Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Quick Notes for Step 1 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Statins

A
  • Treats hypercholesterolemia by inhibiting HMG-CoA reductase (inhibition of cholesterol synthesis)
  • Leads to increased LDL receptor expression to increase LDL uptake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Oseltamvir

A
  • Treats and prevents BOTH influenza A and B
  • Impairs virion release by inhibiting NeurAminidase
  • Prevents viral penetration of mucous secretions in respiratory epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PTU

A

-Inhibits both organification of iodine (via thyroid peroxidase inhibition) AND peripheral conversion of T4 to T3
(Methimazole: only does inhibition of iodine organification)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MTX

A

Structurally similar to folate → irreversibly inhibits DHFR –> polyglutamated form (cannot move out of cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ergonovine

A

Ergot alkaloid that can provoke coronary vasospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bepridil

A

Ca2+ channel blocker used 2nd line as angina therapy, not used as an anti-hyprtensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ceftriaxone resistance:

A

by either beta-lactamases or altered PBP structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Niacin’s Mechanism and Side Effects

A
  • Inhibits hepatic VLDL production and triglycerides
  • increases HDL
  • Acute gout flare is a possible side effect
  • Hyperuricemia, hyperglycemia, and flushing
  • Flushing can be reduced with Aspirin pretreatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nitrate Tolerance

A

Nitrates develop tolerance quickly so much have a nitrate free period every day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mu Receptors

A
  • opioids bind

- increase potassium efflux → hyperpolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx of Gouty Arthritis

A

NSAID, colchicine, and then glucocorticoids
- Uricosuric agents or Xanthine Oxidase inhibitors contraindicated in acute attacks (can worsen it); but they are good for prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antiarrhythmics Na+ Channel Binding Strength

A

1C > 1A > 1B
- Use dependence more prominent in 1C ( higher rates of depolarization → increased channel blockade because less time in resting state)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Reverse Use Dependence

A

Class III: K+ Channel Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Minimal alveolar concentration (MAC):

A

% of anesthetic in inspired gas mixture that renders half of patients unresponsive to painful stimuli

  • Lower the MAC, the higher the potency
  • If anesthetics have a high blood/gas coefficient (meaning they dissolve more in blood), they will have a slower onset of action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ABPA

A

Asthma with aspergillus; high eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Physostigmine

A 
Cholinesterase inhibitor (Ach builds up); similar to edrophonium
- Both peripherally and centrally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pilocarpine

A

Cholinergic Agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Phentolamine and Phenoxybenzamine

A

a-adrenergic antagonist

  • Phentolamine has a half life of 20 min (irreversible)
  • Phenoxybenzamine has a half life of 24 hours and is often used to treat pheochromocytoma (reversible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Phenylephrine

A

a-adrenergic agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Amiodarone

A

Delayed onset interstitial pneumonitis + a lot of other side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mifepristone

A

Inhibits progesterone receptors (induce abortion)

- Used with Misoprostol: PGE1 analog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Aspirin

A

Inhibition of COX pathways → promotes formation of leukotrienes that cause bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Alpha 1, 2, beta 1 ,2 m 1-3. D1-2, H1-2, Vasopressin 1-2

A

QISS QIQ SIQ SQS

  • Q: phospholipase C → DAG, IP3
  • S: stimulate Adenylate cyclase → cAMP increase
  • I: inhibit Adenylate cyclase → cAMP decrease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Red Man Syndrome

A
  • Rapid infusion of vanco → red man syndrome due to widespread release of histamine (NOT IgE mediated allergic reaction)
  • Can be prevented with a slower rate of infusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Michaelis Menten

A

Y intercept - Vmax (up means decrease)
- Vmax is directly proportional to concentration
X intercept – Km (closer to Y line → Km increases → lesser affinity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

COX1

A
  • In platelets prevents thromboxane formation (preventing platelet aggregation)
  • Also does gastric protection
    (Problem with NSAIDs)
  • Selective COX 2 inhibitors (celecoxib) are good for pain (no effect on gastric mucosa)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Tx for MRSA

A

Ceftaroline (5)

  • Vancomycin
  • Daptomycin
  • Linezolid
  • Tigecycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pseudomonas Tx:

A
  • Ceftazidime (3) and Cefepime (4)

- Ticarcillin or piperacillin (w/ clavulanate, tazobactam or sulbactam)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Cephalosporin Generations:

A

1: faz, phal
2: fox, fac, fur
3: tri, trax, tax
4: cefepime
5: ceftaroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

B-lactam that can be used in PCN Allergies

A

Aztreonam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Gram (-) Rod Tx:

A

aztreonam, cephalosporins (3), aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Gm (+):

A

vanco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Always give carbapenems:

A

cilastatin (it inhibits renal tubular secretion of the antibiotic)
eg. similar to giving penicillin w/ probenecid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Aminoglycosides

