pharmacology Flashcards

Question

Uses of different tetracycline(6)

Answer 1

1) tetracycline- i) P/O of cholera. ii) peptic ulcer 2)Demeclocycline -i) chronic SIADH 3)Minocycline - i) Acne ii) Leprosy 4) doxycycline- ABC BPL MRP 5) omadacycline and Eravacycline - HAI = skin and soft tissue , intra- abdominal and CAP [same use for Tigecycline sp. for MRSA and Acinetobacter] 6)Sarecycline - severe acne

Answer 2

1st line = Ceftraxone 500 mg im once +If N/A = Gentamycin im + oral azithro (2gm ) once + If resistance to ceftriaxone- Spectinomycin used

Answer 3

1) only on 30s = streptomycin and spectinomycin 2)No resistance = Amikacin and plazomycin 3)Not effective against = BATA = Burkholderia , acinetobacter , typhoid, anaerobes(since enter via 02 dependent porin) 4) streptomycin- PTT = Plague , Tularemia , TB 5) antitubercular = SACK = streptomycin, amikacin,capreomycin , kanamycin 6)anti pseudomonas - TAG = tobramycin, Amikacin,Gentamycin(also available as eyedrops and inhalational) 7) Arbekacin- MRSA 8)Gentamycin- combined with drugs on cell wall 9) Paramomycin- Protozoal infection = Kala azar and luminal amoebiasis 10) Framycetin and neomycin = creams 11) oral neomycin= Hepatic encephalopathy

Answer 4

1) 100% oral bioavailability 2) bacteriocidal for pneumococcus but bacteriostatic for MRSA,VRSA,VRE,MDR TB 3) narrow spectrum 4) renal safe 5) side-effects: COMB =chorioretinitis , optic neuritis,MAO inhibitor- serotonin syndrome, bone marrow suppression- measure platelets - less with Tedi and sutezolid.

Answer 5

1) Mupirocin 2% cream = inhibit ITR = isoleucine T RNA synthetase 2) fusidic acid = inhibit elongation factor=impetigo(staph and strepto) 3)Retapamulin ] Inhibit peptidyl transferase = impetigo Lefamulin. ] Same = MRSA

Answer 6

Burkholderia Pneumocystis Isospora Nocardia Traveller’s diarrhoea Typhoid prophylaxis Cystitis, UTI, prostatitis + Sulpha 800 mg with 160 mg trimethoprim

Answer 7

1) systemic i) long acting (>12hrs)=sulfadoxine ii) intermediate acting(8-12 hrs) = sulphamethaxazole iii) short acting= sufacytine > sulfadiazine iv) most water soluble= least crystalluria=sulfisoxazole 2) Topical cream= silver sulphasalazine 1% and mafenide = burns 3) topical eyedrops= “. “. 10% and sulfacetamide= fungal keratitis 4) topical oral = for ulcerative colitis= sulfasalazine olsalazine mesalazine

Answer 8

+ 1) CDK with Long PAE = MARS = metronidazole, aminoglycosides,rifampcin,streptogramins(longest pae) 2)CTDK with Long PAE = DaFQ =daptomycin , FQ 3) TDK with Long PAE = AT = Azithromycin, tetracycline 4)TDK with Short PAE =CPEC =cephalosporin , penicillin, erythromycin, clindamycin + 1)drug dec. influx = Carbapenem in pseudomonas 2) drug efflux = p-gp = tetracycline,Tigecycline , chloroquine 3) enzymatic degradation= ABC = AG , beta lactams , Chloramphenicol 4) target mutation= decreased binding = MFM= macrolides, FQ, MRSA(PBP2a) + safe in RF =rifampcin ,erythromycin,naficillin, amoxicillin,linezolid, peF , MoxiF,TrovaF,Doxycycline,INH,Cefoperazone

Answer 9

1)Isoniazid = KATg > InhA and KasA 2) Rifampcin = rpoB 3) Pyrazinamide = pncA > rbps1 and PAN D 4) ethambutol = embAB

