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PHARMA Flashcards

1
Q

What is the definitive treatment for Organophosphate Poisoning?

A

PRALIDOXIME

Organophosphate Poisoning - think DUMBBELS (basang basa)
Organophosphate is a cholinomimetic.
You need Pralidoxime to regenerate AChE
- must be given within 6-8 hours
Atropine is the initial treatment for Organophosphate

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2
Q

Antidote for OPIOID overdose?

A

NALOXONE

Opioid interact with mu, sigma and kappa receptors
Naloxone blocks these receptors (competitive)

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3
Q

Reversal agent of ROCURONIUM?

A

SUGAMMADEX

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4
Q

Treatment for FILARIASIS?

A

DOC: DIETHYCARBAMAZINE (DEC)
Back up: Ivermectin

DEC is also DOC for Eye worm disease

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5
Q

Drug of choice for TRICHINOSIS? (Trichinella spiralis)

A

THIABENDAZOLE

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6
Q

DOC for hookworm & pinworm?

A

PYRANTEL PAMOATE

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7
Q

DOC for whipworm?

A

Whipworm is Trichiuris trichiura, a roundworm (Nematode)

Give MEBENDAZOLE

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8
Q

DOC for Trematodes?

A

PRAZIQUANTEL

  • for Trematodes (Schistosoma, Paragonimus, Chlonorchis, Fasciolopsis, Heterophyes) and Cestodes (Taenia, Diphyllobotrium, Hymenolepis)
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9
Q

Cilastatin inhibits renal metabolism (hydrolysis) of imipenem by?

A

Dyhydropeptidase enzyme inhibition

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10
Q

Alendronate is taken with lots of water to avoid what side effect?

A

Esophagitis

Alendronate is a bisphosphonate used for Tx of Osteoporosis, Pagets of bone, hyperCa in malignancies

MOA: inhibits farnesyl pyrophosphate which suppress osteoclast activity

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11
Q

Symptoms of OPIOID overdose

A

PCR

Pupil constriction (miosis)
Coma
Respi depression (bradypnea)
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12
Q

Antidote for Beta Blocker overdose

A

GLUCAGON

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13
Q

Antidote for Benzodiazepine overdose

A

FLUMAZENIL

- competitive antagonist at benzodiazepine sites on GABA-A receptor

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14
Q

What drug increases the FREQUENCY of opening of Cl channels by allosteric enhancing affinity of GABA receptors?

A

BENZODIAZEPINE

-Benzos are not GABAmimetic compared to Barbiturates

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15
Q

Somatostatin analog used for acromegaly, pituitary adenomas, variceal bleeding, gastrinoma

A

OCTREOTIDE

Pegvisomant naman is also for Acromegaly but MOA is GH receptor antagonist.

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16
Q

Dopamine is responsible for inhibition of Prolactin. What Dopamine agonist is used for Hyperprolactinemia?

A

BROMOCRIPTINE

*cautious use in patients with Schizophrenia

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17
Q

Ondansetron is used for post-operative vomiting. What is the MOA?

A

5HT3 receptor antagonist

5HT3 receptors are found in the CTZ on the floor of 4th ventricle

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18
Q

DOC for acute migraine? MOA?

A

Sumatriptan. 5HT1d receptor agonist

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19
Q

Ketanserin is used for carcinoid tumors by acting on what serotonin receptor?

A

5HT2 antagonist

Remember your 5HTs
1d agonist - sumatriptan
2 antagonist - KENTASERIN, PHENOXYBENZAMINE
3 antagonist - ondansetron

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20
Q

What anesthetic drug causes thalamocortical dissociation?

A

Ketamine

NMDA antagonist, weak GABA A modulation

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21
Q

After exposure to Suçcinylcholine, patient was hyperthermic, tachycardic, hypercapnic, hyperkalemic, with metabolic acidosis. What is the treatment?

A

This is a case of malignant hyperthermia. Give DANTROLENE.

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22
Q

After exposure to Suçcinylcholine, patient was hyperthermic, tachycardic, hypercapnic, hyperkalemic, with metabolic acidosis. What is the pathophysiology of thus condition?

