Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DIT FACTS > PHARM > Flashcards

PHARM Flashcards

1
Q

3 direct cholinergic agonists

A

Carbachol
Bethanechol
Pilocarpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

6 Cholinergic Antagonists

A 
Atropine
Ipratropium
Scopolamine
Benztropine
Oxybutynin
Glucopyrrolate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 Indrect cholinergic agonists (anti-acetylcholinesterases)

A

Neostigmine
Echothiophate
Donepezil
Edrophonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nicotinic antagonist

A

Hexamethonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cholinesterase regenerator

A

Pralidoxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a1 a2 b1 b2 agonist

A

epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

a1 a2 b1 agonist

A

norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

D1=D2 > B1 > a1 agonist

A

Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

B1=B2 agonist

A

Isoproterenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

B2>B1 agonist

A

Dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

a1>a2 agonist

A

Phenylephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HIV Rx that cause pancreattis

A

Ritonavir

NRTIs: Didanosine, stavudine, zalcitabine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

HIV Rx that cause rash

A

NNRTIs: Nevirapine, Delavirdine, Efavirenz

Abacavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which HIV Rx cause lactic acidosis

A

All NNRTIs except abacavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which HIV Rx cause peripheral neuropathy?

A

NRTIs (Didanosine, Stavudine, Zalcitabine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What birth defect results from lithium?

A

Ebstein anomaly - displacement of posterior and septal tricuspid valve leaflets towards the apex which leads to atrialization of the right ventricle.
It is associated with Wolff-Parkinson White

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which receptors use a Gs protein? There are 5.

A

B1, B2, V2, H2, D1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 3 drugs that regulate the secretion of gastric acid.

A

PPIs
H2 blockers
Anti-muscarinics (atropine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Antacid that may cause diarrhea

A

Magnesium hydroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Antacid that may cause constipation

A

Aluminum hydroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Antacid that may cause rebound hypercalcemia

A

Calcium carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Electrolyte abnormality commonly seen in administration of antacids

A

Hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Main MOA of prokinetic agents

A

Increased ACh
Increased 5-HT
Decreased D2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MOA of Metoclopramide

A

Stimulates 5-HT4
Inhibits D2
Prokinetic agent –increases contractility and tone at rest
Indicated in diabetics with gastroparesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MOA of Domperidone

A

Inhibits D2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

MOA of Cisapride

A

Stimulates 5-HT4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

5 drugs known to cause seizures

A 
Metoclopramide
Buproprion
Tramadol
Enflurane
Evening primrose oil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

MOA of protease inhibitors

A

Inhibit viral assembly by blocking protease enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

MOA of fusion inhibitors

A

Bind viral glycoprotein 41, thus inhibiting fusion iwth CD4 cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does aspirin cause Reye syndrome?

A

The metabolites of aspirin inhibit mitochondrial enzymes, thus decreasing beta oxidation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Medications used in treatment of chronic hep B and hep c?

A

IFN alpha is used to treat chronic hep B and hep C.

Ribavirin is also used to treat hep C.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Cocktail of meds taken by patients suffering from severe cirrhosis (4).

A

Lactulose to treat encephalopathy.
Vitamin K to allow for maximum clotting potential (they are not producing coagulation factors as well –their liver sucks)
Diuretics to treat ascites or edema.
A beta blocker to prevent bleeding from esophageal varices.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

MOA of drug of choice in hepatic encephalopathy

A

LACTULOSE
Lactulose is a sugar that is not absorbed by the enterocytes. So the bacteria metabolize lactulose, creating this acidic environment. NH3 passes by the colon and it gets acidified – > as a cation (NH4+), it can not get back into the body. Thus it is excreted in the stool.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Drug that inhibits conversion of dopa –> dopamine

A

Carbidopa (it is inhibiting dopa decarboxylase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treatment for cystinuria

A

Acetazolamide – CAI that alkalinizes urine (prevents cystine stones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Volume of distribution equation

A

Vd=amount of drug given (IV) / [drug] in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Clearance equation

A

Cl=0.7 x Vd / T(1/2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Loading Dose equation

A

LD = Css x Vd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Maintenance dose equation

A

MD = Css x Cl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

7 P450 inhibitors

A 
PICK EGS
Protease inhibitors
Isoniazid
Cimetidine
Ketoconazole
Erythromycin
Grapefruit juice
Sulfonamides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

7 P450 inducers

A 
BCG PQRS
Barbiturates
Carbamazepine
Griseofulvin
Phenytoin
Quinidine
Rifampin
St. John's Wort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

pKa definition

A

the pH at which the amount of non-protonated form (A- or B) is equal to the amount of protonated form (HA or BH+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Tx for an acidic drug overdose (e.g. salicylates)

A

NaHCO3

Traps acidic drug in basic urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Tx for basic drug OD (e.g. amphetamines)

A

NH4Cl

Traps basic drug in the acidic urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

General byproduct of Phase I metabolism and 3 reactions that take place

A

Slightly more polar metabolites

Oxidation, reduction, and hydrolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

General byproduct of Phase II metabolism and 3 reactions that take place

A

Very polar metabolites (aka very inactive; thus easily renally excreted)
Acetylation, sulfation, glucuronidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which hepatic phase of metabolism is lost first by geriatric patients?

A

Phase I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Which hepatic phase of metabolism is mediated by CYP450?

A

Phase I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

4 Rx that cause disulfiram like reactions

A

Metronidazole
Certain cephalosporins
Procarbazine
1st generation sulfonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Rx that inhibits alcohol dehydrogenase

A

Fomepizole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Rx that inhibits acetaldehyde dehydrogenase

A

Disulfiram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Ends in -tidine

A

H2 blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Ends in -mustine

A

Nitrosoureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Ends in -glitazone

A

Thiazolinediones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Treatment for heparin-induced thrombocytopenia?

A

Anti-coagulate! Lepirudin or bivalirudin (direct thrombin inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Diabetes drug that causes lactic acidosis (rare but serious)

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Diabetes drug thats most common SE is hypoglycemia

A

Sulfonylureas (gliburide, glipizide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

MOA of sulfonylureas

A

Closes potassium channel on the beta cells causing depolarization. This leads to an influx of calcium, causing insulin release!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

MOA of acarbose

A

Inhibits alpha-glucosidase at intestinal brush border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

MOA of pioglitazone (TZDs)

A

Agonist at PPAR gamma receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

MOA of heparin

A

Cofactor for activation of anti-thrombin. Decreasing thrombin and decreasing factor Xa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

MOA and advantages of LMWH

A

Enoxaparin and dalteparin act more on factor Xa.
Better bioavailability and longer half life.
Can be admin subcutaneously and without lab monitoring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Rx used in pateitns with HIT

A

Lepirduin and bivalirudin (direct thrombin inhibitors) that are derivatives of hirudin, the anticoagulant used by leeches.
These are used as an alternative to heparin for anticoagulating patients with HIT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Drug that increases [Warfarin]

A

Sulfonamide abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

3 drugs that decrease [Warfarin]

A

Bile acid sequestrants (e.g. cholestyramine)
St. John’s Wort
Vitamin K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Lab value not altered by warfarin

A

Bleeding time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Lab values seen in thrombolytic use

A

Increased PT and PTT

NO CHANGE IN PLATELET COUNT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

MOA of thrombolytics

A

Directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Toxicity of thrombolytics is treated with

A

aminocaproic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

MOA of Hydroxyurea

A

Inhibits ribonucleotide reductase thus decreasing the production of deoxyribonucleotides.
-indicated for use in sickle cell anemia, CML, psoriasis, myeloproliferative d/o, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

