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Drugs Step 1 Flashcards

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1
Q

Chlorthalidone

A

most potent thiazide diuretic

Inhibit Na/Cl transporters in distal convoluted tubule

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2
Q

Torsemide

A

Loop diuretic

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3
Q

Ethacrynic acid

A

Loop diuretic

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4
Q

Loop vs. Thiazide diuretics

A

Loop: cause Hypokalemia + hypocalcemia
Thiadize: hyponatremia + hypercalcemia + hypokalemia

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5
Q

Beta-lactam + rash & fever few weeks later…also high creatinine level?

A 
Acute interstitial nephritis
 - see eosinophils
 - involves renal interstitium
   - edema + leukocyte infiltration
(also happen w/ sulfas, rifampin, diuretics, quinolone antibiotics)
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6
Q

How treat GBS in pregnant mom?

A

At weeks 35-37 culture, then if + give perinatal penicillin (or ampicillin)

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7
Q

Toxicity of aggressive diuresis with osmotic diuretics?

A

Mannitol - given to reduce ICP

- toxicity = pulmonary edema

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8
Q

Vasopressin

A

Acts LATE - medullary segment of collecting duct
- acts on V1 and V2
V1: vasoconstriction + prostaglandin release
V2: antidiuretic response
- increased plasma osmolarity causes ADH release
- saves water
- increase urea reabsorption

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9
Q

Abciximab

A
  • binds glycoprotein GP IIb/IIIa on platelets – prevents binding of fibrinogen which links platelets in a platelet plug
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10
Q

Streptokinase

A

Thrombolytic

  • converts plasminogen to plasmin
  • cleaves fibrin & breaks down clots
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11
Q

Aspirin

A

Irreversibly inhibits COX-1

- inhibit thromboxane A2

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12
Q

Eptifibatide

Tirofiban

A

Both have “fib” = fibrinogen

- bind IIa/IIIb and prevent fibrinogen from causing platelet aggregation

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13
Q

Clopidogrel

A

Block ADP receptor

  • when ADP receptor binds ADP, causes IIa/IIIb to be expressed on platelet surface
  • so blocks IIb/IIIa expression
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14
Q

Ticlopidine
Ticagrelor
Prasugrel

A

Block ADP receptor (like clopidogrel)

  • when ADP receptor binds ADP, causes IIa/IIIb to be expressed on platelet surface
  • so blocks IIb/IIIa expression
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15
Q

Enoxaparin

A

Low molecular weight heparin

- inhibits factor Xa

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16
Q

Infliximab

A

TNF-a antibody

  • manage RA
  • treat Ankylosing spondylitis
  • Crohn’s
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17
Q

Abciximab

A

Antibody against GP IIb/IIIa

  • blocks final step in platelet aggregation
  • give during angioplasty in pt w/ ACS
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18
Q

Vincristine

A

Interferes w/ microtubule formation

  • inhibits MT polymerization after binding beta-tubulin
  • no mitotic spindle
  • chromosomes can’t align/segregate
  • M-phase specific agents
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19
Q

Vitamin K Injection

A

Needed by newborns after birth

  • clotting factor activation via carboxylation
  • needed to prevent bleeding complications
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20
Q

Hydroxyurea

A

Increases hemoglobin F synthesis

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21
Q

Antimalarial drugs

A

Instigators of G6PD deficiency

- Heinz bodies

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22
Q

Nevirapine

A

NNRTI

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23
Q

Zidovudine & Emtricitabine

A

NRTI

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24
Q

TMP-SMX

A

Induce G6PD deficiency (X-linked)

