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Pharmacology Flashcards

1
Q

Alpha-1

A

Gq

* Vascular smooth muscle, pupillary dilator contraction, intestinal and bladder sphincter contraction

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2
Q

Alpha-2

A

Gi

* Decrease insulin, lipolysis, sympathetic outflow, increase platelet aggregation

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3
Q

Beta-1

A

Gs

* HR, contractility, renin, lipolysis

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4
Q

Beta-2

A

Gs
* Vasodilation, bronchodilation, increased HR, contractility, lipolysis, insulin; decreased uterus tone, increased aq. humor, ciliary muscle relaxation

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5
Q

M1

A

Gq

* CNS, enteric

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6
Q

M2

A

Gi

* HR/atria

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7
Q

M3

A

Gq

* Exocrine, miosis, accommodation (ciliary muscle contraction)

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8
Q

D1

A

Gs

* Relaxes renal vascular smooth muscle

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9
Q

D2

A

Gi

* Modulate transmitter release (brain)

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10
Q

H1

A

Gq

* Nasal and bronchial mucus production, contraction bronchioles, pruritis, pain

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11
Q

H2

A

Gs

* Gastric acid

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12
Q

V1

A

Gq

* Vascular smooth muscle contraction

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13
Q

V2

A

Gs

* Collecting tubules (2 kidneys)

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14
Q
  • Match
    DAG/PKC
    IP3/Ca
A 
DAG = PKC
IP3 = Ca2+
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15
Q

Protein kinase A –>

A

Myosin light chain kinase (smooth muscle)

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16
Q

MOA Amphetamine

A

Releases stored catecholamines

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17
Q

Indirect sympathomimetics (3)

A
  1. Amphetamine
  2. Ephedrine
  3. Cocaine
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18
Q

MOA Ephedrine

A

Releases stored catecholamines

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19
Q

Uses Amphetamine

A

Narcolepsy, obesity, ADHD

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20
Q

Uses Ephedrine

A

Nasal decongestion, urinary incontinence, hypotension

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21
Q

MOA Cocaine

A

Reuptake inhibitor

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22
Q

Uses cocaine

A

Vasoconstriction/local anesthesia

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23
Q

You should never give beta-blockers with cocaine intoxication because…

A

Can lead to unopposed alpha-1 activation and extreme hypertension

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24
Q

Antidote to acetaminophen toxicity

A

N-acetylcysteine (replenishes glutathione)

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25
Q

Antidote to salcylates toxicity

A

NaHCO3 (alkalinize urine), dialysis

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26
Q

Antidote to amphetamine toxicity

A

Nh4Cl (acidify the urine)

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27
Q

Antidote to AchE inhibitor (OP) toxicity

A

Atropine, pralidoxime

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28
Q

Antidote to anti-muscarinic toxicity

A

Physostigmine salicylate, control hyperthermia

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29
Q

Antidote to beta-blocker toxicity

A

Glucagon

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30
Q

Antidote to digitalis toxicity

A

KLAM

  • Normalize K
  • Lidocaine
  • Anti-dig Fab
  • Mg2+
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31
Q

Antidote to Fe toxicity

A

Deferoxamine, deferasirox

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32
Q

Antidote to lead poisioning

A

EDTA, dimercaprol, succimer, penicillamine

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33
Q

Antidote to mercury, arsenic, gold

A

Dimercaprol, succimer

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34
Q

Antidote to Cu, arsenic, gold

A

Penicillamine

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35
Q

Antidote to CN toxicity

A

Nitrate + thiosulfate; hydroxocobalamin

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36
Q

Antidote to Methemeglobin

A

Methylene blue, vitamin C

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37
Q

Antidote to CO toxicity

A

O2

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38
Q

Antidote to methanol, ethylene glycol toxicity

A

Fomepizole > ETOH, dialysis (alcohol DH)

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39
Q

Antidote to opioid toxicity

A

Naloxone, Naltrexone

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40
Q

Antidote to benzo toxicity

A

Flumazenil

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41
Q

Antidote to TCA toxicity

A

NaHCO2 (plasma alk)