MOA of methotrexate

A

Inhibits eukaryotic dihydrofolate reductase (unlike TMP which inhibits prokaryotic dihydrofolate reductase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

MOA of mycophenolate

A

A reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH) in purine (guanine) biosynthesis which is necessary for the growth of T cells and B cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

MOA of 6-mercaptopurine

A

Inhibits purine nucleotide synthesis and metabolism by inhibiting an enzyme called Phosphoribosyl pyrophosphate amidotransferase (PRPP Amidotransferase) – the rate limiting enzyme of purine synthesis. Thus, 6-MP alters the synthesis and function of RNA and DNA. It also interferes with nucleotide interconversion and glycoprotein synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

MOA of linezolid

A

Binds 50S, blocking translocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

MOA of Rifampin

A

Inhibits prokaryotic RNA polymerase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

HIV rx that causes bone marrow suppression

A

Zidovudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Tx for lead poisoning

  • In adults?
  • In children?
A

In adults: succimer, EDTA

In kids: dimercaprol, EDTA, succimer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

An 11 y.o. child presents with a chronic non-healing ulcer and a small calcified spleen. What drug can improve his sx?

A

Hydroxyurea

Hint: this is SCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

MOA of streptokinase

A

Directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

MOA of clopidogrel/ticlopidine

A

Inhibits platelet aggregation by irreversibly blocking ADP receptors. Also inhibits fibrinogen binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

MOA of Abciximab/Eptifibatide/Tirofiban

A

Bind glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation.

Used in NSTEMIs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

6 hormones that use tyrosine kinase receptors

A 
Insulin
IGF-1
FGF
PDGF
Prolactin
Growth hormone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

3 drugs that stimulate NE release

A

Amphetamine
Ephedrine
Tyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

3 drugs that inhibit NE reuptake

A

Cocaine
TCAs
Amphetamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

CD4<200 begin prophylaxis with?

A

TMP-SMX
Dapsone or aerosolized pentamidine

Prophylaxis for PCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

CD4<100 begin prophylaxis with

A

TMP-SMX
Dapsone pentamidine + leucovorin

Prophylaxis for toxo if there is a + toxo IgG titer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

CD4 <50 begin prophylaxis with

A

Single weekly dose of azithromycin to prevent a MAC infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Drug that interferes with Gp120

A

Miraviroc (CCR5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Drug that interferes with Gp41

A

Enfuvirtide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Tx for E. coli infections

A

TMP-SMX

Fluoroquinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

3 drugs that cause photosensitivity reactions

A

SAT for a photo
Sulfonamides
Amiodarone
Tetracyclines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

8 drugs to be avoided in patients with an allergy to sulfa

A 
Celecoxib
Furosemide
Probenecid
Thiazides
TMP-SMX
Sulfasalazine
Sulfonylureas
Acetazolamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

4 drug (classes) that cause Stevens Johnson syndrome

A

Penicillins
Sulfa drugs
Seizure drugs
Allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

4 clinical uses of TMP-SMX

A

UTIs
Shigella/Salmonella
MRSA
AIDS - pneumocystis jiroveci pneumonia CD4<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

MOA and indications for Nitrofurantoin

A

Bacteriocidal –reduced by bacterial proteins to a reactive intermediate that inactivates bacterial ribosomes.
Indicated for UTI cystitis (not pyelonephritis) by E. coli or S. saprophyticus (not Proteus)
Safe in pregnancy :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Indications for fluoroquinolones

A

Gram - (1st and 2nd generation like cipro)
Pseudomonas
Gram + (3rd and 4th generation like levo and moxi, respectively)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

1 time you can use fluoroquinolones in pediatric patients

A

Cystic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

6 bugs treated with Metronidazole

A 
GET GAP on the Metro
Giardia lamblia
Entamoeba histolytica
Trichomonas
Gardnerella vaginalis
Anaerobes
H. pylori
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Tx for Chaga’s disease

A

Nifurtimox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

4 treatments for resistant malarias

A

Quinine + doxycycline
Mefloquine
Atovaquone-proguanil
Artemether-lumefantrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Tx for cutaneous leishmaniasis

A

Sodium stibogluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Tx for visceral leishmaniasis

A

Liposomal ampho B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

How does the body metabolize 6-mercaptopurine?

A

Xanthine oxidase

Thus toxicity is increased if used with allopurinol (would use 6-thioguanine instead)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Anti-cancer drug used in rheumatoid diseases as well as ectopic pregnancies

A

Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

For which cancers is dactinomycin particularly useful and what is its MOA?

A

Wilm’s tumor
Ewing’s sarcoma
Rhabdomyosarcoma

Intercalates in DNA therefore DNA cannot replicate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

5 drugs that inhibit microtubules

A 
Vinca drugs (vincristine/vinblastine)
Taxanes (paclitaxel)
Anti-helminthics (-bendazoles)
Griseofulvin
Colchicine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Myelosuppression induced by MTX can be reversed with administration of?

A

Leucovorin –folinic acid “rescue” agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

5-fluorouracil can be used topically to treat?

A

Actinic keratosis (prevent it from progressing to malignancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

MOA of Cytarabine

A

Pyrimidine analog that inhibits DNA polymerase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Drug that chelates iron to prevent cardiotoxicity induced by doxorubicin

A

Dexrazoxane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

2 cancer drugs associated with pulmonary fibrosis

A

Bleomycin

Busulfan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

This alkylating agent is associated with CNS toxicity

A

Nitrosoureas (the -mustines) cross blood brain barrier and can cause CNS toxicity like dizziness and ataxia.

They are used to treat brain tumors including GBM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

The hemorrhagic cystitis associated with cyclophosphamide can be prevented with what Rx?

A

Mesna

Binds acrolein which is a toxic metabolite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Toxicity of vincristine

A

Neurotoxicity (areflexia, peripheral neuritis), paralytic ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Toxicity of vinblastine

A

Vinblastine BLASTS bone marrow (suppression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

3 drugs used to treat testicular cancer

A

Eradicate Ball Cancer

Etoposide
Bleomycin
Cisplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Monoclonal ab against CD20

A

Rituximab – treats NHL and rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

2 anti-cancer agents that cause cardiotoxicity

A

Doxorubicin – DILATED CARDIOMYOPATHY

Trastuzumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Toxicity of cisplatin/carboplatin

A

Acoustic nerve damage and nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

3 anti-cancer agents that cause myelosuppression

A

5-FU
6-MP
Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Antibody against philadelphia chromosome

A

Imatinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Intercalates DNA and produces oxygen free radicals

A

Doxorubicin

Daunorubicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

3 drugs that cause free-radical induced DNA strand breakage

A

Bleomycin
Doxorubicin
Daunorubicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Tx for AML

A

Cytarabine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Tx for CML

A

Busulfan

Imatinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Tx for Trypanosoma

A

Suramin or melarsoprol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

When treating a patient long-term with Dapsone (maybe the patient has leprosy or dermatitis herpetiformis from Celiac disease), what would you want to supplement their tx with in order to prevent methemoglobinemia from occurring?

A

Cimetidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Treatment for methemoglobinemia

A

Methylene blue, vitamin C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

4 treatment options available for pulmonary hypertension

A

Bosentan, ambrisentan
Prostaglandin analog (these decrease bronchial tone)
Sildenafil
Dihydropyridine CCB such as nifedipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

MOA of Bosentan

A

Tx for pulmonary hypertension

Antagonist of endothelium-1 receptor, thus decreasing pulmonary vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Name 6 conditions treated with hyperbaric oxygen therapy.