Answer 10

+Rifampcin> pyrazinamide > bedaquiline +Isoniazid + ethionamide>PAS +ICE= Inh cycloserine and ethambutol +Ethambutol and Linezolid +Linezolid +Bedaquiline and delamanid + Rifabutin(not mpcin) ,Ethambutol strepto and Levo

Answer 11

+COME= clarithro,Ofloxacin,Minocycline,ethionamide + Leave PMT Day= Leprosy , Pneumocystis , madura foot,Toxoplasma, Dermatitis herpatiformis + sulphonamide= - folate synthase

Answer 12

+1) ccr5 = Maraviroc 2)ccr2 and 5= Cenicriviroc +Enfuvirtide = fusion inhibitor Ibalizumab= Cd4 —

Answer 13

+1) Didanosine = pancreatitis 2)Zidovudine= BOMA= BM suppression,Optic neuritis,Myopathy,Alopecia 3)Stavudine =SLAP= Steatosis , Lipodystrophy syndrome , Acidosis(lactic) , Peripheral Neuropathy + Abacavir- also preferred in children but shows rash in HLA B5701 pt +Lamivudine cross with emtricitabine d/t M184V mutation

Answer 14

Nevirapine= CYP3A4 substrate = rifampcin dec.its concentration and also a/w Hepatotoxicity Efavirenz=no cyp3a4 interaction = given with rifampcin but a/w neurotoxicity Also the most preferred drug in pregnancy

Answer 15

1)common = m/c is GI abN but most specific= LDS 2) least LDS = atazanavir = max bilirubin increase 3) Tipranavir = ICH 4)Indinavir = renal stones 5)Saquinavir= QT prolongation 6) CYP interaction = max ritonavir and least Nelfinavir

Answer 16

1) anti sense oligonucleotide= Miraversin(HCV ) and Fomiversin (CMV) 2) Cyclophillin A inhibtor = (HCV)Alispovir(cyclosporin also bind to Cyclophillin) 3)Terminal complex inhibitor = (CMV)Letermovir

Answer 17

1) Diloxanide = Flatulence 2)Iodoquinol= HypoT3 ( iodo) and Angioedema 3) Quindachlor = SMON (subacute myelo optic neuritis) + a/w vomiting and Cardiotoxic + a/w hypoglycaemia and HTN initially but later Hyperglycaemia (pancreatic damage) + QT prolongation , Pancreatitis and Nephrotixic

Answer 18

+acts on all except erythrocytic stage and sporozoites(no drug against it) + Proguanil and Doxycycline + Tafenoquine +Mefloquine 250 mg once/wk >>Doxycyline 100mg/day(CQ= widespread resistance)

Answer 19

+ Quinine and Clindamycin for falciparum and Chloroquine for vivax and ovale + ACT only in 2nd and 3rd trimesters + No radical cure in pregnancy since primaquine is C/I + But in complicated = life saving is iv artesunate

Answer 20

+vincristine bleomycin asparaginase and chlorambucil +Filgrastim and Molgramostim + Palifermin = used for mucus ulcers +Etoposide = early ca (<3 yrs) Mitoxantrone = AML M3 Procarbazine = max carcinogenic Cisplatin = late ca(>4yrs)

Answer 21

+bind to N7 guanine causing cross linking of DNA either by alkyl group or by platinum +1) G1= Palbocitinib , Etoposide , asparaginase and steroids 2)S ( Dna synthesis) = Hydroxyurea , Anti metabolites , Topetecan , Etoposide 3)G2 = Bleomycin , Etoposide , Doxorubicin 4)M(microtubule inhibitor)=Vincristine , Ixabiplone , Taxanes and Colchicine + Etoposide

Answer 22

+1) nitrogen mustard 2)Nitrosamines 3) miscellaneous +1) nitrogen mustard = MCI MC = Mechlorethamine, Cyclophosphamide, Iphosphamide,Melphalan , Chlorombucil 2) Nitrosureas = Se Lo and Car mustine 3) Misc= BAD TTP = Busulfan , Altretamine , Dacarbazine and Procarbazine , Thiotepa and Temozolamide +Antibiotics with Alkylating agent action =MS = Mitomycin C , Streptozotocin

