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Flashcards in Meds Deck (118):
1

finasteride

5-alpha-reductase inhibitor that decreases local conversion of TT to DHT in prostate --> shrinks prostate

2

phenylpehrine

alpha-agonist w/alpha-1 selectivity ... sympathomimetic
-

3

alpha-1 adrenergic agonist examples (4)

methoxamine
methylnorepinephrine
phenylephrine
midodrine

4

alpha-1 adrenergic mechanism and outcomes

PLC stimulation --> PIP2, IN3, DAG, Ca

- smooth muscle contraction
- vasoconstriction (pressors)
- mydriasis
- glycogenolysis and gluconeogenesis
- Na reabsorption

5

alpha-2 adrenergic agonist examples

clonidine
guanfacine
methyldopa
guanethidine

6

alpha-2 mechanism and outcomes

inhibits adenylyl cyclase
sympatholytic

- inhibit insulin release
- induce glucagon release
- contract sphincters
- increased thrombocyte aggregation
- presynaptic inhibition of NE in CNS

7

beta-1 agonist ex

dobutamine
xamoterol
denopamine

8

beta-1 agonist mechanism

adeneylyl cyclase activation (cAMP increase)

- increase HR, conduction velocity, and contractility
- increase renin from JGA
- increase ghrelin from stomach
- lipolysis in adipose
-

9

beta-2 agonist ex

- salbutamol
- salmeterol
- isoproterenol
- terbutaline

10

Short acting benzos (time and ex) (3)

< 10hrs
1. alprazolam
2. triazolam
3. oxazepam

11

medium acting benzos (t and ex) (3)

10-20hrs

1. estazolam
2. lorazepam
3. temazepam

12

long acting benzos (t and ex) (4)

days

1. diazepam
2. chlordiazepoxide
3. clorazepate
4. flurazepam

13

class Ia anti-arrhytmic (3)

1. disopyramide
2. quinidine
3. procainamide

(Double Quarter Pounder)

14

class Ib anti-arrhthmic (3)

1. lidocaine
2. tocainide
3. mexiletine

(Lettuce, Tomatoes, Mayo)

15

class Ic anti-arrythmic (2)

1. moricizine
2. flecainide
3. propafenone

(More Fries Please)

16

class IV anti-arrythmic (2)

1. dilt
2. verapamil

17

class II anti-arrythmic (4)

1. metoprolol
2. propranolol
3. atenolol
4. carvedilol

18

class III anti-arrythmic (4)

1. amio
2. sotalol
3. dofetilide
4. ibutilide

19

zodivudine (ZDV) aka azidothymidine (AZT)

NRTI

20

ganciclovir

antiviral med that treats CMV by acting as a dGTP competitive inhibitor

21

Metformin

- increases glycolysis
- decrease GI glucuose absorption
- decrease gluconeogenesis
- lactic acidosis

absolutely contraindicated in pts with renal failure or any other situations that may precipitate lactic acidosis:

1. liver dysfunction
2. chf
3. alcoholism
4. sepsis

b/c heart, liver, and kidneys use lactate to metabolize ATP

22

chlorpromazine eye ADR

corneal deposits

23

thioridazine eye ADRs

retinal deposits resembling retinitis pigmentosa

24

zipradisone ADRs

- prolonged QT

25

olanzapine ADRs

- WT gain

26

clozapine ADRs

- agranulocytosis
- seizures

27

Physostigmine

AchE inhibitor peripherally and centrally (can cross BBB)
used to counteract atropine's mucarininc cholinergic blockade

28

atropine

muscarinic cholinergic blockade
can be used to reverse muscarinic effects of organophosphate toxicity

29

xanthine oxidase inhibitor

allopurinol

30

uricosuric drugs

probenecid
sulfinpyrazone
-long term serum uric acid lowering therapy
- need good renal function

31

ergonovine

ergot alkaloid that constricts vascular smooth muscle by stimulating both alpha-adrenergic and serotonergic receptors

