Pharmacology Flashcards
1
Q
Pramlintide
A
Amylin analog. MOA = decrease gastric emptying and decrease glucagon. Used for type 1 + type 2 DM.
2
Q
Dopamine MOA
A
At low doses stimulates D1 receptors in the renal vasculature and tubules, thereby increasing GFR, RBF, and sodium excretion. Big heart in middle of room + normal sized christian is squeezing it/at high doses stimulates beta-1 adrenergic receptors in the heart, thereby increasing cardiac contractility + pulse pressure + systolic BP. Huge air force one plane by the left that monster Christian is driving/at highest doses stimulates alpha-1 receptors in the systemic vasculature.
3
Q
Why do you give dopamine for shock?
A
To stimulate a1 receptors in the systemic vasculature, causing vasoconstriction.
4
Q
Amiloride vs. amiodarone vs.
A
Amiloride –> K+ sparing diuretic.
amiodarone –> K channel blocker
amlodipine –> Ca channel blocker
5
Q
Ergotamine
A
o Code: Elisabeth with Erik backpack/ergotamine. Smoking a huge blunt + walking out of air force one/MOA = partial agonist/antagonist activity at tryptaminergic + dopaminergic + alpha-adrenergic receptors. Feet and arms are gangrenous/SE’s = peripheral vascular ischemia + potentially gangrene.
o Location: /usually used for migraines.
6
Q
How can morphine therapy lead to toxicity?
A
Morphine is metabolized to active metabolites that accumulate and can cause CNS depression.
7
Q
Drugs contraindicated in CHF
A
Diltiazem and verapamil.
8
Q
Hydralazine MOA
A
Smooth muscle relaxant and vasodilator in arteries and arterioles. Exact mechanism unclear.
9
Q
Phenoxybenzamine MOA
A
Non-selective irreversible alpha blocker
10
Q
labetalol MOA
A
Mixed alpha/beta adrenergic antagonist
11
Q
What is Vmax proportional to?
A
Enzyme concentration
12
Q
Relationship of Km to Vmax
A
Km is enzyme saturation at 1/2Vmax
13
Q
competitive inhibitor vs. noncompetitive inhibitor
A
FA 236
14
Q
What does a change in y-intercept on Lineweaver-Burk plot indicate?
A
Increased y-intercept = decreased Vmax since y-axis is the reciprocal of Vmax
15
Q
What does x-intercept represent on lineweaver-Burk plot?
A
The further to the right (i.e. the closer to zero), the greater the Km and the lower the affinity since x-axis is reciprocal of negative Km.
16
Q
What is slope on Lineweaver-Burk plot?
A
Km/Vmax
17
Q
How do you differentiate competitive inhibitors from noncompetitive on Lineweaver-Burk plot?
A
Reversible competitive inhibitors cross each other competitively, whereas noncompetitive inhibitors do not.
18
Q
Competitive inhibitors, reversible
1) resemble substrate?
2) overcome by increased saturation?
3) bind active site?
4) effect on Vmax?
5) effect on Km?
6) potency? efficacy?
A
1) Yes
2) Yes
3) Yes
4) Unchanged
5) Increased
6) Decreased potency
19
Q
Competitive inhibitors, IRREVERSIBLE
1) resemble substrate?
2) overcome by increased saturation?
3) bind active site?
4) effect on Vmax?
5) effect on Km?
6) potency? efficacy?
A
1) Yes
2) No
3) Yes
4) Decreased
5) Unchanged
6) Decreased efficacy
20
Q
NONcompetitive inhibitors
1) resemble substrate?
2) overcome by increased saturation?
3) bind active site?
4) effect on Vmax?
5) effect on Km?
6) potency? efficacy?
A
1) No
2) No
3) No
4) Decreased
5) Unchanged
6) Decreased efficacy
21
Q
What is bioavailability?
A
Fraction of administered drug reaching systemic circulation unchanged
22
Q
bioavailability of IV dose of drug
A
100%
23
Q
Why is bioavailability usually less than 100%
A
Incomplete absorption + first pass metabolism
24
Q
How do liver and kidney disease affect Vd?
