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Rx - Month 1 (Nov - Dec) > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the 1st line treatment for oral candidiasis?

A

Nystatin

Works just like Amphotericin B

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2
Q

T or F: Tinnitus is one of the potential adverse effects of aspirin

A

True

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3
Q

A physician prescribe an inhaler that may cause episodes of tremor and palpitations?
• What 2 drugs would this likely be?
• what is the difference?

A

Salmeterol/Formoterol - long acting (up to 12 hours, but takes a bit to kick in )

Albuterol - shorter acting (3-6 hours)

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4
Q

What is the MOA and typical clinical use of Filgastrim?

A

MOA:

• G-CSF to promote bone growth to aid in bone marrow recovery after myelosuppressive therapy

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5
Q

What is the use of Edrophonium in myasthenia gravis?

• what drug(s) is/are often used as treatment?

A

It is an Ach esterase inhibitor with a short duration of action and is only used in the diagnosis of the disease.

Pyridostigmine is the Ach esterase inhibitor of choice in myasthenia gravis

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6
Q

What is the MOA of tamsulosin?

• use?

A

selective alpha-1 blocker that gets concentrated in the bladder and prostate

Drugs Prazosin, terazosin, and doxazosin work similarly

***Remember these drugs can cause 1st dose orthostatic hypotension, dizziness and HA

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7
Q

Hydralazine
• MOA
• Association with pregnancy?
• Adverse Effects?

A

MOA:
• Increases cGMP leading to smooth muscle relaxation and vasodilation

1st line tx for hypertension in pregnancy (even though I’ve also heard methyldopa)

Adverse Effects:
• Reflex Tachycardia, Lupus Like Syndrome

*To prevent reflex tachycardia give this drug with a Beta Blocker

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8
Q

What loop diuretic should be used in people allergic to sulfa drugs?

A

Ethracrynic acid

Works just like furosemide (Na/K/2Cl inhibition) but is MORE OTOTOXIC

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9
Q

What is Lamotrigine used for?

• how is it thought to work?

A

Blocks voltage-gate Na+ channels and is used as an ANTI-EPILEPTIC.

**Used more commonly in the outpatient setting than phenobarbital b/c phenobarbital (that acts on GABA) is heavily sedative

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10
Q

Amiodarone
• MOA
• Toxicity

A

MOA: Class III (potassium channel) antiarrythmic
•Blocks Calcium Channels that are used in phase III DEPOLARIZATION of the cardiac AP
Not being able to depolarize increases AP duration and QT interval

Toxicity: 
• HYPOTHYROIDISM (mimics thyroxine and acts as antagonist) 
•Pulmonary Fibrosis
• Blue-gray Skin discoloration
• Corneal Deposits
• Hepatotoxicity
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11
Q

What drugs act as integrase inhibitors in HIV therapy?

A

RalTEGRAavir
ElviTEGRAavir
DoluTEGRAavir

These prevent HIV from inTEGRAting its genome into host chromosomes

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12
Q

How can you recognize protease inhibitors used in HIV therapy?
• Adverse effects?

A

-NAVIR = protease inhibitors
• Inhibit the protease that is needed to cleave HIV proteins into functional products (pol gene = protease)

These can cause Hyperglycemia, GI problems, Lipodystrophy (Cushing’s Like)

NEPHROPATHY is common Indinavir

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13
Q

What’s another name for vitamin B6?

• what TB therapy drug depletes this?

A

Pyridoxine = Vit B6

Isoniazid depletes B6 by creating adducts with B6

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14
Q

Isoniazid
MOA
ADVERSE EFFECTS

A

Metabolized by KatG (TB enzyme) to create free radical that forms adducts with B6 in the bacterium to INHIBIT MYCOLIC ACID SYNTHESIS

AE’S
• Hepatotoxic
• SLE
• B6 deficiency

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15
Q 
Digoxin
• MOA
• Indication
• Adverse Effects
• Antidote
A

MOA
• Direct inhibition of Na+/K+ ATPase => Indirect inhibition of the Na/Ca exchanger that pumps Ca out of the cell => Increased Ca gradient and increased ionotropy
• Stimulates Vagus n. leading to decreased HR

Indication:
• HF, A-fib

Adverse Effects:
• N/V/D blurry yellow vision, arrhythmia, AV block
• Hyperkalemia (keeps K from getting into cells)
• DRUGS that displace Digoxin from its binding sites: VERAPAMIL, AMIODARONE, QUINIDINE.

Antidote:
• Mg
• Normalize K+
• Digoxin antibody (Fab)

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16
Q

What type of cardiomyopathy are loop diuretics indicated for?
• explain.

