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Flashcards in Final Exam Deck (125)
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1
Q

What is the most commonly prescribed medication for glaucoma?

A

Litanoprost

Brimaprost (same class)

2
Q

What is the primary underlying cause of glaucoma?

A

increased IOP

3
Q

When treating glaucoma, what are the 4 classes of drugs that could be effective?

A

Prostaglandin analog
Beta 2 antagonist
Carbonic anhydrase inhibitor
Parasympathomimetic (muscarinic agonist, cholinesterase inhibitor)

4
Q

What class is acetylcholine? Which condition can be treated by this?

A

parasympathomimetic -muscarinic and nicotinic agonist

-Myasthenia Gravis - increases available ACh, can produce sk. m. contraction.

5
Q

What class is acyclovir?

A

anti-viral agent

6
Q

Acyclovir inhibits which aspect of viral replication? What is special about this pharmacologic agent?

A

guanosine analog; incorporates into the viral DNA and inhibits further synthesis

  • can cross BBB, used in herpes meningitis and encephalitis*
  • although, gen. used topically for HSV 1 and 2
7
Q

Albuterol, one of the most important drugs in pharmacology, is in which class? What advantage does it have over other agents in this class?

A

beta 2 agonist (bronchodilator)
- selective! will not produce effects on myocardium
(most asthma pts cannot tolerate tachycardia s/e)

8
Q

Amiodarone is in which class and what is it’s MOA?

A

Class 3 anti arrhythmic

- K channel blocker

9
Q

What are the two ways in which bacteria can become resistant?

A
  • bacteria can develop beta-lactamase (enzyme against the B-lactam ring in certain antibiotic classes)
  • PBP can change conformation and stop specific antibiotics from binding
10
Q

Penicillins and cephalosporins both contain this specific aspect in their drug class? what does it do?

A

beta-lactam ring

  • inhibits formation and repair of bacterial cell wall
    i. e. bactericidal
11
Q

How can we prevent bacteria from becoming resistant to the effects of a beta-lactam ring? which drug is this represented by?

A

by adding CLAVULINATE
- prevents formation of beta-lactamase

  • Amoxicillin-clavulinate; Augmentin
12
Q

which drug class is amphotericin B in and what is it’s MOA?

A

anti-mycotic agent
- MOA – binds to ergosterol in fungal cell membrane forming pores (pokes holes = cell death)

saved for life threatening fungal infections, IV, inexpensive.

13
Q

What side effect is amphotericin B known for? How do you prevent this?

A

Shake and Bake
- fever, chills, N/V, renal toxicity

Pre-emptively prescribe aspirin, anti-pyretics, and anti-histamines

14
Q

How do the -azoles work in regard to fungal infection?

A

anti-mycotic that prevent formation of ergosterol

fungal-static

15
Q

Atenolol is in which drug class, what is it’s MOA?

A

parasympatholytic - selective beta 1 antagonist (cardio-specific)

  • negative ionotrophic and chronotrophic effects i.e. reduce timing and force of contraction
16
Q

What are the two ways to alter hypertensive states?

A

PR x CO = BP

reduce peripheral resistance (hydration [depending on cause], anti-coagulants/blood thinners)
or
reduce cardiac output (atenolol)

17
Q
atrovastatin is in which class and what is its class's MOA?
What is a common S/E for this drug?
How do we try to alter it, although not proven by science?
A

statin, HMG-CoA reductase inhibitor

S/E - myopathies

supplement with CoQ10

18
Q

Atropine is in which drug class and what is it’s MOA?

A

parasympatholytic
MOA - muscarinic antagonist

i.e. - inhibits SLUD*

19
Q

what muscarinic antagonist is used exclusively to treat respiratory illness such as: asthma and COPD?

A

Ipratroprium (Atrovent)

20
Q

Which drug class is azithromycin in and what distinguishes this drug?

