Brainscape's Knowledge GenomeTM

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


See full index

USMLE Step 1 > Pharmacology > Flashcards

Pharmacology Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Selegiline class, mechanism

A

MAO-B inhibitor, MAO-B metabolizes dopamine, slows the breakdown of dopamine

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

MAO-A inhibitors mechanism

A

preferentially slows the breakdown of norepinephrine and serotonin

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

Levidopa mechanism

A

dopamine precursor, increases circulating dopamine levels in the striatum
(given in combination with carbidopa, peripheral decarboxylase inhibitor, increases peripheral DA)

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

Three dopamine receptor agonists

A

bromocriptine
ropinirole
pramipexole

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

Benztropine and trihexyphenidyl drug class

A

antimuscarinic agents

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

Common sulfa drugs

A

Sulgonylureas: glyburide
NSAIDs: celecoxib
Diuretics: chlorthalidone, furosemide, bumetanide, (-amide, -ide)
Anticonvulsants: Zonisamide, Topiramate
Others: Bosentan, defetilide, dronedarone

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

Drug that damages DNA by forming toxic free radical metabolites

A

Metronidazole

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

Aminopenicillins and spectrum

A

Amoxicillin, ampicillin (penicillinase-sensitive)

H.influenzae
H.pylori
E.coli
Listeria
Proteus
Salmonella
Shigella
enterococci
Triple-therapy for H.pylori
Early stage or young Lyme Disease
coverage in asplenic or dental procedure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drugs that Interrupt Cell Wall Synthesis

A 
Glycopeptides (peptidoglycan synthesis)
Penicillins + Antipseudomonals
Cephalosporins
Carbapenems
Monobactams
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Penicillinase-resistant penicillins + Spectrum

A

Dicloxacillin
Nafcillin
Oxacillin

S.aureus (naf for staph) except MRSA

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

Drugs that interrupt folic acid synthesis

A

Sulfonamides

Trimethoprim

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

Antipseudomonals

A

Piperacillin, Ticarcillin

Same mechanism of penicillins with coverage for Pseudomonas and gram negative rods
Add a B-lactamase inhibitor

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

Drugs that inhibit prokaryotic enzymes topoisomerase II and IV, DNA gyrase

A

Fluoroquinolones (ciprofloxacin, etc)

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

B-lactamase inhibitors

A

Clavulanic Acid
Sulbactam
Taxobactam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mechanism of penicillin

A

Bind penicillin-binding proteins (transpeptidases), block transpeptidase cross-linking of peptidoglycan in the cell wall, activate autolytic enzymes

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

Mechanism of Cephalosporins

A

B-lactam drugs that inhibit cell wall synthesis and peptidoglycan cross-linking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Coverage of penicillin

A

Gram positive organisms (S.pneumo, S.pyo, Actino)
Gram negative cocci (N.menin)
Spirochetes (T.pallidum)

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

1st generation cephalosporins + spectrum

A

Cefazolin, cephalexin

Gram positive cocci + Proteus, E.coli, Klebsiella

Pre-surgical prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2nd generation cephalosporins + spectrum

A

cefoxitin, cefaclor, cefuroxime

1st gen + Haemophilis inf, Enterobacter, Neisseria, Serratia

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

3rd generation cephalosporins + spectrum

A

ceftriaxone (meningitis, gonorrhea, Lyme)
cefotaxime
ceftazidime (Pseudomonas)

serious gram negative infections resistant to other B-lactams

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

4th generation cephalosporins + spectrum

A

Cefepime

Pseudomonas

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

5th generation cephalosporins + spectrum

A

Ceftaroline

broad gram + and gram - including MRSA, not pseudomonas

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

Resistance to cephalosporins is based on

A

Structural change in penicillin-binding proteins (transpeptidases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vancomycin mechanism and clinical use

A

Inhibits cell wall peptidoglycan formation by binding D-ala-D-ala, not susceptible to B-lactamases

Gram positive only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Carbapenems mechanism and clinical use

