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COMLEX > random pharm > Flashcards

random pharm Flashcards

1
Q

what drug can be used to reverse serotonin syndrome?

A

Cyproheptadine

- antagonizes 5-HT2 receptor

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2
Q

what drug can be used to reverse neuroleptic malignant syndrome (NMS)?

A

Dantrolene

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3
Q

what drugs cause NMS?

A
  • Haloperidol

- Fluphenazine

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4
Q

what drug can be used to reverse anticholinergic toxicity?

A

Physostigmine

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5
Q
  • Olanzapine
  • Clozapine
  • Quetiapine
  • Risperidone
  • Aripiprazole
  • Ziprasidone
A

SGA’s (atypical antipsychotics)

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6
Q
  • Haloperidol
  • Trifluoperazine
  • Fluphenazine
  • Chlorpromazine
  • Thioridazine
A

FGA’s

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7
Q 
Gq -> IP3, DAG
• Arteriole constriction
• Mydriasis
• Reduced renin release
• Glycogenolysis
• Urinary retention (stimulates internal urethral sphincter)
A

alpha-1 agonists

- phenylephrine

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8
Q

Gs -> increased cAMP
• Increases SA/AV conduction (inotropy)
• Increases renin release
• Increases aqueous humor

A

beta-1 agonists

- dobutamine

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9
Q 
Gs -> increased cAMP
• Vasodilation
• Bronchodilation
• Uterine relaxation
• Gluconeogenesis
• Lipolysis
A

beta-2 agonists

- albuterol

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10
Q
  • Prazosin (treats hypertension and BPH)
  • Doxazosin
  • Terazosin
  • Tamsulosin (BPH)
A

alpha-1 blockers

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11
Q

abx that causes hypersensitivity reactions, including Stevens-Johnson syndrome

A

sulfamethoxazole/trimethoprim (SMX/TMP)

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12
Q

sulfamethoxazole MOA?

A

inhibits dihydropteroate synthase

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13
Q

trimethoprim MOA?

A

inhibits bacterial dihydrofolate reductase

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14
Q

atypical antipsychotic, is typically used to treat refractory schizophrenia
- notable side effect of this medication is decreased white blood cell count, known as agranulocytosis

A

clozapine

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15
Q

MAOI used to treat severe and refractory depression

- most notable side effect is malignant hypertension secondary to the use of eating tyramine-rich foods

A

phenelzine

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16
Q

short-acting benzodiazepine, is used to treat anxiety disorders
- often prescribed short-term for panic attacks

A

alprazolam

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17
Q

what are the most common side effects of SSRI’s?

A

sexual

- anorgasmia, prolonged time to orgasm, nighttime tumescence

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18
Q

topo II inhibitor used to treat ovarian, breast, and lung cancer

side effects:

  • dilated cardiomyopathy
  • skin reactions
  • nausea/vomiting
  • bone marrow suppression
A

doxorubicin

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19
Q

G2-specific antineoplastic that causes formation of iron free radicals

side effects:
• Pulmonary fibrosis
• Alopecia
• Skin rash

A

bleomycin

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20
Q

anticancer drug that binds to N7 of guanine to alkylate DNA

side effects:
• Nephrotoxicity (manage with amifostine)
• Nausea and vomiting (manage with ondansetron)
• Ototoxicity
• Peripheral neuropathy

A

cisplatin

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21
Q

M-phase antineoplastic that inhibits microtubule depolymerization (stops disassembly)

side effects:
• Peripheral neuropathy
• Bone marrow suppression
• Hypersensitivity 
• Diarrhea
A

paclitaxel

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22
Q

diuretic class that block Na/Cl transporter in DCT, increasing Ca reabsorption in the distal tubule

A

thiazides

- less Na inside cells actives the Na/Ca antiporter on the basolat membrane

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23
Q

potassium-sparing diuretics that are competitive antagonists that either compete with aldosterone or intracellular cytoplasmic receptor sites at the collecting duct

A

spironolactone

- generally used in combination with loop diuretics to keep K+ levels WNL

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24
Q

diuretic that inhibits reabsorption of water and Na, acting at the portions of the nephron that are water-permeable (PCT, thin descending loop, collecting duct)

A

osmotic duiretics (mannitol, acetazolamide)

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25
Q

diuretic class that inhibit the Na-K-2Cl symporter in the thick ascending limb

A

loop diuretics

- cause an increase in K+, Mg and Ca excretion (bad for stones)

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26
Q

potentiates the effect of antithrombin III, thereby inhibiting thrombin and factor Xa
- also inhibits aldosterone in the collecting duct

A

heparin

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27
Q

which diuretics cause hyperkalemia?

