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Uworld Journal > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q 
Gentamycin
Neomycin
Amikacin
Tobramycin
Streptomycinn
Paromycin
A

Aminoglycosides

Bactericidal, inhibit 30S, only works in aerobes

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2
Q

What effect does Omeprazole have on various drugs?

A

Omeprazole is a PPI which lowers the acidity of the stomach (increases pH)

This can affect the absorption of some drugs.

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3
Q
  • Diphenhydramine
  • Dimenhydrinate
  • Chlorpheniramine
A

First generation H1 blockers (antihistamines)

anti-allergy, induce drowsiness, anti-motion sickness

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4
Q
  • Loratadine
  • Fexofenadine
  • Desloratadine
  • Cetirizine
A

Second generation H1 blockers (antihistamines)

do not cross BBB

anti-allergy only

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5
Q

Cyclophosphamide mechansim of action

A

cross-links DNA at guanine N-7 -> inhibiting DNA replication

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6
Q
  • Sertraline
  • Paroxetine
  • Fluoxetine
  • Citalopram
A

SSRI - blocks re-uptake of serotonin only

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7
Q
  • Venlafaxine

- Duloxetine

A

SNRI - blocks re-uptake of serotonin and NE

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8
Q

Urinary urgency means =

What do you give to treat?

A

Urinary urgency means the bladder is over-contracting.

Give them a muscarinic receptor antagonist to relax the detrusor contraction.
ex)atropine, oxybutamine, tolterodine, solifenacin

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9
Q

Excess urination - elevated Ach or decreased Ach

A

elevated Ach

Parasympathetics make you Pee

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10
Q

Cilostazol =

A

phosphodiesteraes inhibitor - inhibits platelet aggregation + direct vasodilation

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11
Q

Reye syndrome of the liver on light microscopy =

A

microvesicular steatosis + reduced number of mitochondria + decreased amount of glycogen

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12
Q

acetaminophen toxicity on LM

A

centrilobular hepatic necrosis

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13
Q

Treatment for TCA overdose =

A

Sodium bicarbonate

Treats the cardiac toxicity by increasing pH and increasing intracellular Na therefore alleviating the VG Na blockade
(fixes the widening of the QRS)

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14
Q

D-penacillamine is a treatment for?

A

Copper overload

used for chelation

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15
Q

Deferoxamine is a treatment for?

A

Iron overload

used for chelation

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16
Q

EDTA and Dimercaprol are treatments for?

A

Lead overload

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17
Q

3 drugs for Absence seizures =

A
  • Ethosuximide = inhibits thalamic T type Ca channels
  • Valproate = increased Na channel inactivation + inhibits GABA transaminase
  • Lamotrigine = inhibits VG Na channels
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18
Q

Status Epilepticus treatments (first, second)

A

First: IV lorazepam = increased frequency of GABA-A channel opening - increases inward Cl current

Second: Phenytoin = increased Na channel inactivation - decreased Na current

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19
Q

How do opioids hyperpolarize neurons?

A

Increased K out, Decreased Ca in

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20
Q

Is glutamate excitatory or inhibitory?

A

excitatory!

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21
Q

Succimer is used for?

A

Lead chelation for children with lead toxicity

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22
Q

Clopidogrel, Parasugrel, Ticagrelor, Ticlopidine

A

ADP receptor inhibitors (P2-Y12 R)

Irreversible inhibition of platelet degranulation

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23
Q

Abciximab
Eptifibatide
Tirofiban

A

GPIIb/IIIa inhibitors -> inhibition of platelet aggregation

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24
Q

ACE inhibitor - hyperkalemia or hypokalemia?

A

Hyperkalemia due to inhibition of aldosterone - increased Na out, increased K in

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25
Q

K sparing diuretics = (4)

A

Spironolactone - mineralocorticoid antagonist
Eplerenone - mineralocorticoid receptor antagonist
Triamterene - inhibits ENaC
Amiloride - inhibits ENaC

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26
Q

Losartan
Candesartan
Valsartan

A

Angiotensin II Receptor Blockers (ARBs)

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27
Q

Diltiazem, Verapamil

A

Nondihydropyridine calcium channel blockers (L-type)

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28
Q

toxicity of: Cisplatin/Carboplatin

A
  • acoustic nerve damage
  • nephrotoxicity

mechanism of drug: cross links DNA

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29
Q

toxicity of: Vincristine

A

-peripheral neuropathy

mechanism of drug: vinca alkaloid, binds beta-tubulin -> inhibits polymerization into microtubules -> inhibits formation of mitotic spindle

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30
Q

toxicity of: Bleomycin, Busulfan

A

-pulmonary fibrosis

mechanism of Bleomycin: induces free radical formation -> DNA breaks
mechanism of Busulfan: cross links DNA

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31
Q

toxicity of: Doxorubicin

_ is used to prevent toxicity

A

-cardiotoxcity (dilated cardiomyopathy)

mechanism of drug: generates free radicals + intercalates DNA -> breaks in the DNA -> inhibits replication

