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Step 1 > Pharmacology Drugs > Flashcards

Pharmacology Drugs Flashcards

1
Q

What does Finasteride do in Prostate cancer?

A

Blocks conversion of Testosterone into DHT

– Inhibits 5-alpha reductase

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2
Q

What would be used to block androgen receptors in prostate cancer?

A

Flutamide – nonsteroid androgen that competes with testosterone/DHT for receptors
– Used in combo with GnRH analog (constant) to reduce LH/FSH as well.

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3
Q

What feature of Ketoconazole can be used for prostate cancer?

A

Weak Anti-Androgen, and inhibits androgen production in Leydig Cells

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4
Q

What antivirals do not need viral kinases to be activated?

A
    • Cidofovir
    • Tenofovir
  • *Nucleotide Analogs, can be activated by only cellular kinases
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5
Q

What is the key enzyme responsible for activating Acyclovir?

A

Thymidine Kinase (Herpes)

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6
Q

What anti-virals need to be activated by viral AND cellular kinases?

A

Acyclovir
Valacyclovir
Famciclovir
Ganciclovir

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7
Q

What classification of antivirals are Zidovudine and Lamivudine?

A

Cellular Dependent Nucleosides (activated by cellular kinases)

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8
Q

What does high dose Dopamine cause?

A

B1 Agonist
D1 Agonist
– Increased contractility
– Increased RBF

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9
Q

What can be given to someone who has organophosphate toxicity as a remedy? (only if near exposure time)

A

Pralidoxime – blocks both Muscarinic and Nicotinic Receptors

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10
Q

If a patient has an overdose of AChE inhibitor and they are given Atropine, what does that help and what might still occur?

A

All symptoms will resolve regarding Muscarinic Receptors, such as HR, GI, Muscosal, etc.
Will not affect the muscle paralysis of Nicotinic

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11
Q

What two drug overdoses are similar with dry muscous membranes, myadriasis, bradycardia?

A

Atropine and Amitripyline

– Both block muscarinic receptors

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12
Q

How does Pioglitazone help treat DM?

A

Binds to Peroxisome Proliferator Activated Receptor Gamma (PRAR-gamma)

    • Transcriptional Modifier of metabolism of glucose and lipolysis
    • Decreases Insulin Resistance
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13
Q

What drug is an Antagonist to estrogen receptors in breast and ovaries, but Agonist in Bone/CV/Liver?

A

Raloxifene – used to treat osteoporosis and breast cancer risk

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14
Q

What is the side effect of all Protease inhibitors for HIV?

A

HYPERGLYCEMIA – leading to DM

– Cushing-like syndrome with fat re-distrobution

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15
Q

What is a unique side effect of Indinavir?

A

Protease Inhibitor — (Hyperglycemia/DM/Cushing)

– Unique – Nephrolithiasis/Toxicity

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16
Q

What is generally used for CMV infections?

A

Foscarnet

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17
Q

What is a unique side effect of Ziduvudine?

A

Nucleoside Reverse Transcriptase Inhibitor

– Bone marrow Toxicity

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18
Q

What do these drugs all have in common?

  • Isoniazid
  • Cimetidine
  • Macrolids
  • Azoles
  • Ciprofloxicin
  • Ritonavir
  • Grapefruit
A

Inhibit Cytochrome P450

- slower break down of drugs

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19
Q

What do these drugs have in common?

  • Carbamazepine
  • Phenobarbital
  • Phenytoin
  • Rifampin
  • Griseofulvin
A

Induce Cytochrome P450

– faster break down of drugs

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20
Q

What is used for bipolar disorder, simple seizures, and induces CYP450?

A

Carbamazepine

  • Induces P450
  • Blocks rapid Na+ channels
  • SIADH (causes extra release)
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21
Q

What drugs are the most common that cause increased metabolism of drugs?

A 
Carbamazipine
Phenytoin
Phenobarbital
Rifampin
Griseofulvin
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22
Q

What drugs are common inhibitors of CYP450?

A
  • Cimetidine
  • Ciprofloxicin
  • Fluconazole
  • Ritonavir
  • Isoniazid
  • Erythromycin
23
Q

How does Rosiglitazone (and other -zones) help with DM?

A

Nonhypoglycemic

– PPAR Agonist – inducing increased GLUT4 and metabolism in muscles and adipocytes

24
Q

How does Glyburide help with DM?

A

Increases Insulin secretion from the pancreas

– binds to the K+ channel causes it to close and depolarize the membrane and influx Ca+2 and insulin release

25
Q

What DM drug works similar to Glyburide, but does not cause a increased insulin during fasting state?

A

Repaglinide

– similar to sulfonurea, but does not increase insulin in low glucose state.

26
Q

What drugs can cause drug-induced lupus?

A

Procainamide
Hydralazine
Isoniazid

27
Q

If a patient is taking Hydralazine and develops elevated creatinine and microscopic hematuria, what might you suspect to find on kidney biopsy?

