Pharm

Question 1

Generalized Absent Seizures

Answer 1

Ethosuximide (1st line)
-Ca+ channel blocker at thalamic neurons

Absent and GTC
=Valproic Acid
-Na channel blocker, increase K+ efflux

Question 2

1st line GAD

Answer 2

SSRI
Fluoxetine
Citalopram
Sertaline
Paroxetine
Escitalopram

Question 3

2nd Line GAD

Answer 3

Buproprion
NDRI
(Smoking cessation too)
No libido side effects

Question 4

Gout drugs

Answer 4

Colchicine (MT)
Allopurinol/Febuxostat
Indomethacin (NSAID) (1st initial Tx)
Rasburicase
Probenecid

Question 5

Colchicine MoA

Answer 5

Binds to tubulin
Inhibits MicroTubules
Initial treatment for flare
Prophylaxis prior to Allopurinol
Contraindicated in elderly and RF
SE:Diarrhea

Question 6

Lithium toxicity description

Answer 6

Bipolar rx
Destroys Aqp-V2 receptors

Cause: Thiazides, ACE-I, NSAIDs, Dehydration

SE:Ataxia, confusion, nausea, vomitting, Epsteins Anomaly

Question 7

2nd line Gout

Answer 7

Probenecid
Increase renal excretion by blocking renal transporter

Question 8

Rasburicase
(Tumor lysis syndrome)

Answer 8

Binds to Urate and converts to Allantoin (non toxic metabolite)

Question 9

Alcohol withdrawal

Answer 9

Benzos (1st line)
Lorazepam
Diazepam
Chlordiazepoxide

GABA antagonist
-increases Glutamate

GABA-A stimulation increases Cl- flow into cell.

GABA-B increases K+ conductance and decreased presynaptic Ca++ conductance

Question 10

Arsenic Poisoning
Lead poisoning

Answer 10

Dimercaperol (1st line)
DMSA/Succimer

Question 11

Diphenhydramine

Answer 11

1st gen antihistamine
-sedative effects
-Anti cholinergic properties

Question 12

Chloroquine

Answer 12

Malaria Rx
Intraerythrocytic phase
(All plasmodium species)

Question 13

Primaquine

Answer 13

Added for Vivax and Ovale infections
Targets hypnozoites (dormant liver)

Question 14

Hypertension and BPH

Answer 14

Alpha 1 blocker
Doxazosin
Prazosin
Terazosin
Tamsulosin (uroselective)

Question 15

BPH drugs of choice

Answer 15

Finasteride (5-alpha reductase inhibitor)

Tamsulosin (uroselective smooth muscle alpha-1 inhibitor)

Flutamide (testosterone receptor inhibitor)

Question 16

Buprenorphine

Answer 16

Partial opioid agonist (high affinity)
SE-precipitated withdrawal symptoms

Question 17

Allopurinol

Answer 17

Xanthine oxidase inhibitor
HXN—>Xanthine->Urate->Urine

(Guanine+PRPP+HGPRT—>GMP/IMP)

Question 18

HIV NRTI

Answer 18

Tenofovir
Abacivir
Lamivudine
Emtricitabine
Zidovudine (aplastic anemia)

Question 19

HIV NNRTI

Answer 19

“…VIR…”

EfaVIRenz
NeVIRapine

Question 20

HIV Protease inhibitors

Answer 20

…”NAVIR” suffix

Inhibits polyprotein cleavage

SE:
-Fat deposition
-hyperglycemia
- inhibition of p450

Question 21

What Drugs induce Lupus

Answer 21

Procainide
-Na ch blocker-1A

Hydralazine
-HTN medication-vasodilation
cGMP

Isoniazid
-inhibits mycolic acid
-needs catalase peroxidase to activate

Question 22

Tetracyclines SE

Answer 22

Esophagitis

Question 23

Aminoglycosides SE

Answer 23

*Ototoxic (furosemide too)

