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UWorld > pharmacology > Flashcards

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
Q

K sparing diuretics (3)

A

spironolactone/eplerenone, amiloride, triamterene

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26
Q

uses for MAOIs

A

atypical or refractory depression, hypochondriasis

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27
Q

tx for serotonin syndrome

A

cyproheptadine (serotonin receptor antagonist)

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28
Q

why add carbidopa to levodopa therapy?

A

it is a peripheral decarboxylase inhibitor and increases bioavailability of L-dopa in brain

  • also limits peripheral side effects
  • can worsen behavioral changes
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29
Q

diuretics that can slow the progression of diabetic nephropathy

A

ACE-I/ARB

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30
Q

MOA of DDAVP for von Wildebrand disease

A

increases vWF release from endothelial cells

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31
Q

contraindication for ACE-I

A

extensive atherosclerotic disease, bilateral renal a. stenosis (ACE needed to maintain GFR)

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32
Q

side effect of all nitrates

A

throbbing headaches

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33
Q

tx for beta blocker overdose

A

glucagon (increases HR and contractility independent of adrenergic receptors)

34
Q

contraindication for sildafinil

A

nitrate use

35
Q

complication of neonatal oxygen therapy

A

retinopathy

36
Q

pioglitazone

A

thiazolidinediones (antidiabetics)

MOA: binds to PPAR-gamma receptor (steroid receptor) to increase levels of adiponectin to decrease insulin resistance

37
Q

main MOA of nitroglycerin

A

venodilation that decrease preload and thus cardiac work

38
Q

pharmacokinetics of lipophilic drugs

A

high volume of distribution
preferentially processed by liver
good penetration into CNS

39
Q

bosenten

A

MOA: antagonist of endothelial receptors
USE: idiopathic pulmonary hypertension (symptom control)

40
Q

drug of choice for myoclonic sz

A

valproic acid

41
Q

chronic use of appetite suppressants can cause…

A

pulmonary hypertension

- phentermine, fenfluramine

42
Q

primidone

A

USES: benign essential tremor, partial sz (it metabolizes into phenobarbital)
ADR: sedation

43
Q

which fluoroquinolone is not effective against pseudomonas?

A

moxifloxacin

44
Q

3 Ps of severe hyperthyroid

A

propranolol (beta-blockers), propylthiouracil, prednisolone

45
Q

side effects of class 1A antiarrhymics

A

increased QT can lead to tornadoes
lupus-like syndrome
cinchonism
(procainamide, quinidine, disopyramide)

46
Q

side effects of class 1B antiarrhythmics

A 
CNS stuff (tremor, paresthesias, slurred speech, sz)
(lidocaine)
47
Q

contraindications of class 1C antiarrhythmics

A

structural heart disease (MI, CAD, etc.)
pacemakers
heart block
(flecainide, propafenone)

48
Q

side effects of K+ channel blockers

A 
thyroid dysfunction
pulmonary fibrosis
photosensitivity, gray appearance
increase QT (no torsades)
(need to check PFTs, LFTs, TFTs)
49
Q

contraindication of levodopa

A

B6 (found in multivitamins)

- increases peripheral metabolism/effectiveness

50
Q

sumatriptan MOA

A

serotonin agonist

- inhibits trigeminal nerve activation and prevents vasoactive peptide release

51
Q

drugs with decreased metabolism in slow acetylators

A

DIPH

- dapsone, INH, procainimide, hydralazine

52
Q

most common side effect of streptokinase

A

hemorrhage (streptokinase is a thrombolytic)

53
Q

drugs with anticholinergic side effects

A

atropine, TCADs, H1 antagonists, neuroleptics, antiparkinson drugs

54
Q

tx for recurrent C. diff

A

fidaxomicin (minimal systemic absorption and bactericidal))

55
Q

2 drugs for status epilepticus

A

lorazepam plus phenytoin

56
Q

tx for esophageal varices

A

octreotide

57
Q

ACE inhibitors reverse preferential constriction of…

A

efferent arteriole (Ang II constricts it)

58
Q

rifampin MOA

A

blocks bacterial DNA-dependent RNA polymerase inhibiting transcription

59
Q

med that slows progression of CHF and improves mortality

A

carvedilol (stable CHF only)

  • reduces cardiac work by slowing ventricular rate and decreasing after load
  • adding spironolactone to existing tx also improves mortality
60
Q

formula for t1/2

A

= (Vd x 0.7)/clearance

61
Q

med contraindicated in hereditary angioedema (low C1 esterase inhibitor)

A

ACE inhibitors (increase bradykinin)

62
Q

ADR amphotericin B

A

nephrotoxicity
arrhythmias (low K and Mg due to increased permeability of distal tubule from nephrotoxicity)
- usually requires supplementation

63
Q

drug that lessens effect of furosemide

A

NSAIDs

- furosemide stimulates PGE release (vasodilation of afferent arterioles) and NSAIDs inhibit PGE production

64
Q

antiviral that doesn’t require intracellular activation

A

foscarnet

65
Q

med that can prevent recurrence of calcium oxalate stones

A

hydrochlorothiazide (reabsorb calcium from renal tubules)

- also citrate for tx

66
Q

med superior to aspirin for peripheral artery disease

A

cilostazol (inhibits platelets and causes vasodilation)

- phosphodiesterase inhibitor

67
Q

supplementation for orotic aciduria

A

uridine (inhibits carbamoyl phosphate synthetase II to improve symptoms)

68
Q

what does a large blood/gas partition coefficient (anesthesia) mean?

A

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
Q

calcipotriene

A

topical vit D analog used to treat psoriasis (also calcitriol)
- vit D receptor inhibits keratinocyte proliferation and stimulates differentiation

70
Q

fomipezole

A

antidote in methanol or ethylene glycol poisoning

- antagonist of alcohol dehydrogenase

71
Q

drug used to prevent nephrotoxicity with cisplatin

A

amifostine

72
Q

role of beta blockers in hyperthyroidism

A
  1. blocks peripheral T4 to T3 conversion

2. minimizes sympathetic outflow

73
Q

supplement for MSUD

A

thiamine (needed for branched-chain alpha keto dehydrogenase)

74
Q

ADR verapamil

A

constipation, gingival hyperplasia, AV node conduction abnormalities (ie: blocks)

75
Q

rasburicase

A

MOA: recombinant version of urate oxidase that converts uric acid to allantoin (more soluble)
USE: to prevent tumor lysis syndrome

76
Q

probenicid

A

MOA: increases uric acid excretion
USE: gout, hyperuricemia
CONTRA: good renal function needed

77
Q

nitroprusside ADR

A

cyanide toxicity, tx with sodium thiosulfate (sulfur enhances metabolism to thiocyanate)

78
Q

prevention of cerebral vascular spasm following SAH

A

calcium channel blockers, especially nimodipine

79
Q

contraindication of beta blockers

A

DM, exacerbates hypoglycemia and masks symptoms

80
Q

theophylline overdose

A

SZ (also abdominal pain and vomiting)

81
Q

low Vd drug characteristics

A

3-5 L

- high molecular wt, high plasma binding protein, high charge, hydrophilic

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