Dexrazoxane (iron chelating agent) is used to prevent cardiotoxicity

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32
Q

toxicity of: Trastuzumab

A

-cardiotoxicity

mechanism of drug: monoclonal antibody against HER-2 (c-erbB2)

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33
Q

toxicity of: Cyclophosphamide

toxicity is reversible via administration of _ or _

A

-hemorrhagic cystitis (hematuria + suprapubic pain)

mechanism of drug: cross links DNA at N7 guanine

Partially reversible via mensa and N-acetylcystine

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34
Q

toxicity of: 5-FU, 6-MP, Methotrexate

A

-myelosuppression

5FU = pyrimidine analog -> (-)thymidylate synthase 
6MP = purine analog
Methotrexate = folic acid analog -> (-)dihydrofolate reductase
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35
Q

What do you give to someone who has urinary retention?

A

Urinary retention means their bladder is not contracting.

Give them a muscarinic agonist to help the detrusor contract.

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36
Q

Function of: mensa

A

Partially reverses toxicity of cyclophosphamide

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37
Q

Function of: Dexrazoxane

A

Iron chelating agent. Also to prevent cardiotoxicity from Doxorubicin.

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38
Q

Glusine
Aspart
Lispro

used for?

A

Rapid acting insulin

used for postprandial control

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39
Q

Neutral Protamine Hagedorn (NPH)

A

Intermediate acting insulin

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40
Q

Detemir
Glargine

used for?

A

Long acting insulin

Used for basal control

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41
Q

Chlorpropamide

Tolbutamide

A

First generation sulfonylureas = close the K+ channel on pancreatic beta cells -> -> release endogenous insulin (+ C peptide)

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42
Q

Disulfiram-like reaction occurs with what class of drugs? (5)

A
  • First generation sulfonylureas (Chlorpropamide, Tolbuamide)
  • Metronidazole
  • Certain Cephalosporins
  • Griseofulvin
  • Procarbazine

Do not drink alcohol while taking these drugs.

Disulfiram inhibits acetaldehyde dehydrogenase in the ethanol metatbolism pathway. Therefore, acetaldehyde accumulates resulting in the “hangover” symptoms.
Disulfiram is given to alcoholics to condition them to stop drinking alcohol.

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43
Q

Glimepiride
Glyburide
Glipizide

A

Second generation syulfonylureas = close the K+ channel on pancreatic beta cells -> -> release endogenous insulin (+ C peptide)

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44
Q

Repaglinide

Nateglinide

A

Meglitinides = close the K+ channel on pancreatic beta cells -> -> release endogenous insulin (+ C peptide)

Works just like sulfonylureas except these can be given to people with sulfa allergies

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45
Q

Pioglitazone

Rosiglitazone

A

Binds to PPAR-gamma (a nuclear transcription regulator)

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46
Q

Exenatide

Liraglutide

A

GLP-1 analogs = increase endogenous insulin release, decrease glucagon release

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47
Q

Linagliptin
Saxagliptin
Sitagliptin

A

Dipeptidyl Peptidase-4 inhibitors (DPP4) = increase endogenous insulin release, decrease glucagon release

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48
Q

Pramlintide

used for?

A

Amylin analog = decreases gastric emptying, decreases glucagon release

controls postprandial glucose spike

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49
Q

Canagliflozin

A

SGLT-2 inhibitor - works at the PCT

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50
Q

Acarbose
Miglitol

inhibitors of what enzyme?
used for?

A

alpha-glucosidase inhibitors - work at the intestinal brush border

controls postprandial glucose spike

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51
Q

Pegvisomant

A

Growth hormone receptor antagonist

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52
Q

Anastrozole
Letrozole
Exemestane

A

Inhibits aromatase enzyme -> decreases the peripheral conversion of androgens to estrogens

Used in the treatment of ER+ breast cancers.

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53
Q

Misoprostol (3 main uses)

A

PGE1 agonist

  • increased production and secretion of gastric mucous
  • maintains PDA
  • off-label use of labor induction (ripens cervix) or pregnancy termination
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54
Q

Fomepizole

A

Inhibits alcohol dehydrogenase

antidote for methanol or ethylene glycol poisoning

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55
Q

Rotenone

A

-inhibits complex I in the electron transport chain

decreases proton gradient and thus blocks ATP synthesis indirectly

rotenONE

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56
Q

Antimycin A

A

-inhibits complex 3 in the electron transport chain

decreases proton gradient and thus blocks ATP synthesis indirectly

“an-3-amycin”

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57
Q

Cyanide (CN) and CO

A

-inhibit complex IV (cytochrome oxidase) in the electron transport chain

decreases proton gradient and thus blocks ATP synthesis indirectly

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58
Q

Oligomycin

A

Directly inhibits the mitochondrial ATP synthase -> increases proton gradient but no ATP is produced

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59
Q

2,4-Dinitrophenol

A

Increases permeability of the mitochondrial membrane therefore causing a decreased proton gradient but an increased O2 consumption as the electrons continue to travel down the chain to try to build up the proton gradient. No ATP synthesis due to the decreased proton gradient.

