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Flashcards in Pharm One Liners High Yield Deck (191):
1

Time it takes for amount of drug to fall to half of its value, constant in first order kinetics (majority of drugs)

Half-life (T1/2)

2

Rifampin, phenobarbital, phenytoin, carbamazepine, St. Johns wort

Inducers of CYP450 (particularly CYP3A4)

3

Ritonavir (protease inhibitors), cimetadine, macrolides, ketoconazole (azoles), quinidine, amiodarone, grapefruit juice

Inhibitors of CYP450 (particularly CYP3A4)

4

Ability of drug to produce the maximal biologic effect

Efficacy

5

Mechanism of action utilizes intracellular receptors

Steroid and hormones

6

Mechanism of action utilizes transmembrane receptors that have intrinsic enzymatic activity

Insulin, EGF, TGFbeta, PDGF, ANP

7

Antidote for organophosphate/anticholinesterase poisoning

Atropine, pralidoxime (2-PAM)

8

Antidote acetaminophen poisoning

N-acetylcysteine

9

Antidote used for heparin toxicity

Protamine sulfate

10

Antidote used for warfarin toxicity

Vitamin K1 and fresh frozen plasma

11

Antidote for tissue plasminogen activator (t-PA), streptokinase

Aminocaproic acid

12

Antidote for opioid toxicity

Naloxone (IV)

13

Antidote for benzodiazepine toxicity

Flumazenil

14

Antidote for methotrexate toxicity

Leucovorin

15

This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention

Bethanechol

16

Toxicity of cholinergics

DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)

17

Antimuscarinic that treats Parkinsonism and extrapyramidal disease

Benztropine, trihexyphenidyl

18

Antimuscarinic for the treatment of motion sickness

Scopolamine

19

Produce mydriasis and cycloplegia

Atropine, anti-muscarinics

20

Antimuscarinic that causes bronchodilation in asthma and COPD

Ipratropium, tiotropium

21

Its ability to vasoconstrict and increase blood pressure makes it useful as local decongestant and for the therapy of spinal shock (temporary maintenance of blood pressure)

Alpha 1 agonists

22

Alpha 1 agonist toxicity

Hypertension

23

Selective alpha 1 blocker used for hypertension, benign prostatic hyperplasia, may cause first dose orthostatic hypotension

Prazosin, terazosin, doxazosin

24

Alpha 1a-selective blocker used for benign prostatic hyperplasia

Tamsulosin

25

Side effect of alpha blockers

Orthostatic hypotension (especially with first dose) and reflex tachycardia

26

Selective beta 1 receptor blockers useful for treating cardiac conditions in patients with asthma

Acebutolol, betaxolol, esmolol, atenolol, metoprolol (A BEAM)

27

Non-selective beta blocker that lacks local anesthetic activity, indicated for glaucoma

Timolol

28

Side effects of beta blockers

Bradycardia, AV block, impotence, dyslipidemia, exacerbation of COPD

29

Beta blockers' effect on the heart in antianginal therapy

Reduce heart rate, blood pressure, contractility, and increase end-diastolic volume

30

Captopril and enalapril (-PRIL ending) are

ACE inhibitors

31

Side effects of angiotensin converting enzyme inhibitors

Dry cough, hyperkalemia, angioedema

32

Inactivated by angiotensin converting enzyme, contributes to dry cough and angioedema

Bradykinin

33

Angiotensin converting enzyme inhibitors are contraindicated in

Pregnancy, hyperkalemia

34

Mechanism of action of losartan and valsartan

Block Angiotensin II Type 1 (AT1) Receptors

35

Side effect associated with angiotensin converting enzyme inhibitors but not angiotensin receptor blockers

Dry cough

36

Calcium channel blockers with predominate effect on arteriole dilation

Nifedipine, amlodipine, nimodipine (dihydropyridines)

37

Calcium channel blockers with predominant effect on the heart

Verapamil, diltiazem (non-dihydropyridines)