A

inhibit cell wall synthesis, administer imipenam with cilastatin to decrease renal tubule inactivation

Use in life-threatening infections or after drug failure due to severe side effects: GI distress, skin rash, CNS toxicity/seizures

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

Amphotericin B mechanism and use

A

Bind ergosterol –> pores in membrane

Systemic mycoses or Intrathecally for fungal meningitis
Supplement K+ and Mg2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Nystatin mechanism and use

A

Bind ergosterol –> pores in membrane

Topical use only: oral candidiasis, diaper rash, vaginal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Azoles mechanism and use

A

Inhibit fungal ergosterol synthesis via 14-a-demethylase/P450 enzyme

Local/less serious systemic mycoses:

  • chronic suppression of cryptococcal in AIDS
  • chronic suppression candidal infections
  • topical fungal infections
  • SE testosterone inhibition, liver dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Echinocandins drugs, mechanism, use

A

-fungin

Inhibit cell wall synthesis of B-glucan

Invasive aspergillosis, candida

  • SE GI upset, flushing (histamine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Flucytosine mechanism, use

A

Inhibit DNA/RNA synthesis by conversion to 5-fluorouracil by cytosine deaminase

Use for systemic infections in combination with amphotericin B

  • SE: bone marrow suppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Griseofulvin mechanism, use

A

Interferes with microtubule function, disrupts mitosis, deposits in keratin containing tissues (nails)

Oral treatment of superficial infections, inhibits growth of dermatophytes (tinea, ringworm)

  • SE: teratogenic, carcinogenic, confusion, headaches, increased P-450 and warfarin metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Oseltamivir, Zanamivir mechanism, use

A

Inhibit influenza NEURAMINIDASE –>
Decrease release of progeny
Use in first 48 hours

Treat/prevent Influenza A & B

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

Acyclovir, Famciclovir, Valacyclovir mechanism, use

A

Inhibit viral DNA polymerase by chain termination
(Guanosine analogs monophosphorylated by viral thymidine kinase –> mechanism of resistance)

Use for HSV and VZV, weak EBV
Prophylaxis in immunocompromised, no effect on latent

Valacyclovir = prodrug acyclovir (better oral bioavailbility)

  • SE crystalline nephropathy, acute renal failure
    (prevent with hydration)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Ganciclovir mechanism, use

A

Inhibit viral DNA polymerase by chain termination
(Guanosine analog 5’ monophosphate formed by CMV viral kinase –> mechanism of resistance)

Use for CMV, especially in immunicompromised

Valgancyclovir = prodrug ganciclovir (better oral bioavailability)

  • SE leukopenia, neutropenia, thrombocytopenia, renal toxicity, more toxic to host than acyclovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Foscarnet mechanism, use

A

Viral DNA/RNA polymerase inhibitor, HIV reverse transcriptase inhibitor, binds to pyrophosphate-binding site or enzyme

Use in CMV retinitis if ganciclovir fails, in acyclovir-resistant HSV

  • SE nephrotoxicity, electrolyte abnormalities can lead to seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

CYP450 Inhibitors

A

Increase warfarin effect –> increase bleeding

PICK EGS (protease inhib, isoniazid, cimetidine, erythromycin, grapefruit juice, sulfonamides)

Acetaminophen, Azoles, Amiodarone, Cimetidine, Clarithromycin, Cranberry juice, Fluoroquinolones, Fluoxetine, Ginkgo biloba, Grapefruit, Isoniazid, Omeprazole, Ritonavir, Thyroid Hormone

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

CYP450 Inducers

A

Decrease warfarin effect –> Clotting risk

Carbamezapine
Cyclophosphamide
Ginseng
Griseofulvin
Modafinil
OCPs
Phenobarbital + other barbs
Phenytoin
Rifampin
St. John's wort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Cholestyramine interaction with warfarin

A

Binds warfarin in intestine –> reduces uptake

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

High risk of drug-induced lupus

A 
Hydralazine
Procainamide
Isoniazid
Minocycline
Quinidine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Sulfonylureas, meglitinides mechanism, class, side effects

