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pharmacology Flashcards

1
Q

what drug would you give following a nuclear accident to protect thyroid from iodine 131?

A

potassium iodide

-competitively inhibits uptake of radioactive iodide

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2
Q

antibiotic that can precipitate serotonin syndrome

A

linezolid (weak MAOI) if used with other serotonergic drugs

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3
Q

pramipexole

A

DA agonist (for Parkinson’s)

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4
Q

why do you need to wait 2 weeks before starting an SSRI after stopping an MAOI?

A

MAOIs irreversibly inhibit MAO (breaks down monoamine neurotransmitters) and it takes 2 weeks to resynthesizes MAO. If they are mixed, pt can get serotonin syndrome.

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5
Q

ACE inhibitor-induced angioedema

A

ACE is responsible for bradykinin degradation so it can build up when an inhibitor is used. Bradykinin is a potent vasodilator that increases vascular permeability

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6
Q

reason for only taking morning and afternoon dose of nitrates (skip evening dose)

A

around the clock administration rapidly creates tolerance

-nitrate-free period must be provided, usually at night

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7
Q

which vitamin can benefit children with measles?

A

vitamin A

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8
Q

exogenous steroids can cause….

A

suppression of the hypothalamic-pituitary-adrenal axis

-low ACTH, CRH leads to atrophy of adrenals

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9
Q

tx for myasthenia gravis

A

cholinesterase inhibitors

  • physostigmine, neostigmine
  • reduce breakdown of cholinesterase in synaptic cleft
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10
Q

selective coronary vasodilators

A

adenosine and dipyramidole

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11
Q

why is trazodone contraindicated in adolescent boys?

A

can cause priapism

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12
Q

ribavirin

A

MOA: nucleoside antimetabolite drug
USES: hep C, RSV

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13
Q

daptomycin

A

MOA: creates transmembrane channels to disrupt bacterial membranes
USES: MRSA
ADR: myopathy and CPK elevation

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14
Q

cause of death in TCA overdose

A

cardiac arrhythmias from inhibition of fast sodium channels in myocytes

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15
Q

tx for listeria

A

ampicillin

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16
Q

cladribine

A

purine analog that achieves high IC concentrations because it is resistant to degradation by adenosine deaminase
- for hairy cell leukemia

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17
Q

5 different types of drug-induced renal disase

A
  1. ARF (dec renal flow) - ACEI
  2. glomerular diasease - gold, heroin, pamidronate
  3. tubular necrosis - AGs, cysplatin, amphtericin, foscarnet
  4. tubular obstruction - sulfas, methotrexate, acyclovir
  5. interstitial nephritis - methicillin, sulfas, NSAIDs, cephalosporins, allopurinol, lithium, cyclosporin
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18
Q

drug for narcolepsy

A

modafinil

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19
Q

rapid reversal of warfarin

A

fresh, frozen plasma

Vit K takes longer

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20
Q

tx for restless leg syndrome

A

DA agonists

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21
Q

which benzo is short-acting? intermediate?

A

short = triazolam ( < 6 hrs)
intermediate = lorazepam
rest are long ( > 24 hrs)

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22
Q

Lithium ADR

A 
HORNET
HypOthyroidism
Renal function
Nephrogenic DI
Ebstein abnormality
Tremor
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23
Q

2 drugs for absence sz

A

ethosuximide or valproate

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24
Q

meds that can cause hyperkalemia (4)

A

ACE-I/ARB, digoxin (blocks Na/K pump), K-sparing diuretics, non-selective beta blockers

