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1

Vasodilation mechanism

Endothelial cells have muscarinic receptors; cholinergic agonist bind -> release of NO (EDRF) -> guanylate cyclase -> dec. Ca2+ -> decreased activity of myosin light-chain kinase --> myosin light chain DEphosphorylation and SMC relaxation

2

Order the insulins in terms of earliest to latest peak

Aspart/lispro/glulisine, regular, NPH, detemir, glargine

3

Lithium toxicity symptoms? tx

Tremors, fascicular twitching, agitation, ataxia, delirium; tx with hemodialysis for acute. Can also cause hypothyroidism and nephrogenic diabetes inspidus.

4

Drugs that could increased Li levels?

Thiazides (increased proximal Na reabsorption as compensation to distal effects), ACEi, NSAIDs

5

Name the short benzos?

Alprazolam (Xanax), Triazolam, Oxazepam.
OATs. Tri- and eat your OATs quickly in the morning.

6

Name the long benzos?

Chlordiazepoxide (Librium), Diazepam (Valium), Flurazepam, Clorazepate. Long view: Libreate and Valor.

7

Name the medium benzos?

Lorazepam (Ativan), estazolam, temazepam.
live and LET die. Medium-lvl bond movie.

8

Reverse benzos with?

Flumazenil

9

Acute neonatal narcotic withdrawal?

Pupillary dilation, rhinorrhea, sneezing, d, n/v, chills. tx = diluted tincture of opium

10

Dobutamine?

B-adrenergic agonist B1>B2 --> Positive inotropy, weakly positive chronotropic, increases conduction velocity (arrhythmias), increases myocardial oxygen consumption

11

Anticholinergic toxicity?

Fever, mucosal/axillary dryness, cutaneous flushing, mydriasis (big), cycloplegia, delirium. e.g. TCA's, atropine

12

What drugs more effective against HSV and VZV than CMV/EBV?

Acyclovir, famciclovir, valaciclovir. B/c dependnet on a thymidine kinase to turn into active triphosphate form.

13

Protease inhibitors?

Squinavir, ritonavir

14

Fusion inhibitors

Enfuvirtide

15

RT inhibitors

Efavirenz (NNRTI), tenofovir, lamivudine

16

Integrase inhibitors

Raltegravir

17

CCR5 receptor inhibitors

Maraviroc

18

Surgery + liver damage?

Inhaled anesthetics (e.g. halothane) associated w/ highly lethal fulminant hepatitis - aminotransferase, PTT inc, eosinophilia

19

Finasteride

Blocks peripheral conversion of testosterone to DHT

20

Flutamide/Cyproterone

Androgen hormone-receptor blocker

21

-mab's

Monoclonal Ab

22

-cept's

Receptor molecules

23

-nib's

Kinase inhibitor

24

Origin substem for -mab's

Mouse (-o-), Human (-u-), Chimeric w/ foreign variable (-xi), Humanized w/ completementarity determining regions (-zu), chimeric/humanized hybrid (-xizu)

25

Statin + fibrates

Myopathy risk. Simvastatin has highest risk.

26

Varenicline?

Partial agonist to nicotinic ACh receptors -> reduced nicotine withdrawal and reduced reward. (A4B4 nicotinic receptor)

27

Efficacy vs. potency

Efficacy = intrinsic ability of drug to elicit an effect (maximum effect). E.g. analgesics, abc, antihistamines, decongestants. Potency = dose of drug required to produce a given affect (Km related). Highly potent drugs include chemo, antiHTN, lipid-lowering. Potent dose, Kim! Max, more efficacious please.

28

HCTZ effects

Diuretic. Also side effect = increased Calcium absorption. Therefore, a nice drug for older women with HTN.

29

Pentazocine

Opioid designed for decreased abuse. Partial agonist and weak antagonist at mu receptors. Can lead to withdrawal symptoms in patients who are dependent on opioids.

30

Opioid administration -> sudden RUQ pain?

Biliary colic induced by contraction of SMC.