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USMLE > Pharm7 - Pharm7 > Flashcards

Pharm7 - Pharm7 Flashcards

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USMLE® Step 1 flashcards
1
Q

which leukotriene is a neutrophil attractant?

A

LTB4

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2
Q

which LT –> bronchoconstriction

A

LTC4, D4, E4

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3
Q

what reaction does phospholipase A2 catalyze

A

phospholipids –> arachidonic acid

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4
Q

what rxn does COX catalyze?

A

arachidonic acid –> PGG, PGH (endoperoxides)

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5
Q

what rxn does lipoxygenase catalyze?

A

arachidonic acid –> HPETEs (hydroperoxides)

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6
Q

what drug blocks lipoxygenase

A

zileuton

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7
Q

what drug blocks COX

A

NSAIDS acetominophen cox-2 inhibitors

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8
Q

what drugs block the effects of leukotrienes?

A

zafirleukast montelukast

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9
Q

actions of PGE?

A

increased uterine tone decreased bronchial tone decreased vascular tone

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10
Q

examples of nsaids

A

ibuprofen naproxen indomethacin ketorolac

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11
Q

mech of nsaids

A

reversibly inhibits cox 1 and 2, blocking PG synth

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12
Q

uses for nsaids

A

antipyretic analgesic anti-inflammatory

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13
Q

what drug is used to close PDA

A

indomethacin

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14
Q

toxicity of nsaids

A

renal damage aplastic anemia GI distress ulcers

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15
Q

MOA cox2 inhibitors

A

reversibly inhibits cox2, maintaining gastric mucosa (cox2 is found only in inflammatory cels that mediate inflamm and pain)

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16
Q

risks associated with cox 2 inibitors

A

thrombosis less gi risk

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17
Q

MOA actaminophen

A

reversibly inhibits cox (mostly in cns) inactivated peripherally

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18
Q

uses of acetaminophen

A

antipyretic analgesic NOT AN ANTI INFLAMMATORY!!!!!!!

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19
Q

toxicity of acetaminophen how?

A

hepatic necrosis a metabolite of acetaminophen depletes glutathione and forms toxic tissue adducts in liver

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20
Q

how is toxic hepatic damage from acetaminophen treated moa?

A

n-acetylcysteine - it regenerates glutathione

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21
Q

drugs that treat gout

A

colchicine allopurinol probenecid indomethacin

22
Q

NSAIDS

A

And said: ‘I be napping in Keto’ ibuprofin naproxen indomethacin ketorolac

23
Q

which gout drugs are used to treat chronic gout?

A

allopurinol probenecid

24
Q

which gout drugs are ued to treat acute gout

A

colchicine indomethacin

25
Q

MOA colchicine

A

depolymerizes MT, impairing WBC chemotaxis and degranuation

26
Q

side effects of colchicine

A

gi

27
Q

what drug is a good alternative to colchicine?

A

indomethacin (less toxic, more commonly used)

28
Q

MOA probenecid

A

inhibits resorption of uric acid

29
Q

MOA allopurinal

A

inhibits xanthine oxidase, so less formation of uric acid

30
Q

aside from gout, what else can allopurinal be used to treat?

A

can help with sx of tumor lysis syndrome, seen in lymphoma/leukemia following chemo

31
Q

what is the original source of uric acid

A

purines from diet and broken down nucleic acids

32
Q

fxn of xanthine oxidase

A

hypoxanthine –> xanthine –> uric acid (blocked by allopurinol)

33
Q

describe interference of probenecid and penicillin

A

inhibits secretion of penecillin

34
Q

what promotes tubular secretion of uric acid

A

diuretics and low dose salicylates

35
Q

MOA etanercept

A

recombinant form of TNF receptor that binds TNF-alpha

36
Q

uses for etanercept

A

RA psoriasis ankylosing spondylitis

37
Q

MOA infliximab

A

TNF-alpha AB

38
Q

uses for infliximab

A

crohns dz RA ankylosing spondylitis

39
Q

toxicity of infliximab

A

predisposes to infection (reactivates latent TB)

40
Q

MOA cyclosporine

A

binds to cyclophilins, blocking differentiation and activiation of t cells by inhibiting calcineruin (prevents the production of IL2 and receptor)

41
Q

fxn of calcineurin

A

phosphatase that activates IL2

42
Q

use for cyclosporine

A

suppress organ transplants treats some autoimmune d/o

43
Q

toxicity of cyclosporine

A

predisp to viral infx and lymphoma NEPHROTOXIC (prevent w mannitol diuresis)

44
Q

MOA tacrolimus

A

binds FK-binding protein, inhibiting the secretion of IL2 and other cytokines

45
Q

uses of tacrolimus

A

immunosuppression following organ transplant

46
Q

toxicity of tacrolimus

A

nephrotoxic peripheral neuropathy HTN pleural effusion hyperglycemia

47
Q

moa azathioprine

A

interferes with metabolism and synth of nucleic acids toxic to prolif wbc

48
Q

uses of azathioprine

A

kidney transplant autoimmune d/o glomerulonephritis hemolytic anemia

49
Q

toxicity of azathioprine

A

bone marrow suppression

50
Q

what is the active metabolite of azathioprine how is it metabolized implication

A

mercaptopurine xanthine oxidase toxic effects may be increased by allopurinol

USMLE (16 decks)

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