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Low Yield Semmelweis > Pharma List A > Flashcards

Pharma List A Flashcards

1
Q

All Prodrugs of ACE I except

A

Captopril , lisinopril

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2
Q

Which drug u won’t give together with ACE I

A

NSAIDS
decrease PG thus constricting the afferent arteriole and decreasing GFR .

ACE I dilated efferent arteries causing decrease GFR

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3
Q

Which drug has the following CI : hereditary angioedeme

A

ACE I

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4
Q

Which ACE I has also liver elimination?

A

fosinopril , Spirapril

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5
Q

Which ARB improves cognitive function ?

A

Candesartan

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6
Q

Which drug is the first line in HTN

A

ACE I ( except in pregnancy- teratogenic)

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7
Q

How many times a day u should give ACE I

A

Once . Short HL but long enzyme inactivation. Reduces ang 2

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8
Q

With which drug will u combine ACE I

A

Thiazides . Balance k level .

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9
Q

Which drug is the DOC in DM and HTN pt

A

ACE I . Reduce proteinuria

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10
Q

Treatment steps in HTN

A

Life style , diuretics , sympatholytic , ACE I , vasodilator

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11
Q

Which thiazides increase LDL

A

Hydrochlorothiazid

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12
Q

Which diuretic is the DOC in severe HTN

A

Furosemide due to rapid and short action

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13
Q

Which drug is the so called “add on drug “ in HTN

A

Spirinolacton - can decrease mortality . If 3 drugs don’t work already than u should add it too

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14
Q

Drug that requires cysteine In his metabolic process

A

Nitroglycerin

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15
Q

Contraindications of nitrates

A

Right Heart failure, silidenafil , HOCM

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16
Q

Methahemaglobinemia is a SE of

A

Nitrates . Rare ! With prolonged if infusion .

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17
Q

Which drug/s u will always combine with hydralazin

A

Beta blocker for reflex and diuretic for the edema .

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18
Q

Which vasodilator u will give to black Americans

A

Hydralazine due to resistance to ACE I

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19
Q

Drugs that induce DM

A

Minoxidil ,diazoxide . Due to opening ATP k Channels .

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20
Q

Which drug indicated for baldness ?

A

Minoxidil

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21
Q

Drug that is indicated in insulinoma and in HTN crisis .

A

Diazoxide

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22
Q

Short acting Ca channel blockers

A

Nifedipine , Nimodipine

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23
Q

Ca channel blockers in atherosclerosis

A

Lacidipine increases affinity to cholesterol rich issue . Isradipine - improve lipid profile

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24
Q

Which drug indicated in prinzmetal angina

A

Amlodipine nifedipine

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25
Q

Risk of ischemic steal phenomena is high in which kind of CCI

A

Short acting . Also cause reflex tachycardia

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26
Q

Pregnancy HTN drugs

A

Nifedipine , Alpha methyl dopa

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27
Q

Verapamil SE

A

Gingival hyperplasia , constipation

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28
Q

Which diuretic drug enhances cox2 expression ?

A

Loop diuretic . Increasing PG causes after the vasodilation and enhance diuretic effect. Most effective diuretic drug !!

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29
Q

Which diuretic is the DOC in acute renal failure and chronic one too ?

A

Furosemide

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30
Q

Why is it CI o give furosemide in cirrhosis

A

Hepatic encephalopathy. Alkalosis inhibits ammonia to ammonium transformation

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31
Q

Which loop won’t cause interstitial nephritis?

A

Ethacrynic . Not sulfonamide . Worse ototoxicity

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32
Q

When do you use furosemide in HTN

A

Only in renal failure and left ventricular failure

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33
Q

What is the effect of thiazides on lipid profile

A

Increase LDL ( except indopamide )

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34
Q

Which drug is combined with hydrochlorothiazid in HTN

A

ACE I

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35
Q

Which diuretic will u use in nephrogenic DI

A

Thiazides

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36
Q

Oral contraceptive that is also aldosterone inhibitor

A

Drospirenone

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37
Q

Drug that used in Polycystic ovary

A

Spirinolacton that blocks 17 alpha hydroxylase

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38
Q

Nephrogenic DI causes by lithium can be treated by which drug

A

amiloride

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39
Q

Indications of osmotic diuretics

A

Acute renal failure (oliguric state ) , cerebral edema , IOP .

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40
Q

CI of osmotic diuretics

A

Cerebral trauma

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41
Q

Vasopressin 2 selective antagonist and indications

A

Tolvaptan- SIADH , polycystic kidney .

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42
Q

Which diuretic decreases mortality in HF

A

K sparing

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43
Q

What do statins do ? And in which hyperlipidemia can be used

A

Increase LDL R , decrease VLDL and LDL cholesterol. Used in combined hyperlipidemia

44
Q

Most potent statin

A

Atrovastatin

45
Q

SE of statins

A

Hepatotoxic due to decrease VLDL
Rhabdomyolysis - decrease coenzyme Q
Renal failure

46
Q

Which drugs is batter not to combine with statins

A

Macrolide’s, fibrate . Due to cytochrome inhibition .

47
Q

Drug that is CI in hypertriglceridemia.

A

Resins . Cholestyramine cholestipol. They increase in compensatory mechanisms the VLDL and TG

48
Q

Indications for statins

A

Primers hypercholestrolemia- increase in LDL only

49
Q

MOA of Niacin

A

Decrease VLDL LDL , increase HDL , decrease HSL which leads to less TG in plasma .