A 
Gas gangrene
Decompression sickness
Arterial gas embolism
CO poisoning
Osteomyelitis
MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Tx of choice for toxoplasma gondii

A

Sulfadiazine + pyrimethamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Use and MOA of cyproheptadine

A

1st gen anti-histamine (H1)

Used as appetite stimulant since it has additional anti-cholinergic, anti-serotinergic, and local anesthetic properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Use and MOA of promethazine

A

1st gen anti-histamine (H1) with anti-emetic and anti-cholinergic properties
Therefore it is used to tx N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Use and MOA of chlorpheniramine

A

1st gen anti-histamine (H1) used in tx of allergies

Its in several OTC allergy/cold medicines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Use and MOA of hydroxyzine

A

1st gen anti-histamine (H1)

Sedative, anti-itch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Use and MOA of meclizine

A

1st gen Anti-histamine (H1) and anti-emetic

Tx of vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Long-acting prophylactic agents for asthma that may cause tremor and arrythmia

A

Salmeterol and formoterol (B2 agonists)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

MOA of last-resort asthma treatment that blocks the actions of adenosine

A

Theophylline likely causes bronchodilation by inhibiting phosphodiesterase, thereby decreasing cAMP hydrolysis. Its limited in use due to its narrow therapeutic index, often causing cardiotoxicity and neurotoxicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Overdose of theophylline is treated with?

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

MOA and use of cromolyn sodium

A

Inhibits the release of mast cell mediators such as histamine.
Prophylaxis in asthma patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

MOA of ipratropium, tiotropium

A

Competitively blocks muscarinic receptors, preventing bronchoconstriction. Used in asthma and COPD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

1st line inhaled therapy for chronic asthma and MOA

A

Corticosteroids – Beclomethasone and fluticasone
These inhibit the synthesis of virtually all cytokines. They inactivate NF-kB, the transcription factor that induces the production of TNF alpha among other inflammatory agents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Tx for aspirin-induced asthma and MOA

A

Montelukast (better in 1 y.o. and up)
Zafirlukast (5 y.o. and up)
Block leukotriene receptors – think lu kast = “last” ste in leukotriene synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

MOA of zileuton

A

5-lipoxygenase pathway inhibitor that blocks the conversion of arachidonic acid to leukotrienes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Drug used for allergic asthma resistant to inhaled steroids and long-acting B2 agonists and its MOA

A

Omalizumab –monoclonal anti-IgE Ab that binds mostly unbound serum IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

What 3 conditions can be treated with N-acetylcysteine?

A

CF –cleaves disulfide bonds within mucous glycoproteins, thus loosening mucus plugs.
Antidote in acetaminophen OD as it regenerates glutathione (an anti-oxidant).
Can be taken orally to protect kidneys against contrast-induced nephropathy, as in diabetics with renal failure who need an emergency contrast CT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

3 things you need to check before placing a patient on amiodarone

A

Liver function tests
Pulmonary function tests
Thyroid function tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

2 major treatments of choice in anaerobic infections

A

Metronidazole

Clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Clinical uses for ampicillin/amoxicillin

A 
H. influenzae
E. coli, enterococci
Listeria
Proteus mirabilis
Salmonella, Shigella

Hint: HEELPSS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

3 anti-pseudomonal penicillins

A

Ticarcillin
Carbencillin
Piperacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Two different mechanisms of resistance used against penicillin agents

A

B-lactamase

Alteration of PBPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

2 beta lactamase inhibitors

A

Sulbactam

Clavulanic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Name 4 penicillinase-resistant penicillins and their toxicity.

A

Oxacillin, nafcillin, dicloxacillin, methicillin

Can cause interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Drug that increases the half life of Penicillin G via blocking active renal secretion of penicillin

A

Probenicid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Jarish-Herxheimer phenomenon

A

Acute worsening of sx (fever, HA, muscle pains) soon after Pen G treatment due to released pyrogens from killed organisms, especially with tx of Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

2 first gen cephalosporins and their clinical use.

A 
Cefazolin, cephalexin
PEcK
Gram + cocci
Proteus mirabilis
E. coli
Klebsiella pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

3 second gen cephalosporins and their clinical uses

A 
Cefoxitin, cefaclor, cefuroxime
Gram + cocci, HEN PEcK**
H. influenzae
Enterbacter
Neisseria
Proteus mirabilis
E. coli
Klebsiella pneumonia
Serratia marcescens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

3 third gen cephalosporins and clinical uses.

A

Ceftriaxone, cefotaxime, ceftazidime
Serious gram negative infections resistant to other B lactams.
Ceftriaxone: Meningitis, CAP, gonorrhea
Ceftazidime: P. aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

4th generation cephalosporin and clinical use

A

Cefepime

Super broad spec. Increased activity against Pseudomonas and gram + organisms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

3 main toxicities associated with cephalosporins

A

Vitamin K deficiency (thus increased risk of bleeds)
INCREASED NEPHROTOXICITY if combined with aminoglycosides
Disulfiram like reactions in some (Cefotetan, cefamandole, cefoperazone)

162
Q

MOA and clinical use of aztreonam

A

Monobactam resistant to beta lactamases. Inhibits cell wall synthesis and binds to penicillin binding proteins. Its used for gram negative rods only in penicillin allergic patients and those with renal insufficiency who thus cannot tolerate aminoglycosides.

163
Q

What drug is always administered with imipenem and how does this agent assist imipenem?

A

Cilastatin is an inhibitor of renal dehydropeptidase I, thus decreasing the inactivation of imipenem in renal tubules.

164
Q

Against what organisms are imipenem and meropenem effective?

A

Empiric treatment of life threatening infections due to its serious side effects (like seizures)

165
Q

Give 4 toxicities of Vancomycin.

A

Nephrotoxicity
Ototoxicity
Thrombophlebitis
Red Man Syndrome (could have been treated prophylactically with anti histamines and slow infusion rate)

166
Q

Only agent used as solo prophylaxis in TB

A

Isoniazid

167
Q

MOA and side effects of Isoniazid

A

Decreased synthesis of mycolic acids.

Can cause neurotoxicity, hepatotoxicity, and drug-induced lupus.

168
Q

What are the 4 R’s of Rifampin?

A

RNA polymerase inhibitor
Revs up microsomal cytochrome P450
Red/organge body fluids
Rapid resistance if used alone

169
Q

For which 4 infections if Rifampin used?

A

M. tuberculosis
Leprosy
Meningococcal prophylaxis
Prophylaxis for H. influenzae type B

170
Q

DOC in Mycoplasma pneumoniae

A

Tetracyclines, macrolides, or fluoroquinolones

171
Q

DOC in early Lyme disease; DOC in late Lyme disease

A

Early: Doxycycline
Late: Ceftriaxone

172
Q

3 drug cocktail to treat Leprosy

A

Dapsone, Rifampin, Clofazimine for 6-24 months

173
Q

Prophylaxis against bacterial endocarditis

A

Pen V
Aminopenicillins
Ampicillin
1st generation ceph (cephalexin)

174
Q

What medications are used to treat CHF?

A

Digoxin
B blockers
ACE inhibitors
Diuretics

175
Q

What medications are used to treat acute heart failure?

A

LMNOP
Lasix/loops
Morphine (decreases stress – > decreases symp system)
Nitrates (dilates pulm vasculature)
O2
Positioning/pressors –get pt to sit on edge of bed so that the blood pools in their legs, not lungs. :)

176
Q

Hyperkalemia increases the toxicity of which class of anti-arrhythmics?