32

non-selective alpha blockers

- phentolamine
- tolazoline
- trazodone
- typical and atypical antipsychotics

33

alpha-1 blockers

tamsulosin
terazosin
alfuzosin
prazosin

34

alpha-2 blockers

mirtazapine
yohimbine
idazoxan
atipamezole

35

diphenoxylate

opiate anti-diarrheal
binds to mu opiate rec in GI to slow motility

ADR
bloating and mild sedation

36

kaolin-pectin and attapulgite

adsorbents that adsorb fluids, toxins, nutrients, and digestive juices to prevent diarrhea

37

bismuth subsalicylate

treat secretory diarrhea

38

doxazosin

alpha-1 blocker for HTN and urinary retention of BPH

39

Mebendazole

treats helminths
Enterobius vermicularis

40

Diethylcarbamazine

treats loa loa (loiasis
and wucherenia bancrofti (lymphatic filariasis infections

41

Ivermectin

treats strongyloides stercoralis and onchocerca volvulus (onchocerciasis)

42

Nifurtimox

treats trypanosomes like Chagas (trypanosoma cruzi)

43

Praziquantel

treats schistosoma (schitosomiasis) clonorchis sinesis (clonorchiasis) and paragoniimus westermani (paragonimiasis)

44

Milrinone
1. mechanism
2. some effects

1. PDE3 inhibitor --> elevated cAMP
2. vasodilation, inotropic

45

Chlorpheniramine

1st gen antihistamine that blocks central and peripheral H1 receptors
can be sedating b/c easily crosses BBB

46

Loratadine

2nd gen antihistamine that can't cross BBB so no sedations

47

Ranitidine

H2 receptor antagonist that inhibits gastric acid secretion

48

Phenytoin treats?
how?

grand mal (tonic-clonic) sz's, partial sz's, status epilepticus

by blocking VG-Na channels

49

Phenytoin toxicitiy

cerebellum and vestibular system --> ataxia and nystagmus

50

Phenytoin ADRs

1) gingival hyperplasia, hirsuitism
2) metagloblastic anemia (2/2 folic acid metabolism deF)

51

Phenytoin and cyt p450

induces p450 --> increases metabolism and decreases blood level of many meds

52

phenytoin and pregnancy

can cause fetal hydantoin syndrome

53

Lithium toxicity

NMJ excitability (irregular coarse tremors, fascicular twitching, rigid motor agitation, ataxia)

- Nephrogenic diabetes insipitus
- hypothryoidism
- cardiac conduction defects

54

Prednisone ADRs (5)

- hyperglycemia
- wt gain
- depression
- fluid retention w/edema
- osteoporosis

55

cocaine mechanism

blocks re-uptake of NE, 5-HT, and Dopa into CNS

56

Methimazole
1) mechanism
2) ADRs (3)

inhibits thyroid hormone synthesis by supprsesing iodination and couple of tyrosine

- edema, rash, agranulocytosis

57

cholinergic syndrome

DUMBELS - muscarinic
Diarrhea and diarphoresis
Urination
Miosis
Bronchospasm and baradycardia
Emesis
Lacrimation
Salivation

muscle fasciculations and paralysis - nicotinic

58

pralidoxime

reverses muscarinic and nicotinic effects of organophsphates by restoring cholineresterase from the bound toxin

59

naloxone
1. reverses what and how
2. what receptors
3. how soon does it work
4. how long does it work
5. vs. naltrexone

1. opioid intoxication or overdose by acting as pure opioid receptor antagonist
2. mu recetpors
3. minutes
4. 1-4 hours
5. naloxone is shorter acting - better for emergencies

60

Calcipotriene
- what is it and how does it work
- treats what

- topical vit D analog that binds to vitD receptor, a nuclear TF that causes inhibition of keratinocyte proliferation and stimulates keratinocyte differentiation
- also, inhibits T cell proliferation and other inflammatory mediators

- psoriasis

61

cyclosporine
- mechanism
- treats what

- inhibits NFAT (nuclear factor of activated T cells) from entering nucleus --> impairs production of IL-2 --> therefore prevents activation of T cells
- treats psoriasis among others