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42
Q

Antidote to heparin toxicity

A

Protamine

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43
Q

Antidote to warfarin toxicity

A

Vitamin K, FFP

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44
Q

Antidote to TPA/streptokinase/urokinase toxicity

A

Aminocaproic acid

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45
Q

Antidote to theophylline toxicity

A

Beta-blocker

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46
Q

Sulfa drugs

A

Popular FACTSSS

Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazide, Sulfonamide, Sulfasalazine, Sulfonurea

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47
Q

Patients with sulfa allergy may develop…

A

Fever, UTI, pruritic rash, SJ, hemolytic anemia, TBO, agranulocytosis, hives

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48
Q

P450 Inducers

A

APPCR (Chronic ETOH, phenytoin, phenobarbital, carbamazepine, rifampin)
Modafinil
St. John’s Wort
Griseofulvin

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49
Q

P450 Inhibitors

A

MAGIC RACKS GQ
Macrolides, Amiodarone, Grapefruit juice, INH, Cimetidine, Ritonavir, acute ETOH, Cipro, Azoles, Sulfonamides, Gemfibrozil, Quinidine

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50
Q

ADR: Coronary vasospasm (3)

A

Cocaine, sumatriptan, ergot alkaloids

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51
Q

ADR: Cutaneous flushing (4)

A

VANC

Vancomycine, Adenosine, Niacin, CCB

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52
Q

ADR: Dilated cardiomyopathy (2)

A

Doxorubicin (Adriamycin), Daunorubicin

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53
Q

ADR: TDP (2)

A

Class IA: Quinidine

Class 3: Sotalol

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54
Q

ADR: Agranulocytosis (6)

A

Clozapine, Carbamazepine, Colchicine, Dapsone, PTU, Methimazole

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55
Q

ADR: Aplastic anemia (5)

A

Chloramphenicol, benzene, NSAIDS, PTU, Methimazole

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56
Q

ADR: AIHA (Direct Coombs positive)

A

Methyldopa, penicillin

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57
Q

ADR: Gray baby syndrome (1)

A

Chloramphenicol

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58
Q

ADR: Hemolysis in G6PD patients (5)

A

IS PAIN

INH, Sulfonamides, Primaquine, ASA, Ibuprofen, Nitrofurantoin

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59
Q

ADR: Megaloblastic anemia (3)

A

Phenytoin, MTX, Sulfa drugs

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60
Q

ADR: Thrombotic complications

A

OCP’s (estrogens)

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61
Q

ADR: Cough

A

ACE inhibitors (not ARB’s)

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62
Q

ADR: Pulmonary fibrosis (3)

A

Amiodarone, Bleomycin, Busulfan

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63
Q

ADR: Acute cholestatic hepatitis, jaundice (1)

A

Erythromycin

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64
Q

ADR: Focal to massive hepatic necrosis (4)

A

HAVAc

Halothane, Amantia phalloides, Valproate, Acetaminophen

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65
Q

ADR: Hepatitis

A

INH

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66
Q

ADR: C. diff (2)

A

Clindamycin, ampicillin

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67
Q

ADR: Adrenocortical insufficiency (1)

A

GC withdrawal

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68
Q

ADR: Gynecomastia (6)

A

Some Drugs Create Awkward Knockers

Spironolactone, Digitalis, Cimetidine, ETOH (chronic), Estrogens, Ketoconazole

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69
Q

ADR: Hot flashes (2)

A

Tamoxifen, clomiphene

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70
Q

ADR: Hyperglycemia (5)

A

Niacin, Tacrolimus, Protease inhibitor, HCTZ, CS

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71
Q

ADR: Hypothyroidism (3)

A

Lithium, amiodarone, sulfonamides

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72
Q

ADR: Fat redistribution (2)

A

PI, GC

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73
Q

ADR: Gingival hyperplasia (2)

A

Phenytoin, Verapamil

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74
Q

ADR: Gout

A

Furosemide, Thiazides, Niacin, Cyclosporin

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75
Q

ADR: Osteoporosis

A

Heparin, CS

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76
Q

ADR: Anti-muscarinic (4)