50
Q

Best HDL rising agent

A

Niacin

51
Q

Agent used mostly in hypertriglyceridemia

A

Fibrates . Gemfibrozil and fenofibrate due to decreasing VLDL , apo C , and increasing LPL

52
Q

Cytochrome interactions of P2Y12 inhibitors

A

Inhibitors of cyp2c19 . Omeprazole fluoxetine fluconazole inhibit clopidogrel activation

53
Q

Not prodrugs of P2Y12 I

A

Ticagrelor cangrelor

54
Q

Ticlopidin SE

A

Thrombocytopenia

55
Q

Vorapexar MOA

A

Inhibit platelet PAR1 ( thrombin receptor )

56
Q

In which drug severe bleeding might need thrombocytes infusion due to long HL

A

Abciximab

57
Q

Competitive antg of Gp2b3a

A

Eptifibatide and tirofiban . More selective to thrombocytes

58
Q

Dypiridamole and cilostazol MOA

A

Inhibit PDE and increase Plasma Adenosine leading to increasing cAMP . Vasodilation and plt inhibition

59
Q

Complication of dipyridamole

A

Coronary steal syndrome - due to its vasodilator activity

60
Q

Dipyridamol indication

A

Heart valve thrombus prophylaxis - only with warfarin

61
Q

Which keep Nd of heparin drug has more predictable BV and longer HL

A

LMWH - binds less to proteins . DOA 2-4 hours

62
Q

Which drug Inactivates factor 10 only among the heparins

A

LMWH (less than 18 MS) and fundaoarinux ( lowest MWH)

63
Q

aPTT must b measured in which heparin drug and what is the goal .

A

UFH . Goal is 1.5 -2.5

64
Q

Which anticoagulant will you use in pregnancy ?

A

Heparin . Warfarin is teratogenic

65
Q

Give an example for LMWH drug

A

Enoxarin , deltaprin , tinzaprin

66
Q

How Heparin is measured

A

Units in 1000 unit range . 5000IU is given in acute therapy -MI

67
Q

High dose SE of Heparin

A

Impaired aldosterone synthesis and osteoporosis in long term .

68
Q

Which anticoagulant will u give as a starting therapy ?

A

Heparin due to rapid action

69
Q

Which platelet factor is involved in HIT

A

Factor 4 and heparin bound by IgG . 4 first days of treatment

70
Q

Which drug is used for DVT mostly

A

Fundaparinux

71
Q

Portamin sulfate works in which type of heparin mostly

A

HMWH

72
Q

Danaparoid indication

A

HIT type 2 . Only factor 10 inactivation

73
Q

Which direct thrombin inhibitors has elimination not depended on kidney and liver

A

Bivalirudin - proteolytic cleavage

74
Q

How Hirudin is monitored

A

aPTT

75
Q

What is the indication if bivaluridin

A

PCI

76
Q

Which thrombin inhibitor is a prodrug

A

Debigatrin etaxilate

77
Q

Which thrombin direct inhibitor is effected from liver disease

A

Argatroben - hepatic elimination

78
Q

Antidote for apixaban and rivaroxaban

A

Ciraparantag

79
Q

Idarucizumab used as …

A

Antidote of Debigatrin

80
Q

Which drug monitored by prothrombin time

A

Warfarin

81
Q

Long acting warfarin drug

A

Phenprocumon-150hrs

82
Q

Which drug is most likely to be given in chronic treatment in thromboembolic prophylaxis

A

Warfarin - start with heparin first

83
Q

Short acting warfarin drug

A

Acenocumarol -16 hr

84
Q

How is warfarin metabolized ?

A

Glucoronide conjugation , mostly renal elimination

85
Q

CYP inducers that increase Cumarin metabolism .

A

Barbiturates, rifampin , phenytoin , grisefluvin

86
Q

CYP inhibitors that decrease cumarin metabolism

A

Metronidazol, fluconazol , amiodarone , cimetidin

87
Q

Which values are increases during using fibrinolytic drugs

A

Pt , aPTT , D dimer

88
Q

Which tissue plasminogen activator is less fibrin selective

A

Reteplase , alteplase

89
Q

Which tPA resistant to PAI 1 inactivation

A

Tenecteplase

90
Q

Name fibrinolytics with some clot selectivity

A

Amistreplase , prourokinase , tenecteplase

91
Q

Which drug will u use in hemophilia A

A

Desmopressin

92
Q

Competitive antg at lys binding site

A

Aminocarporic acid , p amino methylbenzoic . Orally active

93
Q

Which anti ulcer drug is acid labile

A

PPI ; omeprazol , rabeprazol , esmoprazol , lasnoprazol ,

94
Q

Which anti ulcer drug can change the V max of enzymes

A

PPI - irreversible.

95
Q

Reversible proton pump inhibitor

A

Revaprazan

96
Q

Which anti ulcer drug will u use at bedtime

A

Anti histamine . ( histamine dominates at night more )

97
Q

Which anti ulcer drug has hepatic metabolism

A

PPI ( anti H has renal elimination )

98
Q

Cimetidine SE

A

CYP inhibition , inhibition of androgen receptor too .

99
Q

H pylori eradication triple therapy

A

PPI , clarithromycin and amoxicillin / metronidazole

100
Q

How antacids effect oral absorption of basic and acidic drugs . Give examples

A

Acidic drugs decreased e.g. Warfarin

Basic drugs increased e.g. Quinidine

101
Q

Calcium carbonate SE

A

Metabolic alkalosis and milk alkali syndrome .

102
Q

Which antacid causes diarrhea

A

Magnesium hydroxine

103
Q

Misoprostol SE

A

Diarrhea and uterine contraction

104
Q

Clinical us of bismuth subcitrate / subcalicylate

A

H pylori , dyspepsia , diarrhea

105
Q

MOA of sucralfate

A

Works in low ph only , binds ulcers for 6 hours and can increase PG

Low Yield Semmelweis (37 decks)

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