pharmacology 1-30 38% 2-10 48% 3-50% Flashcards
treatment for Lyme and other rickettsial infections (Rocky mount spotted fever and typhus)
doxycycline-can also be used to treat acne
pt with Lyme, end-stage renal disease and severe rxn to penicillin and macs should be given doxycycline and not methacycline because
methacycline is excreted by liver (containidicated in renal dz) vs doxycycline (and minocycline) which are eliminated in feces unchanged.
potency
amount of drug needed to reach 50% effect
treatment for UTIs that can cause tendon rupture and arthropathy in children. mech of action
fluroquinolones-inhbiits DNA gyrase (maes negative supercoils during DNA replication)
blood dycraias, avoid in women in 2nd or 3rd trimester due to risk of kernicterus
sulfonamindes
tooth discoloration, bone abnormalities, and hepatic problems in fetus if taken by mother-mechanism
tetracyclines- blocks aminoacyl-tRNA
neprotoxcity and ototoxity, used for severe gram-negative UTIs
aminoglycosides
parathesias and peripheral nephropathy-prevent how?
isoniazid, prevent by giving pyridoxime
action of benzodiazepems on GABA A channel increases frequency and not duration of channel opening because
benzo works on receptor
barbiturates increase duration of GABA A channel opening
name 2 endings of tricyclic anti-depressants. 2 exceptions
all end in “-iptyline and -ipramine except doxepin and amoxapine”
imipramine amitriptyline, nortriptyline and doxepin
inhibit biogenic amine (NE and 5-HT) reuptake at presynaptic neuron
antidepressants (amitriptyline, nortripttyline, and doxepin)
drug that causes orange urine and used for TB inhibits DNA-dependent RNA polymerase and not mycolic acid synthesis because
rifampin inhibits RNA synthesis, it also blocks RNA transcription. isoniazid disrupts cell wall synthsis in TB but doesn’t cause urine color change.
inhibits mycobacterial arabinsoyl transferase, use if isonazid is not working
ethambutol
used as adjunctive therapy in very early TB
streptomycin
two drugs that can cause urine color changes
rifampin-orange
pyridoxine-bright yellow (used to prevent neuropathy effect of isonazid)
side effect of treatment for parkinson’s (trihexyphenidyl and benztropine) is dry mouth and not diarrehea becuase
these dugs are muscarinic antagonists (decrease Ach which is increased in Parkinson’s) effects of anit-muscarinics are- red as a beet, dry as a bone, blind as a bad, mad as a hatter, and hot asa hare
mecanhism of overdose of acetaminophen
overdose overloads liver’s normal metabolies enzymes and rest is shunted over to P-450 which converts acetaminophen to NAPQI (toxic-centrilobular necrosis). glutathinone is conjugated with NAPQI to become nontoxic, give NAC N-acetylcysteine to replenish glutathione levels
copper overload in Wilson’s disease, other metallic poisons, and treatment for severe rheumatoid arthritis
penicillamine-metal chelator
cyanide overdose
sodium thiosulfate
anti-depressant to avoid in pts with eating disorder is bupropion and not fluoxetine because
bupropion can cause seizures in pts with eating disorder, wheras fluoxetine is the only anti-depressant approved for bulimmia bervosa
- well tolerated antianxiety used for co-morbid depression and anxiety
- causes weight gain, dry mouth, and somnolence
- serotonin syndrome, CNS stimulation and sexual dysfunction
- can be used with eating disorders
- causes seizures if used with eating disorders
buspirone mirtazapine sertraline SSRIs fluoxetine buspirone
pt with ulcerative colitis (UC) needs mesalamine and not infliximab because
mesalamine. infliximab is a monoclonal antibody that bind TNF alpha to reduce inflammation- used for Crohn’s disease.
Crohn’s disease vs ulcerative colitits (UC)
UC-bloody diarrhea, abdominal paon, fecal urgency. inflammation of colonic mucosa
C-transmural inflammation and relapsing and remitting remission
treatment for GERD
lansoprazole, proton pump inhibitor (similar to omeprazole)
pt with BPH and HTN needs a drug that selectively blocks alpha 1 receptors and not a drug that inhibits 5-alpha reductase because
5-alpha reductase inhibitors (finasteride) only treats BPH. whereas alpha-1 receptor blockers (terazosin and doxazosin) treat both HTN and BPH
drug used for child with Wilm’s tumor that can lead to peripheral neuropathy
vincristine-inhibits spindle formation during mitosis.
drugs with Cushinoid syndrome as side effect
prednisone and dexamethasone
tox=hemorrhagic cystitis
cyclophosphamide
tox=pulmonary fibrosis
bleomycin
tox=hyperpigmentation and treatment
busulfan treats chronic myelocytic leukemia
another name for tPA
alteplase
use alteplase and not warfarin for pt with ischemic stroke b/c
tPA is great for breaking down clots that have already formed. Warfarin is good for long time prophylaxis against clot formation but won’t break down clots that have already formed
-alpha adrenergic receptor blocker that lowers systemic vascular resistance and increases HR via baroreceptor reflex
beta1 and beta 2 agonist that lowers TPR and increases HR via beta 2 and baroreceptor reflex
-alpha and beta agonist that increases MAP and lowers HR
-non selective beta blocker that lowers HR
alpha-adrenrgic receptor blocker (phentolamine)
- isoproterenol
- NE (alpha is greater than beta is why HR goes down instead of going up with beta 1 activation)
- non selective beta-adrenergic receptor blocker (propanolol)
in a patient with hepatic encephalopathy a drug that decreases serum ammonia levels is one that acidifies intestinal contents and not a bile acid sequestrant or chelator b/c
chelator used for metal toxicities, cholestryamine lowers LDL by sequestering bile.
mecahism of losartan? effects on arterial pressure, TPR, Na excretion and plasma aldosterone levels?
ANG II inhibitor
-decrease, decrease, increase, decrease
name of mutation seen in CML (chronic myelogenous leukemia)? treatment drug and mechanism
Philadelphia chromosome (bcr-abl transcript), imatinib, protein kinase inhbitor (bcr-abl is a constitutively active tyrosine kinase)
anastrozole
aromatase inhibitor used to treat breast cancer
