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DIT > Drugs > Flashcards

Drugs Flashcards

1
Q

Dextromethorphan

A

opioid cough suppressant commonly used w/ expectorant guaifenesin

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2
Q

loperamide

A

opioid for diarrhea

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3
Q

diphenoxylate

A

opioid for diarrhea

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4
Q

Vesamicol

A

inhibits synthesis of ACh

inhibits choline-acetyl transferase

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5
Q

Hemicholinium

A

inhibits co-transporter of choline + Na into the neuron to make ACh

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6
Q

black widow spider toxin

A

stimulates release of ACh into synaptic cleft

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7
Q

Botulinium

A

causes flaccid paralysis

inhibits release of ACh into synaptic cleft

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8
Q

Metyrosine

A

inhibits tyrosine hydroxylase

Tyrosine –> L-Dopa

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9
Q

Reserpine

A

inhibits NE packaging into vesicles (for release by nerves)

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10
Q

what drugs inhibit reuptake of NE?

A

cocaine

TCAs

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11
Q

what is dopamine metabolized to?

A

HVA = homovanillic acid

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12
Q

what is NE metabolized to?

A

VMA = vanillylmandelic acid

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13
Q

what is EPI metabolized to?

A

metanephrine

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14
Q

bretylium

A

inhibits NE release

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15
Q

guanethylene

A

inhibits NE release

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16
Q

ephedrine

A

facilitate NE release into synapse

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17
Q

tyramine

A

facilitate NE release into synapse

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18
Q

amphetamines

A

facilitate NE release into synapse

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19
Q

angiotensin 2

A

facilitate NE release into synapse

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20
Q

what do you give for organophosphate poisoning?

A

pralidoxime

atropine

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21
Q

Fomepizole

A

inhibits alcohol dehydrogenase
ethanol –> acetaldehyde
use for methanol or ethylene glycol poisoning

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22
Q

Disulfiram

A

inhibits acetaldehyde dehydrogenase
acetaldehyde –> acetate
used to treat alcoholism

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23
Q

inhibits P450

A 
CRACK AMIGOS
Ciprofloxacin
Ritonavir
Amiodarone
Cimetidine
Ketoconazole
Acute Alcohol
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides
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24
Q

Induce P450

A 
Guinness, Coronas and PBRS induce chronic alcoholism
Griseofulvin
Carbamazepine
Phenytoin
Barbiturates
Rifampin
St. John's Wart
Chronic Alcoholism
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25
Q

what drugs cause a disulfiram-like reaction?

A 
metronidazole
cephalosporins (cefotetan, cefamandole, cefoperazone)
1st gen sulfonylureas = tolbutamide
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26
Q

what chronic CHF drugs improve survival?

A

ACE inhibitors (prevent Ang 1 –> Ang 2)
ARBs (inhibit Ang 2 receptors)
Aldosterone antagonists (inhibit mineralocorticoid recept)
B-blockers (block B1 adrenergic)

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27
Q

What chronic CHF drugs relieve symptoms?

A

Diuretics
vasodilators
digoxin

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28
Q

Treatment for Acute CHF

A

NO LIP
Nitrates = dilate veins = low preload
Oxygen
Loop diuretics = use for pulmonary edema*
Inotrops
Positioning = sit up = blood pools in legs

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29
Q

what drugs cause agranulocytosis?

A 
methimazole
PTU
clozapine
carbamazepine
colchicine
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30
Q

what drugs cause osteoporosis?

A

corticosteroids

heparin

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31
Q

what drugs cause pulmonary fibrosis?

A

bleomycin
busulfan
amiodarone

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32
Q

what drugs cause gynecomastia?

A 
Some Drugs Create Awesome Knockers
Spironolactone
Digitalis
Cimetidine
chronic Alcohol
Ketoconazole
\+ Marijuana
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33
Q

what drugs cause photosensitivity?

A

SAT for a photo
Sulfonamides
Amiodarone
Tetracycline

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34
Q

what drugs cause drug-induced Lupus?

A 
SHIPP
Sulfonamides
Hydralazine
Isoniazid
Procainamide
Phenytoin
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35
Q

what’s the MOA of giving N-acetylcystine for acetaminophen OD?