62

Etanercept
- mechanism

- binds TNF alpha

63

pyridostigmine
- mechanism
- treats

- cholinesterase inhibitor (globally)
- myasthenia gravis (but this only needs the nicotinic effect, so may have mAchR mediated ADRs)

64

scopolamine
-mechanism
- another similar med

- selective muscarinic AchR antagonist that reduces effects of global cholinesterase inhibitors
- hyoscyamine

65

pilocarpine
- mechanism

non-selective mAchR agonist

66

ribavirin
- mechanism
- treats

- nucleoside antimetabolite drug that interfers w/duplication of viral genetic material

- chronic HCV and RSV

67

raltegravir
- mechanism
- treats

- integrase inhibitor that inhibits integration of viral DNA into host genome
- HIV

68

indinavir
- mechanism
- treats

- inhibits viral protease activity
- HIV

69

amantadine
- mechanism
- treats

- prevents uncoating of influenza A virion after endocytosis
- influenza A

70

enfuvirtide
- mechanism
- treats

- prevents viral entry into target cell
- HIV fusion inhibitor

71

inhaled anesthetics
- leads to increase in blood flow to where?
- decreases in what (4)

cerebral blood flow
- 1. GFR
2. RPF
3. LVEF
4. hepatic blood flow

72

pentazocine
- mechanism

opioid marcotic w/partial agonist activity and weak antgaonist activity at mu receptors

73

misoprostol
- mechanism
- used for (4)

- PGE1 analog
- prevent gastric ulcers, treat missed miscarriages, induce labor, induce abortion

74

What meds can cause Cushing Syndrome (2)

- glucocorticoids
- HAART therapy

75

What treats absence seizures

Ethosuximide

76

Ethosuximide
- mechanism
- BM suppression?

- blocks T-type CaCh in thalamic neurons
- NO

77

Carbamazepine
- mechanism
- treats what
- possible ADRs

- blocks VG-NaCh in cortical neurons and stabilizes it in inactive state
- simple/complex partial seizures; managing generalized tonic-clonics; mood stabilizer in BPD; treats trigeminal neuralgia
- BM suppression; heptaotoxic (LFT check); ADH-secretion (SIAHD)

78

Isoniazid chemically similar to what vitamin
- what does it do

B6 (pyridoxine)
- part of TB regiment, but it depletes B6

79

What reverses TCA-associated cardiac abnormalities

Soidum bicarb
- can correct QRS prologation
- reverse HoTN
- treat V-dysrhythmias

80

which TB drug causes visual changes
- what changes are they
- how does it affect mycobacterium
- how do to treat visual changes

- Ethambutol
- optic neuritis, color blindness, central scotoma
- inhibits arabinosyl transferase, which is required for cell wall carbohydrate synthesis
- discontinuation usually leads to improvement

81

Primidone
- what is it
- what is it metabolzied to

- antiepileptic
- phenobarbital and phenylethylmalonamide

82

Three classes of antimetabolites

1. Folate antagonist
2. Purine analogs
3. Pyrimidine analogs

83

Folate antagonist (1)

methotrexate

84

Purine analogs (3)

1. 6-thiopurines (6-MP, 6-GP)
2. fludarabine - CLL
3. cladribine - HCL

85

Pyrimidine analogs (4)

1. 5-fluorouracil
2. capecitabine
3. cytarabine
4. gemcitabine

86

lomustine
1. class
2. mechanism
3. activation
4. CNS permeation?

1. nitrosurea
2. DNA alkylation and cross-bridge formation
3. non-enzymatic hydroxylation in liver
4. penetrates well 2/2 lipophilicity

87

cisplatin
1. class
2. activation requirements

1. platinum-tontaining chemo agent
2. needs to by hydrated in environments w/low chloride concentration

88

MTX mechanism

folic acid analog that inhibits dihydrofolate reductase w/out metabolic conversion

89

mercaptopurine
1. class
2. activated by
3. inactivated by

1. purine analog
2. hypoxanthine-guanine phosphoribosyl transferase
3. xanthien oxidase

90

cladribine
1. class
2. resistant to?
3. used for?

