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STEP 1 classic presentations > quick drugs hankk > Flashcards

quick drugs hankk Flashcards

1
Q

rapid acting insulin

A

Lispro, aspart, and glulisine.

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2
Q

long acting insulin

A

detemir and glargine

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3
Q

Biguanides (metformin)

A 
increases insulin sensitivity
lactic acidosis (contraindicated in renal insufficiency)
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4
Q

sulfonyl ureas

A

1st gen- chlorpropamide, tolbutamide
2nd gen- glimepiride glyburide and glipizide
glipizide associated with hepatotoxicity and glimepiride and glyburide with hypoglyceia because of long action
MOA: closes K+ channel in beta cell leading cell depolarization and insulin release.
first generation disulfuram like effects
weight gain and hypoglycemia

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5
Q

Glitazones/TZDs

A

pioglitzone rosiglitazone
increases insulin sensitivoty. binds to PPAR-gamma nuclear transcription regulator.
AE: weight gain, edema, hepatotoxicity, heart failure and increases risk of fracture.

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6
Q

meglitinides

A

nateglinide, repaglinide.
bind to K+ channel in beta cell increasing insulin release.
AE: hypoglycemia and weight gain.

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7
Q

GLP-1 analogs

A

exenatide liraglutide.

AE: pancreatitis, modest weight loss

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8
Q

DPP-4 inhibitors

A

linagliptin, saxagliptin, sitagliptin

AE: mild urinary or respiratory infections.

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9
Q

amylin analogs

A

pramlinitide.
MOA: decrease gastric emptying and decrease glucagon.
hypoglycemia and nausea.

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10
Q

SGLT-2 inhibitors

A

canagliflozin, dapagliflozin, and empagliflozin.
block reabsorption of glucose in PCT.
AE: glucosuria, UTIs, vaginal yeast infections, hyperkalemia, dehydration.

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11
Q

alpha glusidase inhibitors

A

acarbose, miglitol

inhibit intestinal brush border alpha glucosidases.

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12
Q

propylthiouracil (thionamides)

A

block thyoid peroxidase, inhibiting oxidation of iodide and organification of iodine. (methimazole also).
PTU also inhibits 5’-deiodinase decreasing peripheral conversion of T4 to T3.

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13
Q

demeocycline

A

ADH antogonist.

member of tetracycline family.

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14
Q

fludricortisone

A

synthetic analog of aldosterone

AE: worsens HF and leads to hyperpigmentation.

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15
Q

H2 blockers

A

cimentidine, ranitidine, famotidine, nizatidine.
reversible block of H2 receptor.
cimentidine is also a potent blocker of the CYP450 system. also has antoandrogenic effects(prolactin release), gynecomastia, impotence, decreased libido.

both ranitidine and cimentidine decrease renal excretion of creatinine.

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16
Q

PPIs

A

irreversibly inhibit H+/K+ ATPase.

AE: increase risk of C diff infection, pneumonia, decreases serum Mg2+ with long term use, osteoporotic hip fractures

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17
Q

aluminum hydroxide

A

constipation, hyperphosphatemia, prox muscle weakness, osteodystrophy, and seizures.

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18
Q

magnesium hydroxide.

A

diarrhea, hyporeflexia, hypotension, cardiac arrest.

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19
Q

ondansetron

A

5-HT3 antagonist.
post op patients and chemo patients.
AE: headache, constipation and QT interval prolongation

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20
Q

memantine

A

NMDA receptor antagonist (helps prevent exitotoxicity)

used in alzheimer disease

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21
Q

Sumitriptan.

A

5HT 1B/1D agonist. inhibit trigeminal nerve activation. prevent vasoactive peptide release; induce vasoconstriction
AE: coronary vasospasm (contraindicated in patients with CAD or prinzmetal angina); mild paresthesia.

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22
Q

antipsychotics

A

Haloperidol, trifluoperazine, thioridazine, chlorpromazine
block D2 receptors.
high potency: trifluoperazine, fluphenazine, and haloperidol
low potency: chlopromazine thioridazine.

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23
Q

atypical antipsychotics

A

aripripazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone
AE: all cause prolonged QT interval
pines-metabolic syndrome, clozapine agranulocytosis,
risperidone-hyperprolactinemia.

