Pharm cards 1 Flashcards
(226 cards)
1
Q
cladribine
A
mech:
pruine analog -> multiple mechs (eg inhbition of dna polymerase, dna strand breaks)
hairy cell leukemia
myelosupression
nephrotxic
neurotoxcity
2
Q
dactinomycin (actinomycin d)
A
antitumor
intercalates dna
inhibits rna polymerase
wilms tumor, ewing sarcoma, rhabdomyosarcoma, used for childhood tumors.
myelosupression
3
Q
bevacizumab
A
mab agaisnt vegf, inhbiting angiogenesis.
solid tumors (colon renal cell carcinoma)
hemmorhage, blood clots, and impaired wood healing
4
Q
rituximab
A
monoclonal antibody against cd20. found on most b cell neoplasms
non hodgkin lymphoma, cll, itp, RA
increased risk of PML
5
Q
Vemurafenib
A
small molecule inhbitor of BRAF oncogene in + melanomas. for v600e mutation.
metastatic melanoma
6
Q
tumor lysis syndrome
A
emergency, most often in treatment of leukemias/lymphomas.
hyperkalemia and hyperphosphatemia, increased phosphate causes decreased calcium. increased nucelec acid breakdown -> hyperuricemia -> AKI
treat with agressive hydration, allopurinol, rasburicase.
7
Q
rasburicase
A
recombinant uricase -> uric acid to allantoid
use in prevention and treatment of tumor lysis syndrome
8
Q
idarucizumab
A
mab against dabigatran
9
Q
tranexamic acid
A
inhibits fibrin breakdown
10
Q
alemtuzumab
A
mab to cd52
cll and ms
11
Q
daclizumab
A
cd25 (part of il2 receptor)
relapsing MS
12
Q
natalizumab
A
a4 integrin (involved in WBC adhesion)
MS and chron disease
Risk of PML in patients with JC virus
13
Q
ustekinumab
A
il-12/il-23
psorisasis, psoriatic arthritis
14
Q
ranibizumab, bevacizumab
A
vegf
neovascular age related macular degeneration, proliferative diabetic retinopathy, and macular edema
15
Q
alirocumab
A
pcsk9 inhibitor
decrease decrease decrease / increase / decrease
inactivated ldl receptor degradation, increased ldl removed from blood
myalagias, delirium, dementia, other neurocognitive defects
16
Q
evolucumab
A
pcsk9 inhibitor
decrease decrease decrease / increase / decrease
inactivated ldl receptor degradation, increased ldl removed from blood
myalagias, delirium, dementia, other neurocognitive defects
17
Q
ivabradine
A
antiarrythymic
selective inhibition of funny na channels. prolongs phase 4. decreases sa node firing. negative chronotrope without inotrope. reduces o2 requirement.
chronic stable angina in people who cant take b blockers. chronic HF with reduced ejection fraction.
luminous phenomana/visual brightness, hypertension, bradycardia
18
Q
cefazolin
A
1st cephalo
19
Q
cephalexin
A
1st cephalo
20
Q
cefaclor
A
2nd cepha
21
Q
cefoxitin
A
2nd cepha
22
Q
cefuroxime
A
2nd cepha
23
Q
ceftriaxone
A
3rd cepha
24
Q
cefotaxime
A
3rd cepha
25
cefpodoxime
3rd cepha
26
ceftazidime
3rd cepha
27
cefepime
4th cepha
28
ceftaroline
5th cepha
29
aminoglycoside resistance and mech
irreversible inhibition of inititation complex by binding 30s. mrna misreading. block translocation.
bacterial transferases inactivtion drug by acetylation, phosphorylation, or adenylation.
methylation of ribosomes.
modification of 30s genes makes resistant
30
tetracycline mech and resistance
bind to 30s and prevent attachement of aminoacyl trna.
decreasd uptake or increased efflux by plasmid encoded transport pumps
31
chloramphenicol
blocks peptidyl transferase at 50s
plasmid encoded acetyltransferase inactivated the drug
32
clindamycin
blocks peptide transfer (translocation) at 50s
33
linezolid
inhibition of protein synthesis by binding to the 23s of the 50s subunits and preventing formation of the initiation complex
point mutation of the ribosomal RNA
34
macrolide
inhibits protein synthesis bly blocking translocation by binding to the 23s rrna of the 50s.