A

regenerates glutathione

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36
Q

name antiarrythmic drug class: quinidine

A 
Class 1A
Double Quarter Pounder
Disopyramide
Quinidine
Procainamide
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37
Q

name antiarrythmic drug class: procainamide

A 
Class 1A
Double Quarter Pounder
Disopyramide
Quinidine
Procainamide
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38
Q

name antiarrythmic drug class: dispyramide

A 
Class 1A
Double Quarter Pounder
Disopyramide
Quinidine
Procainamide
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39
Q

name antiarrythmic drug class: lidocaine

A 
Class 1B 
Mayo Lettuce Tomato 
Mexiletine
Lidocaine
Tocainide
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40
Q

name antiarrythmic drug class: mexiletine

A 
Class 1B 
Mayo Lettuce Tomato 
Mexiletine
Lidocaine
Tocainide
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41
Q

name antiarrythmic drug class: tocainide

A 
Class 1B 
Mayo Lettuce Tomato 
Mexiletine
Lidocaine
Tocainide
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42
Q

name antiarrythmic drug class: flecainide

A

Class 1C
Fries Please
Flecainide
Propafenone

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43
Q

name antiarrythmic drug class: propafenone

A

Class 1C
Fries Please
Flecainide
Propafenone

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44
Q

name antiarrythmic drug class: Amiodarone

A 
Class 3 = K channel blockers
AIDS
Amiodarone
Ibutilide
Dofetilide
Satalol
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45
Q

name antiarrythmic drug class: Ibutilide

A 
Class 3 = K channel blockers
AIDS
Amiodarone
Ibutilide
Dofetilide
Satalol
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46
Q

name antiarrythmic drug class: Dofetilide

A 
Class 3 = K channel blockers
AIDS
Amiodarone
Ibutilide
Dofetilide
Satalol
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47
Q

name antiarrythmic drug class: Satalol

A 
Class 3 = K channel blockers
AIDS
Amiodarone
Ibutilide
Dofetilide
Satalol
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48
Q

name antiarrythmic drug class: Verapamil

A

Class 4 = CCB

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49
Q

name antiarrythmic drug class: diltiazem

A

Class 4 = CCB

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50
Q

S/E of Quinidine?

A

Cinchonism = HA, dizziness, tinnitus
thrombocytopenia
torsades de pointes

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51
Q

S/E of Amiodarone

A

toxicity:
lungs –> PFT
thyroid –> TFT
liver –> LFT

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52
Q

flutamide

A

non-steroidal competitive inhibitor of androgens at the testosterone RECEPTOR
use = prostate carcinoma

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53
Q

finasteride

A

5-a-reductase inhibitor

use = BPH, promotes hair growth in men

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54
Q

ketoconazole

A

inhibits testis production of testosterone

inhibits 17,20-desmolase

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55
Q

spironolactone

A

inhibits androgen binding at androgen RECEPTOR

inhibits testis PRODUCTION of testosterone

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56
Q

what drugs have zero-order elimination?

A

“PEA” is round like a 0
Phenytoin
Ethanol
Asprin

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57
Q

cyclosporine: MOA, toxicity

A

binds CYCLOPHILINS –> inhibits calcineurin –> prevents IL-2 production –> can’t develop T cells
toxicity = HTN, nephrotoxicity

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58
Q

tacrolimus: MOA, toxicity

A

binds FK-BINDING PROTEIN (FKBP) –> inhibits calcineurin –> prevents IL-2 PRODUCTION–> can’t develop T cells

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59
Q

sirolimus: MOA

A

binds FKBP-12 –> inhibits mTOR -> inhibits T cell RESPONSE TO IL-2

60
Q

Azathioprine: MOA

A

precursor to 6-MP –> metabolized by xanthine oxidase to 6-MP –> can’t make nucleic acids –> BM suppression

allopurinol increases toxicity of azathioprine + 6-MP

61
Q

Muromonab-CD3 (OKT3): MOA

A

binds CD3 on T cells –> messes w/ T cell signal transduction

62
Q

Mycophenolate: MOA

A

inhibits IMP-Dehydrogenase –> prevents synthesis of GUANINE –> no cell replication –> no B/T cell growth

63
Q

Daclizumab: MOA

A

binds CD25 = IL-2 receptor

blocks IL-2 receptor on T cells

64
Q

thalidomide: MOA

A

affects TNF-a, teratogen for pregnancy

65
Q

How do you treat H. Pylori?

A

triple therapy:
PPI + clarithromycin + amoxicillin/metronidazole

quad:
PPI + bismuth + metronidazole + tetracycline

66
Q

Metoclopramide: MOA?