A

MACROLIDE antibiotic
- Z- PACK (5 day, concentration dependent course with front load on the first day)

bacteristatic

21
Q

What S/E is commonly seen in the macrolides erythromycin and azithromycin? Which of the two examples exhibits lower likelihood of side-effects?

A

DIARRHEA

Azithromycin has less side-effects

22
Q

Bethanechol is in which drug class and what is it generally used to treat?

A

parasympathomimetic, muscarinic agonist

used to treat paralytic bowel or paralyzed urinary bladder (i.e. causes SLUD)

23
Q

Carvedilol’s class and MOA, go!

A

Sympathomimetic

non-selective Beta Blocker (beta 1 and 2 antagonist), selective alpha 1 antagonist

24
Q

What is carvedilol used to treat?

A
heart failure (mild to severe) and hypertension
- could prevent second MI
25
Q

What class is cephalexin in and what is the MOA? Because of its class and MOA, you know it has a _____.

A

class: cephalosporin antibiotic
MOA: binds PBP proteins inhibiting bacterial cell wall synthesis

B-lactam ring!

26
Q

What is cephalexin used to treat?

A

bacterial infections - URI, UTI, skin, ear, genital

- alternative in patients with penicillin allergy

27
Q

What is the class and MOA of clopidogrel?

A

prodrug, metabolized by cyp450 to active form

inhibits platelet activation and aggregation

irreversibly binds P2Y12 class of ADP receptors on platelets.

28
Q

Clopidogrel is used to treat?

A

used for MI and stroke prevention

commonly prescribed post MI, stroke, or peripheral vascular disease.

used with aspirin to treat new/worsening chest pain (MI, unstable angina) works to dilate blood vessel

29
Q

What is the MOA of digoxin? Which class of drugs is it in? And what’s a common S/E?

A

class: digitalis glycoside; ATPase inhibitor
MOA: inhibits sodium-potassium ATP-ase enzyme regulating quantity of Na+ and K+ inside cells.

S/E - Diuresis

30
Q

When is digoxin prescribed? When is it C/I? How does it work?

A

A-fib, CHF (some pts)
C/I if PREVIOUS MI*

It works by increasing the force of contraction (positive ionotrophic effect) and slowing rate (negative chronotrophic).

31
Q

what is the class and MOA of diltiazem?

A

class: Ca channel blocker (Class IV anti-arrhythmic); anti-HTN, anti-angina
MOA: prevents Ca from being released; prevents smooth muscle contraction
- heart and periphery

32
Q

Which antibiotic has the distinguishing characteristic of chelation - i.e. commonly chelates Ca so should not be consumed with dairy products or Ca supplements? Which class of antibiotics also chelates Ca?

A

Doxycycline

  • TOOTH DISCOLORATION C/I CHILDREN
  • also causes photosensitivity*

Fluoroquinolones

  • broad spectrum
  • avoid taking with dairy.
33
Q

doxycycline, is in which class?

A

tetracycline antibiotic

MOA: bind 30S ribosomal subunit - bacteriostatic

34
Q

When is doxycycline indicated?

A

IND: N. gonorrhea or severe acne

- good alternative to penicillin allergy

35
Q

what class is epinephrine in? what is the MOA?

A

class: sympathomimetic
MOA: α- and β-adrenergic receptor agonist

36
Q

when is epinephrine indicated?

A

MC tx for anaphylaxis
prolong action of local anesthetics
decreases bleeding
ophthalmic indications

37
Q

what is the class and MOA of ezetimibe?

A

MOA: reduces intestinal absorption of cholesterol and sugar

- without affecting absorption of triglycerides or fat-soluble vitamins

38
Q

when is ezetimibe used?

A

tx of elevated blood cholesterol

39
Q

what is the class and MOA of fluconazole?

A

class: azole anti-mycotic
MOA: decreases ergosterol synthesis; inhibiting cell membrane formation.

40
Q

when is fluconazole indicated?

A

fungal (candida, MC) infection

41
Q

what class is furosemide in and what is it’s MOA?

