Pharm exam 2 Drugs, facts, EVERYTHING Flashcards Preview

x SCO summer 2015 Pharmacology > Pharm exam 2 Drugs, facts, EVERYTHING > Flashcards

Flashcards in Pharm exam 2 Drugs, facts, EVERYTHING Deck (374):
1

Atropine

Muscarinic blocker. not very selective. week long duration! has minimal CNS effects. Good for pre–anesthesia. Tx cholinergic poisoning (but doesn't help against nicotinic effects)

2

MOA: steroid that Triggers production of specific proteins that reduce cell growth and proliferation

Prednisone

3

__[drug]__ can interfere with penicillins and cephalosporins

Tetracyclines can interfere with penicillins and cephalosporins

4

What drug goes through P450 metabolism

Vinblastine and Vincristine and
Docetaxel and Paclitaxel
(microtubule inhibitors)

5

Bethanechol

Direct acting, agonist for ACh. More resistant to AChE

6

Nm nicotinic receptors are on ___

Skeletal Muscle

7

Which generation cephalosporin has NORMAL gram positive coverage with improved gram negative coverage (including some Pseudomonal coverage)?

5th generation (Ceftaroline) [end of the -line!]

8

What is good for accurate refraction?

Homatropine or cyclopentolate

9

Phenoxybenzamine

Non–selective alpha antagonists. IRREVERSIBLE. Greater affinity for alpha 1 over alpha 2. Used for pre–op treatment in cases of pheochromocytoma to control hypertension

10

What does sypmathetic/parasympathetic activity do to the Kidney?

Sympathetic alters the secretion of renin. Parasympathetic does nothing

11

Dactinomycin

Antibiotics – interfere with DNA between GC pair and interferes with RNA polymerase. sometimes combined with methotrexate. via IV. liver excretion. SENSITIZES PATIENT TO RADIATION. Bone marrow depression, Immunosuppression, Nausea, vomiting, diarrhea, stomatitis, alopecia,

12

Which cephalosporin is good for people with renal deficiency?

Ceftriaxone (3rd generation) because drug is excreted through bile

13

Carteolol

Non–selective beta antagonists with partial agonist effect

14

Goserelin

Steroid Hormones and Antagonists ….. Steroid hormone that is GnRH analog. Tx prostate and breast cancer. Fewer side effects with treatment than estrogen

15

What is Tx for hypertension?

Clonidine (Alpha 2 agonist)

16

Which receptor is an "autoreceptor"?

Alpha 2

17

What penicillins are taken IV or IM?

Ticarcillin, piperacillin, ampicillin + sulbactam, ticarcillin + clavulanic acid

18

Neostigmine


Intermediate Indirect acting, inhibits AChE. Reverses neuromuscular blockade produced during anesthesia. Used in myasthenia Gravis


19

Ceftazidime

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

20

Why is a combination of drugs good for cancer treatment?

Provide maximal killing with tolerated toxicity, Effective against broad cell lines, May delay development of resistant cell lines. If use drugs with similar toxicities, dose of each must be reduced

21

Doripenem

Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.

22

Ertapenem

Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.

23

Which antibiotic cancer drug is cell cycle specific?

Bleomycin

24

Tx MRSA, skin infections

Daptomycin, Telavancin

25

Alprenolol

Beta–1 selective antagonists

26

Edrophonium (Tensilon)

Short Indirect acting, inhibits AChE. used for diagnosis of Myasthenia Gravis. also Reverses neuromuscular blockade produced during anesthesia

27

Cefdinir

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

28

What is the neurotransmitter and receptor of postganglionic sympathetics? Long or short?

Long, NE alpha/beta

29

What is the tissue target and actions for Alpha 2?

CNS and PNS nerve terminal (inhibits NT release). Also decreases aqueous production and increase uveoscleral outflow

30

What happens if the miotic pupil does not dilate with phenylephrine?

It's probably not Horner's syndrome, then

31

Terazosin

Alpha–1 antagonists

32

Which cephalosporin is excreted through the bile?

Ceftriaxone (3rd generation)

33

Meropenem

Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.

34

Which generation cephalosporin has diminished gram positive and improved gram negative coverage?

2nd generation (…Zil-or-Tin)

35

What happens when you activate Beta 1 receptors?

Affects HEART: higher bp, heart rate, increase contractility. Affects Kidney too (more renin > increase blood volume because more water)

36

What are the clinical uses of alpha antagonists?

For tumors that secrete NE, hypertension, Urinary obstruction (enlarged prostate), ED

37

Carmustine

Alkylating Agent. Alkylates DNA. Tx brain tumors (crosses CNS). via IV. Kidney excretion. AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis

38

What kind of receptor are the Alpha and beta receptors?

G-protein coupled receptors

39

5–fluorouracil

Antimetabolite – Thymidine analog that prevents DNA synthesis. Tx skin cancer. Through IV and topically. Excreted in the kidney/lungs. Can cause anorexia.

40

Which drug's adverse effect? : Pulmonary toxicity Alopecia Hypertrophic skin changes and hyperpigmentation Fever and chills

Bleomycin

41

Sildenafil

(Viagra) Type 5 Phosphodiesterase Inhibitors

42

Phenylephrine

Alpha–1 agonists. it's a Mydriatic (eye dilator) and OTC decongestant. Tx for Hypotension. also found in many OTC medications for congestion (local constriction) Used often for acute hypotension caused by severe hemorrhage, decreased blood volume, shock, etc. Diagnosis of Horner’s

43

What are the clinical uses of Cholinomimetics in the Eye?

Glaucoma (pilocarpine and carbachol are older treatments)

44

What do muscarinic blockers do to the eye?

They cause mydriasis (constrictor is inhibited), cause cycloplegia (ciliary muscle is inhibited), and reduce lacrimal secretion.

45

AE:
Fever, chills, phlebitis at injection site, flushing and/or shock if rapid infusion (can pretreat with anti-histamine)

Vancomycin

46

What can cause Crystalline retinopathy and other vision probs?