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60
Q

Calcitriol

A

active Vitamin D

given to patients who are hypocalcemic

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61
Q

Alendronate, Risendronate

A

Bisphosphonates - structurally similar to pyrophosphate

-inhibits osteoclasts -> decreases calcium release from bone

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62
Q

Cinacalcet

A

Calcimimetic - stimulates Calcium sensing receptor which decreases PTH release

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63
Q

ADHD treatment (2)

A

Stimulants (Methylphenidate, Dextroamphetamine, Methamphetamine)
Clonidine (alpha-2 agonist)

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64
Q

Alcohol withdrawal treatment (1)

A

Long acting benzodiazepines

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65
Q

Bipolar disorder treatment (3)

A

Lithium
Valproate
Atypical anti-psychotics

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66
Q

Bulimia Nervosa treatment (1)

A

SSRI (Fluoxetine)

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67
Q

Depression treatment (1)

A

SSRI

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68
Q

Generalized anxiety disorder (2)

A

SSRI

SNRI

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69
Q

Obsessive Compulsive Disorder (2)

A

SSRI

Clomipramine (TCA)

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70
Q

Panic Disorder (3)

A

SSRI
Venlafaxine (SNRI)
Benzodiazepine

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71
Q

PTSD (2)

A

SSRI

Venlafaxine (SNRI)

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72
Q

Social phobias (4)

A

SSRI
Venlafaxine (SNRI)
To improve preformance: Beta-blockers, benzodiazepine

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73
Q

Tourette syndrome (3)

A

First generation anti-psychotics (Fluphenazine, Pimozide)
Tetrabenazine (inhibits VMAT -> decreased availability of dopamine)
Clonidine (alpha-2 agonist)

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74
Q 
Haloperidol
Triflupoerazine
Fluphenazine 
Chlorpromazine
Thioridazine

high potency vs low potency

A

First generation anti-psychotics (typicals)

High potency = Triflupoerazine, Fluphenazine, Haloperidol
“Try to Fly High”

Low potency = Chorpromazine, Thioridazine
“Cheating Thieves are Low”

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75
Q 
Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
Ziprasidone
A

Second generation anti-psychotics (atypicals)

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76
Q 
Amitriptyline
Nortriptyline
Imipramine
Desipramine
Clomipramine
Doxepin
Amoxapine
A

Tricyclic antidepressants - block re-uptake of NE and Serotonin, blocks H1 receptors, block alpha-1 receptors

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77
Q
  • Tranylcypromine
  • Phenelzine
  • Isocarboxazid
  • Selegiline
A

Monoamine oxidase inhibitors - increases levels of amine neurotransmitters in the synaptic cleft (NE, Serotonin, Dopamine)

Selegiline - is MOA-B selective

MAO-A also breaks down tyramine in the GI tract

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78
Q

Cyproheptadine

A

5HT-2 receptor antagonist

-treats serotonin syndrome

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79
Q

treatment for major depressive disorder that does NOT have sexual side effects

A

Buproprion - NE and dopamine reuptake inhibitor

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80
Q

Buspirone

  • mechanism
  • used to treat what
A
  • Stimulates 5HT-1A receptors (non-benzodiazapine anoxytic)
  • Used to treat Generalized Anxiety Disorder

Takes up to 2 weeks to take effect (slow onset)
No risk of tolerance, dependence or withdrawal

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81
Q

Benzodiazepines that do not need the liver to be metabolized (3)

A
  • Lorazepam
  • Oxazepam
  • Temazepam

“LOT”

These drugs undergo glucoronidation directly and therefore can be given to patients with impaired liver function

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82
Q

Long acting benzodiazepines (3)

A
  • Chlordiazepoxide
  • Diazepam
  • Flurazepam

Requires the liver to be metabolized

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83
Q

Short acting benzodiazepines (1)

A

-Triazolam

Requires the liver to be metabolized

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84
Q

Statins mechanism of action

A
  • inhibits HMG-CoA Reductase enzyme so less cholesterol is synthesized
  • increases LDL-receptors to pull more LDL molecules out of the serum (to try to get more cholesterol that way)

best at lowering LDL levels out of all the lipid lowering agents

MOST effective at preventing future cardiovascular events

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85
Q

Cholestyramine
Colestipol
Colesevelam

A

Bile acid resigns

-prevents intestinal absorption of bile acids
(so now the cells have to make more bile acids via cholesterol. the cholesterol-stores get used up quickly)
-increases LDL-receptors to pull more LDL molecules out of the serum (to try to get more cholesterol that way)

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86
Q

Ezetimibe

A

-prevents intestinal absorption of cholesterol
(so now the cells have to make more cholesterol. the cholesterol-stores get used up quickly)
-increases LDL-receptors to pull more LDL molecules out of the serum (to try to get more cholesterol that way)