A

inhibits D2 receptors
stimulates Serotonin receptors
helps GI move = antiemetic + gastroprokinetic

67
Q

what drug regimen is used to treat TB?

A 
RIPE
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
68
Q

treatment for diverticulitis

A

metronidazole +

either fluoroquinolone or TMP-SMX

69
Q

Treatment for methemoglobinemia?

A

Methylene Blue
Vitamin C
Cimetidine (works slowly)

70
Q

Treatment for cyanide poisoning?

A
  • nitrites (Fe 2+ –> Fe 3+) which binds cyanide

- thiosulfate (binds this cyanide –> thiocyanate –> excreted in urine)

71
Q

what drugs cause methemoglobinemia?

A 
Nitrates/nitrites
antimalarial = primaquine, chloraquin 
dapsone
sulfonamides
local anesthetic = lidocaine
metoclopramide
72
Q

what are the 3 anti-TNF drugs?

A

Etanercept = not AB, TNF inhibitor (decoy)
Infliximab
Adalimumab

73
Q

what HTN drugs are good for pregnant women?

A 
Hypertensive Moms Love Nifedipine
Hydralazine
Methyldopa
Labetalol
Nifedipine
74
Q

HMG-CoA Reductase: S/E, MOA

A

hepatotoxicity, rhabdomyolysis

inhibit HMG-CoA –> mevalonate

75
Q

niacin: S/E, MOA

A

inhibits lipolysis in adipose tissue
reduces hepatic VLDL secretion into circulation

flushed face, hyperglycemia, hyperuricemia

76
Q

Cholestyramine, Colestipol, Colesevelam: MOA, SE

A

bile acid resins
prevent intestinal absorption of bile acids
liver must use cholesterol to make more

decreases absorption of fat soluble vitamins
Cholesterol gallstones
Cholestyramine –> binds C. Diff toxin

77
Q

Ezetimibe: MOA, S/E

A

Cholesterol Absorption Blockers
prevent cholesterol reabsorption at small intestine brush border

rare increase in LFTs, diarrhea

78
Q

Gemefibrozil, Clofibrate, benzafibrate, fenofibrate: MOA, SE

A

Fibrates
upregulate LPL –> increase TG clearance

Myositis, hepatotoxicity, cholesterol gallstones

79
Q

what are the clinical uses for ampicillin and amoxicillin? Which has a greater oral bioavailablity?

A 
extended spectrum penicillin 
HEELPSS
H. Influenza
E.coli
Enterococci
Listeria
Proteus Mirabilis
Salmonella
Shigella
80
Q

name beta-lactamase inhibitors, when do you use them?

A

CAST
Clavulanic Acid
Sulbactam
Tazobactam

often added to penicillin AB to protect the AB from destruction by b-lactamase (penicillinase)

81
Q

when do you use ticarcillin and piperacillin?

A 
antipseudomonals
MOA = same as penicillin 
use = psudonomas + gram - rods
susceptible to penicillinase
use w/ clavulanic acid
toxicity = hypersensitivity rxns
82
Q

What do first gen cephalosporins kill? what are the drugs?

A

PEcK
Proteus mirabilis
E.Coli
Klebsiella

cefazolin
cephalexin

83
Q

What do second gen cephalosporins kill? what are the drugs?

A 
HENs PEcK
Haemophilus influenza
Enterobacter aerogenes
Neisseria 
Serratia Marcescens
Proteus mirabilis
E.Coli 
Klebsiella

cefoxitin
cefaclor
cefuroxime

84
Q

what do 3rd gen cephalosporins kill?

A

Cefriaxone –> Meningitis + gonorrhea
Cefotaxime
Ceftazidime –> pseudomonas

serious gram(-) resistant to other beta-lactams

85
Q

what do 4th gen cephalosporins kill?

A

Cefepime —> pseudomonas and G+ organisms

86
Q

what are cephalosporins NOT good at covering?

A 
LAME bacteria
Listeria
Atypicals (mycoplasma chlamydia)
MRSA
Enterococci
87
Q

what antibiotics bind at 30S? 50S?

A

buy AT 30, CCELL at 50
30
Aminoglycosides
Tetracycline

50
Chloramphenicol
Clindamycin
Erythromycin (macrolides)
Lincomycin
Linezolid 
Streptogramins
88
Q

furosemide toxicities

A 
OH DANG
Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa)
Nephritis (interstitial) 
Gout
89
Q

thiazide toxicities

A 
hyperGLUC
hyperGlycemia
hyperLipidemia
hyperUricemia
hyperCalcemia

sulfa allergy
hypoKalemic metabolic acidosis
hyponatremia

90
Q

treatment for central DI

A

desmopressin

91
Q

treatment for nephrogenic DI

A

HCTZ, indomethacin, amiloride

92
Q

treatment for lithium-induced DI

A

amiloride

93
Q

what drugs inhibit Complex 1 in the ETC?