Tamoxifen

47

What can regenerate AChE?

Pralidoxime

48

Bleomycin

Antibiotics – scission of DNA. Tx testicular cancer. Via subcutaneous, IM, or IV. Kidney excretion. can cause Pulmonary toxicity Alopecia Hypertrophic skin changes and hyperpigmentation Fever and chills

49

Nilutamide

Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogen. Tx prostate cancer. via oral administration. Kidney excretes. NILUTAMIDE CAN CAUSE VISUAL PROBLEMS

50

Brimonidine

(Alphagan–P) Alpha–2 agonists. Tx of glaucoma

51

Scopolamine

Muscarinic blocker. Good for seasickness but can cause drowsiness and amnesia. used for pre–anesthesia.

52

What is good treatment of Uveitis

Homatropine or Cyclopentolate

53

What drugs gind guanine in DNA to form cross links?

Cisplatin, Carboplatin, Oxaliplatin

54

What will be lower than the other? MIC or MBC?

MIC is a lower concentration than MBC

55

What can treat COPD and Asthma?

Ipratropium or Tiotropium

56

Which drugs can cause anorexia?

5-fluorouracil and 6-mercaptopurine

57

Norepinephrine

non–selective Alpha/beta agonist. Little effect on Beta 2 receptors Used often for acute hypotension caused by severe hemorrhage, decreased blood volume, shock, etc.

58

What receptor stimulates the iris dilator muscle?

Alpha 1

59

Where are the nonsteroidal antiandrogens drugs (anti-cancer)?

Flutamide, Nilutamide (can cause visual problems) Bicalutamide

60

Ipratropium (Atrovent)

Muscarinic blocker. Tx COPD and Asthma

61

What happens when you apply Direct-Acting Cholinoceptor Stimulants to the respiratory system?

Contraction of bronchial smooth muscle: Bronchoconstriction. Stimulation of bronchial glands: Increase mucous secretion. This would be bad for an asthma patient

62

Echothiophate

Long indirect actin, inhibits AChE

63

Carbachol

Direct acting, agonist for ACh. more resistant to AChE. Older treatment for glaucoma

64

What is effect of an Indirect Acting Cholinomimetic on the respiratory tract?

Basically the same as direct.
Contraction of bronchial smooth muscle: Bronchoconstriction. Stimulation of bronchial glands: Increase mucous secretion. This would be bad for an asthma patient

65

Which "steroid hormone and antagonists" are actually steroids? Which are not steroids?

STEROIDS:

66

What is MIC?

Minimum Inhibitory Concentration: Lowest concentration of antibiotic that inhibits bacterial growth. Clinically obtainable antibiotic concentration must be greater than the MIC.

67

Which alkylating agent transforms into an active metabolite?

Dacarbazine

68

What drug Tx enterocolitis?

Oral Vancomycin

69

What are some problems associated with chemotherapy?

Resistance, multidrug resistance, toxicity

70

Do Adrenergic receptors desensitize?

They are non-desensitizing

71

What does Beta-lactamse inhibitors do?

They bind and inactivate penicillinases allowing combined drugs to work.

72

AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis

Carmustine, Lomustine

73

What happens when you apply Direct-Acting Cholinoceptor Stimulants to the heart and blood vessels?

Hyperpolarization of the SA and AV node (decreases AP and contractility), blood vessels release NO from endothelial cells to cause vasodilation

74

What is the tissue target and actions for Alpha 1?

Vascular smooth muscle (contraction), pupillary dilator muscle (contraction -- dilation), and heart (increase force of contraction)

75

Atenolol

Beta–1 selective antagonists

76

Which drug has this MoA: Inhibits DNA polymerase. Also can be incorporated into cellular DNA

Cytarabine

77

Daptomycin

Other" antibiotic. induces rapid depolarization of cell membrane. tx gram positive, skin infections. Inactivated by pulmonary surfactants

78

Labetalol

Non–selective beta antagonists with partial alpha–1 antagonist activity. Can be used in hypertensive emergency

79

Cefixime

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

80

Penbutolol

Non–selective beta antagonists with partial agonist effect

81

AE: Severe reactions have been fatal: Must infuse slowly. Hypotension, bronchospasm, and angioedema; Chills and fever after first infusion; Cardiac arrhythmias; You don't see nausea vomiting hair falling out

Rituximab

82

Which antibiotic cancer drug can cause irreversible cardiotoxicity?

Doxorubicin

83

Bicalutamide

Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogens. Tx prostate cancer. via oral administration. Kidney excretes.

84

Telavancin

Other" antibiotic. inhibits cell wall. tx gram positive. (also MRSA). Tx skin infections. Taste disturbances, nausea, vomiting, insomnia, foamy urine, NOT to be used during pregnancy Caution in cardiac conditions"

85

Which drugs can cause buildup of uric acid in the urine?

Vinblastine and Vincristine (microtubule inhibitors)

86

Is tamoxifen cell-cycle specific or not?

Tamoxifen is NOT cell-cycle specific

87

Doxorubicin

Antibiotics – induces cytotoxicity and free radicals. must be given IV. Red urine and dark red veins because of extravasation.

88

Doxazosin

Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate. Doxazosin has longer half–life

89

Interferons

Recombinant DNA via bacteria, activation of macrophages and suppression of cell proliferation. Alpha– primarily leukocytic Beta– produced by CT fibroblasts Gamma– produced by T–lymphocytes

90

What is the mechanism of MRSA resistance?

Altered PBPs (penicillin binding proteins) for reduced drug affinity.

91

What drug can cause foamy urine?

Telavancin

92

Name MOA: Forms a stable complex with DNA Intercalates into double helix between G-C base pairs Interferes with RNA polymerase and hinders DNA synthesis

Dactinomycin

93

What are the long-acting organophosphates? Where are they distributed?

Echothiophate, Malathion, Parathion, Sarin. All are distributed to CNS except echothiophate

94

Which adregergic receptors lead to a blood pressure decrease?