methylation of the 23s rrna
35
von hippel lindau
3
36
renal cell carcinoma
3
37
pkd2
4
38
achondroplasia
4
39
hemochromatosis
6
40
willams syndrome
7
41
cystic fibrosis
7
42
fridierich ataxia
9
43
wilson disease
13
44
rb1
13
45
brca2
13
46
prader willi
15
47
angelman syndrome
15
48
marfan syndrome
15
49
brca1
17
50
p53
17
51
hairy cell leukemia
adult males. mature b cell tumor. cells have filamentous hair like projections. "fuzzy"
marrow fibrosis. dry tap. pancytopenia and splenomegaly.
trap
treat with cladribine and pentostatin (purine antimetabolite)
no lymphadenoapthy. accumulate in red pulp.
52
adult t cell leukemia/lymphoma
adults
mature cd4 t cells
caused by htlv-1 which is associated with IV drug abuse
rash (infiltration) generalized lymphadenopathy. hepatosplenomegaly, lytic lesions (punched out) with hypercalcemia.
most common in the japan west africa and carribbean
53
mycosis fungiodes
adults
mature cd4 cells
infiltrate the skin producing rash, plagues, and nodules. aggreates of neoplastic cells called pautrier microabscesses.
can spread to blood producing sezary syndrome (t cell leukemia)
- lymphocytes with cerebriform nuclei are seen on blood smear.
54
langerhans cell histocytosis
langerhans cells are dendritic cells found in the skin
derived from bone marrow monocytes
present to naive t cells
birbeck granules (tennis racke) granules. cd1a+ and s100+ (mesodermal origin).
letterer-siwe disease
- malignant
- skin rash and cystic skeletal defects in infant less than 2
- multiple organs involved and rapidly fatal
eosinophilic granuloma
- benign proliferation in the bone
- adolescent with patholgic fracture
- biopsy shows langerhans cells with mixed inflammation including eosinophils
hand-schuller-christian disease
- malignant
- scalp rash, lytic skull lesions, diabetes insipidus, and exopthalmos in a child
FA
presents in child as lytic bone lestions and skin rash or reccurent otitis media with a mass involing the mastoid process. cells are fxnnly immature and do not present antigens
55
MAC prophylaxis and treatment
azithromycin, rifabutin for prophylaxis
hiv prophylaxis < 50 azithromycin or clarithromycin
Treatment
azithromycin or clarithromycin + ethambutol
can add rifabutin or ciprofloxacin
56
M laprea treatment
long term treatment with dapson and rifampin for tuberculoid form. Add clofazimine for lepromatous form
57
haloperidol
high potency typical
58
pimozide
typical not specified
59
trifluoperazine
high potency typical
60
fluphenazine
high potency typical
61
thioridazine
low potency antipsychotic
62
chlorpromazine
low potency antipsychotic
63
aripiprazole
atypical
64
asenapine
atypical
65
clozapine
atypical
66
olanzapine
atypical
67
quetiapine
atypical
68
iloperidone
atypical
69
paliperidone
atypical
70
risperidone
atypical
71
lurasidone
atypical
72
ziprazidone
atypical
73
fluoxetine
ssri
74
fluvoxamine
ssri
75
paroxetine
ssri
76
sertraline
ssri
77
escitalopram
ssri
78
citalopram
ssri
79
venlafaxine
snri
80
desvelafaxine
snri
81
duloxetine
snri
82
levomilnacipram
snri
83
milnacipram
snri
84
amitriptyline
tca
85
nortriptyline
2nd tca
86
imipramine
tca
87
desipramine
tca 2nd
88
clomipramine
tca
89
doxepin
tca
90
amoxapine
tca
91
truncus arteriosus
ascending aorta and pulmonary trunk
92
bulbus cordis
smooth parts (outflow track) of the left and right ventricles
93
endocardial cushions
atrial septum, membranous interventricular septum, av and semilunar valves
