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Random drugs Flashcards

1
Q

Fenoldopam

A

Dopamine D1 receptor agonist used for coronary, peripheral, renal, and splanchnic vasodilation in htn emergency

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2
Q

Drugs to treat spasticity

A

Baclofen (GABA-B agonist) and tizanidine (alpha2 agonist)

decrease excitability of SC reflexes

used eg in MS spasticity

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3
Q

Diuretics that increase survival in CHF

A

aldo receptor antagonists (spironolactone and eplerenone)

diuresis, K-sparing, and block aldo-induced ventricular remodeling

loop diuretcs are strongest diuretic and used to treat pulm congestion and fluid retention, but don’t provide survival benefit (just improve sx)

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4
Q

Triptans - mech of action?

A

serotonin agonists - inhibit release of vasoactive peptides (substance P, calcitonin gene-related peptide etc) to decrease neurogenic inflamm, vasoconstrict meningeal vessels, and block brainstem pain pathways

used to treat migraines (abortive)

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5
Q

Migraine prophylaxis

A

beta blockers, SNRIs (TCAs, venlafaxine), anti-seizure meds (eg topiramate)

vs SSRIs and DNRIs don’t work

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6
Q

bupropion

A

DNRI - used to treat depression and smoking cessation

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7
Q

Eplerenone

A

aldo antagonist

weak diuretic, K sparing

fewer side effects with eplerenone than with spiron (eg less gynecomastia)

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8
Q

First-line dz modifying agent to treat RA?

A

methotrexate

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9
Q

Meds with anticholinergic properties

A

antihistamines

TCAs

1st gen low-potency antipsychotics (chlorpromazine) - vs haloperidol (high-potency) has more neuro side effects from D2 antagonism

Clozapine (2nd gen)

anti-PD drugs (eg benztropine, trihexyphenidyl)

belladonna alkaloids (eg atropine)

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10
Q

Methotrexate mech

A

inhibits dihydrofolate reductase, which regenerates THF from DHF

THF is the methyl donor that helps thymidylate synthase catalyze the conversion of dUMP to dTMP

so without THF, can’t do DNA synthesis - used for chemo

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11
Q

Anthracycline mech

A

intercalate between bases during DNA replication –> defective base pairing and splitting of DNA strands

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12
Q

Drugs that can cause serotonin syndrome

A

Combinations of several serotonin-affecting drugs, eg MAOI (eg LINEZOLID, tranylcypromine, phenelzine, pargyline, clorgyline, selegiline) + SSRI, SNRI, TCA

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13
Q

Isoniazid adverse effects

A

B6 deficiency –> periph neuropathy

Direct hepatotox (mild in 10-20% of pts and usually goes away with time, even if continue drug, but in

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14
Q

Eculizumab

A

terminal complement inhibitor used to treat PNH

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15
Q

Chlorthalidone - fxn and AE?

A

fxn: thiazide diuretic

AE: hypokalemia and metabolic alk; can also decrease insulin secretion –> hyperglycemia

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16
Q

Alirocumab

A

PCSK9 inhibitor (decreases LDL receptor degradation)

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17
Q

Treatment for TCA overdose?

A

sodium bicarb

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18
Q

Treatment for neonatal abstinence syndrome due to withdrawal from opiates?

A

opiates - morphine or methadone with increasing dose until sx are controlled, and then weaning off of it over next few weeks

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19
Q

Filgrastim

A

granulocyte colony stimulating factor analog

used to stimulate proliferation and differentation of granulocytes in pts with neutropenia (eg after chemo)

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20
Q

Amiodarone side effects

A

heart: sinus bradycardia, heart block, proarrhythmic
lungs: chronic interstitial pneumonitis
endo: hypo/hyperthyroidism (b/c amiodarone is 40% iodine) - so can cause decreased or increased prodn ( esp in pts with preexisting thyroid condition) or destructive thyroiditis –> release of preformed hormone

GI: elevated AST/ALT, hepatitis

ocular: corneal microdeposits, optic neuropathy
derm: blue/gray skin discoloration
neuro: peripheral neuropathy

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21
Q

Bortezomib

A

proteasome inhibitor used to treat MM and Waldenstrom macroglobulinemia

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22
Q

Omalizumab

A

anti-IgE used to treat refractory, severe asthma set off by allergy

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23
Q

Pentamidine

A

used for prophylaxis and treatment of PJP

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24
Q

Bosentan

A

endothelin-receptor antagonist (vasodilates and decreases endothelial proliferation)

used to decrease pulmonary arterial pressure in idiopathic PAH

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25
Q

Etanercept

A

anti-TNF-alpha

anti-inflamm agent, used to treat RA, psoriasis, psoriatic arthritis

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26
Q

sx of ischemic vs hemorrhagic stroke

A

ischemic: fluctuating sx that may progress with periods of improvement
hemorrhagic: abrupt onset of sx with loss of consciousness, irreg breathing etc (most common adverse effect of MI thrombolysis)