A

class: loop diuretic
MOA: acts by inhibiting the Na-K-Cl cotransporter in the loop of Henle (thick ascending limb)

42
Q

when is the diuretic furosemide indicated for use? what is a s/e we should be aware of?

A

edema, HTN

S/E - ototoxicity

43
Q

what class is gentamicin in and what is the MOA?

A

class: aminoglycoside (broad-spectrum) antibiotic
MOA: inhibit protein synthesis, irreversibly binds 30s ribosomal sub-unit, bactericidal

44
Q

what are the common s/e we need to be cautious of with gentamicin?

A
NEPHROTOXICITY OTOTOXICITY (esp w. diuretic rx)** 
-irreversible HL
45
Q

what class is hydralazine in and what is the MOA? what is a S/E of this drug?

A

class: direct arterial vasodilator
MOA: increases cGMP relaxes smooth muscle

S/E - Reflex tachycardia
(lupus like syndrome)

46
Q

when is hydralazine indicated for use?

A

severe HTN, CHF

First line therapy for HTN in pregnancy

47
Q

hydrochlorothiazide - class and MOA

A

thiazide diuretic

MOA: Inhibits Na and Cl transporters in Ascending and DCT

48
Q

what is a common s/e of hydrochlorothiazide

A

hypokalemia, hyponatremia

- also, avoid in patients with sulfa allergy

49
Q

what class is ipratropium in and what is the MOA?

A

class: anticholinergic (parasympatholytic)
MOA: Brochodilator
- blocks muscarinic receptor, antagonist of acetylcholine

50
Q

When is ipratropium indicated?

A

asthma

51
Q

What is the number one treatment of glaucoma?

A

Latanoprost

52
Q

What is Latanoprost? Class, MOA?

A

class: prostaglandin analog
MOA: works to decrease IOP by increasing outflow of aqueous humor (prostaglandin F2 receptor agonist)

53
Q

what is the class and MOA of lisinopril?

A

class: ACE-inhibitor
MOA: Blocks conversion of angiotensin I to II.
Effectively decreases peripheral vasoconstriction;
also inhibit bradykinin degradation

54
Q

when is lisinopril used?

A

HTN patients w/ DM or CHF;

post-MI tx to reduce Morbidity and Mortality

55
Q

What s/e is common for lisinopril or all ACE-inhibitors for that matter?

A

DRY COUGH

56
Q

metoprolol MOA?

A

selective beta-1 antagonist

57
Q

when is metoprolol indicated for use?

A

management of acute MI
angina pectoris
heart failure
mild to moderate HTN.

May also be used to treat supraventricular and tachyarrhythmias and as prophylaxis for migraine headaches.

58
Q

what is the class and MOA for metronidazole?

A

antibiotic, antiprotozoa medication

MOA: inhibit nucleic acid synthesis

59
Q

when is metronidazole indicated for use?

A

C. diff -associated diarrhea and colitis** (IV)

tx of anaerobic infections and mixed infections, surgical prophylaxis requiring anaerobic coverage
H. pylori infection and duodenal ulcer disease
amebiasis caused by Entamoeba histolytica
acne rosacea (topical treatment)
Trichomonas infections.

60
Q

this is a common PO medication of asthma tx, what is it’s MOA?

A

Montelukast

- leukotriene receptor antagonist (lipoxygenase pathway)

61
Q

what is the class and MOA of mupirocin?

A

class - antibiotic, bactroban

MOA - inhibits protein and RNA synthesis of bacteria

62
Q

Which topical antibiotic is effective against MRSA?

A

Mupirocin

63
Q

what is the class and MOA of nitroglycerine?

A

class: nitrates
MOA: vasodilator

64
Q

This is used as an emergency treatment for angina, MI, CHF exacerbation? How is it administered?

A

Nitroglycerine

- sublingually

65
Q

what class is phenylephrine in and what is the MOA?

A

Class: sympathomimetic
MOA: selective alpha-1 receptor antagonist

66
Q

when is phenylephrine contraindicated, and why?