A

Atropine, TCA, H1 blocker, neuroleptics

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77
Q

ADR: Disulfram-like reaction

A

Metronidazole, CS, Procarbazine, 1st generation sulfonureas

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78
Q

ADR: Nephro/ototoxicity

A

AG, Vanco, Loop diurectics, cisplatin

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79
Q

ADR: Tardive dyskinesia

A

Antipsychotics

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80
Q

ADR: Seizures

A

I BITE My tongue

INH, Bupropion, Imipenim/cilastatin, Tramadol, Enflurane, Metoclopramide

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81
Q

ADR: Parkinson’s

A

Antipsychotics, reserpine, metoclopramide

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82
Q

ADR: Cinconism

A

Quinidine, quinine

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83
Q

ADR: SIADH

A

Carbamazepine, Cyclophosphamide

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84
Q

ADR: I/S nephritis

A

Methicillin, NSAIDS, Ferosemide

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85
Q

ADR: Hemorrhagic cystitis

A

Cyclo/Ifosfamide (mesna)

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86
Q

ADR: Fanconi’s syndrome

A

Expired tetracycline

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87
Q

ADR: DI

A

Lithium, democlocycline

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88
Q

ADR: Tendonitis, tendon rupture, cartilage damage

A

FQ’s

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89
Q

ADR: Teeth kids

A

Tetracyclines

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90
Q

ADR: SLE-like syndrome

A

HIPP

Hydralazine, INH, Procainamide, Phenytoin

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91
Q

ADR: Myopathy

A

Fibrates, Niacin, Colchicine, Hydroxychloroquine, IFN-alpha, Penicillamine, Statins, GC

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92
Q

ADR: Osteoporosis (2)

A

CS, heparin

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93
Q

ADR: Photosensitivity (3)

A

Sulfonamides, Tetracycline, Amiodarone

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94
Q

ADR: SJ/Rash

A

PEC SLAPP

Penicillin, Ethosuximide, Carbamazepine, Sulfa, Lamotrigine, Allopurinol, Phenytoin, Phenobarbital

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95
Q

Platelet aggregation inhibitors (4 classes)

A
  1. COX inhibitors: ASA
  2. PDE inhibitors: Dipyramidole, Cilastazol
  3. ADP R blockers: Clopidogrel, Ticlopidine,
  4. Gp2b/3a blockers: Abciximab, Eptifibratide, Tirofiban
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96
Q

ADP receptor blockers (4)

A

Clopidogrel, Ticlopidine, Ticagrelor, Prasugrel

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97
Q

Clopidogral and Omeprazole interaction

A

Omeprazole inhibits CYP and clopidogrel requires CPY2C19 to be activated

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98
Q

Four classes of anti-coagulants

A
  1. Indirect thrombin (UFH) & 10 ( LMWH = Fondaparinaux, Enoxaparin/Dalteparin/Tiazaparin)
  2. DTI (Lepirudin, Bivalirudin, Argatroban PO = dabigatrin etexilate)
  3. D10I (Rivaroxiban, Apixiban)
  4. Courmarin (Warfarin)
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99
Q

Thrombolytics

A

SK, UK, Alteplase, Reteplase, Tenecleplase

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100
Q

Chemical antagonist of heparin

A

Protamine sulfate

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101
Q

TPAi drug

A

Aminocaproic acid

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102
Q

Describe HIT

A

Heparin complexes with platelet factor 4; anti-IgG Ab attack and deposit on platelets; more Factor 4 released.
d/c heparin; DTI/Fondaparinaux & protamine sulfate

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103
Q

Part of nephron: CAI
Uses
AE’s

A

PCT: Acetazolamide
Use: metabolic alkalosis, mountain sickness, glaucoma, pseudotumor cerebri
AE: metabolic acidosis

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104
Q

Drug used in treatment of pseudotumor cerebri

A

Acetazolamide

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105
Q

Mannitol contraindications

A

Anuria, CHF; pulmonary edema/dehydration = AE

106
Q

Mannitol uses

A

Drug overdose, elevated ICP/IOP

107
Q

Loop diuretic that can be used in a patient with sulfa allergy

A

Ethacrynic acid

108
Q

AE Furosemide

A

Ototoxicity, hypokalemia, dehydration, sulfa, IS nephritis, gout

109
Q

Which diuretic stimulates PGE release and is inhibited by NSAIDS?