A
  • aldosterone inhibitors (spironolactone)

- ENaC channel blockers in the late distal tubule/collecting duct (amiloride, triamterene)

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28
Q

first line tx for pyelonephritis?

A

SMX-TMP

- fluoroquinolones if sulfa allergy

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29
Q

MOA of fluoroquinolones?

A

inhibit bacterial DNA topoisomerase II and IV

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30
Q

old tetracycline abx

  • pt presents w/ polyuria and polydipsia with bouts of dehydration
  • proteinuria, hypokalemia, hypophosphatemia, and hyperchloremic metabolic acidosis
A

Fanconi syndrome
- when stored for long periods of time in a moist environment, tetracycline degrades and forms the toxic degradation product, anhydro-4-epitetracycline

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31
Q

preferred diuretic for pt w/ fluid overload?

A

loop diuretics
- in comparison with thiazide diuretics, loop diuretics allow for a greater loss of urine and relatively less loss of sodium making them very effective in persons who have volume overload

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32
Q

loop diuretics for fluid overload, thiazides for HTN

A
  • loop diuretics keep more fluid in the tubular lumen (lose Ca, bad for stones)
  • thiazides excrete more sodium (reabsorb Ca, good for stones)
33
Q

where does spironolactone exert its effects?

A

collecting tubule, NOT duct

34
Q

anticonvulsant that inhibits sodium channels in neuronal axons
- side effects: hirsutism, megaloblastic anemia, confusion, ataxia, nystagmus, osteomalacia, and gingival hyperplasia

A

phenytoin

35
Q

anticonvulsant that blocks both sodium and calcium channels

- may cause Stevens-Johnson syndrome, disseminated intravascular coagulation, angioedema, and aplastic anemia

A

lamotrigine

36
Q

decrease carbohydrate polymerization of the mycobacterium cell wall by blocking arabinosyltransferase

A

ethambutol

37
Q

TB med that inhibits DNA-dependent RNA polymerase

A

rifampin

38
Q

TB drug that binds to intracellular proteins in the hepatocytes, leading to actin disruption and mitochondrial disruption

A

isoniazid

- give pyridoxine!! (B6)

39
Q

what GABA activator is used to treat MS muscle spasms?

A

baclophen

  • results in hyperpolarization by 3 distinct actions:
    1. Closure of presynaptic calcium channels
    2. Increased postsynaptic K+ conductance
    3. Inhibition of dendritic calcium influx channels
40
Q

tx for absence seizures that inhibits the T-type calcium channels in thalamocortical neurons

A

ethosuximide

41
Q

acetylcholinesterase inhibitor used particularly for Alzheimer’s disease, which is associated with loss of cholinergic neurons

A

donepezil

42
Q

short-acting acetylcholinesterase inhibitor used to diagnose myasthenia gravis

A

edrophonium

43
Q

med used for acute gout attacks?

A

colchicine
- inhibits polymerization of β-tubulin into microtubules, to prevent the activation, degranulation, and migration of neutrophils (affects cytoskeleton)

44
Q

anti-rheumatoid drug that causes retinal deposits

A

hydroxychloroquine

45
Q

bisphosphonate that inhibits bone resorption (osteoclast activity) and has been found to increase bone density in women with post-menopausal osteoporosis

A

alendronate
- must be taken with water to prevent esophageal perforation. Osteonecrosis of the jaw is another complication that is caused by suppression of bone turnover

46
Q

example of drug that follows zero order kinetics?

A

phenytoin

- rate of drug elimination is constant regardless of the plasma concentration of the drug (linear)

47
Q

when would you see a narrow pulse pressure vs wide?

A
  • narrow pulse pressure: constrictive pericarditis

- wide pulse pressure: aortic regurgitation

48
Q

what is preferred tx for stabile angina?

A
  • nitrates (dilate peripheral veins -> decrease preload, cardiac load)
  • b-blocker (reduce HR and contractility, decrease O2 demand)
49
Q 
overdosing on what med causes:
• Bradycardia
• Hypotension
• *Hypoglycemia*
• Fatigue
A

b-blocker

- give glucagon

50
Q 
overdosing on what med causes:
• Bradycardia
• Hypotension
• Tachycardia
• *Hyperglycemia*
• Dizziness
A

CCB’s

- give calcium and insulin

51
Q 
what drug class lowers LDL, mildly decreases TG and will mildly increase HDL?
- only cholesterol med with mortality benefit
A

statins

52
Q

what drug class significantly lowers TG, mildly lowers LDL and mildly increases HDL?