Alpha 2, Beta 2

95

Cephalexin (Keflex)

1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney. Tx eye (lid) infections. tx pharyngitis

96

What is Tx for cardiac arrest?

Isoproterenol, Epinephrine

97

What do muscarinic blockers do to the GI tract?

Decrease salivation, production of stomach acid, smooth muscle tone and propulsive movements

98

What is the short-acting Indirect Acting Cholinomimetic? How does it work?

Edrophonium. Forms reversible bond with the enzyme. Not actually a substrate for ACh-esterase

99

What happens when you activate Beta 2 receptors?

Bronchodilation, elevates blood glucose (via glycogen breakdown) and increases glucagon secretion from pancreas. Also decreases blood glucose vis insulin. Relaxes smooth ciliary muscle to decrease accommodation.

100

Tx MRSA, infection blepharitis, corneal ulcers…

Bacitracin ("other')

101

What is good for seasickness?

Scopolamine and other muscarinic blockers

102

If you're allergic to penicillin, what else can you not take?

Other beta-lactams like Cephalosporins. Nor Augmentin

103

Nafcillin

Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph. High toxicity, causes interstitial nephritis Used only to identify MRSA.

104

Tiotropium (Spiriva)

Muscarinic blocker. Tx COPD and Asthma

105

Which generation cephalosporin has further diminished gram positive coverage with improved gram negative coverage and FULL coverage against Pseudomonas?

4th generation (cefepime) [4th gen is almost -prime time!]

106

Prednisone

Steroid Hormones and Antagonists ….. Steroid hormone that reduces cell growth and proliferation. Tx lymphomas and induces remission. Via oral, excreted urine. Predispose patient to infection, Hyperglycemia, Cataract formation, increased IOP, Osteoporosis, Mood changes: hyper and happy

107

Isoproterenol

Non–selective beta agonist. Tx cardiac arrest (w/ epinephrine)

108

What are the common adverse side effects of cancer treatment?

Severe vomiting, Bone marrow suppression, Alopecia, Myelosuppression (patient prone to infection)

109

Cevimeline

Direct acting, agonist for ACh. Used in Sjogren's syndrome (for salivation)

110

What generation of cephalosporins are ok to use with people allergic to penicillin?

3rd, 4th, 5th.

111

Metaproterenol

Beta–2 agonists. Tx Asthma

112

What are some AE to penicillins?

Hypersensitivity. Diarrhea, nephritis (esp. with methicillin), neurotoxicity, hematologic toxicity (decreased coagulation).

113

What is the distribution and elimination of muscarinic blockers?

Most are widely distributed through CNS. They are eliminated via the kidney.

114

What drug stops VEGF from stimulating new blood vessels?

Bevacizumab

115

Which antibiotic is safe during pregnancy?

Bacitracin ("other")

116

Parathion

Long indirect actin, inhibits AChE

117

Oxaliplatin

Platinum coordinating complex, IV administration. Little penetration to CSF. Renal excretion. forms cross–links in guanine. Mild nausea, myelosuppression

118

Which drug has this MoA: Pyrimidine analog Forms a molecular complex that deprives the cell of thymidine (DNA synthesis stops)

5-fluorouracil

119

Vincristine

Microtubule Inhibitors–halts anaphase. IV injection. Metabolism by the P450 system. Excretion via bile and feces. hyperuricemia (buildup of uric acid in the urine) Nausea, vomiting, diarrhea, alopecia. Phlebtis or cellulitis if extravasation occurs.

120

What are side effects unique to cholinesterase inhibitors?

Miosis, Salivation, Sweating, and Muscle weakness. Both direct and indirect have Bronchial constriction, Vomiting, Diarrhea, Convulsions,

121

What can cause vasoconstriction?

Alpha agonists (Epi, Phenylephrine, Tetrahydrozoline)

122

How are Monoclonal antibodies administered.

NOT orally! IV

123

Which antimetabolite is given orally?

6-mercaptopurine (and Methotrexate can be oral)

124

Cefoxitin

2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney.

125

What is a Pharmacologic Sanctuary?

A place where some tumor cells can “hide” in tissues where chemotherapeutic agents cannot enter. Radiation "finds" these tumors

126

Ampicillin

Aminopenicillins. tx Gram (+). limited gram (–) coverage Considered extended spectrum. via only oral.

127

What does a selective receptor mean?

It can become non-selective at high concentration

128

What drug class would be bad for an asthma patient?

Direct and indirect acting cholinoceptor stimulant, Timolol (beta blocker)

129

Nadolol

Non–selective beta antagonists. Long duration of action

130

Cefprozil

2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney.

131

What do muscarinic blockers do to the urinary tract and sweat glands?

Slows voiding. Reduces sweating

132

Methotrexate

Antimetabolite – Prevents folic acid conversion to THF leading to decreased DNA/ protein materials. Thymidine depletion is most prominent. Low doses Tx inflammatory diseases (Rheumatoid arthritis, crohn disease). via oral, IM, IV. intrathecal for CNS. Avoid in pregnancy. can lead to crystalluria

133

Which antibiotic type is often combined with penicillinase inhibitor?

Aminopenicillins (like ampicillin and amoxicillin)

134

What is effect of an Indirect Acting Cholinomimetic on the Eye?

Basically the same as direct. Contraction of iris sphincter (miosis), ciliary muscle (accommodation), and opening of trabecular meshwork (lower IOP)

135

What classes of antibiotics show Time-dependent killing?

β-lactams, glycopeptides, macrolides, clindamycin, and linezolid

136

Docetaxel

Microtubule Inhibitors – binds to tubulin and makes too stable. via IV. P450 metabolism Biliary excretion. Neutropenia, peripheral neuropathy Docetaxel contraindicated in cardiac disease (can cause fluid retention) and is more potent than paclitaxel

137

Which cancer drug Sensitizes the patient to radiation (sun)?

