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USMLE Step 1 > Pharmacology - First Aid > Flashcards

Pharmacology - First Aid Flashcards

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USMLE® Step 1 flashcards
1
Q

Enzyme Kinetics:

Michaelis-Menten Kinetics

A
  • Km is inversely related to the affinity of the enzyme for its substrate.
  • Vmax is directly proportional to the enzyme concentration.
  • Most enzymatic reactions follow a hyperbolic curve (ie, Michaelis-Menten kinetics); however, enzymatic reactions that exhibit a sigmoid curve usually indicate cooperative kinetics (eg, hemoglobin).
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2
Q

Enzyme Kinetics:

Lineweaver-Burk Plot

A
  • ↑ y-intercept, ↓ Vmax
  • The further to the right the x-intercept (ie. closer to zero), the greater the Km and the lower the affinity.
  • Competitive inhibitors cross each other, whereas noncompetitive inhibitors do not.
  • Kompetitive inhibitors increase Km.
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3
Q

Inhibitors

A
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4
Q

Inhibitors:

  • resembles substrate
  • overcome by ↑ [S]
  • binda active site
  • no effect on Vmax
  • ↑ Km
  • ↓ potency
A

Reversible Competitive Inhibitors

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5
Q

Inhibitors:

  • resembles substrate
  • not overcome by ↑ [S]
  • binds active site
  • ↓ Vmax
  • no effect on Km
  • ↓ efficacy
A

Irreversible Competitive Inhibitors

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6
Q

Inhibitors:

  • does not resemble substrate
  • not overcome by ↑ [S]
  • does not bind active site
  • ↓ Vmax
  • no effect on Km
  • ↓ efficacy
A

Noncompetitive Inhibitors

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7
Q

Pharmacokinetics:

fraction of administered drug reaching systemi circulation unchanged

A

Bioavailability

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8
Q

Bioavailability of IV Dose

A

F = 100%

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9
Q

Bioavailability of Oral Dose

A

F typically < 100% due to incomplete absorption and first-pass metabolism

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10
Q

Pharmacokinetics:

theoretical volume occupied by the total amount of drug in the body relative to its plasma concentration

A

Volume of Distribution (Vd)

  • Apparent Vd of plasma protein–bound drugs can be altered by liver and kidney disease (↓ protein binding, ↑ Vd).
  • Drugs may distribute in more than one compartment.
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11
Q

Pharmacokinetics:

  • the volume of plasma cleared of drug per unit time
  • may be impaired with defects in cardiac, hepatic, or renal function
A

Clearance (CL)

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12
Q

Pharmacokinetics:

the time required to change the amount of drug in the body by 1⁄2 during elimination

A

Half-Life (t1/2)

  • In first-order kinetics, a drug infused at a constant rate takes 4–5 half-lives to reach steady state.
  • It takes 3.3 half-lives to reach 90% of the steady-state level.
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13
Q

Dosage Calculations

A
  • In renal or liver disease, maintenance dose ↓ and loading dose is usually unchanged.
  • Time to steady state depends primarily on t1/2 and is independent of dose and dosing frequency.
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14
Q

Types of Drug Interactions:

  • effect of substance A and B together is equal to the sum of their individual effects
  • Aspirin
  • Acetaminophen
A

Additive

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15
Q

Types of Drug Interactions:

  • presence of substance A is required for the full effects of substance B
  • Cortisol on catecholamine responsiveness
A

Permissive

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16
Q

Types of Drug Interactions:

  • effect of substance A and B together is greater than the sum of their individual effects
  • Clopidogrel with Aspirin
A

Synergistic

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17
Q

Types of Drug Interactions:

  • acute decrease in response to a drug after initial/repeated administration
  • Nitrates
  • Niacin
  • Phenylephrine
  • LSD
  • MDMA
A

Tachyphylactic

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18
Q

Receptor Binding

A
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19
Q

Receptor Binding:

  • shifts curve right (↓ potency), no change in efficacy
  • can be overcome by ↑ the concentration of agonist substrate
  • Diazepam (agonist) + Flumazenil (antagonist) on GABA receptor
A

Competitive Antagonist

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20
Q

Receptor Binding:

  • shifts curve down (↓ efficacy)
  • cannot be overcome by ↑ agonist substrate concentration
  • Norepinephrine (agonist) + Phenoxybenzamine (antagonist) on α-receptors
A

Noncompetitive Antagonist

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21
Q

Receptor Binding:

  • acts at same site as full agonist, but with lower maximal effect (↓ efficacy)
  • potency is an independent variable
  • Morphine (full agonist) vs. Buprenorphine (_____ agonist) at opioid μ-receptors
A

Partial Agonist

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22
Q

Elimination of Drugs:

  • rate of elimination is constant regardless of Cp (ie. constant amount of drug eliminated per unit time)
  • Cp ↓ linearly with time
  • capacity-limited elimination
  • Phenytoin
  • Ethanol
  • Aspirin (at high or toxic concentrations)
A

Zero-Order Elimination

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23
Q

Elimination of Drugs:

  • rate is directly proportional to the drug concentration (ie. constant fraction of drug eliminated per unit time)
  • Cp ↓ exponentially with time
  • applies to most drugs
  • flow-dependent elimination
A

First-Order Elimination

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24
Q

Urine pH and Drug Elimination:

trapped in urine and cleared quickly

A

Ionized Species

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25
Q

Urine pH and Drug Elimination:

can be reabsorbed

A

Neutral Forms

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26
Q

Urine pH and Drug Elimination:

Weak Acids

A
  • Trapped in basic environments.
  • Treat overdose with sodium bicarbonate to alkalinize urine.
  • Examples:
    • Phenobarbital
    • Methotrexate
    • Aspirin (Salicylates)
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27
Q

Urine pH and Drug Elimination:

Weak Bases

A
  • Trapped in acidic environments.
  • Treat overdose with ammonium chloride to acidify urine.
  • TCA toxicity is generally treated with sodium bicarbonate to overcome the sodium channelblocking activity of TCAs, but not for accelerating drug elimination.
  • Examples:
    • TCAs
    • Amphetamines
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28
Q

Drug Metabolism:

  • Reduction, Oxidation, Hydrolysis with cytochrome P-450 usually yield slightly polar, water-soluble metabolites (often still active).
  • Geriatric patients lose this phase first.
A

Phase I

R-OH:

  • Reduction
  • Oxidation
  • Hydrolysis
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29
Q

Drug Metabolism:

  • Conjugation (Methylation, Glucuronidation, Acetylation, Sulfation) usually yields very polar, inactive metabolites (renally excreted).
  • Geriatric patients have more of this phase.
  • Patients who are slow acetylators have ↑ side effects from certain drugs because of ↓ rate of metabolism.
A

Phase II

Geriatric patients have More GAS (phase II).