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87
Q

Gemfibrozil
Clofibrate
Bezafibrate
Fenofibrate

A

Fibrates

  • activates PPAR-alpha -> upregulates LPL at extra-hepatic sites -> increased metabolism of VLDL and chylomicrons -> decreasing serum triglyceride levels
  • decrease VLDL released from the liver -> decreases circulating serum triglyceride levels
  • directly upregulates synthesis of HDL
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88
Q

Niacin (Vitamin B3)

A
  • decrease VLDL released from the liver -> decreases circulating serum triglyceride levels
  • raises HDL levels

MOST effective at raising HDL levels

89
Q

Volatile anesthetics increase or decrease cerebral blood flow?

A

Increase cerebral blood flow

but that is a bad thing because it increases intracerebral pressures

90
Q
  • Imipenem
  • Meropenem
  • Ertapenem
  • Doripenem
A

Carbapenem

  • broad spectrum beta-lactamase resistant
  • binds to PBPs
  • always administered with cilsastin
91
Q

Cilastin

A

inhibitor of renal dihydropeptdiase I

-administered with Carbapenems to decrease their inactivation

92
Q

Aztreonam

A

Monobactams

  • beta-lactamase resistant
  • binds to PBP-3
93
Q
  • Cefazolin

- Cephalexin

A

First-generation Cephalosporins

-beta-lactam drug - binds to PBPs

94
Q
  • Cefoxitin
  • Cefaclor
  • Cefotetan
  • Cefuroxime
A

Second-generation Cephalosporins

-beta-lactam drug - binds to PBPs

95
Q
  • Cefotaxime
  • Ceftazidime
  • Ceftriaxone
A

Third-generation Cephalosporins

  • beta-lactam drug- binds to PBPs
  • resistant to beta-lactamases
96
Q

-Cefepime

A

Fourth-generation Cephalosporins

  • beta-lactam drug- binds to PBPs
  • resistant to beta-lactamases
  • broad-spectrum
97
Q

-Ceftaroline

A

Fifth-generation Cephalosporins

  • beta-lactam drug- binds to PBPs
  • broad-spectrum
98
Q

Amoxicillin

A
  • beta-lactam drug - binds to PBPs

- beta-lactamase sensitive - can be combined with beta-lactamase inhibitors (Clavulanic Acid) to prevent this

99
Q
  • Dicloxacillin
  • Nafcillin
  • Oxacillin
A
  • beta-lactam drug - binds to PBPs

- beta-lactamase resistant due to their bulky R groups

100
Q
  • Piperacillin

- Ticarcillin

A
  • beta-lactam drug - binds to PBPs
  • beta-lactamase sensitive - can be combined with beta-lactamase inhibitors to prevent this
  • good to use against Pseudomonas and anaerobic bugs (Bacterioides)
101
Q

Clavulanic Acid
Sulbactam
Tazobactam

A

Beta-lactamase inhibitors

102
Q
  • Levofloxacin

- Moxifloxacin

A

Respiratory fluoroquinolones

-treat community-acquired pneumonia and walking pneumonia

103
Q 
Atazanavir
Darunavir
Fosamprenavir
Indinavir
Lopinavir
Ritonavir
Saquinavir
A

Protease inhibitors - prevent maturation of new viruses

-end in “navir”

104
Q 
Abacavir
Didanosine
Emtricitabine
Lamivudine
Stavudine
Tenoforvir
Zidovudine
A

NTRI - competitively inhibits nucleotide binding to reverse transcriptase and terminates chain elongation because these agents (nucleosides) lack a 3’OH group
-requires phosphorylation to be active

Tenofovir - nucleotide, therefore it does not need to be phosphorylated to be active

105
Q

Delavirdine
Efavirenz
Nevirapine

A

NNRTI - allosteric inhibition of reverse trascriptase therefore terminating chain elongation

-do not require phosporylation to be active

106
Q

Raltegravir

A

Integrase inhibitor - inhibits HIV integrating into the host cell chromosome

107
Q

Simepravir

A

HCV protease inhibitor (NS3/4A protease inhibitor)

-do not use as monotherapy

108
Q

Sofosbuvir

A

Inhibits HCV RNA-dependent RNA polymerase -> terminates chain elongation

  • nucleoside analog
  • do not use as monotherapy
109
Q

Adenosine

A

rapid coronary dilation

110
Q

Medication classes that should be avoided in hypertrophic cardiomyopathy (2)

A
  • Vasodilators: Dihydropyridine calcium channel blockers, Nitroglycerine, ACE inhibitors
  • Diuretics
111
Q

DVT treatment in pregnancy =

A

Enoxaparin (LMWH)

112
Q

High risk drugs for drug-induced lupus =

“Low grade fever + multiple joint pains + well demarcated erythematous rash on face and trunk + ANA positive + anti-histone positive”