A
Decreased protein binding leads to increased volume of distribution.
25
Drugs that stick to blood compartment characteristics...
Large/charged molecules; plasma protein bound
26
Relative Vd of ECF, tissue, Blood compartments
Blood = low
ECF = medium
All tissues including fat = high
27
Characteristics of drugs that stay in ECF compartment?
Small hydrophilic molecules
28
Characteristics of drugs that stay in fat/tissue compartment?
Small lipophilic molecules, especially if bound to tissue protein.
29
Steady state in a drug with first-order kinetics?
Takes 4-5 lives to reach steady state and 3.3 half lives to reach 90% of steady-state.
30
What happens to maintenance and loading dose with renal or liver disease?
You need need to decrease maintenance dose. Loading dose is usually unchanged.
31
What does time to steady state depend on?
Primarily half life. Independent of dose and dosing frequency.
32
Additive drug interaction?
Effect of substance A and B together is equal to the sum of their individual effects.
33
Example of additive drug interaction
Aspirin + acetaminophen
34
Permissive drug interaction?
Presence of substance A is required for the full effects of substance B.
35
Example of permissive drug interaction?
Cortisol on catecholamine responsiveness
36
synergistic drug interaction?
Effect of substance A and B together is greater than the sum of their individual effects.
37
Classic example of synergistic drug interaction?
Clopidogrel with aspirin
38
tachyphylactic drug interaction?
Acute decrease in response to a drug after initial/repeated administration.
39
classic examples of tachyphylactic drug interactioN?
MDMA and LSD
40
Graph of plasma concentration of drug vs. time with zero-order elimination?
linear
41
Drugs with zero-order elimination?
1) phenytoin
2) ethanol
3) aspirin (at high or toxic concentrations)
42
term for elimination in zero-order elimination?
"Capacity-limited elimination"
43
What is rate of elimination proportional to in first-order clearance?
Directly proportional to drug concentration (constant fraction eliminated per unit time)
44
term for elimination in first-order elimination?
"flow-dependent elimination"
45
Graph of plasma concentration of drug vs. time with first-order elimination?
exponential
46
Difference between ionized drugs and non-ionized in terms of renal clearance?
Ionized species are trapped in urine and cleared quickly. Neutral forms can be reabsorbed.
47
Examples of drugs that are weak acids...
1) phenobarbital
2) methotrexate
3) aspirin
48
Treating overdose for weak acid drugs...
Trapped in basic environments so treat overdose with bicarbonate.
49
Examples of drugs that are weak bases...
1) amphetamines
| 2) TCAs
50
Treating overdose for weak base drugs...
Trapped in acidic environments so treat with ammonium chloride.
51
Drug metabolism changes with age.
1) Geriatric patients lose phase I metabolism first.
| 2) More Phase II
52
What is Phase I metabolism?
Reduction, oxidation, hydrolysis with CYP-450 usually yielding slightly polar, water-soluble metabolites.
53
Caveat about drugs after Phase 1 metabolism...
Often still active.
54
What is Phase II metabolism?
Conjugation (MGAS - Methylation, glucuronidation, acetylation, sulfating), usually yields very polar, inactive metabolites (really excreted).
55
Problem with people who are slow acetylators?
They have increased side effects from certain drugs because of decreased rate of Phase II metabolism.
56
What is efficacy proportional to?
Vmax
57
How is potency represented on maximal effect vs. dose graph?
X-axis (EC50), left shift = decreased EC50 = increased potency = decreased drug needed.
58
partial agonist vs. agonist
partial agonists have lower efficacy.
59
effect of competitive antagonist
Shifts curve right (decreased potency, no change in efficacy.
60
effect of NONcompetitive antagonist
Shifts curve down (decreasing efficacy).
61
phenoxybenzamine MOA
noncompetitive antagonist on alpha receptors
62
Therapeutic index?
Difference between TD50 and ED50
63
TD50?
median toxic dose
64
ED50?
median effective dose
65
therapeutic window
Dosage range that can safely and effectively treat disease.
66
How to calculate therapeutic index?
