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
1
Q
Adverse effects of statins
A
Hepatoxicity and muscle breakdown Pharmacology Cardio
2
Q
Niacin (mechanism, use, toxicity)
A
Inhibits lipolysis and reduces VLDL secretion, lowering LDL and raising HDL; hyperlipidemia; flushing and hyperuricemia Pharmacology Cardio
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
4
Q
Ezetimibe
A
Prevents cholesterol reabsorption -> lower LDL Pharmacology Cardio
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
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
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
8
Q
Class 1B antiarrhythmics
A
Lidocaine, mexiletine, and tocainide; dec. AP duration especially in depolarized/ischemia tissue; best following MI Pharmacology Cardio
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
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
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
12
Q
Class 3 antiarrhythmics
A
Amiodarone, ibutilide, dofetilide, sotalol; K channel blockers; inc. AP duration and QT interval Pharmacology Cardio
13
Q
Toxicity of amiodarone
A
Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction Pharmacology Cardio
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
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
16
Q
Magnseium (mechanism, use, toxicity)
A
Used in torsades de pointes and digoxin toxicity Pharmacology Cardio
17
Q
Treatment for prolactinoma
A
Bromocriptine or cabergoline (dopamine agonists) Pharmacology Endocrine
18
Q
Treatment of secondary hyperaldosteronism
A
Spironolactone (or other AT2 antagonist) Pharmacology Endocrine
19
Q
Treatment of carcinoid syndrome
A
Octreotide (somatostatin analogues) Pharmacology Endocrine
20
Q
Rapid-acting insulins (3)
A
Lispro, aspart, and glulisine Pharmacology Endocrine
21
Q
Short-acting insulin (1)
A
Regular Pharmacology Endocrine
22
Q
Intermediate-acting insulin (1)
A
NPH Pharmacology Endocrine
23
Q
Long-acting insulins (2)
A
Glargine and detemir Pharmacology Endocrine
24
Metformin (mechanism, use, toxicity)
Biguanide; unknown mechanism; increases insulin sensitivity and glycolysis and decreases gluconeogenesis; can cause lactic acidosis (don't use in renal failure patients) Pharmacology Endocrine
25
Tolbutamide, chlorpropamide (mechanism, use, toxicity)
First-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes disulfuram-like effects Pharmacology Endocrine
26
Glyburide, glimepiride, glipizide (mechanism, use, toxicity)
Second-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes hypoglycemia Pharmacology Endocrine
27
Pioglitazone, rosiglitazone (mechanism, use, toxicity)
Thiazolidinediones; activates PPAR-gamma, increasing insulin sensitivity and adiponectin levels; causes weight gain, hepatotoxicity, and heart failure Pharmacology Endocrine
28
Acarbose, miglitol (mechanism, use, toxicity)
Alpha-glucosidase inhibitors; prevent sugar hydrolysis and absorption, reducing blood sugar levels Pharmacology Endocrine
29
Pramlintide (mechanism, use, toxicity)
Amylin analog; reduces glucagon secretion; causes hypoglycemia Pharmacology Endocrine
30
Exenatide, liraglutide (mechanism, use, toxicity)
GLP-1 analogues; increase insulin, decrease glucagon secretion; causes pancreatitis Pharmacology Endocrine
31
Linagliptin, saxagliptin, sitagliptin (mechanism, use, toxicity)
DPP-4 inhibitors; increase insulin, decrease glucagon secretion; causes mild urinary/respiratory infections Pharmacology Endocrine
32
Propylthiouracil (mechanism, use, toxicity)
Blocks thyroid peroxidase and 5'-deiodinase; used to treat hyperthyroidism; causes agranulocytosis, aplastic anemia, hepatotoxicity Pharmacology Endocrine
33
Methimazole (mechanism, use, toxicity)
Blocks thyroid peroxidase; used to treat hyperthyrodism; teratogenic Pharmacology Endocrine
34
Levothyroxine, triiodothyronine (mechanism, use, toxicity)
Thyroid hormone analogs; causes thyrotoxicosis Pharmacology Endocrine
35
Oxytocin (mechanism, use, toxicity)
Used to control uterine hemhorrage Pharmacology Endocrine
36
Demeclocycline (mechanism, use, toxicity)
ADH antagonist used to treat SIADH; can cause photosensitivty and bone/teeth abnormalities Pharmacology Endocrine
37
Glucocorticoids (mechanism, use, toxicity)
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
38
Cimetidine and ranitidine (mechanism, use, toxicity)
H2 antagonists; used to treat hyperchloridia; cimeditine is a P-450 inhibitor and has antiandrogenic effects, both reduce creatinine secretion Pharmacology GI
39
#NAME?
Irreversibly inhibit the H/K pump; used to treat hyperchloridia; increased risk of C. difficile infection and hypomagnesemia Pharmacology GI
40
Bismuth, sucralfate (mechanism, use, toxicity)
Coats ulcer base and protects underlying tissue Pharmacology GI
41
Misoprostol (mechanism, use, toxicity)
PGE1 analog that decreases acid production and increases bicarb production; used to prevent NSAID ulcers; abortifacient Pharmacology GI
42
Octreotide (mechanism, use, toxicity)
Somatostatin analog; used to treat VIPoma and carcinoid syndrome Pharmacology GI
43
Toxicity of long-term antacid use
Hypokalemia Pharmacology GI
44
Infliximab (mechanism, use, toxicity)
Anti-TNF; used to treat IBD and RA; can cause activation of latent microbes Pharmacology GI
45
Sulfasalazine (mechanism, use, toxicity)
Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory); used to treat IBD; causes oligospermia Pharmacology GI
46
Ondansetron (mechanism, use, toxicity)
5-HT3 antagonist; used as an antiemetic Pharmacology GI
47
Metoclopramide (mechanism, use, toxicity)
D2 antagonist; used to increase gut muscle activity and as an antiemetic; causes parkinson signs Pharmacology GI
48
Can be used to prevent mast cell degranulation
Cromolyn sodium Pharmacology Heme/Onc
49
Treatment of lead poisoning
Dimercaprol and EDTA, succimer in kids Pharmacology Heme/Onc
50
Heparin (mechanism, use, toxicity)
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
51
Enoxaparin, dalteparin (mechanism, use, toxicity)
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
52
Warfarin (mechanism, use, toxicity)
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
53
Alteplase, reteplase, tenecteplase (mechanism, use, toxicity)
Converts plasminogen to plasmin; used as a thrombolytic Pharmacology Heme/Onc
54
Aspirin (mechanism, use, toxicity)
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
55
Clopidogrel, ticlodipine, prasugrel, ticagrelor (mechanism, use, toxicity)
Irreversibly blocks ADP receptors on platelets, preventing degranulation; used for acure coronary syndrome; ticlodipine causes neutropenia Pharmacology Heme/Onc
56
Cilostazol, dipyridamole (mechanism, use, toxicity)
Phosphodiesterase inhibitor, increases cAMP and decreases ADP, preventing platelet degranulation; nausea, headache, facial flushing, hypotension Pharmacology Heme/Onc
57
Abciximab, eptifibatide, tirofiban (mechanism, use, toxicity)
GPIIb/IIIa inhibitors, preventing platelet aggregation; bleeding, thrombocytopenia Pharmacology Heme/Onc
58
Methotrexate (mechanism, use, toxicity)
Inhibits dihydrofolate reductase, inhibiting DNA synthesis; myelosuppression, macrovesicular fatty change in liver Pharmacology Heme/Onc
59
5-fluorouracil (mechanism, use, toxicity)
Pyrimidine analog that is activated and inhibits thymidylate synthase, inhibiting DNA synthesis; myelosuppression, photosensitivity Pharmacology Heme/Onc
60
Cytarabine (mechanism, use, toxicity)
Pyrimidine analog that inhibits DNA polymerase; leukopenia, thrombocytopenia, megaloblastic anemia Pharmacology Heme/Onc
61
Azathioprine, 6-mercaptopurine, 6-thioguanine (mechanism, use, toxicity)
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
62
Dactinomycin (actinomycin D) (mechanism, use, toxicity)
DNA intercalator; used for childhood tumors; myelosuppression Pharmacology Heme/Onc
63
Doxorubicin (Adriamycin), daunorubicin (mechanism, use, toxicity)
Generates free radicals that cause DNA strand breaks; dilated cardiomyopathy, myelosuppression, alopecia Pharmacology Heme/Onc
64
Bleomycin (mechanism, use, toxicity)
Generates free radicals that cause DNA strand breaks; pulmonary fibrosis with minimal myelosuppression Pharmacology Heme/Onc
65
Cyclophosphamide, ifosfamide (mechanism, use, toxicity)
Crosslinks DNA (must be activated by liver); myelosuppression, hemhorragic cystitis (can be minimized with mesna) Pharmacology Heme/Onc
66
Carmustine, lomustine, semustine, streptozocin (mechanism, use, toxicity)
Used to treat CNS tumors Pharmacology Heme/Onc
67
Busulfan (mechanism, use, toxicity)
Alkylates DNA; pulmonary fibrosis, hyperpigmentation Pharmacology Heme/Onc
68
Vincristine, vinblastine (mechanism, use, toxicity)
Block microtubule polymerization; vincristine causes neurotoxicity, vinblastine causes bone marro suppression Pharmacology Heme/Onc
69
Paclitaxel (mechanism, use, toxicity)
Blocks microtubule breakdown; myelosuppression Pharmacology Heme/Onc
70
Cisplatin, carboplatin (mechanism, use, toxicity)
Crosslinks DNA; nephrotoxicity (minimize with chloride diuresis, amifostine), acoustic n. damage Pharmacology Heme/Onc
71
Etoposide, teniposide (mechanism, use, toxicity)
Inhibits topoisomerase II; myelosuppression, GI upset, alopecia Pharmacology Heme/Onc
72
Hydroxyurea (mechanism, use, toxicity)
Inhibits ribonucleotide reductase; used in cancers and HbSS disease; bone marrow suppression Pharmacology Heme/Onc
73
Prednisone (mechanism, use, toxicity)
Unknown but may trigger apoptosis in dividing cells; Cushingoid symptoms Pharmacology Heme/Onc
74
Tamoxifen, raloxifene (mechanism, use, toxicity)
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
75
Trastuzumab (mechanism, use, toxicity)
Antibody against HER-2 receptor; cardiotoxicity Pharmacology Heme/Onc
76
Imatinib (mechanism, use, toxicity)
Antibody against bcr-abl tyrosine kinase Pharmacology Heme/Onc
77
Rituximab (mechanism, use, toxicity)
Antibody against CD20; used to treat non-Hodgkin's lymphoma and rheumatoid arthritis Pharmacology Heme/Onc
78
Vemurafenib (mechanism, use, toxicity)
B-raf kinase inhibitor (V600 mutation); used in metastatic melanoma Pharmacology Heme/Onc
79
Bevacizumab (mechanism, use, toxicity)
Antibody against VEGF Pharmacology Heme/Onc
80
Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac (mechanism, use, toxicity)
Reversible COX inhibitor; gastric ulcers, renal ischemia (due to constriction of afferent arteriole) Pharmacology Musculoskeletal
81
Celecoxib (mechanism, use, toxicity)
Reversible COX-2 inhibitor; anti-inflammatory without damage to gastric mucosa; sulfa allergy, thrombosis Pharmacology Musculoskeletal
82
Acetominophen (mechanism, use, toxicity)
COX inhibitor in the CNS (not anti-inflammatory); causes hepatic necrosis Pharmacology Musculoskeletal
83
Alendronate (mechanism, use, toxicity)
Pyrophosphate analog that inhibits osteoclasts; used to treat osteoporosis, hypercalcemia, and Paget's disease; corrosive esophagitis Pharmacology Musculoskeletal
84
Allopurinol (mechanism, use, toxicity)
Xanthine oxidase inhibitor, reduces production of uric acid Pharmacology Musculoskeletal
85
Febuxostat (mechanism, use, toxicity)
Xanthine oxidase inhibitor Pharmacology Musculoskeletal
86
Probenecid (mechanism, use, toxicity)
Inhibits reabsorption of uric acid in PCT Pharmacology Musculoskeletal
87
Colchine (mechanism, use, toxicity)
Inhibits microtubule polymerization, preventing neutrophil extravasation Pharmacology Musculoskeletal
88
Etanercept (mechanism, use, toxicity)
TNF-alpha receptor that binds free TNF-alpha Pharmacology Musculoskeletal
89
Infliximab, adalimumab (mechanism, use, toxicity)
Anti-TNF-alpha antibody Pharmacology Musculoskeletal
90
Latanoprost (mechanism, use, toxicity)
PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris Pharmacology Neurology
91
Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity)
Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis Pharmacology Neurology
92
Butorphanol (mechanism, use, toxicity)
Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full agonist Pharmacology Neurology
93
Tramadol (mechanism, use, toxicity)
Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures Pharmacology Neurology
94
First-line therapy for simple partial seizures
Carbamazepine Pharmacology Neurology
95
First-line therapy for complex partial seizures
Carbamazepine Pharmacology Neurology
96
First-line therapies for tonic-clonic seizures (3)
Carbamazepine, phenytoin, valproate Pharmacology Neurology
97
First-line therapy for absence seizures
Ethosuximide Pharmacology Neurology
98
Phenytoin (mechanism, use, toxicity)
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
99
Carbamazepine (mechanism, use, toxicity)
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
100
Lamotrigine (mechanism, use, toxicity)
Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome Pharmacology Neurology
101
Gabapentin (mechanism, use, toxicity)
Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia Pharmacology Neurology
102
Topiramate (mechanism, use, toxicity)
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
103
Phenobarbital (mechanism, use, toxicity)
Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer Pharmacology Neurology
104
Valproate (mechanism, use, toxicity)
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
105
Ethosuximide (mechanism, use, toxicity)
Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome Pharmacology Neurology
106
Benzodiazepines (mechanism, use, toxicity)
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
107
Tiagabine (mechanism, use, toxicity)
Inhibits GABA reuptake; used for simple and complex seizures Pharmacology Neurology
108
Vigabatrin (mechanism, use, toxicity)
Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex seizures Pharmacology Neurology
109
Levetriacetam (mechanism, use, toxicity)
Unknown mechanism; used for simple, complex, and tonic-clonic seizures Pharmacology Neurology
110
Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity)
Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias Pharmacology Neurology
111
Triazolam, oxazepam, midazolam (mechanism, use, toxicity)
Short-acting benzodiazepines; more addictive potential Pharmacology Neurology
112
Barbituates vs. benzodiazepines (mechanism)
Increase duration vs. increase frequency Pharmacology Neurology
113
Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity)
BZ1 subtype GABA channel agonists; used to treat insomnia Pharmacology Neurology
114
Ketamine (mechanism, use, toxicity)
Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams Pharmacology Neurology
115
Order of sensory loss when using local anesthetics
Pain -\> temperature -\> touch -\> pressure Pharmacology Neurology
116
Succinylcholine (mechanism, use, toxicity)
ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia Pharmacology Neurology
117
Tubocurarine, -curium drugs (mechanism, use, toxicity)
ACh antagonists; used as paralytics Pharmacology Neurology
118
Dantrolene (mechanism, use, toxicity)
Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome Pharmacology Neurology
119
Levodopa/carbidopa (mechanism, use, toxicity)
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
120
Selegiline (mechanism, use, toxicity)
MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa Pharmacology Neurology
121
Donepezil, galantamine, rivastigmine (mechanism, use, toxicity)
ACh esterase inhibitors; used to treat Alzheimer's disease; cholinergic symptoms Pharmacology Neurology
122
Sumatriptan (mechanism, use, toxicity)
Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm Pharmacology Neurology
123
Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)
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
124
Chlorpromazine, thioridazine (mechanism, use, toxicity)
Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette's; corneal deposits (chlorpromazine), retinal desporits (thioridazine) Pharmacology Psychiatry
125
Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity)
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
126
Lithium (mechanism, use, toxicity)
Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism, polyuria Pharmacology Psychiatry
127
Buspirone (mechanism, use, toxicity)
Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement Pharmacology Psychiatry
128
Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity)
Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures) Pharmacology Psychiatry
129
Venlafaxine, duloxetine (mechanism, use, toxicity)
Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension Pharmacology Psychiatry
130
-iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity)
TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects Pharmacology Psychiatry
131
Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity)
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
132
Bupropion (mechanism, use, toxicity)
Increases NE and dopamine; used for smoking sensation, depression; seizures Pharmacology Psychiatry
133
Mirtazapine (mechanism, use, toxicity)
Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain; Pharmacology Psychiatry
134
Maprotiline (mechanism, use, toxicity)
Blocks NE reuptake; used for depression; sedation, hypotension Pharmacology Psychiatry
135
Trazodone (mechanism, use, toxicity)
Inhibits serotonin uptake; used for insomnia; pripism Pharmacology Psychiatry
136
Mannitol (mechanism, use, toxicity)
Osmotic diuretic; used to treat drug overdose and increased ICP; pulmonary edema, CHF Pharmacology Renal
137
Acetazolamide (mechanism, use, toxicity)
Carbonic anhydrase inhibitor; used for glaucoma, metabolic alklalosis; hyperchloremic metabolic acidosis, ammonia toxicity, sulfa allergy Pharmacology Renal
138
Furosemide (mechanism, use, toxicity)
Inhibits NKCC channel, preventing urine concentration; used in hypertension, CHF, hypercalcemia; ototoxicity, hypokalemia, hypocalcemia, nephritis, gout, sulfa allergy Pharmacology Renal
139
Ethacrynic acid (mechanism, use, toxicity)
Inhibits NKCC channel; used in patients with furosemide (sulfa) allergy; hyperuricemia Pharmacology Renal
140
Hydrochlorothiazide (mechanism, use, toxicity)
Inhibits NaCl reabsorption in DCT and increases Ca reabsorption; hypertension and hypercalcinuria; hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy Pharmacology Renal
141
Spironolactone, eplerenone (mechanism, use, toxicity)
Aldosterone receptor antagonists; hyperaldosteronism, CHF, hypokalemia; hyperkalemia (arrhythmias), antiandrogen effects with spironolactone Pharmacology Renal
142
Triamterene, amiloride (mechanism, use, toxicity)
Block sodium channels in cortical collecting duct; hyperaldosteronism, CHF Pharmacology Renal
143
Captopril, enalapril, lisinopril (mechanism, use, toxicity)
ACE inhibitor, leads to reduced angiotensin II levels and decreases GFR; prevents heart remodeling, hypertension, CHF; cough, angioedema, transient creatinine increase, hyperkalemia Pharmacology Renal
144
Losartan, valsartan (mechanism, use, toxicity)
Angiotensin II receptor antagonists; similar to ACE inhibitors, but do not cause cough due to normal metabolism of bradykinin Pharmacology Renal
145
Leuprolide (mechanism, use, toxicity)
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
146
Finasteride (mechanism, use, toxicity)
5-alpha reductase inhibitor; used for BPH and male-pattern baldness Pharmacology Reproductive
147
Flutamide (mechanism, use, toxicity)
Testosterone receptor antagonist; used in prostate cancer Pharmacology Reproductive
148
Ketoconazole (mechanism, use, toxicity)
Inhibits 17,20-desmolase, stopping sex steroid synthesis; used to treat polycystic ovarian syndrome Pharmacology Reproductive
149
Clomiphene (mechanism, use, toxicity)
Partial estrogen agonist in the hypothalamus, increases release of LH and FSH, stimulating ovulation; used for infertility and PCOS Pharmacology Reproductive
150
Tamoxifen (mechanism, use, toxicity)
Estrogen receptor antagonist at the breast; used for breast cancer; partial agonist at the uterus, can cause endometrial hyperplasia Pharmacology Reproductive
151
Raloxifene (mechanism, use, toxicity)
Estrogen receptor agonist at bone, inhibits osteoclast activity and stimulates osteoblast activity; used to treat osteoporosis Pharmacology Reproductive
152
Anastrozole, exemestane (mechanism, use, toxicity)
Aromatase inhibitors; used in breast cancer Pharmacology Reproductive
153
Mifepristone (mechanism, use, toxicity)
Progesterone receptor antagonist, given with misoprostol for abortion; abortifacient; bleeding, abdominal pain Pharmacology Reproductive
154
Terbutaline (mechanism, use, toxicity)
Beta-2 agonist, inhibits uterine contractions Pharmacology Reproductive
155
Tamsulosin (mechanism, use, toxicity)
Alpha-1 antagonist; used to treat BPH Pharmacology Reproductive
156
Sildenafil, vardenafil (mechanism, use, toxicity)
Phosphodiesterase 5 inhibitors, causing inc. cGMP levels and smooth muscle relaxation; used in erectile dysfunction; impaired blue-green vision, contradindicated with nitrates Pharmacology Reproductive
157
Danazol (mechanism, use, toxicity)
Partial androgen receptor agonist; used to treat endometriosis and hereditary angioedema; weight gain, acne, hirsutism, low HDL, hepatoxicity Pharmacology Reproductive
158
Treat methemoglobinemia with
Methylene blue Pharmacology Respiratory
159
Diphenhydramine, dimenhydrinate, chlorpheniramine (mechanism, use, toxicity)
(First generation) H1 antagonists; used in allergies, motion sickness, insomnia; sedation, antiadrenergic, antiserotonergic, and antimuscarinic effects due to CNS penetration Pharmacology Respiratory
160
Loratadine, fexofenadine, desloratadine, cetrizine (mechanism, use, toxicity)
H1 antagonists; used in allergies; less fatigue than other antihistamines due to decreased CNS penetration Pharmacology Respiratory
161
Albuterol (mechanism, use, toxicity)
Short-acting beta-2 agonist; asthma Pharmacology Respiratory
162
Salmeterol, formoterol (mechanism, use, toxicity)
Long-acting beta-2 agonist; asthma; tremor, arrhythmias Pharmacology Respiratory
163
Theophylline (mechanism, use, toxicity)
Phosphodiesterase inhibitor, increases cAMP and causes bronchodilation; asthma; cardiotoxicity, neurotoxicity Pharmacology Respiratory
164
Ipratropium (mechanism, use, toxicity)
Muscarinic antagonist, prevents bronchoconstriction; asthma and COPD Pharmacology Respiratory
165
Beclomethasone, fluticasone (mechanism, use, toxicity)
Inhibit cytokine synthesis, reducing inflammation due to asthma Pharmacology Respiratory
166
Montelukast, zafirlukast (mechanism, use, toxicity)
Leukotriene receptor antagonists; especially useful in aspirin-induced asthma Pharmacology Respiratory
167
Zileuton (mechanism, use, toxicity)
Inhibits activity of 5-lipoxygenase, inhibiting leukotriene production; reduces inflammation Pharmacology Respiratory
168
Omalizumab (mechanism, use, toxicity)
Anti-IgE antibody; used in refractory allergic asthma Pharmacology Respiratory
169
Guaifenesin (mechanism, use, toxicity)
Thins respiratory secretions Pharmacology Respiratory
170
N-acetylcysteine (mechanism, use, toxicity)
Loosens mucus plugs; used in CF patients and as an antidote to acetominaphen posioning Pharmacology Respiratory
171
Bosentan (mechanism, use, toxicity)
Antagonizes endothelin-1 receptors, reducing vascular resistance in the pulmonary vessels; used in pulmonary hypertension Pharmacology Respiratory
172
Dextromethorphan (mechanism, use, toxicity)
Antagonizes NMDA receptors, inhibiting coughing; produces opioid effects in large doses and carries mild abuse potential Pharmacology Respiratory
173
Pseudoephedrine, phenylephrine (mechanism, use, toxicity)
Alpha-1 agonists that reduce edema and nasal congestion; rhinitis; hypertension, quick tolerance (recurrence of symptoms despite continued treatment) Pharmacology Respiratory
174
Difference in competitive vs noncompetitve inhibitors?
competitive = decrease potency, noncompetitive = decrease efficacy. Pharmacology General
175
What is Km?
Inverse relation of affinity of enzyme for its substrate. Pharmacology General
176
What is Vmax?
Direct proportion to enzyme concentration Pharmacology General
177
What is bioavailability?
Fraction of administered drug that reaches systemic circulation unchanged. Pharmacology General
178
Time to steady state depends on?
depends on half-life. Does not depend on frequency or size of dose. Pharmacology General
179
What is rate of elimination in zero order kinetics?
constant amount eliminated per time. Pharmacology General
180
Give three drugs that are zero order eliminated.
PEA - phenytoin, Ethanol, Aspirin. Pharmacology General
181
What is the rate of elimination for first order kinetics?
A constant FRACTION is eliminted, variable by concentration! Pharmacology General
182
How does ionization relate to urine pH?
Ionzied species are trapped in urine and not resorbed. Neutral can be resorbed. Pharmacology general
183
How do you treat overdose of weak acid? Give drug examples.
Treat with Bicarb to make neutral. Exp: phenobarbital, methotrexate, aspirin. Pharmacology general
184
How do you treat overdose of weak base? Give drug examples.
Treat with ammonium chloride. exp: amphetamines. Pharmacology general
185
What is phase I drug metabolism? What pt. population loses this?
Reduction, Oxidation, hydrolysis with CYP450. Often gives neutral products. Geriatrics lose this phase. Pharmacology general
186
What is phase II metaboloism? What population depend on this?
Conjugation (Glucuronidation, Acetylation, and Sulfation.) Gives charged products. Geriatrics depend on this, old people have GAS. Pharmacology general
187
What is efficacy?
maximal effect a drug can produce. Pharmacology general
188
What is potency?
amount of drug needed for the same effect. Pharmacology general
189
What happends to efficacy when a partial agonist and full agonist are mixed?
DECREASED efficacy. fight for same binding site, full agonist cant exert full effect. Pharmacology general
190
What is therapetuic index?
LD50/ED50. Median lethal dose divded by median effective dose. Safer drugs have a higher TI. pharmacology general
191
What is a therapeutic window?
Minimum effective dose to minimum toxic dose. Think of it as range of use. pharmacology general
192
What are the two types of Nicotonic receptors? What kind of messenger do they use?
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
Alpha-1 sympathetic receptor (G-protein class, major function)
q, increase: vasc. smooth muscle contraction, pupillary dilator muscle contraction, intestinal and bladder sphincter contaction. pharmacology autonomics
194
Alpha-2 sympathetic receptor(G-protein class, major function)
i, decrease: sympathetic outflow, insulin release, lipolysis. increase: platlet aggregation. pharmacology autonomics
195
Beta-1 sympathetic receptor(G-protein class, major function)
s, increase: heart rate, contractilty, renin release, lipolysis pharmacology autonomics
196
Beta-2 sympathetic receptor(G-protein class, major function)
s, vasodilation, brochodilation, increase: heart rate, contractility, lipolysis, insulin release, aqueous humor production. decrease: uterine tone, ciliary muscle tone. pharmacology autonomics
197
M-1 Parasymp receptor(G-protein class, major function)
q, CNS, enteric nervouse system. pharmacology autonomics
198
M-2 Parasymp(G-protein class, major function)
i, decease: heart rate, contractility of atria pharmacology autonomics
199
M-3 parasymp(G-protein class, major function)
increase: exocrine gland secretion (tears, gastric, etc), gut peristalsis, bladder contraction, bronchoconstriction, pupillary spinchter contraction, cilliary muscle contraction. pharmacology autonomics
200
What receptor is responsible for miosis and accomadation?
Parasympathetic M-3. pharmacology autonomics
201
What receptor is responsbile for mydriasis?
Sympathetic Alpha-1. pharmacology autonomics
202
Dopamine D-1 receptor(G-protein class, major function)
s, relaxes renal vascular smooth muscle pharmacology autonomics
203
Dopamine D-2 receptor(G-protein class, major function)
i, modulates transmitter release especially in brain. pharmacology autonomics
204
Histamine H-1 receptor(G-protein class, major function)
q, increase: mucus production, contraction of bronchioles, pruritus, pain. pharmacology autonomics
205
histamine H-2 receptor(G-protein class, major function)
a, increase gastric acid secretion pharmacology autonomics
206
vasopression V-1 receptor(G-protein class, major function)
q, increase: vascular smooth muscle contraction pharmacology autonomics
207
vasopression V-2 receptor(G-protein class, major function)
s, increase water permeability and reabsorption in kidneys. (V2 found in 2 kidneys). pharmacology autonomics
208
Which receptors work via Gq -\> Phospholipase C -\>Pip2-\>DAG + IP3?
H1,Alpha1,V1,M1,M3. (remember HAVe 1 M&M) pharmacology autonomics
209
DAG causes activation of what?
Protein Kinase C. pharmacology autonomics
210
IP3 causes increase in what?
Calcium -\> smouth muscle contraction pharmacology autonomics
211
Which receptors work via Gi-\>Adenyly cyclase -\>cAMP -\>Protein Kinase A?
M2, Alpha2, D2. (remember MAD 2's.) pharmacology autonomics
212
Which receptors work via Gs-\>adenylyate cyclase -\>cAMP-\>Protein Kinase A?
Beta1, Beta2, D1, H2,V2. pharmacology autonomics
213
What does protein kinase A do?
increase calcium release in heart and blocks myosin light chain kinase. pharmacology autonomics
214
What are the two classes of cholinomimetics?
1. direct agonsts 2. indirect agonists (anticholinesterases). pharmacology autonomics
215
Bethanechol(mechanism,use,toxicity)
Direct cholinomimetic. Postop or neurogenic ileus, urinary retention. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
216
Carbachol(mechanism,use,toxicity)
Direct Cholinomimetic. Identical to Ach. Glaucoma, pupillary contraction, relief of IOP. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
217
Pilocarpine(mechanism,use,toxicity)
Direct Cholinomimetic. Stimulates tears, salvia, sweat. Open and closed-angle glaucoma.COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
218
methacholine(mechanism,use,toxicity)
Direct Cholinomimetic. challenge test of asthma diagnosis. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
219
Neostigmine(mechanism,use,toxicity)
Indirect cholinomimetic agonist. NO cns penetration. Postop and neurogenic ileus, myasthenia gravis, reversal of NMJ block. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
220
pyridostigmine(mechanism,use,toxicity)
indirect cholinomimetic agonist. Long acting myasthenia gravis treatment. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
221
edrophonium(mechanism,use,toxicity)
indirect cholinomimetic agonist. Short acting, for myasthenia gravis diagnosis. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
222
Physostigmine(mechanism,use,toxicity)
indirect cholinomimetic agonist. for anti-cholinergic overdose, crosses BBB. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
223
Donepezil(mechanism,use,toxicity)
indirect cholinomimetic agonist. Alzheimers disease. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics
224
signs of cholinesterase inhibitor poisoning. treatment.
DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle +CNS, lacrimation, sweating, salvia.) tx: atropine + pralidoxime. pharmacology autonomics
225
Parathion(mechanism, treatment)
Irreversible cholinesterase inhibitor, ACH overdose. Tx: atropine + pralidoxime. pharmacology autonomics
226
Atropine, homatropine, tropicamide (mechanism, use, toxicity).
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
Benztropine(mechanism,use,toxicity)
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
Scopolamine(mechanism,use,toxicity)
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
Ipratropium,tiotropium (mechanism, use, toxicity)
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
Oxybutynin(mechanism,use,toxicity)
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
Glycopyrrolate(mechanism,use,toxicity)
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
Jimson Weed(mechanism, toxicity)
muscarinic antagonist, causes gardner's pupil (mydriasis). pharmacology autonomics
233
Epinephrine(Mechanism, receptors bound, use, toxicity)
Direct Sympathomemetic. A1,A2,B1,B2. Anaphylaxis, open angle glaucoma, asthma, hypotension. pharmacology autonomics
234
Norepinephine(Mechanism, receptors bound, use, toxicity)
direct sympathomemetic. A1,A2, some B1. used in hypotension but it decrease renal perfusion. pharmacology autonomics
235
Isoproterenol(Mechanism, receptors bound, use, toxicity)
Direct sympathomemetic. B1, B2. Used in Torsade de pointe and bradyarryhmia. Can cause tachycardia and worsen cardiac ischemia. pharmacology autonomics
236
dopamine(Mechanism, receptors bound, use, toxicity)
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
dobutamine(Mechanism, receptors bound, use, toxicity)
Direct sympathomimetic. Mostly B1, little a1,a2,b2. Used in heart failure and cardiac stresstest (ionotrpic and chronotropic) pharmacology autonomics
238
Phenylephrine(Mechanism, receptors bound, use, toxicity)
Direct sympathomimetic. A1, A2. Used in hypotension, to cause mydriasis, and rhinitis (decongestant). pharmacology autonomics
239
Albuterol, salmetrol, terbutaline (Mechanism, receptors bound, use, toxicity)
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
Ritodrine(Mechanism, receptors bound, use, toxicity)
Direct sympathomimetic. B2 only. Used to reduce premature uterine contractions. pharmacology autonomics
241
Amphetamine (mechanism, use)
indirect sympathomimetic. Releases stored catecholamines. Used for narcolepsy, obesity, ADD. pharmacology autonomics
242
Epinephrine(Mechanism, use, toxicity)
indirect sympathomimetic. Releases stored catecholamines. Used for nasal decongestion, urinary incontience, hypotension. pharmacology autonomics
243
Cocaine (mechanims, use).
direct sympathomimetic. Reuptake inhibitor. Causes vasoconstriction and local anesthesia. pharmacology autonomics
244
Why must B-Blockers be avoided in suspected cocaine intoxication?
mixing them can lead to unopposed A1 activation and extreme hypertenion. pharmacology autonomics
245
How does norepinephrine cause reflex bradycardia?
stimulates A1\>B2. Causes increased vasoconstrciton -\> increased BP. This causes reflex bradycardia and slowing of HR. pharmacology autonomics
246
How does isoproterenol cause reflex tachycardia?
Stimulates B2\>A1. This cause vasodilation and dropping of BP. B1 is stimulated and causes tachycardia. pharmacology autonomics
247
Clonidine, alpha-methyldopa(Mechanism, receptors bound, use)
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
Phenoxybenzamine(Mechanism, receptors bound, use, toxicity)
IRREVERSIBLE nonslective alpha blocker. Used in pheochromosytoma BEFORE surgery! toxic: orhtostatic hypotension, reflec tachycardia. pharmacology autonomics
249
phentolamine(Mechanism, receptors bound, use, toxicity)
REVERSBILE nonselective alpha blocker. give to patients on MAOI who each tyramine contraining foods. pharmacology autonomics
250
Prazosin, Terazosin, Doxazosin,Tamsulosin(Mechanism, receptors bound, use, toxicity)
Alpha-1 blocker. Used in hypertension, urinary rentention in BPH. tox:orthostatic hypotension, dizziness, headache. pharmacology autonomics
251
Mirtazapine (mechanism, use, toxicity)
Alpha-2 blocker. Used in depression. tox: sedation, hypercholesterolemia, increased apetite. pharmacology autonomics
252
Describe what occurs when you alpha-blockade epi vs. phenylephrine.
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
Give 6 applications of Beta-blockers in general.
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
give general toxicites of b-blockers
impotence, asthma exacerbation, bradycardia, seizures, sedation, hides hypoglycemia. pharmacology autonomics
255
What are the B1 selective b-blockers? When are they useful?
A BEAM. acebutolol, betaxolol, Esmolol, Atenolol, Metoprolol. Useful in comorbid pum. disease. pharmacology autonomics
256
What are the nonselective ( b1 = b2) b-blockers?
Please Try Not Being Picky. Propranolol, Timolol, Nadolol, Pindolol. B = B-blocker. pharmacology autonomics
257
what are the nonselective a and b-antagonists?
Carvedilol, labetalol. pharmacology autonomics
258
What are the partial B-agonists?
Pindolol, Acebutolol. pharmacology autonomics
259
Give treatment for acetaminophen overdose.
N-Acetylcysteine (replenishes glutathione). pharmacology overdose
260
Give treatment for salicylates overdose.
NaHCO3 (alkalinize urine) pharmacology overdose
261
give treatment for amphetamines overdose
NH4Cl (acidify urine) pharmacology overdose
262
Give treatment for antimuscarinic and anticholinergic overdose.
Phygostigmine and control the hyperhermia. pharmacology overdose
263
Give treatment for b-blocker overdose
Glucagon pharmacology overdose
264
Give treatment for digitalis overdose
(KLAM) normalize K, Lidocaine, Anti-dig fab fragments, Mg2 pharmacology overdose
265
give treatment for iron overdose.
deFEroxamine, deFErasirox. pharmacology overdose
266
give treatment for lead overdose
CaEDTA, dimercaprol, succimer, penicillamine pharmacology overdose
267
give treatment for mercury, arsenix, gold overdose
Dimercaprol, succiner pharmacology overdose
268
give treatment for copper, arsenic, gold overdose
penillamine pharmacology overdose
269
give treatment for cyanide
nitrite + thiosulfate, hydroxocobalamin pharmacology overdose
270
give methemoglobin treatment
Methylene blue, vitamin c pharmacology overdose
271
Give Carbon monocide treatment
100% oxygen or hyperbaric oxygen pharmacology overdose
272
give treatment for methanol, ethylene glycol overdose
Fomepizole\>Ethanol, dialysis pharmacology overdose
273
give treatment for opiods overdose
naloxone/naltrexone pharmacology overdose
274
give treatment for benzodiazepine overdose
flumazenil pharmacology overdose
275
give treatment for TCA overdose
NaHCO3 (alkalinize plasma) pharmacology overdose
276
give treatment for heparin overdose
protamine pharmacology overdose
277
give treatment for warfarin overdose
Vitamin K, fresh frozen plasma pharmacology overdose
278
give treatment for tPA, Streptokinase, urokinase overdose
aminocaproic acid pharmacology overdose
279
give treatment for theophylline overdose
B-Blockers pharmacology overdose
280
give treatment for acetylcholinesterase inhibitors
atropine + pralidoxime pharmacology overdose
281
causes coronary vasospam
cocaine, sumatriptan, ergots pharmacology reactions
282
causes cutaneous flushing
(VANC) Vancomycin, Adenosine, Niacin, Ca blocker pharmacology reactions
283
causes dilated cardiomyopathy
doxorubicin, daunorubicin pharmacology reactions
284
causes torsades de pointes
class III (sotalol) and class Ia (quinidine) pharmacology reactions
285
causes agranulocytoisis
Clozapine, Carbamazepine, Colchine, Propylthiouracil, Methimazole, Dapsone pharmacology reactions
286
causes aplastic anemia
chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole pharmacology reactions
287
causes direct coombs positive hemolytic anemia
methyldopa, penicillin pharmacology reactions
288
causes gray baby syndomr
chloramphenicol pharmacology reactions
289
causes hemolysis in G6PD-defiect patients
(hemolysis IS PAIN)isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin pharmacology reactions
290
causes megaloblastic anemia
(females with PMS are on full BLAST mode) Phenytoin, Methotrexate, Sulfa drugs pharmacology reactions
291
Causes thrombotic complications
OCPs like estrogen pharmacology reactions
292
Causes cough
ACE inhibitors pharmacology reactions
293
causes pulmonary fibrosis
Bleomycin, amiodarone, Busulfan pharmacology reactions
294
causes acute cholestatic hepatits, jaundice
erthryomycin pharmacology reactions
295
causes focal to massice hepatic necrosis
Halothane, Amanita Phalloides, Valrpoic acid, Acetaminophen pharmacology reactions
296
causes hepatits
isoniazid pharmacology reactions
297
can lead to pseudomembranous colitis
clindamycin, ampicillin pharmacology reactions
298
can lead to adrenocortical insufficiency
glucocorticoid withdrawl via HPA suppression pharmacology reactions
299
can causes gynecomastia
`(Some drugs create awkward knockers) spironolactone, digitalis, cimetidine, chronic alcohol use, ketoconazole pharmacology reactions
300
causes hot flashes
estrogen, clomophene pharmacology reactions
301
causes hypergylcemia
niacin, tacrolimus, protease inhibitor, HCTZ, corticosteriods pharmacology reactions
302
causes hypothyroidism
lithium, amiodarone, suldonamides pharmacology reactions
303
causes fat redistribution
glucocoricoids, protease inhibitors pharmacology reactions
304
causes gingival hyperplasia
phenytoin, verpamil pharmacology reactions
305
causes gout
furosemide, thiazides, niacin, cyclosporine pharmacology reactions
306
causes myopathies
fibrates, niacin, colchine, hydroxychloroquine, interferon-alpha, penicillamine, statins, glucocorticoids pharmacology reactions
307
causes osteoporosis
corticosteroids, heparin pharmacology reactions
308
causes photosensitivty
(SAT for a PHOTO) Sulfonamides, amiodarone, tetracycline pharmacology reactions
309
causes rash/SJS
penicillin, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital pharmacology reactions
310
cause drug induced lupus
Hydralazine, isonizid, procainamine, phenytoin pharmacology reactions
311
causes teeth problems
tetracyclines pharmacology reactions
312
causes tendonitis, tendon rupture, tooth damage
fluoroquinolones pharmacology reactions
313
causes diabetes insipidus
lithium, demeclocycline pharmacology reactions
314
causes fanconi's syndome
expired tetracycline pharmacology reactions
315
causes hemorrhagic cystits
Cyclophosamide, ifosfamide pharmacology reactions
316
causes interstital nephritis
methicllin, NSAID, furosemide pharmacology reactions
317
causes SIADH
carbamazepine, cyclophosamide pharmacology reactions
318
causes cinchonism
Quinidine, qunine pharmacology reactions
319
causes parkinson-like syndome
antipsychotics, resperine, metoclopramide pharmacology reactions
320
causes seizures
(with seizures, I BITE My tongue) isoniazid, Buproprion, imipenem, Tramadol, Enflurane, Metoclopramide pharmacology reactions
321
causes tardive dyskinesia
antipsychotics pharmacology reactions
322
acts like an anti-muscarinic
Atropine, TCA, H1-blocker, neuoleptics pharmacology reactions
323
can cause a disulfiram like reaction
metronidazole, some cephalosporins, procarbazine, 1st gen sulphonoureas pharmacology reactions
324
can cause nephro/ototoxicity
aminoglycosides, vancomycin, loop dieuetics, cisplatin pharmacology reactions
325
list p450 inducers
(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
list p450 inhibitors
(MAGIC ROCKS in GQ) Macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir actue alcohol use, ciprofloxacin, ketoconazole, sulfonamides, gemfibrozil, quinidine. pharmacology reactions
327
lists the sulfa drugs
(Popular FACTSSS) probenacid, furosemide, acetazolamide, celecoxib, thiazide, sulfonamide antibiotics, sulfaasalazine, sulfonylureas pharmacology reactions
328
Difference between peniciliin G and V.
G = IV and IM. V = oral. pharmacology micro
329
Penicillin(mechanism,use,toxicity)
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
Oxacillin,Naficillin,Dicloxacillin(mechanism,use,toxicity)
bind transpeptidases, penicillanse resistant due to bukly r-group blocking B-Lactamse; S. Aureus, except MRSA; hypersensitivity and interstitial nephritis. pharmacology micro
331
Ampicillin, amoxicillin(mecanism,use,toxicity)
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
Which has better bioavailibility; amoxicllin or ampicillin?
amOxicllin has better Oral bioavilability. pharmacology micro
333
What does clavulanic acid do?
B-lactamse inhibitor pharmacology micro
334
Ticarcillin,piperacillin(mechanism,use,toxicity)
transpeptidase inhibitor but extended spectrum;pseduomonas and g- rods, use with claculanic acid due to B-lactamse suspectibilty; hypersensitivity reaction. pharmacology micro
335
List the B-lactamse inhibitors
(CAST) Clavulanic Acid, Sulbactam,Tazobactem. pharmacology micro
336
Cephalosporin(mechanism,use,toxiciity)
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
give use of cefazolin, cephalexin.
1st generation cephalosporins. PEcK. Proteus, E.coli,Klebsiella. Cefazolin used preop to prevent A.aureus infections. pharmacology micro
338
give use of cefoxitin, cefaclor,cefuroxime`
2nd generation cephalosporins. HEN PEcKs. H.ib, Enterbacter, Neisseria, Proteus, E.coli,Klebsiella, Serratia. pharmacology micro
339
give use of ceftriaxone, cefotaxime,ceftazidime
3rd gen. cephalosporins. Serious gram - infections. Ceftriaxone = meningitis and gonorrhea. Ceftazidime = pseudomonas. pharmacology micro
340
give use of cefepime.
increased activity against pseudomonas and G+ bugs. pharmacology micro
341
Aztreonam(mechanism,use,toxicty)
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
what transpeptidase inhibitor can be used in penicillin allergy?
aztreonam. pharmacology micro
343
imipenem/cilastatin,meropenem,etrapenem,doripenem(mechanism,use,toxicity)
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
Vancomycin(mechanism,use,toxicty)
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
How is redman syndrome prevented in vancomycin use?
slow infusion and rate and antihistamines. pharmacology micro
346
How does vancomycin resistant occur?
amino acid change of D-ala D-ala to D-ala D-lac. pharmacology micro
347
List antibiotic protein synthesis inhibitors
AT 30, CCEL at 50. 30S = Aminoglycosides, Tetracyclines. 50S = Chloramphenicol, Clindamycin, Erythromycin, Linezolid. pharmacology micro
348
Gentamicin, neomycin, amikacin,tobramycin,streptomycin(mechanism,use,toxicity)
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
how does resistenace to aminoglycosides occur?
transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. pharmacology micro
350
tetracycline, doxycycline, demecycline,minocycline(mechanism, use, toxicity)
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
how does resistance to tetracyclines occur?
decrease uptake into cells or increased efflux by pumps. pharmacology micro
352
Azithromycin, clarithromycin, erythromycin(mechanism,use,toxicity)
bacteriostatic, blocks translocation; atypical pneumonias, chlamydia, gram + cocci; MACRO: increased Motility, arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia. pharmacology micro
353
how does resitance to macrolides occur?
methylation of 23s rRNA binding site. pharmacology micro
354
Chloramphenicol(mechanism,use,toxicity)
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
what causes grey baby syndrome?
use of chloramphenicol in premature infants, they lack UDO-glucuronyl-transferase. pharmacology micro
356
How does resistance to chloramphenicol occur?
plasmid-encoded acetyltransferase. pharmacology micro
357
clindamycin(mechanism,use,toxicity)
Bacteriostatic. Blocks peptide transfer; anaerobic infections in lung infections and oral anerobes; C. Diff infection, fever, diarrhea. pharmacology micro
358
Sulfamethoxazole(SMX), sulfisoxazole, sulfadiazine(mechanism, use, toxicity)
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
how does resistance to sulfonamides occur?
altered bacterial dihydropteroate or increased PABA synthesis. pharmacology micro
360
Trimethoprim(mechanism,use,toxicity)
Bacteriostatic, inhibits bacterial dihydrofolate reductase, blocks folate synthesis; used in UTI, PCP (prophylacis and treatment), shigella, salmonella; megaloblastic anemia, leukopenia, granulocytopenia. pharmacology micro
361
ciprofloxacin, norfloxacin, levofloxacin, etc...(mechanism, use, toxicity)
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
how does resistance to fluroquinolones occur?
mutation in DNA gyrase or efflux pumps. pharmacology micro
363
What groups are susceptible to fluorquinolone tendon rupture?
older than 60 or taking prednisone pharmacology micro
364
Metronidazole(mechanism, use, toxicity)
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
Isoniazid(mechanism,use,toxicity)
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
Rifampin(mechanism,use,toxicity)
inhibits DNA-dependent RNA polymerase; TB, Leprosy, prophylaxis in meningococcus and Hib type B; hepatotox, p450 inducer, orange body fluids. pharmacology micro
367
Pyrazinamide(mechanism, use, toxicity)
unknown; TB; hyperuricemia, hepatotoxic. pharmacology micro
368
Ethambutol(mechanism,use,toxicity)
decreased carbohydrate polymerization of TB cell wall, blocks arabinosyltransferase; TB; optic neuropathy(red-green color blindness\_ pharmacology micro
369
Amphotericin B(mechanism, use, toxicity)
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
nystatin(mechanism,use,toxicty)
binds fungal ergosterol;topical only due to high toxicity, used for oral thrush and topical diaper rash or vaginal candidiasis. pharmacology micro
371
Fluconazole, ketoconazole, clotrimazole, itraconazole, voriconazole(mechanism, use,toxicity)
inhibits fungal ergosterol synthesis by binding p450;Fluconazole for suppression of cryptococcus in AIDs patients, itraconazle for blasto, coccio, histo. pharmacology micro
372
Flucytosine(mechanism, use, toxicity)
inhibits fungal DNA and RNA synthesis by conversion to 5FU; used in systemic fungal infections, especially cryptococcus; bone marrow suppression. pharmacology micro
373
Caspofungin, micafungin(mechanism, use, toxicity)
inhibits fungal cell wall synthesis by inhibiting B-glucan synthesis; invasive aspergillosis, candida; flushing via histamine releae. pharmacology micro
374
terbinafine(mechanism,use,toxicity)
inhibits fungal squalene epoxidase; treat dermatophytes - toe nail infection especially;abnormal LFT, visual disturbances. pharmacology micro
375
Griseofulvin(mechanism,use,toxicity)
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
Pyrimethamine use
toxoplasmosis pharmacology micro
377
suramin and melarsoprol use
trypanosoma brucei pharmacology micro
378
nifurtimox use
trypanosoma cruzi pharmacology micro
379
sodium stibogluconate use
leshmaniasis pharmacology micro
380
Chloroquine(mechanism,use,toxicity)
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
quinidine use
lifethreatening malaria pharmacology micro
382
artemether/lumifantrine use
p. falciparum killing pharmacology micro
383
Zanamivir,oseltamivir(mechanism,use)
inihibits influenza neuraminidase, stops progeny release; treamt of influenze a and b pharmacology micro
384
Ribavarin(mechanism,use,toxicity)
inhibits sythesis of guanine nucleotides by competitvely inhibiting IMP dehydrogenase; RSV, chronic hep C; hemolytic anemia, severe teratogen pharmacology micro
385
Acyclovir,valacyclovir(mechanism, use, toxicity)
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
Famciclovir use
used in herpes zoster active infections pharmacology micro
387
mechanism for resistance to acyclovir
mutated viral thymidine kinase pharmacology micro
388
Ganciclovir,valgangciclovir(mechanism,use,toxicity)
guanosine analog, 5'-monophosphate formed by CMV viral kinase, inhibits viral DNA polymerase;CMV infections;leukopenia,neutopenia,thrombocytopenia,renal toxicity pharmacology micro
389
mechanism for resistance to acyclovir
mutated CMV DNA polymerase or lack of viral kinase pharmacology micro
390
Foscarnet(mechanism,use,toxicity)
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
mechanism for resistance to foscarnet
mutated DNA polymerase pharmacology micro
392
cidofovir(mechanism,use,toxicity)
inhibits DNA polymerase, doesn't require activiation by viral kinase; CMV retenitis, acyclovir resistant HSV; nephrotoxic pharmacology micro
393
HAART consist of what?
[2 NRTI] +[1 NNRTI OR 1 protease inhibitor OR 1 integrase inhibitor] pharmacology micro
394
give mechanism and toxicity of protease inhibitors
all end in -NAVIR! stops HIV mRNA cleavage into functional parts; hyperglycemia, GI upset, lipodystrophy. pharmacology micro
395
Ritonavir does what to be a "booster"
inhibits cytochrome p-450, boosting concentration of other drugs. pharmacology micro
396
Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didansoine, stavudine(mechanism,use,toxicity
(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
Nevirapine, Efavirenz, Delavirdine(mechanism,use,toxicity)
(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
Raltegravir(mechanism,use,toxicity)
inhibits integrase, which stops HIV integration into host cells;HIV;hypercholesterolemia pharmacology micro
399
Interferons(mechanism,use,toxicity)
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
What antibiotics must be avoided in pregnancy?
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