A

Mutation in the RYANODINE receptor of skeletal muscle that results to uncontrolled release of Ca 2+ from SR.

Most reliable test to establish susceptibility:
Caffeine-Halothane contracture test

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23
Q

Milk of Amnesia. Contains egg lecithin.

A

PROPOFOL

- potentiates GABA A receptors, blocks Na channel

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24
Q

Sugammadex, a reversal agent of Rocuronium, is what type of antagonist?

A

CHEMICAL antagonist

-bind to rocuronium and sequester it out so that it wont reach the nicotinic receptor

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25
Q

Aside from Sugammadex, Neostigmine can also be used for reversal of Rocuronium. What is the MOA?

A

Neostigmine: AChE inhibitor

It is an indirect acting Cholinergic

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26
Q

Antidote to Heparin overdose

A

PROTAMINE

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27
Q

IMMEDIATE reversal to Warfarin

A

FFP or PCC (Prothrombin Complex Conc)

Vitamin K has no immediate effect

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28
Q

LH functions to induce final oocyte maturation. What drug is a LH analog used for hypogonadotropic hypogonadism?

A

HCG

-activates LH receptors (because its an LH analog!)

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29
Q

What PGE1 analog maintains the patency of Ductus Arteriosus?

A

Alprostadil

- E1 mong bukas ang ductus arteriosus

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30
Q

Used for closure of PDA

A

INDOMETHACIN

  • nonselective cox inhibitor
  • antiinflammatory
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31
Q

IV anesthetic notorious for adrenal suppression

A

ETOMIDATE

  • modulates GABAa receptor containing beta3
  • minimal cardiorespiratory effects
  • no analgesic properties
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32
Q

Lab test for monitoring Warfarin

A

PT

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33
Q

Lab test for monitoring Heparin

A

aPTT

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34
Q

Heparin antidote

A

PROTAMINE

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35
Q

Iodine induced HYPOthyroidism

A

Wolf-Chaikoff effect

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36
Q

Iondine induced HYPERthyroidism

A

Jod-Basedow phenomenon

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37
Q

This antiarrythmic can cause Hyper/Hypothyroidism

A

AMIODARONE

  • has MOA of Class 1 to 4 antiarrhythmics
  • may cause thyroid dysfunction and pulmonary fibrosis
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38
Q

Pilocarpine MOA as drug for Glaucoma

A

M3 receptor in ciliary muscle

Ciliary muscle contraction causing increased outflow

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39
Q

Side effects of THIAZIDE diuretics

A

HyperGLUC

Glycemia
Lipidemia
Uricemia
Calcemia

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40
Q

Diuretic which may cause the ff:
Hypokalemia
Ototoxicity
Gout

A

FUROSEMIDE

OH DANG
Ototoxic
HypoK
Dehydration
Allergy to Sulfa
Nephritis
Gout
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41
Q

What is the expected acid base abnormality in Salicylate poisoning?

A

Respiratory Alkalosis with HAGMA

42
Q

Neurotoxicity in INH can be prevented by administering

A

Vitamin B6 (Pyridoxine)

43
Q

Rifamipicin MOA

A

Inhibits RNA polymerase in TB

44
Q

Most hepatotoxic anti TB drug

A

PYRAZINAMIDE

“sterilizing agent” in the first 2 months of therapy

45
Q

Anti TB that is CYP450 inducer

A

RIFAMPICIN

46
Q

Anti TB that is CYP450 inhibitor

A

INH

-liver metabolism by acetylation (Filipinos are fast acetylators)

47
Q

Anti TB drug with SE of visual disturbance

A

ETHAMBUTOL

-inhibits arabinosyl transferase in cell wall

48
Q

Most active drug against M. leprae

A

DAPSONE

-inhibits folic acid synthesis

49
Q

Drugs for Leprosy

A

Dapsone

Clofazimine

50
Q

Given alongside Cyclophosphamide to minimize its toxicity

A

MESNA

CYclophosphamide causes hemorrhagic cystitis (remember chemotox man)