A

Furosemide

110
Q

MOA HCTZ

A

NaCl channel in DCT

111
Q

List 3 thiazide diuretics

A
  1. HCTZ
  2. Chlorthalidone
  3. Metalozone
112
Q

Indicated for treatment of Liddle’s syndrome

A

Triamtrene, Amiloride

113
Q

Drugs associated with tubulointerstitial nephritis

A

Sulfonamides (thiazide diurectice), methicillin, cipro, cephalosporins, allopurinol, PPI, rifampin, cimetidine, NSAIDS

114
Q

What should you think of when the urine dipstick reveals large blood, but the UA shows no RBC’s on microscopy

A

Rhabdomyolisis (statin)

115
Q

Which antibiotics are most associated with acute renal failure when combined with cephalosporins?

A

Aminoglycosides

116
Q

Which HIV protease inhibitor is associated with crystal induced nephropathy?

117
Q

In patients with impaired renal function, the loading dose should be the same/higher/lower and the maintenance dose should be the same/higher/lower

A

LD: same
MD: lower

118
Q

The 7 classes of anti-hypertensives.

A
  1. ACEi/ARB
  2. Beta blocker
  3. CCB
  4. Diuretics
  5. Alpha antagonists
  6. Alpha-2 agonists
  7. Vasodilators
119
Q

The 3 major classes of angiotensin drugs used to treat HTN

A
  1. ACEi (-opril)
  2. ARB (-artan)
  3. Renin inhibitors: aliskiren
120
Q

Aliskiren

A

Renin inhibitor

121
Q

The 2 major CI for the use of ACEi’s

A
  1. Bilateral renal artery stenosis

2. Pregnancy

122
Q

Some of the major AE of ACEi’s

A
  1. Angioedema
  2. Cough
  3. Hyperkalemia
123
Q

The 2 major classes of calcium channel blockers

A
  1. Dihydropyrmidines: Amlodipine, Nifidepine

2. Non-dihydropyrimidines: Verapamil, Diltiazem

124
Q

Among the CCB’s, which class of drugs is much more selective for the blood vessels vs the heart?

A

The Dihydropyrmidines (Amlodipine and Nifedipine)

125
Q

The major AE of Verapamil & its major contraindication

A

AE: constipation
CI: CHF (2/2 negative inotropic)

126
Q

The two types of anti-hypertensive treatments useful in black and elderly patients

A
  1. Thiazides

2. CCB’s

127
Q

The preferred beta-blocker in pregnancy

128
Q

Non-selective beta blockers vs. selective beta blockers

A

Non-selective: Propranol, pindolol

Selective: Atenolol, metopropol

129
Q

Should beta-blockers be tapered gradually?

130
Q

Beta-blockers are contraindicated in patients with…

A

COPD and asthmatics

131
Q

When would it be appropriate to use an alpha-1 blocker to treat a patient with HTN?

A

If the patient also has BPH

132
Q

Major AE of alpha-1 blockers? What can be given to prevent this AE?

A

Reflex tachycardia; give beta-blocker

133
Q

A mixed alpha-beta blocker example

134
Q

Labetalol MOA

A

Mixed alpha-beta blocker

135
Q

Which alpha-2 agnoist is associated with a positive Coombs test: hemolytic anemia, hepatitis, drug fever?

A

Methyldopa

136
Q

Among anti-hypertensive drugs, which one is associated with anti-histone antibodies?

A

Hydralizine

137
Q

Which direct vasodilator can be used for the PO treatment of malignant hypertension and can be used topically to treat male pattern baldness?

138
Q

What drugs can be used to treat pulmonary hypertension?

A

PGE (epoprostenol)

Inhibitors of endothelin synthesis (bosentan)

139
Q

Which pharmacologic treatment of pulmonary hypertension is pregnancy category X?