A

HTN, because increases peripheral resistance (reflex bradycardia)

67
Q

When is phenylephrine used?

A

mydriatic, dilates pupil
nasal decongestant
HEMORRHOIDS (Prep-H)

68
Q

T/F

“Surgery, radiation, and chemotherapy are not mutually exclusive.”

A

T
Radiation and surgery are first employed to determine efficacy and possible cure rate. If this is not achievable, then chemotherapy is sought.

69
Q

What is the most important distinguishing factor for antineoplastic drugs to determine the difference between normal cells and cancer cells?

A

Rates of growth and proliferation

70
Q

what is the class and MOA of propranolol?

A

Class - sympatholytic
MOA - non-selective beta 1 and 2 antagonist

anti-HTN

71
Q

What is a C/I of propranolol we need to be aware of?

A

DO NOT use in ASTHMA or DIABETICS

- non-selective; can exacerbate

72
Q

what is the class and MOA of quinidine? What is a major possible side-effect of this drug?

A
class 1a anti-arrhythmic 
- Na channel blocker  
(limits activity and propagation in Purkinje fibers) 

SE: prolonged QT

73
Q

This drug is prescribed to treat arrhythmia (Ventricular), A-Fib and A-flutter, as well as Malaria..

A

Quinidine

74
Q

this is a potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules

A

Spironolactone

  • Aldosterone retains sodium and water, while increasing K+ excretion, this is blocked.
  • increases Na and H2O excretion
75
Q

what side effect of spironolactone should be considered in men?

A

gynecomastia

76
Q

this is a bacterioSTATIC antibacterial agent that interferes with folic acid synthesis in susceptible bacteria, what is it and what class of antibiotics is it in?

A

Sulfamethoxazole
sulfonamide drug

anti-metabolite - folic acid inhibitor
(competes w/ para-aminobenzoic acid (PABA) for binding to dihydropteroate synthetase (dihydrofolate synthetase))

77
Q

when telling a patient how to take sulfamethoxazole, what do you need to remember?

A

Do not take calcium, aluminium, magnesium or iron supplements within 2 hours of taking this medication.
Take on empty stomach: 1 hour before or 2 hours after meals.
Take with a full glass of water.

78
Q

This antibiotic drug class causes tooth discoloration in children due to its high binding capacity for calcium.

What is it’s MOA? What’s an example antibiotic from this class?

A

tetracyclines
(fluoroquinolones also bind Ca)

  • bind 30S ribosomal subunit, inhibiting protein synthesis. BacterioSTATIC
  • Doxycycline
79
Q

This PO treatment for asthma, though rarely used, acts similar to a stimulant, like caffeine in its ability to stimulate CNS while simultaneously causing broncho-dilation - what does it inhibit?

A

theophylline

- phosphodiesterase inhibitor

80
Q

this drug is a pyrimidine analogue, it disrupts folate synthesis by inhibition of dihydrofolate reductase blocking DNA replication. This drug, therefore, exhibits bactericidal activity.

A

Trimethoprim

81
Q

This drug combination is commonly used to treat the following issues:

  • COMMUNITY ACQUIRED-MRSA*
  • Acute Otitis Media
  • Pneumonia, Pneumocystis
  • Uncomplicated Urinary Tract Infections
A

Sulfamethoxazole-Trimethoprim

  • targets TWO steps in folate synthesis when combined. making the combination, bacteriCIDAL
  • can also be used as an anti-malaria combination
82
Q

This antibiotic is administered P.O. ONLY for C.DIFF infection, and IV for what?

A

vancomycin

IV for MRSA*

83
Q

What is the MOA for vancomycin?

A

inhibition of cell-wall biosynthesis

84
Q

higher doses of this drug can be effective against varicella, which drug is it?

A

acyclovir

85
Q

what kind of vaccine is the varicella vaccine?

