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USMLE Step 1 > Pharmacology > Flashcards

Pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

Allopurinol

A

Purine analog that inhibits PRPP amidotransferase.

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2
Q

6-mercaptopurine

A

Purine analog that inhibits PRPP amidotransferase.

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3
Q

Hydroxyurea

A

Inhibits ribonucleotide reductase

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4
Q

5-Fluorouracil

A

Inhibits thymidylate synthase

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5
Q

Methotrexate

A

Inhibits dihydrofolate reductase. Used in Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, lung cancer, breast cancer, osteosarcomas.

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6
Q

Pyrimethamine

A

Inhibits dihydrofolate reductase

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7
Q

Trimethoprim

A

Antimetabolite that inhibits bacterial dihydrofolate reductase. Often used in combo with sulfonamides, e.g. sulfamethoxazole) to sequentially block folate synthesis

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8
Q

Quinolone antibiotics

A

Inhibit bacterial topoisomerase IV

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9
Q

Rifampicin

A

Binds B subunit of RNA polymerase and inhibits initiation of RNA synth. Notably lipophilic thus readily crosses BBB.

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10
Q

Actinomycin D

A

Binds DNA and prevents RNA polym from moving along template. Originally used as antibiotic but now as chemo for gestational trophoblastic tumors, Wilms’ tumor, rhabdomyosarcoma

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11
Q

Abx that inhibit 30s subunit

A

Aminoglycosides, tetracycline

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12
Q

Abx that inhibit 50s subunit

A

Chloramphenicol, erythromycin, clindamycin, lincomycin

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13
Q

Tetracycline

A

Prevents initiation since charged tRNA cannot bind ribosome

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14
Q

Streptomycin

A

Prevents initiation since code is misread

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15
Q

Erythromycin

A

Inhibits translocation

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16
Q

Disulfiram

A

Inhibits conversion of aldehyde to acetic acid (in alcohol metabolism) so meant to stop alcoholics from drinking since they feel like crap

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17
Q

Ethanol

A

Antidote to methanol poisoning. Competitively inhibits ADH by binding to active site thus preventing enzyme from binding to methanol. Prevents further accumulation of formic acid and formaldehyde by favoring conversion to acetaldehyde.

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18
Q

Disulfiram effect

A

I.e. same effect with other medications.

Metronidazole, tolbutamide, cefoperazone, cefotetan

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19
Q

Cardiac glycosides

A

Bind and inhibit Na-K-ATPase by competing for sites on extracellular side. Results in increased cardiac contractility through Ca-dependent mechanism

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20
Q

Melatonin

A

Can treat circadian rhythm disorders like jet lag

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21
Q

Sildenafil citrate

A

Aka viagra. Selective inhibitor or the phosphodiesterase that prolongs the effects of NO

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22
Q

Orlistat

A

Inhibits pancreatic lipase thus prevents absorption of dietary fat. As result–> steatorrhea.

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23
Q

Fibrates

A

Class of lipid-lowering drugs that activate peroxisome proliferator-activated receptor-a (PPAR-a) causing increase in LPL activity. Decrease blood TG but little effect on plasma cholesterol levels

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24
Q

Drugs that lower cholesterol

A

Resins and ezetimibe

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25
Q

Drugs that lower TG

A

Fibrates

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26
Q

Drugs that lower cholesterol and TG

A

Niacin and statins (esp atorvastatin)

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27
Q

Niacin

A

Lowers TG and chol by inhibiting VLDL secretion

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28
Q

Terbinafine

A

Antifungal. Inhibits conversion of squalene to lanosterol in fungi. Esp useful for onychomycosis.

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29
Q

Imidazole and triazle antifungals

A

Inhibit conversion of lanosterol to ergosterol in fungi. Cytochrome p450 inhibitors.

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30
Q

Urodeoxycholate

A

Used in tx of radiolucent gallstones. Solubilizes cholesterol and inhibits its production. However cholecystectomy preferred tx so used in poor surgical candidates

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31
Q

Corticosteroids

A

Block PLA2 and interrupt COX synthesis

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32
Q

Zileuton

A

Blocks lipoxygenase

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33
Q

Zafirlukast

A

Blocks leukotriene receptors

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34
Q

Montelukast

A

Blocks leukotriene receptors

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35
Q

Indomethacin

A

COX inhibitor. Closes PDAs

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36
Q

Most commonly known P450 inducers

A

Carbamazepine, phenytoin, barbiturates, alcohol, griseofulvin, rifampicin

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37
Q

Treatment of lead poisoning

A

EDTA, dimercaprol, succimer

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38
Q

Deferoxamine

A

Iron chelator

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39
Q

Chemo-alkylating agents

A

Cisplatin, carboplatin

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40
Q

imatinib mesylate

A

Specific inhibitor of tyrosine kinase domain in abl and c-kit; useful in CML

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41
Q

Ethyl methanesulfonate (EMS)

A

Introduces mutations by transferrinh methyl groups to DNA nucleotide bases. Do not cause cell death so not used as chemo

42
Q

Ribavirin

A

RSV (resp synctial virus)

43
Q

Foscarnet

A

CMV retinitis

44
Q

Acyclovir

A

HSV1, HSV2, VZV, EBV.

Inhibits viral DNA polymerase

45
Q

Amantidine

A

Influenza A

46
Q

Reserpine

A

Minimizes motor abnormalities in Huntingtons.