Answer 23

+BONBS WARS = burkitt lymphoma , Ovarian cancer ,NHL ,Breast Ca , Solid tu (neuroblastoma) Wegner , Acute cerbral vasculitis,RA, Steroid dependent nephrotic syndrome + breakdown = acrolein= Hhagic cystitis = bladder ca Mx= MESNA(iv for Rx and oral for PO) Ifosphamide is even more a/w H'hagic cystitis and also with neurotoxicity which requires methylene blue

Answer 24

1)Mephalan(3M) = Max marrow suppression along with busulfan , used in myeloablation and for Multiple Myeloma 2) Chlorambucil - targets mature lymphocytes = used in CLL and least BM suppression , least emitogenic

Answer 25

kills myelocytes = AML AND CML Spares lymphocytes S/E- i) Busulfan lung ii) BM suppression iii)Vaso occlusive disease = defibriotide iv) Neurotoxicity= seizures = need phenytoin v)Tumor lysis syndrome vi) cataract

Answer 26

was used in MOPP regimen of HL = Now ABVD with dacarbazine (also in Melanoma) s/e- i) infertility =ii) depression = iii) Disulfiram reaction +Temozolamide = good csf penetration= DoC astrocytoma and malignant gliomas +Thiotepa= OP = myeloablation +Altretamine = platinum resitant ovarian cancer

Answer 27

+astrocytomas resitant to temozolamide +BM suppression= Neutropenia -single dose = prolonged suppression

Answer 28

+copper transporter + Max emitogenic , nephrotoxic,ototoxic = Cisplatin Max Neurotoxicity= oxaliplatin Least s/e= Carboplatin + nephrotoxicity =ATN = decrease K Mg and Ca i) slow infusion of drug ii) adequate hydration iii) Mannitol to excrete and chloride to neutralise platin iv)Amifostine = nephro and radioprotector

Answer 29

Lung ca, Osteosarcoma ,Gi cancer(with 5 FU),Head and neck ca,Urogenital(testis,ovary, cervical),Retinoblastoma , Radiosensitiser

Answer 30

1) Hydroxyurea= Ribonucleotide reductase inhibitor ( no dUMP or other deoxy products)+inc HbF + Radiosensitiser= used in SCA and MPD except CML 2) Antimetabolites = competitive inhibition by mimicking molecules required for DNA synthesis= Folate/purine and pyrimidine analogues

Answer 31

skin pigmentation and painful skin ulcers

Answer 32

1) Mtx= COMB All My Hairs Or People Will SCREAM antidote = folinic acid--->glucarpidase(enzyme)--->forced alkaline diuresis 2) Pemetrexed = mesothelioma (with 5FU)= folic acid and B12 3)Pralitrexate = Peripheral T cell leukemia = folic acid and vit B12 4) Trimetrexate= pneumocystis infection 1) inhibit THFR >TK and ADA 2,3,4= Thymidylate kinase

Answer 33

+resistance= 1) upregulation of DHFR 2)Decreased influx and inc. efflux 3)less polyglutamates formation +S/E= 1) GI mucous ulcers = Diarrhoea 2) Megaloblastic anemia 3)Hepatotoxicity 4) crystalluria 5)ILD So we do CBC LFT and CXR regularly +C/I= pregnancy (NTD) and lactation

Answer 34

1) GUANINE ANALOGUES = A ) 6 Thioguanine B) 6 Mercaptopurine = Azathioprine Inhibit HGPRTase = Used in Resistant Lymphomas and organ Trx S/e= BM suppression and hepatotoxicity M= i) oral = XO ii) iv = TPMT ———> so with allopurinol = dose reduction by 75% 2)ADENINE ANALOGUES = A) Fludarabine = CLL(FCR) B) Cladribine = Histiocytosis , Hairy cell leukemia C) Pentostatin = - ADA = used in resistant a and b S/E= immunosuppressiom = Pneumocystis infection = Cotrimoxazole p/o