A

live-attenuated virus

86
Q

the anti-protozoa, damages parasitic DNA and inactivates plasmodium’s enzymatic ability to polymerize heme, in doing this, it allows soluble heme to stick around, which is toxic to parasites - which drug is this and which parasite is it most active against prophylactically?

A

chloroquine

- anti-malaria

87
Q

these drug can cause severe hemolysis in individuals with G6P deficiency

A

chloroquine

metronidazole

88
Q

this antibiotic, antiprotozoal binds to these buggers DNA, effectively halting cell division. It’s highly lipid soluble, and has a METALLIC taste - which drug is this and what MUST be avoided when using this drug?

A

metronidazole

  • AVOID ALCOHOL - inhibits aldehyde dehydrogenase enzyme **
  • tx for amebiasis
89
Q

-azole antimycotic agents are among the most commonly used, what do they inhibit?

A

ergosterol synthesis

90
Q

this chewable anti-parasitic medication is the MOST COMMONLY used of all the anti-helminthic agents, it works by destroying microtubules and it’s effective without many adverse effects - which drug is this? what does it gen. treat?

A

Mebendazole

- helminths! pinworms, tapeworms.

91
Q

this anti-parasitic intensifies release of GABA transmission, while it’s an anti-helminthic, it also is an anti-ectoparasitic which means, it’s effective against: lice, scabies and fleas. Which drug is this? and which drugs need to be avoided during it’s use?

A

Ivermectin

  • avoid benzodiazepines and barbiturates
  • also avoid during pregnancy
92
Q

which species is responsible for MOST malarial infections?

A

Plasmodium falciparum

malaria causes the most deaths, globally - mostly young children of Sub-Sahara Africa

93
Q

Most individuals in the US who contract malaria have travelled where?

A

Sub-Sahara Africa or

South Asia

94
Q

There are four groups of protozoa that are infectious to humans, what are these groups?

A

Sarcodina – the ameba, e.g. Entamoeba
Mastigophora – the flagellates, e.g. Giardia, Leishmania
Ciliophora – the ciliates, e.g. Balantidium
Sporozoa – organisms whose adult stage is not motile e.g. Plasmodium, Cryptosporidium

95
Q

What are the 5 Neglected Parasitic Infections (NPIs)?

A
Chagas disease
Cysticerosis
Toxocariasis
Toxoplasmosis
Trichomoniasis 

-typically associated with poor, marginalized, low-income communities

96
Q

What is the most common, non-viral STI?

A

trichomoniasis

97
Q

this is a parasitic infection that humans contract from cat feces or infected meats/tissues.
Humans may have swelling of lymph nodes, but gen asx. What is it?
that tell you about the organism?) (Why would that be?)

A

Toxoplasmosis

- only treated in immunocompromised*

98
Q

Toxoplasmosis can be prevented, but not treated with ____?

A

Sulfamethoxazole-Trimethoprim (Bactrim)

When treatment is pursued drugs include selected antimalarial and antibiotic drugs.

99
Q

this disease, spread by the kissing bug generally exhibits a swollen eye and if chronic, can cause fatal cardiopathies

A

chagas disease

100
Q

what is the objected of chemotherapeutic drugs?

A

The objective of their use is to “level the playing field” so that the body’s own defense mechanisms will have an opportunity to prevail against the invaders.

101
Q

Antineoplastic drugs may distinguish cancer cells from normal cells based on these 3 characteristics, which is most common?

A
  • Rate of growth and proliferation (MC)**
  • Consumption of selected nutrients
  • Consumption of oxygen
  • small margin of safety - these distinctions are often, imprecise
102
Q

Normal cells that proliferate rapidly and consume large amounts of nutrients and oxygen are victimized by anti-neoplastic agents - what are these 5 tissues?

A
  • Bone Marrow Cells (anemia, leukopenia, infections)
  • Hair Follicles (alopecia)
  • Buccal mucosa (stomatitis)
  • Gonads (impotence)
  • Embryonic tissues (teratogenicity)
103
Q

when is someone said to be “cured” of cancer?