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27
Q

Donepezil

A

AChE inhibitor used in AD

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28
Q

Phenelzine

A

MAOI

used in atypical subtype of major depression (mood reactivity, leaden paralysis, rejection sensitivity, and reversed vegetative signs) + treatment-resistant depression

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29
Q

Antidepressants that don’t cause sexual side effects

A

bupropion and mirtazapine (NSRI)

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30
Q

Escitalopram

A

SSRI

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31
Q

First-line agent for trigeminal neuralgia

A

carbamazepine

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32
Q

baclofen

A

skeletal muscle relaxant

activates GABA-B receptors in SC

33
Q

Moxifloxacin

A

used to treat respiratory infxns (eg copd exacerbation, sinusitis, CAP)

34
Q

Nystatin vs amphotericin B

A

nystatin isn’t absorbed from GI, so given oral for oropharyngeal candidiasis

vs. amph B = IV and has many toxic AEs, so given for more complex fungal infxns

both work by binding ergosterol in fungal cell membrane and causing pores to form

35
Q

Danazol

A

synthetic estrogen used to treat endometriosis and hereditary angioedema

mech: suppresses GnRH via negative feedback –> decreased LH/FSH –> decreased estrogen –> decreased endometrial growth

36
Q

Ibutilide

A

class 3 anti-arrhythmic

used for afib, atrial flutter

AE: torsades

37
Q

Riluzole

A

ALS drug

blocks Na channels, inhibiting kainate and NMDA receptors - antiglutamatergic, so decrease excitotox

38
Q

Nesiritide

A

recombinant BNP

used to treat decompensated LV dysfxn –> CHF

39
Q

Sevelamer

A

non-absorbable phosphate-binding polymer that decreases absorption of phosphate in GI tract

used to treat hyperphosphatemia in dialysis pts

40
Q

Butorphanol

A

kappa opioid receptor agonist and mu partial agonist; used to treat severe pain

AE: can get opioid withdrawal sx if give with full mu agonist; overdose not easily reversed

41
Q

Tramadol

A

weak opioid agonist; also inhibits serotonin and NE reuptake so can cause serotonin syndrome, seizures, dependence etc

used for chronic pain

42
Q

meperidine

A

mu opioid agonist

43
Q

pentazocine

A

opioid analgesic

44
Q

fentanyl

A

opioid analgesic

45
Q

Cyclobenzaprine

A

centrally acting skel muscle relaxant

structurally similar to TCAs, has similar anticholinergic side effects

46
Q

AChE inhibitors used to treat AD

A

donepezil, galantamine, rivastigmine, tacrine

47
Q

HD drugs

A

Tetrabenazine and reserpine - inhibit VMAT to decrease DA packaging and release

haloperidol - D2 receptor antag

based on idea that DA is increased in HD

48
Q

DDAVP

A

synthetic vasopressin - has antidiuretic effects (to treat central DI and nocturnal enuresis) and –> release of VWF and factor 8 from endothelial cells

minimal effect on V1 vasopressin receptor, so doesn’t really contract smooth muscle in vv, no increased BP

49
Q

causes of ED

A

psychogenic stressors, performance anxiety, depression (esp if ED came on suddenly and still get spontaneous erections at night)

drugs (SSRIs, sympathetic blockers like beta blockers)

vascular or neuro impairment

GU trauma (eg prostate surgery, pelvic trauma, priapism)

50
Q

Contact precautions vs standard precautions vs airborne precautions vs droplet

A

contact (eg c diff) - handwashing with soap and water, gown, nonsterile gloves

standard - handwashing, proper disposal of cleaning instruments and linens, occasional use of gown and gloves for contact with body fluids

airborne (5microns, eg Neisseria meng, flu, Bordetella pertussis, mycoplasma pna, RSV) - simple facemask

51
Q

Griseofulvin mech and use

A

mech: enters fungal cells and binds MTs, inhibiting mitosis
use: dermatophyte fungal infxns (accumulates in keratin-containing tissues)

52
Q

Ipratropium - use and mech

A

asthma and COPD in conjunction with beta-2 agonists (b/c they’re not as effective at bronchodil alone)

block bronchocon effects of PS system and also the mucus production of PS system

53
Q

Flunisolide

A

inhaled glucocorticoid used for prophylactic treatment of bronchial asthma

54
Q

Methylxanthinges

A

theophylline, aminophylline

bronchial dilation by blocking PDE

55
Q

Oxybutynin

A

antimuscarininc used to treat urge incontinence

56
Q

Puromycin

A

aminonucleoside antibiotic that has structure like aminoacyl-tRNA, so it binds the ribosome and causes premature release of unfinished polypeptide in the bacterium

57
Q

Pentagastrin use?

