Big Picture Flashcards
(142 cards)
1
Q
Trade name doesn’t matter except with what drugs?
A
Antibiotics and combination diuretics
2
Q
How are generic product approved?
A
similar absorption profile, similar systemic exposure, area under the curve, time to maximum concentration
3
Q
What drugs should you use the trade name instead of generic versions?
A
Narrow TI drugs (Warfarin, and Theophylline)
4
Q
What are biosimilar drugs?
A
generic biological agents
5
Q
Monoclonal antibodies prefix?
A
unique name
6
Q
Monoclonal antibodies substem (infix)?
A
target, related to action or use of antibody, or source
7
Q
Monoclonal antibodies suffix?
A
-mab or -pab
8
Q
Jimmy Carter was taken what monoclonal antibody for his brain cancer?
A
Pembrolizumab
9
Q
How should epinephrine be administrated?
A
IM or SubQ, never IV
10
Q
What does PCN treat?
A
Syphilis
11
Q
What do you have to be careful with when using Metronidazole?
A
C. difficle
12
Q
Precaution with Amp B dosing because it produces?
A
infusion related side effects
13
Q
What are Amp B related side effects?
A
high fever, chills, hypotension, muscle spasm (cytokine release)
14
Q
Amp B can cause nephrotoxicity over what gram?
A
4 gm
15
Q
If verapamil is taken with GFJ what can happen to the patient?
A
hypotension
16
Q
What is the link between digoxin and antibotics
A
p-glycoprotein inhibition
17
Q
T/F Erythromycin can treat S. aureus infection?
A
False
18
Q
What are the two isomers of Warfarin?
A
S isomer (active), R isomer
19
Q
What enzyme is active in Warfarin S isomer?
A
1A2, 2C19
20
Q
What enzyme is inactive in Warfarin R isomer?
A
3A4
21
Q
What can inhibit/increase Warfarin?
A
fluconazole, amiodarone, metronidazole, sulfamethoxazole-trimethoprim
22
Q
Which drugs are affected by GFJ?
A
CCB, statins
23
Q
What is the food inhibits Warfarin action?
A
greeny leaf vegetables rich in Vitamin Ki
24
Q
Which foods inhibit MAOI?
A
Tyramine rich foods: cheese, red wine, beers on tap, cured or smoked meats or fish, soy products (soup, bean curd, tofu), fava or broad beans
25
Foods that inhibit MAOI will cause what type of reaction?
Hypertensive crisis
26
Beta blockers can cause?
hypotension and bradycardia
27
What drugs go through phase II acetylation?
SHIP
28
Warfarin is sensitivity to what Vitamin K gene?
VKORC1
29
Inhibition of acetaldehyde metabolism causes what?
Disulfiram like reaction
30
What symptoms are seen in disulfiram like reaction?
N/V, flushing, tachycardia, headache, sweating
31
What CNS depressant can cause a disulfiram like reaction?
Alcohol
32
What classes of CPH can cause a disulfiram like reaction?
2G and 3G CPH
33
What is the difference between the 2G and 3G CPH?
the more you go down the more gram positive
the more you go up the more gram negative coverage
34
What antibody can cause a disulfiram like reaction?
Metronidazole
35
What two drugs can disrupt Vitamin K clotting factors?
CPH and Warfarin
36
What are Vitamin K clotting factors?
2, 7, 9, 10
37
What can cause hypoprothrombinemia
Warfarin and CPH
38
What is Therapeutic Index (TI)
Measurement of drug safety. Dose required for death in 50% of the animals. (LD50/ED50)
39
The higher the TI....
the safer the drug
40
The lower the TI...
the bad ass of the drug
41
What drugs can cause bleeding, bruising, bleeding gums?
anticoagulant, aspirin, NSAIDS
42
Undesirable oral thrush
glucocorticosteriods
43
Undesirable diarrhea, C. difficle
antibotics, Clindamycin
44
Undesirable GI ulceration
NSAIDS
45
Undesirable hair loss, alopecia, myelosupression
Anticancer drugs
46
Undesirable sedation, anticholinergic , CV toxicity
TCA: Amitriptyline
47
How do you monitor anticoagulants?
Bleeding time, PT, PTT, INR
48
How do you monitor statins?
Creatine kinase
49
How do you monitor drugs that cause SJS syndrome and Lupus like?
test dose, genetic testing
50
What medicines need genetic testing?
codiene, carbamezepine, Abacavir, Flucloxacillin, Allopurinol, SHIP
51
What causes cough?
ACEI
52
What causes headaches?
Leukotriene antagonist
53
What drugs are commonly asked to monitor for?
Corticosteroids, SSRIs, Benzo, Beta blockers
54
What is the biggest problem with corticosteroids?
adrenal crisis
55
What is the treatment for asthma?
long acting B2 agonist + inhaled steroid for prophylaxis
56
What undesirable side effect of inhaled corticosteroids?
oral candidiasis
57
How do you treat oral candidiasis due to corticosteroids?
rinse mouth and throat w/ water after use, then spit out
| - spacer w/ mouthpiece
58
What drugs can cause oral candidiasis?
Nystain
clotrim-
flucon-azole
59
slowing healing to cuts and bruises suggests..
the pt is on a immunosuppressive
60
What are some sde of long term corticosteroids use?
```
increase appetite
weight gain
fluid retention
hyperglycemia
moon face
Osteoporosis
glaucoma, cataracts
```
61
Whats the txt for osteoporosis?
calcium and vitamin D, biphosphonates
62
When a patient stressful event is over what should be done to avoid adrenal crisis?
dose over several days to previous maintenance level. NO COLD TURKEY
63
What are the sde of cholinomimetics?
```
diarrhea
urination
miosis
bradycardia
bronchoconstriction
emesis
lacrimation
salivation
sweating
```
64
What are the sde of anticholinergic?
```
blurred vision
dry mouth
constipation
urinary retention
tachycardia
```
65
What drugs can cause nystagmus?
phenytoin, carbamazepine, CNS depressants, ALCOHOL
66
How do you test for nystagmus?
horizontal gaze nystagmus test (field sobriety test)
67
What level of alcohol consumption can nystagmus occur?
low as 0.04%
68
What drugs can cause visual, color changes, diplopia?
Voriconazole, anticholinergic, Ethambutol, digoxin
69
Causes impaired night vision, and increase sensitivity to sunlight
Voriconazole
70
Amiodarone causes what?
blue man syndrome
71
Vancomycin causes what?
red man syndrome
72
Rifampin causes what?
orange secretions
73
Heparin causes what?
cytopenia induced antibody rxn
74
FQ causes what?
tendinitis, tendon rupture, QT prolongation
75
Metronidazole causes what?
disulfiram like rxn
76
Amphotericin B causes what?
infusion rate rxn, hypotension, nephrotoxicity (4gm), histamine like rxn
77
Phenytoin causes what?
gingival hyperplasia
78
Clozapine causes what?
bone marrow effects, agranulocytosis
79
What tumors are more responsive to Rx?
small tumors (high proliferating cell to non-diving cell)
80
What does cancer therapy target?
signal transduction pathways that regulate cell proliferation and survival.
81
Topoisomerase inhibitors
directly damage DNA
82
Anthracyclines
directly damage DNA
83
Antimetabolites
interferes w/ DNA precursors inhibits DNA synthesis
84
Hormonal RX
influences hormone homeostasis
85
Anti-tublin agents
blocks or promotes assembly of mircotubules
86
Alkylating agents
directly damage DNA
87
What drugs cause GI mucosa ulceration?
Methotrexate, 5-flurouracil, cisplatin
88
What 4 rapidly diving cells do cancer drugs effect?
GI mucosa
Hair follicles
Ovary/ Testis
Bone Marrow
89
When cancer cells target bone marrow it causes what common toxicity?
Myelosupression
90
Best anti-emetics
5HT-3 antagonists, and NK1
91
What is neutropenia?
<1,000/ul of neutrophils
92
What is febrile neutropenia?
< 500/ul w/ fever
93
What are signs of thrombocytopenia?
easing bruising, excessive gum bleeding
94
What drugs can cause neurotoxicity?
alkylating agents, anti-tubuin: Vincristine, Vinblastine, taxanes
95
What stimulates red cell formation?
erythropoietin
96
What stimulates production of neutrophils?
filgrastim
97
What stimulates production of platelets?
Oprelvekin (Il-11) and thrombopoietin
98
What decrease MTX renal excretion?
NSAIDs, Sulfonamides, probenecid
99
Accumulation of MTX can cause what?
crystalluria
100
T/F Need to stay hydrated taking Methotrexate?
TRUE
101
What can be used to "res-curable" cells from MTX admin?
Leucovorin (folinic acid)
102
Ears toxicity?
cisplatin
103
PNS toxicity?
Vincristine, Vinblastine
104
Mouth toxicity?
MTX (secreted in saliva)
5-FU (deposited platinum in gums)
Imatinib (lichenoid rxn of buccal)
Adriamycin, Cyclophosphamide, 5-FU (salivary gland dysfunction)
105
Heart toxicity?
doxorubicin
106
Lung toxicity?
bleomycin, busulfan (high dose)
107
Bladder toxicity?
ifosamide, cyclophosphamide
108
Kidney toxicity?
cisplatin
109
Antidote for ifosfamide?
Mesna
110
Antidote for gout hyper-uricemia?
Allopurinol
111
Why are chemotherapy often combined therapy?
produces additive or synergistic cytotoxicity
112
What drugs can cause kidney nephrotoxicity?
Aminglycoside, Amp B, Cisplatin
113
What drugs can cause tinnitus and hearing loss?
Aminglycoside, Vancomysin, Cisplatin, ETHACRYNIC ACID
114
Orthostatic hypotension
alpha receptor antagonists
115
Hot flashes
Tamoxifen
116
Stevens Johnson syndrome
Abacavir, Sulfonamides, Carbamazepine, Phenytoin
117
HLA-B1502
Carbamazepine
118
Acne drug that causes teratogenic?
Accutane- Isotretinoin
119
What antibody can still cause pregnancy?
Rifabutin
120
Tooth discoloration, enamel hypoplasia, bone dysplasia
Tetracyclines
121
Neonatal jaundice, hemolytic anemia
Sulfonamides (3rd trimester)
122
Folate antagonist, C/I in 1st trimester
Trimethoprim
123
Fetal otoxtoxicty
Aminglycosides
124
Fetal cartilage damage
FQ
125
Safe but C/I in 1st trimester
Metronidazole
126
Only used for B. fragilis infection
Clindamycin
127
Development of clef lip and palate
Benzo
128
analgesic DOC for all trimesters
Acetaminophen
129
What do nitroglycerin patches do?
prevent development of tolerance (Zopidem)
130
Anatacids, milk, Ca2+
FQ
131
Antidote for Warfarin?
Phytonadione, Factor IX, fresh plasma
132
Antidote for Heparin
Protamine
133
Antidote for Dabigatran
Idarucizumab
134
Antidote for thrombolytic
alteplase
135
Antidote for Benzo
Flumenazil
136
Antidote for Digoxin
Digibind, DigFab
137
Antidote for Acetaminophen
N-acetylcysteine (within 8-10hrs)
138
Antidote for hypoglycemia
glucagon
139
Antidote for cyclophosphamide
Mesna
140
When is hemodialysis useful?
When the drug is confined to the plasma
141
Antidote for opioid?
Narcone
142
Unique property of Clozapine?
its a potent agonist causing salivation and a antagonist causing anticholinergic