A

30s, misread mRNA (inhibiting initiation complex formation)

eg. gentamicin, amikacin, tobramicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tetracyclines

A

30s, block tRNA binding site

  • For intracellular (rickettsia, mycoplasma, borrelia, chlamydia) (eg. Doxycycline)
    eg. tetracyline, doxycycline, minocycline
  • binds inorganic compounds (in bone and teeth) causing teeth discoloration and retarded bone formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Linezolid

A

50s, blocks 70s formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Chloramphenicol

A

50s, blocks peptidyl transferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Macrolides

A

50S, blocks translocation (binds the 23S part of 50s)
Atypical pneumonia, STDs, Gm + cocci
eg. clarithromycin, erythromycin, azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Clindamycin

A

50S, blocks translocation (binds the 23S part of 50S)

  • Anaerobes, GAS
  • Causes C. Diff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Fluoroquinolines

A

(floxacins) inhibit DNA gyrase

- Atypical pneumonias, Gm – rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Metronidazole

A

Makes free radicals to break DNA

- D. diff, gardnerella, giardia, anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Isoniazid

A

Decreased mycolic acid synthesis (must be activated with catalase peroxidase)
- 2 Mechanism of resistance:
decreased expression of catalase peroxidase or modification of protein target binding site
- may cause pyridoxine deficiency; acetylated for excretion (slow acetylators have increased risk of toxicity)
- Also is directly hepatotoxic in 10-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Rifampin

A

Inhibits DNA dep RNA pol

- Prophylaxis for meningococcal and Hib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Ethambutol

A

Inhibits mycobacterial cell wall synthesis by blocking arabinosyl transferase (inhibits carbohydrate polymerization
- central scotomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Amphotericin B and Nystatin

A

Binds ergosterol and makes pores

Nystatin: topical because too toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Griseofulvin

A

Binds microtubules and inhibits mitosis (antifungal)

Also induces P450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Terbinafine

A

Inhibits fungal squalene epoxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Caspofungin

A

Inhibits cell wall synthesis (by inhibits b-glucan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Inhaled gas anesthetics

A
  • Poorly Soluble gas: saturates quickly, so partial pressure starts to rise, rapid equilibration with
  • Highly soluble gas: saturates more slowly so need more to saturate, slower rise in partial pressure so lower onset and equilibration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Lipophilic Drugs

A
  • Highly lipophilic drugs are preferentially metabolized by liver (poorly eliminated by kidney)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Milrinone

A

PDE3 inhibitor → increases cardiac contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Opioids: Tolerance Does Not Develop for _______

A

Miosis and constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Nitroglycerin has greatest effect on:

A

Large veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Statin Metabolism

A

Metabolized by P450 (except pravastatin), inhibitors will increase concentration → more rhabdomyolysis → acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

CYP450 Inhibitors

A 
Cimetidine
Ciprofloxacin
Erythromycin
Azoles
Grapefruit juice
Isoniazid
Ritonavir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Permissive

A

Something with no effect, will increase the effect of something else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Additive

A

When combined effect of drugs together is equal to the sum of their individual effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Synergistic

A

Combined effect exceed the effect of the sum of both effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Bile Acid Binding Resins (eg. Cholestyramine) Side Effect

A
  • Cholesterol Gallstones (prevent absorption, so liver makes more cholesterol)
  • Mild increase in triglycerides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Tx to Decrease Triglycerides

A

Fibrates (1st line) and Niacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Clonidine

A

a2 agonist

- decreases peripheral vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

MTX vs 5FU

A
  • MTX prevents reduction of TH4 while 5FU binds TH4 and thymidylate synthase in a stable intermediate form which decreases the amount of thymidylate synthase available
  • 5FU cannot be overcome with addition of folinic acid or leucovorin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Beta Blockers Effect on AV Conduction

A

Slow AV conduction which prolongs the PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Niacin Induced Flushing Due to:

A

Prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Vancomycin Induced Flushing Due to:

A

Histamine (can be limited with slow infusion and anti-histamine treatmeant ahead of time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Weight Loss Drugs

A
  • dexfenfuramine, phenteramine, fenfluramine

- can cause cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Tx for Methanol or Antifreeze (ethylene glycol) Poisoning

A

Fomepizole (alcohol dehydrogenase inhibitor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Tx for Arsenic, Lead, Mercury & Gold Poisoning

A

Dimercaprol

- EDTA can also be used for lead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Demeclocycline

A
  • Tetracycline antibiotic that can be used to treat SIADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Conivaptan or Tolvaptan

A

ADH Receptor Antagonists used to treat SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Raltegravir

A

Integrase inhibitor that prevents HIV from integrating into chromosome of Host so host cell machinery cannot be used to make HIV mRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Entacapone and Tolcapone

A
  • COMT inhibitor that increases bioavailability of levodopa by decreasing peripheral methylation
  • Tolcapone inhibits BOTH peripheral and central methylation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