A

Rotenone

94
Q

what drugs inhibit Complex 3 in the ETC?

A

Antimycin A

95
Q

what drugs inhibit complex 4 in the ETC?

A

CN

CO

96
Q

what drugs inhibit ATPase in the ETC?

A

Oligomycin A

97
Q

what drugs are uncoupling agents in the ETC?

A

Asprin
thermogenin
2,4-DNP

98
Q

what HIV drug binds to gp41? gp120?

A 
gp41 = enfuvirtide
gp120 = maraviroc (doesn't bind to gp120 directly but binds to CCR5 on the macrophage)
99
Q

what are the S/E of HIV protease inhibitors? “-navir”

A 
hyperglycemia
GI 
lipodystrophy
nephropathy
hematuria (indinavir)
100
Q

amphotericin B: MOA, S/E

A

binds ergosterol –> forms membrane pores –> leakage of electrolytes
used for serious, systemic mycoses
S/E: “shake and bake”, NEPHROTOXICITY

101
Q

nystatin: MOA

A

systemic mycoses infections

binds ergosterol –> forms membrane pores –> leakage of electrolytes

102
Q

azoles: MOA, S/E

A

inhibits fungal sterol (ergosterol) synthesis by inhibiting the P-450 enzyme that converts lanosterol to ergosterol

hepatic toxicity, increases liver enzymes

103
Q

flucytosine: MOA, S/E

A

inhibits DNA–> RNA biosynthesis by conversion to 5-FU by cytosine deaminase

note: 5-FU blocks thymidylate synthase that converts dUMP–> dTMP

S/E = BM suppression

104
Q

caspofungin, micafungin: MOA, S/E

A

inhibits cell wall synthesis by inhibiting the synthesis of b-glucan
S/E: GI, flushing (by histamine release)

105
Q

terbinafine: MOA, S/E

A

inhibits fungal enzyme squalene epoxidase –> decreases ergosterol synthesis
S/E = LFTs, vision

106
Q

griseofulvin: MOA, S/E

A 
MOA = interferes w/ microtubule formation --> disrupts mitosis, deposits in keratin-containing tissues (nails)
S/E = P450 inducer --> watch out for oral contraceptives
107
Q

Methotrexate: MOA, rescue, S/E

A 
MOA = folic acid analog inhibits dihydrofolate reductase --> less dTMP --> less DNA and protein syn
rescue = leucovorin for myelosuppression
S/E = myelosuppression, fatty liver
108
Q

5-FU: MOA, rescue

A 
MOA = pyrimidine analog --> activated to 5F-dUMP --> covalently binds to folic acid --> complex inhibits thymidylate synthase --> less dTMP --> less DNA and protein syn
rescue = thymidine for myelosuppression
109
Q

cytarabine: MOA

A

pyrimidine analog –> inhibition of DNA polymerase

110
Q

6-mercaptopurine
Azathioprine
6-thioguanine

A

purine (thiol) analogs –> less de novo purine synthesis

activated by HGPRT

111
Q

cyclophosphamide

Ifosfamide

A

DNA alkylating agent at guanine N-7
S/E = HEMORRHAGIC CYSTITIS (due to toxic metabolite acrolein, prevented w/ mesna)
-TCC of bladder
-requires bioactivation in liver

112
Q

Nitrosoureas (carmustine, iomustine, semustine, streptozocin): MOA, use

A

Cross BBB –> CNA

used for brain tumors (GBM)

113
Q

Busulfan: MOA, use, S/E

A 
MOA = alkylates DNA
Use = CML
S/E = pulmonary fibrosis
114
Q

Doxorubicin, Daunorubicin: MOA, S/E, rescue

A 
MOA = generate free radicals --> intercalates DNA
S/E = dilated cardiomyopathy, alopecia, myelosuppression
rescue = dexrazoxane = iron-chelating agent
115
Q

dactinomycin: MOA, use

A

intercalates DNA
wilms tumor, ewing sarcoma, rhabdomyosarcoma
children ACT out –> dACTinomycin

116
Q

bleomycin: MOA, S/E, use

A

generate free radicals -> fragments DNA
pulmonary fibrosis
used to treat testicular cancer

117
Q

Oseltamivir

A

brand name = Tamiflu
sialic acid analogue that inhibits neuraminidases of influenza A and B viruses
used for prevention and early Rx of influenza infection

118
Q

etoposide: MOA, S/E

A

inhibits Topoisomerase 2
alopecia
GI irritation
myelosuppression

119
Q

Cisplatin: S/E, MOA

A

crosslinks DNA

ototoxic –> damages hair cells –> high freq hearing loss

120
Q

treatment for calcium stones?

