for treatment of Pseudomonas

A

Ceftazidime

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

3d generation cephalosporin used for treatment of gonorrhea

A

Ceftriaxone

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

Which cephalosporins have increased activity agains Psedudomonas and gram positive organisms

A

4th generation

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

Is there cross hypersensitivity between cephalosporins and penicillin

A

Yes, 5-10%

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

Toxicity for cephalosporins

A

Hypersensitivity reactions

Increase nephrotoxicity of aminoglycosides

Disulfiram like reaction with ethanol (in cephalosporins with methylthiotetrazole group) - cefamandole

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

A monobactam resistant to beta lactamases. Inhibits cell wall synthesis (binds to PBP3), synergistic with aminoglycosides, no cross allerginicity with penicillins

A

AZTREONAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

This antibiotic is used for Gram negative rods (Klebsiella, Pseudomonas, Serratia), no activity agains gram positives or anaerobes, for penicillin allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides

A

AZTREONAM

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

Is there any toxicity associated with AZTREONAM

A

Usually nontoxic, occasional GI upset

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

Broad spectrum beta lactamase resistant carbapenem

A

Imipenem

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

Imipenem is ALWAYS administered with _

WHY?

A

CILASTATIN

Inhibitor of renal dihydropeptidase I - to decrease inactivation of the drug in renal tubules

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

Drug of choice for Enterobacter, also active against gram positive cocci, gram negative rods and anaerobes

A

Imipenem + cilastatin

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

Toxicity associated with Imipenem/cilastatin

A

GI distress, skin rash, CNS toxicity (seizures) at high plasma levels

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

Inhibits cell wall mucopeptide formation by binding D ala D ala portion of cell wall precursors. Resistance occurs with amino acid change of D ala D ala to D ala D lac

A

VANCOMYCIN

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

This antibiotic is used for serious gram positive multi drug resistant organisms, including S aureus, and Clostridium difficile (pseudomembranous colitis)

A

VANCOMYCIN

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

Diffuse flushing (“red man syndrome”) associated with vancomycin can be largely prevented by?

A

Pretreatment with antihistamines and slow infusion rate

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

Toxicity for Vancomycin

A

Nephrotoxicity
Ototoxicity
Thrombophlebitis

Well tolerated in general - does NOT have many problems

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

Gentamicin, neomycin, amikacin, tobramycin, streptomycin - what class of antibiotics?

A

Aminoglycosides

90
Q

Bactericidal, inhibit formation of initiation complex and cause misreading of mRNA. Require O2 for uptake, therefore ineffective against anaerobes

A

AMINOGLYCOSIDES

91
Q

Which aminoglycoside is used for bowel surgery

A

Neomycin

92
Q

Aminoglycosides are _ with beta lactams

A

Synergistic

93
Q

Aminoglycosides are clinically used for treatment of _

A

Severe gram negative rod infections

94
Q

Toxicity of aminoglycosides

A

Nephrotoxicity (especially with cephalosporins)

Ototoxicity (especially with loop diuretics)

95
Q

Doxycycline, demeclocycline, minocycline - name class of antibiotics

A

Tetracyclines

96
Q

Bacteriostatic, bind to 30S and prevent attachment of aminoacyl-tRNA, limited CNS penetration

A

Tetracyclines

97
Q

Which tetracycline is fecally eliminated and can be used in patients with renal failure

A

Doxycycline

98
Q

Must NOT take tetracyclines with _

Why?

A

Milk

Antacids

Iron containing preparations

Divalent cations inhibit its absorption in gut

99
Q

Clinical use of tetracyclines

A 
Vibrio cholerae
Acne
Chlamydia
Ureaplasma
Urealyticum
Mycoplasma pneumonia
Borelia burgdorferi
Riccketsia
Tularemia

VACUUM your BedRoom Tonight

100
Q

Toxicity of tetracyclines

A

GI distress, discoloration of teeth and inhibition of bone growh in children, photosensitivity

101
Q

Erythromycin, azithromycin, clarithromycin- name class of antibiotics

A

Macrolides

102
Q

Inhibit protein synthesis by blocking translocation - bind to 23S rRNA of 50S ribosomall subunit, bacteriostatic

A

Macrolides

103
Q

Clinical use macrolides

A

URI
Pneumonia
STD
gram positive cocci (streptococcal infections in patients allergic to penicillin), Mycoplasma, Legionella, Chlamydia, Neisseria

104
Q

Toxicity macrolids

A

GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes

105
Q

Patient on antibiotic therapy develops acute cholestatic hepatitis - which clas of drug?