A

Bosentan (endothelin receptor blocker)

140
Q

First line treatment for HTN in pregnancy (along with methyldopa)

A

Hydralazine

141
Q

Hydralazine is often administered with a ________________ to prevent this adverse effect

A

Beta-blocker; reflex tachycardia

142
Q

MOA Hydralazine

A

Increases cGMP vasodilates arterioles>veins

143
Q

2 of the most popular treatments of malignant hypertension

A
  1. Nitroprusside

2. Fenoldopam: D1 agonist; decreases BP and increases natriuresis

144
Q

Drug of choice for patients with catecholamine-related emergencies

A

Phentolamine

145
Q

Often used for aortic dissection or postoperative hypertension

146
Q

Drug of choice in treating hypertensive emergencies in pregnancy related to eclampsia

A

Hydralazine

147
Q

Famous AE of sodium nitroprusside

A

CN toxicity (adminster sodium thiocyanate)

148
Q

Can CCB’s be used for Prinzmetal’s angina and Raynaud’s phenomenon?

149
Q

Are beta-blockers contraindicated in cardiogenic shock?

150
Q

Arteries, veins, both: hydralazine, nitrates, ACEi

A

A: Hydralazine
V: Nitrates
Both: ACEi

151
Q

What are 2 reasons patients with advanced heart disease have elevated levels of aldosterone?

A
  1. Angiotensin stimulation

2. Reduced hepatic clearance

152
Q

Mild digoxin toxicity is treated with…

Severe toxicity…

A

Mg, Lidocaine, adjust K to high normal

Severe: pacer, digitalis Ab

153
Q

Inotrope/Chronotrope: Digoxin

A

Positive inotrope

Negative chrontrope

154
Q

HR: nitrates vs. B-blockers/CCB

A

Nitrates: reflex increase

BB/CCB: decrease

155
Q

Arterial pressure nitrates vs. B-blockers/CCB

A

Nitrates: decrease

BB/CCB: decrease

156
Q

EDV nitrates vs. B-blockers/CCB

A

Nitrates: decrease

BB/CCB: increase

157
Q

Contractility nitrates vs. B-blockers/CCB

A

Nitrates: reflex increase

BB/CCB: decrease

158
Q

Ejection time nitrates vs. B-blockers/CCB

A

Nitrates: decrease

BB/CCB: increase

159
Q

First line treatment of angina

A

Nitroglycerin

160
Q

Treatment of unstable angina; 2nd line; 3rd line

A

NG + beta-blocker

2nd line: CCB; 3rd line Ranolazine

161
Q

Beta blockers used in the treatment of variant angina?

162
Q

Acute treatment of ventricular arrhythmias from

myocardial infarction or cardiac manipulation

A

Lidocaine (Class 1B)

163
Q

Class 1A anti-arrhythmics

A

Quinidine, Procainamide, Disopyramide

* Intermediate association/dissociation, non-specific K+ channel blockade

164
Q

Class 1B anti-arrhythmics

A

Lidocaine, Mexiletine; fast association/dissociation; do not directly block K+ channels

165
Q

Class 1C anti-arrhythmics

A

Flecainide, Propafenone; slow association/dissociation; do not directly block K+ channels

166
Q

Hyper or hypokalemia can increase toxicity for all class 1 anti-arrhythmics

A

Hyperkalemia

167
Q

AE Class IA anti-arrhythmics

A

Diso: heart failure
Quin: cinchonism
Procainamide: SLE

168
Q

AE Amiodarone

A

Pulmonary fibrosis, hypothyroidism

169
Q

Peaked T waves and prolonged PR intervals (which electrolyte disturbance?)

A

Hyperkalemia

170
Q

Which anti-arrhythimics are associated with TDP?

A

Class IA & 3

171
Q

Drug useful in acute ventricular arrhythmia (post MI) and in digitalis-induced arrhythmias

172
Q

Increase, Decrease, No Change in AP duration

Class IA, IB, IC anti-arrhythmics

A

1A: Increase
1B: Decrease
1C: No change

173
Q

Which anti-arrhythmics work by decreasing the slope of phase 4?