SGTP2 inhibitors (eg. Canaglifozin)

A
  • Lose glucose in urine due to osmotic diuresis
  • Need to check renal status before using
  • Can cause yeast infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

DPP4 inhibitors

A

prevent degradation of GLP to prolong its action in increasing insulin
(–gliptins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

GLP1 Analogs

A

Exenatide or Liraglutide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Ketoconazole

A

Inhibits testosterone synthesis pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Adrenergic, Muscarinic, Dopaminergic, Histamine, Vasopressin

A

QISS QIQ SIQ SQS
Q: GPCR
S: increase cAMP
I: decrease cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

CYP450 Inducers

A

Phenytoin, Phenobarbital, Rifampin, Carbamazepine, Griseofulvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

DRESS syndrome

A

Adverse drug reaction w/ eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Low Volume of Distribution If:

A

Trapped in plasma

- Due to high MW, high plasma protein binding, hydrophilicity and high charge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

High Volume of Distribution If:

A

Lipophilic, unbound, low charge, low MW can cross membranes more easily and access intracellular compartment → very large Vd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

HAART

A

NNRTI: DEN (efavirenz)
Protease inhibitors: -navir
Integrase inhibitors: -tegra-
NRTI: everything else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Inhibitors of dihydrofolate reductase

A

Trimethoprim, methotrexate, and pyrimethamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Pavilizumab

A

For RSV prevention: Ab to F (fusion) protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Zidovudine

A

NRTI used to treat HIV: causes bone marrow suppression especially with gancyclovir
- Competitively binds reverse transcriptase and is incorporated as thymidine analog and since it does not have a 3OH group, cannot make 3-5’ phosphodiester bond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Protease inhibitors: side effects

A

hyperglycemia, lipodystrophy, and p450 inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

NNRTI

A

Do not require phosphorylation

- MC ones include: Nevirapine, Efavirenz, and Delaviridine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

TNF-a Inhibitors

A

may reactivate latent TB by decreasing macrophage function (maintain granulomas)
- Cord Factor (virulence) in Mycobacteria inhibits macrophage activation and TNFa release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

TNF-a is the main mediator of:

A
  • Paraneoplastic cachexia (wasting syndrome)

- Sepsis (also IL-6 and IL-1 are part of the response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Alemtuzumab

A

CD52 inhibitor used for CLL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Cetuximab

A

EGFR antibody for colorectal and head/neck cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Natalizumab

A

Ab to a4-integrin for MS and Crohns

- Risk of PML from JC virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Azathioprine/6-MP degraded by:

A

xanthine oxidase (which is inhibited by allopurinol) and TPMT in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

ACE Inhibitors

A

Angioedema side effect (c1 inhibitor deficiency)

  • ACE made in lung endothelium
  • Don’t use in patients with bilateral renal artery stenosis → ARF (acute renal failure) because they are dependent on ACE for renal blood flow (can no longer constrict efferent arteriole to maintain GFR)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

IFN’s

A

IFNa- hepC
IFNb- MS
IFNy- for CGD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Ribavirin

A

HepC and RSV

- Inhibits RNA poly and IMP dehydrogenase → interferes with duplication of viral genome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Isoniazid

A

Must be activated by catalase peroxidase enzyme

  • Inhibits mycolic acid synthesis (TB no longer is acid fast)
  • Metabolized by acetylation → excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Pyrazinamide

A

works best in an acidic environment to kill intracellular organisms like TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Ondansetron and Metoclopramide work on:

A

floor of 4th ventricle
Ondensetron is a 5HT3 antagonist
Metoclopramide is a dopamine receptor antagonist (don’t use in parkinson’s patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Thiopental

A

Short acting anesthetic barbiturate
- After equilibrating in brain (takes about 1 min) it redistributes quickly to skeletal muscle and fat (resulting in rapid recovery from anesthesia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Acetazolamide

A

Carbonic anhydrase inhibitor

  • Can be used to treat narrow-angle glaucoma
  • Works in proximal tubule of nephron
  • Can cause metabolic acidosis by blocking NaHCO3 reabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Succinylcholine (Neuromuscular Blockade)

A

May cause hyperkalemia (peak T waves)

  • Burn pts more at risk because of leaking/damaged cells
  • Strong Ach receptor agonist –> sustained depolarization (prevents muscle contraction)
  • Antidote only for Phase II: ACHE inhibitors (eg. neostigmine)
  • May cause malignant hyperthermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Beta Blockers w/ Diabetics and Asthma/COPD

A

Diabetics w/ HTN → it can mask hypoglycemia

  • Use an ACE inhibitor instead (prevents diabetic nephropathy)
  • Can also exacerbate asthma and COPD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Essential Tremor Tx

A

Non-selective Beta Blocker or Primidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Benadryl and Dramamine

