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Boards > Pharm 2 - Kaplan > Flashcards

Pharm 2 - Kaplan Flashcards

1
Q

Statins…side effects

A 
Myalgias
Rhabdomyolysis (if increased [ ] or w/ Gemfibrozil)
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2
Q

Bile acid sequestrants…drugs?

Bad things?

When NOT to use?

A

Cholestipol, Cholestiramine

Increased VLDL and TGs
Malabsorption of lipid-soluble vitamins
Hyperglycemia

Hypertriglyceridemia

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3
Q

Niacin - MoA

Side effect? How to treat?

A

Inhibits VLDL synthesis

Flushing (aspirin)

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4
Q

Fibrates - MoA

Use?

A

Increase PPAR-alpha –> increased lipoprotein lipases

Hypertriglyceridemia

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5
Q

Ezetimibe - MoA

A

Prevents cholesterol absorption, decreasing LDL

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6
Q

Orlistat - MoA

Use?

A

Inhibits pancreatic lipase –> decreased TG breakdown

Weight loss

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7
Q

Only drugs besides Benzos that can be inhibited by Flumazenil

Why?

A

Zolpidem, Zaleplon

Also block the BZ1 receptor on the GABA-A receptor

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8
Q

Buspirone - MoA

Importance?

Problem?

A

Serotonin-1A receptor partial agonist

NO SEDATION (not GABA)

Slow onset (few weeks)

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9
Q

2 pathways to treating anxiety (w/ difference)

A

GABA agonists - FAST

Serotonin agonists - SLOW

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10
Q

2 pathways to treating sleep disorders

A 
Melatonin agonists (Ramelteon)
GABA agonists (Zolpidem, Zaleplon, BZs)
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11
Q

Ethylene glycol – metabolic byproducts

Damage?

A

Glycoaldehyde –> glycolic acid –> oxalic acid

Nephrotoxicity

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12
Q

Methanol – metabolic byproducts

Damage?

A

Formaldehyde –> formic acid

Ocular damage

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13
Q

Commonality between ethanol, methanol, and ethylene glycol

Cheap treatment for the later 2? Why?

A

All use alcohol dehydrogenase

Ethanol = greatest affinity for the enzyme

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14
Q

Fomepizole - MoA

Advantage?

What else might be needed?

A

Long-acting inhibitor of alcohol dehydrogenase

No formation of acetaldehyde –> no hangover S/S

Dialysis to get rid of the substance floating around

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15
Q

Disulfiram - MoA

A

Inhibitor of acetaldehyde dehydrogenase –> accumulation of acetaldehyde –> hangover symptoms

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16
Q

Drug that causes disulfiram effect

A

**Metronidazole (Chlorpropamide) (Griseofulvin)

17
Q

Treatments for UTIs

A

Amoxicillin
Cephalosporins
Nitrofurantoin
TMP-SMX

18
Q

Sirolimus…MoA

How does it differ from tacrolimus and cyclosporin?

Side effects?

A

Inhibits T-cells by binding mTOR (serine-threonine kinase)

Limited neuro and nephrotoxicity

Hypertriglyceridemia, hypercholesterolemia

19
Q

Empiric treatment protocols for community acquired strep pneumonia (3)

A

If healthy – macrolide or doxycycline
If comorbidity – macrolide, PLUS fluoroquinolone or beta-lactam
If CURB-65 – fluoroquinolone, or beta-lactam + macrolide

20
Q

Serotonin receptor…

  • 1A partial agonist
  • 1B/1D agonist
  • 2 antagonist
  • 3 antagonist
A

Buspirone (depression)

-triptans (migraine abortion)

Atypical antipsychotics, Cyproheptadine

-setrons (emesis)

21
Q

Treatment of acute cholelithiasis (w/ MoA)

A

Ursodiol (ursodeoxycholic acid) – concentrates in bile, decreases bile cholesterol, hepatic cholesterol production, and cholesterol absorption

22
Q

Famotidine - MoA

A

H2 antagonist –> decreased gastric acid secretion

23
Q

Alosetron - MoA and Use

Adverse effect?

A

5-HT3 antagonist – diarrhea-predominant IBS

Ischemic colitis

24
Q

Sulfasalazine - explain

A

Split by colon bacteria into 5-ASA and sulfapyridine

  • 5-ASA = ulcerative colitis
  • SP = rheumatoid arthritis
25
Q

Mesalamine - MoA

A

5-ASA for Crohn’s Disease

26
Q

MoA and Use for…

  • Alprostadil
  • Misoprostol
  • Dinoprostone
  • Epoprostenol
  • Latanoprost
  • Carboprost
A 
A = PGE1 - vasodilation for ED
M = PGE1 - cervical ripening and induction
D = PGE2 - cervical ripening and induction
E = PGI2 - vasodilation for pulmonary hypertension
L = PGF2a - glaucoma
C = PGF2a - uterine SM contraction for abortion and hemorrhage
27
Q

Nitroprusside - side effects

A

Hypotension
Cyanide poisoning
Methemoglobin

28
Q

ALS…

  • Drugs for spasticity treatment?
  • Drug for life prolongation?
A

Spasticity = Baclofen (GABA-B agonist), alpha-2 agonists

Life = Riluzole (glutamate and Na+ antagonist –> decreased excitatory toxicity)

29
Q

Recently started a new drug…

  • Fever
  • Impaired autonomic stability
  • Muscle rigidity and breakdown
  • Myoglobinuria
  • Altered mental status

Treatment?

A

Neuroleptic malignant syndrome (typical antipsychotics)

Dantrolene, Amantadine, or Bromocriptine

30
Q

Treatment for hepatic encephalopathy

A

Lactulose – converted to lactic acid, causing acidotic colon and excretion of NH3 as NH4+

Rifamixin or Neomycin – destroy colonic urease-producing bacteria

31
Q

Effects of glucocorticoids on calcium and bone

A
  • Increase osteoclasts (bone breakdown)
  • Decrease Ca++ channels in intestine
  • Oppose Vitamin D
  • Decrease reabsorption in kidney
32
Q

Drug for inhibition of RSV

A

Palivizumab (anti-RSV fusion protein antibody)

33
Q

Jarisch-Herxheimer reaction…treatment?

Explain

A

Anti-TNF drug (Infliximab)

Endotoxin –> direct macrophage activation –> IL-1, IL-6 (pyrogens), and TNF-alpha

34
Q

2 functions of metoclopramide (w/ mechanisms)

A
  • Anti-emetic (D2 antagonist in area postrema)

- Pro-motility (enhances response to acetylcholine in intestines)

35
Q

How exactly do furosemide and digoxin interact?

A

Digoxin binds to the K+ binding place on the Na/K ATPase, thus as serum K+ decreases from furosemide, digoxin binds more easily

36
Q

Acyclovir…MoA

Requires what?

A

Inhibits viral DNA polymerase

Phosphorylation by viral thymidine kinase (Herpes Helps) or by the host thymidine kinase (all other target viruses)

37
Q

Drugs that can lead to hypertensive emergencies

A

Cocaine, Amphetamines, PCP, MAOIs, Triptans

38
Q

Psychiatric
Hepatic
Neurologic
Ring around iris

Treatment?

A

Wilson’s disease (Copper accumulation)

Penicillamine, trientine (chelation)

39
Q

Drugs that can cause disulfiram-like reaction

A

Metronidazole
Some cephalosporins
Griseofulvin
1st gen sulfonylureas

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