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25
K sparing diuretics (3)
spironolactone/eplerenone, amiloride, triamterene
26
uses for MAOIs
atypical or refractory depression, hypochondriasis
27
tx for serotonin syndrome
cyproheptadine (serotonin receptor antagonist)
28
why add carbidopa to levodopa therapy?
it is a peripheral decarboxylase inhibitor and increases bioavailability of L-dopa in brain - also limits peripheral side effects - can worsen behavioral changes
29
diuretics that can slow the progression of diabetic nephropathy
ACE-I/ARB
30
MOA of DDAVP for von Wildebrand disease
increases vWF release from endothelial cells
31
contraindication for ACE-I
extensive atherosclerotic disease, bilateral renal a. stenosis (ACE needed to maintain GFR)
32
side effect of all nitrates
throbbing headaches
33
tx for beta blocker overdose
glucagon (increases HR and contractility independent of adrenergic receptors)
34
contraindication for sildafinil
nitrate use
35
complication of neonatal oxygen therapy
retinopathy
36
pioglitazone
thiazolidinediones (antidiabetics) | MOA: binds to PPAR-gamma receptor (steroid receptor) to increase levels of adiponectin to decrease insulin resistance
37
main MOA of nitroglycerin
venodilation that decrease preload and thus cardiac work
38
pharmacokinetics of lipophilic drugs
high volume of distribution preferentially processed by liver good penetration into CNS
39
bosenten
MOA: antagonist of endothelial receptors USE: idiopathic pulmonary hypertension (symptom control)
40
drug of choice for myoclonic sz
valproic acid
41
chronic use of appetite suppressants can cause...
pulmonary hypertension | - phentermine, fenfluramine
42
primidone
USES: benign essential tremor, partial sz (it metabolizes into phenobarbital) ADR: sedation
43
which fluoroquinolone is not effective against pseudomonas?
moxifloxacin
44
3 Ps of severe hyperthyroid
propranolol (beta-blockers), propylthiouracil, prednisolone
45
side effects of class 1A antiarrhymics
increased QT can lead to tornadoes lupus-like syndrome cinchonism (procainamide, quinidine, disopyramide)
46
side effects of class 1B antiarrhythmics
``` CNS stuff (tremor, paresthesias, slurred speech, sz) (lidocaine) ```
47
contraindications of class 1C antiarrhythmics
structural heart disease (MI, CAD, etc.) pacemakers heart block (flecainide, propafenone)
48
side effects of K+ channel blockers
``` thyroid dysfunction pulmonary fibrosis photosensitivity, gray appearance increase QT (no torsades) (need to check PFTs, LFTs, TFTs) ```
49
contraindication of levodopa
B6 (found in multivitamins) | - increases peripheral metabolism/effectiveness
50
sumatriptan MOA
serotonin agonist | - inhibits trigeminal nerve activation and prevents vasoactive peptide release
51
drugs with decreased metabolism in slow acetylators
DIPH | - dapsone, INH, procainimide, hydralazine
52
most common side effect of streptokinase
hemorrhage (streptokinase is a thrombolytic)
53
drugs with anticholinergic side effects
atropine, TCADs, H1 antagonists, neuroleptics, antiparkinson drugs
54
tx for recurrent C. diff
fidaxomicin (minimal systemic absorption and bactericidal))
55
2 drugs for status epilepticus
lorazepam plus phenytoin
56
tx for esophageal varices
octreotide
57
ACE inhibitors reverse preferential constriction of...
efferent arteriole (Ang II constricts it)
58
rifampin MOA
blocks bacterial DNA-dependent RNA polymerase inhibiting transcription
59
med that slows progression of CHF and improves mortality
carvedilol (stable CHF only) - reduces cardiac work by slowing ventricular rate and decreasing after load * adding spironolactone to existing tx also improves mortality
60
formula for t1/2
= (Vd x 0.7)/clearance
61
med contraindicated in hereditary angioedema (low C1 esterase inhibitor)
ACE inhibitors (increase bradykinin)
62
ADR amphotericin B
nephrotoxicity arrhythmias (low K and Mg due to increased permeability of distal tubule from nephrotoxicity) - usually requires supplementation
63
drug that lessens effect of furosemide
NSAIDs | - furosemide stimulates PGE release (vasodilation of afferent arterioles) and NSAIDs inhibit PGE production
64
antiviral that doesn't require intracellular activation
foscarnet
65
med that can prevent recurrence of calcium oxalate stones
hydrochlorothiazide (reabsorb calcium from renal tubules) | - also citrate for tx
66
med superior to aspirin for peripheral artery disease
cilostazol (inhibits platelets and causes vasodilation) | - phosphodiesterase inhibitor
67
supplementation for orotic aciduria
uridine (inhibits carbamoyl phosphate synthetase II to improve symptoms)
68
what does a large blood/gas partition coefficient (anesthesia) mean?
indicates high blood solubility - amt needed to saturate blood is greater - leads to delayed rise in partial pressure which slows brain saturation - therefore, longer onset time
69
calcipotriene
topical vit D analog used to treat psoriasis (also calcitriol) - vit D receptor inhibits keratinocyte proliferation and stimulates differentiation
70
fomipezole
antidote in methanol or ethylene glycol poisoning | - antagonist of alcohol dehydrogenase
71
drug used to prevent nephrotoxicity with cisplatin
amifostine
72
role of beta blockers in hyperthyroidism
1. blocks peripheral T4 to T3 conversion | 2. minimizes sympathetic outflow
73
supplement for MSUD
thiamine (needed for branched-chain alpha keto dehydrogenase)
74
ADR verapamil
constipation, gingival hyperplasia, AV node conduction abnormalities (ie: blocks)
75
rasburicase
MOA: recombinant version of urate oxidase that converts uric acid to allantoin (more soluble) USE: to prevent tumor lysis syndrome
76
probenicid
MOA: increases uric acid excretion USE: gout, hyperuricemia CONTRA: good renal function needed
77
nitroprusside ADR
cyanide toxicity, tx with sodium thiosulfate (sulfur enhances metabolism to thiocyanate)
78
prevention of cerebral vascular spasm following SAH
calcium channel blockers, especially nimodipine
79
contraindication of beta blockers
DM, exacerbates hypoglycemia and masks symptoms
80
theophylline overdose
SZ (also abdominal pain and vomiting)
81
low Vd drug characteristics
3-5 L | - high molecular wt, high plasma binding protein, high charge, hydrophilic

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