94
primitive atrium
trabeculated (left and right atria)
95
primitive ventricle
trabeculated part of the left and right ventricle
96
primitive pulmonary vein
smooth part of the left atrium
97
left horn of the senous venosis
coronary sinus
98
right horn of the sinus venosus
smooth part of right atrium
99
right common cardinal vein and right anterior cardinal vein
svc
100
endocarditis dental prevention high risk
amoxicillin
101
gonorrhea exposure
cetriaxone
102
reccurent utis
tmp smx
103
meningicoccal exposure
ceftriaxone, ciprofloxacin, rifampin
104
pregnant women with strep b
intrapartum penniciln g or ampicillin
105
prevention of gonogoccal conjuncitivits in newborn
erythromycin ointment on eyes
106
prevention of postsurgical infection due to s aureus
cefazolin
107
prophylaxis of strep pharyngitis in child with prior rhematic fever
penicillin g or oral penicillin v
108
exposure to syphhils
benzathine penicillin g
109
cd4 less than 200 prophylaxis
use tmp smx for pneumocystis
110
cd4 less than 100 prohylaxis
tmp and smx for pneumocystis and toxoplasmosis
111
cd4 less than 50 prophylaxis
use azithromycin or clarithromycin for MAC
112
mrsa treatment
vancomycin, daptomycin, linezolid, tigecycline, cefaroline, doxycycline
113
vre treatment
linezolid, streptogamins (quinupristin, dalfopristin) - bind to 50s, i added (daptomycin, linezolid, tigecycline)
114
multidrug resistant p aeruginosa
polymixins B and E(colistin)
115
multidrug resistant acinetobacter baumannii
polymixins B and E(colistin)
116
azole for histoplasma, coccidioides, blastomyces
itraconazole
117
topical azole for fungal infections of skin
coltrimazole and miconazole
118
asperigillus infection
voriconazole (also works agaisnt some candida)
serious aspergillus use isavuconazole
119
mucorales infection
amphoterricin
isavuconazole
120
terbinafine side effects
gi upset, headaches, hepatotoxicity, tast disturbance
121
-fungins
echinodins
122
echinodins side effects
gi upset, flushing (by histamine release)
123
griseofulvin
teratogenic, carcinogenic, confusion, headaches, disulfarim like reaction, increase cyp and warfarin metabolism
124
toxoplasmosis treatment
pyrimethamine + sulfadiazine
125
t cruzi
benznidazole or nifurtimox; crusing in my benz with a fur coat on
126
leshminiasis
amphotericin b (localized cutaneous) or sodium stibogluconate (sever diffuse cutaneous and visceral)
127
antimite/louse therapy
permethrin (neuronal membrane deplorization via na channels)
malathion (acetylcholinesterase inhibitor)
lindane (blocks gaba channels -> neurotoxicity)
used to treat scabies (sarco scabiei) and live (pediculus and pthirus)
treat Pesky Mites and Lice with PML because they NAG you
scabies: permethin cream, washing/drying all clothing/bedding, treat close contacts
lice: pyrethoids, malathion, or ivermectin lotion, and nit combing. children can attend school and treated at home
128
malaria treatments
use choloroquine for sensitive species (dont use for falciparum, resistance too common)
if resistant use:
mefloquine, atovaquone/proguanil
Treat falciparum with:
artemether/lumefantrine or atovaquone/proguanil
for life threatening use:
use IV quinidine in US (quinine elsewhere) or artesunate
for p vivax/ovale
add primaquine for hypnozoite
129
chloroquine (hydrozychloroquine)
blocks plasmodium heme polymerase which turns heme into hemozoin. heme accumulates and is toxic.