24
Q

SSRIs

A

fluoxetine, paroxetine, setraline, citalopram.

25
Q

SNRIs

A

venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran.
AE: increase BP.

26
Q

treatment of serotonin syndrome.

A

cyproheptadine.

27
Q

Tricyclic antidepressants.

A

amitryptiline, nortriptiline, imipramine, desipramine, clomipramine, doxepin, amoxapine.
Tri C’s- coma convulsions and cardiotoxicity (arrhythmia due to Na+ channel inhibition.
NaHCO3 can prevent arrhythmia in overdose.

28
Q

monoamine oxidase inhibitors

A

tranylcypromine, phenylzine, isocarboxazid, selegiline.

29
Q

bethanechol

A

activates bowel and bladder smooth muscle. resistant to ACHE

postop ileus, neurogenic ileus and urinary retention

30
Q

carbachol

A

constricts pupil and relieves intraocular pressure in open angle glaucoma.

31
Q

pilocarpine

A

potent stimulator of sweat, tears and saliva

used in open and closed angle glaucoma and xerostomia (sjogren syndrome)

32
Q

neostigmine

A

increases Ach

postop and neurogenic ileus, urinary retention, myasthenia gravis and reversal of neuromuscular junction blockade

33
Q

physostigmine

A

increases Ach
phyxes atropine overdose
used in anticholinergic toxicity, crosses BBB

34
Q

pyridostigmine

A

increases Ach

myasthenia gravis; does not penetrate CNS.

35
Q

glycopyrolate

A

muscarinic antagonist GI and respiratory

parenteral: preoperative to reduce airway secretions
oral: drooling, peptic ulcer.

36
Q

hyoscyamine, dicyclomine

A

GI

antispasmotics for IBS

37
Q

reduce bladder spasms and urge urinary incontinence

A

oxybutynin, solifenacin and tolterodine.

38
Q

fenoldopam

A

D1

post op HTN, hyper tensive crisis. promotes natriuresis. can cause hypotension and tachycardia.

39
Q

midodrine

A

autonomic insufficiency and postural hypotension. may exacerbate supine HTN.

40
Q

cephalosporins

A

1st gen. cefazolin, cephalexin
2nd gen. cefaclor, cefoxitin, cefuroxime
3rd gen. ceftriaxone, cefotaxime,
cefpodoxime, ceftazidime ( for psuedomonas)
4th gen cefepime
5th gen ceftaroline (does not cover psuedomonas but does cover MRSA)
MECHANISM OF RESISTANCE Structural change in penicillin-binding proteins
(transpeptidases).

41
Q

carbapenams

A

Imipenem, meropenem, ertapenem, doripenem.
Imipenem is a broad-spectrum, β-lactamase–
resistant carbapenem. Always administered
with cilastatin (inhibitor of renal
dehydropeptidase I) to decrease inactivation of drug
in renal tubules.
imipenam is associated with seizures

42
Q

Monobactams (Aztreonam)

A

Less susceptible to β-lactamases. Prevents peptidoglycan cross-linking by binding to penicillinbinding
protein 3. Synergistic with aminoglycosides. No cross-allergenicity with penicillins.

only works against gram - rods. not effective against anaerobes

43
Q

aminoglycosides

A

Bactericidal; irreversible inhibition of initiation
complex through binding of the 30S subunit.
Can cause misreading of mRNA. Also block
translocation. Require O2 for uptake; therefore
ineffective against anaerobes.
AE: Nephrotoxicity, Neuromuscular blockade,
Ototoxicity (especially when used with loop
diuretics). Teratogen.
MECHANISM OF RESISTANCE Bacterial transferase enzymes inactivate the
drug by acetylation, phosphorylation, or
adenylation

44
Q

tetracycline

A

Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration.
Doxycycline is fecally eliminated and can be used in patients with renal failure. Do not take
tetracyclines with milk (Ca2+), antacids (Ca2+ or Mg2+), or iron-containing preparations because
divalent cations inhibit drugs’ absorption in the gut.
AE:Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration.
Doxycycline is fecally eliminated and can be used in patients with renal failure. Do not take
tetracyclines with milk (Ca2+), antacids (Ca2+ or Mg2+), or iron-containing preparations because
divalent cations inhibit drugs’ absorption in the gut.
decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps.