A
  • Diphenhydramine = Benadryl

- Dimenhydrinate = Dramamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

2nd Generation (histamine) H1-receptor blockers

A

Less side effects because does not cross BBB

- Loratidine, desloratidine, fexofenadine, cetirizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Tx for UTI in Children

A

amoxicillin (w/ or w/out clavulanate), cefixime, ceftriaxone, cephalexin, nitrofurantoin, or sulfamethoxazole/trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

_________ are less effective when taken with Antacids

A

Fluoroquinolones (DNA gyrase inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

PCN allergy cross-allergenicity w/:

A

Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Chloramphenicol: Side effect

A

Can cause pancytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Daptomycin

A
  • Aw/ increased CPK and incidence of myopathy
  • For gram + only
  • Makes pores
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Half-Life

A

t1/2 = (.7*Vd)/Cl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Treat Carcinoid Syndrome w/

A

Octreotide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Drug Efficacy

A

maximum effect of a drug (regardless of dose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Competitive Antagonist

A 
Changes ED50 (effective dose/potency): shift right
- Need a higher dose to overcome antagonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Noncompetitive OR Irreversible competitive antagonist

A 
Changes Emax (max effect/efficacy): shift down
- Increasing the dose will not help
117
Q

Partial Agonist

A

Decreases max effect; variable potency

118
Q

Tacrolimus

A

prevents Transcription of IL2; FKBP; Calcineurin inhibitor

- causes hyperglycemia

119
Q

Sirolimus

A

prevents Signal transduction of IL2; MTOR

120
Q

Cyclosporine

A

prevents Transcription of IL2: Calcineurin inhibitor

- nephrotoxic

121
Q

Cimetidine: P450 effect

A

can decrease P450 metabolism of warfarin → easy bruising and bleeding

122
Q

Anticholinergic Side Effects

A

hot as a hare, dry as a bone, blind as a bat, red as a beet, mad as a hatter

123
Q

Rasburicase

A

effective in preventing and treating hyperuricemia and its renal manifestations from tumor lysis syndrome (it is similar to allopurinol)

124
Q

Aminoglycosides must be administered _________

A

Parenterally

125
Q

Anesthetics that block Na Channels

A
  • Amide types have 2 I’s in the name
  • Ester types have only one i
  • Important to remember if a patient has an allergy to one type, can use the other type because there is no cross reaction
  • Inhaled anesthetics (esp halothane) → hepatotoxicity (necrosis/shunken)
126
Q

Foscarnet

A
  • pyrophosphate analog that does NOT require activation
  • Inhibits RNA pol (in herpesvirus) and reverse transcriptase (in HIV)
  • for CMV
  • Side effects: Hypocalcemia, hypomagnesia
127
Q

Cidofovir

A
  • does not require phosphorylation

- for CMV

128
Q

Amphotericin B: can cause arrhythmias due to:

A

hypokalemia and hypomagnesia

129
Q

Metformin contraindicated in:

A

renal failure

130
Q

Heparin for DVT in

A

Pregnant (warfarin is normally drug of choice for DVT)

131
Q

Carbamazepine:

A
  • Blocks voltage gated Na+ channels
  • Trigeminal neuralgia (triggered by eating or brushing teeth)
  • Carbamazepine may cause blood dyscrasias (agranulocytosis or aplastic anemia), hepatotoxicity, and SIADH
  • First line for Partial Seizures and General Tonic-Clonic
132
Q

Rifampin as Monotherapy

A
  • rarely used alone
  • Can be used as monotherapy for meningococcal exposure
  • Prophylaxis for close contacts of pts with meningitis
  • AMPlifies CYP450 and increases metabolism of Warfarin and Phenytoin
133
Q

Prevent Methotrexate Toxicity w/

A

Folinic Acid Supplementation

134
Q

Vincristine: Side Effect

A

Peripheral Neuropathy

135
Q

Warfarin Metabolism Increased w/

A

antiepileptics, rifampin and griseofulvin

136
Q

Highest risk of drug-induced SLE

A

Hydralazine and procainamide

137
Q

Thiazide: Side effects

A

Hypercalcemia, Hyperlipidemia/hypercholesterolemia, decreased insulin release (Hyperglycemia)

138
Q

Tx of Coagulase (-)

A

Usually methicillin resistant so use Vancomycin

139
Q

Primidone

A

For benign essential tremors (and also tourettes)

  • Active metabolite is phenobarbital and phenylethylmalonomide
  • So can be useful as a narrow spectrum anticonvulsant
  • Beta blockers used as first line for essential tremor but not in pts with asthma
140
Q

Statins used with Fibrates

A
  • Risk of myopathy with Statins increases when combined with Fibrates (eg Gemfibrozil or fenofibrate)
  • Simvastatin has highest risk of myopathy
  • Statins also have a risk of hepatotoxicity
141
Q