TD50/ED50
67
Drugs with lower therapeutic indexes?
1) Digoxin
2) Lithium
3) theophylline
4) warfarin
68
Implication of drugs with low therapeutic indices?
Frequently require monitoring
69
LD50?
Basically TD50 in animal studies.
70
Caveat about adrenal medulla and sweat glands
Part of sympathetic nervous system but innervated by cholinergic fibers
71
Somatic nervous system structure + neurotransmitter
Voluntary motor nerves synapsing on skeletal muscle and release ACh.
72
Parasympathetic nervous system structure + neurotransmitter
1) Long preganglionics releasing ACh and synapsing on nicotinic receptors
2) short postganglionics releasing ACh and synapsing on muscarinic receptors at target organ
73
What receives sympathetic innervation?
1) sweat glands
2) cardiac and smooth muscle (both PS and S)
3) gland cells (both PS and S)
4) renal vasculature
5) vessels
74
Sympathetic vs. parasympathetic nerve structure
1) In parasympathetic, you have long preganglionics and short postganglionics.
2)
75
Sympathetic pregalgnionics
All release ACh onto Nicotinic receptors.
76
Sweat gland innervation
Sympathetic. ACh on muscarinic receptors.
77
Cardiac and smooth muscle, gland cells, nerve terminals innveration in sympathetic
NE synapsing on adrenergic receDptors
78
Dopamine 1 receptors expressed in...
1) renal vasculature
| 2) smooth muscle
79
Adrenal meddle neuromuscular transmission
preganglionics release ACh onto nicotinic receptors in the adrenal medulla. Catecholamines are released into blood. NE acts on A1,A2,B1, Epi on A1,A2, B1,B2
80
Structure of nicotinic ACh receptors?
Ligand-gated Na+/K+ channels.
81
Subdivisions of nicotinic receptors and expression
1) Nn (autonomic ganglia + adrenal medulla)
| 2) Nm (found in NMJ of skeletal muscle)
82
Muscarinic ACh receptor structure
G-protein-coupled receptors that usually act through 2nd messengers.
83
A1 functions
1) vascular smooth muscle contraction
2) Increase pupillary dilator muscle contraction (Mydriasis)
3) increase intestinal and bladder sphincter muscle contraction
84
A2 receptor functions
1) decrease sympathetic (adrenergic) outflow
2) decrease insulin release
3) lipolysis
4) decrease platelet aggregation
5) decrease aqueous humor production
85
B1 receptor functions
1) increase HR
2) increase contractility
3) increase renin release
4) increase lipolysis
86
B2 receptor functions
1) vasodilation
2) bronchodilation
3) increased lipolysis
4) increase insulin release
5) decrease uterine tone (tocolysis)
6) ciliary muscle relaxation
7) increase aqueous humor production
87
beta 3 class
Gs
88
Beta 3 functions
1) increased lipolysis
| 2) thermogenesis in skeletal muscle
89
M1 functions
1) CNS
| 2) enteric nervous system
90
M2 class
Gi
91
M2 functions
1) decrease heart rate
| 2) decrease contractility of atria
92
M3 functions
1) exocrine gland secretions (lacrimal, sweat, salivary, gastric acid)
2) increase gut peristalsis
3) increase bladder contraction
4) bronchoconstriction
5) Increase pupillary sphincter muscle contraction (mitosis)
6) ciliary muscle contraction (accommodation)
93
D1 receptors
Gs
94
D1 functions
1) relax renal vascular smooth muscle
95
D2 receptor
Gi
96
D2 receptor functions
1) modulates transmitter release, especially in brain
97
H1 receptor g protein class
Gq
98
H1 receptor function
1) Increase nasal and bronchial mucus production
2) increase vascular permeability
3) contraction of bronchioles
4) pruritus
5) pain
99
H2 receptor class
Gs
100
H2 receptor function
1) increase gastric acid secretion
101
V1 receptor class
Gq
102
V1 receptor function
Increase vascular smooth muscle contraction
103
V2 receptor class
Gs
104
V2 receptor function
1) ADH
105
Gq pathway
PIP2 (phospholipase C) --> DAG --> PKC
OR
PIP2 (phospholipase C) --> IP3 --> increased calcium concentration --> smooth muscle contraction
106
Gs/Gi pathway
adenylyl cyclase --> ATP to cAMP --> PKA --> increased calcium in heart OR myosin light-chain kinase (smooth muscle)
107
Hemicholinium
enzyme that inhibits choline uptake into neurons
108
vesamicol
enzyme that inhibits ACh uptake into vesicles
109
Metyrosin MOA
inhibits conversion of tyrosine to DOPA
110
Reserpine MOA
inhibits dopamine uptake into vesicles
111
ephedrine cell bio MOA
stimulates release of NE from vesicles
112
Bretylium MOA
Inhibit NE release from vesicles.