A

Class I.

177
Q

Name 3 Class IA anti-arrhythmics, and their MOA.

A

Double Quarter Pounder = Disopyramide, Quinidine, Procainamide.
These block the fast Na+ channels and decrease the slope of phase 0. This increases the overall duration of the AP and the effective refractory period as well as increase the QT intervals.

178
Q

Procainamide is associated with 2 different things –treatment of what? Toxicity of?

A

Procainamide is used to treat Wolff Parkinson White syndrome.
Also, it can cause drug-induced lupus –however, this is reversible.

179
Q

Which subgroup of class I anti-arrhythmics can lead to Torsades de Pointe?

A

Class Ia, especially quinidine!

180
Q

Name 4 Class Ib anti-arrhythmics and describe their MOA.

A

Lettuce, Tomato, Mayo, Pickles = Lidocaine, Tocainide, Mexiletine, and Phenytoin.
These block fast Na+ channels in the inactivated state, thus decreasing conduction in hypoxic or ischemic cardiac states and decreasing the overall duration of the action potential.

181
Q

DOC for ventricular arrhythmias (especially post-MI or digitalis-induced).

A

Lidocaine –also the least cardiotoxic of convential anti-arrhythmics.

182
Q

What is the MOA of flecainide and propafenone? What is their clinical use as well as 2 major contraindications.

A

These are Class IC anti-arrhythmics that have no effect on AP duration. These are only used as a last-resort in refractory tachyarrythmias and are contraindicated in structural heart disease and post-MI since they are pro-arrythmic and significantly prolong the refractory period in the AV node.

183
Q

Describe the MOA of class II anti-arrhythmics. Which Rx exacerbates vasospasm in Prinzmetal’s angina and is thus contraindicated?

A

These beta blockers decrease SA and AV nodal activity by decreasing the cAMP and Ca2+ currents. It takes longer to reach threshold, so abnormal pacemakers are suppressed through the decrease in the Phase 4 slope. An increase in the PR interval is often seen. PROPRANOLOL can exacerbate vasospasm in Prinzmetal’s angina.

184
Q

Describe the MOA of Class III anti-arrhythmics and name 4 classic drugs part of this category.

A

Amiodarone, Ibutilide, Dofetilide, and Sotalol are K+ channel blockers.
They slow down phase III of the ventricular action potential, which are mainly dependent on K+ currents. This increases both the AP duration and effective refractory period as well as the QT interval.

185
Q

Which anti-arrhythmic can cause blue-gray skin deposits that lead to photodermatitis as well as corneal deposits?

A

Amiodarone.

186
Q

How does Amiodarone cause pulmonary fibrosis?

A

It is a hapten which leads to chronic inflammatory states in our lungs –> fibrosis.

187
Q

What is the MOA of class IV anti-arrhythmics?

A

Verapamil and diltiazem block L-type (SA, AV) slow channels, decreasing the slope of phase 0. This decreases conduction velocity while increasing the effective refractory period and PR interval.

188
Q

Describe the MOA of adenosine and what clinical scenario it is most often used in.

A

Adenosine acts on Gi receptors, decreasing cAMP. This decreases the intracellular calcium current and increases the K+ current leaving the cell, thus hyper-polarizing the cell. It is the DOC in diagnosing/abolishing SVT.

189
Q

Name 2 cardiovascular scenarios that Mg2+ can be used.

A

Torsades de Pointes
Digoxin toxicity

It decreases K+ efflux.

190
Q

Name 2 abx that prolong the QT interval.

A

Macrolides

Chloroquine

191
Q

Name 2 anti-psychotics that prolong the QT interval.

A

Haloperidol

Risperidone

192
Q

Which class of HIV drugs prolong the QT interval?

A

HIV protease inhibitors (-navirs)

193
Q

What is the tx for ventricular fibrillation?

A

CPR, defibrillation

194
Q

What is the tx for ventricular tachycardia w/o a pulse?

A

CPR and defibrillation

195
Q

How do nitrates assist in the treatment of angina?

A

NO decrease the preload, thus decreasing myocardial oxygen demand. They do NOT act to dilate the coronary arteries and increase blood flow/O2 supply.

196
Q

What category of BP rx is preferred in treatment of aortic dissection?

A

B blockers as these decrease the slope of the rise in BP.

197
Q

Describe how alpha 2 agonists relax smooth muscle cells.

A

Alpha 2 agonists cause an increased intracellular calcium, which converts L-arginine to citrulline and NO via cNOS. No then goes to activate guanylyl cyclase, responsible for the conversion of GTP to cGMP. This activates myosin phosphatase, which dephosphorylates myosin-phosphate into myosin, causing relaxation.

198
Q

Patient presents complaining of hypertrichosis due to the BP medication you put them on. What is the MOA of this Rx?

A

Minoxidil (aka Rogaine) opens potassium channels and hyperpolarizes smooth muscle, resulting in relaxation of vascular smooth muscle. SE include hypertrichosis, hypotension, reflex tach, and fluid retention/edema.

199
Q

Which anti-hypertensive can cause dry mouth, sedation, and severe rebound HTN?

A

Clonidine.

200
Q

Name 3 classes of anti-hypertensives that can cause reflex tachycardia.

A

Nitrates
Hydralazine
Dihydropyridine CCBs

201
Q

Patient presents with HTN + CHF. What are your initial therapeutic options? There are 5.

A 
Diuretics
ACE inhib
ARB
B-blocker
Aldo antagonist
202
Q

Which Rx should be avoided in patients with HTN + CHF?

A

B-blockers (in acute decompensated CHF or cardiogenic shock)

CCB

203
Q

Patient presents with HTN + DM. What are your 2 initial therapeutic options and which Rx should be avoided?

A

Could use ACE inhib/ARB or thiazides.

Avoid B-blockers.

204
Q

Patient presents post-MI with HTN. What are your initial therapeutic options?

A 
Thiazide
B-blocker
ACE inhib/ARB
CCB (as needed for angina)
Nitrates (as needed for angina)
205
Q

Patient presents with A fib and HTN. What are your initial therapeutic options?

A

Verapamil/Diltiazem (for rate control)

206
Q

If patient has bradycardia and HTN, what 2 classes of medications do you want to avoid?

A

Diltiazem/verapamil

B-blocker

207
Q

If patient has renal insufficiency, what class of drugs may both exacerbate and also be used as treatment?

A

ACE inhibitors/ARBs prevent proteinuria. However, they may decrease GFR, increasing creatininine. Additionally, K+ sparing diuretics may worsen renal insufficiency.

208
Q

If patient has HTN + hyperparathyroidism, what is your treatment of choice? Which class do you avoid?

A 
Use Loops (loops LOSE calcium).
Avoid thiazides (lead to hypercalcemia.)
209
Q

4 classes of drugs that can treat hypertension in a pregnant patient.

A

Hydralazine
alpha Methyldopa
Labetalol
Dihydropyridine CCB

210
Q

Patient has essential tremor + HTN. What is your DOC?

A

Propranolol

211
Q

Patient with a history of poorly controlled HTN presents to the ER with papilledema, retinal hemorrhage, headache, vomiting, and proteinuria. What is your DOC and its MOA?

A

IV nitroprusside for treatment of malignant HTN. It increases cGMP via direct release of NO. You could also use Fenoldopam, a D1 receptor agonist thus causing dilation of coronary, peripheral, renal, and splanchnic vessels.