Cocaine

A
  • Inhibits reuptake of NE, DA, and serotonin by NET

- Indirect sympathomimetic

142
Q

Atropine Reversal

A
  • Physostigmine which inhibits AchE both peripherally and centrally (due to its tertiary amine structure)
  • Neostigmine and Edrophonium are also AchE inhibitors but only peripherally (they don’t cross BBB due to their quaternary amine structure)
143
Q

Fluorinated Inhaled Anesthetics Effects

A
  • increases cerebral blood flow but tend to depress everything else
  • Can increase ICP
144
Q

Understimulation of alpha1 receptors

A

lightheadedness and syncope with standing

145
Q

Extended use of appetite suppressents

A

phentermine or fenfluramine are aw/ increased incidence of pulmonary hypertension → RV hypertrophy + cor pulmonale→ sudden cardiac death

146
Q

TCAs

A
  • inhibit reuptake of serotonin and NE
  • MC cause of death is refractory hypotension and arrhythmias due to inhibition of fast Na+ channels
  • can have antimuscarinic/anticholinergic effects (amytriptyline)
  • may also have alpha adrenergic antagonist effects
147
Q

Triptans

A

5HT1B and 5HT1D agonists (used for terminating migraines)

  • induce vasoconstriction
  • prevents CGRP release (vasoactive peptide)
  • Don’t used with CAD or prinzmetal angina
148
Q

Loading Dose

A

(target concentration * Vd)/ bioavailability

149
Q

Maintenance Dose

A

(target concentration * CL * interval of dosing)/bioavailability

150
Q

Bioavailability

A

area under oral curve/ area under IV curve

151
Q

Zero-order

A
  • fixed amount eliminated

- PEA: phenytoin, ethanol. Aspirin

152
Q

First-order

A
  • fixed proportion eliminated (fraction so exponential)
153
Q

To eliminate salicylates (aspirin):

A

alkalinize urine w/ bicarb

154
Q

To eliminate amphetamines:

A

acidify urine w/ ammonium chloride

155
Q

Elderly Lose Phase ______ of Drug Metabolism First

A

Phase 1 metabolism of drugs first (CYP450)

156
Q

Mirtazipine

A

alpha2 autoreceptor antagonist (atypical antidepressant)

157
Q

Meperidine

A

opioid

158
Q

Tx Glaucoma

A

Cholinergic promoters better

159
Q

ACHE inhibitors

A
  • stigmines, donepezil, galantamine, and edrophonium ( side effects of cholinergics)
  • Only physostigmine crosses CNS
160
Q

Ipratropium and Tiotropium

A

antimuscarinics used for asthma and COPD

161
Q

Oxybutynin and Darefenacin

A

antimuscarinics used for urge incontinence

162
Q

Scopolamine

A

antimuscarinic for motion sickness

163
Q

Glycopyrrolate

A

antimuscarinic for preop use to decrease airway secretions, drooling, and peptic ulcer

164
Q

Tropicamide and Atropine

A

Antimuscarinics used for dilation and cycloplegia

- Atropine used for bradycardia

165
Q

Dopamine

A

D1 and D2 receptors > Beta > alpha receptors

166
Q

Dobutamine

A

B1 > B2, alpha (cardiac stress test)

167
Q

Never give beta blockers to:

A

cocaine users (because unopposed a1 activation → severe hypertension)

168
Q

Clonidine

A
  • Alpha2 agonist for hypertensive emergency
  • Also ethanol and opioid withdrawal
  • DO NOT confuse with clomiphene (estrogen feed back inhibitor antagonist)
169
Q

Theophylline

A

Bronchodilates by inhibiting PDE to increase cAMP (blocks actions of adenosine)
- Low therapeutic index (cardio and neurotoxic): seizures, arrhythmia, vomiting, abdominal pain

170
Q

Tx for isolated systolic HTN

A

DHR Ca2+ Channel blockers (-dipines) or thiazides

171
Q

Denosumab

A

RANKL antibody, prevents osteoclast action

172
Q

Benzo w/ Short Half-life used for Insomnia

A

Triazolam

173
Q

Amifostine

A

Use with platinum containing chemo agents (cisplatin) to prevent nephrotoxicity

174
Q

Dexrazoxane

A

Iron chelator used with doxorubicin to prevent cardiotoxicity

175
Q

Mesna

A

Used with cyclophosphamide to prevent hemorrhagic cystitis

176
Q

Leucovorin

A

Used to treat methotrexate overdose

177
Q

MRSA is resistant to:

A

ALL beta-lactam drugs including ones that are b-lactamase resistant (nafcillin) because it has an altered PBP

178
Q

Nimodipine

A

Ca2+ Channel Blocker that ise used to prevent cerebral vasospasm following a subarachnoid hemorrhage

179
Q

Theophylline Toxicity

A

Seizures and Tachyarrhythmias

180
Q

gp41 inhibitor

A

enfurvitide (inhibits entry)

181
Q

gp120 inhibitor

A

maraviroc (inhibits attachment)