  • Methylation
  • Glucuronidation
  • Acetylation
  • Sulfation
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30
Q

_____ is the maximal effect a drug can produce.

A

Efficacy

  • Represented by the y-value (Vmax). ↑ y-value = ↑ Vmax = ↑ efficacy.
  • Unrelated to potency (ie. efficacious drugs can have high or low potency).
  • Partial agonists have less efficacy than full agonists.
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31
Q

_____ is the amount of drug needed for a given effect.

A

Potency

  • Represented by the x-value (EC50).
  • Left shifting = ↓ EC50 = ↑ potency = ↓ drug needed.
  • Unrelated to efficacy (ie. potent drugs can have high or low efficacy).
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32
Q

_____ is the measurement of drug safety.

A

Therapeutic Index

  • TITE: Therapeutic Index = TD50 / ED50
  • Safer drugs have higher TI values.
  • Drugs with lower TI values frequently require monitoring (eg. Warfarin, Theophylline, Digoxin, Lithium; Warning! These Drugs are Lethal!).
  • LD50 (lethal median dose) often replaces TD50 in animal studies.
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33
Q

_____ is the dosage range that can safely and effectively treat disease.

A

Therapeutic Window

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34
Q

Central and Peripheral Nervous System

A
  • Pelvic splanchnic nerves and CNs III, VII, IX and X are part of the parasympathetic nervous system.
  • Adrenal medulla is directly innervated by preganglionic sympathetic fibers.
  • Sweat glands are part of the sympathetic pathway but are innervated by cholinergic fibers.
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35
Q

Acetylcholine Receptors:

ligand-gated Na+/K+ channels

A

Nicotinic

  • NN (found in autonomic ganglia, adrenal medulla)
  • NM (found in neuromuscular junction of skeletal muscle)
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36
Q

Acetylcholine Receptors:

G-protein–coupled receptors that usually act through 2nd messengers

A

Muscarinic

  • M1–5 found in heart, smooth muscle, brain, exocrine glands, and on sweat glands (cholinergic sympathetic).
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37
Q

G-Protein–Linked Second Messengers:

  • Sympathetic
  • G-Protein: q
  • ↑ vascular smooth muscle contraction
  • ↑ pupillary dilator muscle contraction (mydriasis)
  • ↑ intestinal and bladder sphincter muscle contraction
A

α1

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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38
Q

G-Protein–Linked Second Messengers:

  • Sympathetic
  • G-Protein: i
  • ↓ sympathetic (adrenergic) outflow
  • ↓ insulin release
  • ↓ lipolysis
  • ↑ platelet aggregation
  • ↓ aqueous humor production
A

α2

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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39
Q

G-Protein–Linked Second Messengers:

  • Sympathetic
  • G-Protein: s
  • ↑ heart rate
  • ↑ contractility (one heart)
  • ↑ renin release
  • ↑ lipolysis
A

β1

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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40
Q

G-Protein–Linked Second Messengers:

  • Sympathetic
  • G-Protein: s
  • vasodilation
  • bronchodilation (two lungs)
  • ↑ lipolysis
  • ↑ insulin release
  • ↑ glycogenolysis
  • ↓ uterine tone (tocolysis)
  • ↑ aqueous humor production
  • ↑ cellular K+ uptake
A

β2

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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41
Q

G-Protein–Linked Second Messengers:

  • Sympathetic
  • G-Protein: s
  • ↑ lipolysis
  • ↑ thermogenesis in skeletal muscle
  • ↑ bladder relaxation
A

β3

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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42
Q

G-Protein–Linked Second Messengers:

  • Parasympathetic
  • G-Protein: q
  • mediates higher cognitive functions
  • stimulates enteric nervous system
A

M1

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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43
Q

G-Protein–Linked Second Messengers:

  • Parasympathetic
  • G-Protein: i
  • ↓ heart rate and contractility of atria
A

M2

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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44
Q

G-Protein–Linked Second Messengers:

  • Parasympathetic
  • G-Protein: q
  • ↑ exocrine gland secretions (eg. lacrimal, sweat, salivary, gastric acid)
  • ↑ gut peristalsis
  • ↑ bladder contraction
  • bronchoconstriction
  • ↑ pupillary sphincter muscle contraction (miosis)
  • ciliary muscle contraction (accommodation)
  • ↑ insulin release
A

M3

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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45
Q

G-Protein–Linked Second Messengers:

  • Dopamine
  • G-Protein: s
  • relaxes renal vascular smooth muscle
  • activates direct pathway of striatum
A

D1

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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46
Q

G-Protein–Linked Second Messengers:

  • Dopamine
  • G-Protein: i
  • modulates transmitter release, especially in brain
  • inhibits indirect pathway of striatum
A

D2

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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47
Q

G-Protein–Linked Second Messengers:

  • Histamine
  • G-Protein: q
  • ↑ nasal and bronchial mucus production
  • ↑ vascular permeability
  • bronchoconstriction
  • pruritus
  • pain
A

H1

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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48
Q

G-Protein–Linked Second Messengers:

  • Histamine
  • G-Protein: s
  • ↑ gastric acid secretion
A

H2

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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49
Q

G-Protein–Linked Second Messengers:

  • Vasopressin
  • G-Protein: q
  • ↑ vascular smooth muscle contraction
A

V1

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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50
Q

G-Protein–Linked Second Messengers:

  • Vasopressin
  • G-Protein: s
  • ↑ H2O permeability and reabsorption via upregulating aquaporin-2 in collecting twobules (tubules) of kidney
A

V2

“After qisses (kisses), you get a qiq (kick) out of siq (sick) sqs (super qinky sex).”

