DRUG MECHANISMS and indications (final)

Question 1

PDE-5 Inhibitor; sustains the vasodilatory effects of nitric oxide-dependent synthesis of cGMP

Answer 1

sildenafil moa

Question 2

indications for sildenafil

Answer 2

ED and pulmonary arterial HTN

Question 3

Inhibits vitamin K-dependent coagulation factor synthesis (II, VII, IX, X, proteins C and S)

Answer 3

coumadin moa

Question 4

indication for coumadin

Answer 4

anticoagulation

Question 5

Binds to Antithrombin-III and accelerates its activity, inhibiting thrombin and Factor-Xa

Answer 5

enoxaparin moa

Question 6

indication for enoxaparin

Answer 6

post op DVT prophylaxis, unstable angina

Question 7

Prodrug: metabolized to active metabolite by the CYP450 enzyme CYP2C19

Irreversible inhibition of platelet ADP receptors which normally trigger platelet activation and aggregation via downstream activation of the GP llb/llla complex

Answer 7

clopidogrel moa

Question 8

indication for clopidogrel

Answer 8

acute coronary syndrome, thrombotic event prophylaxis

Question 9

• Fab Fragment: a chimeric human-murine mAB
• Binds to the GP llb/llla receptor of human platelets and inhibits platelets aggregation
• Binds to the vitronectin (αvβ3) receptor on platelets and vessel wall endothelial and smooth muscle cells

Answer 9

moa for abciximab

Question 10

indication for abciximab

Answer 10

An adjunct to percutaneous coronary intervention (PCI) for the prevention of cardiac ischemic complications, Unstable Angina

Question 11

Competitively inhibits HMG-CoA Reductase which is responsible for an early, rate-limiting step in cholesterol biosynthesis

Increases hepatic LDL receptors, enhancing catabolism

Answer 11

atorvastatin moa

Question 12

atorvastatin indication

Answer 12

hyperlipidemia/cvd prevention

Question 13

Stimulates nuclear receptor PPAR which modulates transcription of insulin sensitive genes in liver, muscle and adipose tissue

Enhances HDL production; inhibits triglyceride synthesis and stimulates catabolism of triglyceride-rich lipoproteins

Answer 13

fenofibrate moa

Question 14

indications for fenofibrate

Answer 14

hypertriglyceridemia and hypercholesterolemia

Question 15

Inhibits lipolysis in adipose tissue, resulting in reduced hepatic VLDL synthesis and production of LDLs in the plasma

Answer 15

nicotinic acid moa

Question 16

indication for nicotinic acid

Answer 16

hypertriglyceridemia
hypercholesterolemia
mixed dyslipidemia

Question 17

Biguanide-based; activates AMP-activated protein kinase (AMPK) which in turn suppresses hepatic gluconeogenesis & intestinal glucose absorption; increases insulin sensitivity

Answer 17

metformin moa

Question 18

indication for metformin

Answer 18

DM 2 and PCOS

Question 19

Stimulates pancreatic islet beta cell insulin release

Actions involve binding to an ATP-dependent K+ channel: blocked efflux leads to depolarization, Ca++ release and insulin vesicle effusion

Answer 19

moa for glipizide

Question 20

indication for glipizide

Answer 20

DM 2

Question 21

A thiazolidinedione (aka glitazone) insulin sensitizer selectively stimulates nuclear receptor PPAR which increases insulin sensitivity in liver, skeletal muscle and adipose tissue

Answer 21

MOA of pioglitazone

Question 22

indication of pioglitazone

Answer 22

dm 2

Question 23

sitagliptin moa

Answer 23

Inhibits dipeptidyl peptidase-4, slowing incretin breakdown, increasing insulin synthesis/release, decreasing glucagon levels

Question 24

indiaction for sitagliptin

Answer 24

dm2

Question 25

Slow release, micro-crystallized rDNA insulin analog for stable day-long blood sugar regulation to be used in post-prandial combination with fast acting insulin

Answer 25

moa for insulin glargine

Question 26

Irreversibly inhibits gastric parietal cell H+-K+-ATPase, thereby inhibiting gastric acid secretion

Answer 26

esomeprazole moa

Question 27

indication for esomeprazole

Answer 27

GERD Gastric ulcer prophylaxis (nsaid associated) hypersecretory disorders h. pylori infection

Question 28

Selective antagonism of gastric parietal cell H2 receptors

Answer 28

cimetidine moa

Question 29

cimetidine indications

Answer 29

gerd peptic ulcer dyspepsia

Question 30

Synthetic T4 (tetra-iodothyronine)

Answer 30

levothyroxine

Question 31

indication for levothyroxine

Answer 31

hypothyroidism

Question 32

Binds to estrogen receptors, developing and maintaining female sex characteristics and reproductive systems

Answer 32

estrone moa

Question 33

estrone indication

Answer 33

Menopause, Breast Cancer, Prostate Cancer, Osteoporosis prevention

Question 34

Having a strong affinity for Ca2+, these drugs accumulate in bone where, upon ingestion by osteoclasts, they inhibit the HMG-CoA reductase pathway and leads to cell death, reducing bone resorption and turnover (bisphosphonate)

Answer 34

alendronate moa

Question 35

indication for alendronate

Answer 35

Osteoporosis Paget’s Bo Dz

Question 36

Acts as a folic acid analogue, inhibits DHFR, thus preventing formation of FH4 Inhibits lymphocyte proliferation

Answer 36

methotrexate moa

Question 37

indication for methotrexate

Answer 37

RA psoriasis Choriocarcinoma