182
Q

Sulfahydryl group donor used to treat ________

A

Acetaminophen overdose

183
Q

_______ to HIV+ Pregnant woman

A

Zidovudine

184
Q

First Dose Effect w/ ACE inhibitors

A

First-dose hypotension
- predisposing factors: hyponatremia, hypovolemia due to diuretic use, renal impairment, heart failure, low BP, high renin or aldosterone

185
Q

Drug Characteristics if Vd is plasma (3-5L)

A

high MW, high protein binding, high charge, hydrophilic

186
Q

Piperacillin + Tazobactam is effective against:

A

Most Gm (-) enteric rods, including pseudomonas and Bacteroides

187
Q

Cidofovir and Tenofovir

A

Nucleotides only need cellular kinase to be activated (not viral kinase)

188
Q

T1/2=

A

(.693*Vd)/ CL

189
Q

Ethosuximide

A
  • blocks T-type Ca2+ channels

- Used for absence seizures

190
Q

Opioids (8)

A

Morphine, fentanyl, codeine, loperamide, methadone, meperidine, dextromethorphan, diphenoxylate

191
Q

Butorphanol

A

Partial agonist at Mu and agonist at kappa

  • analgesia for severe pain (less respiratory depression)
  • Can cause withdrawal symptoms if taken with a full opioid agonist and overdose is not easily reversed
192
Q

Tramadol

A

Very weak opioid agonist

  • also inhibits serotonin and NE reuptake
  • decreases seizure threshold, risk of Serotonin Syndrome
193
Q

Phenytoin vs Valproic Acid Uses

A

Phenytoin: all seizures + status epilepticus except absence

Valproic acid: all seizures except status epilepticus

194
Q

Phenytoin Side effects

A

Nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, fetal hydantoin (teratogen), SLE-like syndrome, p450 induction, SJS
- Zero-order Kinetics (use dependent)

195
Q

Tx for Postherpetic neuralgia and peripheral neuropathy

A

Gabapentin (GABA analog that inhibits voltage gated Ca channels)

196
Q

Barbiturates (Phenobarbital, pentobarbital, secobarbital, Thiopental)

A

Increased GABA duration of Cl- opening

-contraindicated in porphyria

197
Q

Benzodiazepines (Zolam or Zepam)

A

Increased GABA frequency of Cl- opening

  • Short acting: triazolam, oxazepam, alprazolam, and midazolam (more likely to fall but less withdrawal)
  • increased risk of falls with hangover effect
198
Q

Short acting benzodiazepines

A

Triazolam
Oxazepam
Alprazolam
Midazolam

199
Q

Nonbenzo Hypnotics

A

Zolpidem, Zaleplon, Eszepiclone
Act on BZ1 subtype receptor
- less dependence risk

200
Q

Less soluble in blood –>

A

rapid induction and recovery

201
Q

Inhaled Anesthetics (Halothane, -Fluranes, and NO)

A

Respiratory and cardiac depression, increase cerebral blood flow

  • halothane has hepatotoxicity, methoxyflurane has nephrotoxicity, enflurane is proconvulsant
  • Risk of malignant hyperthermia (tx w/ dantrolene)
202
Q

IV Anesthetics

A 
Barbiturates
Benzodiazepines
Ketamine
Opioids
Propafol
203
Q

IV Anesthetic: Barbiturate

A

Thiopental: very potent and lipid soluble

  • induction of anesthesia and short procedures
  • rapid redistribution into tissue and fat
  • decreased cerebral blood flow
204
Q

IV Anesthetic: Benzodiazepine

A

Midazolam: MC used for endoscopy

  • used w/ gaseous anesthetics and narcotics
  • May have severe post-op respiratory depression, low BP, and anterograde amnesia
205
Q

IV Anesthetic: Ketamine

A

PCP analog (dissociative anesthetic)

  • Blocks NMDA receptors (decreases morphine tolerance by blocking glutamate)
  • Cardio stimulant
  • Causes disorientation, hallucination, and bad dreams
206
Q

IV Anesthetic: Opioid

A

Morphine and fentanyl (used w/ other depressants)

207
Q

IV Anesthetic: Propofol

A

Used for sedation in ICU, rapid induction, short procedures

  • Less post-op nausea than thiopental
  • Potentiates GABAa
208
Q

Local Anesthetics: Esters and Amides

A

Esters: -Caines; Amides: Caines but w/ 2 I’s

  • Block Na channels (prefer activated)
  • Vasoconstrictors will enhance local action
  • Nerve blockade: small > large; myelin> unmyelin (size factor predominates)
  • Order of Loss: pain, temp, touch, pressure
209
Q

Bupivicaine Side Effect

A

Severe Cardio toxicity

210
Q

Local Anesthetics: Infected Tissue

A

Need more anesthetic in infected (acidic) tissue because alkaline anesthetics can’t penetrate