212
Q

Which 2 lipid-lowering agents can cause elevated LFTs and myositis?

A

Statins –can also lead to rhabdomyolysis (especially when combined with fibrates) ==> RENAL FAILURE.
Fibrates

213
Q

Which lipid lowering agent has the best effect on HDL and what is its MOA?

A

Niacin which inhibits lipolysis in adipose tissue and reduces hepatic VLDL secretion into circulation.

214
Q

Which lipid-lowering agent has the best effect on triglycerides/VLDL and what is their MOA?

A

Fibrates which upregulate lipoprotein lipase, increasing triglyceride clearance.

215
Q

Which lipid-lowering agent binds C dif toxin?

A

Cholestyramine

216
Q

Name 2 lipid lowering agents that can lead to cholesterol gallstonse.

A

Bile acid resins

Fibrates

217
Q

CT of a patient demonstrates blood in cisterns of the brain. What drug do you administer?

A

Nimodipine (CCB) in order to prevent vasospasm that could occur due to blood breakdown and rebleed.

218
Q

DOC in pseudotumor cerebri

A

Acetazolamide

219
Q

Name 3 DA agonists used in treatment of PD.

A

Bromocriptine (ergot)
Pramipexole
Ropinirole

Non-ergots are preferred.

220
Q

Name 2 drugs that are used to increase dopamine in Parkinson’s Disease.

A

Amantadine increases DA release (also used as anti-viral against influenza A and rubella)
L-dopa/carbidopa

221
Q

Name 3 drugs that prevent dopamine breakdown in the treatment of Parkinson’s Disease.

A

Selegiline – a selective MAO type B inhibitor

Entacapone, tolcapone - COMT inhibitors that prevent L-dopa degrdation

222
Q

Name one antimuscarinic that is used to curb the excess cholinergic activity of Parkinson’s.

A

Benztropine –improves tremor and rigidity.

223
Q

Describe the MOA of L-dopa/carbidopa. What are 3 toxicities attributed to this tx and 2 scenarios in which you should NOT administer this drug to the patient?

A

L-dopa can cross BBB unlike dopamine, and is converted by dopa decarboxylase in the CNS to DA. Carbidopa is a peripheral decarboxylase inhibitor that is used to increase the bioavailability of L-dopa in the brain and limit peripheral side effects.
It can cause arrhythmias due to the increased peripheral formation of catecholamines. It can also lead to dyskinesia following administration and akinesia between doses.
Never administer to a patient on MAOIs or who also has melanoma.

224
Q

Describe the MOA of Selegiline.

A

Administered adjunctively with L-dopa. Selectively inhibits MAO-B, which preferentially metabolizes DA over NE and 5-HT thereby increasing the availability of dopamine. However, this may enhance the adverse effects of L-dopa.

225
Q

46 y.o. man presents to you complaining of frequent twitching in both of his arms and hands. You note +1 reflexes bilaterally at C7 as well as muscle strength 2/5 in both wrist extension and flexion. Upon further examination, you note pain and temperature sensation as well as eye movements remain intact. He is also oriented X3. What can you give this patient to help improve survival?

A

This is ALS. Riluzole decreases pysynaptic glutammate release and has been shown to modestly increase survival in these pts.

226
Q

Name 2 drugs used to slow the progression of MS.

A

IFN beta

Natalizumab

227
Q

A patient presents post-operatively with a fever of 103, HR of 160, RR of 32, muscle rigidity and acidosis. What is the MOA of the drug used to treat this condition?

A

This is malignant HTN treated with DANTROLENE.
Dantrolene prevents the release of calcium from the sarcoplasmic reticulum via blocking the opening of the ryanodine receptor.

This is also used in the tx of neuroleptic malignant syndrome (similar scenario with TCAs).

228
Q

A 45 y.o. man presents with pannus, radial deviation, and swan-neck deformity in both hands. He also happens to mention he has recently seen his primary for another disorder, who treated him with Omeprazole. What drug do you choose to give him, and what is its MOA?

A

This patient has RA and was recently treated for gastric ulcers. Thus, the first line (NSAIDS) would be avoided in this patient because prostaglandins protect the gastric mucosa. Celecoxib reversibly inhibits COX 2, found in inflammatory and vascular endothelium and mediates inflammation and pain. Since it spares COX-1, it helps maintain gastric mucosa in this patient and thus is used in patients with RA and OA and patients that suffer from gastritis or ulcers.

It should not be used in those with sulfa allergy.

229
Q

This drug used to treat osteoporosis and Paget’s disease of bone can cause corrosive esophagitis and osteonecrosis of the jaw. What is its MOA?

A

Bisphosphonates are pyrophosphate analogs that bind hydroxyapatite in bone, inhibiting osteoclast activity.

230
Q

A patient with a history of gout presents to you saying his antibiotic for his recent strep throat is causing him severe diarrhea and rash. What drug is he most likely taking for his gout, and why is it causing toxicity?

A

Probenecid inhibits the reabsorption of uric acid in PCT and is thus sometimes used in tx of chronic gout. However, it also inhibits the secretion of penicillin, thus the patient is experiencing increased serum levels of PCN.

Sometimes, this is actually beneficial and physicians do this on purpose to give the patient a lower dose of PCN (so the patient experiences less side effects), coadministering it with probenicid.

231
Q

This drug inhibits xanthine oxidase, thus decreasing the conversion of xanthine to uric acid. What 2 drugs known to have increased concentrations under administration of this drug?

A

Allopurinol increases the concentrations of azathioprine and 6-MP. It is used in chronic gout as well as lymphoma and leukemia to prevent tumor lysis-associated urate nephropathy.

Note: Febuxostat also inhibits xanthine oxidase.

232
Q

This antifungal is a cell wall synthesis inhibitor used in invasive aspergillosis.

A

Caspofungin

233
Q

These 2 antifungals bind ergosterol and form membrane pores.

A

Amphotericin B

Nystatin

234
Q

These 2 antifungals inhibit ergosterol synthesis

A

-azole

Terbinafine

235
Q

2 most common tx for onychomycosis

A

Terbinafine

-azoles

236
Q

This antifungal can cause arrhythmias and nephrotoxicity.

A

Amphotericin B

237
Q

This anti-fungal is important as it deposits in keratin-containing tissues

A

Griseofulvin

238
Q

These anti funagls inhibit hormone synthesis and cytochrome P450.

A

-azoles, particularly Ketoconazole

239
Q

These 2 antifungals can cause liver dysfunction

A

-azoles

Griseofulvin

240
Q

Treatment of cryptococcal meningitis in AIDS

A

IV Ampho B + flucytosine

241
Q

This antifungal is converted to fluorouracil, inhibiting DNA synthesis

A

Flucytosine

242
Q

This is the DOC for sporotrichosis

A

Itraconazole

243
Q

This antifungal can be used intrathecally for fungal meningitis

A

Amphotericin B

244
Q

Clinical use for Griseofulvin

A

Dermatophytes (ringworm, athlete’s foot)
Tinea capitis
Tinea unguium

245
Q

Tx for dry macular degeneration

A

Smoking cessation

Supplementation of anti-oxidants

246
Q

5 drug classes used in treatment of glaucoma

A 
Alpha agonists
B blockers
Diuretics
Cholinomimetics
Prostaglandins
247
Q

Tx of narcolepsy

A

Modafinil (treats daytime sleepiness – its a stimulant)

248
Q

SNRI used in tx of ADHD

A

Atomoxetine

249
Q

A patient comes in belligerent, demonstrating nystagmus and homicidal ideations. What drug do you use to treat this?