113
Guanethidine MOA
Inhibit NE release from vesicles. indirect general agonist + releases stored catecholamines, thus activating alpha and beta receptors
114
How is NE release from sympathetic nerves modulated?
NE regulates itself, by feeding back and acting on presynaptic alpha2 receptors.
115
How do amphetamines get into presynaptic terminal?
NET transporter (NE transporter) (NET)
116
How do amphetamines get into vesicles? What happens after?
VMAT, vesicular monoamine transporter. This displace NE from the vesicles. Once NE reaches a concentration threshold within the presynaptic terminal, the action of NET is reversed, and NE is expelled into the synaptic cleft, contributing to the characteristics and effects of increased NE observed in patients taking amphetamines.
117
Excess tyramine mechanism
It enters presynaptic vesicles and displaces other neurotransmitters (eg, NE) --> increasing amount of active presynaptic neurotransmitters, which diffuse into the synaptic cleft, leading to increased sympathetic simulation and hypertensive crisis.
118
Bethanechol impt pharmacology point
resistant to AChE
119
Bethanechol
direct agonist at bowel and bladder smooth muscle
120
bethanechol uses
1) postoperative ileus
2) neurogenic ileus
3) urinary retention
121
carbachol MOA
direct cholinomimetic
122
carbachol applications
constricts pupil and relives intraocular pressure in open-angle glaucoma (increases aqueous humor outflow)
123
pilocarpine MOA
direct agonist -- contracts ciliary muscle of eye (open-angle glaucoma) + pupillary sphincter (closed-angle glaucoma).
124
pilocarpine impt pharmacology ypoint
resistant to AChe
125
pilocarpine uses
1) potent stimulator of sweat, tears, and saliva.
2) open-angle and closed-angle glaucoma
3) xerostomia (Sjogren's)
126
rivastigmine MOA
indirect, increases ACh
127
galantine MOA
indirect, increases ACh
128
options for AD
1) donepezil
2) galantine
3) rivastigmine
129
How is MG actually diagnosed now?
Anti-AChR Ab (anti-acetylcholine receptor antibody) test.
130
edrophonium MOA
indirect, increases ACh
131
All cholinomimetics can exacerbate...
1) COPD
2) asthma
3) peptic ulcers
132
neostigmine impt pharmacology poitn
Neo CNS = NO CNS penetration
133
neostigmine uses
1) postoperative and neurogenic ileus and urinary retention
2) MG
3) reversal of neuromuscular junction blockade (postop)
134
physostigmine is used for anticholinergic toxicity because...
it crosses BBB into CNS
135
pyridostigmine and CNS
Long acting but does NOT penetrate CNS.
136
organophosphate commonly causing cholinesterase inhibitor .
parathion
137
Why do organophosphates cause poisoning?
They irreversibly inhibit AChE
138
How is pralidoxime affective?
Regenerates AChE if given early.
139
Major concern with untreated cholinesterase inhibitor poisoning...
respiratory failure
140
DUMBBELSS
Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation.
141
What does muscarinic antagonism create in the eye?