A
  • Hydralazine
  • Procainamide
  • Isoniazid
  • Minocycline
  • Quinidine
113
Q

Patient who is aspirin intolerant is given _ to prevent further cardiovascular events

A

Clopidogrel - P2Y12 R inhibitor -> prevents platelet aggregation

114
Q

Tetrodotoxin

A

Binds fast VG Na channels in cardiac and nerve tissue

  • inactivates channels
  • does not change the resting potential

Poisoning - poorly prepared puffer fish

115
Q

Ciguatoxin

Main sfx

A

Opens VG Na channels -> depolarizaion

Temperature-related dysthesia (cold feels hot and hot feels cold) is specific

Poisoning - consumption of reef fish (barracuda, snapper, moray eel)

116
Q

Scombroid poisoning

A

Bacterial histinide decarboxylase turns histidine -> histamine

Histamine is not degraded by heat/cooking

acute onset burning of the mouth, flushing, erythema, anaphylais-like

117
Q

Scombroid poisoning treatment

A

anti-histamines

caused by a histamine overload

118
Q

Phenylephrine

A

alpha1 agonist > alpha2 agonist

  • increases MAP -> reflex bradycardia
  • increases diastolic P
  • increases systolic P

used to treat hypovolemic/distributive shock

119
Q

Norepinephrine

A

alpha1 agonist > alpha2 agonist > beta1 agonist

  • increases diastolic P
  • increases systolic P
  • increases MAP -> reflex bradycardia
  • increases cardiac contractility

used to treat hypovolemic/distributive shock

120
Q

Isoproterenol

A

beta1 agonist = beta2 agonist

  • increases cardiac contractility
  • decreases SVR
  • decreases diastolic P
  • decreases MAP
  • increases PP
  • increases HR
121
Q

Dobutamine

A

beta1 agonist > beta2 agonist

  • increases systolic P
  • decreases diastolic P
  • increases PP
  • decreases SVR
  • increases HR
  • increases cardiac contractility
  • increases CO

used to treat cardiogenic shock

122
Q

Epinephrine

A

beta agonist > alpha agonist
(at low doses)

  • increased cardiac contractility
  • increased HR
  • increased systolic P
  • decreased diastolic P
  • increased MAP
  • decreased SVR
  • increased PP

(at high doses) alpha agonist > beta agonist

123
Q

Amphetamines mechanism of action

A

-release stored catecholamines into the synapse

124
Q

Reserpine

A

inhibits VMAT -> neurotransmitters cannot be stored in pre-synaptic vesicles -> depletion of neurotransmitter stores

125
Q

Cocaine mechanism

A

inhibits DAT and NET -> increased concentration of NE and dopamine in the synapse

126
Q
  • Clonidine
  • alpha methyldopa
  • tizanidine
A

alpha2 agonists -> decreases sympathetic outflow

127
Q

beta blockers from a-m

A

beta1 > beta 2

“cardioselective”

128
Q

beta blockers from n-z

A

beta1 = beta2

“nonselective”

129
Q

alpha + beta blockers (2)

A
  • Carvedilol

- Labetalol

130
Q

Beers Criteria (5 main categories)

A

Anticholinergics:

  • First generation antihistamines
  • GI antispasmodics

Cardiovascular:

  • Antithrombotics
  • alpha blockers
  • central alpha agonists
  • antiarrythmics

CNS:

  • TCA
  • Anti-psychotics
  • Barbiturates
  • Benzodiazepine

Endocrine:

  • Sliding scale insulins
  • Sulfonylurease

Pain:

  • Indomethacin
  • Muscle relaxants
  • Meperidine
131
Q

Ranolazine

A

Used to treat angina refractory to other medical therapies

Mechanism: inhibits the late phase of Na current -> decreasing the diastolic wall tension and O2 consumption
No effect on HR or contractility

May prolong QT interval

132
Q

MI that is treated with coronary stenting is now in recovery. Patient keeps having repeated ventricular arrhythmias caused by the ischemic tissue. What drug is given? (2)

A

Class IB antiarrhythmics - Lidocaine - works especially well in ischemic ventricular tissue

Class III antiarrhythmics - Amiodarone - has class I, II, III, IV activity

133
Q

Antiarrhythmics that prolong QT

A

Class IA and Class III - Due to their effect on prolonging the ventricular action potential

This is why these classes have an increased risk for Torsades des Pointes

134
Q

What antiarrhythmic drugs can be used to treat WPW?

A

Class IA or III antiarrhythmics

The drugs that decrease AV node conduction (II, IV) will not have an effect due to the WPW being an accessory pathway

135
Q

Metolazone =

A

thiazide-type diuretic -> inhibits Na/Cl reabsorption in the early distal convoluted tubule

136
Q

What diuretic is given to treat altitude sickness?