51
Q

Rescue therapy for Methotrexate toxicity

A

LEUCOVORIN

Methotrexate is an antimetabolite that inhibits dihydrofolate reductase. Give Leucovorin (Folinic acid)

52
Q

Rescue therapy for Doxorubicin

A

Doxorubicin : Dexrazoxane

53
Q

Antihyperlipidemic drug that causes flushing

A

NACIN

Give aspirin pre-treatment to reduce flushing

54
Q

DOC for hypertriglyceridemia which activates PPAR alpha and upregulates lipoprotein lipase

A

Gemfibrozil
(Fibrates)

FULL (Fibrates upregulate lipoprotein lipase)

55
Q

What hyperlipidemic agents to avoid in patients with increased liver enzymes (hepatic dysfunction)?

A

Ezetimibe

Gemfibrozil

56
Q

Most common undesirable SE of methyldopa

A

Sedation

Methyldopa - alpha2 selective

57
Q

A female patient taking an antihypertensive was noted to have positive Coombs test. What is the drug?

A

Methyldopa

-causes hemolytic anemia = (+) Coombs test

58
Q

Chemotherapeutic drug which causes dilated cardiomyopathy

A

DOXORUBICIN

Chemotox man

59
Q

Idiosyncratic drug response

Aplastic anemia with _______
Cataract _______

A

Idiosyncratic drug response

Aplastic anemia with Chloramphenicol
Cataract with Allopurinol

60
Q

Antiarrhythmic drug for Digitalis toxicity

A

LIDOCAINE

Class 1B

61
Q

Next line antiarrhythmic for V fib that is not responsive to shock and epinephrine

A

AMIODARONE

62
Q

Best to give post-MI

A

Class IB
-highly selective, reduces AP duration, little effect on ECG

LIDOCAINE

63
Q

What parameter is used to monitor effects of PROTAMINE on high dose heparin?

A

ACT

64
Q

Depolarizing NM blocker that produces bradycardia

A

Succinylcholine

Kapag nag DEPOsit sa banyo, SUCCess!!
DEPOlarizing = SUCCinylcholine

65
Q

Hoffman elimination (rapid spontaneous breakdown) yielding Laudanosine

A

Cisatracurium and Atracurium

66
Q

Succinylcholine causes what electrolyte imbalance?

A

Hyperkalemia

67
Q

DOC for Amoebiasis

A

Metronidazole

68
Q

What antiParkinson drug has a MOA of anticholinergic (Muscarinic antagonist)?

A

BIPERIDEN (Similar: Benztropine, Trihexiphenidyl)

Mnemonic for ANTIMUSCARINIC agents for Park:

TRI to PARK your BENZ, BIP here
Trihexiphenydyl, Parkinsons, Benztropine, Biperiden

69
Q

Tx of glaucoma which increases outflow via canal of Schlemm

A

Latanoprost

LatanoproSch (schlemm)

70
Q

Tx of glaucoma which increases outflow via uveoscleral veins

A

Epinephrine

Epi is a nonselective alpha agonist

71
Q

Tx of glaucoma which increases outflow via ciliary muscle contraction

A

Cholinomimetics

Pilocarpine, physostigmine, ecthiopate

72
Q

Give examples of cardioselective B1 blocker

A

Cardioselective = B1 selective blocker
Suited for patients with airway disease

ATE is SMOL & METaba BUT NEBer nagBISYO.
Atenolol, Esmolol, Metoptolol, Betaxolol, Nebivolol, Bisoprolol

73
Q

Absence seizure DOC

A

Ethosuximide

Reduces Ca influx thru T type channels (similar MOA with Valproic acid)

74
Q

Anticonvulsant with SE of gingival hyperplasia

A

Phenytoin

```
Drugs causing Gingival Hyperplasia:
NPC-pangit ng gingiVa mo
Nifedipine
Cyclosporine
Phenytoin
Verapamil
~~~

75
Q

DOC for trigeminal neuralgia & generalized tonic clonic seizure

A

Carbamazepine

Blocks voltage gated Na channels
Structurally similar to phenytoin

76
Q

In inhalational anesthetics:
The higher the MAC, the _______ the potency

(MAC = minimum alveolar concentration)

A

LOWER

77
Q

Compound A is a renally toxic metabolite produced by which anesthetic gas?