A

Mechanism: Inhibit B-cell K-atp channels, increase insulin secretion

“Insulin secretagogues” glyburide, glimipride, glipizide
Repaglinite, Metaglinide

SE: HYPOGLYCEMIA, weight gain

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

Metformin mechanism, class, side effects

A

Mechanism: Stimulate AMPK, decrease glucose production, decrease hepatic gluconeogenesis, decrease insulin resistance

“Biguanides”

SE: lactic acidosis
check creatinine before use

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

Pioglitazone mechanism, class, side effects

A

Mechanism: activate transcription regulator PPAR-y, decrease insulin resistance

“Thiazolidinediones”

SE: fluid retention, heart failure, weight gain

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

Exenatide, liragluitide mechanism, class, side effects

A

Mechanism: increase glucose-dependent insulin secretion, decrease glucagon secretion, delay gastric emptying

“GLP-1 agonists”

SE: Pancreatitis

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

Sitagliptin, saxagliptin mechanism, class, side effects

A

Mechanism: Increase endogenous GLP-1 and GIP levels

“DPP4 inhibitors”

SE: nasopharyngitis

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

acarbose, miglitol mechanism, class, side effects

A

Mechanism: reduce intestinal disaccharide absorption

“a-glucosidase inhibitors “

SE: diarrhea, flatulence

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

canagliflozin, dapagliflozin mechanism, class, side effects

A

Mechanism: increase renal glucose excretion

“SGLT2 inhibitors”

SE: UTI, hypotension

47
Q

Factor Xa inhibitors

A

Direct: Rivaroxaban, Apixaban

Indirect: Fondaparinux

48
Q

Thrombin/IIa inhibitors

A

Direct: Argatroban, Bivalirudin, Dabigatran

Bind to thrombin active site
Use to treat HIT

49
Q

Vitamin K antagonists act on…

A

Factors II, VII, IX, X

50
Q

Weak antiandrogen drug that decreases synthesis of steroid hormones in gonads and adrenals

A

Ketoconazole

51
Q

Decreases peripheral conversion of testosterone to DHT by inhibiting alpha-reductase

A

Finasteride

52
Q

Aromatase inhibitor mechanism, example

A

Decrease peripheral conversion of androgens to estrogen

Anastrozole

53
Q

Androgen receptor inhibitor

A

Flutamide, blocks stimulatory effect of androgens

54
Q

GP IIb/IIIa receptor antagonist

A

Abciximab

–> Inhibits platelet aggregation

55
Q

Organophosphate poisoning effect and treatment

A

Organophosphates irreversibly inhibit

Atropine (reverses muscarinic only, doesn’t reverse paralysis)
Pralidoxime (restores cholinesterase, reverses both muscarinic and nicotinic)

56
Q

Isoniazid clinical use, mechanism, side effects

A

Use as part of treatment for tuberculosis with Ethambutol, Rifampin, Pyrazinamide

Inhibition of mycolic acid synthesis, activation by mycobacterial catalase peroxidase

Neurotoxicity (give B6/pyrox), hepatotoxicity

57
Q

Ethambutol clinical use, mechanism, side effects

A

Tuberculosis

Inhibit synthesis of mycobacterial cell wall

Optic neuropathy

58
Q

Pyrazinamide clinical use, mechanism of resistance, side effects

A

Tuberculosis

Unknown, Must be activated by mycobacterial enzyme pyrazinamidase

Hepatotoxicity, hyperuricemia

59
Q

Rifampin clinical use, mechanism of resistance, side effects

A

Tuberculosis, but not specific

Mutation in DNA polymerase necessary for transcription and RNA prolongation

GI side effects, rash, red-orange body fluids

60
Q

Nitroprusside

A

Vasodilator

Metabolized to nitric acid + cyanide

61
Q

Phenytoin mechanism, side effects

A

Inhibits electrical activity by blocking voltage-gated Na channels

SE: CNS ataxia, nystagmus; gingival hyperplasia, folic acid metabolism interference, P450 inducer, fetal hydantoin syndrome

62
Q

Cocaine mechanism, side effects

A

Blocks re-uptake of NE, 5-HT, and DA in CNS

SE: cardiac ischemia, hypertension, seizures

63
Q

How do you treat cyanide toxicity?

A

Sodium nitrate: promotes methamaglobin formation
Sodium thiosulfate: sulfur donor
Hydroxocobalamin: cobalt binds cyanide, excreted in urine

64
Q

Lower incidence of torsades-de-pointes than other QT-prolonging drugs

A

Amiodarone

65
Q

Class I Antiarrhythmic drugs

A

Sodium channel blockers
Class IA - disopyramide, procainamide, quinidine
–> Prolong APD, slow AP conduction velocity

Class IB - Lidocaine, Mexiletine, Phenytoin
–> Shorten APD

Class IC - Flecainide, Propafenone
–> Slow AP conduction velocity

66
Q

Class II Antiarrhythmic drugs

A

Beta receptor blockers
Atenolol, Metoprolol, Esmolol, Carvedilol

Slow sinus node discharge rate
Slow AV nodal conduction

67
Q

Class III Antiarrhythmic drugs

A

Potassium channel blockers
Amiodarone, Dronedarone, Dofetilide, Sotalol (also II)

Prolong APD/QT interval

68
Q

Class IV Antiarrhythmic drugs

A

Non-dihydropyridine CCBs
Verapamil, Diltiazem

Slow sinus node discharge rate
Slow AV nodal conduction

69
Q

COX-2 inhibitor

A

Celecoxib

Acts only at site of inflammation

70
Q

Irreversibly inhibits platelet aggregation by acetylating serine residues

A

Aspirin

71
Q

Drugs that inhibit both COX1 and COX2

A 
Diclofenac
Fenoprofen
Ibuprofen
Indomethacin
Ketorolac
Piroxicam
72
Q

Drugs that may cause aplastic anemia

A

Carbamazepine, chloramphenicol, sulfonamides

73
Q

Benzodiazepine mechanism of action

A

Bind allosterically to GABA receptor, increase frequency of chloride channel opening

74
Q

Barbituates mechanism of action

A

Bind allosterically to GABA receptor, increase the duration of chloride channel opening (or, at high dose, GABA agonist)

75
Q

Buspirone mechanism of action

A

partial agonist of 5ht1a receptor

76
Q

Antibiotics that act on the 50s subunit

A

chloramphenicol, clindamycin, linezolid, macrolides

77
Q

Antibiotics that act on the 30s subunit

A

tetracycline, doxycycline, aminoglycosides

78
Q

Improves survival in CHF

A

spironolactone, other mineralocorticoid receptor antagonists

79
Q

Alpha-1 agonists

A

Epinephrine
Norepinephrine
Phenylephrine
Methoxamine

80
Q

Beta-1 agonists

A 
Epinephrine
Dopamine
Dobutamine
Isoproterenol
Norepinephrine
81
Q

Beta-2 agonists

A

Epinephrine
Isoproterenol
Terbutaline
Ritodrine

82
Q

Epinephrine effect on a1, a2, B1, B2 receptors

A

Agonist a1, a2, B1, B2

83
Q

Isoproterenol effect on a1, a2, B1, B2 receptors

A

Agonist at B1, B2

84
Q

Norepinephrine effect on a1, a2, B1, B2 receptors

A

Agonist at a1, a2, B1

85
Q

Phentolamine effect on a1, a2, B1, B2 receptors

A

a1, a2 antagonist

86
Q

Propranolol effect on a1, a2, B1, B2 receptors

A

B1, B2 antagonist

87
Q

Inhibit nucleic synthesis

A

Fluoroquinolines, rifampin

88
Q

Inhibit folic acid synthesis

A

Sulfonamides, trimethoprim, pyrimethamine

89
Q

MAO inhibitors example, use

A

phenelzine, tranylcypromine, selegiline

atypical depression, treatment-resistant depression

90
Q

Best anticoagulant to use during pregnancy

A

Low-Molecular-Weight Heparins (enoxaparin)

