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Pharm Flashcards

1
Q

Dimercaprol (Bal) and Dimercaptosuccinic acid (DMSA)

A

Bal treatment for lead, arsenic, mercury, and gold poisoning

DMSA is indicated in for lead poisoning in children with blood level measured above 45 µg/d

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2
Q

Pyridostigmine

A

achetacholinesterase inhibitor used for myasthinia gravis

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3
Q

Warfarin

A

Inhibits vitamin K epoxide reductase, which inhibits y-carboxylation of glutamic acid residues of 2,7,9,10,C(remember C is anticoagulant but is reduced early in warfarin tx due to short half life so results in early hyper coagulable state with unchecked 2,7,9,10),S. Remember, WEPT –> Warfarin, Extrinsic, PT uses: AFIB, tx and prophylaxis of DVT Teratogenic. NOT USE IN PREGNANCY (can use heparin)

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4
Q

Abx associated with tendon rupture (achilles tendinitis)

A

Floroquinolones (ciprofloxacin)

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5
Q

Imatinib (Gleevec)

A

Gleevec. A tyrosine kinase inhibitor used to treat CML

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6
Q

Aspirin mechanism and a side effect

A

Irreversibly binds COX1/COX2. This prevents arachidonic acid –> prostaglandins. Potential side effect of tinitis

uncouples oxidative phosphorylation and disrupts the electron transport chain (reason that cuases Reye syndome in kiddos who take ASA for infleunza or other illness)

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7
Q

Arcabose

A

inhibit intestinal border alpha-glucosidase used in T2 DM. Delays carbohydrate hydrolysis and glucose absorption

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8
Q

Chlorpropramide

A

first generation sulfonylurea used to treat T2 DM. Closes K channel on B cells in pancreas and cause increase release of insulin. Side effect: can cause anatabuse-like (disulfuram) reaction

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9
Q

Levothyroxine (synthroid)

A

thyroid hormone replacement for hypothyroid and myxedema. Can be used off-label as weight loss supplement Side effects: weight loss, tachycardia, tremor, arrhythmia

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10
Q

Tolbutamide

A

first generation sulfonylurea sed to treat T2 DM. Closes K channel on B cells in pancreas and cause increase release of insulin. Side effect: antabuse-like reaction

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11
Q

Drugs that can cause antabuse-like reactions

A

metronitazole (damages DNA: flagyl), tolbutamide (sulfonylurea), Chlorpropramide (sulfonylurea), chloramphenicol (50S abx), and some cephalosporins

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12
Q

Metformin

A

Go to drug for T2 DM. Class biguanides

Mechanism: decrease gluconeogenesis, decrease glycogenolysis, increase peripheral glucose uptake (via increased skeletal muscle glycogenesis)

Side effect: can cause lactic acidosis (mudpiLes)

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13
Q

Retuximab

A

anti CD20 antibody (found on most B-cell neoplasms

Remember CD20 is found on B-cells

use in B-cell non-hodgkin lymphoma, CLL, RA, ITP

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14
Q

Allopurinol (3 uses) (Zyloprim)

A
  1. Used in the treatment of chronic gout. Inhibits Xanthine Oxidase to prevent production of uric acid
  2. Also can be used to treat tumor lysis syndrome (esp seen in ALL and Lymphoma)
  3. Also used in treatment of Lesch-Nyhan syndrome Side effects: SJS, rashes esp seen when using chemo drugs, Dress syndrome (eosinophilia)
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15
Q

Infiximab (Remicade)

A

TNF-alpha inhibitor used in PAIR

treatment for ankylosing spondylitis. this is an immunosuppressant and can raise dormant opportunistic infections such as TB. Need to get PPD first Anti TNF-alpha monoclonal antibody Other Uses: IBD, RA, psoriasis

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16
Q

Tacrolimus

A

Calcineurin inhibitor; binds FK506 binding protein (FKBP).