A

thiazides save calcium

citrate

121
Q

miravoc

A 
HIV drug
inhibits gp120 (binds to CD4)
122
Q

xenfuvirtide

A 
HIV drug
inhibits gp41 (fusion/entry)
123
Q

metformin: MOA, S/E

A

MOA = decreases liver gluconeogenesis, increases glycolysis, increases peripheral glucose uptake (insulin sensitivity)

S/E = lactic acidosis; do NOT use w/ renal failure

124
Q

sulfonylureas “-ide”: MOA, S/E
1st gen = tolbutamide, chlorpropamide
2nd gen = glyburide, glimepiride, glipizide

A

MOA = close K channel in b-cell –> depolarizes –> Ca –> release insulin

S/E = 1st gen have disulfiram-like effects= inhibits acetaldehyde dehydrogenase.

125
Q

glitazones/thiazolidinediones (TZD): MOA, S/E
pioglitaxone
rosiglitazone

A

binds PPAR-gamma –> gene transcription –> insulin sensitivity + adiponectin

S/E: hepatotoxicity, heart failure (worsen CHF)
metabolized in the liver = good for renal failure pts

126
Q

a-glucosidase inhibitors: MOA, S/E
acarbose
miglitol

A

inhibit intestinal brush-border a-glucosidases

S/E = GI, don’t use in pts w/ cirrhosis or IBD

127
Q

amylin analog = pramlintide: MOA, S/E

A

decreases glucagon

s/e = hypoglycemia, N/D

128
Q

GLP-1 = exenatide, liraglutide: MOA, S/E

A

increase insulin
decrease glucagon release
S/E = pancreatitis, N/V

129
Q

DPP-4 = “-gliptin”: MOA, S/E

A

increase insulin
decrease glucagon release
S/E = mild urinary and respiratory infections

130
Q

lepirudin
bivalirudin
hirudin
argatroban

A

inhibits thrombin, used by leeches

used as an alternative therapy for patients with heparin-induced thrombocytopenia (IgG against heparin-PF4)

131
Q 
thrombolytics: 
Alteplase (tPA)
reteplase (rPA)
tenecteplase (TNK-tPA)
MOA, PT/PTT/Platelet count, toxicity rx?
A

convert plasminogen –> plasmin
increases PT and PTT
no change in platelet count
treat toxicity w/ aminocaproic acid

132
Q

asprin

MOA, PT/PTT/bleeding time

A

blocks COX-1/2 by covalent acetylation
no change in PT, PTT
increased bleeding time

133
Q

Clopidogrel

A

block ADP receptors on platelets

134
Q

ticlopoidine

A

block ADP receptors on platelets

toxicity = neutropenia

135
Q

prasugrel

A

block ADP receptors on platelets

136
Q

ticagrelor

A

block ADP receptors on platelets

137
Q

cilostazol

A

PDE 3 inhibitor –> increases cAMP in platelets –> inhibits platelet aggregation
VASODILATORS

138
Q

dipyridamole

A

PDE 3 inhibitor –> increases cAMP in platelets –> inhibits platelet aggregation
VASODILATORS

139
Q

abciximab

A

binds GP 2b/3a on activated platelets –> prevents aggregation

140
Q

eptifibatide

A

binds GP 2b/3a on activated platelets –> prevents aggregation

141
Q

tirofiban

A

binds GP 2b/3a on activated platelets –> prevents aggregation

142
Q

pergolide

A

ergot dopamine agonist

  • bromocriptine
  • pergolide
143
Q

pramipexole

A

nonergot dopamine agonists

  • pramipexole
  • ropinirole
144
Q

ropinirole

A

nonergot dopamine agonists

  • pramipexole
  • ropinirole
145
Q

filgrastim

A

G-CSF analog –> more granulocytes, used after myelosuppressive chemotherapy

DIT (3 decks)

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