A

Class 2 (beta-blockers)

174
Q

Lipid lowering agents: lower LDL

175
Q

Lipid lowering agents: increase HDL

176
Q

Lipid lowering agents: lower TG

177
Q

Lipid lowering agents: can paradoxically increase TG

178
Q

AE: statins

A

Hepatotoxicity, rhabdomyolysis

179
Q

Lipid lowering agents: can cause cholesterol gallstones

A

Fibrates, Resin

180
Q

Lipid lowering agents: can cause hepatotoxicity

A

Statin, Fibrate, Ezetimbe

181
Q

Lipid lowering agents: Can cause red, flushed face, hyperglycemia, acanthosis nigricans, gout

182
Q

Lipid lowering agents: Best for pregnant women and children

183
Q

Lipid lowering agents: inhibit conversion of HMG coA to mevalonte

184
Q

Lipid lowering agents: inhibits lipolysis in adipose tissue; reduced VLDL secretion

185
Q

Lipid lowering agents: upregulates LPL which increases TG clearance

186
Q

Lipid lowering agnets: decreases HSL vs. upregulates LPL

A

Niacin; fibrates

187
Q

Aldesleukin

A

IL-2: RCC, metastatic melanoma

188
Q

Filgrastim vs. Sargramostim

A

G-CSF

GM-CSF

189
Q

Alpha-interferon

A

HBV, HCV, KS, Leukemia, Malignant melanoma

190
Q

Beta-interferon

191
Q

Gamma-interferon

192
Q

Oprelvekin

A

IL-11 (TBOcytopenia)

193
Q

Il-11

A

TBOpenia (Oprelvekin)

194
Q

TNF-alpha agents

A

Infliximab, Adalimumab

195
Q

Infliximab

196
Q

Adalimumab

197
Q

Trastuzumb

A

Herceptin (HER2 overexpressing breast cancer)

198
Q

Rituximab

199
Q

Omalizumab

A

IgE: Additional line treatment for severe asthma

200
Q

Muromonab-CD3 (OKT3)

A

CD3 target (prevent acute rejection)

201
Q

What agent can be used to treat sickle cell anemia? What is its effect? AE?

A

Hydroxyurea; increases HbF

* AE = cutaneous vasculitis

202
Q

3 drugs which can deplete folate

A
  1. MTX
  2. Trimethoprim
  3. Pyrimethamine
203
Q

2 reactions requiring B12

A
  1. Methylmalonyl coA –> succs CoA

2. Homocysteine –> methionine

204
Q

Anti-CD20-Ab

205
Q

Rituximab

A

Anti-CD20-Ab

206
Q

Cituximab

A

Anti-EGFR-Ab

207
Q

Anti-EGFR-Ab

208
Q

CNI (2)

A

Cyclosporine, Tacrolimus

209
Q

mTOR inhibitor

210
Q

IL-2 receptor antagonists

A

Basiliximab, Daclizumab

211
Q

Anti-TNF-alpha agents

A

Adalimumab, Etanercept, Infliximab

212
Q

Stimulates IL-2 (can be used for RCC)

A

Aldesleukin

213
Q

Anti-CD3-Ab

214
Q

First line treatment in multiple myeloma

A

Thalidomide

215
Q

Thalidomide MOA

A

Decreases TNF-alpha production; anti-androgenic

216
Q

Nitroglycerin increases/decreases myocardial O2 consumption; whereas dobutamine does the opposite

A

NG: decreases
Dobutamine: increases

217
Q

Major toxicity: Cyclophosphamide & Ifosfamide

A

Hemorrhagic cystitis

218
Q

Major toxicity: Bleomycin

A

Pulmonary fibrosis

219
Q

Major toxicity: Cisplatin

A

Nephrotoxicity & deafness

220
Q

Major toxicity: Doxorubicin & Daunorubicin

A

Dilated cardiomyopathy

221
Q

Major toxicity: Vincristine

A

Peripheral neuropathy

222
Q

Major toxicity: Etoposide, MTX and Vinblastine

A

BM suppression

223
Q

Major toxicity: L-Asparaginase

A

Pancreatitis & bleeding

224
Q

Prevention of Hemorrhagic cystitis by cyclophosphamide & ifosfamide

225
Q

Prevention of Cisplatin induced nephrotoxicity

A

Good hydration & amifostine

226
Q

Prevention of Doxorubicin & daunorubicin induced dilated cardiomyopathy

A

Dexrzoxane

227
Q

Prevention of BM suppression by CTX agents

A

Filgrastim

228
Q

Prevention of MTX induced BM supression

A

Leucovorin (THF)

229
Q

Major toxicity: Trastuzumab

A

Cardiotoxicity

230
Q

Cell cycle specific CTX agents: G1, S, G2, M

A

G1: Topo 2 (Etoposide)
S: Anti-metabolites
G2: Bleomycin
M: Vinca & taxanes (MT)

231
Q

Non cell cycle specific CTX agents

A

ABX (minus bleomycin), Alkylators, Topo 1 (Camptothecins)

232
Q

Differentiate between adjuvant and neo-adjuvant CTX

A

Adjuvant: post SX/Radiation

Neo-adjuvant: pre-surgery

233
Q

Hydroxyurea affects what stage of the cell cycle?

