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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
What DM drug works similar to Glyburide, but does not cause a increased insulin during fasting state?
Repaglinide | -- similar to sulfonurea, but does not increase insulin in low glucose state.
26
What drugs can cause drug-induced lupus?
Procainamide Hydralazine Isoniazid
27
If a patient is taking Hydralazine and develops elevated creatinine and microscopic hematuria, what might you suspect to find on kidney biopsy?
Drug-Induced Lupus - - Diffuse Proliferative Glomerulonephritis * Proliferation of cells of capillary loop * *Wire Loop Deposits**
28
What are the signs of lithium toxicity?
- Tremor / Agitation - Fasciculations - Hyperexcitability neuromuscular - Ataxia - Delirium
29
What drugs should not be taken with Lithium due to increased risk of toxicity?
Thiazides -- due to upregulation of sodium channels that will reabsorb lithium into toxicity range NSAIDS/ACEi -- impair renal excretion of Lithium
30
What should be given after surgery to help the patient have a bladder and bowel movement?
Bethanechol -- to overcome the anticholinergic effects of anesthesia Epoprostenol -- prostaglandin dilator
31
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)
Carbachol | Pilocarpine
32
What drug binds gp41 of HIV to prevent fusion of HIV?
Enfuvirtide -- fusion inhibitor
33
What antiviral drugs do not require intracellular phosphorlyation for activation?
Non-nucleoside reverse transcriptase inhibitors - Nevirapine - Efavirenz - Delaviridine
34
What tests should you regularly follow in someone who is being treated for bipolar disorder?
- - 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
What AChE inhibitor should be used to treat acute Atropine toxicity?
Physostigmine -- Can penetrate CNS to remedy ALL symptoms both peripheral and central. Neostigmine/Edrophonium -- Unable to penetrate CNS
36
What is Exenatide used for most commonly?
Glucagon-like Polypeptide analog -- goes to pancreas and increases insulin secretion -- Usually added to regimen when Metformin and Sulfonourea drugs are not enough.
37
What is the mechanism of Ethanbutol when treating TB?
Inhibits Cell wall synthesis by inhibiting Arabinosyl Transferase -- can cause color vision change (?)
38
What drug is best for killing intracellular TB?
Pyrazinamide
39
What TB drug inhibits synthesis of mycolic acid?
Isoniazid -- competes with B6 / inhibits P450 as well
40
What anti-depressant does NOT have sexual side effects?
Bupropion - - increases NE in the cleft - - contraindicated in patients with seizure disorders or who that have lower threshold for seizure
41
What does Isoproterenol activate?
B1 -- Agonist B2 -- Agonist **Increases contractility of the heart and decreases peripheral resistance
42
What are the roles of the B2 receptor in the body?
Activated - - Dilates the Bronchioles - - Reduces peripheral resistance in muscles - - Relaxes Uterine Muscle - - Increases Insulin secretion from Beta-cells
43
What can Chaga's Disease be treated with?
Nifurtimox
44
What can Strongyloides be treated with?
Ivermectin
45
What can you treat Schistosoma (from snails) be treated with?
Praziquantel
46
What drug most commonlyl causes neuroleptic malignant syndrome?
Haloperidol - - hyperthermia - - generalized rigidity - - autonomic instability - - AMS * *Treat with Bromocriptine (D agonist)**
47
What can be given in an immune compromised individual who prevent against P. Jirovecii and Toxoplasmosis?
TMP-SMX
48
What can be given to prevent against Mycobacterium Avium Complex in compromised patients? (Below CD4 - 50)
Azithromycin
49
What should you give if a patient's CD4 count is below 150 ?
Itraconazole
50
What medications are associated with increased bone fractures?
- P450 inducers - Anything that reduces estrogen - Proton Pump inhibitors (limits VitD absorption) - Glucocorticoids
51
A patient is unable to tolerate ASA for prevention of heart disease and is started on Ticlopidine (ADP agonist), what should be monitored?
Frequent Blood Counts | -- Monitor for Neutrapenia
52
What is the accumulation of metabolites when a patient is on Methotrexate?
Prevents recycling of DHT to THF - - Increased DHT - - Decreased THF
53
Which Receptors are Gq-coupled? | - Activates Phospholipase C > IP3 + DAG > Activates Protein Kinase C -- Increases Ca+2
``` Alpha-1 M1/M3 Histamine-1 AngII TRH/GnRH Vasopressin Oxytocin ```
54
If a patient has HTN and Bradycardia, what might be a good drug to use to treat the HTN?
- Nifedipine - -- reflexive tachycardia - -- calcium channel blocker peripherally

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