resistance due to membrane pump that reduces intracellular concentrations
retinopathy; pruitis (especially in dark skinned people)
130
adenoma
benign of the epithelium
131
adenocarcinoma
malignant of epithelium
132
leiomyoma
benign smooth muscle
133
leiomyosarcoma
malignant smooth muscle
134
rhabdomyoma
benign striated
135
rhabdomyosarcoma
malignant striated
136
three most common cancers
basal > squamos > > melanoma (skin)
137
men cancer incidence
prostate, lung, colon/rectum
138
men cancer mortality
lung, prostate, colon/rectum
139
women cancer incidence
breast, lung, colon/rectum
140
women cancer mortality
lung, breast, colon/rectum
141
children cancer incidence/mortality (0 to 14)
leukemia. brain and CNS, neuroblastoma
142
four carcinomas with hematogenous spread
renal, hepatocellular, follicular of thyroid, choriocarcinoma
143
cytokeratin/keratin
epithelial
144
vimentin
mesenchymal tissue (eg fibroblasts, endothelial cells, macrophages)
mesenchymal tumors and others (eg endometrial carcinoma, renal cell carcinoma, meningioma)
145
desmin
muscle tumors (eg rhabdomyosarcoma)
146
gfap
neuroglia (astrocytes, schwann cells, oligodendrocytes)
eg astrocytoma, glioblastoma
147
neurofilaments
neurons
148
empiric meningitis treatment
ceftriaxone and vancomycin (add ampicillin if listeria suspected)
149
viral causes of meningitis
enterviruses (especiialy coxsackie), hsv-2 (hsv-1 = encephalitis), hiv, wnv (also causes encephalitis), vzv
150
infections causing brain abscess
most commonly viridans group or s aureus. if dental extraction or infection, oral anerobes commonly involved.
multiple abscesses are usually from bactermia, single lesions from contigous sites: otitis media and mastoiditis -> temporal lobe. sinusitis or dental infection -> frontal lobe
151
distal renal tubular acidosis causes (type 1)
amphoterricin b, ibuprofen, congenital abnormalities (obstruction), autoimmune like sjorgrens and rheuematoid, ifosfamide, hypercalcuria for any reason, genetic
152
proximal renal tubular acidosis (type 2)
fanconi or carbonic anhydrase inhibitor
153
hyperkalemic renal tubular acidosis (type 4)
decreased aldosterone production (diabetic hyporenism, ace in, arbs, nsaids, heparin, cyclosporine, adrenal insufficiency) or aldosterone resistance (k sparing dieuretics, nephropathy due to obstruction, tmp smx)
154
fanconi syndrome causes
heriditary causes - wilson disease, tyrsinemia, glycogen storage disorder, cystinosis
acquired - iscehmia, multiple myleoma, nephrotoxins/drugs (eg ifosfamide, cisplatin, tenofovir, expired tetracyclines), lead poisoning
155
septic arthritis
s aureus, strep, and n gonorrhea are common causes. affected joint is swollen red and painful. synovial fluid purulent (greater than 50000 wbcs)
gonococcal ahtirtis - sti that presents as either purulent arthritis (eg knee) or triad of polyarthalgia, tenosynovitis (hand), dermatitis (eg pustules)
156
molecules working on the parietal cells
ach, gastrin, histamine, somatostatin, prostaglandins
157
parietal cell ach
m3 gq
158
gastrin parietal cell
cckb gq
159
histamine on parietal cell
h2 recep gs
160
somatostain on parietal
gi
161
prostaglandin on parietal
gi
162
abacavir (ABC)
nrti hlab 5701
163
didanosine (ddl)
nrti pancreatitis
164
emtricitabine (ftc)
nrti macular rash on palms
165
lamivudine
nrti
166
stavudine (d4t)
nrti
167
tenofovir (tdf)
nrti nucleotide
168
zidovudine (zdv, formely azt)
nrti general prophylaxis and pregnancy, anemia
169
delavirdine
nnrti ci in pregnancy
170
efavirenz
nnrti cns symptoms and vivide dreams
171
nevirapine
nnrti ci in pregnancy
172
rilpivirine
nnrti
173
indinavir
protease inhbitor. nephopathy and hematuria from stones of drug. thrombocytopenia
174
autoclave
pressurized steam at greater than 120. may be sporicidal
175
alcohols
denature proteins and disrupt cell membranes. not sporicidal
176
chlorhexidine
denatures proteins and disrupts cell membranes. not sporicidal
177
hydrogen peroxide
free radical oxidation. sporicidal.
178
iodine and iodophors
halogenation of dna, rna, and proteins. may be sporicidal.
179
c tetani treatment
prevent with vaccine. treat with antitoxin plus minus vaccine booster., diazepem (for muscle spasms), wound debridement.
