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Pharmacology Flashcards

1
Q

Atazanavir

A

CYP34A Strong inhibitor HIV Protease inhibitor used for PEP

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2
Q

Boceprevir

A

CYP34A Strong inhibitor HCV genotype 1 protease inhibitor

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3
Q

Clarithromycin

A

CYP34A Strong inhibitor

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4
Q

Cobicistat

A

CYP34A Strong inhibitor In combination with other HIV drugs to increase the levels

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5
Q

Darunavir

A

CYP34A Strong inhibitor HIV protease inhibitor

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6
Q

Idelalisib

A

CYP34A Strong inhibitor phosphoinositide 3-kinase inhibitor Treats relapsed CLL in combo with Ritux

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7
Q

Indinavir

A

CYP34A Strong inhibitor HIV protease inhibitor

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8
Q

Itraconazole

A

CYP34A Strong inhibitor

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9
Q

Ketoconazole

A

CYP34A Strong inhibitor

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10
Q

Lopinavir

A

CYP34A Strong inhibitor HIV protease inhibitor

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11
Q

Mifepristone

A

CYP34A Strong inhibitor antiprogestogen - competitive

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12
Q

Nefazodone

A

CYP34A Strong inhibitor atypical antidepressant (not used much)

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13
Q

Nelfinavir

A

CYP34A Strong inhibitor HIV protease inhibitor

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14
Q

Ombitasvir-paritaprevir-ritonavir

A

CYP34A Strong inhibitor HCV

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15
Q

Posaconazole

A

CYP34A Strong inhibitor

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16
Q

Saquinavir

A

CYP34A Strong inhibitor HIV protease inhibitor

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17
Q

Telaprevir

A

CYP34A Strong inhibitor HCV protease inhibitor

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18
Q

Telithromycin

A

CYP34A Strong inhibitor Ketolide / macrolide antibiotic

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19
Q

Voriconazole

A

CYP34A Strong inhibitor

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20
Q

Amiodarone

A

CYP34A inhibitor

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21
Q

Aprepitant

A

CYP34A inhibitor

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22
Q

Cimetidine

A

CYP34A inhibitor histamine H₂ receptor antagonist

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23
Q

Conivaptan

A

CYP34A inhibitor non-peptide inhibitor of antidiuretic hormone (vasopressin). It was approved in 2004 for hyponatremia (low blood sodium levels) caused by syndrome of inappropriate antidiuretic hormone (SIADH)

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24
Q

Crizotinib

A

CYP34A inhibitor ALK TKI (ALK + NSCLC) Criz.. Crazy rich asians get ALK (Asian Lung Kancer)