A

This is PCP overdose

Can use benzos and/or haloperidol to control seizures, agitation

250
Q

What weak opioid agonist is commonly used in chronic pain control prior to prescribing stronger opioids?

A

Tramadol

251
Q

4 Rx used to prevent relapse in recovering alcoholics

A

Disulfiram
Topiramate
Naltrexone
Acamprosate

252
Q

Drug used for heroin detoxification or long-term maintenance

A

Methadone

253
Q

What drug combination is often used in recovering heroin addicts to lower abuse potential?

A

Naloxone + buprenorphine

Naloxone is not active when taken orally so withdrawal symptoms occur only if injected

254
Q

MOA of Memantine and toxicity

A

This is an Alzheimer’s Rx that is an NMDA receptor antagonist, helping to prevent excitotoxicity mediated by Ca2+. It can cause dizziness, confusion, and hallucinations.

255
Q

MOA of Donepezil, Galantamine, and Rivastigmine

A

These are Alzheimer’s Rx that are all acetylcholinesterase inhibitors (remember, Alzheimer’s pts have low ACh).

256
Q

MOA and clinical use of Tetrabenazine and reserpine

A

Inhibit VMAT; limit dopamine vesicle packaging and release.

Used in Huntington’s (pts have elevated dopamine levels)

257
Q

Dopamine receptor antagonist used in the treatment of Huntington’s

A

Haloperidol

258
Q

MOA of Sumatriptan and effects

A

5-HT 1B/1D agonist.
Inhibits trigeminal nerve activation
Prevents vasoactive peptide release
Induces vasoconstriction

259
Q

3 Contraindications to Sumatriptan use

A

Pregnancy
CAD
Prinzmetal’s angina

260
Q

How can you treat a pregnant patient who suffers from migraines?

A

Opioids

261
Q

MOA of Selegiline

A

Selectively inhibits MAO-B, which preferentially metabolizes DA over NE and 5-HT, thereby increasing the availability of dopamine. It is an adjunctive agent to L-dopa in treatment of Parkinson’s disease.

262
Q

Which receptors do morphine, enkephalin, and dynorphin act at and what is their MOA?

A

These all act as agonists at opioid receptors (mu=morphine, delta=enkephalin, kappa=dynorphin) to modulate synaptic transmission by opening K+ channels and closing Ca2+ channels. This decreases synaptic transmission and inhibits the release of ACh, NE, 5-HT, glutamate, and substance P.

263
Q

DOC in status epilepticus

A

Benzos (lorazopam and diazepam)

264
Q

DOC in alcohol withdrawal to prevent delirium tremens

A

Benzodiazepines (Chlordiazepoxide)

265
Q

Potent inhaled anesthetic associated with hepatotoxicity

A

Halothane

266
Q

Inhaled anesthetic associated with nephrotoxicity

A

Methoxyflurane

267
Q

Inhaled anesthetic associated with seizures

A

Enflurane

268
Q

Only inhaled anesthetic not associated with malignant hyperthermia

A

Nitrous oxide

269
Q

Inhaled anesthetic used in brain surgery

A

Isoflurane

270
Q

Most common anesthetic used for endoscopy

A

Midazolam

271
Q

Which anesthetics are associated with amnesia?

A

Benzos

272
Q

Anesthetic used in kids that block NMDA receptors. What are some SE?

A

Ketamine – causes disorientation, hallucinations, and bad dreams.

“Special K” :)

273
Q

This anesthetic potentiates GABA-A and has a high triglyceride content.

A

Propofol (can lead to acute pancreatitis)

This is why its only used short term.

274
Q

A patient requires spinal anesthesia but tells you they are allergic to tetracaine. What drug can you administer instead?

A

Any of the amide anesthetics, which all have 2 I’s. Lidocaine, bupivacaine, etc.

275
Q

Order of nerve blockade in local anesthetics

A

Small myelinated> small unmyelinated > large myelinated > large unmyelinated

276
Q

Local anesthetic associated with severe CV toxicity

A

Bupivacaine

277
Q

Describe the MOA of succinylcholine.

A

This is the only depolarizing neuromuscular blocker. It is a strong ACh receptor agonist that produces sustained depolarization and prevents muscle contraction.

278
Q

MOA of Tubocurarine

A

This is a non depolarizing NM blocker. It is a competitive antagonist at the ACh receptor.

279
Q

Unexpected clinical use of phenobarbital

A

Can be used to treat Crigler Najjar type II as it increases liver enzymes.

280
Q

MOA of dantrolene

A

Inhibits release of calcium from sarcoplasmic reticulum of skeletal muscle thus stopping muscle contraction.

281
Q

DOC for partial (simple and complex) and tonic clonic seizures

A

Carbamazepine

282
Q

Common SE of epilepsy drugs

A 
Diplopia
Sedation
Ataxia 
Nystagmus
Dizziness
283
Q

5 AE of phenytoin

A 
Gingival hyperplasia
Hirsutism
Fetal hydantoin syndrome
CYP450 inducer
SJS
284
Q

Patient presents to you with her 2 year old saying that he is not progressing as well as other kids his age. You note a heart murmur as well as cleft lip. What drug did the mother most likely take during her pregnancy?

A

This is fetal hydantoin syndrome caused by phenytoin use during pregnancy. Causes MR, cleft lip, and cardiac defects.

285
Q

Name 4 drugs that cause Stevens Johnson syndrome.

A

Seizure drugs
Sulfonamides
-cillins
Allopurinol

286
Q

6 drugs that cause agranulocytosis

A 
Carbamazepine
Clozapine
Colchicine
PTU
Methimazole
Dapsone
287
Q

Which 3 anti epileptics are teratogens

A

Phenytoin
Carbamazepine
Valproic aicd

288
Q

2 anti epileptics associated with hepatotoxicity

A

Valproic acid

Carbamazepine

289
Q

5 Anti-epileptics that block Na+ channels

A 
Carbamazepine
Phenytoin
Lamotrigine
Topiramate
Valproic acid
290
Q

Which 5 anti-epileptics work by potentiating the inhibitory effects of GABA?

A 
Valproic acid
Phenobarbital
Benzos
Gabapentin
Topiramate
291
Q

3 high potency neuroleptics

A

Haloperidol
Fluphenazine
Trifluoperazine

More extrapyrimidal sx than low-potency.

292
Q

2 low potency neuroleptics

A

Chlorpromazine
Thioridazine

More anticholinergic, antihistamine, and a1-blockade effects than high-potency.

293
Q

MOA of all antipsychotics

A

Block dopamine D2 receptors (increase [cAMP])

294
Q

Toxic side effect associated with long-term use of antipsychotics

A

Tardive dyskinesia – stereotypic oral-facial movements. Often irreversible. :(

295
Q

Name 6 atypical antipsychotics.

A 
Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
Ziprasidone
296
Q

This anti-psychotic is reserved for refractory schizophrenia due to agranulocytosis.

A

Clozapine

297
Q

Atypical antipsychotic that may prolong QT interval

A

Ziprasidone

298
Q

Atypical antipsychotic associated with weight gain and increased risk of diabetes/metabolic syndrome

A

Olanzapine

299
Q

Benefits of atypical vs typical antipsychotics

A

Antipsychotics have little to no effect on negative sx of schizophrenia, whereas atypicals are can treat both positive and negative sx of schizophrenia.

300
Q

Atypical anti-psychotic that can be used in Parkinson’s pts who are suffering from psychosis as a result of their tx

A

Quetiapine

301
Q

Name 4 SSRIs

A

Fluoxetine
Paroxetine
Sertraline
Citalopram

Flashbacks paralyze senior citizens.