A

Sevoflurane

Compound A causes proximal tubule necrosis

78
Q

What anesthetic is responsible for coronary steal syndrome?

A

Isoflurane

coronary steal syndrome is the preferential redistribution of blood from ischemic to non ischemic areas

79
Q

Anesthetic gas that is a pulmonary irritant

A

Desflurane

Desflurane is pungent and can cause bronchospasm. It is unique because it requires special heated and pressurized vaporizer

80
Q

The only inhalational anesthetic that increases cerebral BF and increases ICP due to activation of sympa NS

A

Nitrous Oxide

Do not use in: Middle ear surgeries, Brain surgeries, Bowel surgeries due to expansion of air filled cavities in non-compliant spaces

81
Q

Most effective vasodilator which affects both arteries and veins.

A

Nitroprusside

Relaxes arteriolar and venous SM by increasing NO – increase cGMP
High maintenance, not commonly used

82
Q

Aspirin (irreversible, reversible) inhibition of COX pathway

NSAIDs (irreversible, reversible) inhibition of COX pathway

A

Aspirin - irreversible

NSAID - reversible

83
Q

Used in sickle cell disease to increase production of fetal hemoglobin

A

Hydroxyurea

-inhibits ribonucleotide reductase

84
Q

A prokinetic agent that has extrapyramidal side effects and is not used in patients with Parkinsons disease.

A

Metoclopramide

Metoclopramide and Domperidone block D2 receptors. Domperidone does not cross BBB.

85
Q

Preparation for surgical thyroidectomy to reduce the size and vascularity of the thyroid gland.

A

Potassium Iodide (Lugol’s Solution)

Inhibit iodine organification and hormone release. Reduce size and vascularity.

86
Q

Antiemetic + histamine antagonist

A

Promethazine

87
Q

Longest half-life among beta blockers

A

Nadolol

88
Q

Oral anticoagulant to give to a patient with history of Heparin Induced Thrombocytopenia (HIT)

A

Dabigatran

Is the only PO among the direct thrombin inhibitors. The rest are parenteral (Lepirudin, Argatroban, Bivalirudin, etc)

89
Q

Antidote for methanol poisoning

A

Fomepizole

  • inhibitor of alcohol dehydrogenase (ADH normally metabolized methanol to formaldehyde)

Note: Methanol poisoning may cause blindness

90
Q

DOC for lidocaine systemic toxicity

A

INTRALIPID

91
Q

Antibiotic for hepatic toxicity

A

Neomycin

Aminoglycoside which inhibits protein synthesis by binding to 30s subunit

92
Q

Among antipsychotics, which has the highest propensity to cause hyperprolactinemia

A

Risperidone

  • inhibits serotonin receptor
93
Q

What opioid has the ff MOA
mu receptor agonist
NMDA antagonist
blocks monoamine reuptake

A

METHADONE

94
Q

Opioid with shortest half-life?

A

Remifentanil

95
Q

Opioid with longest half life?

A

Buprenorphine

96
Q

Major ovarian estrogen

A

Estradiol

97
Q

Hormonal agent under Progestin class that is used as an appetite stimulant

A

Megestrol acetate

98
Q

Conjugated estrogen used in HRT

A

PREMARIN

99
Q

Testosterone derivative that is used in combination with ethinyl estradiol (COC)

A

NORETHINDRONE

100
Q

Spironolactone derivative that is used in combination with ethinyl estradiol (COC)

A

Drosperinone

101
Q

Levonorgestrel, a post-coital contraceptive, must be taken within ___ hrs of unprotected intercourse

A

72 hours

102
Q

Synthetic steroid with weak estrogenic, progestogenic, and androgenic activity

A

TIBOLONE

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