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USMLE Pharmacology > Sheet-2 > Flashcards

Sheet-2 Flashcards

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USMLE® Step 1 flashcards
1
Q

Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema

A

Morphine

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2
Q

Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI’s can lead to serotonin syndrome

A

Meperidine

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3
Q

Moderate opioid agonists

A

Codeine, hydrocodone, and oxycodone

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4
Q

Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

A

Propoxyphene

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5
Q

Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal

A

Buprenorphine

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6
Q

Opioid antagonist that is given IV and had short DOA

A

Naloxone

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7
Q

Opioid antagonist that is given orally in alcohol dependency programs

A

Naltrexone

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8
Q

These agents are used as antitussive

A

Dextromethorphan, Codeine

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9
Q

These agents are used as antidiarrheal

A

Diphenoxylate, Loperamide

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10
Q

Inhalant anesthetics

A

NO, chloroform, and diethyl ether

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11
Q

Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation

A

Fluorocarbons and Industrial solvents

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12
Q

Cause dizziness, tachycardia, hypotension, and flushing

A

Organic nitrites

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13
Q

Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression

A

Steroids

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14
Q

Readily detected markers that may assist in diagnosis of the cause of a drug overdose include

A

Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses

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15
Q

Most commonly abused in health care professionals

A

Heroin, morphine, oxycodone, meperidine and fentanyl

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16
Q

This route is associated with rapid tolerance and psychologic dependence

A

IV administration

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17
Q

Leads to respiratory depression progressing to coma and death

A

Overdose of opioids

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18
Q

Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome

A

Abstinence syndrome

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19
Q

Treatment for opioid addiction

A

Methadone, followed by slow dose reduction

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20
Q

This agent may cause more severe, rapid and intense symptoms to a recovering addict

A

Naloxone

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21
Q

Sedative-Hypnotics action

A

Reduce inhibition, suppress anxiety, and produce relaxation

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22
Q

Additive effects when Sedative-Hypnotics used in combination with these agents

A

CNS depressants

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23
Q

Common mechanism by which overdose result in death

A

Depression of medullary and cardiovascular centers

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24
Q

Date rape drug

A

Flunitrazepam (rohypnol)

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25
Q

The most important sign of withdrawal syndrome

A

Excessive CNS stimulation (seizures)

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26
Q

Treatment of withdrawal syndrome involves

A

Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol

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27
Q

These agents are CNS depressants

A

Ethanol, Barbiturates, and Benzodiazepines

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28
Q

Withdrawal from this drug causes lethargy, irritability, and headache

A

Caffeine

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29
Q

W/D from this drug causes anxiety and mental discomfort

A

Nicotine

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30
Q

Treatments available for nicotine addiction

A

Patches, gum, nasal spray, psychotherapy, and bupropion

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31
Q

Chronic high dose abuse of nicotine leads to

A

Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures

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32
Q

Tolerance is marked and abstinence syndrome occurs

A

Amphetamines

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33
Q

Amphetamine agents

A

Dextroamphetamines and methamphetamine

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34
Q

These agents are congeners of Amphetamine

A

DOM, STP, MDA, and MDMA “ecstasy”

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35
Q

Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)

A

Cocaine “super-speed”

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36
Q

Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic

A

PCP

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37
Q

Removal of PCP may be aided

A

Urinary acidification and activated charcoal or continual nasogastric suction

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38
Q

THC is active ingredient, SE’s include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur

A

Marijuana

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39
Q

This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention

A

Bethanechol

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40
Q

Only direct acting agent that is very lipid soluble and used in glaucoma

A

Pilocarpine

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41
Q

This agent used to treat dry mouth in Sjögren’s syndrome

A

Cevimeline

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42
Q

Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis

A

Edrophonium

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43
Q

Carbamate with intermediate action, used for+A1170 postoperative and neurogenic ileus and urinary retention

A

Neostigmine

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44
Q

Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions

A

Physostigmine

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45
Q

Treatment of myasthenia gravis

A

Pyridostigmine

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46
Q

Antiglaucoma organophosphate

A

Echothiophate

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47
Q

Associated with an increased incidence of cataracts in patients treated for glaucoma

A

Long acting cholinesterase inhibitors

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48
Q

Scabicide organophosphate

A

Malathion

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49
Q

Organophosphate anthelmintic agent with long DOA

A

Metrifonate

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50
Q

Toxicity of organophosphate:

A

DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)

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51
Q

The most frequent cause of acute deaths in cholinesterase inhibitor toxicity

A

Respiratory failure

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52
Q

The most toxic organophosphate

A

Parathion

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53
Q

Treatment of choice for organophosphate overdose

A

Atropine

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54
Q

This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure

A

Pralidoxime

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55
Q

Prototypical drug is atropine

A

Nonselective Muscarinic Antagonists

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56
Q

Treat manifestations of Parkinson’s disease and EPS

A

Benztropine, trihexyphenidyl

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57
Q

Treatment of motion sickness

A

Scopolamine, meclizine

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58
Q

Produce mydriasis and cycloplegia

A

Atropine, homatropine,C1208 tropicamide

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59
Q

Bronchodilation in asthma and COPD

A

Ipratropium

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60
Q

Reduce transient hyper GI motility

A

Dicyclomine, methscopolamine

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61
Q

Cystitis, postoperative bladder spasms, or incontinence

A

Oxybutynin, dicyclomine

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62
Q

Toxicity of anticholinergics

A

block SLUD (salivation, lacrimation, urination, defecation

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63
Q

Another pneumonic for anticholinergic toxicity

A

dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat

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64
Q

Atropine fever is the most dangerous effect and can be lethal in this population group

A

Infants

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65
Q

Contraindications to use of atropine

A

Infants, closed angle glaucoma, prostatic hypertrophy

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66
Q

Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate

A

Severe hypertension

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67
Q

Reversal of blockade by neuromuscular blockers

A

Cholinesterase inhibitors

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68
Q

Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis

A

Nondepolarizing Neuromuscular Blockers

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69
Q

Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use; has short duration of action

A

Succinylcholine

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70
Q

Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred)

A

Cholinesterase regenerators, pralidoxime

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71
Q

Used to treat patients exposed to insecticides such as parathion

A

Pralidoxime, atropine

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72
Q

Pneumonic for beta receptors

A

You have 1 heart (Beta 1) and 2 lungs (Beta 2)

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73
Q

This is the drug of choice for anaphylactic shock

A

Epinephrine

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74
Q

Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction

A

Amphetamines

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75
Q

Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia

A

Phenylephrine

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76
Q

Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to

A

Reduce aqueous secretion

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77
Q

Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis

A

Albuterol

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78
Q

Longer acting Beta 2 agonist is recommended for prophylaxis of asthma

A

Salmeterol

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79
Q

These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock

A

Beta1 agonists

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80
Q

These agents decrease blood flow or increase blood pressure, are local decongestants, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion

A

Alpha1 agonists

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81
Q

Shock due to septicemia or myocardial infarction is made worse by

A

Increasing afterload and tissue perfusion declines

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82
Q

Epinephrine is often mixed with a local anesthetic to

A

Reduce the loss from area of injection

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83
Q

Chronic orthostatic hypotension can be treated with

A

Midodrine

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84
Q

Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus

A

Terbutaline

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85
Q

Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses

A

Epinephrine

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86
Q

Mast cells to reduce release of hisamine and inflammatory mediators

A

Epinephrine

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87
Q

Agent used in shock because it dilates coronary arteries and increases renal blood flow

A

Dopamine

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88
Q

Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance

A

Dobutamine

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89
Q

Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis

A

Ephedrine

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90
Q

Alpha 1 agonist toxicity

A

Hypertension

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91
Q

Beta 1 agonist toxicity

A

Sinus tachycardia and serious arrhythmias

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92
Q

Beta 2 agonist toxicity

A

Skeletal muscle tremor, tachycardia

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93
Q

The selective agents loose their selectivity at

A

high doses

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94
Q

Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis

A

Phenoxybenzamine

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95
Q

Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud’s phenomena

A

Phentolamine

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96
Q

Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension

A

Prazosin, terazosin, doxazosin

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97
Q

Selective Alpha-1A blocker, used for BPH, but with little effect on HTN

A

Tamsulosin

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98
Q

Selective Alpha 2 blocker used for impotence (controversial effectiveness)

A

Yohimbine

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99
Q

SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma

A

Acebutolol, atenolol, esmolol, metoprolol

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100
Q

Combined alpha and beta blocking agents that may have application in treatment of CHF

A

Labetalol and carvedilol

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101
Q

Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma

A

Pindolol and acebutolol

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102
Q

This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma

A

Timolol

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103
Q

This parenteral beta blocker is a short acting (minutes)

A

Esmolol

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104
Q

This beta blocker is the longest acting

A

Nadolol

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105
Q

These beta blockers are less lipid soluble

A

Acebutolol and atenolol

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106
Q

This beta blocker is highly lipid soluble and may account for side effects such as nightmares

A

Propranolol

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107
Q

Clinical uses of these agents include treatment of HTN, angina, arrhythmias, chronic CHF, and selected post MI patients

A

Beta blockers

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108
Q

Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)

A

Beta blockers

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109
Q

Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction

A

Pilocarpine, carbachol, physostigmine

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110
Q

Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins

A

Epinephrine, dipivefrin

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111
Q

Selective alpha agonists that decreases aqueous secretion

A

Apraclonidine, brimonidine

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112
Q

These Beta blockers decrease aqueous secretion

A

Timolol (nonselective), betaxolol (selective)

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113
Q

This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis

A

Acetazolamide

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114
Q

This agent cause increased aqueous outflow

A

Prostaglandin PGF2a

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115
Q

Inhibit angiotensin-converting enzyme (ACE)

A

ACE inhibitors

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116
Q

Captopril and enalapril (-OPRIL ending) are

A

ACE inhibitors

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117
Q

SE of ACE inhibitors

A

Dry cough, hyperkalemia

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118
Q

ACE inhibitors are contraindicated in

A

pregnancy and with K+

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119
Q

Losartan and valsartan block

A

Angiotensin receptor

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120
Q

Angiotensin receptor blockers do NOT cause

A

Dry cough

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121
Q

Agents that block L-type calcium channel

A

Calcium channel blockers

122
Q

CCB contraindicated in CHF

A

Verapamil

123
Q

CCB with predominate effect on arteriole dilation

A

Nifedipine

124
Q

SE of CCB

A

Constipation, edema, and headache

125
Q

Agents that reduce heart rate, contractility, and O2 demand

A

Beta-blockers

126
Q

B-blockers that are more cardioselective

A

Beta-1 selective blockers

127
Q

Cardioselective Beta 1-blockers

A

Atenolol, acebutolol, and metoprolol

128
Q

Beta-blockers should be used cautiously in

A

Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease

129
Q

Non-selective Beta-blocker also used for migraine prophylaxis

A

Propranolol

130
Q

SE of beta blockers

A

Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)

131
Q

Alpha 1selective blockers

A

Prazosin, terazosin and doxazosin (-AZOSIN ending)

132
Q

Non-selective Alpha1blockers use to treat pheochromocytoma

A

Phenoxybenzamine

133
Q

For rebound HTN from rapid clonidine withdrawal

A

Phentolamine

134
Q

A1a-selective blocker with no effects on HTN used for BPH

A

Tamsulosin (Flomax)

135
Q

SE of alpha blockers

A

Orthostatic hypotension (especially with first dose) and reflex tachycardia

136
Q

Presynaptic Alpha 2 agonist used in HTN, and acts centrally

A

Clonidine, and methyldopa

137
Q

SE of methyldopa

A

Positive Comb’s test, depression

138
Q

Methyldopa is contraindicated in

A

Geriatrics due to its CNS (depression) effects

139
Q

SE of clonidine

A

Rebound HTN, sedation, dry mouth

140
Q

Direct vasodilator of arteriolar smooth muscle

A

Hydralazine

141
Q

SE of hydralazine

A

Lupus-like syndrome

142
Q

Arterial vasodilator that works by opening K+ channels

A

Minoxidil

143
Q

SE of minoxidil

A

Hypertrichosis

144
Q

IV Drug used Hypertensive Crisis

A

Nitroprusside

145
Q

Nitroprusside vasodilates

A

Arteries and veins

146
Q

Toxicity caused by nitroprusside and treatment

A

Cyanide toxicity treated with sodium thiosulfate

147
Q

Carbonic anhydrase inhibitor

A

Acetazolamide

148
Q

Diuretic used for mountain sickness and glaucoma

A

Acetazolamide

149
Q

SE of acetazolamide

A

Paresthesias, alkalization of the urine (which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment

150
Q

MOA of loop diuretics

A

inhibits Na+/K+/2Cl- cotransport

151
Q

Site of action of loop diuretics

A

Thick ascending limb

152
Q

SE of loop (furosemide) diuretics

A

Hyperuricemia, hypokalemia and ototoxicity

153
Q

Aminoglycosides used with loop diuretics potentiate adverse effect

A

Ototoxicity

154
Q

Loops lose and thiazide diuretics retain

A

Calcium

155
Q

MOA of thiazide diuretics

A

Inhibit Na+/Cl- cotransport

156
Q

Site of action of thiazide diuretics

A

Work at early distal convoluted tubule

157
Q

Class of drugs that may cause cross-sensitivity with thiazide diuretics

A

Sulfonamides

158
Q

SE of thiazide (HCTZ) diuretics

A

Hyperuricemia, hypokalemia and hyperglycemia

159
Q

Potassium sparing diuretics inhibit

A

Na+/K+ exchange

160
Q

Diuretic used to treat primary aldosteronism

A

Spironolactone

161
Q

SE of spironolactone

A

Gynecomastia hyperkalemia, and impotence

162
Q

Osmotic diuretic used to treat increased intracranial pressure

A

Mannitol

163
Q

ADH agonist used for pituitary diabetes insipidus

A

Desmopressin (DDAVP)

164
Q

Used for SIADH

A

Demeclocycline

165
Q

SE of demeclocycline

A

Bone marrow and teeth discoloration for children under 8 years of age

166
Q

MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics

A

Sodium channel blockers

167
Q

SE of procainamide

A

Lupus-like syndrome

168
Q

Limiting side effect of Quinidine

A

Prolongs QT interval

169
Q

Other side effects of Quinidine

A

Thrombocytopenic purpura, and CINCHONISM

170
Q

Major drug interaction with Quinidine

A

Increases concentration of Digoxin

171
Q

DOC for management of acute ventricular arrhythmias

A

Amiodarone

172
Q

DOC for digoxin induced arrhythmias

A

Phenytoin

173
Q

SE of phenytoin

A

Gingival hyperplasia

174
Q

Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents

A

Class IC (flecainide, propafenone, moricizine)

175
Q

Class II antiarrhythmics are

A

B-blockers

176
Q

Antiarrhythmic that exhibits Class II and III properties

A

Sotalol

177
Q

Side effect of sotalol

A

prolongs QT and PR interval

178
Q

Used intravenously for acute arrhythmias during surgery

A

Esmolol

179
Q

Anti-arrhythmics that decrease mortality

A

B-blockers

180
Q

MOA of class III antiarrhythmics

A

Potassium channel blockers

181
Q

Class III antiarrhythmic that exhibits properties of all 4 classes

A

Amiodarone

182
Q

Specific pharmacokinetic characteristic of amiodarone

A

Prolonged half-life, up to six weeks

183
Q

Antiarrhythmic effective in most types of arrhythmia

A

Amiodarone

184
Q

SE of Amiodarone

A

Cardiac dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits

185
Q

MOA of class IV antiarrhythmics

A

Calcium channel blockers

186
Q

Life threatening cardiac event that prolong QT leads to

A

Torsades de pointes

187
Q

Agent to treat torsades de pointes

A

Magnesium sulfate

188
Q

Drug used supraventricular arrhythmias

A

Digoxin

189
Q

DOC for paroxysmal supraventricular tachycardia (PSVT)

A

Adenosine

190
Q

Adenosine’s MOA

A

Activattion on an inward K+ current and inhibition of Ca++ current resulting in marked hyperpolarization

191
Q

Anti-arrhythmic with 15 second duration of action

A

Adenosine

192
Q

MOA of sildenafil (Viagra)

A

Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP

193
Q

Drugs used in the management of angina

A

Aspirin, Nitrates, CCB, and Beta blockers

194
Q

Aspirin reduces mortality in unstable angina by

A

Platelet aggregation inhibition

195
Q

MOA of nitrates

A

Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles

196
Q

Nitrate used for acute anginal attacks

A

Nitroglycerin sublingual tablets

197
Q

Nitrate used to prevent further attacks

A

Oral and transdermal forms of nitroglycerin

198
Q

Nitrate free intervals are needed due to

A

Tolerance

199
Q

SE of nitrates

A

Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation

200
Q

CCB are DOC for

A

Prinzmetal’s angina

201
Q

Beta blockers are used for which type of anginal attack

A

Classic

202
Q

MOA of Cardiac glycosides (eg. digoxin)

A

Indirectly increase intracellular calcium and cardiac contractility by inhibiting Na+/K+ ATPase

203
Q

Digoxin is used in

A

Atrial fibrillation and CHF

204
Q

Digoxin toxicity can be precipitated by

A

Hypokalemia

205
Q

Antidote for digoxin toxicity

A

Digibind

206
Q

Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects

A

Amrinone and milrinone

207
Q

SE of amrinone

A

Thrombocytopenia

208
Q

Beta 1 agonists used in acute CHF

A

Dobutamine and dopamine

209
Q

Diuretics work in CHF by

A

Reducing preload

210
Q

Beta blockers work in CHF by

A

Reducing progression of heart failure (never use in acute heart failure)

211
Q

Peptide drug used to treat CHF

A

Nesiritide (BNP)

212
Q

MOA of nesiritide

A

Increasing sodium excretion and decreases arterial and venous tone

213
Q

SE of nesiritide

A

Excessive hypotension and kidney failure

214
Q

Agent used in CHF that is a selective alpha and nonselective beta blocker

A

Carvedilol

215
Q

Agent used in acutely decompensated CHF resembling natriuretic peptide

A

Nesiritide (Natrecor)

216
Q

Vitamin K dependent anticoagulant

A

Warfarin (PT)

217
Q

Warfarin is contraindicated in

A

Pregnancy

218
Q

Anticoagulant of choice in pregnancy

A

Heparin

219
Q

Heparin (PTT) increases activity of

A

Antithrombin 3

220
Q

Route of administration of warfarin

A

Oral

221
Q

Routes of administration of heparin

A

IV and IM (only LMW)

222
Q

SE of both warfarin and heparin

A

Bleeding

223
Q

SE of heparin

A

Heparin induced thrombocytopenia (HIT)

224
Q

Alternative anticoagulant used if HIT develops

A

Lepirudin

225
Q

Antidote to reverse actions of warfarin

A

Vitamin K or fresh frozen plasma

226
Q

Antidote to reverse actions of heparin

A

Protamine sulfate

227
Q

MOA of aspirin

A

Irreversibly blocking cyclooxygenase

228
Q

Agent used to treat MI and to reduce incidence of subsequent MI

A

Aspirin, metoprolol

229
Q

SE of Aspirin

A

GI bleeding

230
Q

Antiplatelet drug reserved for patients allergic to aspirin

A

Ticlopidine

231
Q

SE for ticlopidine

A

Neutropenia and agranulocytosis

232
Q

Effective in preventing TIA’s

A

Clopidogrel and ticlopidine

233
Q

Prevents thrombosis in patients with artificial heart valve

A

Dipyridamole

234
Q

Block glycoprotein IIb/IIIa involved in platelet cross-linking

A

Abciximab, tirofiban and eptifibatide

235
Q

MOA of thrombolytics

A

Degradation of fibrin clots and are administered IV

236
Q

Thrombolytics are used for

A

Pulmonary embolism and DVT

237
Q

Thrombolytic that can cause allergic reaction

A

Streptokinase

238
Q

Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA

A

Tissue plasmin activator

239
Q

SE of tPA

A

Cerebral hemorrhage

240
Q

Antidote for thrombolytics

A

Aminocaproic acid

241
Q

Agent to treat hypochromic microcytic anemias

A

Ferrous sulfate

242
Q

Chelating agent used in acute iron toxicity

A

Deferoxamine

243
Q

Agent for pernicious anemia

A

Cyanocobalamin (Vit B12)

244
Q

Agent used for neurological deficits in megaloblastic anemia

A

Vitamin B12

245
Q

Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy

A

Folic acid

246
Q

Agent used for anemias associated with renal failure

A

Erythropoietin

247
Q

Agent used neutropenia especially after chemotherapy

A

G-CSF (filgrastim) and GM-CSF (sargramostim)

248
Q

Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy

A

Interleukin 11 (oprelvekin)

249
Q

Drugs decrease intestinal absorption of cholesterol

A

Bile acid-binding resins

250
Q

Cholestyramine and colestipol are

A

Bile acid-binding resins

251
Q

Major nutritional side effect of bile acid-binding resins

A

Impair absorption of fat soluble vitamin absorption (A,D,E,K)

252
Q

MOA of lovastatin (STATIN)

A

inhibits HMG COA reductase

253
Q

HMG CoA reductase inhibitors are contraindicated in

A

Pregnancy

254
Q

MOA of drug or foods (grapefruit juice) that increase statin effect

A

Inhibit Cytochrome P450 3A4

255
Q

SE of HMG COA reductase inhibitors

A

Rhabdomyolysis and Hepatotoxicity

256
Q

Monitoring parameter to obtain before initiation of STATINS

A

LFT’s

257
Q

Decreases liver triglycerol synthesis

A

Niacin

258
Q

SE of niacin

A

Cutaneous flush

259
Q

Cutaneous flush and be reduced by pretreatment with

A

Aspirin

260
Q

Fibrates (gemfibrozil) increase activity of

A

Lipoprotein lipase

261
Q

Most common SE of fibrates

A

Nausea

262
Q

Fibrates are contraindicated in

A

Pregnancy

263
Q

Concurrent use of fibrates and statins increases risk of

A

Rhabdomyolysis

264
Q

New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins

A

Ezetimibe (Zetia)

265
Q

MOA of NSAIDS

A

inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)

266
Q

Difference between aspirin and other NSAIDS

A

Aspirin irreversibly inhibits cyclooxygenase

267
Q

Four main actions of NSAIDS

A

Anti-inflammatory, analgesia, antipyretic and antiplatelet activity

268
Q

Agent used for closure of patent ductus arteriosus

A

Indomethacin

269
Q

Aspirin is contraindicated in children with viral infection

A

Potential for development of Reye’s syndrome

270
Q

SE of salicylates

A

Tinnitus, GI bleeding

271
Q

NSAID also available as an ophthalmic preparation

A

Diclofenac, ketoralac

272
Q

NSAID available orally, IM and ophthalmically

A

Ketoralac

273
Q

NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity

A

Ketoralac

274
Q

Newer NSAID that selectively inhibits COX-2

A

Celecoxib

275
Q

COX 2 inhibitors may have reduced risk of

A

Gastric ulcers and GI Bleeding

276
Q

COX 2 inhibitors should be used cautiously in pts with

A

Pre-existing cardiac or renal disease

277
Q

Acetaminophen only has

A

Antipyretic and analgesic activity

278
Q

SE of acetaminophen

A

Hepatotoxicity

279
Q

Antidote for acetaminophen toxicity

A

N-acetylcysteine

280
Q

DMARDs are slow acting drugs for

A

Rheumatic disease

281
Q

Initial DMARD of choice for patients with RA

A

Methotrexate

282
Q

Drug ofter used in combination with TNF - alpha inhitors for RA

A

Methotrexate

283
Q

Causes bone marrow suppression

A

Methotrexate

284
Q

SE of penicillamine

A

Aplastic anemia and renal toxicity

285
Q

Interferes with activity of T-lymphocytes

A

Hydroxychloroquine

286
Q

Anti-malarial drug used in rheumatoid arthritis (RA)

A

Hydroxychloroquine

287
Q

SE of hydroxychloroquine

A

Retinal destruction and dermatitis

288
Q

MOA of Leflunomide (newer agent)

A

Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis, decreased T cell proliferation and decreased antibody production by B cells

289
Q

Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)

A

Adalimumab, infliximab and etanercept

290
Q

Anti-rheumatic agent also used for ulcerative colitis

A

Sulfasalazine

291
Q

Anti-rheumatic agent also used for Chron’s disease

A

Infliximab

292
Q

NSAID used in gout

A

Indomethacin

293
Q

NSAID contraindicated in gout

A

Aspirin

294
Q

MOA of colchicine (used in acute gout)

A

Selective inhibitor of microtubule assembly

295
Q

SE of colchicine

A

Kidney and liver toxicity, diarrhea

296
Q

Agent used to treat chronic gout by increasing uric acid secretion and excretion

A

Probenecid and sulfinpyrazone

297
Q

Allopurinol treats chronic gout by decreasing uric acid production by inhibiting

A

Xanthine oxidase

298
Q

Rapid acting insulins that do not self-aggregate

A

lispro insulin, aspart insulin, glulisine insulin

299
Q

Peakless ling acting insulin

A

Insulin glargine

300
Q

DOC for paroxysmal supraventricular tachycardia; has high efficacy and short duration of action

A

Adenosine

USMLE Pharmacology (2 decks)

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