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25
Cyclosporine
CYP34A inhibitor
26
Diltiazem
CYP34A inhibitor
27
Duvelisib
CYP34A inhibitor Dual inhibitor of PI3Kδ and PI3Kγ Haem malignancies Du.. dual inhibitor vel..phosphokinase
28
Dronedarone
CYP34A inhibitor like amiodarone
29
Erythromycin
CYP34A inhibitor
30
Fluconazole
CYP34A inhibitor
31
Fosamprenavir
CYP34A inhibitor
32
Grapefruit juice
CYP34A inhibitor
33
Imatinib
CYP34A inhibitor
34
Isavuconazole
CYP34A inhibitor
35
Letermovir
CYP34A inhibitor
36
Netupitant
CYP34A inhibitor
37
Nilotinib
CYP34A inhibitor
38
Ribociclib
CYP34A inhibitor Cyclin-dependent kinase inhibitor that is used in combination with aromatase inhibitors for breast cancer
39
Schisandra / magnolia berry
CYP34A inhibitor
40
Verapamil
CYP34A inhibitor
41
Apalutamide
CYP34A inducer Antiandrogen Like enza-LUTAMIDE
42
Carbamazepine
CYP34A inducer
43
Enzalutamide
CYP34A inducer
44
Fosphenytoin
CYP34A inducer
45
Lumacaftor
CYP34A inducer INDUCES CFTR proteins to treat CF LumaCaFToR
46
Mitotane
CYP34A inducer steroidogenesis inhibitor and cytostatic antineoplastic medication which is used in the treatment of adrenocortical carcinoma and Cushing's syndrome
47
Phenobarbital
CYP34A inducer
48
Phenytoin
CYP34A inducer
49
Primidone
CYP34A inducer anticonvulsant of the barbiturate class
50
Rifampin
CYP34A inducer
51
Bexarotene
CYP34A inducer It is a third-generation retinoid to treat cutaneous T cell lymphoma bexaROTENE betacaroene
52
Bosentan
CYP34A inducer Dual endothelin receptor antagonist
53
Dabrafenib
CYP34A inducer B-RAF inhibitor
54
Dexamethasone
CYP34A inducer
55
Efavirenz
CYP34A inducer non-nucleoside reverse transcriptase inhibitors (NNRTIs)
56
Eslicarbazepine
CYP34A inducer
57
Etravirine
CYP34A inducer non-nucleoside reverse transcriptase inhibitors (NNRTIs)
58
Modafinil
CYP34A inducer
59
St. John's wort
CYP34A inducer
60
Drugs that follow zero order kinetics
Zero WHATS Warfarin Heparin Alcohol Theophyline Salicylates
61
CYP3A4 main inhibitors
GRACE Grapefruit Ritonavir (Protease inhibitors) Azole antifungals Calcium channel blockers (verapamil/diltiazam) Erythromycin/clarithromycin (macrolides)
62
CYP3A4 main inducers
CRP - DDB SN Carbamazepine Rifampicin Phenytoin Dexamethasone, Dabrafinib (other TKIs are inhibitors), Bosentan St John's Wart, NNRTIs
63
P-glycoprotein substrates
CA DAMP Calcineurin inhibitor Amlodipine Digoxin Anti-neoplastics: docetaxal, etoposide, vincristine Macrolides Protease inhibitors
64
CYP3A4 substrates
WC - PCOS & macrolides Warfarin & DOACS Carbemazeopine Protease inhibitors Calcium channel inhibitors Opiates & benzos Statins Macrolides
65
P-glycoprotein inhibitors
MVP Macrolides Verapamil Protease inhibitors
66
P-glycoprotein inducers
St John's Wart Rifampicin
67
CYP2D6 substrates
Got C Phaff Gefitinib Olanzapine Tamoxifen Codeine Propranolol Haloperidol Amitriptyline Flecanide Fluoxetine
68
CYP2D6 inhibitors
ABCDM Amiodarone Abiraterone Cobicistat Duloxetine/fluoxetine Mirabigron
69
Which antiepileptic causes visual field changes?
Vigabatrin Wt gain, visual field changes, drowsiness and neuropsychiatric symptoms
70
Which AED causes the most SJS?
Lamotragine Carbamazepine - HLAB\*1502
71
Which AEDs are inducers of CYP3A4? ie decreases effect of OCP and cyclosporin
Carbamazepine Phenytoin Phenobarbital Na Valproate is safe w OCP (it is a CYP2C9 inhibitor)
72
COMPT inhibitors?
Entacapone Tolcapone Prolong dopamine activity by inhibit breakdown of levadopa Therefore extending the dose / stabilising plasma concentration useful for treating pts with motor fluctuations SEs: dopaminermgic + diarrhoea, orange urine
73
Highest risk factor for stroke?
Age risk doubles each successive decade after 55
74
Highest modifiable risk factor for stroke?
HTN Rx 33-44% risk reduction
75
Charcot Mary Tooth
Hereditary sensory motor neuropathy Distal weakness \> sensory - Peripheral neuropathy (glove and stocking) Pes cavus foot deformity HSMN 1 - hypertrophic myelin, onion bulbs (slow NCV) with secondary axonal degeneration HSMN2 - neuronal type degeneration (normal NCV)
76
Carbamazepine
NA Channel CYP3A4 substrate and inducer Indicated for partial seizures Can worsen myoclonus or absebce seizures Concentration dependent SEs Diplopia, dizziness, drowsiness, nausea Idiosyncratic: Rash, SJS Hyponatraemia
77
Leviteracetam
Inhibits presynaptic calcium channels, neuromodulating transmitter release \<10% porotein bound Renally excreted Minmal interactions SEs: sedations, psychosis
78
Phenytoin
Sodium channel non-linear kinetics 90% bprotein bound, displaced in states of hypoalbuminaemia Met CYP2C9 exc bile and urine Interactions: Inhibitors: fluoxetine, fluconazole, isonizid, tamoxifen, amiodarone Inducers: Rifampicin, chronic EtOH
79
SIde effects of phenytoin
Concentration dependent: ataxia, nystagmus, headache, incoordination, sedation Idiosyncratic: Blood dyscrasias, rash, immunological Chronic: Cerebellar syndrome, skin thickening, hirsuitism, acne, done disease, folate deficiency
80
Sodium valproate
PIP3 reduction, sodium channel, increases GABA 90% protein bound Met: liver CYP 2C9 inducers: clobazam, stiripentol Inhibitors: rifampicin, cisplatin, MTX, carbopenums, topiramate
81
Side effects of sodium valproate
Concentration dependent: GI, sedation, thrombocytopenia, tremor, avoid in mitochondrialopathies Idiosyncratic: acute hepatic failure, pancreatitis, alopecia Chronic: tremor, ataxia, weight gain, PCOS
82
Key CYP3A4 substrates:
Carbamazipine Macrolides Benzodiazepines Protease inhibitors Calcium channel blockers Warfarin
83
CYP2C19 key substrates
PPPDW - \*Important for 19year olds not to get pregnant Progesterone Phenytoin PPIs Diazepam Warfarin
84
CYP2C19 key inhibitors
If the 19 year old gets pregnant she'll need.. SSRIs PPIs
85
CYP2C19 inducers
\*Not rifampicin Carbamazepine
86
CYP2C9 key substrates
NAWPS NSAIDs ARBs Warfarin Phenytoin Sodium Valproate
87
CYP2C9 key inhibitors
FAT ## Footnote Fluconazole Amiodarone Topiramate CYP2C9 - NAWPS FAT RClobezam
88
CYP2C9 key inducers
Rifampicin Clobezam CYP2C9 - NAWPS FAT RClobezam

FRACP (12 decks)

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