STEP1 Pharm Flashcards

1
Q

Glucocorticoids inhibit

A

Phospholipase A2

Cortisone, hydrocortisone,
“-sone, -olone”

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2
Q

Glucocorticoids increase ____ which ____

A

IkB inhibits NF-kB (prevents increase COX-2)

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3
Q

Inhibit COX-2 only

A

celecoxib

Glucocorticoids increase IkB which inhibits NF-kB which increases COX-2

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4
Q

Inhibit COX1/2

A

Aspirin (irreversible)
NSAIDS
- Ibuprofen, naproxen, indomethacin

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5
Q

Inhibit 5-Lipoxygense

A

Zileuton

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6
Q

Inhibit Leukotriene receptor

A

Montelukast

Zafirlukast

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7
Q

Arachidonic pathway

A

Membrane phospholipids –> Arachidonic acid [Phosphlipase A2]

Arachidonic acid –> 5-HPETE [5-Lipoxygenase] –> Leukotrienes

Arachidonic acid –> cyclic enoperoxides [COX1/2] –> Prostacyclin (PGI2), Prostglandins (PGE), Thromboxane (TXA)

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8
Q

Acetaminophen MOA

A

reversibly inhibits cycloxygenase

Not anti-inflammatory

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9
Q

Aspirin MOA

A

Irreversibly inhibits cycloxygenase
Covalent acetylation

Tinnitus, Acute renal failure, GI bleeding

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10
Q

Celecoxib MOA

A

COX2 specific

Spares platelet fxn as TXA2 production is dependent on COX-1

Rheumatoid arthritis, osteoarthritis

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11
Q

Leflunomide MOA

A

Reversibly inhibits dihydroorotate dehydrogenase
Preventing pyrimidine synthesis
Suppress T cell proliferation

RA, psoriatic arthritis

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12
Q

Bisphosphonates

  • Examples (4)
  • MOA
  • Clinical (5)
  • AE (3)
A

Alendronate, ibandronate, risedronate, zoledronate

Pyrophosphate analog, bind hydroxyapatite in bone, inhibiting osteoclast activity

Osteoporosis, hypercalcemia, Paget dises of bone, metastatic bone disease, osteogenesis imperfecta

Epophagitis, osteonecrosis of jaw, atypical stress fracture

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13
Q

Teriparatide MOA

A

Recombinant PTH analog give SQ daily
Increase osteoblast activity

Osteoporosis

Increase risk of osteosarcoma

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14
Q

Gout drugs (7)

A

Chronic

1) Allopurinol
2) Febuxostat
3) Pegloticase
4) Probenecid

Acute

5) NSAIDs
6) Glucocorticoids
7) Colchicine

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15
Q

Purine excretion pathway (1,1, 3)

A

Purines –> hypoxanthine –> xanthine [Xanthine oxidase]

Xanthine –> Plasma uric acid [Xanthine oxidase]

Plasma uric acid –> Urate crystals in joints –> Gout

                        - -> Tubular reabsorption 
                        - -> Urine
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16
Q

Allopurinol MOA

A

Competitive inhibitor of xanthine oxidase

Decrease conversion to hypoxanthine and xanthine to urate

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17
Q

Febuxostat MOA

A

Inhibits xanthine oxidase

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18
Q

Inhibits xanthine oxidase

A

Allopurinol

Febuxostat

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19
Q

Recombinant uricase that catalyzes metabolism of uric acid to allantoin (more water soluble product)

A

Pegloticase

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20
Q

Probenecid MOA

A

inhibits reabsorption of uric acid in proximal convoluted tubule

Can precipitate uric acid calculi

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21
Q

Colchicine MOA

A

Binds and stabilizes tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis and degranulation

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22
Q

TNF-alpha inhibitors

A

Etanercept

Infliximab
Adalimumab
Certolizumab
Golimumab

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23
Q

Etanercept MOA

A

TNF-alpha inhibitor

Fusion protein (receptor for TNF-alpha + IgG Fc) produced by recombinant DNA

eTaNerCEPT interCEPTs TNf

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24
Q

Infliximab
Adalimumab
Certolizumab
Golimumab

A

TNF-alpha inhibitor

Anti-TNF-alpha monoclonal ab

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25
Q

-sartan

A

Angiotension receptor blockers

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26
Q

-stigmine

A

cholinesterase inhibitors

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27
Q

-curium/ -curonium

A

Non-depolarizing neuromuscular blocking drugs

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28
Q

-glitazone

A

thiazolidinediones

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29
Q

-dipine

A

dihydropyridine calcium channel blockers

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30
Q

-azepam

A

Benzodiazepine

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31
Q

-conazole

A

antifungal drugs

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32
Q

-caine

A

local anesthetics

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33
Q

-cycline

A

tetracycline antibiotics

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34
Q

-navir

A

protease inhibitors

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35
Q

cholinesterase inhibitors

A

-stigmine

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36
Q

local anesthetics

A

-caine

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37
Q

dihydropyridine calcium channel blockers

A

-dipine

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38
Q

protease inhibitors

A

-navir

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39
Q

Non-depolarizing neuromuscular blocking drugs

A

-curium/ -curonium

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40
Q

Angiotension receptor blockers

A

-sartan

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41
Q

antifungal drugs

A

-conazole

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42
Q

tetracycline antibiotics

A

-cycline

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43
Q

Benzodiazepine

A

-azepam

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44
Q

thiazolidinediones

A

-glitazone

45
Q

Proteasome inhibitor

A

Bortezomib

Carfilzomib

46
Q

Boronic acid contain dipeptide

A

Bortezomib

Proteasome inhibitor

47
Q

Proteasome inhibitor MOA

A

Results in accumulation of toxic intracellualr proteins

Excess pro-apoptotic proteins –> induce apoptosis

48
Q

Tx of hypercalcemia

A

Hydration

Corticosteroids (mild)

Bisphosphonates (moderate to severe hypercalcemia)

49
Q

-sartan

A

Angiotensin II receptor blocker

50
Q

-stigmine

A

AChE inhibitor

51
Q

-curium/ curonium

A

Nondepolarizing paralytic

52
Q

-glitazone

A

PPAR-gamma activator

53
Q

-azole

A

Ergosterol synthesis inhibitor

54
Q

-bendazole

A

Antiparasitic/ antihelminthic

55
Q

-cillin

A

transpeptidase (penicillin binding protein)

56
Q

-cycline

A

Protein synthesis inhibitor

57
Q

-ivir

A

Neuraminidase inhibitor

58
Q

-navir

A

Protease inhibitor

59
Q

-ovir

A

DNA polymerase inhibitor

60
Q

-thromycin

A

Macrolide antibiotic

61
Q

-ane

A

inhalational general anesthetic

62
Q

-azine

A

typical antipsychotic

63
Q

-barbital

A

barbiturate

64
Q

-caine

A

local anesthetic

65
Q

-etine

A

SSRI

66
Q
  • ipramine

- triptyline

A

TCA

67
Q

-triptan

A

5-HT agonist

68
Q

-zepam, -zolam

A

Benzodiazepine

69
Q

-chol

A

Cholinergic agonist

70
Q

-olol

A

beta blocker

71
Q

-terol

A

beta2 agonist

72
Q

-zosin

A

alpha 1 antagonist

73
Q

-afil

A

PDE-5 inhibitor

74
Q

-dipine

A

Dihydropyridine Ca channel blocker

75
Q

-pril

A

ACE inhibitor

76
Q

-statin

A

HMG-CoA reductase inhibitor

77
Q

-xaban

A

Direct factor Xa inhibitor

78
Q

-dronate

A

Biphosphonate

79
Q

-prazole

A

Proton pump inhibitor

80
Q

-prost

A

Prostaglandin analog

81
Q

-tidine

A

H2 antagonist

82
Q

-tinib

A

tyrosine kinase inhibitor

83
Q

-tropin

A

Pituitary hormone

84
Q

-ximab

A

chimeric monoclonal Ab

85
Q

-zumab

A

Humanized monoclonal ab

86
Q

ACE inhibitors adn ARBs AE

A

renal failure

Oligohydramnios

87
Q

Aminoglycosides AE

A

[Antibiotics]

Ototoxicity

88
Q

Fluoroquinolones AE

A

[Antibiotics]

Cartilage damage

89
Q

Tetracyclines AE

A

[Antibiotics]

Discolored teeth

90
Q

Cyclophosphamide AE

A

[Cancer drug]
Ear/ facial anomalies
limb hypoplasia
Absence of digits

91
Q

Methotrexate AE

A

[Cancer drug]
Neural tube defects
Abortion

92
Q

Carbamazepine AE

A

[Seizure drug]

Neural tube defects

93
Q

Valproic acid AE

A

[Seizure drug]

Neural tube defects

94
Q

Phenytoin AE

A

Fetal hydantoin syndrome

95
Q

Lithium AE

A

[Mood stabilizer]

Ebstein anomaly

96
Q

Statins AE

A

CNS and limb abnormalities

97
Q

Warfarin AE

A

Bone/ cartilage defects

Nasal hypoplasia

98
Q

Isotretinoin AE

A

Spontaneous abortion

Birth defects

99
Q

Diethylstilbestrol (DES) AE

A

Clear cell vaginal adenocarcinoma

100
Q

Thalidomide AE

A

Phocomelia

Limb deformities

101
Q

Metformin

  • type
  • MOA (2)
  • SE (2)
A

[Biguanide]

Decrease gluconeogenesis in liver

Improve insulin sensitivity

SE: GI upset, lactic acidosis

102
Q

Glimepiride

  • type
  • two others
  • MOA (1)
  • SE (2)
A

[Sulfonylureas]
also glipizide, glyburide

Close K channels in beta cells –> increased secretion insulin

Hypoglycemia
Weight gain

103
Q

Sulfonylureas (3)

A

Glimepiride
GLipizide
Glyburide

104
Q

Glipizide

  • type
  • two others
  • MOA (1)
  • SE (2)
A

[Sulfonylureas]
also glimepiride, glyburide

Close K channels in beta cells –> increased secretion insulin

Hypoglycemia
Weight gain

105
Q

Glyburide

  • type
  • two others
  • MOA (1)
  • SE (2)
A

[Sulfonylureas]
also glipizide, Glimepiride

Close K channels in beta cells –> increased secretion insulin

Hypoglycemia
Weight gain

106
Q

Pioglitazone

  • type
  • other one
  • MOA (3)
  • SE (2)
A

[thiazolidinediones]

Rosiglitazone

Increased sensitivity to insulin in peripheral tissue

Decrease hepatic gluconeogenesis

Bind to PPAR-gamma receptor (regulate FA storage and glucose metabolism, improve insulin secretion)

Fluid retention
Weight gain

107
Q

Liraglutide

  • type
  • others (3)
  • MOA (3)
  • SE (2)
A

GLP-1 agonists

Exenatide
Albiglutide
Dulaglutide

Increases glucose-dep insulin release

Decrease glucagon release

Promote delayed gastric emptying

WL
Nausea

108
Q

Sitagliptin

  • type
  • others (3)
  • MOA (2)
  • SE (1)
A

DDP-4 inhibitors

Alogliptin
Saxagliptin
Linagliptin

Prevents DDP-4 from inactivating GLP-1

Increases glucose-dependent insulin release

Low side effet profile

109
Q

Dapagliflozin

  • type
  • others (2)
  • MOA (1)
  • AE (3)
A

SGLT-2 inhibitors

Empagliflozin
Canagliflozin

More glucose lost in urine

Recurrent UTI and mycotic infection

Dehydration

Diabetic ketoacidosis