91
Q

Loop diuretics

  • Examples
  • Mechanism
  • Location of action
  • Side Effects
A

Furosemide, bumetanide, tosemide

Thick ascending limb

Hypokalemia, hypoMg, hypoCa, OTOTOXICITY

92
Q

Thiazide diuretics

  • Examples
  • Mechanism
  • Location of action
  • Side effects
A

Chlorthalidone, Hydrochlorothiazide

Enhance Na, Cl, water excretion via inhibition of Na/Cl symporter

Distal convoluted tubule

Hyperuricemia, Hypercalcemia, HypoK, HypoNa

93
Q

Potassium-sparing diuretics

  • Examples
  • Mechanism
  • Location of action
  • Side effects
A

Triamterene, Spironolactone, Amiloride

Collecting duct

Hyperkalemia
Sp: gynecomastia, antiandrogen

94
Q

Carbonic anhydrase inhibitors

  • Examples
  • Mechanism
  • Location of action
  • Side effects
A

Acetazolamide

Block the resorption of NaHCO3 in Proximal tubule

Metabolic acidosis

95
Q

Osmotic diuretics

  • Examples
  • Mechanism
  • Location of action
  • Side effects
A

Mannitol

Reduce Na/water reabsorption in proximal tubule and Loop of Henle

Hypernatremia, pulmonary edema

96
Q

Bind bile acids in the GI tract

A

Cholestyramine, Colestipol, Colesevelam

–> divert hepatic cholesterol to synthesize new bile acids, increase uptake of LDL, reduce blood LDL levels

SE: GI upset, impaired absorption of nutrients and drugs, hypertriglyceridemia

97
Q

Low potency typical antipsychotics

High potency typical antipsychotics

A 
Low = non neuro side effects, 
High = pyramidal/neuro side effects

Chlorpromazine, Thioridizine (Cheating Thieves are low)

Trifluroperazine, Fluphenizine, Haloperidol (Try to Fly High)

98
Q

May be used for the acute treatment of delirium with agitation and psychosis

A

Haloperidol

99
Q

Short acting benzodiazepines

A

Triazolam, Oxazepam, Midazolam

–> sleep or panic

100
Q

Intermediate acting (6-24hr) benzodiazepines

A

Alprazolam, lorazepam, temazepam

  • -> sleep
  • -> lorazepam for withdrawal
101
Q

Long acting benzodiazepines

A

Diazepam, chlordiazepoxide, flurazepam

–> withdrawal

102
Q

Bipolar disorder

A

Lithium, valproic acid, atypical antipsychotics (olanz, cloz, queti, risper)

103
Q

5-ht specific reuptake inhibitors

A

SSRIs

fluozetine, paroxetine, sertraline, citalopram

104
Q

5-ht and NE reuptake inhibitors

A

SNRIs

venlafaxine, duloxetine

105
Q

Block reuptake of NE and 5-ht

A

Tricyclic antidepressants

amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine

106
Q

non-selective monoamine oxidase inhibitor that increases levels of amine neurotransmitters NE, 5-ht and DA

A

phenelzine, selegiline (B), tranylcypromine, isocarboxazid

107
Q

Increase NE and DA through unknown mechanism

A

Bupropion (atypical) - smoking cessation, anxiety disorder, not panic attacks

108
Q

Blocks 5-ht2 and a1 adrenergic receptors

A

Trazodone (atypical) - insomnia

109
Q

Treatment for schizophrenia

A

Atypical antipsychotics (olanz, cloz, queti, risper)

110
Q

Panic disorder

A

SSRIs, venlafaxine, benzodiazepines

111
Q

Obsessive-compulsive disorder

A

SSRIs, clomipramine

112
Q

PTSD

A

SSRIs, venlafaxine

113
Q

Atypical antipsychotics

A 
Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
Ziprasidone

USMLE Step 1 (5 decks)

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