30S
Gentamicin, streptomicin, neomycin, paromycin

Rx for:
-Osteomyelitis (staph/salmonella)
-GI infections

Question 24

Nitrofurantoin

Answer 24

Disrupts DNA,RNA,and other intracellular processes

Activated inside bacteria to toxic metabolites

Rx for cystitis and UTIs

Question 25

Fluoroquinolones SE

Answer 25

*Tendon Rupture “…floxacins” Topoisomerase inhibitor (DNA gyrase)

Question 26

TMP/Sulf SE

Answer 26

Hyperkalemia and B9 deficiency Can cross placenta and remove bilirubin from albumin- toxic to baby

Question 27

Cyanide toxicity treatment

Answer 27

Mitochondrial toxin. Binds to Ferric Fe3+ of Cyt-C-Oxidase. Blocking ETC. No Oxygen. Sodium thiosulfate -sulfur donor forming thiocyanate to urine Hydroxocobalamin -cobalt bins to CN- forming cyanocobalamin into urine Sodium nitrite -forms methehemoglobin binding CN- reducing toxicity.

Question 28

Anti Psychotics

Answer 28

Schizophrenic treatment -Dopamine antagonists Decrease dopamine in mesolimbic pathway (hallucinations/delusions)

Question 29

Antifungals MOA -Nystatin -Amphotericin B

Answer 29

Bing to ergosterol on cell membrane, pores then lysis.

Question 30

AntiFungals -…Azoles”

Answer 30

Inhibit ergosterol synthesis

Question 31

Antifungals -“…fungins”

Answer 31

Inhibit synthesis of Glucan, component of cell wall

Question 32

Antifungals -Flucytosine

Answer 32

Converted to 5-fu inhibiting RNA and protein synthesis

Question 33

Amphotericin B SE

Answer 33

Binds to ergosterol on cell membrane—> creates pores *Nephrotoxic -Hypokalemia -Hypomagnesemia

Question 34

Alcohol toxicity Tx

Answer 34

Fomepizole Alcohol dehydrogenase inhibitor Decrease toxic metabolites (And methanol toxicity)

Question 35

Heavy metal toxicity Tx

Answer 35

Deferoxamine Forms inert complex cleared renally

Question 36

Opiod toxicity Tx

Answer 36

Naloxone Competitively binds Opiod receptors

Question 37

Alcohol use disorder (wants to quit)

Answer 37

Naltrexone Opioid antagonist Inhibits pleasure feeling from alcohol

Question 38

2nd line alcohol use disorder Tx

Answer 38

Disulfiram Aldehyde dehydrogenase inhibitor When pt drinks it causes very shitty SE.

Question 39

Beta Blocker Overdose Tx

Answer 39

Glucagon Increase cAMP (+GaQ)

Question 40

Rifampin

Answer 40

DdRpoly inhibition

Question 41

Isoniazid

Answer 41

Mycolic acid synthesis inhibition

Question 42

Ethambutol

Answer 42

Arabinosyl transferase inhibition

Question 43

Benzos OD Tx “Impaired cognition, slurred speech, ataxia, nystagmus, muscle weakness, bradypnea, amnesia”

Answer 43

Flumanezil Competitive Benzos receptor antagonist

Question 44

Seratonin syndrome Tx

Answer 44

Cyproheptadine -anti-histamine and anti-serotonin  *altered mental status, mydriasis, hyperreflexia/clonus, synthetic hyperactivity.

Question 45

Flutamide

Answer 45

Competitive testosterone receptor inhibitor

Question 46

Ketoconazole

Answer 46

 Inhibits ergosterol synthesis Also, a weak antiandrogen that decreases synthesis in the gonads and adrenals

Question 47

Griseofulvin

Answer 47

Inhibits fungal cell mitosis at metaphase

Question 48

Terbinafine

Answer 48

Allylamine antifungal that accumulates in skin nails and Adipose tissue

Question 49

Copper toxicity

Answer 49

Penicillamine