A

Macrolides

106
Q

Most common cause of non compliance with macrolides

A

GI discomfort

107
Q

Inhibits 50S peptidyltransferase, bacteriostatic

A

Chloramphenicol

108
Q

This drug is used for treatment of meningitis (H flu, N meningitidis, Strep pneumoniae) but conservatively used due to toxicities

A

Chloramphenicol

109
Q

Toxicities with chloramphenicol

A

Anemia (dose dependent)

Aplastic anemia (dose independent)

Gray baby syndrome

110
Q

Which drug causes gray baby syndrome and why

A

Chloramphenicol - premature infants because they lack liver UDP-glucuronyl transferase)

111
Q

Blocks peptide bond formation at 50S ribosomal subunit, bacteriostatic

A

Clindamycin

112
Q

Which antibiotic is used to treat anaerobic infections (Bacteroides fragilis, Clostridium perfringens)

A

CLindamycin

113
Q

Toxicity associated with clindamycin

A

Pseudomembranous colitis (C. difficile overgrowth), fever, diarrhea

114
Q

PABA antimetabolites inhibit dehydropteorate synthase, bacteriostatic

A

Sulfonamides

115
Q

Which sulfonamides are used for treatment of simple UTI

A

Triple sulfas or SMX

116
Q

Clinical use of sulfonamides

A

Gram positive
Gram negative
Nocardia
Chlamydia

117
Q

Toxicity with sulfonamides

A

Hypersensitivity reactions
Hemolysis if G6PD deficient
Nephrotoxicity (tubulointerstitial nephritis)
Kernicterus in infants
Displace other drugs from albumin (warfarin)

118
Q

Antibiotic inhibits dihydropteorate synthase

A

Sulfonamides

119
Q

Antibiotic inhibits dihydrofolate reductase

A

Trimethoprim, pyrimethamine

120
Q

Inhibits bacterial dihydrofolate reductse, bacteriostatic

A

Trimethoprim

121
Q

This drug is used in combination with sulfonamides causing sequential block of folate synthesis

A

Trimethoprim

122
Q

This drug is used for recurrent UTI’s, Shigella, Salmonella, Pneumocystis carinii pneumonia

A

TMP-SMX

123
Q

Toxicity of trimethoprim

A

Megaloblastic anemia
Leukopenia
Granulocytopenia

TMP - Treats Marrow Poorly

124
Q

Toxicity connected with trimethoprim can be alleviated by _

A

Supplemental folinic acid

125
Q

Ciprofloxacin, norfloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin - name class

A

Fluoroquinolones

126
Q

Antibiotics inhibit DNA gyrase (topoisomerase II), bactericidal

A

Fluoroquinolones

127
Q

Used clinically for treatment of gram negative rods of urinary and GI tracts (including Pseudomonas), Neisseria, some gram positive organisms

A

Fluoroquinolones

128
Q

Are fluoroquinolones safe in pregnant women

A

Contraindicated in pregnant women and in children because animal studies show damage to cartilage.

129
Q

Fluoroquinolones toxicity

A 
Tendonitis and tendon rupture in adults
GI upset
Superinfections
Skin rashes
Headache
Dizziness

FluoroquinoLONES hurt attachments to your BONES

130
Q

Forms toxic metabolites in bacterial cells, bactericidal

A

Metronidazole

131
Q

Antiprotozoal, Giardia, Entamoeba, Trichomonas, Gardenrella vaginalis, anearobes (bacteroides, clostridium) - name drug

A

Metronidazole

132
Q

This drug is used with bismuth and amoxicillin (or tetracycline) for “triple therapy” against H pylori

A

Metronidazole

133
Q

Anaerobic infections above diaphragm - ?

