PRAZIQUANTEL - for Trematodes (Schistosoma, Paragonimus, Chlonorchis, Fasciolopsis, Heterophyes) and Cestodes (Taenia, Diphyllobotrium, Hymenolepis)

PHARMA Flashcards by John Marquez

What is the definitive treatment for Organophosphate Poisoning?

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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Antidote for OPIOID overdose?

NALOXONE

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

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Reversal agent of ROCURONIUM?

SUGAMMADEX

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Treatment for FILARIASIS?

DOC: DIETHYCARBAMAZINE (DEC)
Back up: Ivermectin

DEC is also DOC for Eye worm disease

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Drug of choice for TRICHINOSIS? (Trichinella spiralis)

THIABENDAZOLE

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DOC for hookworm & pinworm?

PYRANTEL PAMOATE

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DOC for whipworm?

Whipworm is Trichiuris trichiura, a roundworm (Nematode)

Give MEBENDAZOLE

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DOC for Trematodes?

PRAZIQUANTEL

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

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Cilastatin inhibits renal metabolism (hydrolysis) of imipenem by?

Dyhydropeptidase enzyme inhibition

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

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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Symptoms of OPIOID overdose

PCR

Pupil constriction (miosis)
Coma
Respi depression (bradypnea)

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Antidote for Beta Blocker overdose

GLUCAGON

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Antidote for Benzodiazepine overdose

FLUMAZENIL

- competitive antagonist at benzodiazepine sites on GABA-A receptor

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

BENZODIAZEPINE

-Benzos are not GABAmimetic compared to Barbiturates

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

OCTREOTIDE

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

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

BROMOCRIPTINE

*cautious use in patients with Schizophrenia

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

5HT3 receptor antagonist

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

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DOC for acute migraine? MOA?

Sumatriptan. 5HT1d receptor agonist

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

5HT2 antagonist

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

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What anesthetic drug causes thalamocortical dissociation?

Ketamine

NMDA antagonist, weak GABA A modulation

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

This is a case of malignant hyperthermia. Give DANTROLENE.

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

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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Milk of Amnesia. Contains egg lecithin.

PROPOFOL

- potentiates GABA A receptors, blocks Na channel

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

CHEMICAL antagonist

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

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

Neostigmine: AChE inhibitor | It is an indirect acting Cholinergic

Antidote to Heparin overdose

PROTAMINE

IMMEDIATE reversal to Warfarin

FFP or PCC (Prothrombin Complex Conc) Vitamin K has no immediate effect

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

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

What PGE1 analog maintains the patency of Ductus Arteriosus?

Alprostadil | - E1 mong bukas ang ductus arteriosus

Used for closure of PDA

INDOMETHACIN - nonselective cox inhibitor - antiinflammatory

IV anesthetic notorious for adrenal suppression

ETOMIDATE - modulates GABAa receptor containing beta3 - minimal cardiorespiratory effects - no analgesic properties

Lab test for monitoring Warfarin

Lab test for monitoring Heparin

aPTT

Heparin antidote

PROTAMINE

Iodine induced HYPOthyroidism

Wolf-Chaikoff effect

Iondine induced HYPERthyroidism

Jod-Basedow phenomenon

This antiarrythmic can cause Hyper/Hypothyroidism

AMIODARONE - has MOA of Class 1 to 4 antiarrhythmics - may cause thyroid dysfunction and pulmonary fibrosis

Pilocarpine MOA as drug for Glaucoma

M3 receptor in ciliary muscle | Ciliary muscle contraction causing increased outflow

Side effects of THIAZIDE diuretics

HyperGLUC Glycemia Lipidemia Uricemia Calcemia

Diuretic which may cause the ff: Hypokalemia Ototoxicity Gout

FUROSEMIDE ``` OH DANG Ototoxic HypoK Dehydration Allergy to Sulfa Nephritis Gout ```

What is the expected acid base abnormality in Salicylate poisoning?

Respiratory Alkalosis with HAGMA

Neurotoxicity in INH can be prevented by administering

Vitamin B6 (Pyridoxine)

Rifamipicin MOA

Inhibits RNA polymerase in TB

Most hepatotoxic anti TB drug

PYRAZINAMIDE | "sterilizing agent" in the first 2 months of therapy

Anti TB that is CYP450 inducer

RIFAMPICIN

Anti TB that is CYP450 inhibitor

INH | -liver metabolism by acetylation (Filipinos are fast acetylators)