1) mydriasis
| 2) cycloplegia
142
cycloplegia
paralysis of ciliary muscle
143
benztropine MOA
muscarinic antagonist in the CNS
144
benztropine uses
1) PD
| 2) Acute dystonia
145
glycopyrrolate MOA
Muscarinic antagonist targeting GI + respiratory
146
glycopyrrolate uses
1) parenteral: preoperative use to reduce airway secretions
| 2) oral: drooling + peptic ulcers
147
drug like hyoscyamine
dicyclomine
148
dicyclomine, hyoscyamine uses
Antispasmodics for IBS
149
Ipratropium, tiotropium uses
1) COPD
| 2) asthma
150
Ipratropium, tiotropium MOA
muscarinic antagonists targeting respiratory system
151
muscarinic antagonists targeting GU system
1) oxybutynin
2) solifenacin
3) tolterodine
152
Atropine affects
1) mydriasis, cycloplegia
2) decrease airway secretions
3) decrease acid secretion in stomach
4) decrease gut motility
5) decrease urgency in cystitis
153
AE's of atropine
1) Hot as a hare
2) Dry as a bone (dry, flushed skin)
3) Red as a beet
4) Blind as a bat
5) Mad as a hatter (disorientation)
rapid pulse + dry mouth + constipation.
154
Atropine AE's/contranidcations
1) urinary retention in men with BPH
2) hyperthermia in infants
3) acute angle-closure glaucoma
155
albuterol vs. salmeterol clinical applications
1) albuterol for acute asthma or COPD
| 2) salmeterol for long-term asthma or COPD control.
156
Dobutamine primarily targets...
B1 more so than B2, alpha
157
dobutamine uses
1) HF (inotropic more so than chronotropic)
| 2) cardiac stress testing
158
Dopamine targets...
D1 = D2, then B, then A
159
dopamine uses
1) unstable bradycardia
2) HF
3) shock
4) inotropic AND chronotropic effects at lower doses
5) vasoconstriction at high doses due to alpha effects
160
epinephrine targets primarily
beta more so than alpha
161
isoproterenol uses
1) electrophysiologic evaluation of tachyarrhythmias
162
isoproterenol contraindications
CAD (can worsen ischemia)
163
midodrine MOA
alpha1 agonist
164
norepinephrine uses
1) hypotension
| 2) septic shock
165
norepinephrine targets
alpha1, then alpha 2, then beta1
166
phenylephrine targets
alpha1 primarily, but also alpha 2
167
phenylephrine uses
1) hypotension (vasoconstrictor)
2) ocular procedures
3) rhinitis (decongestant)
168
what are the indirect sympathomimetics?
1) amphetamine
2) cocaine
3) ephedrine
169
amphetamine MOA
1) Indirect general agonist
2) reuptake inhibitor
3) releases stored catecholamines
170
cocaine MOA
1) indirect general agonist
| 2) reuptake inhibitor
171
ephedrine MOA
1) indirect general agonist, releases stored catecholamines
172
ephedrine uses
1) nasal decongestion
2) urinary incontinence
3) hypotension
173
isoproterenol affects on BP, HR
vasodilation (via B2) + increased HR through both B1 + reflex activity
174
guanfacine MOA
A2 agonists
175
clonidine, guanfacine uses
1) hypertensive urgency in limited situations
2) ADHD
3) Tourettes
176
Clonidine, guanfacine AE's
1) CNS depression
2) bradycardia
3) hypotension
4) respiratory depression
5) miosis
177
alpha-methyldopa AE's
1) direct coombs positive hemolysis
| 2) SLE-like syndrome
178
beta blockers used for SVTs?
metoprolol + esmolol
179
beta blocker MOA for use in SVTs?
Decrease AV conduction velocity.
180
beta blocker MOA for use in HTN?
1) decrease cardiac output
| 2) *decrease renin secretion (beta1 blockade on JGA cells)
181
beta blockers used to decrease mortality in HF?
1) bisoprolol
2) carvedilol
3) metoprolol
182
timolol mechanism in glaucoma?
Decreases secretion of aqueous humor
183
Other BB usage?
Decrease variceal bleeding
184
BB's to use to decrease variceal bleeding?
1) nadolol
| 2) propranolol
185
beta blocker MOA for use in variceal bleeding?
Decrease hepatic venous pressure gradient and portal HTN.