Anaerobic infections below diaphragm?

A

Above - clindamycin

Below - metronidazole

134
Q

Toxicity of metronidazole

A

Disulfiram like reaction with alcohol, headache

135
Q

Bind to cell membranes of bacteria and disrupt their osmotic properties, cationic, basic proteins that act like detergents - treat resistant gram negativ infections

A

Polymyxins

136
Q

Toxicity for polymyxins

A

Neurotoxicity

Acute renal tubular necrosis

137
Q

Name anti TB drugs

A 
RESPIre
Rifampin
Ethambutol
Streptomycin
Pyrazinamide
Isoniazid
138
Q

2nd line therapy for TB

A

Cycloserine

139
Q

All anti TB drugs have same toxicity - name it

A

liver toxicity

140
Q

Anti TB drug - decreases synthesis of mycolic acids

A

Isoniazid

141
Q

The only agent used as solo prophylaxis against TB

A

Isoniazid

142
Q

Toxicity for INH (Isoniazid)

A

Hemolysis if G6PD defficient
Neurotoxicity
Hepatoxocitiy
SLE like syndrome

INH - Injures Neurons and Hepatocytes

143
Q

_ can prevent neurotoxicity caused by isoniazid

A

Pyridoxine (B6)

144
Q

Which anti TB drug has different half lifes in fast vs slow acetylators

A

Isoniazid

145
Q

Anti TB drug - inhibits DNA dependent RNA polymerase

A

Rifampin

146
Q

Delays resistance to dapsone when used for leprosy

A

Rifampin

147
Q

Used for meningococcal prophylaxis and chemoprophylaxis in contacts of children with H influenzae type B

A

Rifampin

148
Q

Rifampin toxicity

A

Minor hepatoxicity and drug interactions (increases P450)

149
Q

Rifampin 4 R’s

A

RNA polymerase inhibitos
Revs up P450
Red/orange body fluids
Rapid resistance if used alone

150
Q

Beta lactamase cleavage of beta lactam drug is a resistance mechanism against which drugs

A

Penicillins and cephalosporins

151
Q

Modification via acetylation, adenylation, or phosphorylation is resistance mechanism against which drugs

A

Aminoglycosides

152
Q

Terminal D ala component of cell wall replaced with D lac, decreases affinity - resistance mechanism against which drug

A

Vancomycin

153
Q

Modification via acetylation - resistance mechanism against which drug

A

Chloramphenicol

154
Q

Decreased uptake or increased transport out of cell is resistance mechanism against which drugs

A

Tetracyclines

155
Q

Altered enzyme (bacterial dihdropteorate synthetase), decreased uptake or increased PABA synthesis is resistance against which drugs

A

Sulfonamides

156
Q

Drug of choice for prophylaxis of meningococcal infections

Alternative?

A

Rifampin

Minocyclin

157
Q

Prophylaxis of gonorrhea

A

Ceftriaxone

158
Q

Prophylaxis of syphillis

A

Benzathine penicillin G

159
Q

Prophylaxis in patients with history of recurrent UTI

A

TMP-SMX

160
Q

Drug of choice for prophylaxis for pneumocystic carinii pneumonia

Alternative

A

TMP-SMX

Aerosolized pentamidine

161
Q

Binds ergosterol (unique to fungi), forms membrane pores that allow leakage of electrolytes and disrupt homeostasis

A

Amphotericin B

162
Q

Used for wide spectrum of systemic mycoses (Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor). Intrathecally for fungal meningitis, does NOT cross BBB

A

Amphotericin B

163
Q

Toxicity of Amphotericin B

A

NEPHROTOXICITY
Arrhythmias (amphoterrible)
Fever/chills (shake and bake)
Hypotension

164
Q

Binds to ergosterol, disrupting fungal membranes, used as “swish and swallow” for oral candidiasis (thrush)