Dactinomycin

138

Dobutamine

Beta–1 agonist

139

Which antibiotic is used to identify resistant strains of S. aureus?

Methicillin

140

What are the properties of Choline esters?

ACh, Carbachol, Bethanechol are hydrophilic (poorly absorbed), Carbachol and Bethanechol are more resistant to AChE --longer duration of action

141

What is Tx for chronic orthostatic hypotension?

Midodrine (Alpha 1 agonist)

142

Which cholinomimetric alkaloid can be absorbed across the skin?

Nicotine

143

What is the process of making NE?

Tyrosine > DOPA > Dopamine, which enters vesicles > NE via Dopamine β hydroxylase. NE is metabolized by MAO and diffused into surrounding tissue

144

Which Antibiotic cancer drugs can be given subcutaneously, IM, or IV?

Bleomycin

145

Clavulanic acid + amoxicillin (Augmentin)

β–lactamase Inhibitor + Antibiotic Combos. bindand inactivate penicillinases allowing combined drugs to work. Used in to treat many eye infections.

146

What cancer drug is a powerful blistering agent?

Mechlorethamine

147

AE: Severe vomiting, Nephrotoxicity, Ototoxicity

Cisplatin

148

Which is more potent:
Docetaxel, Paclitaxel?

Docetaxel

149

What antibiotic should not be used during pregnancy?

Telavancin

150

What is Tx for acute hypotention?

Alpha agonists (NE, Phenylephrine)

151

Albuterol

Beta–2 agonists. Most commonly used asthma Rx

152

What antibiotic has no activity against gram (+)?

Monobactams

153

Flutamide

Steroid Hormones and Antagonists ….. Nonsteroidal antiandrogens. Tx prostate cancer. via oral administration. Kidney excretes.

154

Tacrine

Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's (not as often as other options because of side effects)

155

Prazosin

Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate

156

Which ANS receptors are nicotinic?

All pre-ganglionic cells (and somatic skeletal muscle motor end plates)

157

Cefotaxime

3rd Gen Cephalosporins. GOOD CSF penetration. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

158

Which adrenergic receptors lead to an increase in heart contractility and heart rate?

Beta 1

159

Ceftaroline

5th Gen Cephalosporins. gram positive. improved gram negative. is active against S. aureus (including MRSA) and S. pneumoniae. elimination through Kidney.

160

What classes of antibiotics show concentration-dependent killing?

Aminoglycosides

161

Timolol (Timoptic)

Non–selective beta antagonists. Very effective when used topically to the eye, but do not prescribe for an asthmatic patient. Increased survival after heart attack

162

Which cephalosporin can penetrate the CSF well?

Cefotaxime (3rd generation)

163

Curing cancer results in about ___% of patients. Overall 5-year survival rate for cancer patients is
__%

10%. 65%

164

What is the tissue target and actions for Beta 2?

Respiratory, uterine, and vascular smooth muscle (Relaxes smooth muscle). Skeletal muscle (promotes K+ uptake)

165

Metoprolol

Beta–1 selective antagonists. Increased survival after MI

166

Apraclonidine

Alpha–2 agonists. Tx of glaucoma

167

What are the different ways drug resistance happens?

Spontaneous mutations (good, neutral, bad), DNA transfer (conjugation), altered protein expression

168

Which antibiotic is highly toxic, causing interstitial nephritis?

Methicillin [Penicillinase-Resistant Penicillin] (and Bacitracin ["other" category])

169

What cephalosporin is good for eye lid infections?

Cephalexin (1st generation)

170

Penicillins act against gram ____ bacteria

Penicillins act against gram positive bacteria

171

Are alkylating agents cell cycle specific or non-cell cycle specific?

Not cell-cycle specific

172

What adrenergic drugs are limited clinically?

Alpha 2 antagonists, but they are being used experimentally in diabetes and depression.

173

Letrozole

Nonsteroidal Aromatase inhibitors: decrease the production of estrogen. More potent selective. Do not need hydrocortisone supplement. does not predispose to endometrial cancer.

174

Which drug has this MoA: Inhibits the first step of purine-ring biosynthesis and blocks formation of AMP

6-thioguanine and 6-mercaptopurine

175

AE: Hot flashes, nausea, vomiting, skin rash; Potential to cause endometrial cancer, Crystalline retinopathy and other vision problems

Tamoxifen

176

What is effect of an Indirect Acting Cholinomimetic on the CNS?

Low concentrations: alerting response. High concentrations: convulsions

177

Which antibiotic type is often combined with other antibiotics? What should you do to avoid an inactive complex from forming between the two?

Penicillins. Never place in same infusion fluid because they can form an inactive complex

178

Esmolol

Beta–1 selective antagonists. Very short acting (Eskimos are short)

179

Propranolol

Non–selective beta antagonists. Increased survival after heart attack

180

Cefazolin

1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney. longer duration of action (penetrates bone!)

181

Nicotine

Direct acting, agonist for ACh. Can be absorbed through the skin.

182

Cefaclor

2nd Gen Cephalosporins. has diminished gram positive and improved gram negativecoverage. elimination through Kidney.

183

Aztreonam

Monobactams. only for gram negative! tx pseudomonas. it's a ring not fused to another ring. No cross reactivity with penicillin!

184

What kind of receptor is muscarinic?

g-protein.

185

What are side effects unique to Direct-Acting Muscarinic Stimulants?

Nausea, Frontal headache (from accommodation stimulated), Urinary urgency, Salivation, Sweating, and flushing of the skin (vasodilation) . Both direct and indirect have Bronchial constriction, Vomiting, Diarrhea, convulsions

186

What is used to treat lymphomas?

Prednisone, Rituximab

187

Which antibiotic is good against gram +, -, anerobes, and pseudomonas?

Carbapenems

188

What drug should not be given to people undergoing cataract surgery?

Tamsulosin because it can cause IFIS (Floppy iris syndrome)

189

What is effect of an Indirect Acting Cholinomimetic on the heart and vessels? What is the NET result?