47
Q

Side effects amiodarone

A

Pulm fibrosis (restrictive), interstitial pneumonitis, photosensitivity, thyroid disorders, GI disturbances

48
Q

Cholestyramine

A

Bile acid resin. Decreases serum TGs and chol

49
Q

Thiazide diuretics

A

Inhibit NaCl reabsorption in early distal tubule. Increased Na delivery to principal cells of late DCT causes increased Na reabsorption and an increase in K secretion to maintain electroneutrality. (Note not K+ sparing.)
Limit Ca loss

50
Q

Amiloride

A

K+ sparing diuretic. Acits on Na channels of collecting duct to prevent its reabsorption and thus K+ secretion

51
Q

Ketorolac

A

NSAID

52
Q

Diphenhydramine

A

H1 antag. Tx-allergic rxns, motion sickness, dystonic rxns. May cause sedation, anticholinergic effects, anti-alpha-adrenergic effects

53
Q

Lithium, demeclocycline

A

ADH antags, act along collecting tubule

54
Q

Carbonic anhydrase inhibitors

A

act in PCT

55
Q

Osmotic diuretics

A

Act in loop, PCT, collecting duct

56
Q

Loop diuretic toxicity

A

metabolic alklalosis

57
Q

Important side effect statins

A

Rhabdomyolysis

58
Q

Acetazolamide

A

Helps with acute mtn sickness by causing metabolic acidosis….increased breathing drive and higher O2 levels in body

59
Q

NSAID toxicity

A

Acute interstitial nephritis

60
Q

Urinary flow rate

A

GFR*[inulin]plasma/[insulin]urinary

61
Q

Km

A

inversely proportional to the affinity of the enzyme for the substrate

62
Q

Vancomycin

A

Only Gram +ve. Resistance-precents vanco from binding by mutating terminal aa in microorganism’s cell wall

63
Q

Resistance to macrolides

A

Through methyltion of its rRNA at ribo binding site

64
Q

Tx for neurocysticerosis

A

Albendazole

65
Q

Reserpine

A

Minimizes motor abnormalities in Huntingtons

66
Q

Penacillamine

A

Chelating agent for Cu

67
Q

Prochlorperazine

A

Acts on area postrema of medulla (CTZ)

68
Q

Bismuth

A

Triple therapy in H pylori

69
Q

Ranitidine

A

Mild reflux

70
Q

Sulcrafate

A

Coats gastric mucosa

71
Q

Unfractionated heparin

A

DVT/PE. Catalyzes activation antithrombin III, decreases available thrombin, inhibits factor Xa. Monitor with PTT.

72
Q

PTT

A

Intrinsic pathway

73
Q

Bleeding time

A

Measures platelet fn. If bad, think von Willebrand.

74
Q

INR

A

Measures PT. Extrinsic. Warfarin.

75
Q

LWMH

A

$$$. No need to monitor.

76
Q

Trastuzumab

A

Ab to HER-2. Binds to EC domain

77
Q

All-trans retinoic acid

A

acute promyelocytic leukemia

78
Q

Imantinib mesylate

A

CML

79
Q

Methotrexate

A

Folic acid analog
Specific for S phase of cell cycle. Can cause myelosuppression.
Reversed with leucovorin.

80
Q

Rituximab

A

non-Hodgkins lymphoma

81
Q

Cyclosporine

A

Immunosuppressant. -IL-2. Blocks differentiation and activation T-lymphos. Metab by p450

82
Q

P450 inhibitors

A 
Macrolides
Amiodarone
Grapefruit juice
Isoniazid
Cimetidine
Ritonavir
Acute alcohol abuse
Ketoconazole
Sulfonamides
83
Q

Drugs for Hodgkins

A

Adriamycin (doxorubicin)
Bleomycin
Vinblastine
Dacarbazine

84
Q

Hydroxyurea

A

Sickle cell. Antimetabolite.

85
Q

TB drugs

A

Rifampicin, isoniazid, pyrazinamide, ethambutol, streptomycin

86
Q

Abciximab

A

IIb/IIIa inhib-prevents fibrinogen from binding, interferes with platelet agg

87
Q

Clopidogrel

A

ADP inhibitor which is involved in binding of fibrinogen to platelets

88
Q

Selegiline

A

MAOB inhib. Increases Da availability. PD.

89
Q

Artesunate

A

Treats p. falciparum infection

90
Q

Platelet phsopholipids

A

Intrinsic and extrinsic clotting pathways.

91
Q

Bleomycin toxicity

A

Pulmonary fibrosis, pigmentation

92
Q

Aminocaproic acid

A

Reverses tPA. Blocks plasminogen–>plasminogen

93
Q

Recomb factor VIII

A

Hemophilia A

94
Q

Vit k

A

Cofactors for epoxide reductase….II, VII, IX, X. Warfarin reversal.

95
Q

Prednisone SE

A

Glucocorticoid psychosis

96
Q

Vincristine SE

A

Areflexia, peripheral neuritis

97
Q

Imantinib

A

CML

98
Q

Bisphosphonates

A

Bind to hydroxyapatite and inhibit osteoclast mediated resorption

99
Q

Isoniazid

A

TB exposure prophylaxis, decreases synth mycolic acids.

100
Q

Treatment for syphilis

A

Penicillin

101
Q

P450 Inducers

A 
Quinidine
Barbiturates
St John's wort
Phenytoin
Rifampicin
Griseofulvin
Carbamazepine
Chronic alcohol use

USMLE Step 1 (15 decks)

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