A

NYSTATIN

165
Q

Inhibit fungal steroid (ergosterol) synthesis

A

AZOLES

166
Q

Drug of choice for cryptococcal meningitis in AIDS patients and candidal infections of all types (i.e yeast infections)

A

FLuconazole

167
Q

Drug of choice for Blastomyces, Coccidioides, Histoplasma, Candida albicans, hypercortisolism

A

Ketoconazole

168
Q

Toxicity of azoles

A

Hormone synthesis inhibition (gynecomastia)
Liver dysfuntion (inhibits cytochrome P450)
Fever, chills

169
Q

Inhibits DNA synthesis by conversion to fluorouracil which competes with uracil, used in systemic fungal infections (Candida, Cryptococcus), causes bone marrow suppression, n/v/d

A

FLUCYTOSINE

170
Q

Antifungal medication, inhibits cell wall synthesis, clinically used for invasive aspergillosis, can cause GI upset and flushing

A

CASPOFUNGIN

171
Q

Antifungal, inhibits fungal enzyme squalene epoxidase, used to treat dermatophytoses (especially onychomycosis)

A

TERBINAFINE

172
Q

Anti fungal, interferes with microtubule function, disrupts mitosis, deposits in keratin containing tissues (nails) - oral treatment of superficial infections, inhibits growth of dermatophytes (tinea, ringworm)

A

GRISEOFULVIN

173
Q

Toxicity Griseofulvin

A 
Teratogenic
Carcinogenic
Confusion'
Headache
Increased warfarin metabolism
174
Q

Antiviral drug used for prophylaxis for influenza A and treatment of Parkinsons

A

Amantadine

175
Q

Derivative of Amantadine with fewer CNS side effects

A

Rimantidine

176
Q

Anti viral medication, blocks biral penetration/uncoating, may buffer pH of endosome, also causes release of dopamine from intact nerve terminals

A

Amantadien

177
Q

Toxicity of amantadine

A

Ataxia + dizziness+ slurred speech

Amantadine causes problems with cerebellA

178
Q

Two antiviral medications that inhibits influenza neuraminidase, both used for influenza A and B

A

Zanamivir

Oseltamivir

179
Q

Antiviral - inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase, used for treatment of RSV and chronic hep C

A

Ribavirin

180
Q

Toxicity for Ribavirin

A

Severe teratogen

Hemolytic anemia

181
Q

THis antiviral medication preferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase

A

Acyclovir

182
Q

Antiviral medication used for treatment of VZV, HSV, EBV, mucocutaneous and genital herpes lesions, prophylaxis in immunocompromised patients

A

Acyclovir

183
Q

Toxicity for acyclovir

A

Delirium
Tremor
Nephrotoxicity

184
Q

Antiviral drug - works by phosphorylation viral kinase, preferentially inhibits CMV DNA polymerase, drug of choice for CMV especialy in immunocopromised patients

A

Ganciclovir

185
Q

Which drug is more toxic - acyclovir or ganciclovir to host enzymes

A

Ganciclovir

186
Q

Ganciclovir toxicity

A

Leukopenia
Neutropenia
Thrombocytopenia
Renal toxicity

187
Q

Viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme. Does not require activation by viral kinase

A

FOSCARNET = pyroFOSphate analog

188
Q

Antiviral drug used for treatment of CMV retinitis in immunocompromised patients when ganciclovir fails

A

FOSCARNET

189
Q

Patient is on foscarnet for CMV retinitis, which toxicity could be suspected?

A

Nephrotoxicity

190
Q

Saquinavir, ritonavir, indinavir, nelfinavir, aprenavir - class of drugs

A

HIV therapy, protease inhibitors - inhibit assembly of new virus by blocking protease enzyme

191
Q

HIV patient is taking anti HIV drugs, develops GI intolerance - nausea, diarrhea, hyperglycemia, lipid abnormalities, thrombocytopenia - which drugs was he taking

A

PROTEASE INHIBITORS

192
Q

Zidovudine (AZT), didanosine, zalcitobine, stavudine, lamivudine, abacavir - what class of drugs

A

Reverse transcriptase inhibitors, nucleosides

193
Q

Name non-nucleosides reverse transcriptase inhibitors

A

Nevirapine

Delavirdine

Efavirenz

194
Q

Toxicity associated with reverse transcriptase inhibitors

A 
Bone marrow suppression (neutropenia, anemia)
Peripheral neuropathy
Lactic acidosis (nucleosides)
Megaloblastic anemia
Rash (non-nucleosides)
195
Q

Highly active antiretroviral therapy (HAART) generally entails combination of?