Decrease heart rate and force of contraction (decrease in cardiac output and BP). Increase in vascular resistance (vasoconstriction causes increase in BP because of sympathetic ganglia stimulation). Net result is mild BP increase but high dose will cause BP to fall.

190

Tadalafil

(Cialis) Type 5 Phosphodiesterase Inhibitors

191

Nebivolol

Beta–1 selective antagonists

192

Which cephalosporin can cross BBB. Tx bronchitis / pneumonia in the elderly/immunocompromised?

Cefuroxime (2nd generation)

193

What is good for dilated fundus exam?

Tropicamide or Cyclopentolate

194

Cisplatin

Platinum coordinating complex, forms cross–links in guanine. IV administration. Little penetration to CSF Renal excretion. Severevomiting, Nephrotoxicity, Ototoxicity

195

Which nonsteroidal antiandrogens drug can cause visual problems?

Nilutamide can cause visual problems

196

What can cause chemical conjunctivitis at high doses?

Cytarabine (antimetabolite)

197

How do you test for Horner's syndrome?

Use phenylephrine. If it doesn’t dilate then it's probably not Horner's. then test with opthalmic cocaine: No dilation = postganglionic lesion. Dilation= preganglionic lesion.

198

What treats breast cancer?

First line treatment: Tamoxifen Aminoglutethimide, Anastrozole and Letrozole, Exemestane [all aromatase inhibitors]. For advanced breast cancer: Leuprolide and Goserelin [GnRH analogs]

199

What is MBC?

Lowest concentration of antibiotic that kills the bacteria

200

Which antimetabolite should be avoided in pregnancy ?

Methotrexate

201

What happens when you apply Direct-Acting Cholinoceptor Stimulants to the eye

Contraction of iris sphincter (miosis), ciliary muscle (accommodation), and opening of trabecular meshwork (lower IOP)

202

Which ANS receptors are muscarinic?

Only post-ganglionic receptors

203

Adult eye bacteria are mostly gram ___

Adult eye bacteria are mostly gram positive

204

What happens when you activate Alpha 2 receptors?

Reduces NE release from preganglionic neuron, reducing sympathetic effects. Insulin release is inhibited

205

Cefadroxil

1st Gen Cephalosporins. Tx gram positive and basic gram negative. poor oral administration. elimination through Kidney

206

What adrenergic receptor prevents urination?

Alpha 1

207

What is good against pseudomonas?

Kinda (3rd, 4th, 5th, cephalosporins) carbapenems, and monobactams (which is Aztreonam) Antipseudomonal Penicillins (think TiPi)

208

What should you NOT use in pneumonia because pulmonary surfactants deactivates?

Daptomycin

209

What's good for advanced breast cancer?

Leuprolide and Goserelin

210

What is the tissue target and actions for Beta 1?

Heart (increases force and rate of contraction)

211

Which receptor targets the Vascular smooth muscle, pupillary dilator muscle, and heart?

Alpha-1

212

Salmeterol

Beta–2 agonists

213

Tamsulosin

(Flomax) Alpha–1 antagonists. Relaxes vascular smooth muscle as well as smooth muscle in the prostate. Tx enlarged prostate (BPH) but can cause Floppy iris syndrome in cataract surgery patients.

214

What receptor is only on the heart?

Beta 1

215

What are the clinical uses of Cholinomimetics in the GI/urinary tract?

Postpoperative atony, neurogenic bladder. Basically smooth muscle disorders where there is no obstruction. Pilocarpine and Cevimeline can increase salivary secretion in Sjogren's syndrome.

216

What is a treatment of testicular cancer?

Bleomycin with vineblastine or etoposie

217

What happens if the cocaine drops cause dilation?

Horner's syndrome is from preganglionic lesion

218

Pilocarpine

Direct acting, agonist for ACh. Older treatment for glaucoma. Used in Sjogren's syndrome (for salivation)

219

What is the neurotransmitter and receptor of postganglionic parasympathetics? Long or short?

Short, Ach muscarinic

220

What is the goal of chemotherapy?

Goal is to cause a lethal cytotoxic event or apoptosis in the cancer cell or arrest tumor’s progression

221

What is effect of an Indirect Acting Cholinomimetic on the NMJ?

prolong and intensify the actions of acetylcholine

222

Which generation cephalosporin has further diminished gram positive coverage with improved gram negative coverage (including some Pseudomonal coverage)?

3rd generation (many drugs)

223

AE of "other" cancer drugs: Mild nausea, myelosuppression

carboplatin and oxaliplatin

224

What receptor relaxes the smooth ciliary muscle?

Beta 2

225

Bacitracin (common ocular)

Other" antibiotic. Gram positive. similar to vancomycin. via TOPICAL. SAFE IN PREGNANCY. causes nephrotoxicity. Tx MRSA, infection blepharitis, corneal ulcers"

226

6–thioguanine

Antimetabolite – Inhibits the first step of purine–ring biosynthesis and blocks formation of AMP. Genetic counseling is recommended because some patients accumulate higher toxic metabolites. Don't use for maintenance therapy

227

cholinomimetric alkaloid are easily or hardly absorbed from administration sites?

cholinomimetric alkaloid are EASILY absorbed from administration sites?

228

What drugs bind to tubulin subunits and make microtubules more stable (cells are stuck in metaphase)

Docetaxel, Paclitaxel

229

What does sympathetic activity do to the blood vessels in skeletal muscle and in the skin?

Symp causes dilation in muscles but constriction in the skin

230

What are the adverse effects of Muscarinic blockers?

Mydriasis, Cycloplegia, Dry mouth, Tachycardia, Flushed skin, Agitation, Delirium, Elevated body temperature

231

What is still used to treat ED ouside US? What mechanism?

Yohimbine! It's alpha 2 antagonist that promotes NE release to increase sympathetic activation

232

Which drugs are the choline esters?