45
Q

Chloramphenicol

A

Blocks peptidyltransferase at 50S ribosomal subunit. Bacteriostatic.
AE: Anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (in premature
infants because they lack liver UDP-glucuronyltransferase).
MECHANISM OF RESISTANCE Plasmid-encoded acetyltransferase inactivates the drug.

46
Q

Oxazolidinones (Linezolid)

A

Inhibit protein synthesis by binding to 50S subunit and preventing formation of the initiation
complex.
AE: Bone marrow suppression (especially thrombocytopenia), peripheral neuropathy, serotonin
syndrome.
MECHANISM OF RESISTANCE Point mutation of ribosomal RNA.

47
Q

Macrolides

A

Azithromycin, clarithromycin, erythromycin.
Inhibit protein synthesis by blocking translocation (“macroslides”); bind to the 23S rRNA of the
50S ribosomal subunit. Bacteriostatic.
AE: MACRO: Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT interval, acute
Cholestatic hepatitis, Rash, eOsinophilia. Increases serum concentration of theophylline, oral
anticoagulants. Clarithromycin and erythromycin inhibit cytochrome P-450.
MECHANISM OF RESISTANCE Methylation of 23S rRNA-binding site prevents binding of drug.

48
Q

Sulfamethoxazole (SMX), sulfisoxazole,

sulfadiazine.

A

Inhibit dihydropteroate synthase, thus inhibiting
folate synthesis. Bacteriostatic (bactericidal
when combined with trimethoprim).
AE: Hypersensitivity reactions, hemolysis if G6PD
deficient, nephrotoxicity (tubulointerstitial
nephritis), photosensitivity, Stevens-Johnson
syndrome, kernicterus in infants, displace
other drugs from albumin (eg, warfarin
resistance: Altered enzyme (bacterial dihydropteroate
synthase), 􀁲 uptake, or 􀁱 PABA synthesis.

49
Q

Fluoroquinolones

A

Inhibit prokaryotic enzymes topoisomerase
II (DNA gyrase) and topoisomerase IV.
Bactericidal. Must not be taken with antacids.
AE: GI upset, superinfections, skin rashes, headache,
dizziness. Less commonly, can cause leg
cramps and myalgias. Contraindicated in
pregnant women, nursing mothers, and
children < 18 years old due to possible damage
to cartilage. Some may prolong QT interval.
May cause tendonitis or tendon rupture in
people > 60 years old and in patients taking
prednisone. Ciprofloxacin inhibits cytochrome
P-450.
MECHANISM OF RESISTANCE Chromosome-encoded mutation in DNA
gyrase, plasmid-mediated resistance, efflux
pumps.

50
Q

Daptomycin

A

Lipopeptide that disrupts cell membranes of
gram ⊕ cocci by creating transmembrane
channels.
ADVERSE EFFECTS Myopathy, rhabdomyolysis.

51
Q

selective arterial dilators

A

minoxidil and hydralazine

result in sodium and fluid retention because of the reflex tachycardia which is provided by the sympathetic nervous which also causes renin release

52
Q

side affects of mannitol

A

Pulmonary edema, dehydration. Contraindicated in anuria, HF.

53
Q

Ethacrynic acid

A

Nonsulfonamide inhibitor of cotransport system
(Na+/K+/2Cl−) of thick ascending limb of loop
of Henle.
more ototoxic than furosemide

54
Q

thiazide dirutics adverse effects

A

Hypokalemic metabolic alkalosis,
hyponatremia, hyperGlycemia,
hyperLipidemia, hyperUricemia,
hyperCalcemia. Sulfa allergy.

Hydrochlorothiazide, chlorthalidone,
metolazone.

55
Q

Potassium-sparing diuretics

A

Spironolactone and eplerenone; Triamterene,
and Amiloride
Spironolactone and eplerenone are competitive
aldosterone receptor antagonists in cortical
collecting tubule. Triamterene and amiloride
act at the same part of the tubule by blocking
Na+ channels in the cortical collecting tubule.

56
Q

Aliskiren

A

Direct renin inhibitor, blocks conversion of angiotensinogen to angiotensin I.

STEP 1 classic presentations (2 decks)

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