Anti TB drug with SE of visual disturbance

ETHAMBUTOL -inhibits arabinosyl transferase in cell wall

Most active drug against M. leprae

DAPSONE -inhibits folic acid synthesis

Drugs for Leprosy

Dapsone | Clofazimine

Given alongside Cyclophosphamide to minimize its toxicity

MESNA CYclophosphamide causes hemorrhagic cystitis (remember chemotox man)

Rescue therapy for Methotrexate toxicity

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

Rescue therapy for Doxorubicin

Doxorubicin : Dexrazoxane

Antihyperlipidemic drug that causes flushing

NACIN Give aspirin pre-treatment to reduce flushing

DOC for hypertriglyceridemia which activates PPAR alpha and upregulates lipoprotein lipase

Gemfibrozil (Fibrates) FULL (Fibrates upregulate lipoprotein lipase)

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

Ezetimibe | Gemfibrozil

Most common undesirable SE of methyldopa

Sedation Methyldopa - alpha2 selective

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

Methyldopa -causes hemolytic anemia = (+) Coombs test

Chemotherapeutic drug which causes dilated cardiomyopathy

DOXORUBICIN | Chemotox man

Idiosyncratic drug response Aplastic anemia with _______ Cataract _______

Idiosyncratic drug response Aplastic anemia with Chloramphenicol Cataract with Allopurinol

Antiarrhythmic drug for Digitalis toxicity

LIDOCAINE Class 1B

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

AMIODARONE

Best to give post-MI

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

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

ACT

Depolarizing NM blocker that produces bradycardia

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

Hoffman elimination (rapid spontaneous breakdown) yielding Laudanosine

Cisatracurium and Atracurium

Succinylcholine causes what electrolyte imbalance?

Hyperkalemia

DOC for Amoebiasis

Metronidazole

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

BIPERIDEN (Similar: Benztropine, Trihexiphenidyl) Mnemonic for ANTIMUSCARINIC agents for Park: TRI to PARK your BENZ, BIP here Trihexiphenydyl, Parkinsons, Benztropine, Biperiden

Tx of glaucoma which increases outflow via canal of Schlemm

Latanoprost LatanoproSch (schlemm)

Tx of glaucoma which increases outflow via uveoscleral veins

Epinephrine Epi is a nonselective alpha agonist

Tx of glaucoma which increases outflow via ciliary muscle contraction

Cholinomimetics Pilocarpine, physostigmine, ecthiopate

Give examples of cardioselective B1 blocker

Cardioselective = B1 selective blocker Suited for patients with airway disease ATE is SMOL & METaba BUT NEBer nagBISYO. Atenolol, Esmolol, Metoptolol, Betaxolol, Nebivolol, Bisoprolol

Absence seizure DOC

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

Anticonvulsant with SE of gingival hyperplasia

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

DOC for trigeminal neuralgia & generalized tonic clonic seizure

Carbamazepine | Blocks voltage gated Na channels Structurally similar to phenytoin

In inhalational anesthetics: The higher the MAC, the _______ the potency (MAC = minimum alveolar concentration)

LOWER

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

Sevoflurane Compound A causes proximal tubule necrosis

What anesthetic is responsible for coronary steal syndrome?

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

Anesthetic gas that is a pulmonary irritant

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

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

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

Most effective vasodilator which affects both arteries and veins.

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

Aspirin (irreversible, reversible) inhibition of COX pathway NSAIDs (irreversible, reversible) inhibition of COX pathway

Aspirin - irreversible | NSAID - reversible

Used in sickle cell disease to increase production of fetal hemoglobin

Hydroxyurea -inhibits ribonucleotide reductase

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

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

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

Potassium Iodide (Lugol's Solution) Inhibit iodine organification and hormone release. Reduce size and vascularity.

Antiemetic + histamine antagonist

Promethazine

Longest half-life among beta blockers

Nadolol

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

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

Antidote for methanol poisoning

Fomepizole - inhibitor of alcohol dehydrogenase (ADH normally metabolized methanol to formaldehyde) Note: Methanol poisoning may cause blindness

DOC for lidocaine systemic toxicity

INTRALIPID

Antibiotic for hepatic toxicity

Neomycin Aminoglycoside which inhibits protein synthesis by binding to 30s subunit

Among antipsychotics, which has the highest propensity to cause hyperprolactinemia

Risperidone - inhibits serotonin receptor

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

METHADONE

Opioid with shortest half-life?

Remifentanil

Opioid with longest half life?

Buprenorphine

Major ovarian estrogen

Estradiol

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

Megestrol acetate

Conjugated estrogen used in HRT

PREMARIN

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

NORETHINDRONE

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

Drosperinone

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

72 hours

Synthetic steroid with weak estrogenic, progestogenic, and androgenic activity

TIBOLONE