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Rapid Review STEP 1 > USMLE First Aid 2013 Pharm w/antibios > Flashcards

USMLE First Aid 2013 Pharm w/antibios Flashcards

1
Q

Nitrates (mechanism, use, toxicity)

A

Cause NO release -> vasodilation (veins >>> arteries); used in angina; fast tolerance, hypotension, flushing, headache Pharmacology Cardio

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1
Q

Adverse effects of statins

A

Hepatoxicity and muscle breakdown Pharmacology Cardio

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2
Q

Niacin (mechanism, use, toxicity)

A

Inhibits lipolysis and reduces VLDL secretion, lowering LDL and raising HDL; hyperlipidemia; flushing and hyperuricemia Pharmacology Cardio

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3
Q

Cholestyramine, colestipol, colesevelam (mechanism, use, toxicity)

A

Inhibits reabsorption of bile acids -> lower LDL with slight increase in HDL; unpigmented gallbladder stones and malabsorption Pharmacology Cardio

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4
Q

Ezetimibe

A

Prevents cholesterol reabsorption -> lower LDL Pharmacology Cardio

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5
Q

Fibrates (gemfibrozil + -fibrates) (mechanism, use, toxicity)

A

Upregulates LPL -> lower triglycerides, slightly inc. HDL and slightly dec. LDL; myositis and hepatoxicity Pharmacology Cardio

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6
Q

Digoxin and digitoxin (mechanism, use, toxicity)

A

Inhibits Na/K ATPase -> indirectly inhibits Na/Ca exchanger -> inc. calcium levels -> inc. contractility; stimulates the vagus; causes cholinergic symptoms and hyperkalemia Pharmacology Cardio

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7
Q

Class 1A antiarrhythmics

A

Quinidine, procainamide, and disopyramide; inc. AP duration and QT interval; can cause torsades de pointes, cinchonism (qunidine), procainamide (drug-induced lupus) Pharmacology Cardio

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8
Q

Class 1B antiarrhythmics

A

Lidocaine, mexiletine, and tocainide; dec. AP duration especially in depolarized/ischemia tissue; best following MI Pharmacology Cardio

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9
Q

Class 1C antiarrhythmics

A

Flecainide, propafenone; no effect on AP, used in ventricular tachycardias; do not use post-MI due to risk for arrhythmias Pharmacology Cardio

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10
Q

Class 1 antiarrhythmics (general mechanism and toxicity)

A

Blocks Na channels, decreasing the slope of phase 0 depolarization; toxicity exacerbated by hyperkalemia Pharmacology Cardio

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11
Q

Class 2 antiarrhythmics

A

Beta-blockers; reduces cAMP, slowing SA and AV node activity, increases PR interval; adverse effects include impotence, asthma exacerbation, sedation Pharmacology Cardio

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12
Q

Class 3 antiarrhythmics

A

Amiodarone, ibutilide, dofetilide, sotalol; K channel blockers; inc. AP duration and QT interval Pharmacology Cardio

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13
Q

Toxicity of amiodarone

A

Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction Pharmacology Cardio

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14
Q

Class 4 antiarrhythmics

A

Ca channel blockers; verapamil and diltiazem; dec. conduction velocity and inc. PR interval; cause constipation, flushing, and edema Pharmacology Cardio

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15
Q

Adeosine (mechanism, use, toxicity)

A

Inc. K efflux, hyperpolarizing the cell; used in supraventricular tachycardias; can cause flushing, hypotension, and chest pain Pharmacology Cardio

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16
Q

Magnseium (mechanism, use, toxicity)

A

Used in torsades de pointes and digoxin toxicity Pharmacology Cardio

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17
Q

Treatment for prolactinoma

A

Bromocriptine or cabergoline (dopamine agonists) Pharmacology Endocrine

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18
Q

Treatment of secondary hyperaldosteronism

A

Spironolactone (or other AT2 antagonist) Pharmacology Endocrine

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19
Q

Treatment of carcinoid syndrome

A

Octreotide (somatostatin analogues) Pharmacology Endocrine

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20
Q

Rapid-acting insulins (3)

A

Lispro, aspart, and glulisine Pharmacology Endocrine

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21
Q

Short-acting insulin (1)

A

Regular Pharmacology Endocrine

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22
Q

Intermediate-acting insulin (1)

A

NPH Pharmacology Endocrine

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23
Q

Long-acting insulins (2)

A

Glargine and detemir Pharmacology Endocrine

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24
Q

Metformin (mechanism, use, toxicity)

A

Biguanide; unknown mechanism; increases insulin sensitivity and glycolysis and decreases gluconeogenesis; can cause lactic acidosis (don’t use in renal failure patients) Pharmacology Endocrine

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25
Q

Tolbutamide, chlorpropamide (mechanism, use, toxicity)

A

First-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes disulfuram-like effects Pharmacology Endocrine

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26
Q

Glyburide, glimepiride, glipizide (mechanism, use, toxicity)

A

Second-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes hypoglycemia Pharmacology Endocrine

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27
Q

Pioglitazone, rosiglitazone (mechanism, use, toxicity)

A

Thiazolidinediones; activates PPAR-gamma, increasing insulin sensitivity and adiponectin levels; causes weight gain, hepatotoxicity, and heart failure Pharmacology Endocrine

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28
Q

Acarbose, miglitol (mechanism, use, toxicity)

A

Alpha-glucosidase inhibitors; prevent sugar hydrolysis and absorption, reducing blood sugar levels Pharmacology Endocrine

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29
Q

Pramlintide (mechanism, use, toxicity)

A

Amylin analog; reduces glucagon secretion; causes hypoglycemia Pharmacology Endocrine

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30
Q

Exenatide, liraglutide (mechanism, use, toxicity)

A

GLP-1 analogues; increase insulin, decrease glucagon secretion; causes pancreatitis Pharmacology Endocrine

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31
Q

Linagliptin, saxagliptin, sitagliptin (mechanism, use, toxicity)

A

DPP-4 inhibitors; increase insulin, decrease glucagon secretion; causes mild urinary/respiratory infections Pharmacology Endocrine

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32
Q

Propylthiouracil (mechanism, use, toxicity)

A

Blocks thyroid peroxidase and 5’-deiodinase; used to treat hyperthyroidism; causes agranulocytosis, aplastic anemia, hepatotoxicity Pharmacology Endocrine

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33
Q

Methimazole (mechanism, use, toxicity)

A

Blocks thyroid peroxidase; used to treat hyperthyrodism; teratogenic Pharmacology Endocrine

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34
Q

Levothyroxine, triiodothyronine (mechanism, use, toxicity)

A

Thyroid hormone analogs; causes thyrotoxicosis Pharmacology Endocrine

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35
Q

Oxytocin (mechanism, use, toxicity)

A

Used to control uterine hemhorrage Pharmacology Endocrine

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36
Q

Demeclocycline (mechanism, use, toxicity)

A

ADH antagonist used to treat SIADH; can cause photosensitivty and bone/teeth abnormalities Pharmacology Endocrine

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37
Q

Glucocorticoids (mechanism, use, toxicity)

A

Inhibits phospholipase A2 activity and expression of COX-2; used for immune suppression; can cause Cushing’s syndrome, adrenal insufficiency (if withdrawn quickly) Pharmacology Endocrine

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38
Q

Cimetidine and ranitidine (mechanism, use, toxicity)

A

H2 antagonists; used to treat hyperchloridia; cimeditine is a P-450 inhibitor and has antiandrogenic effects, both reduce creatinine secretion Pharmacology GI

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39
Q

NAME?

A

Irreversibly inhibit the H/K pump; used to treat hyperchloridia; increased risk of C. difficile infection and hypomagnesemia Pharmacology GI

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40
Q

Bismuth, sucralfate (mechanism, use, toxicity)

A

Coats ulcer base and protects underlying tissue Pharmacology GI

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41
Q

Misoprostol (mechanism, use, toxicity)

A

PGE1 analog that decreases acid production and increases bicarb production; used to prevent NSAID ulcers; abortifacient Pharmacology GI

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42
Q

Octreotide (mechanism, use, toxicity)

A

Somatostatin analog; used to treat VIPoma and carcinoid syndrome Pharmacology GI

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43
Q

Toxicity of long-term antacid use

A

Hypokalemia Pharmacology GI

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44
Q

Infliximab (mechanism, use, toxicity)

A

Anti-TNF; used to treat IBD and RA; can cause activation of latent microbes Pharmacology GI

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45
Q

Sulfasalazine (mechanism, use, toxicity)

A

Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory); used to treat IBD; causes oligospermia Pharmacology GI

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46
Q

Ondansetron (mechanism, use, toxicity)

A

5-HT3 antagonist; used as an antiemetic Pharmacology GI

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47
Q

Metoclopramide (mechanism, use, toxicity)

A

D2 antagonist; used to increase gut muscle activity and as an antiemetic; causes parkinson signs Pharmacology GI

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48
Q

Can be used to prevent mast cell degranulation

A

Cromolyn sodium Pharmacology Heme/Onc

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49
Q

Treatment of lead poisoning

A

Dimercaprol and EDTA, succimer in kids Pharmacology Heme/Onc

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50
Q

Heparin (mechanism, use, toxicity)

A

Activates antithrombin, which inactivates thrombin and Xa; used for immediate coagulation and in pregnant women; some patients develop antibodies to platelet factor 4 (HIT) Pharmacology Heme/Onc

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51
Q

Enoxaparin, dalteparin (mechanism, use, toxicity)

A

Same actions as heparin, but has a longer half-life, does not have to be monitored as closely, and has a reduced risk of HIT Pharmacology Heme/Onc

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52
Q

Warfarin (mechanism, use, toxicity)

A

Inactivated gamma-carboxylation of factors II, VII, IX, X, C, and S; used for long-term and non-immediate anticoagulation; can cause tissue necrosis, teratogenic Pharmacology Heme/Onc

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53
Q

Alteplase, reteplase, tenecteplase (mechanism, use, toxicity)

A

Converts plasminogen to plasmin; used as a thrombolytic Pharmacology Heme/Onc

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54
Q

Aspirin (mechanism, use, toxicity)

A

Irreversibly inhibits COX-1 and COX-2; anti-platelet and anti-inflammatory; gastric ulcers, tinnitus, Reye’s syndrome in childhood viral infections Pharmacology Heme/Onc

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55
Q

Clopidogrel, ticlodipine, prasugrel, ticagrelor (mechanism, use, toxicity)

A

Irreversibly blocks ADP receptors on platelets, preventing degranulation; used for acure coronary syndrome; ticlodipine causes neutropenia Pharmacology Heme/Onc

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56
Q

Cilostazol, dipyridamole (mechanism, use, toxicity)

A

Phosphodiesterase inhibitor, increases cAMP and decreases ADP, preventing platelet degranulation; nausea, headache, facial flushing, hypotension Pharmacology Heme/Onc

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57
Q

Abciximab, eptifibatide, tirofiban (mechanism, use, toxicity)

A

GPIIb/IIIa inhibitors, preventing platelet aggregation; bleeding, thrombocytopenia Pharmacology Heme/Onc

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58
Q

Methotrexate (mechanism, use, toxicity)

A

Inhibits dihydrofolate reductase, inhibiting DNA synthesis; myelosuppression, macrovesicular fatty change in liver Pharmacology Heme/Onc

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59
Q

5-fluorouracil (mechanism, use, toxicity)

A

Pyrimidine analog that is activated and inhibits thymidylate synthase, inhibiting DNA synthesis; myelosuppression, photosensitivity Pharmacology Heme/Onc

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60
Q

Cytarabine (mechanism, use, toxicity)

A

Pyrimidine analog that inhibits DNA polymerase; leukopenia, thrombocytopenia, megaloblastic anemia Pharmacology Heme/Onc

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61
Q

Azathioprine, 6-mercaptopurine, 6-thioguanine (mechanism, use, toxicity)

A

Purine analogs that are activated by HGPRT and inhibit purine synthesis; toxicity is increased with allopurinol, causes bone marrow, GI, and liver toxicity Pharmacology Heme/Onc

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62
Q

Dactinomycin (actinomycin D) (mechanism, use, toxicity)

A

DNA intercalator; used for childhood tumors; myelosuppression Pharmacology Heme/Onc

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63
Q

Doxorubicin (Adriamycin), daunorubicin (mechanism, use, toxicity)

A

Generates free radicals that cause DNA strand breaks; dilated cardiomyopathy, myelosuppression, alopecia Pharmacology Heme/Onc

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64
Q

Bleomycin (mechanism, use, toxicity)

A

Generates free radicals that cause DNA strand breaks; pulmonary fibrosis with minimal myelosuppression Pharmacology Heme/Onc

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65
Q

Cyclophosphamide, ifosfamide (mechanism, use, toxicity)

A

Crosslinks DNA (must be activated by liver); myelosuppression, hemhorragic cystitis (can be minimized with mesna) Pharmacology Heme/Onc

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66
Q

Carmustine, lomustine, semustine, streptozocin (mechanism, use, toxicity)

A

Used to treat CNS tumors Pharmacology Heme/Onc

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67
Q

Busulfan (mechanism, use, toxicity)

A

Alkylates DNA; pulmonary fibrosis, hyperpigmentation Pharmacology Heme/Onc

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68
Q

Vincristine, vinblastine (mechanism, use, toxicity)

A

Block microtubule polymerization; vincristine causes neurotoxicity, vinblastine causes bone marro suppression Pharmacology Heme/Onc

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69
Q

Paclitaxel (mechanism, use, toxicity)

A

Blocks microtubule breakdown; myelosuppression Pharmacology Heme/Onc

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70
Q

Cisplatin, carboplatin (mechanism, use, toxicity)

A

Crosslinks DNA; nephrotoxicity (minimize with chloride diuresis, amifostine), acoustic n. damage Pharmacology Heme/Onc

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71
Q

Etoposide, teniposide (mechanism, use, toxicity)

A

Inhibits topoisomerase II; myelosuppression, GI upset, alopecia Pharmacology Heme/Onc

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72
Q

Hydroxyurea (mechanism, use, toxicity)

A

Inhibits ribonucleotide reductase; used in cancers and HbSS disease; bone marrow suppression Pharmacology Heme/Onc

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73
Q

Prednisone (mechanism, use, toxicity)

A

Unknown but may trigger apoptosis in dividing cells; Cushingoid symptoms Pharmacology Heme/Onc

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74
Q

Tamoxifen, raloxifene (mechanism, use, toxicity)

A

Prevents estrogen receptor binding; used in breast cancer and prevention of osteoporosis; tamoxifen increases the risk of endometrial cancer due to agonist effects Pharmacology Heme/Onc

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75
Q

Trastuzumab (mechanism, use, toxicity)

A

Antibody against HER-2 receptor; cardiotoxicity Pharmacology Heme/Onc

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76
Q

Imatinib (mechanism, use, toxicity)

A

Antibody against bcr-abl tyrosine kinase Pharmacology Heme/Onc

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77
Q

Rituximab (mechanism, use, toxicity)

A

Antibody against CD20; used to treat non-Hodgkin’s lymphoma and rheumatoid arthritis Pharmacology Heme/Onc

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78
Q

Vemurafenib (mechanism, use, toxicity)

A

B-raf kinase inhibitor (V600 mutation); used in metastatic melanoma Pharmacology Heme/Onc

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79
Q

Bevacizumab (mechanism, use, toxicity)

A

Antibody against VEGF Pharmacology Heme/Onc

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80
Q

Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac (mechanism, use, toxicity)

A

Reversible COX inhibitor; gastric ulcers, renal ischemia (due to constriction of afferent arteriole) Pharmacology Musculoskeletal

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81
Q

Celecoxib (mechanism, use, toxicity)

A

Reversible COX-2 inhibitor; anti-inflammatory without damage to gastric mucosa; sulfa allergy, thrombosis Pharmacology Musculoskeletal

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82
Q

Acetominophen (mechanism, use, toxicity)

A

COX inhibitor in the CNS (not anti-inflammatory); causes hepatic necrosis Pharmacology Musculoskeletal

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83
Q

Alendronate (mechanism, use, toxicity)

A

Pyrophosphate analog that inhibits osteoclasts; used to treat osteoporosis, hypercalcemia, and Paget’s disease; corrosive esophagitis Pharmacology Musculoskeletal

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84
Q

Allopurinol (mechanism, use, toxicity)

A

Xanthine oxidase inhibitor, reduces production of uric acid Pharmacology Musculoskeletal

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85
Q

Febuxostat (mechanism, use, toxicity)

A

Xanthine oxidase inhibitor Pharmacology Musculoskeletal

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86
Q

Probenecid (mechanism, use, toxicity)

A

Inhibits reabsorption of uric acid in PCT Pharmacology Musculoskeletal

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87
Q

Colchine (mechanism, use, toxicity)

A

Inhibits microtubule polymerization, preventing neutrophil extravasation Pharmacology Musculoskeletal

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88
Q

Etanercept (mechanism, use, toxicity)

A

TNF-alpha receptor that binds free TNF-alpha Pharmacology Musculoskeletal

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89
Q

Infliximab, adalimumab (mechanism, use, toxicity)

A

Anti-TNF-alpha antibody Pharmacology Musculoskeletal

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90
Q

Latanoprost (mechanism, use, toxicity)

A

PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris Pharmacology Neurology

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91
Q

Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity)

A

Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis Pharmacology Neurology

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92
Q

Butorphanol (mechanism, use, toxicity)

A

Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full agonist Pharmacology Neurology

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93
Q

Tramadol (mechanism, use, toxicity)

A

Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures Pharmacology Neurology

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94
Q

First-line therapy for simple partial seizures

A

Carbamazepine Pharmacology Neurology

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95
Q

First-line therapy for complex partial seizures

A

Carbamazepine Pharmacology Neurology

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96
Q

First-line therapies for tonic-clonic seizures (3)

A

Carbamazepine, phenytoin, valproate Pharmacology Neurology

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97
Q

First-line therapy for absence seizures

A

Ethosuximide Pharmacology Neurology

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98
Q

Phenytoin (mechanism, use, toxicity)

A

Increases Na channel inactivation and inhibits glutamate release; used for simple, complex, and tonic-clonic seizures and status epilecticus prophylaxis; nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenic, drug-induced lupus, P450 inducer Pharmacology Neurology

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99
Q

Carbamazepine (mechanism, use, toxicity)

A

Increases Na channel inactivation; first-line for simple, complex, and tonic-clonic seizures and trigeminal neuralgia; agranulocytosis, aplastic anemia, P450 inducer, SIADH, liver toxicity Pharmacology Neurology

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100
Q

Lamotrigine (mechanism, use, toxicity)

A

Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome Pharmacology Neurology

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101
Q

Gabapentin (mechanism, use, toxicity)

A

Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia Pharmacology Neurology

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102
Q

Topiramate (mechanism, use, toxicity)

A

Blocks Na channels and increases GABA secretion; used for simple, complex, and tonic-clonic seizures and migraine prevention; mental dulling, kidney stones, weight loss Pharmacology Neurology

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103
Q

Phenobarbital (mechanism, use, toxicity)

A

Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer Pharmacology Neurology

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104
Q

Valproate (mechanism, use, toxicity)

A

Increases Na channel inactivation and increases GABA levels; first-line for tonic-clonic seizures, used for simplex, complex, tonic-clonic, and myoclonic seizures; hepatotoxicity, neural tube defects, weight gain, tremor Pharmacology Neurology

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105
Q

Ethosuximide (mechanism, use, toxicity)

A

Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome Pharmacology Neurology

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106
Q

Benzodiazepines (mechanism, use, toxicity)

A

Increases frequency of GABA channel opening; first-line for status epilepticus (diazepam, lorazepam), used for eclampsia seizures (diazepam, lorazepam), anxiety, alcohol withdrawl, sleep walking, night terrors; sedation Pharmacology Neurology

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107
Q

Tiagabine (mechanism, use, toxicity)

A

Inhibits GABA reuptake; used for simple and complex seizures Pharmacology Neurology

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108
Q

Vigabatrin (mechanism, use, toxicity)

A

Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex seizures Pharmacology Neurology

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109
Q

Levetriacetam (mechanism, use, toxicity)

A

Unknown mechanism; used for simple, complex, and tonic-clonic seizures Pharmacology Neurology

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110
Q

Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity)

A

Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias Pharmacology Neurology

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111
Q

Triazolam, oxazepam, midazolam (mechanism, use, toxicity)

A

Short-acting benzodiazepines; more addictive potential Pharmacology Neurology

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112
Q

Barbituates vs. benzodiazepines (mechanism)

A

Increase duration vs. increase frequency Pharmacology Neurology

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113
Q

Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity)

A

BZ1 subtype GABA channel agonists; used to treat insomnia Pharmacology Neurology

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114
Q

Ketamine (mechanism, use, toxicity)

A

Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams Pharmacology Neurology

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115
Q

Order of sensory loss when using local anesthetics

A

Pain -> temperature -> touch -> pressure Pharmacology Neurology

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116
Q

Succinylcholine (mechanism, use, toxicity)

A

ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia Pharmacology Neurology

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117
Q

Tubocurarine, -curium drugs (mechanism, use, toxicity)

A

ACh antagonists; used as paralytics Pharmacology Neurology

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118
Q

Dantrolene (mechanism, use, toxicity)

A

Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome Pharmacology Neurology

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119
Q

Levodopa/carbidopa (mechanism, use, toxicity)

A

Converted to dopamine by dopa decarboxylase in CNS/inhibits peripheral dopa decarboxylase activity; used to treat parkinson symptoms; can cause arrhythmias and “on/off” phenomenon Pharmacology Neurology

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120
Q

Selegiline (mechanism, use, toxicity)

A

MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa Pharmacology Neurology

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121
Q

Donepezil, galantamine, rivastigmine (mechanism, use, toxicity)

A

ACh esterase inhibitors; used to treat Alzheimer’s disease; cholinergic symptoms Pharmacology Neurology

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122
Q

Sumatriptan (mechanism, use, toxicity)

A

Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm Pharmacology Neurology

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123
Q

Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)

A

High potency antipsychotics that antagonize D2 receptors; used to treat schizoprehnia, psychosis, mania, and Tourette’s; hyperprolactinemia, anti-cholinergic symptoms (dry mouth, constipation), extrapyramidal effects (dyskinesia), neuroleptic malignany syndrome, tardive dyskinesia (haloperidol) Pharmacology Psychiatry

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124
Q

Chlorpromazine, thioridazine (mechanism, use, toxicity)

A

Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette’s; corneal deposits (chlorpromazine), retinal desporits (thioridazine) Pharmacology Psychiatry

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125
Q

Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity)

A

Atypical antipsychotics with unknown mechnism; used for schizophrenia, bipolar disorder, OCD, and others; weight gain (olanzapine, clozapine), agranulocytosis (clozapine), seizures (clozapine), prolonged QT (ziprasidone) Pharmacology Psychiatry

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126
Q

Lithium (mechanism, use, toxicity)

A

Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism, polyuria Pharmacology Psychiatry

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127
Q

Buspirone (mechanism, use, toxicity)

A

Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement Pharmacology Psychiatry

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128
Q

Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity)

A

Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures) Pharmacology Psychiatry

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129
Q

Venlafaxine, duloxetine (mechanism, use, toxicity)

A

Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension Pharmacology Psychiatry

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130
Q

-iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity)

A

TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects Pharmacology Psychiatry

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131
Q

Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity)

A

Inhibit breakdown of NE, serotonin, and dopamine; used for atypical depression, anxiety, and hypochondriasis; hypertensive crisis (tyramine in wine/cheese), don’t use with other serotonin agonists Pharmacology Psychiatry

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132
Q

Bupropion (mechanism, use, toxicity)

A

Increases NE and dopamine; used for smoking sensation, depression; seizures Pharmacology Psychiatry

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133
Q

Mirtazapine (mechanism, use, toxicity)

A

Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain; Pharmacology Psychiatry

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134
Q

Maprotiline (mechanism, use, toxicity)

A

Blocks NE reuptake; used for depression; sedation, hypotension Pharmacology Psychiatry

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135
Q

Trazodone (mechanism, use, toxicity)

A

Inhibits serotonin uptake; used for insomnia; pripism Pharmacology Psychiatry

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136
Q

Mannitol (mechanism, use, toxicity)

A

Osmotic diuretic; used to treat drug overdose and increased ICP; pulmonary edema, CHF Pharmacology Renal

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137
Q

Acetazolamide (mechanism, use, toxicity)

A

Carbonic anhydrase inhibitor; used for glaucoma, metabolic alklalosis; hyperchloremic metabolic acidosis, ammonia toxicity, sulfa allergy Pharmacology Renal

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138
Q

Furosemide (mechanism, use, toxicity)

A

Inhibits NKCC channel, preventing urine concentration; used in hypertension, CHF, hypercalcemia; ototoxicity, hypokalemia, hypocalcemia, nephritis, gout, sulfa allergy Pharmacology Renal

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139
Q

Ethacrynic acid (mechanism, use, toxicity)

A

Inhibits NKCC channel; used in patients with furosemide (sulfa) allergy; hyperuricemia Pharmacology Renal

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140
Q

Hydrochlorothiazide (mechanism, use, toxicity)

A

Inhibits NaCl reabsorption in DCT and increases Ca reabsorption; hypertension and hypercalcinuria; hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy Pharmacology Renal

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141
Q

Spironolactone, eplerenone (mechanism, use, toxicity)

A

Aldosterone receptor antagonists; hyperaldosteronism, CHF, hypokalemia; hyperkalemia (arrhythmias), antiandrogen effects with spironolactone Pharmacology Renal

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142
Q

Triamterene, amiloride (mechanism, use, toxicity)

A

Block sodium channels in cortical collecting duct; hyperaldosteronism, CHF Pharmacology Renal

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143
Q

Captopril, enalapril, lisinopril (mechanism, use, toxicity)

A

ACE inhibitor, leads to reduced angiotensin II levels and decreases GFR; prevents heart remodeling, hypertension, CHF; cough, angioedema, transient creatinine increase, hyperkalemia Pharmacology Renal

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144
Q

Losartan, valsartan (mechanism, use, toxicity)

A

Angiotensin II receptor antagonists; similar to ACE inhibitors, but do not cause cough due to normal metabolism of bradykinin Pharmacology Renal

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145
Q

Leuprolide (mechanism, use, toxicity)

A

GnRH analog that acts as an agonist in pulsatile doses and an antagonist in continuous doses; used as an agonist for infertility and an antagonist for prostate cancer, fibroids, and precocious puberty; antiandrogenic Pharmacology Reproductive

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146
Q

Finasteride (mechanism, use, toxicity)

A

5-alpha reductase inhibitor; used for BPH and male-pattern baldness Pharmacology Reproductive

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147
Q

Flutamide (mechanism, use, toxicity)

A

Testosterone receptor antagonist; used in prostate cancer Pharmacology Reproductive

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148
Q

Ketoconazole (mechanism, use, toxicity)

A

Inhibits 17,20-desmolase, stopping sex steroid synthesis; used to treat polycystic ovarian syndrome Pharmacology Reproductive

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149
Q

Clomiphene (mechanism, use, toxicity)

A

Partial estrogen agonist in the hypothalamus, increases release of LH and FSH, stimulating ovulation; used for infertility and PCOS Pharmacology Reproductive

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150
Q

Tamoxifen (mechanism, use, toxicity)

A

Estrogen receptor antagonist at the breast; used for breast cancer; partial agonist at the uterus, can cause endometrial hyperplasia Pharmacology Reproductive

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151
Q

Raloxifene (mechanism, use, toxicity)

A

Estrogen receptor agonist at bone, inhibits osteoclast activity and stimulates osteoblast activity; used to treat osteoporosis Pharmacology Reproductive

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152
Q

Anastrozole, exemestane (mechanism, use, toxicity)

A

Aromatase inhibitors; used in breast cancer Pharmacology Reproductive

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153
Q

Mifepristone (mechanism, use, toxicity)

A

Progesterone receptor antagonist, given with misoprostol for abortion; abortifacient; bleeding, abdominal pain Pharmacology Reproductive

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154
Q

Terbutaline (mechanism, use, toxicity)

A

Beta-2 agonist, inhibits uterine contractions Pharmacology Reproductive

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155
Q

Tamsulosin (mechanism, use, toxicity)

A

Alpha-1 antagonist; used to treat BPH Pharmacology Reproductive

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156
Q

Sildenafil, vardenafil (mechanism, use, toxicity)

A

Phosphodiesterase 5 inhibitors, causing inc. cGMP levels and smooth muscle relaxation; used in erectile dysfunction; impaired blue-green vision, contradindicated with nitrates Pharmacology Reproductive

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157
Q

Danazol (mechanism, use, toxicity)

A

Partial androgen receptor agonist; used to treat endometriosis and hereditary angioedema; weight gain, acne, hirsutism, low HDL, hepatoxicity Pharmacology Reproductive

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158
Q

Treat methemoglobinemia with

A

Methylene blue Pharmacology Respiratory

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159
Q

Diphenhydramine, dimenhydrinate, chlorpheniramine (mechanism, use, toxicity)

A

(First generation) H1 antagonists; used in allergies, motion sickness, insomnia; sedation, antiadrenergic, antiserotonergic, and antimuscarinic effects due to CNS penetration Pharmacology Respiratory

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160
Q

Loratadine, fexofenadine, desloratadine, cetrizine (mechanism, use, toxicity)

A

H1 antagonists; used in allergies; less fatigue than other antihistamines due to decreased CNS penetration Pharmacology Respiratory

161
Q

Albuterol (mechanism, use, toxicity)

A

Short-acting beta-2 agonist; asthma Pharmacology Respiratory

162
Q

Salmeterol, formoterol (mechanism, use, toxicity)

A

Long-acting beta-2 agonist; asthma; tremor, arrhythmias Pharmacology Respiratory

163
Q

Theophylline (mechanism, use, toxicity)

A

Phosphodiesterase inhibitor, increases cAMP and causes bronchodilation; asthma; cardiotoxicity, neurotoxicity Pharmacology Respiratory

164
Q

Ipratropium (mechanism, use, toxicity)

A

Muscarinic antagonist, prevents bronchoconstriction; asthma and COPD Pharmacology Respiratory

165
Q

Beclomethasone, fluticasone (mechanism, use, toxicity)

A

Inhibit cytokine synthesis, reducing inflammation due to asthma Pharmacology Respiratory

166
Q

Montelukast, zafirlukast (mechanism, use, toxicity)

A

Leukotriene receptor antagonists; especially useful in aspirin-induced asthma Pharmacology Respiratory

167
Q

Zileuton (mechanism, use, toxicity)

A

Inhibits activity of 5-lipoxygenase, inhibiting leukotriene production; reduces inflammation Pharmacology Respiratory

168
Q

Omalizumab (mechanism, use, toxicity)

A

Anti-IgE antibody; used in refractory allergic asthma Pharmacology Respiratory

169
Q

Guaifenesin (mechanism, use, toxicity)

A

Thins respiratory secretions Pharmacology Respiratory

170
Q

N-acetylcysteine (mechanism, use, toxicity)

A

Loosens mucus plugs; used in CF patients and as an antidote to acetominaphen posioning Pharmacology Respiratory

171
Q

Bosentan (mechanism, use, toxicity)

A

Antagonizes endothelin-1 receptors, reducing vascular resistance in the pulmonary vessels; used in pulmonary hypertension Pharmacology Respiratory

172
Q

Dextromethorphan (mechanism, use, toxicity)

A

Antagonizes NMDA receptors, inhibiting coughing; produces opioid effects in large doses and carries mild abuse potential Pharmacology Respiratory

173
Q

Pseudoephedrine, phenylephrine (mechanism, use, toxicity)

A

Alpha-1 agonists that reduce edema and nasal congestion; rhinitis; hypertension, quick tolerance (recurrence of symptoms despite continued treatment) Pharmacology Respiratory

174
Q

Difference in competitive vs noncompetitve inhibitors?

A

competitive = decrease potency, noncompetitive = decrease efficacy. Pharmacology General

175
Q

What is Km?

A

Inverse relation of affinity of enzyme for its substrate. Pharmacology General

176
Q

What is Vmax?

A

Direct proportion to enzyme concentration Pharmacology General

177
Q

What is bioavailability?

A

Fraction of administered drug that reaches systemic circulation unchanged. Pharmacology General

178
Q

Time to steady state depends on?

A

depends on half-life. Does not depend on frequency or size of dose. Pharmacology General

179
Q

What is rate of elimination in zero order kinetics?

A

constant amount eliminated per time. Pharmacology General

180
Q

Give three drugs that are zero order eliminated.

A

PEA - phenytoin, Ethanol, Aspirin. Pharmacology General

181
Q

What is the rate of elimination for first order kinetics?

A

A constant FRACTION is eliminted, variable by concentration! Pharmacology General

182
Q

How does ionization relate to urine pH?

A

Ionzied species are trapped in urine and not resorbed. Neutral can be resorbed. Pharmacology general

183
Q

How do you treat overdose of weak acid? Give drug examples.

A

Treat with Bicarb to make neutral. Exp: phenobarbital, methotrexate, aspirin. Pharmacology general

184
Q

How do you treat overdose of weak base? Give drug examples.

A

Treat with ammonium chloride. exp: amphetamines. Pharmacology general

185
Q

What is phase I drug metabolism? What pt. population loses this?

A

Reduction, Oxidation, hydrolysis with CYP450. Often gives neutral products. Geriatrics lose this phase. Pharmacology general

186
Q

What is phase II metaboloism? What population depend on this?

A

Conjugation (Glucuronidation, Acetylation, and Sulfation.) Gives charged products. Geriatrics depend on this, old people have GAS. Pharmacology general

187
Q

What is efficacy?

A

maximal effect a drug can produce. Pharmacology general

188
Q

What is potency?

A

amount of drug needed for the same effect. Pharmacology general

189
Q

What happends to efficacy when a partial agonist and full agonist are mixed?

A

DECREASED efficacy. fight for same binding site, full agonist cant exert full effect. Pharmacology general

190
Q

What is therapetuic index?

A

LD50/ED50. Median lethal dose divded by median effective dose. Safer drugs have a higher TI. pharmacology general

191
Q

What is a therapeutic window?

A

Minimum effective dose to minimum toxic dose. Think of it as range of use. pharmacology general

192
Q

What are the two types of Nicotonic receptors? What kind of messenger do they use?

A
  1. Nicotinic - Ligang gated Na/K channels. Two nicotinic types: Nm(NMJ) and Nn(autonomic ganglia. 2. Muscarinic - G-proteins. 5 types, M1-M5. pharmacology general
193
Q

Alpha-1 sympathetic receptor (G-protein class, major function)

A

q, increase: vasc. smooth muscle contraction, pupillary dilator muscle contraction, intestinal and bladder sphincter contaction. pharmacology autonomics

194
Q

Alpha-2 sympathetic receptor(G-protein class, major function)

A

i, decrease: sympathetic outflow, insulin release, lipolysis. increase: platlet aggregation. pharmacology autonomics

195
Q

Beta-1 sympathetic receptor(G-protein class, major function)

A

s, increase: heart rate, contractilty, renin release, lipolysis pharmacology autonomics

196
Q

Beta-2 sympathetic receptor(G-protein class, major function)

A

s, vasodilation, brochodilation, increase: heart rate, contractility, lipolysis, insulin release, aqueous humor production. decrease: uterine tone, ciliary muscle tone. pharmacology autonomics

197
Q

M-1 Parasymp receptor(G-protein class, major function)

A

q, CNS, enteric nervouse system. pharmacology autonomics

198
Q

M-2 Parasymp(G-protein class, major function)

A

i, decease: heart rate, contractility of atria pharmacology autonomics

199
Q

M-3 parasymp(G-protein class, major function)

A

increase: exocrine gland secretion (tears, gastric, etc), gut peristalsis, bladder contraction, bronchoconstriction, pupillary spinchter contraction, cilliary muscle contraction. pharmacology autonomics

200
Q

What receptor is responsible for miosis and accomadation?

A

Parasympathetic M-3. pharmacology autonomics

201
Q

What receptor is responsbile for mydriasis?

A

Sympathetic Alpha-1. pharmacology autonomics

202
Q

Dopamine D-1 receptor(G-protein class, major function)

A

s, relaxes renal vascular smooth muscle pharmacology autonomics

203
Q

Dopamine D-2 receptor(G-protein class, major function)

A

i, modulates transmitter release especially in brain. pharmacology autonomics

204
Q

Histamine H-1 receptor(G-protein class, major function)

A

q, increase: mucus production, contraction of bronchioles, pruritus, pain. pharmacology autonomics

205
Q

histamine H-2 receptor(G-protein class, major function)

A

a, increase gastric acid secretion pharmacology autonomics

206
Q

vasopression V-1 receptor(G-protein class, major function)

A

q, increase: vascular smooth muscle contraction pharmacology autonomics

207
Q

vasopression V-2 receptor(G-protein class, major function)

A

s, increase water permeability and reabsorption in kidneys. (V2 found in 2 kidneys). pharmacology autonomics

208
Q

Which receptors work via Gq -> Phospholipase C ->Pip2->DAG + IP3?

A

H1,Alpha1,V1,M1,M3. (remember HAVe 1 M&M) pharmacology autonomics

209
Q

DAG causes activation of what?

A

Protein Kinase C. pharmacology autonomics

210
Q

IP3 causes increase in what?

A

Calcium -> smouth muscle contraction pharmacology autonomics

211
Q

Which receptors work via Gi->Adenyly cyclase ->cAMP ->Protein Kinase A?

A

M2, Alpha2, D2. (remember MAD 2’s.) pharmacology autonomics

212
Q

Which receptors work via Gs->adenylyate cyclase ->cAMP->Protein Kinase A?

A

Beta1, Beta2, D1, H2,V2. pharmacology autonomics

213
Q

What does protein kinase A do?

A

increase calcium release in heart and blocks myosin light chain kinase. pharmacology autonomics

214
Q

What are the two classes of cholinomimetics?

A
  1. direct agonsts 2. indirect agonists (anticholinesterases). pharmacology autonomics
215
Q

Bethanechol(mechanism,use,toxicity)

A

Direct cholinomimetic. Postop or neurogenic ileus, urinary retention. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

216
Q

Carbachol(mechanism,use,toxicity)

A

Direct Cholinomimetic. Identical to Ach. Glaucoma, pupillary contraction, relief of IOP. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

217
Q

Pilocarpine(mechanism,use,toxicity)

A

Direct Cholinomimetic. Stimulates tears, salvia, sweat. Open and closed-angle glaucoma.COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

218
Q

methacholine(mechanism,use,toxicity)

A

Direct Cholinomimetic. challenge test of asthma diagnosis. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

219
Q

Neostigmine(mechanism,use,toxicity)

A

Indirect cholinomimetic agonist. NO cns penetration. Postop and neurogenic ileus, myasthenia gravis, reversal of NMJ block. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

220
Q

pyridostigmine(mechanism,use,toxicity)

A

indirect cholinomimetic agonist. Long acting myasthenia gravis treatment. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

221
Q

edrophonium(mechanism,use,toxicity)

A

indirect cholinomimetic agonist. Short acting, for myasthenia gravis diagnosis. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

222
Q

Physostigmine(mechanism,use,toxicity)

A

indirect cholinomimetic agonist. for anti-cholinergic overdose, crosses BBB. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

223
Q

Donepezil(mechanism,use,toxicity)

A

indirect cholinomimetic agonist. Alzheimers disease. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

224
Q

signs of cholinesterase inhibitor poisoning. treatment.

A

DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle +CNS, lacrimation, sweating, salvia.) tx: atropine + pralidoxime. pharmacology autonomics

225
Q

Parathion(mechanism, treatment)

A

Irreversible cholinesterase inhibitor, ACH overdose. Tx: atropine + pralidoxime. pharmacology autonomics

226
Q

Atropine, homatropine, tropicamide (mechanism, use, toxicity).

A

Muscarinic antagonist. produces mydriasis and cycloplegia. (Atropine also used for bradycardia). Causes hot as a hare, dry as bone, red as beet, blind as bat, mad as a hatter. pharmacology autonomics

227
Q

Benztropine(mechanism,use,toxicity)

A

Muscarinic antagoist. Parkinsons disease (park my benz). Causes hot as a hare, dry as bone, red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

228
Q

Scopolamine(mechanism,use,toxicity)

A

Muscarinic antagonist. Motion sickness. causes hot as a hare, dry as a cone, red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

229
Q

Ipratropium,tiotropium (mechanism, use, toxicity)

A

Muscarinic antagonist. COPD, Asthma. Causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

230
Q

Oxybutynin(mechanism,use,toxicity)

A

Muscarinic anatagonist. reduces urgency in mild cystitis and reduce bladder spasms. causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.

231
Q

Glycopyrrolate(mechanism,use,toxicity)

A

Muscarinic anatagonist. IP: given in preop to reduce airway secretions. oral:reduce drooling, peptic ulcer. Can cause hot as a hare, dry as a bone red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

232
Q

Jimson Weed(mechanism, toxicity)

A

muscarinic antagonist, causes gardner’s pupil (mydriasis). pharmacology autonomics

233
Q

Epinephrine(Mechanism, receptors bound, use, toxicity)

A

Direct Sympathomemetic. A1,A2,B1,B2. Anaphylaxis, open angle glaucoma, asthma, hypotension. pharmacology autonomics

234
Q

Norepinephine(Mechanism, receptors bound, use, toxicity)

A

direct sympathomemetic. A1,A2, some B1. used in hypotension but it decrease renal perfusion. pharmacology autonomics

235
Q

Isoproterenol(Mechanism, receptors bound, use, toxicity)

A

Direct sympathomemetic. B1, B2. Used in Torsade de pointe and bradyarryhmia. Can cause tachycardia and worsen cardiac ischemia. pharmacology autonomics

236
Q

dopamine(Mechanism, receptors bound, use, toxicity)

A

Direct sympathomimetics. Receptors depend on dose. low = D1, med = D1,B2,B1, high = A1,A2,B1,B2,D1. Used in shock and heart failure (ionotropic and chronotropic). pharmacology autonomics

237
Q

dobutamine(Mechanism, receptors bound, use, toxicity)

A

Direct sympathomimetic. Mostly B1, little a1,a2,b2. Used in heart failure and cardiac stresstest (ionotrpic and chronotropic) pharmacology autonomics

238
Q

Phenylephrine(Mechanism, receptors bound, use, toxicity)

A

Direct sympathomimetic. A1, A2. Used in hypotension, to cause mydriasis, and rhinitis (decongestant). pharmacology autonomics

239
Q

Albuterol, salmetrol, terbutaline (Mechanism, receptors bound, use, toxicity)

A

Direct sympathomimetic. Mostly B2, some b1. Sal = long term ashtma or copd. Albuterol for short term asthma. Terbutaline for to reduce premture uterine contractions. pharmacology autonomics

240
Q

Ritodrine(Mechanism, receptors bound, use, toxicity)

A

Direct sympathomimetic. B2 only. Used to reduce premature uterine contractions. pharmacology autonomics

241
Q

Amphetamine (mechanism, use)

A

indirect sympathomimetic. Releases stored catecholamines. Used for narcolepsy, obesity, ADD. pharmacology autonomics

242
Q

Epinephrine(Mechanism, use, toxicity)

A

indirect sympathomimetic. Releases stored catecholamines. Used for nasal decongestion, urinary incontience, hypotension. pharmacology autonomics

243
Q

Cocaine (mechanims, use).

A

direct sympathomimetic. Reuptake inhibitor. Causes vasoconstriction and local anesthesia. pharmacology autonomics

244
Q

Why must B-Blockers be avoided in suspected cocaine intoxication?

A

mixing them can lead to unopposed A1 activation and extreme hypertenion. pharmacology autonomics

245
Q

How does norepinephrine cause reflex bradycardia?

A

stimulates A1>B2. Causes increased vasoconstrciton -> increased BP. This causes reflex bradycardia and slowing of HR. pharmacology autonomics

246
Q

How does isoproterenol cause reflex tachycardia?

A

Stimulates B2>A1. This cause vasodilation and dropping of BP. B1 is stimulated and causes tachycardia. pharmacology autonomics

247
Q

Clonidine, alpha-methyldopa(Mechanism, receptors bound, use)

A

Centrally acting alpha-2 agonists, this causes LESS peripheral sympathetic release.Used in hypertension, especially renal disease due to no increase in renal blood flow! pharmacology autonomics

248
Q

Phenoxybenzamine(Mechanism, receptors bound, use, toxicity)

A

IRREVERSIBLE nonslective alpha blocker. Used in pheochromosytoma BEFORE surgery! toxic: orhtostatic hypotension, reflec tachycardia. pharmacology autonomics

249
Q

phentolamine(Mechanism, receptors bound, use, toxicity)

A

REVERSBILE nonselective alpha blocker. give to patients on MAOI who each tyramine contraining foods. pharmacology autonomics

250
Q

Prazosin, Terazosin, Doxazosin,Tamsulosin(Mechanism, receptors bound, use, toxicity)

A

Alpha-1 blocker. Used in hypertension, urinary rentention in BPH. tox:orthostatic hypotension, dizziness, headache. pharmacology autonomics

251
Q

Mirtazapine (mechanism, use, toxicity)

A

Alpha-2 blocker. Used in depression. tox: sedation, hypercholesterolemia, increased apetite. pharmacology autonomics

252
Q

Describe what occurs when you alpha-blockade epi vs. phenylephrine.

A

Before blockade: Both epi and phen RAISES BP. After alpha blockade: only epi raises, no change in phenyl. Why: Epi has B binding, phenyl does NOT. pharmacology autonomics

253
Q

Give 6 applications of Beta-blockers in general.

A

Angina - decreases HR and contractility, decreasing oxygen use. MI - decrease mortality. SVT - decrease AV duction. Hypertension - decrease CO and renin secretion. CHF - slows progression. Glaucoma - decrease secretion of aqueous humor. pharmacology autonomics

254
Q

give general toxicites of b-blockers

A

impotence, asthma exacerbation, bradycardia, seizures, sedation, hides hypoglycemia. pharmacology autonomics

255
Q

What are the B1 selective b-blockers? When are they useful?

A

A BEAM. acebutolol, betaxolol, Esmolol, Atenolol, Metoprolol. Useful in comorbid pum. disease. pharmacology autonomics

256
Q

What are the nonselective ( b1 = b2) b-blockers?

A

Please Try Not Being Picky. Propranolol, Timolol, Nadolol, Pindolol. B = B-blocker. pharmacology autonomics

257
Q

what are the nonselective a and b-antagonists?

A

Carvedilol, labetalol. pharmacology autonomics

258
Q

What are the partial B-agonists?

A

Pindolol, Acebutolol. pharmacology autonomics

259
Q

Give treatment for acetaminophen overdose.

A

N-Acetylcysteine (replenishes glutathione). pharmacology overdose

260
Q

Give treatment for salicylates overdose.

A

NaHCO3 (alkalinize urine) pharmacology overdose

261
Q

give treatment for amphetamines overdose

A

NH4Cl (acidify urine) pharmacology overdose

262
Q

Give treatment for antimuscarinic and anticholinergic overdose.

A

Phygostigmine and control the hyperhermia. pharmacology overdose

263
Q

Give treatment for b-blocker overdose

A

Glucagon pharmacology overdose

264
Q

Give treatment for digitalis overdose

A

(KLAM) normalize K, Lidocaine, Anti-dig fab fragments, Mg2 pharmacology overdose

265
Q

give treatment for iron overdose.

A

deFEroxamine, deFErasirox. pharmacology overdose

266
Q

give treatment for lead overdose

A

CaEDTA, dimercaprol, succimer, penicillamine pharmacology overdose

267
Q

give treatment for mercury, arsenix, gold overdose

A

Dimercaprol, succiner pharmacology overdose

268
Q

give treatment for copper, arsenic, gold overdose

A

penillamine pharmacology overdose

269
Q

give treatment for cyanide

A

nitrite + thiosulfate, hydroxocobalamin pharmacology overdose

270
Q

give methemoglobin treatment

A

Methylene blue, vitamin c pharmacology overdose

271
Q

Give Carbon monocide treatment

A

100% oxygen or hyperbaric oxygen pharmacology overdose

272
Q

give treatment for methanol, ethylene glycol overdose

A

Fomepizole>Ethanol, dialysis pharmacology overdose

273
Q

give treatment for opiods overdose

A

naloxone/naltrexone pharmacology overdose

274
Q

give treatment for benzodiazepine overdose

A

flumazenil pharmacology overdose

275
Q

give treatment for TCA overdose

A

NaHCO3 (alkalinize plasma) pharmacology overdose

276
Q

give treatment for heparin overdose

A

protamine pharmacology overdose

277
Q

give treatment for warfarin overdose

A

Vitamin K, fresh frozen plasma pharmacology overdose

278
Q

give treatment for tPA, Streptokinase, urokinase overdose

A

aminocaproic acid pharmacology overdose

279
Q

give treatment for theophylline overdose

A

B-Blockers pharmacology overdose

280
Q

give treatment for acetylcholinesterase inhibitors

A

atropine + pralidoxime pharmacology overdose

281
Q

causes coronary vasospam

A

cocaine, sumatriptan, ergots pharmacology reactions

282
Q

causes cutaneous flushing

A

(VANC) Vancomycin, Adenosine, Niacin, Ca blocker pharmacology reactions

283
Q

causes dilated cardiomyopathy

A

doxorubicin, daunorubicin pharmacology reactions

284
Q

causes torsades de pointes

A

class III (sotalol) and class Ia (quinidine) pharmacology reactions

285
Q

causes agranulocytoisis

A

Clozapine, Carbamazepine, Colchine, Propylthiouracil, Methimazole, Dapsone pharmacology reactions

286
Q

causes aplastic anemia

A

chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole pharmacology reactions

287
Q

causes direct coombs positive hemolytic anemia

A

methyldopa, penicillin pharmacology reactions

288
Q

causes gray baby syndomr

A

chloramphenicol pharmacology reactions

289
Q

causes hemolysis in G6PD-defiect patients

A

(hemolysis IS PAIN)isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin pharmacology reactions

290
Q

causes megaloblastic anemia

A

(females with PMS are on full BLAST mode) Phenytoin, Methotrexate, Sulfa drugs pharmacology reactions

291
Q

Causes thrombotic complications

A

OCPs like estrogen pharmacology reactions

292
Q

Causes cough

A

ACE inhibitors pharmacology reactions

293
Q

causes pulmonary fibrosis

A

Bleomycin, amiodarone, Busulfan pharmacology reactions

294
Q

causes acute cholestatic hepatits, jaundice

A

erthryomycin pharmacology reactions

295
Q

causes focal to massice hepatic necrosis

A

Halothane, Amanita Phalloides, Valrpoic acid, Acetaminophen pharmacology reactions

296
Q

causes hepatits

A

isoniazid pharmacology reactions

297
Q

can lead to pseudomembranous colitis

A

clindamycin, ampicillin pharmacology reactions

298
Q

can lead to adrenocortical insufficiency

A

glucocorticoid withdrawl via HPA suppression pharmacology reactions

299
Q

can causes gynecomastia

A

`(Some drugs create awkward knockers) spironolactone, digitalis, cimetidine, chronic alcohol use, ketoconazole pharmacology reactions

300
Q

causes hot flashes

A

estrogen, clomophene pharmacology reactions

301
Q

causes hypergylcemia

A

niacin, tacrolimus, protease inhibitor, HCTZ, corticosteriods pharmacology reactions

302
Q

causes hypothyroidism

A

lithium, amiodarone, suldonamides pharmacology reactions

303
Q

causes fat redistribution

A

glucocoricoids, protease inhibitors pharmacology reactions

304
Q

causes gingival hyperplasia

A

phenytoin, verpamil pharmacology reactions

305
Q

causes gout

A

furosemide, thiazides, niacin, cyclosporine pharmacology reactions

306
Q

causes myopathies

A

fibrates, niacin, colchine, hydroxychloroquine, interferon-alpha, penicillamine, statins, glucocorticoids pharmacology reactions

307
Q

causes osteoporosis

A

corticosteroids, heparin pharmacology reactions

308
Q

causes photosensitivty

A

(SAT for a PHOTO) Sulfonamides, amiodarone, tetracycline pharmacology reactions

309
Q

causes rash/SJS

A

penicillin, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital pharmacology reactions

310
Q

cause drug induced lupus

A

Hydralazine, isonizid, procainamine, phenytoin pharmacology reactions

311
Q

causes teeth problems

A

tetracyclines pharmacology reactions

312
Q

causes tendonitis, tendon rupture, tooth damage

A

fluoroquinolones pharmacology reactions

313
Q

causes diabetes insipidus

A

lithium, demeclocycline pharmacology reactions

314
Q

causes fanconi’s syndome

A

expired tetracycline pharmacology reactions

315
Q

causes hemorrhagic cystits

A

Cyclophosamide, ifosfamide pharmacology reactions

316
Q

causes interstital nephritis

A

methicllin, NSAID, furosemide pharmacology reactions

317
Q

causes SIADH

A

carbamazepine, cyclophosamide pharmacology reactions

318
Q

causes cinchonism

A

Quinidine, qunine pharmacology reactions

319
Q

causes parkinson-like syndome

A

antipsychotics, resperine, metoclopramide pharmacology reactions

320
Q

causes seizures

A

(with seizures, I BITE My tongue) isoniazid, Buproprion, imipenem, Tramadol, Enflurane, Metoclopramide pharmacology reactions

321
Q

causes tardive dyskinesia

A

antipsychotics pharmacology reactions

322
Q

acts like an anti-muscarinic

A

Atropine, TCA, H1-blocker, neuoleptics pharmacology reactions

323
Q

can cause a disulfiram like reaction

A

metronidazole, some cephalosporins, procarbazine, 1st gen sulphonoureas pharmacology reactions

324
Q

can cause nephro/ototoxicity

A

aminoglycosides, vancomycin, loop dieuetics, cisplatin pharmacology reactions

325
Q

list p450 inducers

A

(Momma Barb Steals Phen-phen and Refuses Greasy Carbs Chronically)Modafinil, Barbiturates, St. John wart, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use. pharmacology reactions

326
Q

list p450 inhibitors

A

(MAGIC ROCKS in GQ) Macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir actue alcohol use, ciprofloxacin, ketoconazole, sulfonamides, gemfibrozil, quinidine. pharmacology reactions

327
Q

lists the sulfa drugs

A

(Popular FACTSSS) probenacid, furosemide, acetazolamide, celecoxib, thiazide, sulfonamide antibiotics, sulfaasalazine, sulfonylureas pharmacology reactions

328
Q

Difference between peniciliin G and V.

A

G = IV and IM. V = oral. pharmacology micro

329
Q

Penicillin(mechanism,use,toxicity)

A

Bind penicillin-binding proteins(transpeptidases), block cross linking of peptidoglycans;most effective on G+, also N. Meningitidis, Treponema;hypersensitivy reaction, hemolytic anema. pharmacology micro

330
Q

Oxacillin,Naficillin,Dicloxacillin(mechanism,use,toxicity)

A

bind transpeptidases, penicillanse resistant due to bukly r-group blocking B-Lactamse; S. Aureus, except MRSA; hypersensitivity and interstitial nephritis. pharmacology micro

331
Q

Ampicillin, amoxicillin(mecanism,use,toxicity)

A

bind transpeptidases, wide spectrum and more penicillinase sensitive. combo with claculanic acid to protect from B-lactams;kills enterococci(HELPSS)H.iB, E.coli,Listera,Proteus,Salmonella,Shigella,enterococci;hypersensitivity reaction,rash,pseudomemrane colitis. pharmacology micro

332
Q

Which has better bioavailibility; amoxicllin or ampicillin?

A

amOxicllin has better Oral bioavilability. pharmacology micro

333
Q

What does clavulanic acid do?

A

B-lactamse inhibitor pharmacology micro

334
Q

Ticarcillin,piperacillin(mechanism,use,toxicity)

A

transpeptidase inhibitor but extended spectrum;pseduomonas and g- rods, use with claculanic acid due to B-lactamse suspectibilty; hypersensitivity reaction. pharmacology micro

335
Q

List the B-lactamse inhibitors

A

(CAST) Clavulanic Acid, Sulbactam,Tazobactem. pharmacology micro

336
Q

Cephalosporin(mechanism,use,toxiciity)

A

inhibit cell wall synthesis but are less susceptible to B-lactamases, are bactericidal;use depends on generation, there are four;hypersensitivty reactions, vitamin K defiency, increased nephrotoxicity of aminoglycosides. pharmacology micro

337
Q

give use of cefazolin, cephalexin.

A

1st generation cephalosporins. PEcK. Proteus, E.coli,Klebsiella. Cefazolin used preop to prevent A.aureus infections. pharmacology micro

338
Q

give use of cefoxitin, cefaclor,cefuroxime`

A

2nd generation cephalosporins. HEN PEcKs. H.ib, Enterbacter, Neisseria, Proteus, E.coli,Klebsiella, Serratia. pharmacology micro

339
Q

give use of ceftriaxone, cefotaxime,ceftazidime

A

3rd gen. cephalosporins. Serious gram - infections. Ceftriaxone = meningitis and gonorrhea. Ceftazidime = pseudomonas. pharmacology micro

340
Q

give use of cefepime.

A

increased activity against pseudomonas and G+ bugs. pharmacology micro

341
Q

Aztreonam(mechanism,use,toxicty)

A

a monobactem resistant to B-lactamases, prevents binding to PBP3 and is synergistic with aminoglycosides;gram - rods only;very nontoxic, some GI upset. pharmacology micro

342
Q

what transpeptidase inhibitor can be used in penicillin allergy?

A

aztreonam. pharmacology micro

343
Q

imipenem/cilastatin,meropenem,etrapenem,doripenem(mechanism,use,toxicity)

A

broad spectrum, B-lactamase resistent but imipenem needs cilastatin to inhibit renal dehydropeptidase. later carbepenems do not;G+ cocci,G- rods, anerobes. used only in life threating events;skin rash, CNS toxicity, seizures. pharmacology micro

344
Q

Vancomycin(mechanism,use,toxicty)

A

inhibits cell wall binding peptidoglycan formation by binding D-ala percursors, is bacterialcidal; G+ only, especially for multidrug resistant onces;NOT - nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome. pharmacology micro

345
Q

How is redman syndrome prevented in vancomycin use?

A

slow infusion and rate and antihistamines. pharmacology micro

346
Q

How does vancomycin resistant occur?

A

amino acid change of D-ala D-ala to D-ala D-lac. pharmacology micro

347
Q

List antibiotic protein synthesis inhibitors

A

AT 30, CCEL at 50. 30S = Aminoglycosides, Tetracyclines. 50S = Chloramphenicol, Clindamycin, Erythromycin, Linezolid. pharmacology micro

348
Q

Gentamicin, neomycin, amikacin,tobramycin,streptomycin(mechanism,use,toxicity)

A

aminoglycosides, bacterialcidal, block translocation but require oxygen for uptake;ineffective in anaerobes,use in gram - rod infections and before bowel surgery; nephrotoxicty, NMJ block, ototoxicity, teratogen. pharmacology micro

349
Q

how does resistenace to aminoglycosides occur?

A

transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. pharmacology micro

350
Q

tetracycline, doxycycline, demecycline,minocycline(mechanism, use, toxicity)

A

bacteriostatic, prevents aminoacyl-tRNA binds;Borrela, M. Pneuomo, Rickettsia, Chlamysia; can’t take with milk, antacids, iron because ions bind it, GI distress, discoloration of teeth, inhibition of bone growth, contraindication in pregnancy. pharmacology micro

351
Q

how does resistance to tetracyclines occur?

A

decrease uptake into cells or increased efflux by pumps. pharmacology micro

352
Q

Azithromycin, clarithromycin, erythromycin(mechanism,use,toxicity)

A

bacteriostatic, blocks translocation; atypical pneumonias, chlamydia, gram + cocci; MACRO: increased Motility, arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia. pharmacology micro

353
Q

how does resitance to macrolides occur?

A

methylation of 23s rRNA binding site. pharmacology micro

354
Q

Chloramphenicol(mechanism,use,toxicity)

A

Bacterialstatic, blocks peptidlytransferase; Meningitis in adults, used in power countries due to being cheap; dose dependent anemia, dose independent aplastic anemia, gray baby syndrome. pharmacology micro

355
Q

what causes grey baby syndrome?

A

use of chloramphenicol in premature infants, they lack UDO-glucuronyl-transferase. pharmacology micro

356
Q

How does resistance to chloramphenicol occur?

A

plasmid-encoded acetyltransferase. pharmacology micro

357
Q

clindamycin(mechanism,use,toxicity)

A

Bacteriostatic. Blocks peptide transfer; anaerobic infections in lung infections and oral anerobes; C. Diff infection, fever, diarrhea. pharmacology micro

358
Q

Sulfamethoxazole(SMX), sulfisoxazole, sulfadiazine(mechanism, use, toxicity)

A

Bacteriostatic, PABA metabolites inhibit dihydropteroate synthase; Gram +, G-, Nocardia, Chlamydia, UTI; hypersensitivty, hemolysis in G6PD, nephrotoxic, kernicterus, displaces other drugs from albumin. pharmacology micro

359
Q

how does resistance to sulfonamides occur?

A

altered bacterial dihydropteroate or increased PABA synthesis. pharmacology micro

360
Q

Trimethoprim(mechanism,use,toxicity)

A

Bacteriostatic, inhibits bacterial dihydrofolate reductase, blocks folate synthesis; used in UTI, PCP (prophylacis and treatment), shigella, salmonella; megaloblastic anemia, leukopenia, granulocytopenia. pharmacology micro

361
Q

ciprofloxacin, norfloxacin, levofloxacin, etc…(mechanism, use, toxicity)

A

bactericidal, inhibits DNA gyrase(topo II and IV);G- rods of urinary and GI tracts, Neisseria, some G+;( lones hurt the bones) tenonitis and tendon rupture, superinfections, don’t give to kids or pregnant women due to cartilage damage. pharmacology micro

362
Q

how does resistance to fluroquinolones occur?

A

mutation in DNA gyrase or efflux pumps. pharmacology micro

363
Q

What groups are susceptible to fluorquinolone tendon rupture?

A

older than 60 or taking prednisone pharmacology micro

364
Q

Metronidazole(mechanism, use, toxicity)

A

bacterialcidal, forms free radical toxic metabolites that damge bacterial DNA damage; (GET GAP) Giardia, Entamoeba, trichomonas, Gardnerella, Anaerobes, Pylori; causes disulfiram like reaction, headache, metallic taste. pharmacology micro

365
Q

Isoniazid(mechanism,use,toxicity)

A

decrease synthesis of mycolic acids, bacterial catalase peroxidase(KatG) must activate INH; TB drug, only one used as prophylaxis and in latent TB; peripheral neuropathy, hepatoxic, lupis like drug interaction, pyridoxine antagonist. pharmacology micro

366
Q

Rifampin(mechanism,use,toxicity)

A

inhibits DNA-dependent RNA polymerase; TB, Leprosy, prophylaxis in meningococcus and Hib type B; hepatotox, p450 inducer, orange body fluids. pharmacology micro

367
Q

Pyrazinamide(mechanism, use, toxicity)

A

unknown; TB; hyperuricemia, hepatotoxic. pharmacology micro

368
Q

Ethambutol(mechanism,use,toxicity)

A

decreased carbohydrate polymerization of TB cell wall, blocks arabinosyltransferase; TB; optic neuropathy(red-green color blindness_ pharmacology micro

369
Q

Amphotericin B(mechanism, use, toxicity)

A

binds fungal ergosterol, causes holes in membranes; use in systemtic and CNS mycoses infections; fever/chills, hypotension, arrythmias, nephrotoxic, IV phlebitis, must supplement K and MG. pharmacology micro

370
Q

nystatin(mechanism,use,toxicty)

A

binds fungal ergosterol;topical only due to high toxicity, used for oral thrush and topical diaper rash or vaginal candidiasis. pharmacology micro

371
Q

Fluconazole, ketoconazole, clotrimazole, itraconazole, voriconazole(mechanism, use,toxicity)

A

inhibits fungal ergosterol synthesis by binding p450;Fluconazole for suppression of cryptococcus in AIDs patients, itraconazle for blasto, coccio, histo. pharmacology micro

372
Q

Flucytosine(mechanism, use, toxicity)

A

inhibits fungal DNA and RNA synthesis by conversion to 5FU; used in systemic fungal infections, especially cryptococcus; bone marrow suppression. pharmacology micro

373
Q

Caspofungin, micafungin(mechanism, use, toxicity)

A

inhibits fungal cell wall synthesis by inhibiting B-glucan synthesis; invasive aspergillosis, candida; flushing via histamine releae. pharmacology micro

374
Q

terbinafine(mechanism,use,toxicity)

A

inhibits fungal squalene epoxidase; treat dermatophytes - toe nail infection especially;abnormal LFT, visual disturbances. pharmacology micro

375
Q

Griseofulvin(mechanism,use,toxicity)

A

interferes with microtubules, stops mitosis in fungi;deposits in keratin so used in superficial infections, stops dermatophytes; teratogenic, carcinogenic, confusion, p450 inducer. pharmacology micro

376
Q

Pyrimethamine use

A

toxoplasmosis pharmacology micro

377
Q

suramin and melarsoprol use

A

trypanosoma brucei pharmacology micro

378
Q

nifurtimox use

A

trypanosoma cruzi pharmacology micro

379
Q

sodium stibogluconate use

A

leshmaniasis pharmacology micro

380
Q

Chloroquine(mechanism,use,toxicity)

A

blocks formation of heme into hemozoin. Heme accumulates and is toxic to plasmodia;used on all species but falciparum(too much resitance); retinopathy pharmacology micro

381
Q

quinidine use

A

lifethreatening malaria pharmacology micro

382
Q

artemether/lumifantrine use

A

p. falciparum killing pharmacology micro

383
Q

Zanamivir,oseltamivir(mechanism,use)

A

inihibits influenza neuraminidase, stops progeny release; treamt of influenze a and b pharmacology micro

384
Q

Ribavarin(mechanism,use,toxicity)

A

inhibits sythesis of guanine nucleotides by competitvely inhibiting IMP dehydrogenase; RSV, chronic hep C; hemolytic anemia, severe teratogen pharmacology micro

385
Q

Acyclovir,valacyclovir(mechanism, use, toxicity)

A

Guanosine analog, inhibits viral DNA polymerase; monophosphorylated by thymidine kinase in HSV/VZV so active in lesions and encephalitis, good for prophylaxis, pharmacology micro

386
Q

Famciclovir use

A

used in herpes zoster active infections pharmacology micro

387
Q

mechanism for resistance to acyclovir

A

mutated viral thymidine kinase pharmacology micro

388
Q

Ganciclovir,valgangciclovir(mechanism,use,toxicity)

A

guanosine analog, 5’-monophosphate formed by CMV viral kinase, inhibits viral DNA polymerase;CMV infections;leukopenia,neutopenia,thrombocytopenia,renal toxicity pharmacology micro

389
Q

mechanism for resistance to acyclovir

A

mutated CMV DNA polymerase or lack of viral kinase pharmacology micro

390
Q

Foscarnet(mechanism,use,toxicity)

A

viral DNA polymerase inhibitor, binds to pyrofosphate binding site, doesn’t need viral kinase activation;CMV retinitis when ganciclovir fails and acyclovir restitant HSV; nephrotoxic pharmacology micro

391
Q

mechanism for resistance to foscarnet

A

mutated DNA polymerase pharmacology micro

392
Q

cidofovir(mechanism,use,toxicity)

A

inhibits DNA polymerase, doesn’t require activiation by viral kinase; CMV retenitis, acyclovir resistant HSV; nephrotoxic pharmacology micro

393
Q

HAART consist of what?

A

[2 NRTI] +[1 NNRTI OR 1 protease inhibitor OR 1 integrase inhibitor] pharmacology micro

394
Q

give mechanism and toxicity of protease inhibitors

A

all end in -NAVIR! stops HIV mRNA cleavage into functional parts; hyperglycemia, GI upset, lipodystrophy. pharmacology micro

395
Q

Ritonavir does what to be a “booster”

A

inhibits cytochrome p-450, boosting concentration of other drugs. pharmacology micro

396
Q

Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didansoine, stavudine(mechanism,use,toxicity

A

(NRTI)competitively blocks binding of nucleotide to reverse transcriptase, only tenofovir doesn’t need to be activated;all NRTIs, zidovidine used in pregnancy to reduce fetal transmision; bone marrow suppression, lactic acidosis, peripheral neuropathy. pharmacology micro

397
Q

Nevirapine, Efavirenz, Delavirdine(mechanism,use,toxicity)

A

(NNRTI) bind at a site different from NRTIs, no don’t require activation don’t compete with nucleotides; bonow marrow suppression, peripheral neuropathy, lactic acidosis, pharmacology micro

398
Q

Raltegravir(mechanism,use,toxicity)

A

inhibits integrase, which stops HIV integration into host cells;HIV;hypercholesterolemia pharmacology micro

399
Q

Interferons(mechanism,use,toxicity)

A

glycoproteins synthesized my virus infected cells, block RNA and DNA virus replication; INFa- chronic hep b and c, Kaposi sarcoma, IFN-b -MS, INF-gamma -NADPH oxidase defiency; neutropenia, myopathy. pharmacology micro

400
Q

What antibiotics must be avoided in pregnancy?

A

SAFe Children Take Really Good Care. sulfonamides(kericterus), aminoglycosides(ototox), fluoroquinolones(cartilage damage), Clarithromycin(embryotoxic), Tetracycline(teeth,bone damage),Ribavarin(teratogenic),Griseofulvin(teratogenic),Chloramphenicol(grey baby) pharmacology micro

Rapid Review STEP 1 (13 decks)

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