Blocks T-cell activation by preventing IL-2 transcription (prevent ALL T-cells from being activated)

used in transplant rejection

HIGHLY NEPHROTOXIC

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17
Q

Treatment of Actinomyces Isralii (gram positive rod that can cause oral and facial abscesses)

A

Penicillin G (blocks bacterial wall synthesis)

  • Gram + filamentous rod
  • infection associated with jaw trauma
  • formation of sinus tracts
  • obligate anaerobe
  • yellow sulfur granules
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18
Q

Mesna

A

Give with cyclophosphamide (alkalating agent cross-link N-7)

for prevention of hemorrhagic cystitis

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19
Q

Dabigatran (Pradaxa)

A

Direct thrombin inhibitor used as PO anticoagulant in the setting of AFIB. Does NOT require weekly monitoring.

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20
Q

Lamotrigine (Lamictal)

A

Antiepileptic used in both focal and generalized seizures, blocks voltage gated Na channels. **KNOWN TO CAUSE STEVENS JOHNSON SYNDROME** must be titrated slowly to avoid

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21
Q

Ribavirin

A

Used to treat Hep C

  • Also used in RSV -Inhibits synthesis of guanine nucleotides
  • Side effect: Hemolytic Anemia, SEVERE teratogen
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22
Q

Reversal for heparin

A

Protamine Sulfate

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23
Q

Alendronate

A

Osteoporosis drug. Works by binding hydroxyapetitie and inhibiting osteoclast activity Side effect: erosive esophagitis and can cause osteonecrosis of the jaw

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24
Q

Dantrolene

A

used in malignant hyperthermia and NMS. Inhibits release of calcium from sarcoplasmic reticulum, thus preventing muscle contraction

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25
Q

D-penacillamine

A

Copper chelating agent used for Wilson’s Disease

-works as a chemical antagonist (binds directly to the agonist, thus preventing it from binding to its target)

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26
Q

Carbidopa-Levodopa

A

Used to treat parkinson disease. Increases DA level in CNS Carbidopa: blocks peripheral conversion of l-DOPA to dopamine by inhibiting DOPA decarboxylase

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27
Q

Clindamycin

A

Blocks 50s subunit. Good choice for dental abscesses Can cause C-Diff

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28
Q

Sulfasalazine

A

Used for UC and Crohn Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory). Activated by colonic bacteria.

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29
Q

Doxorubicin

A

antitumor antibiotic that generates free radicals and noncovalently intercalates into DNA Side Effects: Can cause Doxorubicin induced cardiomyopathy (DCM) and heart failure

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30
Q

Chloramphenicol

A

blocks peptidyltransferase at 50s ribosomal subunit (not used in USA very often) Side effects: aplastic anemia, grey baby syndrome

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31
Q

Drugs associated with “lupus-like syndrome”

A

Having Lupus is SHIPP-E

Sulfa-drugs

Hydralazine (HTN, HF)

INH (TB)

Procainamide (1A sodium channel blocker)

Phenytoin (dilantin, epilepsy, CYP450 drug)

Entanarcept (TNF-alpha inhibitor)

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32
Q

cyclosporine and tacrolimus (FK506)

A

both are used prophylactically for transplant rejection to prevent graft-vs-host

Cyclosporine: calcineurin inhibitor binds cyclophilin, prevents IL-2 transcription. Also used in psoriasis and RA.

Tacrolimus: calcineurin inhibitor, binds FK506 binding protein, prevents IL02 trancription

**BOTH ARE HIGHLY NEPHROTOXIC**

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33
Q

All Trans Retinoic Acid

A

used to treat acute promyelocytic leukemia (APML)

t(15:17) 65 year old with Auer Rods

  • which often presents as a pt in DIC
  • mechanism: rapidly induces tumor cell differentiation
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34
Q

Azathioprine

A

antimetabolite precursor of 6-mercaptopurine. Interferes with purine nucleotide synthesis Preventing organ rejection, rheumatoid arthritis, IBD, SLE Side Effects: metabolized by xanthine oxidase; thus both have toxicity with allopurinol

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35
Q

micafungin (similar to capsofungin)

A

inhibit carbohydrate synthesis in fungal cell wall (inhibit synthesis of Beta-glucan) Side effects: GI, flushing (by histamine release)

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36
Q

Dextromethorphan

A

Short term cough suppressant (antitussive) Antagonizes NMDA glutamate receptors. Synthetic codeine analog Side effects: mild opiate, minimal abuse potential. May cause serotonin syndrome if taken with other serotonic agents

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37
Q

Oseltamavir, Zanamivir

A

Inhibit influenza neuraminidase and decrease release of progeny virus Used to treat both Influenza A and B

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38
Q

Sumatriptan

A

Used for: migraine HA, cluster HA

Mechanism: 5HT 1B/1D agaonist. Causes vasoconstriction, inactivation of trigeminal activation.