A

synthetic gastrin - used to screen for carcinoid syndrome and MTC

58
Q

Amifostine

A

cytoprotective free-radical scavenger used to decrease nephrotox associated with platinum-containing and alkylating chemo agents

also decreases xerostomia caused by chemo

59
Q

Synthetic prostacyclin - uses?

A

use it for vasodil and anti-thrombotic properties to treat pulmonary HTN, peripheral vascular disease, and raynaud

60
Q

Ranolazine

A

antianginal drug

inhibits late phase inward Na channels –> decreased [Na]i –> decreased calcium influx –> decreased contractility and myocardial oxygen demand

61
Q

Fenoldopam

A

short-acting D1 agonist, no effect on alpha or beta receptors –> AC –> increased cAMP –> vasodilation of arterial beds and decreased BP

**renal vasodilation –> INCREASED RENAL PERFUSION, so good for pts with htn emergency and AKI

62
Q

Short-acting insulin

A

Lispro, Aspart, Glulisine (peak in 45-75 min so used postprandially)

vs regular (peaks 2-4 hrs, but best IV, so used for DKA)

63
Q

Long-acting insulin

A

Glargine, detemir (once-daily)

vs. NPH (twice daily) = intermediate-acting

64
Q

Fluphenazine

A

DA antagonist

used to treat Tourette (antipsychotics are used for Tourette)

65
Q

Milrinone

A

selective PDE3 inhibitor

used as inotropic agent in refractory HF to increase cAMP and thus increase [Ca]i in myocytes (positive inotrope)

but also –> vascular smooth m relaxation due to increased cAMP –> decreased BP

66
Q

Ivabradine

A

selective inhibitor of funny sodium channels

prolonged phase 4 (depolarization) in nodes –> slowed HR with no effect on contractility (inotropy) or relaxation (lusitropy)

67
Q

definition of “permissiveness” in pharm vs. “synergism”

A

one hormone allows another to exert its max effect

eg cortisol upregulates alpha1 receptors on vasc smooth muscle –> increased vascular responsiveness to NE (though cortisol alone has no effect on vessels, so not synergistic)

synergism: both drugs have some effect, and when combined, the effect is greater than the sum of their individual effects

68
Q

Example of hormone with permissive effect on other hormones?

A

Cortisol

increases vasc and bronchial smooth muscle response to NE and epi

increases glucose release by liver in response to glucagon

69
Q

Ranolazine

A

anti-anginal agent

blocks Na channels and K channels (dose-dep increase in QT, but no TdP)

70
Q

“-prep” (aprepitant, fosaprepitant)

A

neurokinin 1 receptor antagonists

used to treat central (chemo-induced) nausea

71
Q

Cytarabine, Gemcitabine

A

pyrimidine analog antimetabolites that are incorporated into DNA –> strand termination

gemcitabine isn’t S-phase specific, while cytarabine is

both are chemo drugs

72
Q

fludarabine

A

purine nucleotide analog, chemo drug (used for CLL)

inhibits DNA pol, DNA primase, DNA ligase, ribonucleotide reductase

73
Q

significance of monoclonality in T cell receptor genes?

A

indicates malignancy in lymph node (if responding to antigen, multiple genetically-distinct cells undergo limited monoclonal expansion –> overall polyclonal response, but malig = monoclonal)

74
Q

Diphenoxylate

A

opioid anti-diarrheal agent (similar to meperidine)

binds mu opiate receptors in GI tract and slows motility

combined with atropine to cause adverse effects if taken in high doses (and thus to discourage abuse, since it produces euphoria and –> dependence at high doses)

75
Q

clonidine - mech and use?

A

alpha 2 agonist

treats ADHD

76
Q

Cladribine

A

cytotoxic purine analog used to treat HCL

resistant to degradation by ADA

77
Q

Acitretin

A

systemic retinoid used to treat psoriasis, acne, photoaging, skin neoplasms

other systemic = isotretinoin

topical = tretinoin

its elimination t1/2 is 2 days, but in combo with alcohol, it’s esterified and has t1/2 of 120 days

78
Q

Imiquimod

A

nucleoside analog that’s agonist of TLL7 and 8 –> activation of NF-kappaB

tx of genital or perianal warts/condyloma acuminata + actinic keratosis

Misc (6 decks)

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