1. purine analog
2. resists degradation by adenosine deaminase
3. hairy cell leukemia

91

deferoxamine
- what does it do
- what is it antidote for

- specific chelator of iron
- antidote for serious iron poisoning

92

TCA toxicity treated by?

so`dium bicarbonate

93

how is acetaminophen detoxed in liver

cyt P450 metabolizes it to NAPQI that the liver puts through sulfation and glucuronide conjugation

94

antidote for acetaminophen toxicity
- mechanism

NAC (N-acetyl cysteine)
- provides sulfhydryl groups

95

polyethylene glycol
- mechanism
- other examples

- osmotic laxative
- magnesium hydroxide (magnesium citrate)

96

drug-induced lupus erythematous (5)

1. hydralazine
2. procainamide
3. isoniazid
4. minocycline
5. quinidine

97

findings for drug-induced lupus erythematous (4)

1. new onset lupus sxs
2. ANA and anti-histone antibodies
3. anti-dsDNA rarely seen
4. exposure to the drug

98

halothane can cause?
how?

massive hepatic necrosis
- halothane metabolite direct damage to liver
- formation of autoantibodies to liver proteins

99

what meds can cause coronary steal phenomenon

adenosine
dipyridamole

100

shortest acting benzo

triazolam

101

what causes orthostatic hypotension and lightheadedness

blockade of alpha-1 adrenergic receptors

102

extrapyramidal sxs

over-blockade of dopamine receptors 2/2 antipsychotics

103

octeotride
- what is it
- mechanism

- somatostatin
- potent inhibitor of GH, glucagon, and insulin

104

common precipitating factors of G6PD deficiency anemia (4)

1. infectins
2. drugs (dapsone, antimalarials, sulfonamide abx (TMP-SMX)
3. DKA
4. favism

105

hyroxyurea
- what does it do
- when is it used

- increases fetal hemoglobin in an not understood way
- in pts with sickle cell anemia w/frequent pain crises

106

clomiphene
- mechanism
- used for?

- selective estrogen receptor modulator
- prevents negative feedback inhibition of hypothalamus --> allows increased release of gonadtotropin (FSH, LH) --> aids in ovulation

107

leflunomide inhibits?

dihydroorotate dehydrogenase ... therefore, inhibits pyrimidine synthesis

108

mycophenolate and ribavirin inhibit?

IMP dehydrogenase --> inhibits GMP synthesis during de novo purine synthesis

109

hydroxyurea inhibits?

ribonucleotide reductase --> screws up de novo pyrimidine synthesis

110

6-mercaptopurine (6-MP) inhibits?

de novo purine synthesis ... stops it right at the beginning

111

5-fluorouracil (5-FU) inhibits?

thymidylate synthase --> decreases dTMP formation --> inhibits de novo pyrimidine synthesis

112

MTX, TMP, pyrimethamine inhibit what?

Dihydrofolate reductase --> decreases DHF conversion to THF which is needed for dTMP formation

113

meds that act on microtubules (5)

"Microtubules Get Constructed Very Poorly"
1. Mebendazole (anti-helminth)
2. Griseofulvin (anti-fungal)
3. Colchicine (anti-gout)
4. Vincristine/Vinblastine (anti-cancer)
5. Paclitaxel (anti-cancer)

114

Fomepizole
- inhibits what?
- used for ?

- inhibits alcohol dehydrogenase
- antidote for methanol or ethylene glycol poisoning

115

disulfiram (Antabuse)
- inhibits what?
- used for?

- acetaldehyde dehydrogenase, therefore excess acetaldehyde
- makes you feel more hungover w/alcohol, treats chronic alcoholism

116

Clomifene
- what is it
- used for?
- ADR

- SERM (inhibits EstR's in hypothalamus --> inhibits negative feedback) --> upregulation of HPA gonad axis
- ovulation induction and reversal of anovulation
- hot flush

117

Tamoxifen
- receptors
- used for?

- estrogen receptor antagonism in breast but agonism in endometrium

118

Amiodarone toxicity
- check what?
- causes what?

- LFTs, PFTs, TFTs
- Transaminitis
- Interstital lung disease
- Hypo/Hyperthyroidism b/c Amiodarone ~ Throxine (T4)