Answer 35

1)URACIL ANALOGUES A) 5 FU = inhibit thymidylate synthase —>co factor = folinic acid —> together increase efficacy M= DPD = c/i in its deficiency Uses= HBG BMS = Head and neck, Breast and GI cancer , Bcc , Mycosis fungoides , Solar keratosis S/E = i)mucous ulcers = fulminant diarrhoea ii) Palmoplantar erythro dysesthesia B) Capecitabine = oral form of 5 FU C)FloxUridine = hepatic Metastatic CRC via Hepatic A. 2) URACIL ANALOGUES A) Gemcitabine = radiosensitiser for Pancreatic cancer B) Cytosine arabinoside /Cytarabine = AML(intrathecal)—>Cerebellar toxicity C) Azacytidine and Decitabine = -Methylation of DNA = use in MDS

Answer 36

+1)Vinca = i)Vincristine(oncovin) = max neurotoxicity and least BM suppression ii) Vinblastine = Max BM suppression and least Neurotoxicity Used in Blood cancers= AML ,HL,NHL,ALL (not in solid tumors) iii) Eribuline = taxane like action = Breast Cancer 2)Taxanes = i) Paclitaxel = hepatic excretion ii) Docetaxel = renal excretion, iii) Cabazitaxel Use= i)hormone resistant breast and prostrate cancer ii) Paclitaxel = Drug Eluting Stents iv) Ixabiplone = taxane like = in breast cancer v)Estramustine = taxane + estrogen like = prostrate ca vi) Colchicine = taxane like = - wbc migration = acute gouty attack S/E = since MT needed for NT movement, lead to i) neurotox = vinka : Foot drop and taxane : Glove stock Neuropathy ii) paralytic ileus iii) SIADH = vincristine max

Answer 37

1) TOP 1 inhibitors= camptothecins i)topotecan ii) Irinotecan = SN38 by metabolism via UDP GT = C/I CNS And Gilbert syndrome also = anti AchE = inc. Ach = diarrhoea = Rx -->Loperamide 2)TOP 2 inhibitors = Epipododoxophyllin i)Etoposide = BEP and RCHEOP regimen ii)Teniposide Other drugs with similar action (antibiotics) i) Anthracyclines ii)Mitoxantrone

Answer 38

1)Anthracylines (-rubicin ) = 4 reds i)Doxo= max cardiotoxic ii)Ida= least iii) red -flare,urine,drug soln,Rediation recall syndrome Use= all ca like breast and bladder 2)Mitoxantrone = MAP = MS , AML , Prostrate ca mets l/t AML M3 3)Streptozotocin = doc insulinoma 4)Mitomycin C = i)intravesical for bladder ca ii) kills fibroblasts= dec. post injury fibrosis and scarring s/e= Hus TTP 5) BLEOMYCIN= oxidative DNA damage +rapid degradation d/t Hydrolase = No BM supp. Use= HL , Testicular ca S/E = no hydrolase in - i) Lungs = Fibrosis -->kills type 1 pneumocytes = decrease DLCO ii) skin = FIR= Flagellate pigmentation , Icthyosis , Raynaud phenomenon 6)Actinomycin D /dactomycin = Dna transcription inhibitor RDW= i) Rhabdomyosarcoma ii)Wilms tumor s/e= i) SIADH ii) Radiation recall syndrome 7) plica/mithramycin= kill osteoclasts (not used now)

Answer 39

1)L asparaginase = protein breakdown esp. in lymphocytes = VPAD regimen of ALL +S/E= break body proteins too 2)ATRA= + Retinoic acid Receptor = maturn/differentiation of cancer cells = death of ca cells = used in APML also used in acne s/e= i) since fat sol. vit = metabolic syndrome ii) since rapid lympho maturn = go to lungs = ARDS= Retinoic acid / Leukocyte maturn syndrome iii) amenorrhea and infertility iv) teratogenic drug = preg. C/I v) vit A = Pseudotumor cerebrii 3) platinum and arsenic + AS203= resistant APML S/E= i) Mees line ii) QT prolongation