ACh, Carbachol, Bethanechol

233

Piperacillin

Antipseudomonal Penicillins. tx Gram (+). has good gram (–) coverage (considered extended spectrum). via IV or IM

234

Penicillin G

Natural Penicillins. tx Gram (+).Cannot be taken orally. Susceptible to inactivation by B–lactamases

235

Bevacizumab (Avastin)

Monoclonal antibody … Anti VEGF. Tx retinal neovascular diseases. Via IV.

236

Ceftizoxime

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

237

What do muscarinic blockers do to the lungs?

They cause Bronchodilation, a reduce secretions in lung

238

Tetrahydrozoline

(aka visine) Alpha–1 agonists. It sucks! Leads to rebound redness due to receptor desensitization Local constriction reduces red eye

239

What penicillins are taken orally?

penicillin V, amoxicillin, amoxicillin + clavulanic acid

240

Activation of what receptor causes bronchodilation?

Beta 2

241

Oxybutynin

Muscarinic blocker. Tx urinary urgency/bladder spasm.

242

Which cancer drug basically activates the immune system?

Interferons

243

What are some examples of prophylactic use of antibiotics?

Rheumatic heart disease, dental excretions, using before surgery, preventing HIV in fetus

244

Acetylcholine (Miochol)

Direct acting, agonist for ACh

245

Which drugs Bind to microtubule protein and prevent polymerization?

Vinblastine and Vincristine (microtubule inhibitors)

246

Which drug is only topical?

Bacitracin

247

AE: Constipation (all the rest are diarrhea), nausea, headache,

Daptomycin

248

Pyridostigmine

Intermediate Indirect acting, inhibits AChE. common long–term myasthenia gravis treatment.

249

Paclitaxel

Microtubule Inhibitors – binds to tubulin and makes too stable. via IV. P450 metabolism Biliary excretion. Neutropenia, peripheral neuropathy. Docetaxel is more potent than paclitaxel.

250

Acebutolol

Non–selective beta antagonists with partial agonist effect

251

What is Log kill?

The concept that destroying cancer cells follows first-order kinetics (that a steady dose kills a constant FRACTION of cells)

252

Why don't we use nicotinic blockers?

They are too non-specific and would cause major side-effects

253

What is the first line therapy for breast cancer?

Tamoxifen

254

Child eye bacteria are mostly gram ___

Child eye bacteria are mostly gram negative

255

Tamoxifen

Steroid Hormones and Antagonists.. Estrogen antagonist. First line treatment for breast cancer (and prophylactic). often given with leuprolide. Hot flashes, nausea, vomiting, skin rash; Potential to cause endometrial cancer; Crystalline retinopathy and other vision probs

256

Which antimetabolite is given topically for skin cancer and the prevention of scar formation?

5-fluorouracil

257

Dicyclomine

Muscarinic blocker

258

Which drugs are Cholinomimetric Alkaloids?

Pilocarpine, nicotine, muscarine

259

Nn nicotinic receptors are on ___

Neurons

260

Which non-selective alpha agonist can potentially be used for ED treatment (injection)?

Phentolamine

261

Dicloxacillin

Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph.

262

Physostigmine

Intermediate Indirect acting, inhibits AChE

263

How are penicillins excreted?

Most via kidneys

264

Phentolamine

Non–selective alpha antagonists. Causes cardiac stimulation via reduced peripheral resistance Used in an injection format for treatment of ED – may lead to orthostatic hypotension and fibrosis (eek!)

265

How are cephalosporins eliminated?

Through the kidney, except for ceftriaxone (3rd gen)

266

Formoterol

Beta–2 agonists

267

Which generation cephalosporin has gram positive coverage (including Staph aureus) and basic gram negative coverage

1st generation (...oxil lin xin)

268

What is the effect of activating muscarinic receptors of the GI tract?

Increased muscle tone and peristaltic activity

269

Yohimbine

Alpha–2 antagonist. Used to treat ED Still found in many OTCs/”nutritional supplements”

270

Sarin

Long indirect actin, inhibits AChE

271

Imipenem–cilastatin

Carbapenems. tx both gram + and –, anaerobes, and pseudomonas. Resist hydrolysis by most penicillinases. IM / IV. kidney excreted.

272

What do muscarinic blockers do to the cardiovascular system?

Increase HR but no strong net effect

273

What can treat cholinergic poisoning?

Atropine (muscarinic blocker)

274

Ceftibuten

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

275

Which adrenergic receptors lead to a blood pressure increase?

Alpha 1, Beta 1 (but there is a reflex decreasein HR)

276

Leuprolide

Steroid Hormones and Antagonists ….. Steroid hormone that is GnRH analog. Tx prostate and breast cancer. Fewer side effects with treatment than estrogen

277

Which alkylating agent is given orally?

Lomustine

278

What receptor is on respiratory, uterine, and vascular smooth muscle and skeletal muscles?

Beta 2

279

What is the neurotransmitter and receptor of preganglionic sympathetics? Long or short?

Short, ACh nicotinic

280

What do nonsteroidal antiandrogens do?

Nonsteroidal antiandrogens that compete with natural hormone for the androgen receptor and prevent translocation of the hormone into the nucleus

281

Cefditoren

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

282

Betaxolol

Beta–1 selective antagonists. Also used as a glc tx

283

Ticarcillin

Antipseudomonal Penicillins. has good gram (–) coverage (considered extended spectrum). via IV or IM.

284

Which anti-metabolite is not used for maintenance therapy?

6-thioguanine

285

Which non-selective alpha antagonist has greater affinity for alpha 1 over alpha 2?

Phenoxybenzamine

286

What Tx for certain lymphomas and leukemias?

Rituximab

287

What drugs are mutagenic and carcinogenic?

Alkylating agents

288

Amoxicillin

Aminopenicillins. tx Gram (+). limited gram (–) coverage Considered extended spectrum. via only oral. Almost completely absorbed. COMBINE WITH CLAVULANIC ACID FOR AWESOMENESS

289

What is Tx for asthma?

Albuterol, Metaproterenol, Terbutaline

290

What does a specific receptor mean?

Specific means it will stay specific regardless of concentration

291

Anastrozole

Nonsteroidal Aromatase inhibitors: decrease the production of estrogen. More potent selective. Do not need hydrocortisone supplement. does not predispose to endometrial cancer.

292

Which antibiotic cancer drug can make red urine and dark red veins?

Doxorubicin

293

Malathion

Long indirect actin, inhibits AChE

294

6–mercaptopurine

Antimetabolite– Inhibits the first step of purine–ring biosynthesis. Given orally in spite of lower bioavailability. Bone marrow depression Anorexia, nausea, can cause JAUNDICE

295

What is the mechanism of Type 5 Phosphodiesterase inhibitors?

It inhibits PDE5 to allow for more cGMP (causes vasodilation). Muscarinic ACh > Nitric Oxide > cGMP.

296

Methicillin

Penicillinase–Resistant Penicillins. tx Gram (+).

297

Exemestane

Steroidal inhibitor of aromatase. Tx Breast cancer. Via oral.

298

Retuximab

Monoclonal antibody … Induce cell–mediated cytotoxicity. Tx Lymphomas and Leukemias. Via IV. Severe rxns have been fatal, must be infused slowly. Hypotension, bronchospasm and angioedema. Chills and fever after first infusion. Cardiac arrhythmia. You don't see nausea vomitinghair falling out

299

Cefuroxime

2nd Gen Cephalosporins. has diminished gram positive and improved gram negative coverage. elimination through Kidney. can cross BBB. Tx bronchitis / pneumonia in the elderly/immunocompromised

300

What are beta blockers used for clinically?

Hypertension, Ischemic heart disease by regulating heart beat and decreasing O2 demand, Cardiac arrhythmias, Heart failure, Glaucoma, Hyperthyroidism, migraines, tremors and stage fright/anxiety

301

Donepezil

Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's

302

Tropicamide

Muscarinic blocker. shortest duration (6 hours). Good for dilated fundus exam, uveitis treatment

303

Homatropine

Muscarinic blocker. Second longest effect (1–3 days). Good for accurate refraction, uveitis treatment

304

What generation cephalosporin is active against S. aureus (including MRSA) and S. pneumoniae

5th generation (Ceftaroline) [end of the -line!]

305

Which receptors are rapid on/off and desensitize to constant activation?

Nicotinic receptors

306

Aminoglutethimide

Nonsteroidal Aromatase inhibitor. Tx breast cancer. Also inhibits hydrocortisone synthesis, given with hydrocortisone.

307

Which antibiotic cancer drug goes through extensive liver metabolism?

Doxorubicin.

308

Which drugs are analogs of gonadotrophin releasing hormone?

Leuprolide and Goserelin

309

What are the effects of Beta blockers on the cardiovascular system?

Decrease in blood pressure in patients with hypertension (decrease in renin release), Slow atrioventricular conduction (Decrease heart rate and cardiac output). Can have an acute effect of increasing BP via the blocking of B2 mediated vasodilation

310

Where are alpha 2 receptors located?

On the presynaptic membrane. They are "autoreceptors"

311

Penicillin V

Natural Penicillins. tx Gram (+).CAN be taken orally. Susceptible to inactivation by B–lactamases

312

Which cancer drug treats melanoma?

Dacarbazine

313

Oxacillin

Penicillinase–Resistant Penicillins. tx Gram (+). only for infections caused by penicillinase staph.

314

Dacarbazine

Alkylating Agents. Attacks nucleophilic groups in DNA. Tx melanoma. via IV. Nausea and vomiting, myelosuppression, hepatotoxicity

315

AE: Severe nausea and vomiting Severe bone marrow depression Latent viral infections due to immunosuppression Patient will be very susceptible to infection. Must use caution.

Mechlorethamine

316

Tx MRSA, infection blepharitis, corneal ulcers

Bacitracin

317

What drug induces cell-mediated cytotoxicity and must be infused slowly?

Rituximab

318

What can be used for Alzheimer's treatment?

Tacrine (not used as often due to side effects), Donepezil, Galantamine, Rivastigmine

319

What cephalosporin is good for gonorrhea?

Ceftriaxone (3rd generation)

320

What are common steroid effects?

Predispose patient to infection, Hyperglycemia, Cataract formation, increased IOP, Osteoporosis, Mood changes: hyper and happy

321

What happens when you apply Direct-Acting Cholinoceptor Stimulants to the NMJ?

Causes depolarization followed by depolarization blockade

322

Vardenafil

(Levitra) Type 5 Phosphodiesterase Inhibitors

323

Carvedilol

Non–selective beta antagonists with partial alpha–1 antagonist activity

324

What is the MoA of penicillins?

The beta lactam causes autolysis by forming covalent bonds to the Penicillin binding proteins

325

Cytarabine

Antimetabolite – interferes with DNA polymerase. Given IV, excreted in the Kidneys. high doses can induce chemical conjunctivitis.

326

Which cancer drug is hardly excreted?

Mechlorethamine

327

Antibiotics have what kind of toxicity?

Relative, so the concentration of drug must be carefully controlled to avoid damage to the host

328

Which alkylating agent can penetrate the CNS?

Carmustine, Lomustine

329

Cefpodoxime

3rd Gen Cephalosporins. further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal). elimination through Kidney.

330

Vancomycin

Other" antibiotic. Inhibits cell wall synthesis. mostly topical because oral = nephrotoxicity. via slow IV. elim via kidneys. tx MRSA, tx enterocolitis (oral). Fever, chills, phlebitis at injection site, flushing and/or shock if rapid infusion (can pretreat with anti–histamine)"

331

Which adrenergic drug is effective in topical administration to the eye?

Timolol

332

What are the steps of ACh production and use?

1 Choline enters and 2 combines with Acetyl CoA through Choline acetyltransferase. 3 Ach put in vesicles. 4 AP causes Ca++ to enter the axon > 5 vesicle fuses with axon terminal. 6 ACh eventually gets broken down by AChE. 7 Choline gets recycled

333

Which drugs contain a benzene ring with ethylamine side chain?

Sympathomimetic

334

What happens if the cocaine drops do not cause dilation?

Horner's syndrome is from postganglionic lesion

335

What is the distribution of penicillins?

All cross the placenta but NOT teratogenic. Penetration to bone or CSF insufficient unless inflammation is also present. Prostate levels are insufficient. Excretion for most via the kidneys

336

Midodrine

Alpha–1 agonists. Tx orthostatichypotension (it helps get blood to the heart)

337

Vinblastine

Microtubule Inhibitors–halts anaphase. IV injection. Metabolism by the P450 system. Excretion via bile and feces. hyperuricemia (buildup of uric acid in the urine) Nausea, vomiting, diarrhea, alopecia. Phlebtis or cellulitis if extravasation occurs

338

Which antimetabolite is used in low doses to treat inflammatory diseases: severe psoriasis, rheumatoid arthritis, crohn disease?

Methotrexate

339

What is good against MRSA?

Vancomycin, Bacitracin, Ceftaroline (5th) (kinda Telavancin, kinda Daptomycin)

340

Which cholinomimetric alkaloid is toxic?

Muscarine

341

Lomustine

Alkylating Agents. Alkylates DNA. Tx brain tumors (crosses CNS). via oral. Kidney excretion. AE: Delayed hematopoietic depression, development of aplastic marrow, renal toxicity and pulmonary fibrosis

342

Which drug has this MoA:
Prevents folic acid conversion to THF leading to decreased DNA/ protein materials

Methotrexate

343

What are the ocular side effects of type 5 Phosphodiesterase inhibitors?

Mild impairment of color vision, Blurry vision, Increased risk of ischemia

344

Which cancer drugs tend to have fewer adverse effects?

Monoclonal antibodies because they can be directed at specific targets.

345

Carboplatin

Platinum coordinating complex, IV admistration. Little penetration to CSF. Renal excretion. forms cross–links in guanine. Mild nausea, myelosuppression

346

Which drug is an estrogen antagonist?

Tamoxifen

347

Cyclopentolate

Muscarinic blocker. short duration (1 day). Good for accurate refraction, dilated fundus exam, uveitis treatment

348

Cefepime

4th Gen Cephalosporins. has furtherdiminished gram positive coverage with improved gram negative coverage and FULL coverage against Pseudomonas. elimination through Kidney.

349

Galantamine

Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's

350

What are the side effects of beta blockers?

Increased airway resistance in the respiratory tract – CAUTION IN USE WITH AN ASTHMATIC PATIENT! Impair recovery from hypoglycemia; Increase VLDL and decrease HDL, Bradycardia, Mild sedation or depression, Cardiac decompensation, Caution in use in high cholesterol and diabetic patients!

351

Rivastigmine

Intermediate Indirect acting, inhibits AChE. Treatment for Alzheimer's

352

Clonidine

Alpha–2 agonists. Tx high blood pressure.

353

Terbutaline

Beta–2 agonists. Tx long–term asthma

354

MoA: induces rapid depolarization of cell membrane.

Daptomycin

355

Which drugs help increase survival after a heart attack?

Propranolol (Beta blocker), Timolol (beta blocker), Metoprolol (Beta 1 blocker)

356

How can bacteria have resistance against penicillins?

Bacteria can make beta-lactamase to hydrolyze the beta-lactam ring, use an efflux pump to lower permeability, and alter PBPs (penicillin binding proteins) for reduced drug affinity.

357

Which cancer drugs are aromatase inhibitors?

Aminoglutethimide, Anastrozole and Letrozole, Exemestane

358

Mechlorethamine

Alkylating Agent. Cross links between guanine bases in DNA Causes strand breakage and the occasional miscoding mutations. Very unstable blistering agent. Via IV. almost no drug is excreted. Severe nausea and vomiting Severe bone marrow depression Latent viral infections due to immunosuppression Patient will be very susceptible to infection. Must use caution.

359

Pindolol

Non–selective beta antagonists with partial agonist effect

360

What Tx for prostate cancer?

Flutamide, Nilutamide (can cause visual problems) Bicalutamide [all nonsteroidal antiandrogens]. Also
Leuprolide and Goserelin

361

Varenicline (Chantix)

Direct acting, agonist for ACh

362

Ceftriaxone

3rd Gen Cephalosporins. Tx gonorrhea. BILE excretion



further diminished gram positive coverage with improved gram negative coverage. (including some pseudomonal).

363

What does a long postantibiotic effect allow?

A long PAE allows for infrequent dosing (once a day, for example)

364

What antibiotic has no cross reactivity with penicillin?

Aztreonam (Monobactams)

365

What is good for myasthenia gravis?

Indirect acting Cholinomimetic (Edrophonium for diagnosis, pyridostigmine for treatment and neostigmine)

366

What are the 3 properties of antibiotics that have significant influence?

Concentration-dependent killing, Time-dependent killing, post-antibioitc effect.

367

Vomiting and diarrhea are uncommon for which anticancer drug?

Docetaxel and Paclitaxel

368

What do adrenoceptor antagonists do (heart, and other effects)

They block vasoconstriction, lowering blood pressure. This can result in orthostatic hypotension and reflex tachycardia. They also cause pupil constriction, cause nasal stuffiness, and increase urine flow

369

What is the neurotransmitter and receptor of preganglionic parasympathetics? Long or short?

Long, Ach nicotinic

370

Pralidoxime

Reactivates AChE

371

What can produce a fever in younger patients?

Muscarinic blockers

372

What was developed as a mustard gas during WWI

Mechlorethamine

373

What can treat urinary urgency or bladder spasm?

Oxybutynin (Muscarinic blocker)

374

What happens when you activate Alpha 1 receptors?

Vasoconstriction in skin increases blood pressure, Iris dilator muscle dilates pupil, urine retention, slows GI tract (but contracts sphincters)