A

Drug-Induced Lupus

    • Diffuse Proliferative Glomerulonephritis
  • Proliferation of cells of capillary loop
  • *Wire Loop Deposits**
28
Q

What are the signs of lithium toxicity?

A
  • Tremor / Agitation
  • Fasciculations - Hyperexcitability neuromuscular
  • Ataxia
  • Delirium
29
Q

What drugs should not be taken with Lithium due to increased risk of toxicity?

A

Thiazides – due to upregulation of sodium channels that will reabsorb lithium into toxicity range
NSAIDS/ACEi – impair renal excretion of Lithium

30
Q

What should be given after surgery to help the patient have a bladder and bowel movement?

A

Bethanechol – to overcome the anticholinergic effects of anesthesia
Epoprostenol – prostaglandin dilator

31
Q

What is used to help lower the intraocular pressure in the eye by widening the anterior chamber via miosis (dilation of the iris causes obstruction of flow)

A

Carbachol

Pilocarpine

32
Q

What drug binds gp41 of HIV to prevent fusion of HIV?

A

Enfuvirtide – fusion inhibitor

33
Q

What antiviral drugs do not require intracellular phosphorlyation for activation?

A

Non-nucleoside reverse transcriptase inhibitors

  • Nevirapine
  • Efavirenz
  • Delaviridine
34
Q

What tests should you regularly follow in someone who is being treated for bipolar disorder?

A
    • TSH – Li can cause hypothyroidism
    • Renal Function – creatinine, can cause renal dysfunction and can even cause nephrogenic diabetes insipidus
    • If levels are too high agitation and delirium
35
Q

What AChE inhibitor should be used to treat acute Atropine toxicity?

A

Physostigmine – Can penetrate CNS to remedy ALL symptoms both peripheral and central.
Neostigmine/Edrophonium – Unable to penetrate CNS

36
Q

What is Exenatide used for most commonly?

A

Glucagon-like Polypeptide analog – goes to pancreas and increases insulin secretion
– Usually added to regimen when Metformin and Sulfonourea drugs are not enough.

37
Q

What is the mechanism of Ethanbutol when treating TB?

A

Inhibits Cell wall synthesis by inhibiting Arabinosyl Transferase
– can cause color vision change (?)

38
Q

What drug is best for killing intracellular TB?

A

Pyrazinamide

39
Q

What TB drug inhibits synthesis of mycolic acid?

A

Isoniazid – competes with B6 / inhibits P450 as well

40
Q

What anti-depressant does NOT have sexual side effects?

A

Bupropion

    • increases NE in the cleft
    • contraindicated in patients with seizure disorders or who that have lower threshold for seizure
41
Q

What does Isoproterenol activate?

A

B1 – Agonist
B2 – Agonist
**Increases contractility of the heart and decreases peripheral resistance

42
Q

What are the roles of the B2 receptor in the body?

A

Activated

    • Dilates the Bronchioles
    • Reduces peripheral resistance in muscles
    • Relaxes Uterine Muscle
    • Increases Insulin secretion from Beta-cells
43
Q

What can Chaga’s Disease be treated with?

A

Nifurtimox

44
Q

What can Strongyloides be treated with?

A

Ivermectin

45
Q

What can you treat Schistosoma (from snails) be treated with?

A

Praziquantel

46
Q

What drug most commonlyl causes neuroleptic malignant syndrome?

A

Haloperidol

    • hyperthermia
    • generalized rigidity
    • autonomic instability
    • AMS
  • *Treat with Bromocriptine (D agonist)**
47
Q

What can be given in an immune compromised individual who prevent against P. Jirovecii and Toxoplasmosis?

A

TMP-SMX

48
Q

What can be given to prevent against Mycobacterium Avium Complex in compromised patients? (Below CD4 - 50)

A

Azithromycin

49
Q

What should you give if a patient’s CD4 count is below 150 ?

A

Itraconazole

50
Q

What medications are associated with increased bone fractures?

A
  • P450 inducers
  • Anything that reduces estrogen
  • Proton Pump inhibitors (limits VitD absorption)
  • Glucocorticoids
51
Q

A patient is unable to tolerate ASA for prevention of heart disease and is started on Ticlopidine (ADP agonist), what should be monitored?

A

Frequent Blood Counts

– Monitor for Neutrapenia

52
Q

What is the accumulation of metabolites when a patient is on Methotrexate?

A

Prevents recycling of DHT to THF

    • Increased DHT
    • Decreased THF
53
Q

Which Receptors are Gq-coupled?

- Activates Phospholipase C > IP3 + DAG > Activates Protein Kinase C – Increases Ca+2

A 
Alpha-1
M1/M3
Histamine-1
AngII
TRH/GnRH
Vasopressin
Oxytocin
54
Q

If a patient has HTN and Bradycardia, what might be a good drug to use to treat the HTN?

A
  • Nifedipine
  • – reflexive tachycardia
  • – calcium channel blocker peripherally

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