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51
Q

G-Protein–Linked Second Messengers

A
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52
Q

Autonomic Drugs

A
  • Release of norepinephrine from a sympathetic nerve ending is modulated by NE itself, acting on presynaptic α2-autoreceptors → negative feedback.
  • Amphetamines use the NE transporter (NET) to enter the presynaptic terminal, where they utilize the vesicular monoamine transporter (VMAT) to enter neurosecretory vesicles. This displaces NE from the vesicles.
  • Once NE reaches a concentration threshold within the presynaptic terminal, the action of NET is reversed, and NE is expelled into the synaptic cleft, contributing to the characteristics and effects of ↑ NE observed in patients taking amphetamines.
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53
Q

When using cholinomimetic agents, you should watch out for _____ in susceptible patients.

A
  • exacerbation of COPD
  • asthma
  • peptic ulcers
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54
Q

Cholinomimetic Agents:

  • direct agonist
  • activates bowel and bladder smooth muscle
  • resistant to AChE
  • no nicotinic activity
  • postoperative ileus
  • neurogenic ileus
  • urinary retention
A

Bethanechol

“Bethany, call (bethanechol) me to activate your bowels and bladder.”

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55
Q

Cholinomimetic Agents:

  • direct agonist
  • carbon copy of acetylcholine (but resistant to AChE)
  • constricts pupil
  • relieves intraocular pressure in open-angle glaucoma
A

Carbachol

Carbachol = carbon copy of acetylcholine

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56
Q

Cholinomimetic Agents:

  • direct agonist
  • stimulates muscarinic receptors in airway when inhaled
  • challenge test for diagnosis of asthma
A

Methacholine

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57
Q

Cholinomimetic Agents:

  • direct agonist
  • contracts ciliary muscle of eye (open-angle glaucoma) and pupillary sphincter (closed-angle glaucoma)
  • resistant to AChE
  • can cross blood-brain barrier (tertiary amine)
  • potent stimulator of sweat, tears, and saliva
  • xerostomia (Sjögren syndrome)
A

Pilocarpine

“You cry, drool, and sweat on your ‘pilow.’ ”

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58
Q

Cholinomimetic Agents:

  • indirect agonist (anticholinesterase)
  • ↑ ACh
  • Alzheimer disease
A
  • Donepezil
  • Rivastigmine
  • Galantamine

Dona & Riva dances at the gala.

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59
Q

Cholinomimetic Agents:

  • indirect agonist (anticholinesterase)
  • ↑ ACh
  • historically used to diagnose myasthenia gravis
  • replaced by anti-AChR Ab (anti-acetylcholine receptor antibody) test
A

Edrophonium

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60
Q

Cholinomimetic Agents:

  • indirect agonist (anticholinesterase)
  • ↑ ACh
  • postoperative and neurogenic ileus and urinary retention
  • myasthenia gravis
  • reversal of neuromuscular junction blockade (postoperative)
A

Neostigmine

Neo CNS = No CNS penetration (quaternary amine).

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61
Q

Cholinomimetic Agents:

  • indirect agonist (anticholinesterase)
  • ↑ ACh
  • antidote for anticholinergic toxicity
  • atropine overdose
A

Physostigmine

Phreely (freely) crosses blood-brain barrier → CNS (tertiary amine).

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62
Q

Cholinomimetic Agents:

  • indirect agonist (anticholinesterase)
  • ↑ ACh
  • ↑ muscle strength
  • myasthenia gravis (long acting)
  • does not penetrate CNS (quaternary amine)
A

Pyridostigmine

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63
Q

_____ is often due to organophosphates, such as parathion, that irreversibly inhibit AChE. Organophosphates are often components of insecticides; poisoning usually seen in farmers.

A

Cholinesterase Inhibitor Poisoning

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64
Q

Symptoms of Cholinesterase Inhibitor Poisoning

A

DUMBBELSS

  • Diarrhea
  • Urination
  • Miosis
  • Bronchospasm
  • Bradycardia
  • Emesis
  • Lacrimation
  • Sweating
  • Salivation

*may lead to respiratory failure if untreated

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65
Q

_____ is the antidote for cholinesterase inhibitor poisoning.

A

Atropine (competitive inhibitor) + Pralidoxime (regenerates AChE if given early)

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66
Q

Muscarinic Antagonists:

  • eye
  • mydriasis
  • cycloplegia
A
  • Atropine
  • Homatropine
  • Tropicamide
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67
Q

Muscarinic Antagonists:

  • CNS
  • Parkinson disease
  • acute dystonia
A
  • Benztropine
  • Trihexyphenidyl

Park my Benz.

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68
Q

Muscarinic Antagonists:

  • GI
  • respiratory
  • Parenteral: preoperative use to reduce airway secretions
  • Oral: drooling, peptic ulcer
A

Glycopyrrolate

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69
Q

Muscarinic Antagonists:

  • GI
  • antispasmodics for irritable bowel syndrome
A
  • Hyoscyamine
  • Dicyclomine
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70
Q

Muscarinic Antagonists:

  • respiratory
  • COPD
  • asthma
A
  • Ipratropium
  • Tiotropium
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71
Q

Muscarinic Antagonists:

  • genitourinary
  • reduce bladder spasms
  • urge urinary incontinence (overactive bladder)
A
  • Oxybutynin
  • Solifenacin
  • Tolterodine
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72
Q

Muscarinic Antagonists:

  • CNS
  • motion sickness
A

Scopolamine

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73
Q

_____ is a muscarinic antagonist used to treat bradycardia and for ophthalmic applications. It blocks DUMBBeLSS in cholinesterase inhibitor poisoning. Does not block excitation of skeletal muscle and CNS (mediated by nicotinic receptors).