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25
Morphine
Binds mu receptors, GPCR, cause K+ efflux out of the cells = hyper polarization
26
St. John's Wort
Induces hepatic CYP450 enzymes | - increases warfarin metabolism -- decreased warfarin drug levels
27
Narrow spectrum anticonvulsants
Phenytoin Carbamazepine Gabapentin Phenobarbital
28
Broad spectrum anticonvulsants
Valproic acid Topiramate Lamotrigine Levetiracetam
29
Status Epilepticus
Treat w/ Benzodiazepines | - enhanced postsynaptic chloride influx
30
Blurred vision, flushed skin, pupils dilated, dry oral mucosa
Jimson Weed poisoning -- Gardner's mydriasis -- treat w/ physostigmine
31
Isoniazid
Chemically similar to pyridoxine (B6) - cause B6 deficiency - GABA deficiency
32
Diphenhydramine
1st generation antihistamine - block histamine - block acetylcholine (anti-cholinergic)
33
Rifampin
P450 inducer -- lower phenytoin levels
34
Amitryptyline
TCA: inhibits NE & 5-HT reuptake - anticholinergic effects (dry mouth, constipation, urinary retention)
35
Azathioprine
Allopurinol blocks Xanthine Oxidase which results in increased conversion of Azathioprine to 6-MP. This allows more 6-MP to be incorporated into cellular DNA -- get bone marrow suppression
36
Celecoxib
Specific COX-2 inhibitor | - less blessing
37
Omeprazole
Risk of osteoporosis & hip fracture | Possibly due to decreased Ca++ absorption
38
Methotrexate
``` #1 for Moderate to severe Rheumatoid Arthritis SE: painful mouth ulcers + hepatotoxicity ```
39
Alendronate
Bisphosphonate - similar structure to pyrophosphate - disrupt osteoclast function - binds to hydroxyapatite binding sites
40
Chronic use of prednisone
Osteoporosis
41
Risedronate
Inhibits mature osteoclast-mediated bone resorption
42
Thiazide diuretics
Increase distal tubular reabsorption of filtered Ca++
43
Sulfonylureas - glipizide - glyburide - glimepiride
Glipizide -- short acting Glyburide -- long acting Glimepiride -- long acting
44
Niacin
Decreases TG and VLDL | Cause gouty arthritis
45
Varenicline
Partial agonist of a4b2 nicotinic ACh receptor | - causes only limited release of dopamine
46
Inhaled glucocorticoids
Can cause oropharyngeal candidacies | - use spacer & rinse mouth
47
Amiodarone SE
PFT's, LFT's, and TFT's Pulmonary fibrosis Hepatotoxicity Hypo/hyper-thryoidism
48
Fluticasone
Asthma - Corticosteroid - inactivate NFkB | - especially decreased TNF-a
49
Budesonide
Asthma - Corticosteroid - inactivate NFkB | - especially decreased TNF-a
50
Omalizumab
anti-IgE -- Asthma drug | - used in allergic asthma resistant to inhaled steroids and LABA
51
Theophylline
Asthma - bronchodilation via PDE inhibition - increase cAMP Narrow TI = cardio/neurotoxic...blocks adenosine (P450)
52
Bosentan
Treat PAH; antagonist endothelin-1 receptors - decreased pulmonary vascular resistance - give while waiting for lung transplant
53
Allopurinol
Can cause stevens-johnson syndrome | - fever, bullae, sloughing, necrosis, DEATH
54
Amiodarone SE
``` Check PFT, LFT, TFT - QT prolongation, TdP, heart block - Interstitial pneumonitis - Hypo/Hyper-thyroidism - Elevated Transaminases - Liver +++ blue-gray skin discoloration ```
55
Propylthiouracil | Methimazole SE's
Agranulocytosis - pt comes in w/ fever, sore throat, oral ulcerations GET CBCwdiff
56
Pioglitazone
Thiazolidinedione TZD - binds PPAR-g and this complex - binds transcription regulatory sequence of genes * *increases insulin sensitivity (increases adiponectin)
57
Anastrozole
Aromatase inhibitor
58
Letrozole
Aromatase inhibitor
59
Exemestane
Aromatase inhibitor
60
Cholestyramine
``` Bind bile acids -- shit them out Liver has to make more bile acids - this increases LDL cholesterol uptake - reduces LDL blood levels SE: increase TG ```
61
Propranolol
Inhibits NE & Epi compensatory rxn to hypoglycemia - block b2 block gluconeogenesis - block glycogenolysis & lipolysis Don't use nonselective beta blockers in diabetics Reduce the awareness of hypoglycemia in diabetics
62
Repaglinide
``` Meglitinide - closes ATP K+ channel - depolarizes cell - induces L-type Ca++ channel opening - insulin release Short acting ```
63
Sildenafil
Can't give with nitrates -- double SM relaxation | - deadly hypotension
64
OCP Use SE
Hepatic adenoma
65
Tamoxifen & Raloxifen SE's
Increase risk of thromboembolic events Tamoxifen - increased risk endometrial cancer Raloxifen - used for osteoporosis; does not cause endo ca
66
Anastrozole
Aromatase inhibitors used in POSTMENOPAUSAL women with ER+ breast cancer
67
Disulfiram-like reaction
Metronidazole when combined w/ alcohol

Drugs Step 1 (5 decks)

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