186
beta blocker AE's
1) erectile dysfunction
2) cardiovascular AE's (bradycardia, AV block, HF)
3) CNS (seizures, sedation, sleep alterations)
4) asthma/COPD exacerbations
187
metoprolol other AE
dyslipidemia
188
What's the deal with using beta blockers in diabetics?
despite concern with masking hypoglycemia, benefits likely outweigh risk so they are indicated.
189
nonselective betablockers
1) nadolol
2) pindolol
3) propranolol
4) timolol
190
nonselective antagonism means what?
B1 = b2 (unlike selective, which primarily target B1) N
191
Nebivolol MOA
Blocks beta1 but stimulates B3, thus activating NO synthase in vasculature
192
tetrodotoxin source
pufferfish
193
tetrodotoxin MOA
Highly potent; binds fast voltage-gated Na+ channels in cardiac/nerve tissue, preventing depolarization.
194
tetrodotoxin symptoms
nausea + diarrhea + paresthesias + weakness + dizziness + loss of reflexes
195
tetrodotoxin treatment
primarily supportive
196
ciguatoxin sources
Reef fish...
1) barracuda
2) snapper
3) moray eel
197
ciguatoxin mechanism
1) OPENs Na+ channels, causing depolarization
198
ciguatoxin presentation
symptoms mimic cholinergic poisoning
199
ciguatoxin poisoning treatment
primarily supportive
200
scombroid poisoning is basically...
histamine poisoning
201
scombroid sources
spoiled dark-meat fish..
1) tuna
2) mahi-mahi
3) mackerel
4) bonito
202
scombroid mechanism
Bacterial histidine decarboxylase converts histidine to histamine
203
What is scombroid poisoning frequently misdiagnosed as?
Fish allergy
204
scombroid poisoning presentation...
anaphylaxis picture...
1) acute burning sensation of mouth
2) flushing of face
3) erythema
4) urticaria
5) itching
6) bronchospasm
7) angioedema
8) hypotension
205
scombroid treatment
Antihistamines. Albuterol + epinephrine if needed.
206
Treatment for amphetamine overdose...
ammonium chloride (amphetamines are basic so you want to acidify the urine)
207
Treatment for antimuscarinic/anticholinergic overdose...
physostigmine + *control hyperthermia
208
Treatment for arsenic overdose...
dimercaprol + succimer
209
Treatment for beta-blocker overdose...
saline + atropine + glucagon
210
Treatment for copper overdose...
penicillamine + trientine
211
Treatment for cyanide overdose...
Nitrite + thiosulfate + hydroxocobalamin
212
Treatment for digitalis overdose...
anti-dig Fab fragments
213
Treatment for gold overdose...
penicillamine + dimercaprol (BAL) + succimer
214
Treatment for heparin overdose...
protamine sulfate
215
Treatment for iron overdose...
deFERoxamine, deFERasirox, deFERipone
216
Treatment for lead overdose...
1) EDTA
2) dimercaprol
3) succimer
4) penicillamine
217
Treatment for amphetamine overdose...
diMERCaprol + succimer
218
Treatment for methanol, ethylene glycol (antifreeze) overdose...
Fomepizole. Also, ethanol or dialysis if fomepizole isn't available.
219
Treatment for opioid overdose...
naloxone
220
Treatment for salicylate overdose...
sodium bicarb (alkalinize urine) + dialysis
221
Drugs associated with coronary vasospasm...
1) cocaine
2) sumatriptan
3) ergot alkaloids
222
Drugs associated with cutaneous flushing...
```
VANCE
Vancomycin
Adenosine
Niacin
Ca2+ channel blockers
Echinocandins
```
223
What do you give to prevent dilated cardiomyopathy with anthracyclines (doxorubicin, daunorubicin)?