A

DILATED CARDIOMYOPATHY (90% of cardiomyopathy) calls for Loop Diuretics

• dilated cardiomyopathy is systolic dysfunction - reducing fluid reduces the stress put on the heart in systole

17
Q

Which TB drug is known to cause aberrations in vision?

A

Ethambutolol

18
Q

What is the MOA of imatinib?

A

Used in CML because it binds to the BCR-abl fusion protein

19
Q

How do you treat Heparin TOXICITY?

A

Protamine Sulfate

Remember before surgery patients on warfarin are typically transferred to heparin

20
Q

How do you treat Heparin Induced Thrombocytopenia (HIT)?

A

HIT - IgG antibodies against PF4 (heparin bound platelet factor 4) this leads to platelet activation and widespread hemolytic anemia. This typically take 5 days or so to develop (assuming there as been prior exposure?)

HEPARIN SHOULD BE CONTINUED (b/c clearly thrombosis is an issue)

THROMBIN (factor II) inhibitors like ARGOTROBAN, BIVALIRUDIN and LEPIRUDIN should be given to stop thrombosis

THIS IS VERY IMPORTANT

21
Q

Always give Amphotericin B + __________ before fluconazole in cryptococcal infections

A

Flucytosine is given along with Amphotericin because it crosses the BBB

22
Q

What is the first line treatment of pneumocystis jirovecii?

• what if the person is allergic?

A

1st line: TMX-SMX

2nd line: Pentamidine

23
Q

What is Aminocaproic acid used for?

A

Used to reverse thrombolytic effects of Streptokinase urokinase, and tPA because it INHIBITS FIBRINOLYSIS

Basically only use this if you fucked up and gave too much clot buster and the patient starts bleeding out

24
Q

Methimazole
• MOA
• Indication
• Contraindication

A

MOA:
• Inhibits thyroid peroxidase (similar to PTU)

Indication:
• Hyperthyroidism

Contraindication:
• Pregnancy (known teratogen, think cretenism)

25
Q

What ion is likely to be elevated in Digitalis Toxicity?

• MOA of Digitalis?

A

K+ is likely to be elevated in digitalis toxicity because of inhibition of Na/K ATPase that normally sequesters K into cells.

Digitalis works by increasing intracellular Na+ that is exchanged for Ca2+ at the cell membrane in myocytes. (exchanger works by pumping Ca2+ out and Na+ in along its concentration gradient - remember Na+ is mostly extracellular). This leads to decreased Na/Ca exchange and more intracellular Ca during systole (+ ionotropy).

26
Q

What is the MOA of dantroline?

A

Prevents release of Ca from the SR

27
Q

What drugs are known to INDUCE CYP3A4?

A

Barbiturates, carbamazepine, corticosteriods, griseofulvin, phenytoin, pioglitazone, rifampin, rifabutin

**St. John’s warts also induces CYPs

These can reduce the efficacy of birth control

28
Q

`How does Acetozolamide work to lower blood pressure and reduce the effects of altitude sickness?

A

Acetazolamide works on carbonic anhydrase in the LUMEN of the renal tubules to prevent HCO3- from getting back in (this would happen by way of HA catalyzing conversion of HCO3- and H+ into H2O and CO2 that can cross back into the tubules and be reabsorbed in the blood as H+ and HCO3-)

Alkalosis is counteracted by promoting HCO3- secretion. Also, since HCO3- is an ion it draws more H2O into the lumen of the tubules and increases diuresis to d

29
Q

Which part of the coagulation cascade does Warfarin act on (intrinsic or extrinsic)?
- what test do we use to monitor warfarin?

A

Warfarin is monitored using the PT and it affects the Extrinsic Cascade

30
Q

What metabolite is increased in the urine in lead poisoning?

A

Delta ALA (aminolevulinic acid)

31
Q

What what are the long acting insulin?

A

Determir and Glargine

32
Q

What medications might an otherwise healthy diabetic be taking that cause a disulfram-like effect?

A

1st generation sulfonurea potassium channel blockers that lead to increased insulin vesicle fusion

These are:
Chlorpropamide
Tolbutamide

33
Q

What is the most important of 2nd generation sulfonureas?

A

HYPOGLYCEMIA

Drugs: Glimepiride, glipizide, and glyburide (the G-ides)

not really ass’d with a disulfram-like effect like the 1sts generations

34
Q

What drugs should you associate immediately with a disulfram-like effect?

A
  • Metronidazole
  • Procarbazine
  • Cephalosporins (only some of them)
  • 1st generation Sulfonureas
35
Q

How can you differentiate hypokalemic, hyponatremic, metabolic acidosis caused by thiazide and loop diuretics?

A

Thiazide Diuretics cause hypOcalcinuria while Loop Diuretics cause HypErcalcinuria

Rx - Month 1 (Nov - Dec) (9 decks)

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