38

Side effects of calcium channel blockers

Constipation, peripheral edema, cardiac depression, AV block

39

Alpha 2 agonist used in pregnant women with hypertension

Methyldopa

40

Methyldopa is contraindicated in

Geriatrics due to its CNS (depression) effects

41

Side effect of hydralazine

Lupus-like syndrome

42

MOA and effect of nitric oxide

Stimulates cGMP, leads to vascular smooth muscle relaxation

43

Mechanism of action of sildenafil

Inhibits phosphodiesterase-5, which keeps it from degrading cGMP (allowing for smooth muscle relaxation and vasodilation)

44

Mechanism of action of organic nitrates

Requires an enzymatic process to form NO, relaxes vascular smooth muscle of veins

45

Mechanism of action of class I antiarrhythmics

Sodium channel blockers

46

Mechanism of action of class III antiarrhythmics

Potassium channel blockers

47

Limiting side effect of class Ia and III antiarrhythmics

Prolongs QT interval

48

Most common side effects of quinidine that limits its use

Cinchonism

49

Side effect of procainamide

Systemic lupus-like syndrome

50

Drug of choice for management of acute ventricular tachycardia

Amiodarone

51

Side effects of Amiodarone

Thyroid dysfunction, corneal deposits, liver damage and pulmonary fibrosis

52

Life threatening cardiac event that prolong QT leads to

Torsades de pointes

53

Mechanism of action of statins

inhibits HMG COA reductase

54

Two side effects of HMG COA reductase inhibitors

Rhabdomyolysis and Hepatotoxicity

55

Two parameters to obtain before initiation of statins

LFT's, creatine kinase

56

How grapefruit juice increases statin effect

Inhibit CYP450 3A4

57

Fibrates increase activity of

Lipoprotein lipase

58

Mechanism of action involves indirect reduction of liver triglyceride synthesis

Niacin, fibrates

59

Side effects of niacin

Cutaneous flush

60

Side effect of aspirin

GI bleeding

61

Vitamin K dependent anticoagulant with zero-order kinetics of elimination

Warfarin (PT)

62

Heparin (PTT) increases activity of

Antithrombin 3

63

Specific side effect of heparin

Heparin induced thrombocytopenia (HIT)

64

Mechanism of action of thrombolytics

Lyse thrombi by catalyzing the formation of plasmin which cleaves fibrin

65

Indications for thrombolytics

Pulmonary embolism, severe deep vein thrombosis

66

Diuretic used as prophylactic for mountain sickness and glaucoma

Acetazolamide

67

Side effects of acetazolamide

Alkalization of the urine (precipitate Ca salts), metabolic acidosis, hypokalemia, paresthesias, and encephalopathy in patients with hepatic impairment

68

Site of action of loop diuretics

Thick ascending limb (NKCC channel)

69

Side effects of loop diuretics

Hyperuricemia, hypokalemia, metabolic alkalosis and ototoxicity (also hyperglycemia and hypocalcemia)

70

An electrolyte that is lost in the urine by acute treatment with loop diuretics but can be retained by thiazides

Calcium

71

Site of action of thiazide diuretics

Early distal convoluted tubule (Na-Cl Symporter)

72

Side effects of thiazide diuretics

Hyperuricemia, hypokalemia, metabolic alkalosis, hyperlipidemia, and hyperglycemia (also hypercalcemia)

73

Mechanism of action of amiloride

Inhibit epithelial sodium channels (ENaC) in the distal convoluted tubules and collecting duct

74

Diuretic used to treat primary aldosteronism

Spironolactone, eplerenone

75

Side effect of spironolactone

Gynecomastia, hyperkalemia, and impotence

76

Diuretic used to reduce intracranial pressure

Mannitol

77

Antidiuretic hormone analog used for central diabetes insipidus and nocturnal enuresis

Desmopressin

78

Cheap wide spectrum antibiotic drug of choice for otitis media

Amoxicillin

79

Drug of choice for N. gonorrhea

Ceftriaxone

80

Drug used for MRSA

Vancomycin

81

Mechanism of action of vancomycin

Binds D-Ala-D-Ala on murein monomers and prevent polymerization of the murein monomers

82

Drug of choice for giardia, entamoeba, pseudomembranous colitis (C. Diff.), and trichomonas