A

fibrates

53
Q

what drug class significantly lowers LDL, and mildly lowers TG with no effect on HDL?

A

PCSK-9 inhibitors

- Evolocumab

54
Q

what 2 drug classes only lowers LDL and nothing else?

A
  1. Cholesterol absorption blockers: ezetimibe

2. Bile acid resins: cholestyramine, colestipol

55
Q

what drug lowers LDL, increases HDL, and mildly decreases TG?
- causes flushing

A

niacin

  • affects glycemic control (bad for diabetics)
  • can precipitate gout by increasing uric acid levels
56
Q

tx for chagas disease?

A

nifurtimox

57
Q

tx for trigeminal neuralgia?

A

carbemazepine

58
Q

what is the antidote for ethylene glycol toxicity?

A

Fomepizole
- works as an inhibitor of alcohol dehydrogenase, the enzyme that is responsible for the metabolism of ethylene glycol and methanol

59
Q

organophosphate pesticides?

A

cholinesterase inhibitors

- pralidoxime directly affects the inactivated cholinesterase enzyme

60
Q

what antihypertensives cause peripheral edema?

A

CCB’s

- amlodipine, nifedipene

61
Q

what is the first line tx of glaucoma?

A

prostaglandins: latanoprost

- increase outflow of aqueous humor

62
Q

nonselective beta blocker that also blocks a-1 receptors

- decreases venous return, SVR, and HR

A

labetalol

63
Q

selective CCB that improves outcomes in pts with SAH, by preventing/reducing the extent of ischemic neurologic defectis caused by cerebral vasospasm

A

nimodipine

64
Q

anti-inflammatory that binds tubulin and inhibits polymerization
- reduces neutrophil chemotaxis (acute gout flare)

A

colchicine

65
Q

glycopyrrolate, hyoscyamine, propanthelene

A

selective muscarinic antagonists

- used to lessen GI sx of pyridostigmine (inhibits ACh degradation) for MG

66
Q

meds that increase risk of osteoporosis?

A

PPI’s, glucocorticoids, aromatase inhibitors, anticonvulsants that induce CYP450 (carbamazepine, phenobarbital, phenytoin)

67
Q

why give desmopressin to kid with vWD?

A

increases vWF release from endothelial cells

68
Q

MOA of methimazole and PTU?

A

thioamides inhibit thyroid peroxidase, the enzyme responsible for iodine organification and coupling of iodotyrosines
- PTU also decreases peripheral conversion of T4 -> T3

69
Q

do macrolides inhibit or induce CYP3A4?

A

inhibit
- watch out for concurrent abx use with statins (statins can cause myoglobinuria, and can be exacerbated by erythromycin/clarithromycin)

70
Q

donepezil, rivastigmine

A

AChE-inhibitors used to treat Alzheimers

- can precipitate bradycardia and AV block d/t unopposed PNS stimulation

71
Q

what meds up-regulate LPL, resulting in increased oxidation of fatty acids
- also inhibit cholesterol 7a-hydroxylase which halts the synthesis of bile acids

A

fibrates (fenofibrate, genfibrozil)

- reduced bile acid production decreases cholesterol solubility -> increases likelihood of gallstones

72
Q

difference between paclitaxel and vinka alkaloids?

A
  • paclitaxel inhibits microtubule disassembly (makes it super stable)
  • vinkas inhibit microtubule formation

both cause neuropathy!

73
Q

preferred anticoag for venous thromboembolism in pregnancy?

A

enoxaparin (low molecular weight heparin)

74
Q

anti-HER2 monoclonal Ab?

A

tratuzumab (trat-TWO-zumab for HER-two)

75
Q

what is the antidote for b-blocker overdose?

A

glucagon

- increases HR and contractility independent of adrenergic receptors (upregulates cAMP -> increasing Ca release)

76
Q

peripheral dopamine-1 receptor agonist that raises intracellular cAMP -> vasodilation
- tx for hypertensive emergency

A

fenoldapam

77
Q

what is the first line tx for essential tremor

- tremor that gets worse when holding an object, improves with alcohol

A

propranolol

78
Q

what synthetic hormone acts like FSH and triggers the formation of a dominant ovarian follicle?

A

menotropin (human menopausal gonadotropin)

- HCG mimics LH surge (can be given to induce ovulation)

79
Q

tx for organophosphate poisoning (AChE-I)?

A
  1. atropine: relieves muscarinic hyperstimulation

2. THEN pralidoxime: cholinesterase reactoivator works at both muscarinic and nicotinic

COMLEX (14 decks)

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