A

Acetazolamide - inhibits CA

Causes metabolic acidosis (removal of HCO3) to counteract the respiratory alkalosis that occurs at high altitudes

137
Q

Bumetadine

Torsemide

A

Loop diuretics - inhibits Na/K/2Cl cotransporter

Also, in this class: Furosemide

138
Q

Aliskiren

A

Direct renin inhibitor (blocks conversion of angiotensinogen to angiotensin I)

Contraindicates in patients taking ACE-I or ARBs.

139
Q

oxybutamine, tolterodine, solifenacin

A

Reduce bladder spasms and urge incontenence

M3 antagonists -> decreases Ach activity

140
Q

Guaifenesin

A

Expectorant - thins respiratory secretions, does not suppress cough reflex

141
Q

What does N-acetylcysteine do in CF patients?

A

Mucolytic - loosens mucous plugs by disrupting disulfide bonds

142
Q

Dextromethorphan

A

Antitussive

  • antagonizes NMDA glutamate receptors
  • synthetic codeine analog
  • mild abuse potential
  • may cause serotonin syndrome
143
Q

Bosentan

A

endothelin receptor atangoinst -> decreases pulmonary vascular resistance -> vasodilation

treats pulmonary hypertenon

144
Q

Epoprostenol

Iloprost

A

Prostacyclin analogs - PGI2

145
Q

Albuterol - beta1 or beta2 agonist?

A

Beta2 agonist -> relaxes bronchial smooth muscle

146
Q

Ipratoprium

Tiotropium

A

muscarinic antagonist

-used to prevent bronchoconsriction

147
Q

Zileuton

A

5-lipoxygenase inhibitor -> decreased production of leukotrienes

148
Q

Timeline of glucocorticoid function in the treatment of asthma

A

Takes a few weeks to work

The good thing is oral glucocorticoids do not have the same sfx profile as systemic glucocorticoids (weight gain, etc)

149
Q

Side effect of albuterol for asthma treatment

A

Skeletal muscle tremors

150
Q

Pramiprexole
Bromocriptine
Ropinirole

A

Dopamine receptor agonists

  • First line parkinsons treatment
  • Restless leg treatment

Bromocriptine - Ergot
Pramiprexole (DR-3), Ropinirole (DR-2) - Non-ergot

151
Q

Amantadine

A

Increases dopamine release and decreases dopamine reuptake - Parkinson’s treatment for motor symptoms
Also used as an antiviral against Influenza A and Rubella

152
Q

Pralidoxime

A

Given to patients with organophosphate poisoning to reverse the Muscarinic and Nicotinic receptor overstimulation. Only works if given early after the exposure.

Mechanism: restores cholinesterases therefore they can breakdown Ach

153
Q

Baclofen

A

GABA-B receptor antagonist

Used in the treatment of spasticity seen in MS

154
Q

Treatment and cause of Neuroleptic Malignant Syndrome

A

Cause: overdose of antipsychotic medications
-diffuse muscle rigidity, high fever, hypertension, tachycardia, altered sensorium, rhabdomyolysis (elevated CK)

Treatment: Dantrolene

155
Q

Treatment resistant Schizophrenia is treated with

A

Clozapine - second generation antipsychotic

156
Q

Treatment for the behavioral and psychotic manifestations of delerium?

A

Low dose antipsychotics (Haloperiodol)

157
Q

Majority of overdose deaths in the U.S. are caused by _

A

Opioids - heroin and prescription analgesics

158
Q

Function of methadone

A
  • Long half life
  • Mu full agonist
  • Good oral bioavailability
  • Suppresses withdrawal and cravings
159
Q

N-methyl-D-aspartate Receptor antagonist =

A

PCP (Phencyclidine)

160
Q

TNF-alph inhibitors - used for OA or RA treatment?

A

RA

161
Q

Treatment for dermatomyositis or polymyositis

A

steroids followed by long-term immunosuppressants (methotrexate)

162
Q

Inhibition of xanthine oxidase by a, increases the concentration of the active metabolite of of b.

A 
a = allopurinol
b = azathioprine

azathioprine -> 6MP -> active metabolite -> inhibition of purine synthesis

163
Q 
Tubocurrarine
Atracurium
Micacurium
Pancuronium
Vecuronium
Rocuronium
A

Competitive nondepolarizing antagonist of Nicotinic R

  • compete with Ach for receptors
  • to reverse blockade - cholinesterase inhibitors
164
Q

Depolarizing neuromuscular blocking drug (1)

A

Succinylcholine

  • Ach R agonist -> sustained depolarization prevents muscle contraction
  • Phase I - prolonged depolarization, no antidote
  • Phase II - reploarized but blocked, receptors are available but desensitized, cholinesterase is antidote
  • sfx: hypercalcemia, hyperkalemia, malignant hyperthermia
165
Q

HLAB57O1 allele corresponds with a negative reaction to _

A

Abacavir - stimulates a delayed type IV hypersensitivity reaction

166
Q

Why is celecoxib better than other NSAIDs?