Metronidazole

83

Drug of choice for treatment of mild to moderate pseudomembranous colitis

Metronidazole

84

Mechanism of action of fluoroquinolones

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV

85

Reason fluoroquinolones are contraindicated in children and pregnancy

Cartilage damage

86

Anemia caused by trimethoprim

Megaloblastic anemia

87

Anti-bacterials that cause hemolysis in G6PD-deficient patients

Sulfonamides

88

Mechanism of action of sulfonamides

Inhibit dihydropteroate synthase

89

Quadruple therapy for the treatment of tuberculosis

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

90

Meningitis prophylaxis in exposed patients

Rifampin

91

Common side effect of Rifampin

Orange urine discoloration

92

Technique used to diagnose perianal itching, and the drug used to treat it

Scotch tape technique (Pinworm test - Enterobius vermicularis); mebendazole (can also use albendazole)

93

Drug of choice for influenza A and B

Oseltamivir or Zanamivir

94

Drug of choice for respiratory syncytial virus (RSV)

Ribavirin

95

Drug of choice for herpes and its mechanism of action

Acyclovir; activated by viral thymidine kinase, inhibits viral DNA replication

96

Anti-retroviral class that causes drug interactions by causing inhibition of CYP enzymes

Protease inhibitors

97

Prostaglandins that cause abortions

Prostaglandin E1 (misoprostol), PGE2, and PGF2alpha

98

Prostaglandin analog used as 2nd line for erectile dysfunction

Alprostadil (PGE1)

99

Prostaglandin analog used in pediatrics to maintain patency of ductus arteriosis

Alprostadil (PGE1)

100

NSAID that may be used for closure of patent ductus arteriosus

Indomethacin

101

Two main actions of acetaminophen

Antipyretic and analgesic activity

102

Inhibitor of lipoxygenase

Zileuton

103

Agent that inhibits xanthine oxidases and used to treat chronic gout

Allopurinol, febuxostat

104

DMARDs are slow acting drugs for this indication

Rheumatic diseases

105

1st line for rheumatoic arthritis for most patients

Low-dose methotrexate

106

Dose-limiting toxicity of methotrexate

Myelosuppression

107

Drug for treating malignant hyperthermia associated with drug-drug interaction between halogenated anesthetics and depolarizing neuromuscular blocker (succinylcholine)

Dantrolene

108

Mechanism of action of cromolyn

Prevent mast cell degranulation (by blocking opening of Cl- channels)

109

Ergot dopamine agonist used to suppress prolactin release

Bromocriptine

110

Synthetic human corticotropin used for diagnosis of adrenal insufficiency

Cosyntropin

111

Agent used to stimulate uterine contraction and labor, milk letdowns, and control postpartum bleeding

Oxytocin

112

Agent of choice for the treatment of hypothyroidism

Levothyroxine (T4)

113

Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and indicated for pregnant women in 1st trimester

Propylthiouracil (PTU)

114

Propylthiouracil (PTU) mechanism of action

Inhibits thyroid peroxidase

115

Side effects of corticosteroids

Iatrogenic Cushing's syndrome, hyperglycemia, impaired wound healing, osteoporosis, peptic ulcers, myopathy, adrenal suppression (> 2 week treatment)

116

Intermediate-acting insulin with variable pharmacokinetics; use is mostly replaced by long-acting insulin

Neutral protamine Hagedorn (NPH) insulin

117

First line drug for the treatment of type 2 diabetes

Metformin

118

Most serious side effect of metformin

Lactic acidosis

119

May be used intranasally to decreases bone resorption

Calcitonin (salmon prep)

120

Selective estrogen receptor modulator most commonly used for the treatment of breast cancer

Tamoxifen

121

Selective estrogen receptor modulator used for prevention of osteoporosis and invasive breast cancer

Raloxifene

122

Androgen receptor agonist used to treat hypogonadism and promote secondary sex characteristics

Testosterone

123

Distribution of histamine receptors H1, H2, and H3

Smooth muscle and mast cells; stomach, heart, and mast cells; nerve endings, CNS respectively

124

1st generation antihistamine that is highly sedating

Diphendydramine

125

Three 2nd generation antihistamines

Fexofenadine, loratadine, and cetirizine

126

H2 antagonist that causes the most interactions with other drugs

Cimetidine

127

5HT-1A receptor partial agonist indicated for generalized anxiety disorder; due to longer onset of action, is less effective for acute anxiety

Buspirone

128

5HT-1D/1B agonist used for migraine headaches

Sumatriptan and -triptans

129

H1 antihistamine with 5HT2 antagonist activity that is mostly used for carcinoid tumor but may be used to treat serotonin syndrome

Cyproheptadine

130

5HT-3 antagonist used for the prevention of chemotherapy-induced nausea and vomiting

Ondansetron and -setrons

131

Three beta blockers that decrease aqueous production

Timolol (nonselective), betaxolol (selective), carteolol (nonselective)

132

Prostaglandin 2 alpha analog used to increase aqueous humor outflow

Latanoprost

133

Mechanism of action of benzodiazepines

Increase frequency of GABA-mediated chloride ion channel (GABAA) opening

134

Mechanism of action of barbiturates

Increase duration of GABAA chloride channel opening

135

Three nonbenzodiazepine hypnotics that lack suppressive effect on REM and are preferred over benzodiazepines for the treatment of insomnia

Zolpidem, zaleplon, eszopiclone

136

Drug of choice for treatment of acute status epilepticus

Diazepam, lorazepam

137

Drug of choice for partial seizures

Carbamazepine

138

Drugs of choice for generalized tonic-clonic seizures

Carbamazepine, phenytoin, valproic acid

139

Antiepileptic agent that exhibits zero-order kinetics, causes fetal hydantoin syndrome, and induces CYP450

Phenytoin

140

Side effects of phenytoin

Gingival hyperplasia, nystagmus, diplopia and ataxia

141

Drug of choice for myoclonic seizures that may also be used for absence seizures

Valproic acid

142

Drug of choice for absence seizures

Ethosuximide

143

Antiepileptic drug used also for pain of neuropathic orgin

Gabapentin

144

Mechanism of action of opioids on analgesia

Activate mu receptors to 1. close presynaptic Ca2+ channels to inhibit neurotransmitter release, 2. open postsynaptic K+ channels to hyperpolarize cell membrane

145

Tolerance to all effects of opioid agonists can develop except

Miosis, constipation

146

Opioid that can be given PO, IV, IM, and intrathecal to relieve anxiety associated with pulmonary edema

Morphine

147

Opioid available trans-dermally

Fentanyl

148

Long-acting opioids used for the management of withdrawal states (these drugs are used for pts with an opioid addiction)

Methadone, buprenorphine

149

Moderate opioid agonists

Codeine, hydrocodone, and oxycodone

150

Opioid antagonist that is given IV

Naloxone

151

Opioid antagonist that is given orally

Naltrexone

152

Rare, but fatal side effect associated with combination of halogenated inhalation anesthetic and depolarizing neuromuscular blocker (succinylcholine)

Malignant hyperthermia

153

Opioid safe for use of analgesia and anesthesia during cardiac surgery

Fentanyl

154

Produces dissociative anesthesia but has significant analgesic activity

Ketamine

155

Precursor of dopamine that can cross the blood-brain-barrier and used to alleviate motor dysfunction in Parkinson's disease

Levodopa (L-dopa)

156

Inhibits peripheral DOPA decarboxylase, reduces peripheral side effects of dopamine precursor and enhances its delivery to the brain

Carbidopa

157

Inhibits monoamine oxidase type B (MAO-B), used as monotherapy for early or mild Parkinson's disease or adjunct to improve motor function in patients with fluctuations in clinical response

Selegiline

158

Three main classes of CNS depressant drugs of abuse

Alcohol, opioid, barbiturate/benzodiazepine

159

Agent that is metabolized by alcohol dehydrogenase or microsomal ethanol-oxidizing system (MEOS) to acetaldehyde; displays zero-order kinetics of elimination

Ethanol

160

Enzyme that is induced through chronic exposure to alcohol, may contribute to tolerance

Microsomal ethanol oxidizing system (MEOS)

161

Neurological abnormality caused by chronic alcohol use and thiamine deficiency

Wernicke-Korsakoff syndrome

162

Respiratory and CNS depression, pinpoint pupils, seizures, and needle track marks are symptoms of this intoxication

Opioid

163

Opioid receptor antagonist that is used to treat opioid intoxication, may cause more rapid and intense symptoms of withdrawal

Naloxone

164

Two date rape drugs that work through enhancement of GABA receptors in the brain

Flunitrazepam, GHB (γ-hydroxybutyrate)

165

Benzodiazepine antagonist used to treat benzodiazepine intoxication

Flumazenil

166

Treatments available for nicotine addiction

Patch, gum, lozenge, bupropion, varenicline

167

Synthetic ergot derivative that can produce perceptual hallucinations and used as an illicit drug; may cause paranoia

LSD (lysergic acid diethylamide)

168

Active ingredient is tetrahydrocannabinol (THC); side effects include impairment of judgment, altered sense of time, increased appetite, and hallucinations

Marijuana

169

Primary mechanism of action of typical antipsychotics

Inhibits D2 receptors

170

Common endocrine side effects of all typical antipsychotic drugs

Hyperprolactinemia, galactorrhea

171

Common side effects of low potency typical antipsychotic drugs

Dry mouth (anticholinergic), sedation (antihistamine), hypotension (α1 block)

172

Side effects more commonly associated with high potency typical antipsychotic drugs

Extrapyramidal symptoms: Dystonia (continuous spasms/muscle contractions), Akathisia (motor restlessness), Bradykinesia (slow movement), Tardive Dyskinesia (irregulary, jerky movements - typically in the face)

173

Life-threatening side effect associated with typical antipsychotic drugs

Neuroleptic malignant syndrome

174

Treatment for drug-induced neuroleptic malignant syndrome

Dantrolene

175

Primary mechanism of action of atypical antipsychotics

Inhibit 5-HT2 receptors

176

Atypical antipsychotic that can produce potentially fatal agranulocytosis and increase incidence of seizures

Clozapine

177

Three life-threatining side effects associated with tricyclic antidepressants

Convulsion, cardiotoxocity, coma (3 C's)

178

Serious side effect of selective serotonin reuptake inhibitors when used with other drugs such as monoamine oxidase inhibitors, serotonin-norepinephrine reuptake inhibitors, or tricyclic antidepressants

Serotonin Syndrome

179

Antidepressant that non-selectively inhibits neuronal reuptake; less likely to cause sedation, autonomic, cardiovascular, or sexual dysfunction; also used for smoking cessation

Bupropion

180

Antidepressant that inhibits serotonin reuptake but also antagonizes 5HT-2 receptors; causes priapism

Trazodone

181

First line drug for classic bipolar disorder with euphoric mania

Lithium

182

Side effects of lithium

Tremor, hypothyroidism, nephrogenic diabetes insipidus, fetal cardiac defects

183

Antineoplastic folic acid analog that inhibits dihydrofolate reductase

Methotrexate

184

Two antineoplastics that require dose-reduction in patients who are taking allopurinol

Azathioprine, 6-mercaptopurine

185

Hyperstabilizes microtubule polymer and prevents microtubule breakdown

Paclitaxel, -taxels

186

Nitrosureas that spontaneously form active intermediates that cross-link DNA; can cross blood-brain-barrier and is indicated for brain tumors

Carmustine, -mustines, streptozocin

187

Iron-chelator that is used to protect against anthracycline-induced cardio-toxicity

Dexrazoxane

188

DNA intercalating agent with minimal myelosuppression that induces formation of free radicals; dose-limiting side effects include pulmonary fibrosis and mucocutaneous reactions

Bleomycin

189

Agent used for megaloblastic anemia (but does not reverse neurologic symptoms) and decrease neural tube defects during pregnancy

Folic acid

190

Agent used for pernicious anemia

Cyanocobalamin (Vit B12)

191

Agent used for anemias (especially with renal failure)

Erythropoietin