211
Q

Nondepolarizing Muscular Blockade: -curium and -uronium

A
  • competitive antagonists w/ Ach

- Reverse with neostigmine (give w/atropine to prevent bradycardia), edrophonium, and other ACHE inhibitors

212
Q

Dantrolene

A

Prevents release of Ca2+ from SR

- Tx for malignant hyperthermia and neuroleptic malignant syndrome

213
Q

VMAT inhibitors

A

Tetrabenzine and Reserpine

- used for Huntingtons

214
Q

D2 agonists for Parkinsons

A

Pramipexole and Ropinerole (non-ergots preferred) and Bromocriptine (ergot)

215
Q

Amantadine

A

Antiviral that increases dopamine and can be used for Parkinsons

216
Q

Selegiline

A

Selective MAO-B inhibitor for Parkinsons

217
Q

Alzheimer’s Drugs

A

Memantine: NMDA antagonist

Donepezil, galantamine, rivastigmine: ACHE inhibitors

218
Q

Benztropine

A

Antimuscarinic that helps with Parkinsons by curbing excess cholinergic activity
- Use for drug induced Parkinsons

219
Q

Tx of Alcohol Withdrawal

A

Diazepam, Chlordiazepoxide, Disulfiram

220
Q

Antidepressants: Risk of Inducing _______

A

Mania (in susceptible patients)

221
Q

Venlafaxine

A

Serotonin and NE reuptake inhibitor used for PTSD

222
Q

Pentazocine

A

Opioid narcotic w/ partial agonist activity and weak antagonist activity at mu receptors
- can cause withdrawal symptoms in patients dependent or tolerant to morphine/opioids

223
Q

Alpha2 vs Beta2: insulin

A

A2 inhibits insulin

B2 released insulin

224
Q

Gancyclovir: adverse effect

A

Neutropenia (granulocytopenia)

- incidence is increased with co-administration of zidovudine

225
Q

3 types of signal pathways

A

cAMP, IP3, and ion channels

226
Q

Nicotinic Receptors

A

Ligand gates ion channels that open after binding Ach

- opening results in immediate influx of Na and Ca in and K out

227
Q

Maternal to neonate HIV - prophylaxis

A

Zidovudone starting at 14 weeks to birth and postpartum to infant for 6 more weeks
reduced risk of transmission by 2/3s

228
Q

DRESS Syndrome

A

Drug reaction 2-8 weeks after exposure

  • common w/ anticonvulsants, allopurinol, sulfonamides, and antibiotics
  • fever, general lymphadenopahy, facial edema, and diffuse morbilliform skin rash
  • Eosinophili and atypical lymphocytosis
229
Q

Crossing of Placenta

A

Water soluble materials DO NOT readily cross placenta (heparin)
Lipophilic materials easily cross (warfarin)

230
Q

Tx for CMV Retinitis

A

Gancyclovir
Foscarnet
Cidofavir

231
Q

Aciretin

A

synthetic retinoid used systemically to treat psoriasis

  • strongly teratogenic
  • retinoid medication function by binding nuclear receptors which subsequently function as transcription factors
232
Q

Aminoglycosides used w/ Beta-lactams

A

Increased efficacy of aminoglycoside because beta lactam disrupts the bacterial cell wall and allows it to penetrate the bacteria and inhibit the 30S subunit

233
Q

Orlistat

A

Weight loss agent for obesity

- inhibits intestinal lipase inhibiting fat absorption in gut

234
Q

Tx for Bullous Pemphigoid

A

Tetracyclines

235
Q

ACE inhibitor fetopathy (AIF)

A

Blockade of angiotensin II which is needed for normal renal development
- anuria, oligohydramnios (Potters), pulmonary hypoplasia, and calvarium defects

236
Q

Paclitaxel in a Drug Eluting Coronary Artery Stent

A

Functions to decrease stent thrombosis by:
inhibiting intimal hyperplasia
- binds b-tubulin and prevent microtubule break down leading to cell cycle arrest and inhibition of cell division

237
Q

Clopidogrel w/ Omeprazole

A

Clopidogrel is an inactive prodrug and requires activation by CYP2C19
Omeprazole inhibits CYP2C19 causing decreased efficacy of clopidogrel

238
Q

Nandrolone

A

Anabolic steroid

- may be used in competitive atheletes

239
Q

Jimson Weed

A

Mydriasis (gardener’s pupil)

Anticholinergic

240
Q

Itraconazole

A

Azoles: Inhibit ergosterol synthesis by inhibiting p450

241
Q

Fenoldopam

A

Used to tx Hypertensive Crisis

  • Selective D1 receptor agonist
  • arteriolar dilation and natriuresis (improved renal perfusion)
242
Q