A

GI protective. Does not block COX1 therefore the Gastric mucosa protection (via prostaglandins) is maintained.

Good for people who have a history of peptic ulcer disease.

167
Q

What hyperlipidemia drug has the sfx of gouty arthritis?

A

Niacin (B3) -> decreases the renal excretion of uric acid

168
Q

Main side effect of sulfonylureas? (2)

A
  • weight gain
  • hypoglycemia - dangerous in the elderly

2nd generation glyburide and glimepiride are long acting - have a higher risk for hypoglycemia
2nd generation glipizide is short acting - has a slightly less risk for hypoglycemia

169
Q

Is tamoxifen used to treat a post-menopausal woman with osteoporosis?

A

NO

Tamoxifen is a SERM - can provide some bone protection in post-menopausal women who are also fighting ER+ breast cancer but due to its bad effects on the endometrium, it is not given as a first line osteoporosis treatment to non-breast cancer women

  • antagonist in breast
  • agonist in bone
  • partial agonist in endometrium
170
Q

What drugs can be given to treat osteoporosis in post-menopausal women? (4)

A

Bisphosphonates - inhibit osteoclast activity

Raloxifene - SERM

  • antagonist in breast
  • agonist in bone

Denosumab - RANK-L monoclonal antibody

Teraparatide - PTH analog

171
Q

Patient with grave’s disease on long term antithyroid medication presents with a fever + sore throat. What is the main sfx concern?

A

Main SFX of thionamides (propylthiouracil/methimazole) is agranulocytosis
-absolute neutrophil count is less than 500

172
Q

Oral fidaxomicin

A

recurrent cases of C. diff infections

part of the macrolide family

173
Q

Sulfasalazine

A

Combination drug of sulfapyridine (antibacterial) + 5-aminosalicylic acid (anti-inflammatory)

First line for ulcerative colitis

174
Q

Arsenic poisoning/overload treatment?

A

Dimercaprol chelation

175
Q

Carcinoid treatment

A
  • Octreotide - somatostatin analog

- Surgery

176
Q

Treatment of lyme disease in pregnancy

A

Amoxicillin

Normal (non-pregnancy) treatment of Lyme Disease is doxycycline but this has teratogenic effects (teeth staining)

177
Q

Mifepristone (RU-486)

A
  • progesterone antagonist (->necrosis of the uterine decidua)
  • glucocorticoid antagonist
178
Q

Flutamide

A

competitive inhibitor at androgen receptors

used in the treatment of prostate cancer

179
Q

Minodixil

A

Direct arteriolar vasodilator
Used for androgenic alopecia or severe refractory HTN

sfx: sympathetic activation and RAAS activation

180
Q

Clot busting of an ST elevated MI

A

Fibrinolytic drugs - useful if given within 6 hours of onset

Two classes fibrin specific (attacks fibrin that is attached to a clot only) or non-fibrin specific (ex: Streptokinase)

SFX: may cause re-perfusion arrhythmia but these are usually benign

181
Q

Argatroban
Lepirudin
Hirudin

A

Direct thrombin inhibitors (Factor II)

-Used to treat Heparin Induced Thrombocytopenia

182
Q

Rasburicase

A

recombinant version of urate oxidase
(uric acid -> allantoin)

given to help prevent the hyperuricemia of tumor lysis syndrome

183
Q

Antidote for cyanide poisoning

A

Inhaled amyl/sodium nitrite

Cyanide inhibits cytochrome c oxidase in the ETC.

Amyl nitrite oxidizes Hb Fe2+ -> Fe3+ (methemoglobin) which has a high affinity for cyanide and can bind it up so that the cyanide cannot bind to the ETC.

184
Q

Triptans

  • mechanism
  • contraindications
A

serotonin (5HT 1b/1d) agonists)

  • inhibit release of vasoactive peptides
  • promote vasoconstriction
  • block pain pathways in brainstem

should be avoided in patients with cardiac or cerebrovascular disease

185
Q

Nitroprusside toxicity

A

Cyanide poisoning leading to sulfur depletion

  • CN -> (-) ETC cytochrome oxidase
  • altered mental status, seizures, cardovascular collapse, lactic acidosis, bright red blood
  • CN metabolism occurs by transferring a sulfur group onto it
  • Eventually sulfur stores are depleted, give sodium thiosulfate for antidote
186
Q

Valproate teratogenicity

A

neural tube defects

187
Q

Ramelteon

A

melatonin receptor agonist

  • safe in older adults
  • few side effects
  • melatonin receptors are in the chiasmatic nucleus
188
Q

Phenylephrine
Xylometazoline
Oxymetazoline

A

topical treatment of allergic rhinitis

alpha-agonists

189
Q

Flumazenil

A

Antidote for Benzodiazepine, Nonbenzodiazepine hypnotic overdose

  • competitive antagonist at GABA benzodiazepine receptor
  • may precipitate seizures
190
Q

Beta blocker overdose treatment?