Side effects: can cause coronary vasospasm. contraindicated with pts with CAD or prinzmetal angina (angina at rest secondary to coronary artery spasm)

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39
Q

Bevacizumab

A

anti VEGF. slows angiogenesis used in Colorectal cancer, renal cell carcinoma, glioblastoma

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40
Q

bromocriptine/cabergoline

A

dopamine agonist used for prolacinomas (remember that most antipsychotics ie dopamine antagonist can cause prolactin secretion

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41
Q

abciximab (reopro)

A

antiplatelet agent for prevention of ischemic complications in patients undergoing percutaneous coronary intervention Monoclonal IgG antibody targets Glycoprotein IIA/IIIB receptors on platelets

Side effects: bleeding, drug induced thrombocytopenia

No target if pt has Glanzmann (defect in GpIIb/IIIa)

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42
Q

clopidogrel (plavix), ticlopidine, prasugrel (effient)

A

ADP receptor inhibitor (irreversible). This prevents expression of GP IIa/IIIb use in Acute coronary syndrome, Acute MI, decrease incidence of thrombotic stroke Side effects: neutropenia (esp in ticlopidine, thus need for CBC every few weeks to avoid agranulocytosis), TTP

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43
Q

dipyridamole, Cilostazol

A

Phosphodiesterase inhbitors –> increased cAMP –> PKA resulting in impaired platelet fxn

Cilostazol (drop the ball) also causes arterial vasodilation Side effects: nausea, HA, facial flushing

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44
Q

treatment of coronary stent thrombosis

A

dual platelet therapy 1. ADA antagonist –> clopidogrel 2. COX 1 and COX 2 inhibitor –> ASA

45
Q

infliximab/adalimumab (humira)

A

Used to treat IBD, rheumatoid arthritis, ankylosing spondylitis, psoriasis

used to treat PAIR

Mechanism: Soluble TNF-α inhibitor

46
Q

cyproheptadine

A

Used to treat serotonin syndrome

Mechanism: 5-HT2 receptor antagonist

47
Q

propylthiouracil

A

used to treat hyperthyroidism Mechanism: inhibits thyroid peroxidase AND 5’ deiodinase (interferes with the synthesis and peripheral conversion of thyroid hormone) -safe to use in pregnancy

48
Q

Trazodone

A

5HT2 receptor antagonist used primarily for insomnia, as high doses are needed for antidepressant effects

-ALSO an alpha-1 adrenergic antagonist, which gives the sedating effect, which works via Gq

Rare side effect is priaprism

TraZZZobone

49
Q

metoclopramide

A

An antiemetic used for the treatment of gastroperesis. Mechanism: principally a D2 antagonist; antagonism of D2 in the chemoreceptor trigger zone (CTZ) of the CNS leads to the antiemetic effects.

Side Effects: Antagonism of D2 also leads to drug-induced Parkinsonism, which presents with akathisia, focal dystonia, and tardive dyskinesia.

50
Q

Quinidine

A

exhibits both class Ia and class III anti-arrhythmic properties by blocking both fast inward Na+ channels and K+ channels, respectively

  • By blocking K+ channels, quinidine prolongs the repolarization phase (phase 3) of the action potential, thereby lengthening the QT interval.
  • quinidine also prolongs phase 0. However, phase 0 contributes very little to the overall duration of the cardiac action potential

Side effect: HA, tinitus

51
Q

Gemfibrozil

A

belongs to a class of lipid drugs called fibrates

known to produce the greatest reduction in triglyceride levels

Activate PARA-alpha to induce HDL synthesis

Side effect: myopathy, cholesterol gallstones

52
Q

Digoxin (mechanism and overdose)

A

Cardiac glycoside that is used in the treatment of heart failure. It directly inhibits the Na+/K+ ATPase, leading to indirect inhibition of the cardiac Na+/Ca2+ exchanger. Inhibition of the Na+/Ca2+ exchanger, in turn, increases intracellular Ca2+, thereby exerting a positive inotropic effect

  • slows HR by inducing vagal stimulation
  • overdose causes a blurry yellow vision, arrhythmias, and hyperkalemia. Digoxin slows conduction through the AV node, accounting for the prolonged PR interval
  • cleared by kidney, so must be dosed accordingly in renal impaired pts

Tx for overdose: Digoxin immune Fab

53
Q

Active TB treatment and a major side effect

A

RIPE for treatment

R: Rifampin

I: Isoniazid (peripheral neuropathy secondary to vitamin B6 inactivation, which can present as tingling or numbness of the fingers and toes, usually in a “stocking glove” distribution)

P: pyrazinamide

E: ethambutol (optic neuropathy. Red-green color blindness)

54
Q

succinylcholine

A

depolarizing paralytic

Mechanism: Succinylcholine acts by binding to the postsynaptic nicotinic acetylcholine (nACh) receptors and producing a sustained depolarization. The depolarization opens sodium channels, but after a brief period of time, continued depolarization will cause inactivation of the sodium channels, producing accommodation. The result is complete muscle paralysis.

55
Q

Fomepizole

A

inhibits alcohol dehydrogenase and is an antidote for methanol or ethylene glycol poisoning.

-Historically, ethanol was used to treat methanol poisoning, but is no longer commonly used in settings where fomepizole is available. Ethanol acts as a competitive inhibitor of alcohol dehydrogenase by occupying enzyme active sites that may otherwise be used to metabolize methanol, thereby preventing methanol metabolism into formic acid.

56
Q

Ketoconazole

A

imidazole antifungal medication used to treat infections caused by candida, histoplasma, coccidioides, and blastomyces.

-It is an inhibitor of the cytochrome P450 (CYP450)

ALSO blocks cholesterol desmolase that converts cholesterol –> pregnenolone in adrenal gland (essentially blocks mineralcorticoid, cortisol, androgen production)

57
Q

Riluzole

A

decrease presynsaptic glutamate release (glutamate antagonist)

-used in the treatment of Lou Gehrig Disease (ALS)

58
Q

Benztropine

A

Antimuscarinic; used for parkinsons improves tremor and rigidity but has little effect on bradykinesia

Also used to treat the extrapyramidal side effects of antipsychotic (D2 blockers)

“Park your Benz”

59
Q

NIacin

A

used to raise HDL levels.

Side effects: flushing typically manifests as facial erythema, warmth, and pruritus. These episodes usually occur shortly after taking the niacin.

Niacin potentiates dermal Langerhan cell release of prostacyclin into capillaries, causing cutaneous vasodilation.

-Taking aspirin (which reduces prostacyclin levels) shortly before taking niacin has been shown to reduce this side effect.

60
Q

Isotrentoin (accutane or roaccutane)

A

Vitamin A derivative used to treat acne.

REQUIRED to have a negative pregnancy (beta-HCG) test and must use two forms of contraception if they are sexually active

Severe teratogenic effects such as cleft palate, cardiac abnormalities, and other birth defects

61
Q

misoprostol

A

prostaglandin E1 analog and works to protect the gastric mucosa. It exerts its protective effects by increasing production of gastric mucous and decreasing production of gastric acid.

ALSO, maintanence of Patent Ductus Arteriosus (because prostaglandin analog…PGE2 KEEEPS the PDA open)

-It is often used to prevent peptic ulcers in patients that require long-term use of nonsteroidal anti-inflammatory drugs

ALSO can be used to ripen the cervix and induce labor or used in ABORTIONS (with mifipristone)

62
Q

Cimetidine, ranitidine, famotidine, nizatidine.

A

reversibly blocks histamine H2 receptors in order to decrease proton secretion from gastric parietal cells, leading to decreased acidity (increased pH) in the stomach. Cause inhibition of Gs

  • It is used to treat peptic ulcers, gastroesophageal reflux, and gastrititis
  • Cimetidine is a potent inhibitor of cytochrome P-450

Take H2 blockers before you dine. Think “table for 2” to remember H2.

63
Q

Bleomycin (mechanism, use, and toxicity)

A

mechanism: Antitumor antibiotic that induces free radical formation –> breaks in DNA strands.

Use: Testicular cancer, Hodgkin lymphoma.

Toxicity: Pulmonary fbrosis, skin hyperpigmentation, mucositis

64
Q

Disulfuram (antabuse)

A

inhibits acetaldehyde dehydrogenase (acetaldehyde accumulates, contributing to hangover symptoms).

65
Q

absent seizures treatment and side effects to be aware of

A

first line: ethosuximide (EFGHIJ—Ethosuximide causes Fatigue, GI distress, Headache, Itching, and Stevens-Johnson syndrome

second line: valproic acid (rare but fatal hepatotoxicity)

66
Q

insulin overdose (what is the drug when cannot swallow simple carbs/juice, and what is the mechanism of this drug)

A

Glucagon

Mechanism: binding of glucagon to its receptor activates adenylate cyclase, which increases the intracellular concentration of cAMP and ultimately promotes glycogenolysis and gluconeogenesis

67
Q

Treatment of Cystic Fibrosis

A

N-acetylcysteine: loosen mucus plugs (cleaves disul de bonds within mucus glycoproteins)

Dornase alfa (DNAse): can also be used to thin mucus

Ivacaftor: CFTR modulator that enhances the opening of the CFTR ion channel.

68
Q

Methyelene Blue

A

treatment for methemoglobinemia

Converts Fe3+ –> Fe 2+ (which can bind oxygen)

69
Q

bisphosphonate

A

Alendronate, other -dronates, used for osteoporosis

Mechanism: Pyrophosphate analogs; bind hydroxyapatite in bone, inhibiting osteoclast activity

Side effects: osteonecrosis of jaw, esophagitis

70
Q

isoniazid

A

Used in treatment of TB.

synthesis of mycolic acids. Bacterial catalase- peroxidase (encoded by KatG) needed to convert INH to active metabolite.

CYP450 inhibitor

Toxicity: Neurotoxicity, hepatotoxicity. Pyridoxine (vitamin B6) can prevent neurotoxicity.

“INH Injures Neurons and Hepatocytes”

71
Q

Hypertensive emergency 1st line treatment

A

Sodium Nitroprusside

Mechanism: short acting; cGMP via direct release of NO.

Toxicity: Can cause cyanide toxicity (releases cyanide). Can give sodium thiosulfate to avoid the cyanide toxicity

72
Q

Zero order elimination drugs

A

PEA

Phenytoin

Ethanol

ASA

  • Rate of elimination is constant regardless of Cp.
  • Cp decreases linearly with time
73
Q

Drugs that cause agranulocytosis

A

“Gangs CCCrush Myeloblasts and Promyelocytes”

Ganciclovir (cytomegalovirus)

Clozapine (atypical antipsychotic)

Carbamazepine (seizures, increase Na inactivation)

Colchicine (acute gout)

Methimazole (hyperthyroid)

Propylthiouracil (hyperthyroid)

74
Q

cocaine mechanism and presentation

A

Blocks reuptake of NE, DA, 5HT

Impaired judgement, pupillary dilation, hallucinations, paranoid ideas

Can cause coronary vasospasm

NEVER give β-blockers if cocaine intoxication is suspected (can lead to unopposed α1 activation and extreme hypertension).

75
Q

finasteride, dutasteride

A

Finasteride- Type II

Dutastride- Type I and II

(I: non-genital skin, liver, bone. II: urogenital tissue, hair follicles)

5-alpha reductase inhibitors inhibit conversion of testosterone to Dihydrotestosterone

-useful in BPH and male pattern baldness

Adverse: decreased libido, ejaculatory or erectile dysfunction

76
Q

Leuprolide

A

GnRH analog with agonist properties
when used in pulsatile fashion; antagonist properties when used in continuous fashion (downregulates GnRH receptor in pituitary FSH/LH).

use: prostate cancer, precocious puberty in boys

Adverse: HA, nausea, hypogonadism with prolong treatment. If use for prostate cancer, will have FLARE SYMPTOMS due to initial rise in Testosterone causing BONE PAIN and UTI sx

77
Q

Bicalutamide, Flutamide

A

Androgen receptor antagonist

Use: hirsutism of polycystic ovarian syndrome, prostate carcinoma.

Adverse: androgen deprivation effects (loss of libido, gynecomastia), transient abnormal LFT

78
Q

Spironolcatone

A

Inhibits steroid binding, 17α-hydroxylase, and 17,20-desmolase. (androgen receptor antagonist)

(ALSO aldosterone antagonist in cortical collecting tubule used as a K sparing diuretic. Used in HF due to aldosterone receptors on heart to avoid remodeling of cardiac tissue)

  • used to treat polycystic ovarian syndrome to reduce androgenic symptoms.
  • side effects of gynecomastia and amenorrhea, hyperkalemia
79
Q

Enfuvirtide and Maraviroc

A

Enfuvirtide: Binds gp41, inhibiting viral entry.

  • Both used in HAART therapy for HIV.
  • Maraviroc binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120.
80
Q

phenoxybenzamine

A

non-selective alpha-blocker used in the treatment of a Pheochromocytoma

(remember triad of HA, diaphoresis, tachycardia)

  • used preoperatively to prevent hypertensive crisis.
  • can give Bblockers AFTER*** alpha blockers, or use a Calcium channel blocker instead
  • surgery is ultimate solution to pheo
81
Q

Folate (B9) deficiency can be caused by what durgs?

A

phenytoin, sulfonamides, methotrexate

82
Q

Amantadine

A

increase dopamine release and increase dopamine reuptake; also used as an antiviral against in influenza A (not really used anymore, unless specific indication) and rubella

toxicity = ataxia, livedo reticularis (mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin)

83
Q
A
84
Q

Treatment of Addison’s Disease

A

exogenous glucocorticoids (dexamethasone, hydrocortisome), and mineralcorticoids (fludrocortisone)

85
Q

Drug that reduces the transmission of HIV from mother to child

A

Zidovudine (ZDV) (Retrovir) reduces vertical transmission by >70%

Competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain (lack a 3′ OH group)

86
Q

Diethylstilbestrol (DES)

A

Old drug that used to be used during pregnancy.

  • Leads to clear cell adenocarcinoma or adenosis and abnormal smooth muscle leading to ectopic pregnancy
  • Mothers with DES exposure increased risk breast carcinoma

Stoped using in 1970’s

-no effect in sons

87
Q
A
88
Q

Buproprion (Welbutrin, Zyban)

A

atypical antidepressant that is also used for smoking cessation

Toxicity: stimulant effects, seizures in anorexic/bulimic pts.

89
Q

Griseofulvin

A
  • an antifungal agent that binds to alpha/beta tubulin dimers and disrupts the spindle apparatus (interferes with microtubule function)
  • Oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
  • Teratogenic, carcinogenic, confusion, headaches, cytochrome P-450 INDUCER and warfarin metabolism.
90
Q

Fenoldopam

A

D1 agonist (increases cAMP) used to treat hypertensive emergencies

NO effect on alpha or beta**

-Causes coronary, peripheral, renal, and splanchnic vasodilation. BP, natriuresis (leading to increased sodium and H20 excretion)

91
Q

Treatment of Malignant Hypertension (5)

A
  • Nitroprusside (vasodilation via NO –> cGMP)
  • Fenoldapam (D1 agonist)
  • Clevidipine (CCB)
  • Labetalol (non-selective B-blocker)
  • Nicardipine (CCB)
92
Q

Calcium Channel Blockers dihydropyridines vs non-dyhydropyridines

A
  • dihydropyridines–> block L-Type calcium channels in SMOOTH muscle. ex: Nifedipine
  • non-dyhydropyridines –> block L-type calcium channels in CARDIAC muscle. ex: verapamil, diltiazam. Decrease cardiac output by decreasing intracellular calcium influx
93
Q

Side effect of nitroprusside

How to avoid?

A

used to treat a hypertensive emergency, can result in Cyanide toxicity. Causes inhibiton if mitochondrial cytochrome oxidase in the electron transport chain

Add thiosulfate to avoid problem

94
Q

Mechanism of Acyclovir

A

-Acyclovir is an acyclic nucleoside analogue

Uses viral thymidine kinase for first phosphorylation.

It is selevtively phosphorylated by HSV-infected cells.

  • A competitive inhibitor of DNA polymerase, causes chain termination.
  • For second and third phosphorylation, can use cellular thmidine kinases

Related to Vaclacyclovir and Famciclovir

95
Q

Tranylcypromine, Phenelzine

A

MAO-I

-Increase level of amine neurotransmitters (norepinephrine, 5-HT, dopamine).

-Hypertensive crisis (most notably with ingestion of tyramine, which is found in many foods such as wine and cheese); CNS stimulation.

Contraindicated with SSRIs, TCAs, St. John’s wort, meperidine, dextromethorphan (to prevent serotonin syndrome).

96
Q

Antibiotics to avoid in pregnancy (with 1 antiviral and 1 antifungal) and why

A

SAFe Children Take Really Good Care.

Sulfonamides –> kernicterus

Aminoglycosides –>ototoxicity

Fluoroquinolones –> cartilage damage

Clarithromycin –>embryotoxic

Tetracyclines –>Discolored teeth, inhibit bone growth

Ribavirin (antiviral) –> Teratogenic

Griseofulvin (antifungal) –> Teratogenic

Chloramphenicol –> Grey baby syndrome

97
Q

Sotalol

A

NON-selective beta blocker that has both Class II (bb) and Class III (potassium channel blocking) antiarrhythmic properties

The other Class III potassium channel blockers are: Amiodarone, Ibutilide, Dofetilide, Sotalol.

-Used to prevent reentry SVT

98
Q

First line treatment of absent seizures

A

Ethosuximide

  • blocks T-type calcium channels
  • Can cause SJS
99
Q

Clonidine

A

-alpha 2 antagonist that can be used as a third line for hypertensive pts.

  • need to caution pts that removing patch suddently can lead to hypertensive crisis
  • it can be given in the transdermal patch
  • Can also be used for ADHD and Tourette’s

Side effects: rebound hypertension, dry mouth, constipation, ED, sleep disturbances, HA, confusion (for this reason this drug is only used in pts who have failed or cannot tolerate other therapies)

100
Q

Interferon alpha uses

A

Called Leukocyte Interferon

Used for:

Chronic hepatitis B and C

Kaposi sarcoma

Hairy cell leukemia

Condyloma acuminatum

Renal cell carcinoma

Malignant melanoma.

101
Q
A
102
Q

Treatment of Heparin Induced Thrombocytopenia

A

STOP HEPARIN, start DIRECT THROMBIN INHIBITOR

-development of IgG antibodies against heparin- bound platelet factor 4 (PF4). Antibody-heparin-PF4 complex activates platelets thrombosis and thrombocytopenia.

103
Q

Treatment of Von-Willebrand Disease

A
  • Desmopressin, which releases Von-willibrand factor stored in endothelium
  • synthetic analog of ADH used to treat or prevent severe bleeding
  • Remember the sx of VWD is easy bruising, menorragia, epistaxis. AD disease
104
Q

Cromolyn Sodium

A

Mast cell stabilizer used for asthma prophylaxis (prevents mass cell degredation)

105
Q

clonidine

A

sympatholytic (a2 agonist)

used in hypertensive urgency

ADHD

Tourette synrome

(decrease BP by decrease symp tone)

106
Q

alpha-methyldopa

A

sympatholytic (a2 agonist)

Used for hypertension in pregnancy

Can cause SLE-like syndrome

107
Q

Phenoxybenzamine

A

Alpha-blocker that is nonselective (irreversible)

Used in pheochromocytoma (preoperatively) to prevent catecholamine crisis

Can cause orthostatic hypotension, reflex tachy

108
Q

Phentolamine

A

Nonselective alpha blocker (reversible)

Give to pts on MAO-I who eat tyramine containing foods

-Orthostatic hypotension, reflex tachy

109
Q

Prazosin, terazosin, doxazosin tamsulosin

A

These are alpha-1 selective blockers

They are used for urinary symptoms of BPH,

PTSH (prazosin)

Hypertension

Can cause first dose hypotension

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