A

cancer free x 5 years

  • If a cure is not attainable, the treatment goal becomes palliation and increased longevity
104
Q

Why is surgery preferred for some cancer treatments?

A

Reducing tumor burden through surgery or radiation often causes remaining cancer cells to enter proliferation stages where they are more susceptible to antineoplastic drugs.

105
Q

Most cancer drugs are administered how?

A

IV - optimize concentration

106
Q

what is primary tumor resistance? what cancers are commonly susceptible to this type of resistance?

A

Primary resistance is the absence of response on first exposure to contemporary antineoplastic drugs among specific cancers. (Possibly due to absence of suppressor gene in certain cancers)

  • Malignant melanoma
  • Brain cancer
  • Renal cell cancer
107
Q

what is acquired tumor resistance?

A

Acquired resistance develops in response to repeated exposure to selected antineoplastic drugs. (Various mechanisms)
-Cancer cell mutations mitigate drug effects -Enhance drug efflux via P-glycoprotein**

108
Q

these are common side effects caused by debris from dead cancer cells in treating leukemia and lymphoma with anti-neoplastics

A

tumor lysis syndrome

-Referred to as Spontaneous Tumor Lysis Syndrome if not precipitated by antineoplastics

109
Q

This anti-neoplastic is an alkylating agent, what is it’s MOA?

A

cyclophosphamide

- inhibits DNA replication, RNA transcription and nucleic acid function

110
Q

This anti-neoplastic is an alkylating agent, what is it’s MOA?

A

cyclophosphamide

- inhibits DNA replication, RNA transcription and nucleic acid function

111
Q

How is cyclophosphamide administered?

A

orally - few anti-neoplastic are administered in this manner

112
Q

This anti-neoplastic is an anti-metabolite agent, though it could also be considered an immunosuppressant or DMARD - which drug is it and what enzyme does it inhibit?

A

methotrexate

  • folic acid inhibitor
  • inhibits dihydrofolate reductase
113
Q

Do humans manufacture their own folate?

A

NO

  • that’s why folic acid inhibitors are bad-to-the-bone AWESOME in antibiotic/anti-neoplastics! ;) I mean, in pharm world.
114
Q

this drug masquerades as a purine or pyrimidine - which become the building blocks of DNA, preventing these substances incorporation into DNA during the “S” phase (of the cell cycle), stopping normal development and division.

A

Methyltrexate

115
Q

what are the bogus purines that methyltrexate create?

A

6-mercaptopurine

thioguanine

116
Q

this antineoplastic, antibiotic-like, anthracycline agent is the MOST efficacious for broad range of cancers, however, cardiotoxicity limits it’s usefulness

A

doxorubicin

117
Q

Which drug must be administered RAPID IV, for fear tissue necrosis at site of injection will occur

A

doxorubicin

118
Q

This drug can create red urine due to a pigment in the drug

A

doxorubicin

119
Q

this anti-neoplastic, microtubule inhibitor - reversibly binds the microtubule, and prevents cell division - which drug is it?

A

paclitaxel

- (S/E) can cause joint pain, sore throat and alopecia

120
Q

this is an anti-neoplastic, it’s a selective competitive antagonist to breast tissue, yet partial AGONIST of uterine tissue - what is it and what is it’s MOA?

A

Tamoxifen

  • binds E receptor and prevents RNA synthesis
121
Q

what is the standard treatment for early breast cancer?

A

Tamoxifen

122
Q

Preparation H label says, “shrinks swollen hemorrhoid tissue” what is the active ingredient and what is the MOA?

A

phenylephrine
- alpha 1 agonist (sympathomimetic)

SE - HTN

123
Q

Will propranolol or atenolol (beta blockers), produce reflex tachycardia? why or why not?

A

No.
Because block B1 receptors

  • otherwise BP drop would stimulate baroreceptors to activate B1.
124
Q

what is a natural vasodilator? vasoconstrictor?

A

NO - dilates

Angiotensin II - constricts

125
Q

What is the most common parasite infection?

A

worms