A

Atropine

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74
Q

Atropine Effects:

Eye

A
  • ↑ pupil dilation
  • cycloplegia
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75
Q

Atropine Effects:

Airway

A
  • bronchodilation
  • ↓ secretions
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76
Q

Atropine Effects:

Stomach

A

↓ acid secretion

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77
Q

Atropine Effects:

Gut

A

↓ motility

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78
Q

Atropine Effects:

Bladder

A

↓ urgency in cystitis

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79
Q

Adverse Effects of Atropine

A
  • *Hot** as a hare
  • *Dry** as a bone
  • *Red** as a beet
  • *Blind** as a bat
  • *Mad** as a hatter
  • *Full** as a flask
  • ↑ body temperature (due to ↓ sweating)
  • rapid pulse
  • dry mouth
  • dry, flushed skin
  • cycloplegia
  • constipation
  • disorientation
  • Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with prostatic hyperplasia, and hyperthermia in infants.
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80
Q

_____ causes gardener’s pupil (mydriasis due to plant alkaloids).

A

Jimson weed (Datura)

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81
Q

Direct Sympathomimetics:

  • β2 > β1
  • acute asthma
  • COPD
A

Albuterol

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82
Q

Direct Sympathomimetics:

  • β2 > β1
  • long-term asthma
  • COPD
A

Salmeterol

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83
Q

Direct Sympathomimetics:

  • β2 > β1
  • bronchospasm in asthma
  • tocolysis
A

Terbutaline

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84
Q

Direct Sympathomimetics:

  • β1 > β2, α
  • heart failure
  • cardiogenic shock (inotropic > chronotropic)
  • cardiac stress testing
A

Dobutamine

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85
Q

Direct Sympathomimetics:

  • D1 = D2 > β > α
  • unstable bradycardia
  • heart failure
  • shock
  • inotropic and chronotropic effects at lower doses due to β effects
  • vasoconstriction at high doses due to α effects
A

Dopamine

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86
Q

Direct Sympathomimetics:

  • β > α
  • anaphylaxis
  • asthma
  • open-angle glaucoma
  • α effects predominate at high doses
  • significantly stronger effect at β2-receptor than norepinephrine
A

Epinephrine

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87
Q

Direct Sympathomimetics:

  • D1
  • postoperative hypertension
  • hypertensive crisis
  • vasodilator (coronary, peripheral, renal, and splanchnic)
  • promotes natriuresis
  • can cause hypotension and tachycardia
A

Fenoldopam

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88
Q

Direct Sympathomimetics:

  • β1 = β2
  • electrophysiologic evaluation of tachyarrhythmias
  • can worsen ischemia
  • has negligible α effect
A

Isoproterenol

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89
Q

Direct Sympathomimetics:

  • α1
  • autonomic insufficiency and postural hypotension
  • may exacerbate supine hypertension
A

Midodrine

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90
Q

Direct Sympathomimetics:

  • β3
  • urinary urge incontinence or overactive bladder
A

Mirabegron

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91
Q

Direct Sympathomimetics:

  • α1 > α2 > β1
  • hypotension
  • septic shock
A

Norepinephrine

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92
Q

Direct Sympathomimetics:

  • α1 > α2
  • hypotension (vasoconstrictor)
  • ocular procedures (mydriatic)
  • rhinitis (decongestant)
  • ischemic priapism
A

Phenylephrine

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93
Q

Indirect Sympathomimetics:

  • indirect general agonist
  • reuptake inhibitor
  • releases stored catecholamines
A

Amphetamine

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94
Q

Indirect Sympathomimetics:

  • indirect general agonist
  • reuptake inhibitor
  • causes vasoconstriction and local anesthesia
  • caution when giving β-blockers if intoxication is suspected (can lead to unopposed α1 activation, activation → extreme hypertension, coronary vasospasm).
A

Cocaine

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95
Q

Indirect Sympathomimetics:

  • indirect general agonist
  • releases stored catecholamines
  • nasal decongestion (pseudoephedrine)
  • urinary incontinence
  • hypotension
A

Ephedrine

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96
Q

Norepinephrine vs. Isoproterenol

A
  • NE ↑ systolic and diastolic pressures as a result of α1-mediated vasoconstriction → ↑ mean arterial pressure → reflex bradycardia.
  • Isoproterenol (rarely used) has little α effect but causes β2-mediated vasodilation, resulting in ↓mean arterial pressure and ↑ heart rate through β1 and reflex activity.
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97
Q

Sympatholytics (α2-agonists):

  • Applications:
    • hypertensive urgency (limited situations)
    • ADHD
    • Tourette syndrome
    • symptom control in opioid withdrawal
  • Adverse Effects:
    • CNS depression
    • bradycardia
    • hypotension
    • respiratory depression
    • miosis
    • rebound
    • hypertension with abrupt cessation
A
  • Clonidine
  • Guanfacine
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98
Q

Sympatholytics (α2-agonists):

  • Applications:
    • hypertension in pregnancy
  • Adverse Effects:
    • direct Coombs ⊕ hemolysis
    • drug-induced lupus
A

α-methyldopa

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99
Q

Sympatholytics (α2-agonists):

  • Applications:
    • relief of spasticity
  • Adverse Effects:
    • hypotension
    • weakness
    • xerostomia
A

Tizanidine

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100
Q

α-Blockers:

  • nonselective
  • irreversible
  • Applications:
    • pheochromocytoma (used preoperatively) to prevent catecholamine (hypertensive) crisis
  • Adverse Effects:
    • orthostatic hypotension
    • reflex tachycardia
A

Phenoxybenzamine

101
Q

α-Blockers:

  • nonselective
  • reversible
  • Applications:
    • give to patients on MAO inhibitors who eat tyramine-containing foods and for severe cocaine-induced hypertension (2nd line)
  • Adverse Effects:
    • orthostatic hypotension
    • reflex tachycardia
A

Phentolamine

102
Q

α-Blockers:

  • α1 selective
  • Applications:
    • urinary symptoms of BPH
    • PTSD (prazosin)
    • hypertension (except tamsulosin)
  • Adverse Effects:
    • 1st-dose orthostatic hypotension, dizziness, headache
A
  • Prazosin
  • Terazosin
  • Doxazosin
  • Tamsulosin
103
Q

α-Blockers:

  • α2 selective
  • Applications:
    • depression
  • Adverse Effects:
    • sedation
    • ↑ serum cholesterol
    • ↑ appetite
A

Mirtazapine

104
Q

Effects of α-Blocker on BP Responses to Epinephrine and Phenylephrine

A
  • Epinephrine response exhibits reversal of mean arterial pressure from a net increase (the α response) to a net decrease (the β2 response). properties).
  • Phenylephrine response is suppressed but not reversedbecause it is a “pure” α-agonist (lacks β-agonist properties).
105
Q

β-Blockers

A
  • Acebutolol
  • Atenolol
  • Betaxolol
  • Bisoprolol
  • Carvedilol
  • Esmolol
  • Labetalol
  • Metoprolol
  • Nadolol
  • Nebivolol
  • Pindolol
  • Propranolol
  • Timolol
106
Q

β-Blocker Applications:

↓ heart rate and contractility, resulting in ↓ O2 consumption

A

Angina Pectoris

107
Q

β-Blocker Applications:

↓ production of aqueous humor

A

Glaucoma

  • Timolol
108
Q

β-Blocker Applications:

↓ mortality

A
  • Heart Failure
    • Bisoprolol
    • Carvedilol
    • Metoprolol
  • Myocardial Infarction
109
Q

β-Blocker Applications:

  • ↓ cardiac output
  • ↓ renin secretion (due to β1-receptor blockade on JGA cells)
A

Hypertension

110
Q

β-Blocker Applications:

  • symptom control (↓ heart rate, ↓ tremor),
  • thyroid storm
A

Hyperthyroidism

  • Propranolol
111
Q

β-Blocker Applications:

↓ heart rate → ↑ filling time, relieving obstruction

A

Hypertrophic Cardiomyopathy

112
Q

β-Blocker Applications:

↓ AV conduction velocity (class II antiarrhythmic)

A

Supraventricular Tachycardia

  • Metoprolol
  • Esmolol
113
Q

β-Blocker Applications:

  • ↓ hepatic venous pressure gradient
  • portal hypertension (prophylactic use)
A

Variceal Bleeding

  • Nadolol
  • Propranolol
  • Carvedilol
114
Q

Adverse Effects of β-Blockers

A
  • erectile dysfunction
  • cardiovascular (bradycardia, AV block, HF)
  • CNS (seizures, sleep alterations)
  • dyslipidemia (metoprolol)
  • asthma/COPD exacerbations
  • use with caution in cocaine users due to risk of unopposed α-adrenergic receptor agonist activity
115
Q

β-Blocker Selectivity:

β1-Selective Antagonists (β1 > β2)

A
  • Acebutolol (partial agonist)
  • Atenolol
  • Betaxolol
  • Bisoprolol
  • Esmolol
  • Metoprolol

Selective antagonists mostly go from A to M (β1 with 1st half of alphabet)

116
Q

β-Blocker Selectivity:

Nonselective Antagonists (β1 = β2)

A
  • Nadolol
  • Pindolol (partial agonist)
  • Propranolol
  • Timolol

Nonselective antagonists mostly go from N to Z (β2 with 2nd half of alphabet)

117
Q

β-Blocker Selectivity:

Nonselective α- and β-Antagonists

A
  • Carvedilol
  • Labetalol

Nonselective α- and β-antagonists have modified suffixes (instead of “-olol”).

118
Q

_____ combines cardiac-selective β1‑adrenergic blockade with stimulation of β3‑receptors (activate nitric oxide synthase in the vasculature and ↓ SVR).

A

Nebivolol

Nebivolol increases NO.

119
Q

Ingested Seafood Toxins

A
  • Histamine (Scombroid poisoning)—Histamine release
  • Tetrodotoxin—Total block of Na+ channels
  • Ciguatoxin—opening of Na+ channels to Cause depolarization
120
Q

Ingested Seafood Toxins:

  • spoiled dark-meat fish such as tuna, mahimahi, mackerel, and bonito
  • bacterial histidine decarboxylase converts histidine to histamine
  • frequently misdiagnosed as fish allergy
  • mimics anaphylaxis: acute burning sensation of mouth, flushing of face, erythema, urticaria, itching
  • may progress to bronchospasm, angioedema, and hypotension
  • treated with antihistamines, Albuterol and Epinephrine if needed
A

Histamine (Scombroid poisoning)

121
Q

Ingested Seafood Toxins:

  • pufferfish
  • highly potent toxin
  • binds fast voltage-gated Na+ channels in cardiac/nerve tissue, preventing depolarization
  • nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes
  • supportive therapy
A

Tetrodotoxin

122
Q

Ingested Seafood Toxins:

  • reef fish such as barracuda, snapper, and moray eel
  • opens Na+ channels, causing depolarization
  • nausea, vomiting, diarrhea; perioral numbness
  • reversal of hot and cold sensations
  • bradycardia, heart block, hypotension
  • supportive therapy
A

Ciguatoxin

123
Q

_____ is a widely used criteria developed to reduce potentially inappropriate prescribing and harmful polypharmacy in the geriatric population. Includes > 50 medications that should be avoided in elderly patients due to ↓ efficacy and/or ↑ risk of adverse events.

A

Beers Criteria

  • α-Blockers (↑ risk of hypotension)
  • Anticholinergics, Antidepressants, Antihistamines, Opioids (↑ risk of delirium, sedation, falls, constipation, urinary retention)
  • Benzodiazepines (↑ risk of delirium, sedation, falls)
  • NSAIDs (↑ risk of GI bleeding, especially with concomitant anticoagulation)
  • PPIs (↑ risk of C. difficile infection)
124
Q

Antidotes:

Acetaminophen

A

N-acetylcysteine (replenishes glutathione)

125
Q

Antidotes:

  • AChE Inhibitors
  • Organophosphates
A

Atropine > Pralidoxime

126
Q

Antidotes:

  • Antimuscarinic agents
  • Anticholinergic agents
A
  • Physostigmine
  • control hyperthermia
127
Q

Antidotes:

Arsenic

A
  • Dimercaprol
  • Succimer
128
Q

Antidotes:

Benzodiazepines

A

Flumazenil

129
Q

Antidotes:

β-blockers

A
  • Atropine
  • Glucagon
130
Q

Antidotes:

Carbon Monoxide

A
  • 100% O2
  • Hyperbaric O2
131
Q

Antidotes:

Copper

A
  • Penicillamine (copper penny)
  • Trientine
132
Q

Antidotes:

Cyanide

A
  • Nitrite
  • Thiosulfate
  • Hydroxocobalamin
133
Q

Antidotes:

Digitalis (Digoxin)

A

Anti-dig Fab fragments

134
Q

Antidotes:

Heparin

A

Protamine Sulfate

135
Q

Antidotes:

Iron

A
  • Deferoxamine
  • Deferasirox
  • Deferiprone
136
Q

Antidotes:

Lead

A
  • EDTA
  • Dimercaprol
  • Succimer
  • Penicillamine
137
Q

Antidotes:

Mercury

A
  • Dimercaprol
  • Succimer
138
Q

Antidotes:

  • Methanol
  • Ethylene Glycol (antifreeze)
A
  • Fomepizole > Ethanol
  • Dialysis
139
Q

Antidotes:

Methemoglobin

A
  • Methylene Blue
  • Vitamin C (reducing agent)
140
Q

Antidotes:

Opioids

A

Naloxone

141
Q

Antidotes:

Salicylates

A
  • NaHCO3 (alkalinize urine)
  • dialysis
142
Q

Antidotes:

TCAs

A

NaHCO3 (stabilizes cardiac cell membrane)

143
Q

Antidotes:

Warfarin

A
  • Vitamin K (delayed effect)
  • fresh frozen plasma (immediate)
144
Q

Drug Reactions—Cardiovascular:

coronary vasospasm

A

CASE

  • Cocaine
  • Amphetamines
  • Sumatriptan
  • Ergot Alkaloids
145
Q

Drug Reactions—Cardiovascular:

cutaneous flushing

A

Flushed from VANCEN (dancing):

  • Vancomycin
  • Adenosine
  • Niacin
  • Ca2+ Channel Blockers
  • Echinocandins
  • Nitrates
146
Q

Drug Reactions—Cardiovascular:

dilated cardiomyopathy

A

Anthracyclines

  • Doxorubicin
  • Daunorubicin

*prevented with Dexrazoxane

147
Q

Drug Reactions—Cardiovascular:

torsades de pointes

A

Prolong QT Interval (ABCDE):

  • antiArrhythmics (class IA, III)
  • antiBiotics (eg. macrolides)
  • anti“C”ychotics (eg. haloperidol)
  • antiDepressants (eg. TCAs)
  • antiEmetics (eg. ondansetron)
148
Q

Drug Reactions—Endocrine/Reproductive:

adrenocortical insufficiency

A

HPA suppression 2° to glucocorticoid withdrawal

149
Q

Drug Reactions—Endocrine/Reproductive:

diabetes insipidus

A
  • Lithium
  • Demeclocycline
150
Q

Drug Reactions—Endocrine/Reproductive:

hot flashes

A

SERMs

  • Tamoxifen
  • Clomiphene
  • Raloxifene
151
Q

Drug Reactions—Endocrine/Reproductive:

hyperglycemia

A

The People Need Hard Candies:

  • Tacrolimus
  • Protease Inhibitors
  • Niacin
  • HCTZ
  • Corticosteroids
152
Q

Drug Reactions—Endocrine/Reproductive:

hyperprolactinemia

A
  • Typical Antipsychotics (eg. haloperidol)
  • Atypical Antipsychotics (eg. quetiapine)
  • Metoclopramide
  • Methyldopa

*presents with hypogonadism (eg. infertility, amenorrhea, erectile dysfunction) and galactorrhea (more common in men)

153
Q

Drug Reactions—Endocrine/Reproductive:

hyperthyroidism

A
  • Lithium
  • Amiodarone
154
Q

Drug Reactions—Endocrine/Reproductive:

hypothyroidism

A

I AM SUddenly Lethargic:

  • AMiodarone
  • SUlfonamides
  • Lithium
155
Q

Drug Reactions—Endocrine/Reproductive:

SIADH

A

Can’t Concentrate Serum Sodium:

  • Carbamazepine
  • Cyclophosphamide
  • SSRIs
156
Q

Drug Reactions—Gastrointestinal:

  • acute cholestatic hepatitis
  • jaundice
A

Macrolides (eg. Erythromycin)

157
Q

Drug Reactions—Gastrointestinal:

diarrhea

A
  • Acamprosate
  • Antidiabetic Agents (eg. Acarbose, Metformin, Pramlintide)
  • Colchicine
  • Cholinesterase Inhibitors
  • Lipid-Lowering Agents (eg. Ezetimibe, Orlistat)
  • Macrolides (eg. Erythromycin)
  • Quinidine
  • SSRIs
158
Q

Drug Reactions—Gastrointestinal:

focal to massive hepatic necrosis

A

Liver “HAVAc”

  • Halothane
  • Amanita phalloides (death cap mushroom)
  • Valproic Acid
  • Acetaminophen
159
Q

Drug Reactions—Gastrointestinal:

hepatitis

A
  • Rifampin
  • Isoniazid
  • Pyrazinamide
  • Statins
  • Fibrates
160
Q

Drug Reactions—Gastrointestinal:

pancreatitis

A

Drugs Causing A Violent Abdominal Distress:

  • Didanosine
  • Corticosteroids
  • Alcohol
  • Valproic Acid
  • Azathioprine
  • Diuretics (Furosemide, HCTZ)
161
Q

Drug Reactions—Gastrointestinal:

pill-induced esophagitis

A
  • Bisphosphonates
  • Ferrous Sulfate
  • NSAIDs
  • Potassium Chloride
  • Tetracyclines

*caustic effect minimized with upright posture and adequate water ingestion

162
Q

Drug Reactions—Gastrointestinal:

pseudomembranous colitis

A
  • Ampicillin
  • Cephalosporins
  • Clindamycin
  • Fluoroquinolones

*sntibiotics predispose to superinfection by resistant C. difficile

163
Q

Drug Reactions—Hematologic:

agranulocytosis

A

Can Cause Pretty Major Collapse of Granulocytes:

  • Clozapine
  • Carbamazepine
  • Propylthiouracil
  • Methimazole
  • Colchicine
  • Ganciclovir
164
Q

Drug Reactions—Hematologic:

aplastic anemia

A

Can’t Make New Blood Cells Properly:

  • Carbamazepine
  • Methimazole
  • NSAIDs
  • Benzene
  • Chloramphenicol
  • Propylthiouracil
165
Q

Drug Reactions—Hematologic:

direct Coombs positive hemolytic anemia

A

P. Diddy Coombs:

  • Penicillin
  • MethylDopa
  • Cephalosporins
166
Q

Drug Reactions—Hematologic:

drug reaction with eosinophilia and systemic symptoms (DRESS)

A
  • Allopurinol
  • Anticonvulsants
  • Antibiotics
  • Sulfa Drugs
167
Q

_____ is a potentially fatal delayed hypersensitivity reaction. Latency period (2–8 weeks) followed by fever, morbilliform skin rash, and frequent multiorgan involvement. Treatment: withdrawal of offending drug, corticosteroids.