180
c diff treatment
often caused by clindamycin, ampicillin, associated with ppi use.
metronidazole or oral vancomycine. reccurent cases consider fidaxomicin, or fecal microbiota transplant.
181
listeria monocytogenes treatment
ampicillin
182
nocardia treatment
tmp smx
183
actinomyces treatment
penicillin
184
gonocci treatment
cetriaxone + (azithromycin or doxycyline) for chlamydia
erythromycin oitment prevents neonatal blindness
185
menigocci treatment
rifampin, ciprofloxacin, ceftriaxone for prophylaxis of close contacts.
treat with ceftriaxone or penicillin g
186
haemophilus influenza treatment
amoxicillin +/- claculanate for mucosal infections. ceftriaxone for meningitis. rifampin prophylaxis for close ocntacts.
187
legionella treatment
macrolide or quinolone
188
pseudomonas treatment treatment
"campfire"
carbapenems
aminoglycosides
monobactams
polymyxins (polymixn b, colistin)
fluroquinolones (ciprofloxacin, levofluroquinolone)
thIRd and fourth gen cepahlospoins (eg ceftazidime, cefepime)
extended spectrum peniciilins (eg ticarcillin, piperacillin)
189
salmonella typhi
ceftriaxone or fluroquinolones
190
h pylori
amoxicillin (metronidazole if allergic) + clarythromycin + ppi (antibiotics cure pylori)
191
lyme disease
doxycyline (1st line); amoxicillin and cefuroxime in pregnant women and children
utd says all work for early stage
192
g vaginalis
metro or clindamycin
193
chlamydiae
treatment: azithromycin (prefered because one time treatment) or doxycyline (+ceftriaxone)
lacks classic peptidoglycan due to reducde muramic acid so b lactams dont work
194
m pneumonia
macrolides, doxycyline, or fluroquinionlens.
penicillin infeective since no cell wall
195
candida
oral fluconazole/topical azole for vaginal.
nystatin, fluconazole, or capsofungin for oral/esophageal.
fluconazole, caspofungin, or amphoterricin b for systemic
196
c neoformans
amphoterricin b + flucytosine followed by fluconzaole for meningitis
197
mucor and rhizopus
surgical debridement and amphoterricin b
198
PCP
tmp-smx, pentamidine (if sulfa allergy), dapsone (prophylaxis only), atovaquone. Start prophylaxis when cd4 less than 200
199
sporothrix
itraconazole or k iodide
200
giardia
metro
201
e histolytica
metronidazole; paromomycin or iodoquinol for asymptomatic stool passers
202
cryptosporidium
prevention by filtering city water supplies; nitazoxanide in immunocmopetent hosts
203
toxoplasmosis
tmp smx prophylaxis
sulfadiazine + pyrimethamine
204
n fowleri
amphoterrin b has been effective in a few
205
t brucei
suramin for blood
melarsoprol for CNS
206
babesia
atovaquone + azithromycin
207
t cruzi
benznidazole or nifurtomox
curising in my benz with my fur coat
208
l donovani
amphoterricn b (localized cutaneous)
sodium stibogluconate (severe diffuse cutaneous or visceral)
209
t vaginalis
metronidazole for patient and partner (prophylaxis)
210
enterobius vermiculuari (pin worm)
bendazoles (1st line)
pyrantel pamoate (pregnant)
211
ascaris (giant roundworm)
bendazoles
212
strongyloides (threadworm)
ivermectin or bendazoles
213
ancyclostome/necator (hookworms)
bendazoles or pyrantel pamoate
214
t spiralis
bendazoles
215
trichuris trichiura (whipworm)
bendazoles
216
toxocara canis
bendazoles
217
onchocerca volvulus
ivermectin
218
loa loa
diethylcarbamazine
219
wuchereria bancrofti
diethylcarbamazine
220
t solium
intestinal tapeworm - paziquantel
cystercercosis - praziquantel
neurocystercerci - albendazole
221
d latum
praziquantel
222
e granulosis
albendazole
223
schistoma
praziquantel
224
clonorchis
praziquantel
225
rsv prophylaxis in premies
palivizumab
226
postexposure prohylazin rabies
wound cleaning plus immunization with killed vaccine and rabies immunoglobin