234
Q

The major alkylating CTX agents:

A
  1. N mustards (Cyclophosphamide)
  2. Busulfan - PF, hyperpig
  3. Carmustine - CNS tumor
  4. Platinum compounds (cisplatin)
  5. Dacarbazine, procarbazine
235
Q

The toxic compound of cyclophosphamide once it is activated by the liver

236
Q

All TNF-alpha inhibitors predispose to…

A

Infection, including re-activation of latent TB since TNF blockade prevents activation of macrophages and destruction of phagocytosed microbes

237
Q

Dronates, i.e. Aldendronate MOA

A

Pyrophosphate analogs; bind hydroxyapatite in the bone; inhibits osteoclastic activity

238
Q

Dronates, i.e. Aldendronate use

A

Osteoporosis, hypercalcemia, Paget’s disease

239
Q

Dronates, i.e. Aldendronate AE

A

Osteonecrosis of the jaw; corrosive esophagitis

240
Q

Dose of 6-MP or Azathioprine must be reduced if co-administered with…

A

Allopurinol

241
Q

Myelosupression of MTX is reversible with

A

Leucovorin

242
Q

5-FU inhibits

A

Thymidylate synthase

243
Q

Supplementing leucovorin with ________ leads to a stronger CTX effect, yet stronger cytotoxic effects

244
Q

AE 5-FU

A

Skin exfoliation on palm and feet (hand-foot syndrome), photosensitivity

245
Q

Use Gemcitabine

A

Pancreatic cancer

246
Q

ara-C CTX MOA

A

Competitively inhibits DNA polymerase

247
Q

Differentiate between the vinca alkaloids and the taxanes MOA

A

Both are microtubule inhibitors working on M phase; Vinca = prevent MT polymerization; Taxanes = hyperstabalize polymerized MT’s

248
Q

AE Vincristine

A

Neuropathy; bone marrow sparing

249
Q

The 2 bone marrow sparing CTX agents

A

Vincristine and bleomycin

250
Q

AE taxanes

A

Skin toxicity, fluid retention

251
Q

CTX agent: topoisomerase 2 inhibition

A

Etoposide and Tenoposide

252
Q

CTX agent: topoisomerase 1 inhibition

A

Camptothecin: topotecan, irinotecan

253
Q

MOA anti-tumor antibiotics

A

Free radical mediated DNA strand breaks

254
Q

Radiation recall reaction

A

Anthracyclines: Doxo/Daunorubicin, Dactinomycin

255
Q

Dactinomycin is primarily used for…

A

Childhood tumors

256
Q

Glaucoma drugs that decrease synthesis of aq humor

A

Alpha Agonist: Epi, Brimonidine
Beta blocker: timolol, betaxolol, carteolol
Acetazolamide

257
Q

Glaucoma drugs that increase aq humor outflow

A

Direct M: Pilocarpine, carbachol
Indirect M: Physostigmine, echothiophate
PGE2-alpha: Latanoprost

258
Q

Opioid used for cough supression

A

Dextromethorphan

259
Q

Opioid used for diarrhea (2)

A

Lopiramide, Diphenoxylate

260
Q

Opioid receptors: mu, delta, kappa

A

Mu: morphine
Delta: Enkephalin
Kappa: dynorphin

261
Q

Partial mu agonist and kappa agonist that can precipitate pain if used with a full Ag

A

Butorphanol

262
Q

Weak opioid gnoist; inhibits serotonin and NE reuptake; used for chronic pain. What is the AE?

A

Tramadol; increased risk for seizures

Step 1 Prep (15 decks)

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