A

DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)

168
Q

Drug Reactions—Hematologic:

gray baby syndrome

A

Chloramphenicol

169
Q

Drug Reactions—Hematologic:

hemolysis in G6PD deficiency

A

Hemolysis IS D PAIN:

  • Isoniazid
  • Sulfonamides
  • Dapsone
  • Primaquine
  • Aspirin
  • Ibuprofen
  • Nitrofurantoin
170
Q

Drug Reactions—Hematologic:

megaloblastic anemia

A

You’re having a mega blast with PMS.

  • Hydroxyurea
  • Phenytoin
  • Methotrexate
  • Sulfa Drugs
171
Q

Drug Reactions—Hematologic:

thrombocytopenia

A

Help! Very Low platelets!

  • Heparin
  • Vancomycin
  • Linezolid
172
Q

Drug Reactions—Hematologic:

thrombotic complications

A
  • Combined Oral Contraceptives
  • Hormone Replacement Therapy
  • SERMs (eg. Tamoxifen, Raloxifene, Clomiphene)

*estrogen-mediated side effect

173
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:
drug-induced lupus

A

Having lupus is Mega “SHIPP-E”

  • Methyldopa
  • Sulfa Drugs
  • Hydralazine
  • Isoniazid
  • Procainamide
  • Phenytoin
  • Etanercept
174
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

fat redistribution

A

Fat PIG:

  • Protease Inhibitors
  • Glucocorticoids
175
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

gingival hyperplasia

A

Can Cause Puffy Gums

  • Cyclosporine
  • Ca2+ Channel Blockers
  • Phenytoin
176
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

hyperuricemia (gout)

A

Painful Tophi and Feet Need Care.

  • Pyrazinamide
  • Thiazides
  • Furosemide
  • Niacin
  • Cyclosporine
177
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

myopathy

A
  • Statins
  • Fibrates
  • Niacin
  • Colchicine
  • Daptomycin
  • Hydroxychloroquine
  • Interferon-α
  • Penicillamine
  • Glucocorticoids
178
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

osteoporosis

A
  • Corticosteroids
  • Depot Medroxyprogesterone Acetate
  • GnRH Agonists
  • Aromatase Inhibitors
  • Anticonvulsants
  • Heparin
  • PPIs
179
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

photosensitivity

A

SAT For photo:

  • Sulfonamides
  • Amiodarone
  • Tetracyclines
  • 5-FU
180
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

rash (Stevens-Johnson syndrome)

A

Steven Johnson has epileptic allergy to sulfa drugs and penicillin.

  • Anti-Epileptic drugs (Lamotrigine)
  • Allopurinol
  • Sulfa Drugs
  • Penicillin
181
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

teeth discoloration

A

Tetracyclines

Teethracyclines

182
Q

Drug Reactions—Musculoskeletal/Skin/Connective Tissue:

tendon and cartilage damage

A

Fluoroquinolones

183
Q

Drug Reactions—Neurologic:

cinchonism

A
  • Quinidine
  • Quinine

*can present with tinnitus, hearing/vision loss, psychosis, and cognitive impairment

184
Q

Drug Reactions—Neurologic:

Parkinson-like syndrome

A

cogwheel rigidity of ARM:

  • Antipsychotics
  • Reserpine
  • Metoclopramide
185
Q

Drug Reactions—Neurologic:

peripheral neuropathy

A
  • Phenytoin
  • Vincristine
186
Q

Drug Reactions—Neurologic:

pseudotumor cerebri

A
  • Growth Hormones
  • Tetracyclines
  • Vitamin A
187
Q

Drug Reactions—Neurologic:

seizures

A

With seizures, I BITE my tongue.

  • Isoniazid (vitamin B6 deficiency)
  • Bupropion
  • Imipenem/Cilastatin
  • Tramadol
  • Enflurane
188
Q

Drug Reactions—Neurologic:

tardive dyskinesia

A
  • Antipsychotics
  • Metoclopramide
189
Q

Drug Reactions—Neurologic:

visual disturbance

A

These Drugs Irritate Very Precious Eyes:

  • Topiramate (blurred vision/diplopia, haloes)
  • Digoxin (yellow-tinged vision)
  • Isoniazid (optic neuropathy/color vision changes)
  • Vigabatrin (bilateral visual field defects)
  • PDE-5 inhibitors (blue-tinged vision)
  • Ethambutol (color vision changes)
190
Q

Drug Reactions—Renal/Genitourinary:

Fanconi syndrome

A
  • Cisplatin
  • Ifosfamide
  • expired Tetracyclines
  • Tenofovir
191
Q

Drug Reactions—Renal/Genitourinary:

hemorrhagic cystitis

A
  • Cyclophosphamide
  • Ifosfamide

*prevent by coadministering with Mesna

192
Q

Drug Reactions—Renal/Genitourinary:

interstitial nephritis

A
  • Penicillins
  • Furosemide
  • NSAIDs
  • Proton Pump Inhibitors
  • Sulfa Drugs
193
Q

Drug Reactions—Respiratory:

dry cough

A

ACE Inhibitors

194
Q

Drug Reactions—Respiratory:

pulmonary fibrosis

A

My Nose Cannot Breathe Bad Air.

  • Methotrexate
  • Nitrofurantoin
  • Carmustine
  • Bleomycin
  • Busulfan
  • Amiodarone
195
Q

Drug Reactions—Multiorgan:

antimuscarinic

A
  • Atropine
  • TCAs
  • H1-Blockers
  • Antipsychotics
196
Q

Drug Reactions—Multiorgan:

Disulfiram-like reaction

A

Sorry Pals, Can’t Go Mingle.

  • 1st-Generation Sulfonylureas
  • Procarbazine
  • Cephalosporins
  • Griseofulvin
  • Metronidazole
197
Q

Drug Reactions—Multiorgan:

nephrotoxicity/ototoxicity

A

Listen And Pee Very TERriBly:

  • Loop Diuretics
  • Aminoglycosides
  • CisPlatin
  • Vancomycin
  • AmphoTERicin B

*Cisplatin toxicity may respond to amifostine

198
Q

Drugs affecting pupil size:

↑ pupil size (mydriasis)

A
  • Anticholinergics (atropine, TCA, tropicamide, scopolamine, antihistamines)
  • Drugs of Abuse (amphetamines, cocaine, LSD)
  • Sympathomimetics
199
Q

Drugs affecting pupil size:

↓ pupil size (miosis)

A
  • Antipsychotics (haloperidol, risperidone, olanzapine)
  • Drugs of Abuse (eg. heroin/opioids)
  • Parasympathomimetics (pilocarpine)
  • Organophosphates
200
Q

Cytochrome P-450 Inducers (+)

A

Most chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs.

  • Modafinil
  • Chronic Alcohol Use
  • St. John’s Wort
  • Phenytoin
  • Phenobarbital
  • Nevirapine
  • Rifampin
  • Griseofulvin
  • Carbamazepine
201
Q

Cytochrome P-450 Substrates

A

Always Think When Outdoors:

  • Anti-Epileptics
  • Theophylline
  • Warfarin
  • OCPs
202
Q

Cytochrome P-450 Inhibitors (–)

A

SICKFACES.COM (when I Am drinking grapefruit juice):

  • Sodium Valproate
  • Isoniazid
  • Cimetidine
  • Ketoconazole
  • Fluconazole
  • Acute Alcohol Abuse
  • Chloramphenicol
  • Erythromycin/Clarithromycin
  • Sulfonamides
  • Ciprofloxacin
  • Omeprazole
  • Metronidazole
  • Amiodarone
  • Grapefruit Juice
203
Q

Sulfa Drugs

A

Scary Sulfa Pharm FACTS:

  • Sulfonamide Antibiotics
  • Sulfasalazine
  • Probenecid
  • Furosemide
  • Acetazolamide
  • Celecoxib
  • Thiazides
  • Sulfonylureas
204
Q

Patients with sulfa allergies may develop _____. Symptoms range from mild to life threatening.

A
  • fever
  • urinary tract infection
  • Stevens-Johnson syndrome
  • hemolytic anemia
  • thrombocytopenia
  • agranulocytosis
  • acute interstitial nephritis
  • urticaria (hives)
205
Q

Antimicrobials:

ergosterol synthesis inhibitor

A

-azole

Ketoconazole

206
Q

Antimicrobials:

antiparasitic/antihelminthic

A

-bendazole

Mebendazole

207
Q

Antimicrobials:

transpeptidase (penicillin-binding protein)

A

-cillin

Ampicillin

208
Q

Antimicrobials:

protein synthesis inhibitor

A

-cycline

Tetracycline

209
Q

Antimicrobials:

neuraminidase inhibitor

A

-ivir

Oseltamivir

210
Q

Antimicrobials:

protease inhibitor

A

-navir

Ritonavir

211
Q

Antimicrobials:

DNA polymerase inhibitor

A

-ovir

Acyclovir

212
Q

Antimicrobials:

macrolide antibiotic

A

-thromycin

Azithromycin

213
Q

CNS Drugs:

inhalational general anesthetic

A

-ane

Halothane

214
Q

CNS Drugs:

typical antipsychotic

A

-azine

Thioridazine

215
Q

CNS Drugs:

barbiturate

A

-barbital

Phenobarbital

216
Q

CNS Drugs:

local anesthetic

A

-caine

Lidocaine

217
Q

CNS Drugs:

TCA

A
  • -ipramine
  • -triptyline

Imipramine

Amitriptyline

218
Q

CNS Drugs:

5-HT1B/1D Agonist

A

-triptan

Sumatriptan

219
Q

CNS Drugs:

benzodiazepine

A
  • -zepam
  • -zolam

Diazepam

Alprazolam

220
Q

Autonomic Drugs:

cholinergic agonist

A

-chol

Bethanechol

Carbachol

221
Q

Autonomic Drugs:

nondepolarizing paralytics

A
  • -curium
  • -curonium

Atracurium

Vecuronium

222
Q

Autonomic Drugs:

β-blocker

A

-olol

Propranolol

223
Q

Autonomic Drugs:

AChE inhibitor

A

-stigmine

Neostigmine

224
Q

Autonomic Drugs:

β2-agonist

A

-terol

Albuterol

225
Q

Autonomic Drugs:

α1-antagonist

A

-zosin

Prazosin

226
Q

Cardiovascular Drugs:

PDE-5 inhibitor

A

-afil

Sildenafil

227
Q

Cardiovascular Drugs:

dihydropyridine Ca2+ channel blocker

A

-dipine

Amlodipine

228
Q

Cardiovascular Drugs:

ACE inhibitor

A

-pril

Captopril

229
Q

Cardiovascular Drugs:

angiotensin-II receptor blocker

A

-sartan

Losartan

230
Q

Cardiovascular Drugs:

direct factor Xa inhibitor

A

-xaban

Apixaban

Edoxaban

Rivaroxaban

231
Q

Drugs:

bisphosphonate

A

-dronate

Alendronate

232
Q

Drugs:

DPP-4 inhibitors

A

-gliptin

Sitagliptin

233
Q

Drugs:

PPAR-γ activator

A

-glitazone

Rosiglitazone

234
Q

Drugs:

calcineurin inhibitor

A

-limus

Everolimus

Tacrolimus

235
Q

Drugs:

proton pump inhibitor

A

-prazole

Omeprazole

236
Q

Drugs:

prostaglandin analog

A

-prost

Latanoprost

237
Q

Drugs:

endothelin receptor antagonist

A

-sentan

Bosentan

238
Q

Drugs:

H2-antagonist

A

-tidine

Cimetidine

239
Q

Drugs:

pituitary hormone

A

-tropin

Somatotropin

240
Q

Monoclonal Antibodies:

chimeric human-mouse monoclonal Ab

A

-ximab

Rituximab

241
Q

Monoclonal Antibodies:

humanized mouse monoclonal Ab

A

-zumab

Bevacizumab

242
Q

Monoclonal Antibodies:

human monoclonal Ab

A

-mumab

Ipilimumab

243
Q

Small Molecule Inhibitors:

tyrosine kinase inhibitor

A

-tinib

Imatinib

244
Q

Small Molecule Inhibitors:

proteasome inhibitor

A

-zomib

Bortezomib

245
Q

Small Molecule Inhibitors:

cyclin-dependent kinase inhibitor

A

-ciclib

Palbociclib

246
Q

Receptor Fusion Proteins:

TNF-α antagonist

A

-cept

Etanercept

247
Q

Interleukin Receptor Modulators:

IL-2 agonist/analog

A

-leukin

Aldesleukin

248
Q

Interleukin Receptor Modulators:

interleukin receptor antagonist

A

-kinra

Anakinra

USMLE Step 1 (18 decks)

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