A

Glucagon

191
Q

Copper, Arsenic, Gold OD treatment?

A

Penacillamine

192
Q

Methemoglobin toxicity treatment

A

Methylene blue, Vitamin C

193
Q

Salicylates toxicity treatment

A

NaHCO3 + dialysis

-alkalinizes the urine

194
Q

Aminocaproic acid is used for?

A

tPA, Streptokinase, Urokinase reversal

195
Q

Warfarin reversal?

A
  • Vitamin K - delayed effect

- Fresh frozen plasma - immediate

196
Q

Timolol acts where when treating open-angle glaucoma?

A

Acts on the the ciliary epithelium.

  • nonselective beta-blocker
  • decreases aqueous humor production
197
Q

Acetazolamide works via what mechanism to treat open-angle glaucoma?

A

Decreases aqueous humor production from the ciliary epithelium

198
Q

Lantanoprost, Travoprost work via what mechanism to treat open-angle glaucoma?

A

Prostaglandin agonists (PG2-alpha)

Increase aqueous humor outflow and therefore decreases intraocular pressure

199
Q

Pilocarpine, Carbachol work via what mechanism to treat open-angle glaucoma?

A

(direct) Cholinomemetics

Increase aqueous humor outflow via contraction of ciliar muscles and opening of trabecular meshwork, therefore decreases intraocular pressure

sfx: miosis, cyclospasm

200
Q

Brimonidine’s mechanisim for treatment of open-angle glaucoma

A

alpha-2 agonist

-acts at ciliary body - decreases aqueous humor synthesis

201
Q

IL-2 can be used as treatment for what 2 cancers?

A
  • Renal cell carcinoma

- Melanoma

202
Q

Infliximab

A
  • chimeric human/mouse antibody to TNF-alpha
  • used in treatment of RA, ankylosing spondylitis, Crohn’s disease
  • anti-TNF-alpha
203
Q

Gabapentin

A

Inhibits (active) VG Ca channels

  • GABA analogue
  • used to treat painful diabetic neuropathy, fibromyalgia, post-herpetic neuralgia, simple seizures
  • sfx: ataxia, confusion
204
Q

First line treatment for trigeminal neuralgia

A

Carbamazepine = increaes Na channel inactivation

-sfx: myelosuppression/agranulocytosis

205
Q

Etanercept

A

recombinant TNF receptor fusion protein (anti-TNF-alpha)

206
Q

How does lactulose work?

A

acidifies the contents of the GI tract -> NH3 diffuses into GI and turns into NH4+ and now gets trapped

207
Q

Mechanism: Inhibition of peptidoglycan synthesis via the blockade of transpeptidation enzymes
Use: to prevent PID

What drug?

A

Ceftriaxone

transpeptidation enzymes = PBPs

208
Q

Cyclosporine

A

Calcineurin inhibitor - blocks IL-2 transcription

  • binds to cyclophilin
  • used for transplant rejection prophylaxis, psoriasis, RA
  • sfx: nephrotoxic (dose dependent)
209
Q

Tacrolimus (FK506)

A

Calcineurin inhibitor - blocks IL-2 transcription

  • binds to FKBP
  • used for transplant rejection prophylaxis
  • sfx: nephrotoxic
210
Q

Metoclopramide
mechanism?
contraindications?

A

D2 receptor antagonist

  • prokinetic agent, does not influence colonic transport time
  • contraindicated in parkison’s patients or patients with small bowel obstruction
211
Q

Calcipotriol

A

Vitamin D analog used to treat psoriasis

-topical

212
Q

Acitretin

A

Retinoid

  • used to treat psoriasis, acne, photoaging, some skin neoplasms
  • this is preferred for psoriasis
  • teratogenic - should not conceive for up to 3 years after stopping
213
Q

Orlistat

A

Inhibits pancreatic and gastric lipase -> decreases breakdown and absorption of dietary fats
Used for weightloss
sfx: diarrhea, steatorrhea,

214
Q

danazol

A

androgen used to suppress FSH and LH release by the pituitary

215
Q

Treatment of sexual dysfunction caused by mumps induced orchitis

A

Testosterone

orchitis -> leydig cell atrophy -> decreased production of T -> sexual dysfunction

216
Q

Paclitaxel coated stent does what?

A

causes cell cycle arrest in the M phase -> inhibits cellular division -> prevents stent re-stenosis by preventing intimal hyperplasia

217
Q

patient on furosemide who experiences excessive urination and occasional weakness and cramps

A

Furosemide sfx

  • increased dilute urine production
  • hypokalemia (and contraction metabolic alkalosis)
218
Q

Vemurafenib

A

BRAF kinase inhibitor

  • used to treat metastatic or unresectable melanoma
  • specific for BRAF V600E
219
Q

direct arterial vasodilators (2)

-sfx

A
  • Hydralazine
  • Minodixil

sfx:
-reflex sympathetic and RAAS activation -> increases Na and fluid retention

Uworld Journal (12 decks)

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