Dexrazoxane
224
Drugs associated with torsades de pointes
1) 1A + III antiarrhythmics
2) macrolides
3) haloperidol
4) TCA's
5) ondansetron
225
Drugs associated with hot flashes
1) tamoxifen
| 2) clomiphene
226
Drugs associated with hyperglycemia
1) tacrolimus
2) protease inhibitors
3) niacin
4) HCTZ
5) corticosteroids
227
Drugs associated with hypothyroidism
1) lithium
2) amiodarone
3) sulfonamides
228
Erythromycin AE's
acute cholestatic hepatitis + jaundice
229
Drugs causing diarrhea
1) acamprosate
2) acarbose
3) cholinesterase inhibitors
4) colchicine
5) erythromycin
6) ezetimibe
7) metformin
8) misoprostol
9) Orlistate
10) pramlintide
11) quinidine
12) SSRIs
230
Drugs associated with focal to massive hepatic necrosis...
```
HAVAc
Halothane
Amanita phalloides
Valproic acid
Acetaminophen
```
231
drugs associated with hepatitis
```
Rifampin
Isoniazid
Pyrazinamide
Statins
Fibrates
```
232
Drugs associated with pancreatitis
```
Didanosine
Corticosteroids
Alcohol
Valproic acid
Azathioprine
Diuretics (furosemide, HCTZ)
```
233
Drugs associated with pill-induced esophagitis
1) tetracyclines
2) bisphosphonates
3) potassium chloride
234
How do you minimize pill-induced esophagitis?
good posture + adequate water ingestion
235
Drugs associated with pseudomembranous colitis
Clindamycin
Ampicillin
Cephalosporins
236
Drugs associated with
| agranulocytosis
```
Clozapine
Carbamazepine
propylthiouracil
Methimazole
Colchicine
Ganciclovir
```
237
Drugs associated with aplastic anemia
```
Carbamazepine
Methimazole
NSAIDs
Benzene
Chloramphenicol
PTU
```
238
Drugs associated with direct Coombs-positive hemolytic anemia
1) methyldopa
| 2) penicillin
239
Drugs associated with hemolysis in G6PD deficiency
```
Isoniazid
Sulfonamides
Dapsone
Primaquine
Aspirin
Ibuprofen
Nitrofurantoin
```
240
Drugs associated with megaloblastic anemia
Phenytoin
Methotrexate
Sulfa drugs
241
Drugs associated with thrombosis
1) OCPs
| 2) hormone replacement therapy
242
Drugs causing gingival hyperplasia
1) phenytoin
2) calcium channel blockers
3) cyclosporine
243
Drugs associated with hyperuricemia
1) pyrazinamide
2) thiazides
3) furosemide
4) niacin
5) cyclosporine
244
Drugs associated with myopathy
```
Vibrates
Niacin
colchicine
hydroxycloroquine
INF-alpha
penicillamine
statins
GCs
```
245
Drugs associated with osteoporosis
corticosteroids, heparin
246
Drugs associated with photosensitivity
Sulfonamides
Amiodarone
Tetracyclines
5-FU
247
Drugs associated with Stevens-Johnson syndrome
1) lamotrigine
2) allopurinol
3) sulfa drugs
4) etanercept
248
drugs causing cinchonism
quinidine + quinine
249
Drugs associated with Parkinson-like syndrome
Cogwheel rigidity of ARM
1) antipsychotics
2) reserpine
3) metoclopromide
250
Drugs associated with seizures
1) isoniazid
2) bupropion
3) Imipenem/cilastatin
4) tramadol
5) enflurane
251
Drugs associated with tardive dyskinesia
1) antipsychotics
| 2) metoclopramide
252
Drugs associated with fanconi syndrome
1) tenofovir
| 2) ifosfamide
253
Drugs associated with hemorrhagic cystitis?
1) cyclophosphamide
| 2) ifosfamide
254
Drugs associated with interstitial nephritis?
1) methicillin
2) NSAIDs
3) furosemide
255
Drugs associated with SIADH?
1) carbamazepine
2) cyclophosphamide
3) SSRIs
256
Drugs associated with pulmonary fibrosis?
1) methotrexate
2) nitrofurantoin
3) carmustine
4) bleomycin
5) busulifan
6) amiodarone
257
Drugs with antimuscarinic side effects?
1) TCA's
2) H1-blockers
3) antipsychotics
258
Drugs associated with disulfiram-like reaction?