A

Protease inhibitors + reverse transcriptase inhibitors

196
Q

Which antiretroviral drug is used during pregnancy to reduce risk of fetal transmission

A

AZT

197
Q

Patient on anti HIV therapy develops megaloblastic anemia - which drug most likely caused it

A

AZT

198
Q

When is HAART initiated?

A

When patients have low CD4 counts (<500 cell/mm3) or high viral load

199
Q

Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis, used for treatment of chronic hep B and C, Kaposis sarcoma

Name drug and what toxicity associated with it

A

Interferons

Neutropenia

200
Q

Antiparasitic drug from onchocerciasis

A

Ivermectin (rIVER blindness treated with IVERmectin)

201
Q

Antiparasitic drug used to treat nematode/roundworm (pinworm, whipworm) infections

A

Mebendazole/thiabendazole

202
Q

Antiparasitic drugs used to treat gian roundowrm (ascaris), hookworm (Necator/Ancylostoma) and pinworm (Enterobius)

A

Pyrantel pamoate

203
Q

Antiparasitic used to treat trematode/fluke (shistosomes, Paragonimus, Clonorchis) and cysticercosis

A

Praziquantel

204
Q

Niclosamide is used to treat?

A

Cestode/tapeworm infections except cysticercosis

205
Q

Drug of choice for leishmaniasis

A

Pentavalent antimony

206
Q

Name anti malaria drugs

A 
Chloroquine
Quinine
Mefloquine
Atovaquone
Proguanil
207
Q

Name drug used for treatment of latent hypnozoite (liver) forms of malaria (Plasmodium vivax, P.ovale)

A

Primaquine

208
Q

Drug of choice agains giardiasis, amebic dysentery, bacteria vaginitis, Trichomonas

A

Metronidazole

209
Q

Drug of choice for Chagas disease, American trypanosomiasis (trypanosoma cruzi)

A

Nifurtimox

210
Q

Drug of choice for African trypanosomiasis (sleeping sickness)

A

Suramin

211
Q

Cholinomimetic used for postoperative and neurogenic ileus and urinary retention - activates bowel and bladder smooth muscle

A

BETHANECHOL

212
Q

Direct agonist, cholinomimetic used for treatment of glaucoma, activates ciliary muscle of eye (open angle), pupillary sphincter (narrow angle)

A

Carbachol, pilocarpine

213
Q

Anticholinesterase, used in treatment of postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative), increases endogenous Ach

A

Neostigmine

214
Q

Anticholinesterase used in treatment of myasthenia gravis - increases endogenous Ach, increases strength

A

Pyridostigmine

215
Q

This anticholinesterase is used for diagnosis of myasthenia gravis (extremely short acting), increases endogenous Ach

A

Edrophonium

216
Q

Anticholinesterase, used in treatment of glaucoma (crosses BBB to CNS) and atropine overdose, increases endogenous Ach

A

Physostigmine

217
Q

Anticholinergic, used for treatment of glaucoma, increases endogenous Ach

A

Echothiophate

218
Q

Name symptoms of cholinesterase inhibitor poisoning

A 
DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscle
Lacrimation
Sweating 
Salivation (also abdominal cramping)
219
Q

Name substances that can lead to cholinesterase inhibitor poisoning

A

Parathion and other organophosphates

220
Q

Antidote used in treatment of organophosphate poisoning

A

Atropine (muscarinic antagonist) plus pralidoxime (chemical antagonist used to regenerate active cholinesterase)

USMLE (13 decks)

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