302
Q

Treatment for serotonin syndrome

A

Cyproheptadine (5-HT2 receptor antagonist)

303
Q

Symptoms of serotonin syndrome

A 
Muscle rigidity
Hyperthermia
CV collapse
Flushing
Diarrhea
Seizures
Confusion
Myoclonus
304
Q

Which drug class of anti-depressants are known to cause sexual dysfunction?

A

SSRIs

305
Q

SNRI used for fibromyalgia

A

Milnacipran

306
Q

SNRI used for weight loss

A

Sibutramine

307
Q

2 classic SNRIs

A

Venlafaxine

Duloxetine

308
Q

SNRI also indicated for diabetic peripheral neuropathy

A

Duloxetine

309
Q

Most common AE of SNRIs

A

Increased blood pressure

310
Q

TCA used in obsessive compulsive d/o

A

Clomipramine

311
Q

Symptoms of TCA overdose

A 
Convulsions
Coma
Cardiotoxicity
Hyperpyrexia
Respiratory depression
312
Q

MOA of tricyclic antidepressants as well as common suffixes

A

Block reuptake of NE and serotonin

Include -iptylines and -ipramines; also doxepin and amoxapine

313
Q

4 MAOIs including 1 selective MAO-B inhibitor

A

Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline (selective MAO-B inhibitor also used in Parkinson’s)

MAO Takes Pride in Shangai

314
Q

Class of anti-depressants that can cause hypertensive crisis with ingestion of tyramine

A

MAOIs (wine and cheese). Could also cause cardiac arrythmias and even hemorrhagic stroke.

315
Q

Antidepressant used in bedwetting for children

A

Imipramine (TCA)

316
Q

This antidepressant is known for NOT having any sexual SE.

A

Buproprion

-Also used in smoking cessation

317
Q

MOA and clinical use of Mirtazapine

A 
Alpha2 antagonist (increases release of NE, serotonin) and potent 5-HT2 and 5-HT3 antagonist.  
Can be used in anorexic or elderly patients to stimulate their appetite as well as depressed patients who are not sleeping well (induces sedation).
318
Q

MOA of Maprotiline

A

Atypical antidepressant that blocks NE reuptake

319
Q

MOA and serious AE of Trazodone

A

Inhibits serotonin reuptake
Can cause PRIAPISM (its called TrazoBONE because of this).

Nobody calls it that.

320
Q

Whats the difference in the MOA of Benzos vs Barbiturates?

A

Benzos increase GABA by increasing the frequency* of chloride channel opening.
Barbiturates increase GABA by increasing the duration* of chloride channel opening.

321
Q

What kind of drug is Bumetanide?

A

Loop diuretic

322
Q

What type of drug is metolazone?

A

Thiazide

323
Q

Which diuretic would you use to treat Acute pulmonary edema

A

Loop

324
Q

Which type of diuretics (2) would you use to treat mild to moderate CHF with expanded ECV?

A

Thiazide or loop

325
Q

Which typeo f diuretic would you use to treat edema associated iwth nephrotic syndrome?

A

Loop

326
Q

2 diuretics that cause acidemia

A

CAI (Decreases HCO3- reabsorption)
K+ sparing (aldosterone blockade prevents K+ secretion and H+ secretion. Additionally, hyperkalemia leads to K+ entering al lcells via H/K exchanger, in exchange for H+ exiting cells.)

327
Q

Which 2 diuretics cause alkalemia?

A

Loops and thiazides

Volume contraction causes increased AT II –> Increased Na/H exchange in proximal tubule –> Increased HCO3- reabsorption.
K+ loss leads to K+ exiting all cells via H/K exchanger in exchange for H entering cells.
In low K+ state, H (rather than K+) is exchanged for Na+ in cortical collecting tubule, leading to alkalosis and paradoxical aciduria.

328
Q

MOA and clinical use of aminoglycosides

A

Bactericidal – inhibit formation of initiation complex and cause misreading of mRNA. Also block translocation.
Used in severe gram negative rod infections.

329
Q

With what type of abx are aminoglycosides synergistic? Why are they ineffective against anaerobes?

A

Work synergistically with beta lactams.

Ineffective because they require O2 for uptake.

330
Q

MOA of Tetracyclines

A

Bacteriostatic – bind to 30S and prevent attachment of aminoacyl-tRNA.

331
Q

Which tetracyclines can be used in patients with renal failure?

A

Doxycycline

Minocycline

332
Q

Clinical uses ofr tetracyclines

A 
VACUuM THe BedRoom
Vibrio cholera
Acne
Chlamydia
Ureaplasma
M. pneumo
Tularemia
H. pylori
B. burgdorferi
Rickettsia
333
Q

What 3 things should you never take with tetracyclines?

A

Milk
Antacids
Iron-containing preparations

334
Q

MOA of macrolides

A

Inhibit protein synthesis by blocking translocation (macroSLIDES!)
Bind to 23S rRNA of 50S ribosomal subunit
Bacteriostatic

335
Q

Clinical uses for macrolides

A

Atypical pneumonia
URIs
STDs

336
Q

What is the clinical use and side effects of Chloramphenicol?

A

Meningitis

SE:Anemia (dose dependent)
Aplastic anemia
Gray baby syndrome

337
Q

What are the clinical uses for clindamycin?

A

Anaerobic infection
Aspiration pneumonia
Lung abscesses
MRSA

338
Q

Examples of and MOA of Streptogramins

A

Quinupristin/Dalfopristin
Synthesized by Streptomyces virginiae
Streptogramin A bnds peptiyl transferase of 50S ribosomal subunit
Streptogramin B: prevents protein chain extension

339
Q

Uses of Streptogramins and SE

A

Uses: MRSA, VRE, staph and strep skin infections
SE: hepatotoxicity, pseudomembranous colitis

340
Q

Macrolide associated with acute cholestatic hepatitis

A

Erythromycin

341
Q

AE of Macrolides

A 
MACRO
Motility issues
Arrhythmia due to prolonged QT
acute Cholestatic hepatitis (erythro)
Rash
eOsinophilia
342
Q

MOA of Clindamycin

A

Blocks peptide transfer (transpeptidation) at 50S ribosomal subunit
Bacteriostatic

343
Q

Prophylaxis for recurrent UTIs

A

TMP-SMX (or nitrofurantoin)

344
Q

Prophylaxis for gonorrhea (if a girl got raped and they do not know hx of rapist)

A

Ceftriaxone

345
Q

Prophylaxis for postsurgical infection due to S. aureus

A

Cefazolin

346
Q

Prophylaxis of strep pharyngitis in child with prior rheumatic fever

A

Oral penicillin

347
Q

Tx of VRE

A

Linezolid and streptogramins (quinupristin/dalfopristin)

348
Q

Drugs used in H. pylori triple therapy

A

PPI + amoxicillin + Clarithromycin

If allergic to amox, use metronidazole

349
Q

Clinical uses and side effects of polymyxins

A

Resistant gram negative infections
SE: neurotoxicity, nephrotoxicity*

*For this reason, used topically only.

350
Q

Name 5 classes of abx effective against Pseudomonas

A 
Fluoroquinolones
Cefepime
Aztreonam
Aminoglycosides
Extended spectrum penicillins
351
Q

Abx avoided in pregnancy

A 
Clarithromycin
Metronidazole (1st trimester)
Griseofulvin
Chloramphenicol
Sulfonamides
Fluoroquinolones
Tetracyclines
Aminoglycosides
Ribavirin
352
Q

Side effects of Ganciclovir

A

Leukopenia
Neutropenia (especially if AIDS pt taking ZDV)
Renal toxicity
Thrombocytopenia

353
Q

MOA of Foscarnet

A

Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme (inhibits viral DNA polymerase).
Does NOT require activation by viral kinase.