1) metronidazole
2) certain cephalosporins
3) griseofulvin
4) procarbazine
5) 1st generation sulfonylureas
259
Drugs associated with nephrotoxicity/ototoxicity?
1) aminoglycosides
2) vancomycin
3) loop diuretics
4) cisplatin
260
What can you treat cisplatin toxicity with?
Amifostine
261
CYP 450 inducers
1) *Chronic* alcohol
2) *St. John's wort
3) phenytoin
4) phenobarbital
5) nevi rapine
6) rifampin
7) griseofulvin
8) carbamazepine
262
CYP-450 substrates
1) Anti-epileptics
2) theophylline
3) warfarin
4) OCPs
263
CYP-450 inhibitors
1) acute alcohol abuse
2) ritonavir
3) amiodarone
4) cimetidine/ciprofloxacin
5) ketoconazole
6) sulfonamides
7) isoniazid
8) grapefruit juice
9) quinidine
19) macrolides (*except azithromycin)
264
sulfa allergic reaction presentation...
fever + UTI + SJS + hemolytic anemia + thrombocytopenia + agranulocytosis + urticaria
265
Sulfa drugs
1) sulfonamide antibiotics
2) sulfasalazine
3) probenecid
4) furosemide
5) acetazolamide
6) celecoxib
7) thiazides
8) sulfonylureas
266
-azole suffix means...
ergosterol synthesis inhibitor
267
-cillin means...
peptidoglycan synthesis inhibitor
268
-ivir suffix means...
neuraminidase inhibitor (oseltamivir)
269
-ovir suffix means..
DNA polymerase inhibitor (acyclovir)
270
-ane suffix means
inhalation general anesthetic
271
thioridazine
typical antipsychotic (ends in -azine)
272
-caine means...
local anesthetic
273
-etine means...
SSRI
274
-curium, -curonium
*nondepolarizing paralytic
275
atracurium, vecuronium
non depolarizing paralytics
276
-terol means...
Beta2 agonist
277
prazosin
alpha *1 antagonist
278
-afil means...
PDE-5 inhibitor
279
-dipine means..
dihydropyridine Ca2+ channel blocker
280
-xaban means...
direct factor Xa inhibitors
281
examples of factor Xa inhibitors
1) apixaban
2) edoxaban
3) rivaroxaban
282
-glitazone means...
PPAR-gamma activator
283
Example of PPAR-gamma activator
Rosiglitazone
284
-prost means...
prostaglandin analog
285
-tidine means
H*2 antagonist
286
-tropin means
pituitary hormone
287
-ximab means...
Chimeric monoclonal Ab (eg basiliximab)
288
-zumab means
Humanized monoclonal Ab (daclizumab)
289
daclizumab vs. basiliximab
Basiliximab is a chimeric monoclonal Ab, daclizumab is a monoclonal Ab.
290
ergot alkaloids
bromocriptine + cabergoline
291
nitrosoureas
Carmustine
Lomustine
Semustine
Streptozocin
292
NNRTIs
Delaviridine
Efavirenz
Nevirapine
293
Cholinergic effects
o Code: Coleen: Huge red inflatable car man to left + she’s in a gocart with nitrous boosters (nitric oxide code)/receptors present on endothelial surface of peripheral blood vessels. Binding promotes release of NO, thus producing vasodilation. NO activates guanylate cyclase and increases intracellular cGMP. She’s shitting on a towel + drenched in sweet + crying + salivating saliva everywhere + brady in passenger seat + neon eyes/effects = increase tone of smooth muscle of visceral walls + increase motility and secretion in GI tract, manifesting as nausea + vomiting + abdominal cramps + diarrhea + sweating + lacrimation + decreased contractility of heart + decreased conduction velocity + pupillary constriction (via M3 agonism). /decreased conduction velocity may result in heart block. Fizz cartoon and sally cooper resuscitating colleen + waving fan over her on the left/antidote = physostigmine salicylate + control hyperthermia. Erin in car next to brady/NOTE vasodilation can result in baroreceptor-mediated tachycardia.
o Location: Entryway
