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Rapid Fire Facts > Step 1 > Flashcards

Step 1 Flashcards

1
Q

Most common cause of neural tube defects?

A

Folate deficiency

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2
Q

Most common preventable cause of congenital malformations in US?

A

Fetal Alcohol Syndrome

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3
Q

“Fried egg” appearance

A

Expansive clear cytoplasm seen in

  1. Oligodendrocytes
  2. Koilocytes (HPV)
  3. Testicular tumor cell (Seminoma)
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4
Q

Anti-epileptics that cause Steven’s Johnson syndrome. + 3 more

A 
Ethosuxamide
Lamotrigene
Carbamazapine
Phenytoin
Phenobarbital

Sulfonamides
Penicillin
Allopurinol

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5
Q

Anti-epileptics that are teratogens.

A

Carbamazipine
Phenytoin
Valproic acid (spina bifida)

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6
Q

Anti-epileptics that cause hepatotoxicity.

A

Valproic acid

carbamazipine

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7
Q

Drugs that induce CYP450

A 
"Coronas, guinness, and PBRS cause chronic alcoholism"
Carbamazipine
Griseofulvin
Phenytoin
Barbituates
Rifampin
St. Johns worts
Chronic alcoholism
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8
Q

Treatment for absence seizure

A

Ethosuxamide

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9
Q

treatment for tonic clonic seizure

A

Phenytoin
carbamazipine
valproic acid

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10
Q

Vitamin A toxicity can cause what neuro pathology?

A

pseudotumor cerebri (idiopathic intracranial hypertension)

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11
Q

What medications have anti-cholinergic side effects?

A

First gen H1 blockers - diphenhydramine, doxalymine, chlorpheniramine
Neuroleptics
TCA - dry mouth
amantidine

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12
Q

CYP450 inhibitors

A

CRACK AMIGOS

Cipro
Ritonavir (protease inhibitor)
Amniodorone
Cimetidine
Ketoconazole
Acute alcohol use
Macrolides
Isoniazid
Grapefruit juice
Omeprazole
Sulfonamides
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13
Q

Gq receptors

A

C(Q)utsies HAVe 1 M&M

Gq --> phospholipase C
H1
alpha1 
V1
M1
M3
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14
Q

Gi receptors

A

MAD 2

M2
alpha 2
D2

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15
Q

Gs receptors

A

B1, B2, H2, V2, D1

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16
Q

Effects of stimulation of alpha 2 receptors.

A

Decreased SNS output (Decreased NE release)
decreased insulin release
decreased lipolysis

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17
Q

Stimulation of alpha 1 receptors

A 
vasoconstriction
Increased peripheral resistance
mydriasis
increase bladder sphincter contraction
increased gut sphincter contraction
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18
Q

Stimulation of B1 receptors

A

Increased chronotropy and inotropy
Increased renin release
Increased lipolysis

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19
Q

Stimulation of B2 receptors

A

Bronchodilation
vasodilation
Decreased uterine tone (tocolytic)

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20
Q

Cholinergic (Muscarinic) effects

A

DUMBBELSS

Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skeletal muscles
Lacrimation
Sweating
Salivation
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21
Q

Anti-Cholinergic (Muscarinic) effects

A 
Hyperpyrexia (hot as a hare)
No salivation/lacrimation (dry as a bone)
Flushing (red as a beet)
Mydriasis (Blind as a bat)
Delirium (mad as a hatter)
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22
Q

Equation for volume of distribution (Vd)

A

Vd = amount of drug in body / amount of drug in plasma

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23
Q

Equation for clearance

A

CL = (0.693 x Vd) / half-life

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24
Q

Equation for loading dose

A

Loading dose = Steady state concentration x Vd / F

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25
Q

Maintenance dose equation

A

Maint dose = Steady state concentration x CL / F

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26
Q

Does a decrease in Km mean increased or decreased potency?

A

Increased potency

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27
Q

Does an increase in Vmax mean increased or decreased efficacy?

A

Increased efficacy

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28
Q

What reactions occur in Phase I drug metabolism?

A

Reduction, oxidation, and hydrolysis (P450)

lost first in elderly

Can activate pro-drug or make something toxic

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29
Q

What reactions occur in Phase II drug metabolism?

A

Glucuronidation, acetylation, sulfation

Some elderly can be slow acetylators

produces very soluble (polar) and inactive metabolites

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30
Q

Drugs used for urge incontinence.

A

Oxybutynin
Solifenacin
Tolterodine
Trospium

Muscarinic antagonists

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31
Q

Neuroleptic drugs often have anticholinergic effects. What drug would you use to mitigate these?

A

Bethanochol (cholinergic agonist)

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32
Q

What drugs cause cutaneous flushing?

A

Vancomycin
Adenosine
Niacin
Dihydropiridine CCB

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33
Q

What drugs cause coronary vasospasm?

A

Cocaine
Amphetamines
Sumatriptans
Ergotamine

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34
Q

What drugs cause dilated cardiomyopathy?

A

Anthracyclines

Doxarubicin
Donarubicin

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35
Q

What drugs can cause Torsaddes de pointe?

A 
Class III anti-arrhythmics --> K+ block
Class Ia anti-arrhythmics
Macrolides 
Haloperidol
Chloroquine
Protease inhibitors for HIV 
antipsychotics / TCA

Treat with IV Mg2+

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36
Q

What drugs causes thrombocytopenia?

A

Heparin

Cymetidine

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37
Q

What drugs cause agranulocytosis?

A

Clozapine
Carbemazipine
Colchicine

Propylthiouracil
Methimazole
Dapsone

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38
Q

What drugs cause aplastic anemia?

A 
Carbamazepine
Methimazole
NSAID
Benzene
Chloramphenicol
Propylthiouracil
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39
Q

What drugs can cause grey baby syndrome?

A

Chloramphenicol

–> UDP glucuronyltransferase hasn’t matured yet in babies

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40
Q

What causes hemolysis in G6PD deficient patients?

A 
Isoniazid
sulfonamides
dapsone
primaquine
aspirin
ibuprofen
Nitrofurantoin (UTI drug)
Fava beans
Naphthalene
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41
Q

What drugs can cause thrombotic complications?

A

OCP (especially in smokers >35 y/o)

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42
Q

What drugs can cause pulmonary fibrosis?

A

Bleomycin
Amiodarone
Busulfan
Methotrexate

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43
Q

What drug can cause a persistent dry cough?

A

ACE - I

mediated by bradykinin

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44
Q

What drugs can cause pseudomembranous colitis?

A

Clindamycin

Amoxicillin / ampicillin

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45
Q

What drugs can cause hepatic necrosis?

A

Excess halothane
Excess acetominophen
valproic acid
amitina phyloides (mushroom toxin)

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46
Q

What drugs can cause hepatitis?

A 
Rifampin
isoniazid
Pyrazinamide
statins
fibrate
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47
Q

What drug causes tertiary adrenal insufficiency?

A

Corticosteroid withdrawl

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48
Q

What drugs can cause pancreatitis?

A 
Didanosine (Reverse transcriptase inhibitor)
Corticosteroids
Alcohol
Valproic acid
azothioprine
Diuretics (HCTZ, furosemide)
49
Q

What drugs can cause gynecomastia?

A 
"Some Drugs Cause Awesome Knockers" 
Digoxin
spironolactone
estrogens
cimetidine
chronic alcohol use (cirrhosis)
ketoconazole
marijuana use
50
Q

What drugs can cause hot flashes?

A

SERMS (tamoxifen, clomiphene)

51
Q

What drugs can cause hypothyroidism?

A

amiodorone
Lithium
sulfonamides

52
Q

What drugs can cause gout?

A

Diuretics (loop / thiazide)
Niacin
cyclosporine
pyrazinamide

53
Q

What drugs can cause gingival hyperplasia?

A

Verapamil

Phenytoin

54
Q

What drugs can cause osteoporosis?

A

Corticosteroids

Heparin

55
Q

What drugs can cause photosensitivity?

A

SAT for Foto

sulfonamides
amiodarone
tetracyclines
5-FU

56
Q

What drugs can cause Steven Johnson Syndrome?

A 
"CLAPPPErS"
Anti-epileptics (lamotrigene, ethosuxamide, phenytoin, phenobarbital, carbamazipine)
allopurinol
sulfa drugs
penicillin
57
Q

What drugs can cause SLE-like syndrome?

A 
"SHIPP-E"
Sulfonamides
hydralazine
isoniazid
procainamide
phenytoin
etanercept
58
Q

What drugs can cause tendonitis/cartilage damage?

A

Fluoroquinolones

59
Q

What drugs can cause teeth discoloration?

A

tetracycline

60
Q

What drug can cause myopathy?

A 
fibrates
niacin
colchicine
hydroxychloroquine
IFN alpha
penicillamine
statins
glucocorticoids
61
Q

What drugs can cause interstitial nephritis?

A

NSAID
furosemide
antibiotics

62
Q

What drugs can cause nephrogenic diabetes insipidus?

A

Lithium
Demeclocycline

Treat with HCTZ or Amiloride

63
Q

What drugs can cause fanconi syndrome?

A

expired tetracycline
heavy metal exposure
wilsons disease

64
Q

What drugs can cause hemorrhagic cystitis?

A

cylophosphamide
isofamide

Prevent by co-administering MESNA

65
Q

What drugs can cause Parkinson like syndrome?

A

Metaclopramide
anti-psychotics
reserpine

66
Q

What drugs can cause Cinchonism (Dizziness with headache, vision changes, and tinnitus).

A

Quinidine

Quinine

67
Q

What drugs can cause seizures?

A 
Buproprion
imipenem/cilastin
isoniazid
tramadol
metaclopramide
Enflurane
Withdrawl from alcohol or benzos
68
Q

What drugs can cause Tardive dyskenesia?

A

Antipsychotic

metoclopramide

69
Q

What drugs can cause a disulfram like syndrome?

A 
Metronidazole
Cephalosporins
Procarbazine
Disulfram
First gen sulfonylureas
70
Q

What drugs cause Nephrotoxicity / Neurotoxicity?

A

aminoglycosides
cisplatin
polymixins

71
Q

What drugs are nephrotoxic / ototoxic?

A

Vanco
aminoglycosides
cisplatin
loop diuretics

72
Q

What drugs have anti-cholinergic side effects?

A

Atropine
TCA
H1 blockers
Low potency neuroleptics

73
Q

Antidote for amphetamine

A

ammonium chloride (acidifies urine)

Treat symptoms with benzos, anti-psychotics, and anti-hypertensives

74
Q

Antidote for acetominophen

A

N-Acetylcystine (replenishes glutathione)

75
Q

Salicylate (Aspirin) overdose antidote

A

Sodium Biacarb (alkalinize urine)

76
Q

Organophosphate poisoning antidote

A

Pralidoxime (regenerates AChE)

Atropine - immediate

77
Q

Anti-muscarinic antidote

A

Physostigmine (anti-cholinesterase)

78
Q

B-blocker and CCB overdose antidote.

A

Glucagon (increases cAMP in myocardium)
Atropine!!!
Calcium

79
Q

Digitalis overdose antidote (arrhythmias)

A

K+ and Mg2+ optimization
Anti-Dig Fab fragments
Atropine (for sig bradycardia)

80
Q

Iron poisoning antidote

A

Deferoxamine

Deferasirox

81
Q

Lead poisoning antidote (developmental delay, GI symptoms)

A

Dimercaprol / Calcium EDTA
Succimer
Penicillamine (3rd line agent)

82
Q

Mercury, arsenic, or gold poisoning antidote

A

Dimercaprol

succimer

83
Q

Copper, arsenic, or gold poisoning antidote

A

Penicillamine

84
Q

Carbon monoxide poisoning antidote

A

100% O2

Hyperbaric oxygen

85
Q

Methemoglobin antidote

A

Methylene blue –> restores iron to Fe2+

Vitamin C

86
Q

Cyanide poisoning antidote (inhibition of cytochrome C oxidase)

A

Hydroxocobalamin (Vit B12 that binds cyanide and inactivates it)
Thiosulfate
+
Nitrites (converts Hb to Met Hb) because cyanide loves metHb

87
Q

Methanol / ethylene glycol antidote

A

Fomepizole (inhibits alcohol dehydrogenase)
Ethanol
Dialysis

88
Q

Opioid overdose antidote

A

naloxone / naltrexone

89
Q

Benzodiazepine overdose antidote

A

Flumazenil

Supportive care –> too rapid can lead to seizures

90
Q

TCA overdose antidote

A

Sodium bicarbonate (alkalinize the urine)

91
Q

Heparin overdose antidote

A

Protamine

92
Q

Warfarin overdose antidote

A

vitamin K (works very slowly)

Quick action –> FFP

93
Q

tPA, streptokinase, urokinase overdose antidote

A

aminocaproic acid

94
Q

Theophylline overdose (Asthmatic patients)

A

B-blocker

95
Q

What electrolyte imbalance can facilitate procainamide toxicity?

A

hyperkalemia

96
Q

What is the therapy for procainamide OD?

A

sodium lactate

97
Q

Which anti-arrhythmic is most effectiv in acute thyrotoxic arrhythmias?

A

B-blockers like esmolol

98
Q

Which anti-arrhythmic has the longest half-life?

A

amiodarone

99
Q

3 uses of N-acetylcysteine

A

Acetominophen toxicity
Mucolytic (CF)
Prevention of contrast nephropathy

100
Q

What are two 1st generation H1 blockers?

A

Diphenhydramine
Chlorpheniramine

Side effects - anti-muscarinic (blurred vision - mydriasis)
anti-alpha adrenergic (hypotension, postural dizziness) anti-serotonergic (appetite stimulation and weight gain)

Crosses BBB easily causing sedating effects

101
Q

What kind of reactions occur in phase I metabolism and what types of products are produced?

A

Hydroxylation, reduction, oxidation

Slightly more polar/soluble products are made. Sometimes can activate an inactive pro-drug or make something toxic.

102
Q

What kind of reactions occur in phase II metabolism and what types of products are produced?

A

Glucuronidation, sulfation, acetylation

Very polar / soluble products that are usually inactive metabolites. Easily excreted by kidney after.

103
Q

What are the by-products of MAO and COMT activity on dopamine, NE, and epinephrine?

A 
Dopamine = Homovanillic acid 
NE = vanillylmandelic acid
Epinephrine = metanephrine
104
Q

What are some drugs that have a small therapeutic index?

A

warfarin
lithium
digoxin
phenobarbital

105
Q

Where is NE made in the brain?

A

Locus Ceruleus (pons)
Solitary tract
reticular formation

106
Q

Where is dopamine made in the brain?

A

Ventral tegmentum

substantia nigra pars compacta

107
Q

Where is 5-HT made in the brain

A

Raphe nuclei

108
Q

Where is ACh made in the brain?

A

Basal nucleus of Meynert

109
Q

Where is GABA made in the brain?

A

Nucleus accumbens

110
Q

Which drug can be used to reverse neuromuscular blockade?

A

Cholinesterase inhibitors

Neostigmine –> only for non-depolarizing agents like tubocurarine or vecuronium

111
Q

First generation H1 blockers

A

Diphenhydramine
Dimenhydrinate
Chlorpheniramine

112
Q

Second generation H1 blockers

A

Fexofenadine
Loratidine
Desloratidine
Cetirizine

113
Q

What receptors does Albuterol / salmeterol agonize / applications

A

B2 > B1

Acute asthma - albuterol
long term asthma control - salmeterol

114
Q

What receptors does dobutamine agonize / application

A

B1 > B2 > a

Heart failure (inotropy&raquo_space; chronotropy)

115
Q

What receptor does dopamine agonize / application

A

D1 = D2 > B > a

D (low doses)
B (medium doses)
a (large doses)

Unstable bradycardia
HF
Shock

116
Q

What receptor does epinephrine agonize / application

A

B > a

Anaphylaxis
asthma
open-angle glaucoma

117
Q

What receptor does isoproterenol agonize / application

A

B1 = B2

E-phys evaluation of arrhythmias

118
Q

What receptor does norepinephrine agonize / application

A

a1 > a2 > B1

Hypotension (decreases renal perfusion)

119
Q

What receptor does phenylephrine agonize / application

A

a1 > a2

Hypotension (vasoconstriction)
ocular procedures (mydriatic)
rhinitis (decongestant)

Rapid Fire Facts (13 decks)

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