Hypertensive Emergency: Tx with ________ or _________

A

Fenoldopam or Nitroprusside

243
Q

HIV Prophylaxis: Pneumocystis jirovecii and Toxoplasma Gondii

A

Trimethoprim-sulfamethoxazole

244
Q

HIV Prophylaxis: MAC complex

A

Azithromycin

245
Q

Norepinephrine vs Epinephrine

A

E: Beta more than alpha
NE: Alpha more than beta

246
Q

Methotrexate Side Effects

A

Stomatitis (painful mouth ulcer), hepatotoxicity, and myelosuppression

247
Q

Mexiletine

A

Class IB Antiarrhythmic

248
Q

Propafenone

A

Class IC Antiarrhythmic

249
Q

Ibutilide or Dofetilide

A

Class III Antiarrhythmic

250
Q

Flecainide

A

Class IC Antiarrhythmic

251
Q

Gingival Hyperplasia is a side effect of:

A

Phenytoin

252
Q

Opioids and Biliary Colic

A

Opioid action on Mu can cause contraction of smooth muscle cells in Sphincter of oddi causing constriction and spasm –> biliary colic due to increased pressure in bile duct and gall bladder

253
Q

PPI: Osteoporosis

A

Long term acid suppression w/ proton pump inhibitors –> increased risk of osteoporotic hip fractures

254
Q

Aspirins effect on Colon Adenocarcinoma

A

Increased activity of COX2 is linked to some forms of colon adenocarcinoma
- aspirin use may decrease adenomatous polyp formation

255
Q

Cilostazol

A 
PDE inhibitor (direct vasodilator) and inhibits platelet aggregation
- used in patients w/ intermittent claudication
256
Q

Txt for Enterococci

A

Vanco/amplicillin + aminoglycoside

257
Q

Tx for Wegeners

A

Cyclophosphamide and Corticosteroids

258
Q

Her2neu breast cancer

A

Trastuzumab

259
Q

ER breast cancer

A

Tamoxifen

260
Q

Tx for Legionella

A

Macrolide or Fluoroquinolone

261
Q

Tx for Sporothrix Schenkii

A

Oral Potassium iodide

262
Q

Tx for Nephrogenic DI

A

Amiloride, hydrochlorothiazide, indomethacin

263
Q

Tx H Pylori

A

PPI + clarithromycin + amoxicillin or metronidazole

264
Q

Tx for Ricketsia

A

Doxycycline

- also Chloramphenicol

265
Q

Tx for Chlamydia

A

Azithro or Doxycycline

266
Q

Tx for Lyme

A

Ceftriaxone or Doxycycline

267
Q

Tetracycline absorption inhibited by:

A

Milk (Ca2+), antacids (Ca+ or Mg+), or iron containing preparations

268
Q

Tx Atypical Pneumonias w/

A

Macrolides or FQs

269
Q

Binds 23 rRNA

A

Macrolides

- inhibit translocation

270
Q

Tx for Anaerobes ABOVE diaphragm

A

Clindamycin

271
Q

Tx for Anaerobes BELOW diaphragm

A

Metronidazole

272
Q

Sulfonamides

A

Inhibit folate synthesis by inhibition of dihydropteroate synthase
- hypersensitivity, hemolysis in G6PD, nephrotoxic, photosensitive, kernicterus in infants, and displaces drugs from albumin

273
Q

Aw/ tendon rupture and arthropathy in children

A

Fluoroquinolones

274
Q

Mechanism of Metronidazole

A

free radicals that damage DNA

275
Q

Drug induced lupus

A

Isoniazid, procainamide, and hydralazine

276
Q

Prophylaxis of Strep Pharyngitis in child w/ prior Rheumatic Fever and Prophylaxis for Endocarditis prior to dental work

A

Penicililn

277
Q

Prevention of postsurgical infection w/ S. Aureus

A

Cefazolin

278
Q

Prevention of gonococcal or chlamydial conjunctivitis in a newborn

A

Erythromycin Ointment

279
Q

Tx for VRE (Vanco Resistant)

A

Linezolid or Streptogranins (-pristin)

280
Q

Lanosterol Synthesis inhibitor

A

Terbinafine (inhibits squalene epoxidase)

281
Q

Ergosterol Synthesis inhibitor

A
  • Conazoles

by inhibiting p450

282
Q

Fungal Cell Wall Synthesis Inhibitor

A

Caspofungin

- inhibition of b glucan

283
Q

Fungus Membrane Pore Formation

A

Amphotericin B (systemic) and Nystatin (swish and swallow)

284
Q

5FU (flucytosine)

A

May be used for systemic fungal infections
inhibits DNA and RNA synthesis
- bone marrow suppression

285
Q

Mechanism of Chloroquine

A

Prevents detox of heme into hemozoin (heme accumulates –> toxic)

286
Q

IFN alpha used for: (6)

A

Hep B and C, Kaposi, Condyloma accuminatum, Hairy cell, RCC, melanoma

287
Q

Basiliximab

A

Monoclonal Ab that blocks IL2R

288
Q

In decompensated CHF, do not use:

A

Beta blockers

can be used in compensated

Quick Notes for Step 1 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions