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Pharm > Miscellaneous Meds > Flashcards

Miscellaneous Meds Flashcards

1
Q

2 classes of antineoplastic agents and how they are used:

A

1) cell cycle-specific (useful in hematological malignancies or tumors with large # of cells in proliferation)
2) cell cycle-nonspecific (slowly proliferating tumors)

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2
Q

Cell cycle-specific antineoplastics:

A

Methotrexate
Bleomycin
Vincristine

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3
Q

Cell cycle-nonspecific antineoplastics:

A

Cyclophosphamide
Doxorubicin
Cisplatin

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4
Q

2 alkylating chemotherapeutics:

A

Cyclophosphamide
Cisplatin

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5
Q

Antimetabolite chemotherapeutic:

A

Methotrexate

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6
Q

Natural product chemotherapeutic:

A

Vincristine

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7
Q

Antitumor antibiotics:

A

Bleomycin
Doxorubicin

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8
Q

Metabolite of Cyclophosphamide:

A

Acrolein

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9
Q

Uses of Cyclophosphamide:

A

breast CA
ovarian CA
non-Hodgkin’s
neuroblastoma

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10
Q

s/s of toxicity of Cyclophosphamide:

A
  • cardiac dysfxn
  • pulmonary toxicity
  • SIADH
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11
Q

How to reduce build-up of acrolein:

A

good hydration

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12
Q

Uses of cisplatin:

A
  • testicular CA
  • bladder CA
  • lung CA
  • ovarian CA
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13
Q

s/s of toxicity of cisplatin:

A
  • acoustic nerve damage
  • nephrotoxicity
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14
Q

MOA of methotrexate:

A

inhibits dihydrofolate reductase –> interferes with nucleic acid and protein metabolism

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15
Q

Uses of Methotrexate:

A
  • choriocarcinoma
  • bladder CA
  • non-hodgkin’s
  • leukemia
  • RA
  • psoriasis
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16
Q

s/s of methotrexate toxicity:

A
  • hepatotoxicity
  • pulmonary fibrosis
  • lymphoma
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17
Q

Cyclophosphamide is metabolized through which method?

A

CYP450

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18
Q

Uses of vincristine:

A
  • neuroblastoma
  • Wilms tumor
  • non-small cell lung CA
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19
Q

s/s of toxicity of vincristine:

A

peripheral neuropathy

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20
Q

Bleomycin is part of a series of antineoplastic abx produced from which organism?

A

Streptomyces verticillus

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21
Q

Which 3 drugs have synergistic actions in treating testicular CA?

A
  • Bleomycin
  • Vincristine
  • Cisplatin
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22
Q

Uses for bleomycin:

A
  • testicular CA
  • squamous cell CA of head, neck, cervix, penis, rectum
  • ovary and breast intracavitary therapy
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23
Q

What fatal adverse effect can be seen with bleomycin?

A
  • pulmonary fibrosis
  • older patients
  • worse when exposed to high O2 levels
  • (use <30% O2 to maintain sats >90%)
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24
Q

Uses for doxorubicin:

A
  • many cancers
  • sarcomas
  • hematologic CA
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25
Q

Adverse effects of doxorubicin:

A
  • bone marrow suppression
  • cardiac toxicity
26
Q

How does cardiac toxicity occur with doxorubicin?

A

excessive intracellular production of free radicals within the myocardium

27
Q

The adrenal cortex synthesizes 3 main types of hormones:

A

1) mineralcorticoid (aldosterone)
2) glucocorticoid (cortisol)
3) adrenergic hormone

28
Q

How do steroids move and work in the body?

A
  • bind to corticosteroid-binding globulin in plasma
  • unbinds when it reaches a cell
  • crosses through the cell membrane and binds to an intracellular receptor
  • alter gene transcription
  • create tissue-specific responses
29
Q

List the effects that steroids have on the body:

A
  • stimulate gluconeogenesis
  • muscle protein breakdown
  • stimulate insulin secretion
  • increase lipolysis & lipogenesis
  • osteoporosis
  • immunosuppression
  • anti-inflammatory
  • behavior changes
30
Q

Natural glucocorticoids:
Synthetic glucocorticoids:

A

natural: cortisol
synthetic: prednisone, dexamethasone

31
Q

Daily cortisol production:

A

15-30mg

32
Q

What substance regulates (and is regulated by) cortisol?

A

adrenocorticotropin (ACTH)

33
Q

Which hormone functions to control the body’s response to stress?

A

cortisol

34
Q

Natural mineralcorticoid:
Synthetic mineralcorticoid:

A

natural: aldosterone
synthetic: fludocortisone

35
Q

Aldosterone maintains BP through which 2 mechanisms?

A

1) retention of Na+ and H2O by the kidney
2) excretion of K+ and H+ ions by the kidney

36
Q

Definition, s/s, and tx of acute adrenal crisis:

A
  • definition: sudden onset or exacerbation of several adrenal insufficiency
  • s/s: weakness, nausea, hypotension, fever, CNS changes
    tx: steroids, electrolyte correction, fluids, inotropic support
37
Q

What is the standard method of perioperative steroid replacement?

A

mixed glucocorticoid/mineralcorticoid (cortisone/hydrocortisone)
- 0.8 glucocorticoid / 1.0 mineralcorticoid activity
- 25-150mg based on stress/type of surgery

38
Q

Give the dosages for weight-based dosing of Ancef:

A

<80kg = 1g
80-120kg = 2g
>120kg = 3g

39
Q

Define an allergic response to an abx:

A

delayed reaction characterized by maculopapular rash or fever

40
Q

Describe an immediate hypersensitivity to an abx:

A

IgE mediated and medical emergency including laryngeal edema, bronchospasm, and CV collapse

41
Q

MOA of beta-lactams:

A

target the cell wall to kill or inhibit bacteria

42
Q

What types of bacteria are beta-lactams effective against?
List some examples:

A
  • effective against gram + and gram -
  • Examples = PCN, cephalosporin, carbapenem, monobactam
43
Q

SE of beta-lactams:

A
  • severe allergic reactions
  • seizures
44
Q

Important things about Ancef:

A
  • mostly g- but also some g+
  • kills skin flora
  • dose adjusted for renal fxn
  • 10% cross reactivity with PCN
  • give within 60min of incision and re-dose Q3h during sx
45
Q

MOA of beta-lactamase inhibitors:
2 examples?

A

bind irreversibly to beta-lactamase
1) Vancomycin
2) Bacitracin

46
Q

How is Vanco dosed? What are some side effects?

A

body weight dosing (adjusted for renal fxn)
SE = Red Man’s Syndrome, hypotension (infuse slowly)

47
Q

What type of bacteria do aminoglycosides target?

A

gram -

48
Q

Examples of aminoglycosides

A

1) Streptomycin
2) Gentamicin

49
Q

SE of aminoglycosides:

A
  • ototoxicity
  • nephrotoxicity
  • prolong NMBAs!
50
Q

What types of procedures is Ancef given for?

A
  • cardiac
  • thoracic
  • GI
  • gyn
  • neuro
51
Q

What drug do you add to ancef for a GI obstruction?

A

metronidazole

52
Q

Cipro is given for which procedure type?

A

Cystoscopy

53
Q

3 questions for asthmatic patients:

A

1) What inhalers do they take and how often?
2) Last time they used their inhaler?
3) Been to ED for asthma in last 6 months?

54
Q

2 things to remember before administering an albuterol inhaler via the vent:

A

1) needs a filter to be used with vent tubing
2) remove CO2 line before administrating

55
Q

MOA of nitric oxide:

A
  • direct vasodilator of pulmonary arteries
  • decreases intrapulmonary shunt

*monitor methemoglobin levels if used >24 hours

56
Q

MOA/uses/SE of albuterol:

A
  • MOA: short-acting B2 agonist
  • uses: rapid relief of wheezing, bronchospasm, airflow obstruction
  • SE= tremors, tachycardia
57
Q

Albuterol can be used to correct which electrolyte imbalance? How?

A
  • hyperkalemia
  • agonist effect on B2 receptors and stimulation of Na+/K+ pump
58
Q

MOA of Saleterol/Formoterol:

A
  • long-acting B2 agonist
  • recommended when short-acting used >2x/wk
59
Q

MOA/uses/SE of ipatropium:

A
  • MOA: short-acting inhaled cholinergic antagonist; acts on muscarinic receptors in airway to reduce tone
  • uses: maintenance for COPD, rescue for COPD & asthma
  • SE: dry mouth, urinary retention, pupillary dilation, blurred vision
60
Q

List the anesthetics that have a favorable effect on bronchomotor tone:

A
  • Sevo
  • Iso
  • Propofol
  • Midazolam
  • Ketamine
61
Q

Define hypoxic pulmonary vasoconstriction

A

intrinsic response within the lungs that occurs with hypoxia; vasculature in a hypoxic area will constrict to direct more blood flow to the well-ventilated areas

  • all volatiles cause this in a dose-dependent fashion
  • also caused by systemic vasodilators nitroglycerine, nitroprusside

Pharm (19 decks)

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