354
Q

SE of Foscarnet

A

Nephrotoxicity

355
Q

7 drugs or drug classes that cause anticholinergic SE

A 
Atropine
TCAs
H1 blockers
Low potency neuroleptics
Digoxin
Amantadine
Promethazine
356
Q

5 drugs that cause coronary vasospasm

A 
Cocaine
Amphetamines
Methamphetamines
Triptans
Ergotamines
357
Q

4 drugs that cause cutaneous flushing

A

Vanco
Niacin
Adenosine
Dihydropyridine CCBs

358
Q

6 drugs that cause torsades de pointes

A 
Class III antiarrhythmics
Class Ia anti-arrhythmics
Macrolides
Haloperidol
Chloroquine
Protease inhibitors
359
Q

5 drugs that can cause aplastic anemia

A 
Chloramphenicol
Benzene
NSAIDS
PTU
Methimazole
360
Q

2 drugs associated with thrombocytopenia

A

Heparin

H2 blockers

361
Q

9 things that can cause hemolysis in G6PD deficient patients

A 
INH
Sulfonamides
Primaquine
High dose ASA
Ibuprofen
Nitrofurantin
Dapsone
Fava beans
Naphthalene
362
Q

3 drugs that cause pulmonary fibrosis

A

Busulfan
Bleomycin
Amiodarone

363
Q

4 drugs that cause focal to massive hepatic necrosis

A

Halothane
Acetaminophen
Valproic acid
Amanita phalloides

364
Q

Drug that can cause acute cholestatic hepatitis, jaundice

A

Erythromycin estylate

365
Q

7 things associated with gynecomastia

A 
Spironolactone
Digitalis
Cimetidine
Estrogens
Ketoconazole
Marijuana
Chronic alcohol use
366
Q

2 drugs associated with hot flashes

A

Tamoxifen

Clomiphene

367
Q

3 drugs associated with hypothyroidism

A

Lithium
Amiodarone
Sulfonamides

368
Q

2 Rx that cause fat redistribution

A

Glucocorticoids

Protease inhibitors

369
Q

2 drugs responsible for gingival hyperplasia

A

Phenytoin

Verapamil

370
Q

4 drugs responsible for gout

A

Furosemide
Thiazides
Niacin
Cyclosporine

371
Q

8 drugs known for causing myopathies

A 
Fibrates
Niacin
Colchicine
Hydroxychloroquine
IFN-alpha
Penicillamine
Statins
Glucocorticoids
372
Q

8 drugs associated with Stevens Johnson syndrome

A 
Penicillin
Ethosuximide
Carbamazepine
Sulfa drugs
Lamotrigine
Allopurinol
Phenytoin
Phenobarbital
373
Q

2 drugs that can cause nephrogenic DI and how to treat this

A

Lithium and demeclocycline

TX: hydrochlorothiazine, indomethacin, amiloride if Lithium induced

374
Q

3 things that can cause proximal renal tubular acidosis

A

Fanconi syndrome

Expired tetracycline
Heavy metal exposure
Wilson disease

375
Q

3 drugs associated with interstitial nephritis

A

Methicillin
NSAIDs
Furosemide

376
Q

2 drugs associated with SIADH

A

Carbamazepine

Cyclophosphamide

377
Q

3 drugs associated with Parkinson like syndrome

A

Antipsychotics
Reserpine
Metoclopramide

378
Q

3 drugs that can cause increased lithium toxicity

A

Thiazides
ACE inhibitors
NSAIDs

379
Q

Antidote for copper, arsenic, and gold poisoning

A

Penicillamine

380
Q

TCA overdose antidote

A

Sodium bicarb

381
Q

Theophylline OD antidote

A

Beta blocker

382
Q

Methanol or ethylene glycol poisoning can be treated with?

A

Fomepizole

If unavailable use ethanol, dialysis

383
Q

2 drugs used to treat PCOS

A

Ketoconazole (inhibits steroid synthesis via inhibition of 17,20-desmolase) and Spironolactone, which prevents steroid binding.

Both cause gynecomastia and amenorrhea.

384
Q

How does flutamide differ from finasteride in relation to MOA and clinical use?

A

Flutamide is an inhibitor of androgens at the testosterone receptor and is used for prostatic adenocarcinoma. Finasteride is a 5 alpha reducase inhibitor that prevents conversion of testosterone to DHT and is used for BPH and male pattern baldness.

385
Q

What is a good choice of contraception for patients with MR?

A

Depo provera – associated with bone mineral density loss

386
Q

What is a contraindication to IUD use?

A

if patient has a high risk of STD

387
Q

Why does HRT work in treatment of osteoporosis?

A

Decreased osteoclastic activity (decreases bone breakdown)

388
Q

Best option for BC in mentally retarded patient

A

Depo

389
Q

Why is progesterone used in combination with estrogen during estrogen replacement?

A

Unopposed estrogen increases the risk of endometrial cancer.

390
Q

Pros of OCP use

A

Low failure rate
Decreases risk of endometrial and ovarian cancers
Decreases risk of ectopic pregnancy

391
Q

MOA of drug that is used to treat endometriosis and hereditary angioedema

A

Danazol - synthetic androgen that acts as partial agonist at androgen receptors

392
Q

How does the dosing of leuprolide affect its physiologic impact?

A

Puts women in synthetic menopause because it is a GnRH analog with agonist properties when used in pulsatile fashion. Antagonist properties when used in continuous fashion (downregulates GnRH receptor in pituitary –> decreased FSH/LH).

393
Q

MOA of terbutaline

A

Beta 2 agonist that relaxes the uterus; reduces premature uterine contractions

394
Q

MOA of drug used to treat infertility and PCOS

A

Clomiphene – partial agonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and increased release of LH and FSH from pituitary which stimulates ovulation.

395
Q

MOA of mifepristone

A

Competitive inhibitor of progestins at progesterone receptors –causes termination of pregnancy

396
Q

3 commonly used tocolytics

A

Magnesium sulfate
Ritodrine
Terbutaline

397
Q

A 58 y.o. post-menopausal woman is on Tamoxifen. What is she at increased risk of acquiring and what is this drugs MOA?

A

Endometrial cancer

Tamoxifen is an antagonist on breast tissue and used to treat and prevent recurrence of ER positive breast cancer.

398
Q

Describe the MOA of anastrozole/exemestane.

A

Aromatase inhibitors used in post-menopausal women with breast cancer.

399
Q

3 short acting benzodiaepines

A

Triazolam
Oxazepam
Midazolam

Because they are short-acting, they have higher addictive potential.

400
Q

Vitamin that should never be administered with levodopa

A

B6. It increases the peripheral metabolism of levodopa, thus decreasing its effects (less enters CNS.)

401
Q

3 drugs used in treatment of acute manic episode

A

Mood stabilizers

Lithium
Valproic acid
Carbamazepine

Often administered with an atypical antipsychotic like olanzapine.

402
Q

3 drugs used to treat oculogyric crisis

A

Oculogyric crisis is an acute dystonic reaction to anti-psychoticcs such as haloperidol and fluphenazine. Other sx include restlessness, agitation, or a fixed stare. It can be treated with diphenhydramine, benztropine, or amantadine.

DIT FACTS (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions