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Drugs Flashcards

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1
Q

Finasteride MOA

A

5-alpha reductase inhibitor

Use for BPH

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2
Q

Tx of BPH:

A

Initial: alpha antag (terazosin, tamsulosin) relax sm mm in bladder neck/prostatic urethra

5 alpha reductase inhib (finasteride, dutasteride) to reduce large prostate volumes

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3
Q

Flutamide

A

Nonsteroidal competitive testosterone R antagonist

Use in prostate Ca

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4
Q

Cause pseudomembranous colitis:

A

aminopenicillins (ampicillin, amoxicillin), Clindamycin, cephalosporins

Tx: oral dose of vanco

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5
Q

First Gen Cephalosporins

A

Cephalexin, Cefazolin

Gram + cocci, PEK (Proteus, E. coli, Klebsiella pneumoniae)

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6
Q

Second Gen Cephalosporins (2A)

A

Cefaclor, Cefuroxime

Gram + cocci, HEN PEK (H. flu, Enterobacter, Neisseria)

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7
Q

Cephalosporins 2B

A

Cefotetan, Cefoxitin (Cephamycins)

Gram + cocci, HEN PEK, Anaerobes!!!

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8
Q

Third Gen Cephalosporins

A

Cefotaxime, Cefixime, Cefpodoxime, Ceftriaxone

Excellent Gram -, nosocomial G - infection resistant to other beta lactams

Ceftriaxone: Meningitis, gonorrhea

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9
Q

Unique 3rd Gen Cephalosporin

A

Ceftazadime

Less G +, good G -, Pseudomonas!

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10
Q

Fourth Gen Cephalosporin

A

Cefepime

Pseudomonas, G + great, G - great

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11
Q

Ceftaroline

A

broad G + and G -, MRSA

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12
Q

Atreonam

A

monobactam, binds PBP 3, resistant to beta lactamases

G - only, Pseudomonas

Use: penicillin allergy or renal unsuffic who can’t tol. aminoglycosides

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13
Q

Carbapenems

A

Doripenem, Imipenem, Meropenem, Ertapenem

Broad! G + cocci, G - rods, anaerobes
Ertapenem: no Acinetobacter, Pseudomonas, Enterococcus

Give Imipenem with Cilastatin - prevents inactivation in renal tubules

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14
Q

Carbapenem Side Effects

A

Seizures, GI, rash

Renal dose adjust

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15
Q

Vancomycin

A

inhibits peptidoglycan format. by binding D-ala D-ala
Gram + only! only resistant ones (MRSA, VRE)
Oral dose for C. dif

Resistance: D-ala D-lac modific

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16
Q

Vancomycin SEs

A

Red man syndrome (histamine mediated), Nephrotox, Ototox, Thrombophlebitis

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17
Q

Protein synth inhibitors that blocks A-site tRNA binding:

A

Tetracyclines (30S)

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18
Q

Protein synth inhibitors that block initiation complex formation:

A

Aminoglycosides (30S)

Also cause misreading of mRNA

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19
Q

Aminoglycosides SEs:

A

Nephrotoxic, Neuromuscular blockade, Ototoxic, Teratogen

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20
Q

Aminoglycoside names/uses:

A

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

Aerobes only!! MOA requires 02
G +: synergy with BLs
Severe G - rod infections, Pseudomonas

Resistance: bacterial transferase enzymes add side chain

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21
Q

Tetracycline SEs:

A

N/V/D, bind to growing teeth/bones, photosensitivity, contraindic in preg, chelate with divalent cations

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22
Q

Tetracycline names/uses:

A

Tetracycline, Doxycycline, Minocycline

Borrelia burgdorferi, M. pneumonia, Rickettsia, Chlamydia
(Atypical pneumonia, tick bites, chlamydia)

Resistance: efflux pumps, plasmid-encoded

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23
Q

Macrolides

A

Azithromycin, Clarithromycin, Erythromycin

Block translocation, bind 23S rRNA of 50S ribosome

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24
Q

HELP SES Bugs

A

Aminopenicillins: Ampicillin, Amoxicillin (better oral) (ESBLs)

Haemophilus influenza, E. coli, L. monocytogenes, Proteus mirabalis, Salmonella, Enterococci, Shigella

Give with Clavulanic acid/sulbactam: BLase inhibitors

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25
Phenoxybenzamine
Noncompetitive, irreversible alpha antagonist To manage Pheo Sx preop
26
Phentolamine
competitive, reversible alpha antag Give to tx HTN crisis when withdraw clonidine or eat tyramine containing foods on MAO-I
27
Prazosin
Alpha-1 selective antagonist used to treat HTN, BPH urinary Sx, PTSD Also Terazosin, doxazosin, tamsulosin (selective @ prostate's alspha-1A Rs)
28
Mirtazapine
Selective alpha-2 antagonist Used to treat depression, causes sedation
29
Cause gingival hyperplasia: (4)
Phenytoin, verapamil, cyclosporine, nifedipine
30
Cause Myopathy:
Fibrates, niacin, colchicine, hydroxychloroquine, IFN-alpha, penicillamine, statins, glucocorticoids
31
Cause SLE-like syndrome:
Sulfa drugs, hydralazine, INH, Procainamide, Phenytoin, Etanercept
32
Cause SIADH:
Carbamazepine, cyclophosphamide, SSRIs
33
Cause Pulmonary fibrosis
Bleomycin, Amiodarone, Busulfan, Methotrexate
34
Sulfa Drugs:
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide ABs, Sulfasalazine, Sulfonylureas PROfessional FACTSSS May cause fever, UTI, SJS, hemolytic anemia, thrombocytopenia, agranulocyt, and urticaria in ppl w/ allergies
35
Insulin release mediated by:
Decreased by alpha-2 | Increased by beta-2
36
Metronidazole Treats:
GET GAP on the Metro Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes below belt (Bacteroides, C. dif), H. Pylori - triple ther with PPI and clarithromycin
37
ABs to avoid during pregnancy:
SAFe Children Take Really Good Care Sulfonamides, Aminoglycosides, FQs, Clarithromycin, Tetracyclines, Ribavirin, Griseofulvin, Chloramphenicol
38
Opioid MOA
Open K channels, close Ca channels Increase K efflux and Decrease Ca influx hyperpolarizes post syn neurons. Inhibit release of ACh, NE, 5HT, glutamate, substance P
39
Ethosuximide
DOC for absence seizures Blocks thalamic T-type Ca chan SE: GI, rash, SJS, HA, fatigue
40
Benzos for Seizures
IV tx of status epilepticus (followed by IV Phenobarbital or fosphenytoin) Also for eclampsia seizures (MgSO4 is DOC) Diazepam/Lorazepam (longer DoA, preferred) Increase GABAa action
41
Phenytoin
Tonic-clonic and status epilep prophylaxis: 1st line, also used in partial Na channel inactivation, zero order kinetics SE: nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, periph neuropathy, megaloblastic anemia, teratogen, SLE like sindrome, SJS, osteopenia CYP inducer
42
Carbamazepine
partial, tonic clonic: 1st line Increased Na chan inactivation SE: diplopia, ataxia, blood dyscrasias, liver tox, teratogen, SIADH, SJS CYP inducer Also used for BPD and Trigeminal neuralgia
43
Valproic acid
Tonic clonic: 1st line, also used in absence, partial, myoclonic seizures Na chan inactivation, Increased GABA conc by inhib GABA transaminase GI, hepatotox-can be fatal-monitor LFTs, tremor, wt gain. CONTRAINDIC in preg-NTDs Also used for BPD
44
Gabapentin
not 1st line, partial, tonic-clonic Inhibits high-voltage-activated Ca chan SE: sedation, ataxia Also used for periph neuropathy, postherpetic neuralgia, migraine prophylaxis, BPD
45
First Line Partial seizures:
Carbamazepine*, oxcarbazepine, valproate, lamotrigine, phenytoin
46
First line generalized tonic clonic:
Carbamazepine, phenytoin, valproate, lamotrigine, oxcarbazepine
47
Phenobarbital
1st line in Neonates! Other uses: partial, tonic clonic Increases GABAa SE: sedation, tolerance, dependence, cardioresp depression CYP Inducer
48
Topiramate
Blocks Na channels, increases GABA action Partial, tonic clonic Sedation, mental dulling, cidney stones, wt loss also migraine prophylaxis
49
Lamotrigine
Partial, tonic clonic, absence Blocks voltage-gated Na chan SE: SJS Also used for depressive phase of BPD
50
Levetiracetam
Partial, tonic-clonic unknown MOA
51
Tigabine
partial Increased GABA by inhibiting reuptake
52
Vigabatrin
partial increases GABA by irreversibly inhibiting GABA transaminase
53
Tx of serotonin syndrome:
cyproheptadine (5HT2 R antag)
54
Which antiviral polymerase inhibitors do not require phosphorylation by cellular kinases?
Foscarnet (for CMV retinitis in AIDS or resistant HSV/VZV) Cidofovir (preferentially inhib viral DNA pol, CMV in immunocomp, resistant HSV) Tenofovir (only NRTI that doesn't require phosphorylation) all the NNRTIs (Efavirenz, Nevirapine, Delaviridine - bind RT)
55
Drugs that prolong QT:
Some Risky Meds Can Prolong QT: ``` Sotalol Risperidone Macrolides Chloroquine Protease Inhibitors (-navir) Quinidine Thiazides Ziprasidone ```
56
Meds that may cause seizures
Bupropion (antidepressant), clozapine (APD), Isoniazid (if given without pyridoxine), ciprofloxacin, imipenem
57
First Gen Antihistamines:
Diphenhydramine, dimenhydrinate, chlorpheniramine H1 blockers Uses: allergy, motion sickness, sleep aid SEs: Anti-HAM
58
2nd gen antihistamines:
Loratadine, fenoxfenadine, desloratadine, cetirizine Allergy Less sedating
59
H2 blockers:
Cimetidine, ranitidine, famotidine, nizatidine reversibly block H2 Rs to decrease H+ sec by parietal cells Uses: peptic ulcer, gastritis, mild reflux Cimetidine is Potent CYP INHIBITOR, also anti-androgenic effects, can cross BBB and placenta Cimetidine and ranitidine decr renal creatinine excretion
60
PPIs
Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole Irrevers inhib H+/K+ ATPase in stomach parietal cells Uses: peptic ulcer, gastritis, reflux, ZES
61
Cilostazol
PDE 3 Inhibitor, increases cAMP in platelets, inhibiting platelet agg, also vasodilates Dipyridamole does same thing Can use for claudication Watch out, can cause coronary steal b/c vasodilate
62
Tx for methemoglobinemia:
IV methylene blue helps reduce Fe3+ back to 2+ (can be caused by nitrates/sulfa drugs)
63
Tx of atrial flutter:
Conversion to sinus rhythm: class 1A, 1C, or 3 Rate control: beta block or Ca chan blocker
64
Tx for Diptheria:
DT antitoxin (passive immunity) GIVE FIRST Penicillin/erythromycin DPT vaccine
65
Listeria tx
ampicillin in infants/immunocomp/elderly
66
Actinomyces tx:
Penicillin G+ anaerobe, branching filamentous oral flora oral/facial abscesses that drain through sinus tracts
67
Tx for nocardia:
Sulfonamides G + aerobe, filamentous branching, weak acid fast, in soil Pulm infections in immunocomp and cutaneous infections after trauma
68
MAC prophylaxis
Azithromycin disseminated non-TB dz in AIDS grows at high temps
69
Mycobacterium leprae tx:
Lepromatous (Th2 response): Dapsone, rifampin, clofazimine for 2-5 years Tuberculoid (Th1 response): Dapsone and rifampin 6 mo
70
Hydralazine
increases cGMP, vasodilates arterioles > veins Reduces afterload First line for HTN in pregnancy w/ methyldoa SE: causes reflex tachycardia, can give with beta blocker lupus-like syndrome, fluid retention, nausea, headache, angina
71
Hypertensive emergency tx:
nitroprusside, nicardipine, clevidipine, labetalol, fenoldopam Nitroprusside: increases cGMP via direct release of NO, short acting -SE: cyanide toxicity! releases cyanide, tx w/ sodium thiosulfate Fenoldopam: D1 agonist - coronary, peripheral, renal, and splanchnic vasodilation --> decr BP and incr natriuresis -improves renal perfusion
72
H. flu mucosal infection tx:
amox +/- clav
73
H. flu meningitis tx/prophylaxis:
Tx: ceftriaxone, rifampin prophylaxis in close contacts
74
Meningococcus treatment:
ceftriaxone or penicillin G Prophylaxis: rifampin, cipro, or ceftriaxone in close contacts
75
Legionella treatment
macrolide or quinolone
76
Pseudomonas tx:
Aminoglycoside plus ESBL (piperacillin, ticarcillin, cefepime, imipenem, meropenem)
77
Lyme dz tx:
doxycycline, ceftriaxone
78
Rickettsial dz tx:
Doxycycline
79
Mycoplasma pneumoniae tx:
macrolide, doxy, or FQ
80
cardioselective beta blockers
atenolol, acebutolol, betaxolol, esmolol, metoprolol
81
beta blockers for MI:
metoprolol, carvedilol, bisoprolol - decrease mortality
82
Partial beta agonists:
Pindolol, Acebutolol

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