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Acute arsenic poisoning
Acute mercury poisoning
Chronic severe lead poisoning

SE: hypertension

Dimercaprol

1

Pica, ingestion if flakes of paint, abdominal colic, acute encephalopathy, wrist drop, mental retardation

Lead

2

Chronic lead poisoning (oral treatment)

Succimer

3

Chronic severe lead poisoning

SE: hypocalcemia

EDTA (Edetate Calcium Disodium)

4

Rice-water stools, garlicky breath, Mee's lines, raindrop pigmentation, milk and roses complexion

Arsenic

5

Hemorrhagic, gastroenteritis, renal failure, loosening of gums and teeth, erethism

Inorganic mercury

6

Minamata disease (cerebral palsy, deafness, blindness, mental retardation)

Organic mercury

7

Severe GI necrosis, hemosiderosis, restrictive cardiomyopathy

Iron

8

Acute iron poisoning, hemochromatosis

Deferoxamine

9

Hepatotoxicity, Kayser-Fleisher rings, sunflower cataracts

Copper

10

Copper poisoning, Wilson's disease

SE: drug-induced lupus

Penicillamine

11

Treatment of lymphomas

SE: hemorrhagic cystitis

Rescue agent: Mesna

Cyclophosphamide

12

Treatment of colon cancer

SE: ototoxicity, nephrotoxicity

Rescue agent: Amifostine

Cisplatin

13

SE: marked vesicant actions (skin blistering)

Mechlorethamine

14

SE: Disulfiram reaction, Leukemogenesis

Procarbazine

15

Testicular and ovarian tumor

SE: Pulmonary fibrosis, bone marrow-sparing

Bleomycin

16

Treatment of brain tumors

SE: CNS toxicity

Carmustine

17

Tyrosine kinase inhibitor

Treatment of CML

SE: fluid retention, multiple drug interations

Imatinib

18

Treatment of metastatic breast cancer, active against cells expressing HER-2/neu

Trastuzumab

19

Inhibits VEGF, treatment of metastatic cancers

Bevacizumab

20

Differentiation therapy, treatment of acute promyelocytic leukemia, only vitamin that can cure cancer

All trans retinoic acid (ATRA)

21

Drugs that cause PULMONARY FIBROSIS

BBBAN ME
Bleomycin
Busulfan
Bromocriptine
Amiodarone
Nitrofurantoin
Methotrexate

22

Treatment of lymphomas and GTN

Myelosuppression, pulmonary fibrosis

Rescue agent: Leucovorin (folinic acid)

Methotrexate

23

Treatment of acute leukemias

Myelosuppression, hepatotoxicity, metabolism inhibited by allopurinol

6-Mercaptopurine

24

Treatment of colorectal and skin cancer, causes thymine-less death of cells

Myelosuppression

5-Flurouracil

25

Treatment of CML in blast crisis, most specific for the S phase of the cell cycle

Cytarabine

26

Inhibits ribonucleotide reductase, treatment of pancreatic cancer

Gemcitabine

27

Vinca alkaloid, prevents microtubule assembly

Peripheral neuropathy

Vincristine

28

Podophyllotoxin, inhibits DNA topoisomerase II, treatment of lung cancer, non Hodgkin's lymphoma and GTN

Etoposide

29

Camptothecin, inhibits DNA topoisomerase I, treatment of small cell lung cancer

Topotecan

30

Taxane, prevents microtubule disassembly, advanced breast and ovarian cancers

Paclitaxel

31

Intercalating agent

Dilated cardiomyopathy

Rescue agent: Dexrazoxane

Doxorubicin

32

Treatment of testicular cancer

Pulmonary fibrosis, most specific for the G2 phase of the cell cycle

Bleomycin

33

Treatment of melanoma, Wilm's tumor and GTN

Actinomycin D

34

Opioid antispasmodic, DOC for noninfectious diarrhea

SE: paralytic ileus (in children)

Loperamide

35

Stimulant laxative

SE: Melanosis coli

Senna

36

Osmotic laxative

Treatment of hepatic encephalopathy

Lactulose

37

Prokinetic agent, antiemetic, DOC for diabetic gastroparesis

Metoclopromide

38

Irreversible blockage of H+/K+ ATPase, DOC for peptic ulcer disease and Zollinger-Ellison syndrome

Omeprazole

39

Neutralizes stomach acids

SE: diarrhea-constipation (cancels each other)

Maalox

40

Greatly suppresses nocturnal acid secretion, H2 blocker

SE: gynecomastia

Cimetidine

41

Describe the function of osteoblasts and osteoclasts

osteoBlast = Builds Bone

osteoClast = Cleaves/resorbs bone

42

Function of PTH

ParaThyroid Hormone
PTH
Phosphate
Thrashing
Hormone

43

Signs and symptoms of excess PTH

HYPERPARATHYROIDISM
Painful bones
Renal stones
Abdominal groans
Psychiatric overtones

44

What is the function of calcitonin?

CalciTONin = TONes down
Calcium
(Reduces blood Ca, decreases bone resorption)

45

Phosphate-binding resin

Sevelamer

46

Suppresses osteoclast activity, treatment of Paget's disease of bone and osteoporosis

SE: esophagitis

Alendronate

47

Treatment of Paget's disease of bone, Hypercalcemia, tumor marker for medullary thyroid CA

Calcitonin

48

Active vitamin D, treatment of secondary hyperparathyroidism

Calcitriol

49

Inactive Vitamin D, treatment of rickets and osteomalacia

Ergocalciferol

50

Why is there paradoxical improvement of diabetes in patients with end-stage renal disease?

Insulin has prolonged half life due to decreased clearance

51

Which patient are more prone to developing hypoglycemia with insulin use?

PRONE TO HYPOGLYCEMIA
1. Advanced renal disease
2. Elderly
3. Children younger than 7 years

52

a-glucosidase inhibitor

Flatulence

Acarbose

53

TZD, acts on PPAR-y, insulin sensitizer

CHF

Pioglitazone

54

First line anti diabetic drug, decreases gluconeogenesis

SE: lactic acidosis, weight loss (DOC for obese diabetics)

GI upset

Metformin

55

Newer insulin secretagogue, NO hypoglycemia

Repaglinide

56

2nd generation SU

Hypoglycemia, weight gain, disulfiram reaction

Glipizide

57

1st generation SU

Hypoglycemia, weight gain, disulfiram reaction

Chlorpropamide

58

Most efficacious anti diabetic drug, activates tyrosine kinase

Hypoglycemia, lipodystrophy

Insulin

59

Treatment of male hypogonadism

SE: virilization, paradoxical feminization

Testosterone

60

Anabolic steroids, illegal performance enhancers

Oxandrolone

61

Treatment of prostate cancer, coadministered to prevent acute flare-ups of tumor

Flutamide + Leuprolide

62

5-a-reductase inhibitor, treatment of benign prostatic hyperplasia and male pattern baldness

Finasteride

63

Most frequently used synthetic estrogen in OCPs

SE: hypertension, DVT/PE, endometrial CA, contraindicated in women (age >35) who are heavy smokers

Ethinyl estradiol

64

SE: clear cell vaginal adenoCA in daughter

Diethylstilbestrol

65

Prevents estrogen-induced endometrial CA

Norgestrel

66

OCP of choice in lactating women

DMPA

67

Emergency contraception, Yuzpe regimen

Levonorgestrel

68

Hormone-responsive breast CA

SE: endometrial CA

TAMOxifen

TAnggal Mammary Mo

69

Ovulation induction

SE: multiple pregnancies

Clomiphene

Clone Me Phlease

70

Treatment of endometriosis

Danazol

71

Medical abortion

Mifepristone

72

NORgestimate, NORethindrone and NORgestrel are NOT ESTROGENS!

They are PROGESTINS!

73

Treatment of genetic short stature, failure to thrive

Somatotropin

74

Treatment of acromegaly, variceal bleeding

Ocreotide

75

Treatment of hyperprolactinemia, prolactinoma

Bromocriptine

76

Labor induction/augmentation, control of postpartum hemorrhage

SE: fluid retention

Oxytocin

77

Treatment of central diabetes insipidus

Desmopressin

78

Treatment of hypothyroidism, myxedema coma

Levothyroxine

79

Inhibits thyroid peroxidase, blocks peripheral conversion to T4 to T3

SE: agranulocytosis, DOC in pregnant hyperthyroid patients

PTU

80

Inhibits thyroid peroxidase

SE: agranulocytosis, teratogen (aplasia cutis)

Methimazole

81

Preferred treatment for hyperthyroidism

SE: permanent hypothyroidism

Radioactive Iodine

82

Reduces size and vascularity of thyroid gland

SSKI

83

Sympathetic treatment of hyperthyroidism, decreases peripheral conversion of T4 to T3

Propanolol

84

Differentiate Wolf-Chaikoff effect from Jod-Basedow phenomenon

Wolf-Chaikoff effect ingestion of iodine causes hypothyroidism

Jod-Basedow phenomenon ingestion of iodine causes hyperthyroidism

85

Which antithyroid drug inhibit peripheral conversation to T4 to T3?

PTU, propanolol, hydrocortisone

86

What drugs can cause drug-induced hyperthyroidism?

Clofibrate

87

Acute adrenal insufficiency, status asthmaticus, thyroid storm

Hydrocortisone

88

Prototype oral glucocorticoid

SE: adrenal suppression, Cushing syndrome

Prednisone

89

Hastens fetal lung maturation

Betamethasone

90

Mineralocorticoid replacement for chronic adrenal insufficiency (Addison disease)

Fludrocortisone

91

Why are statins used in the management of coronary artery disease?

Stabilizes atherosclerotic plaque

92

What are the drugs that cause flushing?

Vancomycin
Adenosine
Niacin
Calcium channel blockers

93

HMG-CoA reductase inhibitor, lowers LDL

Hepatotoxicity, rhabdomyolysis, myopathy

Simvastatin

94

Bile acid binding resin, lowers LDL

Constipation, steatorrhea

Cholestyramine

95

Reduces all building blocks for hyperlipidemia, increases HDL, lowers LDL and TG

Flushing, hyperglycemia, hyperuricemia

Niacin

96

PPAR-a activator, upregulates lipoprotein lipase, lowers TG

Gallstones, addictive myopathy

Gemfibrozil

97

Dream-like state, red conjunctiva, tachycardia, dry mouth

Marijuana

98

Psychedelic effects (out of body experience), mind raveling effects, bad trips

LSD

99

Most dangerous hallucinogen, psychotomimetic effects, nystagmus

Phencyclidine

100

Mydriasis, crack lung, teratogen (cystic cortical lesions)

Cocaine

101

Sexual enhancement, hyponatremia

MDMA (ecstasy)

102

Euphoria, sleeplessness, self-confidence

Amphetamine

103

Triad of opioid overdose

OPIOID OVERDOSE
P-C-R
Pupillary constriction
Comatose state
Respiratory depression

104

Which opioids have the shortest and longest half-lives?

REMIFENTANIL = shortest half-life (3-4mins)

BUPRENORPHINE = longest half-life (4-8 hrs)

105

Prototype opioid (full agonist)

Miosis, respiratory depression, constipation

Morphine

106

Severe pain, breakthrough cancer pain, available in lollipop form or transdermal patch

Fentanyl

107

Opioid of choice for acute pancreatitis, does NOT cause miosis

Seizures (normeperidine)

Meperidine

108

Replacement therapy for opioid dependence

Methadone

109

Cough suppression

Dextromethorphan

110

Balanced anesthesia, frequently abused by healthcare professionals

Nalbuphine

111

Antidote to opioid overdose

Naloxone

112

Treatment of opioid dependence

Naltrexone

113

Symptoms of serotonin syndrome

FAT CHD
Fever
Agitation
Tremor
Clonus
Hyperreflexia
Diaphoresis

114

Drugs that can cause priapism

Tigas PeniS Qu AyaW Bumaba!
Trazodone
Papaverine
Sildenafil
Quetiapine
Alprostadil
Warfarin
Bupropion

115

Drugs that can cause erectile dysfunction

A SORE PEniS can't Fuck Hard!
SSRIs
Opiates
Risperidone
Ethanol
Propranolol
Estrogens
Spironolactone
Finasteride
Hydrochlorothiazide

116

What are the features of tricyclic antidepressant overdose?

3 Cs TCA Overdose
Coma
Convulsions
Cardiotoxicity

117

Monoamine oxidase inhibitor

Hypertensive crisis when taken with tyramine (in cheese), serotonin syndrome

Phenelzine

118

Tetracyclic antidepressant, smoking cessation

Weight loss, priapism, seizures

Bupropion

119

Serotonin antagonist

Priapism

Trazodone

120

Serotonin-Norepinephrine reuptake inhibitor (SNRI)

Hypertension

Venlafaxine

121

Selective serotonin reuptake inhibitor (SSRI), first line drug for major depressive disorder

Erectile dysfunction, serotonin syndrome

Fluoxetin

122

Tricyclic antidepressant, treatment of enuresis

Atropine-like effects, cardiotoxicity

Imipramine

123

What are the features of neuroleptic malignant syndrome?

Fever
Encephalopathy
Vitals unstable
Elevated CPK
Rigidity

124

Nephrogenic diabetes insipidus, teratogen (Ebstein's anomaly)

Mania

Lithium

125

Marked hyperprolactinemia

For schizophrenia in the youth

Risperidone

126

Priapism, hypnagogic hallucinations

2nd generation

Quetiapine

127

Marked weight gain, hyperglycemia

2nd generation

Olanzapine

128

DOC for suicidal and refractory schizophrenics

Agranulocytosis

Clozapine

129

Treatment of floridly psychotic patients

Major EPS (neuroleptic malignant syndrome)

Haloperidole

130

Prototype typical antipsychotic

Corneal/lens deposits, failure of ejaculation

Chlorpromazine

131

Drugs that cause livedo reticularis

A man reads FHM and GQ
Amantadine
Hydroxyurea
Minocycline
Gemcitabine
Quinidine

132

Primary signs of Parkinson's Disease

It's a TRAP!
Tremor
Rigidity
Akinesia
Postural instability

133

Improves tremor and rigidity but has no effect of bradykinesia, atropine-like effects

Benztropine

134

Antiparkinsonism drug with antiviral properties

SE: livedo reticularis, cerebellar ataxia

Amantadine

135

Drug of choice for Parkinson's disease

Levodopa + Carbidopa

136

Treatment of hyperprolactinemia

SE: erythromelalgia, pulmonary fibrosis

Bromocriptine

137

Adjunctive drug for wearing-off phenomena

Entacapone

138

Prototype nondepolarizing neuromuscular blocker

Orthostatic hypotension

Tubocurarine

139

Undergoes human elimination

Bronchospasm, most frequently used nondepolarizing neuromuscular blocker

Atracurium

140

Lethal injection

Strychnine poisoning

Pancuronium

141

Reversal agent for nondepolarizing neuromuscular blockade

Neostigmine

142

Depolarizing neuromuscular blocker

Malignant hyperthermia, affected by pseudocholinesterase activity

Succinylcholine

143

What is the toxic dose if LIDOCAINE?

Toxic dose = 5 mg/kg for any drug or solution
1% = 10 mg/mL

144

Why should we not inject LIDOCAINE into abscesses?

DONT INJECT LIDOCAINE INTO ABSCESS

Won't work due to acidic environment (below pKa = protonated form predominates, so it can't penetrate tissues)

145

Which local a esthetics have the shortest and longest half-lives?

PROCAINE = shortest half-life (1-2 mins)

A PRO finishes the race fastest.

ROPIVACAINCE = longest half-life (4.2 hrs)

At the end of the long ROPe.

146

How will you distinguish whether local anesthetics are esters or amides?

ESTERS have only 1i in their names.
Tetracaine, Procaine, Benzocaine

AMIDES have 2i in their names.
Bupivacaine, Ropivacaine, Lidocaine

147

Prolonged sedation, "milk of amnesia"

Hypotension

Rate of onset similar to THIOPENTAL but better recovery

Pain at site of injection: mc side effect

Propofol

148

Anesthesia for patients with limited cardiopulmonary reserve

Adrenal suppression

Etomidate

149

Dissociative anesthesia, NMDA receptor blocker

Emergence delirium

Used in trauma cases where cardiovascular support is necessary

Catatonia, amnesia, analgesia without LOC

Ketamine

150

Lowest MAC (highest potency), slowest induction and recovery

Methoxyflurane

151

Postoperative hepatitis, malignant hyperthermia

Halothane

152

Pulmonary irritant

Desfurane

153

Highest MAC (lowest potency)

Euphoria

Nitrous Oxide

154

Generalized Tonic-Clonic seizures

DOC: Valproic acid, phenytoin, carbamazepine

Alternative: Phenobarbital, lamotrigine, topiramate

155

Partial seizures

DOC: carbamazepine, lamotrigine, phenytoin

Alternative: felbamate, phenobarbital, topiramate, Valproic acid

156

Absence seizures

DOC: ethosuximide, valproic acid

Alternative: lamotrigine, levetiracetam, zonisamides, clonazepam

157

Myoclonic and Atypical absence syndromes

DOC: Valproic acid

Alternative: clonazepam, levetiracetam, topiramate, zonisamide, felbamate

158

Status epilepticus

DOC: lorazepam, diazepam, phenytoin, phenobarbital

159

Potent CYP450 inducer

SE: gingival hyperplasia, hirsutism, fetal hydantoin syndrome

PHENYTOIN

160

Potent CYP450 inducer

DOC for partial seizures and trigeminal neuralgia

SE: blood dyscrasias

CARBAMAZEPINE

161

Potent CYP450 inhibitor

DOC for GTC and myoclonic seizures

SE: teratogen (spina bifida)

VALPROIC ACID

162

Potent CYP450 inducer

DOC for seizures in children and pregnant women

SE: porphyria

PHENOBARBITAL

163

DOC for absence seizures

ETHOSUXIMIDE

164

DOC for status epilepticus

DIAZEPAM

165

Treatment of neuropathic pain

GABAPENTIN

166

SE: Stevens-Johnson syndrome

LAMOTRIGINE

167

Most frequently abused drug, Wernicke-Korsakoff syndrome in overdose, delirium tremens in withdrawal

ETHANOL

168

Prevention of Wernicke-Korsakoff syndrome

THIAMINE

169

Treatment of alcohol withdrawal

DIAZEPAM

170

Wood alcohol

SE: visual dysfunction due to formaldehyde accumulation

METHANOL

171

Antifreeze

SE: nephrotoxicity due to oxalic acid accumulation

ETHYLENE GLYCOL

172

Alcohol dehydrogenase inhibitor

FOMEPIZOLE

173

Aldehyde dehydrogenase inhibitor

DISULFERAM

174

SEDATIVE HYPNOTIC POISONING

(Hot Hot Hot DeCisioN)
Hypothermia
Hypotension
Hypoactive BS
Disinhibition
Coma
Nystagmus

175

What is the most catastrophic symptom of sedative-hypnotic withdrawal?

Rebound suicide

176

Shortest acting

THIOPENTAL

TAYO agad!!!

177

Which drugs are considered date-rape drugs?

DATE-RAPE DRUGS:
Alcohol (most common)
Flunitrazepam (rohypnol)
Gamma-hydroxybutyrate

178

Which benzodiazepine has the longest half-life?

CHLORDIAZEPOXIDE

longest half-life (36-200 hours)
Longest spelling (many letters)

179

What abnormal sleep pattern results from the use of benzodiazepines?

Decreased REM SLEEP

180

Seizure disorders in children

SE: precipitates porphyria, potent inducer of CYP450

PHENOBARBITAL

181

Anesthesia induction, lethal injection, truth serum

THIOPENTAL

182

Antidote to benzodiazepine overdose

FLUMAZENIL

183

Date-rape drug

FLUNITRAZEPAM

184

Seizure disorders (status epilepticus)
Alcohol withdrawal
Tranquilizer

DIAZEPAM

185

Acute anxiety attacks
Anesthesia induction
Preoperative sedation

MIDAZOLAM

186

Inhibits helminthology microtubules
Ovicidal

Mebendazole

187

Inhibits helminthic microtubules
Ovicidal and larvicidal
DOC for hydatid disease (echinococcosis)

Albendazole

188

DOC for Filaria and Loa loa

SE: filarial fever

DEC (Diethylcarbamazine)

189

DOC for Strongyloides and Onchocerca

SE: Mazzotti reaction

Ivermectin

190

DOC for Enterobius

Pyrantel Pamoate

191

DOC for Trichinosis

Thiabendazole

192

DOC for trematodes and cestodes EXCEPT echinococcosis (ALBENDAZOLE)

PRAZIQUANTEL

193

Back-up drug to PRAZIQUANTEL

NICLOSAMIDE

194

Pneumocystis jerovocii

TMZ-SMX

195

Chaga's disease

NIFURTRIMOX

196

African sleeping sickness

Suramin + Melarsoprol

197

Toxoplasmosis

Pyrimethamine-Sulfadiazine

198

Cryptosporidium parvum infection

Nitazoxanide

199

Amebic dysentery
Trichomoniasis
Bacterial vaginosis

Metronidazole

200

Asymptomatic cyst carriers of E. Histolytica

Diloximife furoate

201

DOC for malaria in the Philippines (P. Falciparum)

Co-artem

202

Chemoprophylaxis (multi-drug resistant areas)

Doxycycline

203

Chemoprophylaxis (chloroquine-resistant areas)

Mefloquine Malaxone

204

Eradication of hypnozoites of P. Vivax and ovale

Primaquine

205

Chloroquine-resistance
Severe malaria
DOC for pregnant patients with malaria

SE: hypoglycemia, Blackwater fever, cinchonism

Quinine

206

Primary drug for malaria
Prevents heme polymerization into hemozoin

SE: retinal damage, hearing loss

Chloroquine

207

Binding inhibitor, CCR5 antagonist

Maraviroc

208

Fusion inhibitor, binds gp41 subunit

Enfuvirtide

209

Protease inhibitor

SE: fat redistribution syndrome, hyperlipidemia, insulin resistance

Indinavir

210

Non-nucleoside reverse transcriptase inhibitor (NNRTI)
No phosphorylation required

SE: hepatotoxicity

Delavirdine

211

Nucleoside reverse transcriptase inhibitor (NRTI)
Requires phosphorylation
Primary drug for HIV
Prevents vertical transmission of HIV

SE: Lactic acidosis

Zidovudine (AZT)

212

Treatment of hepatitis C and RSV infection

Ribavirin

213

Treatment of Hepatitis B infection

Lamivudine

214

Neuraminidase inhibitor

DOC for influenza

Oseltamivir

215

Prevents viral uncoating
Influenza A coverage

SE: cerebellar dysfunction, livedo reticularis

Amantadine

216

Treatment of HSV, VZV and CMV
Does NOT require viral thymidine kinase activation

Foscarnet

217

Treatment of CMV
Requires activation by viral thymidine kinase (neutropenia)

Ganciclovir

218

Treatment of HSV and VZV
Requires activation by viral thymidine kinase

SE: cystalluria

Acyclovir

219

Treatment of candidiasis (oropharnygeal, esophageal, vaginal)
Swish and swallow or suppository preparations

Nystatin

220

Interferes with fungal microtubules

SE: potent CYP450 inducer

Griseofulvin

221

Prophylaxis and treatment of candidiasis and cryptococcosis

Fluconazole

222

Topical treatment of dermatophytosis and candidiasis

SE: gynecomastia, CYP450 inducer

Ketoconazole

223

Most efficacious antifungal drug
Forms artificial pores

SE: nephrotoxicity (RTA, ATN)

Amphotericin B

224

Which antibiotics are considered drugs of last resort?

I AM your Last Shot at Victory
IMIPENEM
AMIKACIN
MEROPENEM
LINEZOLID
STREPTOGRAMINS
VANCOMYCIN

225

Silver bullet against gram negative bacteria
No gram positive activity with PSEUDO COVERSGE

Aztreonam

226

Beta-lactamase inhibitor

Clavulanic acid (Tazobactam)

227

Treatment for MRSA

SE: Red Man Syndrome

Vancomycin

228

Drug of last resort
Broad spectrum of activity

SE: toxicity

Meropenem

229

Anaerobic and antiprotozoal coverage
Treatment of pseudomembranous colitis

SE: disulfiram reaction, metallic taste, neurotoxicity

Metronidazole

230

Treatment of urinary tract infections

SE: pulmonary fibrosis

Nitrofurantoin

231

Most active drug against M. Leprae
Inhibits folate synthesis

SE: methomoglobinemia (chocolate blood color)

Tx: methylene blue

Dapsone (hemolysis in G6PD)

232

Inhibits DNA-dependent RNA polymerase

SE: red-orange urine, delays onset of dapsone resistance

Rifampicin

233

Phenazine dye
Binds to guanine bases

SE: skin discoloration

Clofazimine

234

Which anti-TB drugs are hepatotoxic?

ISO a Red PYRe! (I saw a red fire)

Isoniazid < Rifampicin < Pyrazinamide

235

Cidal
Inhibits mycolic acid synthesis

SE: neurotoxicity, hepatotoxicity, sideroblastic anemia, drug-induced lupus, potent CYP450 inhibitor

Isoniazid

236

Static
Inhibits DNA-dependent RNA polymerase

SE: red orange urine, hepatotoxicity

Rifampicin

237

Static
Inhibits arabinoglactan synthesis

SE: visual dysfunction (retrobulbar neuritis, color blindness)

Ethambutol

238

Static but cidal on actively dividing MTB

SE: hyperuricemia, hepatotoxicity (most)

Pyrazinamide

239

Cidal
Binds to 30S

SE: nephrotoxicity, ototoxicity

Streptomycin

240

4th generation quinolone

SE: diabetes mellitus

Gatifloxacin

241

4the generation quinolone
Broad spectrum of activity
Anaerobic coverage
Treatment of ocular infections

Moxifloxacin

242

3rd generation quinolone
Treatment of pulmonary infections

Levofloxacin

243

2nd generation quinolone
Treatment of urinary tract infections and GIT infections

TX: tendinitis

Ciprofloxacin

244

Treatment of burn infections

Sulfadiazine

245

Sequential blockage in folate synthesis
Urinary tract infections

SE: hypersensitivity (SJS, TEN), kernicterus hemolysis in patients with G6PD

TMP-SMX (pneumocystis, pneumonia)

246

Blocks dihydrofolate reductase

Trimethoprim

247

Blocks dihydropteroate synthase

Sulfamethoxazole

248

Treatment of hepatic encephalopathy

Neomycin

249

Widest spectrum of activity
Pseudomonas coverage
Narrow therapeutic window

Amikacin

250

Treatment of drug-resistant gonorrhea

Spectinomycin

251

Tuberculosis

Streptomycin

252

Treatment of ocular infections

Tobramycin

253

Prototype aminoglycoside, bactericidal
Binds to 30S subunit

SE: nephrotoxicity, ototoxicity

Gentamicin

254

Binds to 50S subunit
Vancomycin-resistance

Linezolid

255

Binds to 50S subunit
Anaerobic coverage

SE: pseudomembranous colitis

Clindamycin

256

Binds to 50S subunit
Highest volume of distribution
Single dose administration

Azithromycin

257

Binds to 50S subunit subunit
DOC for penicillin-allergic patients

SE: diarrhea, choke static jaundice

Erythromycin

258

Binds to 30S subunit

SE: tooth enamel discoloration, photosensitivity

Tetracycline

259

Binds to 50S subunit subunit

SE: aplastic anemia, gray baby syndrome

Chloramphenicol

260

Anti-pseudomonal cephalosporins

Ceftazidine
Cefepime
Cefoperazone

261

Third generation cephalosporins

Ceftamet
Cefpodoxin
Cefoperazone
Cefixime
Ceftriaxone
Ceftazidine
Cefotaxime
Ceftrizoxime
Ceftibuten

262

Cephalosporins causing disulfiram reaction

Cefamandole
Cefmetazole
Cefotetan
Cefoperazone

263

Which cephalosporin has the best penetrance to the BBB?

Ceftriaxone

264

4th generation cephalosporins
Broad spectrum activity (gram positive and gram negative)

Cefepime

265

Most efficacious cephalosporin for Pseudomonas aeruginosa

Ceftazidime

266

3rd generation cephalosporins
Pseudomonas coverage

SE: Disulfiram reaction

Cefoperazone

267

2nd generation cephalosporins
Added gram negative coverage

SE: Disulfiram reaction

Cefamandole

268

1st generation cephalosporin
High bone penetration
Surgical prophylaxis
Greatest gram positive coverage

SE: hypersensitivity reaction

Cefazolin

269

Narrow spectrum penicillins

SE: hypersensitivity

Penicillin G

270

Penicillinase-resistant penicillins

Interstitial nephritis

Methecillin

271

Extended-spectrum penicillins

Pseudomembranous colitis

Ampicillin

272

Antipseudomonal penicillins

SE: hypertension, hypovolemia, bleeding

Ticarcillin

273

Bacteriostatic antibiotics

Erythromycin
Clindamycin
Sulfamethoxazole
Trimethoprim
Tetracycline
Chloramphenicol

274

Bactericidal antibiotics

Vancomycin
Fluoroquinolones
Penicillins
Aminoglycosides
Metronidazole

275

Drug of choice for acute asthma attacks

Albuterol/Salbutamol

276

Adjunct for asthma maintenance

Salmeterol

277

Prophylaxis for nocturnal asthma

SE: seizures, antidote: Propanol

Theophylline

278

Bronchodilator of choice in COPD

Ipratropine

279

Stabilizes mast cells
No bronchodilator effects

Cromolyn

280

Drug of choice for asthma maintenance

SE: oral candidiasis, growth stunting

Fluticasone

281

Lipooxygenase inhibitor

SE: increased AST/ALT

Zileuton

282

Blocks slow-reacting substances of anaphylaxis (Leukotrienes C4, D4, E4

Montelukast

283

Prostaglandin E1

PDA, erectile dysfunction

Alprostadil

284

Prostaglandin E1

Peptic ulcer disease
Abortifacient prevention of NSAIDs-induced gastric mucosal injury

Misoprostol

285

Prostaglandin F2alpha

Glaucoma

Latanoprost

286

Prostaglandin E2

Induction of labor
Abortifacient

Dinoprost

287

Prostaglandin F2alpha

Control of postpartum hemorrhage
Abortifacient

Carboprost

288

Prostaglandin I2

Pulmonary HPN
Reduces PLT aggregation in dialysis machines

Epoprostenol

289

SE: retroperitoneal fibrosis

Ergotamine

290

Treatment of postpartum bleeding

Ergonovine

291

Adjunct for migraine and cluster headache

Ergotamine

292

Treatment for postop and postchemo vomiting

Ondansetron

293

Drug of choice for migraine and cluster headache

Sumatriptan

294

Treatment of peptic ulcers

SE: gynecomastia

Cimetidine

295

Treatment of hypersensitivity, non-sedating

Cetirizine

296

Adjunct for motion sickness, vertigo

Meclizine

297

Treatment of hypersensitivity (food allergy, rhinitis, hay fever, angioedema)

SE: sedation

Diphenhydramine

298

Reversibly inhibits cyclooxygenase 1 and 2
Antipyretic of choice in pediatric population

Paracetamol

299

Irreversibly inhibits cyclooxygenase 2

Celecoxib

300

Reversible inhibitor of cyclooxygenase 1and 2

Ibuprofen

301

Irreversibly inhibits cyclooxygenase 1and 2

Aspirin

302

What are the drugs that cause flushing?

Vancomycin
Adenosine
Niacin (ASA prophylaxis)
Calcium channel blockers

303

Why are statins used in the management of coronary artery disease?

For stabilization of atherosclerotic plaque

304

PPAR-a activator
Upregulates lipoprotein lipase
Lowers TG

SE: gallstones, additive myopathy

Gemfibrozil

305

Reduces all building blocks for hyperlipidemia
Increases HDL
Lowers LDL and TG

SE: flushing, hyperglycemia, hyperuricemia

Niacin

306

Cholesterol absorption blocker
Lowers LDL

Ezetimibe

307

Bile acid binding resin
Lowers LDL

SE: constipation, steatorrhea

Cholestyramine

308

HMG-CoA reductase inhibitor
Lowers LDL

SE: hepatotoxicity, rhabdomyolysis, myopathy

Simvastatin

309

What is the difference between an inhibitor and an uncoupler of oxidative phosphorylation?

INHIBITORS: completely hat ETC

UNCOUPLERS: dissipate proton gradient without interrupting ETC

310

What is the difference between in presentation of aspirin intoxication in children and adults?

ADULTS: mixed acid-base disorder, respiratory alkalosis with HAGMA

CHILDREN: pure acid-base disorder, HAGMA

311

What is the expected acid-base abnormality in salicylate poisoning?

Respiratory Alkalosis with HAGMA

312

What are the signs of ASA poisoning?

ASPIRIN POISONING:
C-H-A-F-S
Coma
Hyperventilation
Acidosis (HAGMA)
Fever
Seizure

313

What is the triad of aspirin hypersensitivity?

SAMTER's triad:
Asthma
Nasal polyp
NSAIDs sensitivity

314

How many 500mg Aspirin tablets must be ingested to produce toxicity? Death?

Toxic dose: 150mg/kg
150mg/kg x 70kg/500mg/tab = 21 tabs

Lethal dose: 500mg/kg
500mg/kg x 70kg/500mg/tab = 70 tabs

315

Phosphodiesterase inhibitor
Cardiac stress testing

Dipyridamole

316

Glycoprotein IIb-IIIa inhibitor

Abciximab

317

ADP inhibitor
Addictive effects with Aspirin

Clopidogrel

318

Irreversible COX inhibitor
Instant prevention of arterial thrombosis

SE: tinnitus, hypersensitivity, Reye syndrome

Aspirin

319

Antidote to thrombolytic overdose

Aminocaproic acid
Tranexamic acid

320

Bacteria-derived thrombolytic
Decreased effect on subsequent uses due to antibody formation

Streptokinase

321

Thrombolysis in AMI
Ischemic CVD and PE

SE: bleeding

Alteplase R-TPA

322

In patients requiring anticoagulation, why is an overlap between heparin and warfarin usually done?

1. Warfarin's effect requires elimination of preformed clotting factors (8-60h)
2. To bypass the initial prothrombotic effect of warfarin (skin necrosis)

323

What laboratory tests will you request to assess the extrinsic and intrinsic coagulation pathways?

PiTT
PTT for intrinsic pathway
PeT
PT for extrinsic pathway

324

Antidote to warfarin (immediate reversal)

FFP (fast)

325

Chronic anticoagulation

SE: bleeding, skin necrosis, many drug interactions

Warfarin

326

Antidote to heparin-induced bleeding

Protamine sulfate

327

Treatment of heparin-induced thrombocytopenia

Lepirudin

328

Low molecular weight heparin
Less risk of thrombocytopenia
Does not need monitoring

Enoxaparin

329

Acute treatment of DVT, PE and AMI

SE: bleeding, thrombocytopenia, monitor with PPT

330

Treatment of chemotherapy induced thrombocytopenia

Oprelvekin

331

Treatment of neutropenia and agranulocytosis

Filgrastim

332

Anemia in chronic kidney disease

Epoetin Alfa

333

Treatment of Megaloblastic anemia
Prevention of neural tube defects (spina bifida)

Folic acid

334

Treatment of Megaloblastic anemia
vitamin B12 deficiency

Cyanocobalamin

335

Treatment of iron deficiency anemia

Ferrous sulfate

336

What drugs can cause gynecomastia?

Some Drugs Create Awesome Knockers!
Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole

337

Adverse effects of Thiazide Diuretics

THIAZIDE TOXICITIES
HYPER GLUC
Glycemia
Lipidemia
Uricemia
Calcemia

338

What are the adverse effects associated with loop diuretics?

OH DANG!
Ototoxicity
Hypokalemia
Dehydration
Allergy to sulfa
Nephritis
Gout

339

NAGMA

Non Anion Gap Metabolic Acidosis
Hyperalimentation
Acetazolamide
RTA
Diarrhea
Ureteral diversion
Pancreatic fistula

340

HAGMA

High Anion Gap Metabolic Acidosis
Methanol
Uremia
Diabetic Ketoacidosis
Paraldehyde
Isoniazid
Lactic acid
Ethanol
Salicylates

341

Acts on PCT, DCT and CCD
Treatment of rhabdomyolysis and increased ICP
Contraindicated in heart failure

Mannitol

342

Acts on CCD

SE: Gynecomastia, Hyperkalemia

Spironolactone

343

Acts on DCT

SE: hyperglycemia, hyperlipidemia, hypercalcemia

Hydrochlorothiazide

344

Acts on TAL
Treatment of pulmonary edema
Most efficacious diuretics

SE: ototoxicity, hypokalemia, hypocalcemia

Furosemide

345

Acts on PCT
Treatment of glaucoma and mountain sickness

SE: NAGMA, hepatic encephalopathy

Acetazolamide

346

Why are dihydropyridine calcium channel blockers not useful as antiarrhythmics?

Dihydropyridine CCBs evoke compensatory sympathetic discharge which facilitates arrhythmics rather than terminating them

347

AMIODARONE TOXICITY

Pulmonary fibrosis
Parethesias
Tremors
Thyroid dysfunction
Corneal deposits
Skin deposits

348

What are the effects of class1 antiarrhythmics on action potential?

Class I: prolongs AP duration
Class IB: shortens AP duration
Class IC: no effect on AP duration

349

Outpatient management of SVT

SE: gingival hyperplasia

Verapamil

350

Most efficacious antiarrhythmic

SE: skin deposits, pulmonary fibrosis, hyper/hypothyroidism

Amiodarone

351

SE: dose-dependent torsades de pointes

Sotalol

352

Perioperative and thyrotoxic arrhythmias
SVT

Esmolol

353

Contraindicated post-MI
Refractory arrhythmias

Flecainide

354

Post-MI arrhythmias
Digitalis arrhythmias

SE: seizures

Lidocaine

355

SE: cinchonism (headache, tinnitus, vertigo)

Quinidine

356

Treatment of all types of arrhythmias
WPW syndrome

SE: drug-induced lupus

Procainamide

357

What drugs have been shown to improve survival in cases of heart failure?

ABA! Bahay ka pa!
ACE inhibitors
Beta-blockers
Aldosterone Antagonists

358

Improves survival in CHF patients of African-American descent

Hydralazine & ISDN

359

Decreases hospitalization in CHF

Digoxin

360

Improves survival (decreases mortality) in CHF

ACE-I / ARBS
Beta blockers
Spironolactone

361

First line drug for chronic CHF
Cardioprotective

ACE-I
ARBS

362

Treatment of pulmonary edema in CHF

Furosemide

363

Positive inotrope for heart failure

SE: arrhythmias (PVC, AVB), RG color blindness, yellow visual halos

Digoxin

364

What drugs can cause gingival hyperplasia?

Nifedipine

Cyclosporine
Phenytoin
Verapamil

365

Why do patients taking nitrate usually experience throbbing headaches?

Due to meningeal artery dilatation

366

Why is calcium-dependent neurotransmission or hormone release not affected by CCBs?

CCBs block L-type calcium channels other functions use N-, P-, and R-types

367

Supraventricular tachycardia
Cardiac > Vascular effect

SE: gingival hyperplasia

Verapamil

368

Angina maintenance
Vascular < Cardiac effect
Vasospastic angina
Raynaud's phenomenon
Does not cause gingival hyperplasia

Diltiazem

369

Angina maintenance
Vascular > Cardiac effect

SE: flushing, edema, gingival hyperplasia

Nifedipine

370

Relief of acute anginal attacks

SE: headache

Nitroglycerin + ISDN

371

What is the antidote for cyanide poisoning?

Inhaled amyl + nitrate + IV sodium nitrate + IV sodium thiosulfate

372

Which portion of the electron transport chain is affected by cyanide?

IV cytochrome oxidase

373

Treatment of cyanide poisoning

Amyl nitrite

374

Hypertensive emergency

SE: cyanide poisoning

Nitroprusside

375

Hypertensive emergency

SE: hypertrichosis

Minoxidil

376

Pre-eclampsia (acute BP lowering)

SE: reflex tachycardia, drug-induced lupus

Hydralazine

377

Pre-eclampsia (maintenance medication)

SE: hemolytic anemia (positive Coombs test)

Methyldopa

378

Hypertension with comorbid BPH

Prazosin

379

ACE-inhibitor intolerance

Losartan

380

Hypertension with comorbid CHF/DM

SE: cough, angioedema, contraindicated in bilateral RAS

Captopril

381

First-line drug for essential hypertension

Hydrochlorothiazide

382

What is the expanded formula for your blood pressure?

BP = hr x sv x svr

383

What is the formula for blood pressure?

BP = co x svr

384

What is the pharmacologic advantage of a1 selectivity?

Reflex tachycardia is less common and less severe

385

What drugs are used to control blood pressure in pheochromocytoma?

Phenoxybenzamine
Phentolamine
Labetalol

386

Combined alpha and beta blockade

Labetalol

387

Treatment of glaucoma

Timolol

388

Beta-1 selectivity

Atenolol / Metoprolol

389

Intrinsic sympathomimetic activity

Pindolol

390

Angina prophylaxis
Hyperthyroidism
Masks hypoglycemia in diabetes

SE : Bronchospasm, erectile dysfunction

Propranolol

391

Benign prostatic hyperplasia

SE: first dose orthostatic hypotension

Prazosin

392

Treatment of rebound hypertension

Phentolamine

393

Pre-operative treatment of pheochromocytoma

Phenoxybenzamine

394

Tocolysis for preterm labor

Terbutaline

395

Bronchial asthma, COPD

Salbutamol

396

SE: Hemolytic anemia (positive Coombs test)

Methyldopa

397

SE: Rebound hypertension on discontinuation

Clonidine

398

Nasal congestion
Mydriasis without cycloplegia

Phenylephrine

399

Drug of last resort for shock

Norepinephrine

400

Acute CHF, shock (cardiogenic, septic)

Dopamine

401

DOC for anaphylactic shock
Adjunct to local anesthesia
Cardiac arrest
Croup

Epinephrine

402

What are the signs of atropine toxicity?

HOT as a hare
DRY as a bone
RED as a beet
BLIND as a bat
MAD as a hatter

403

Why is ipratropium the preferred bronchodilator in patients with comorbid COPD and heart disease?

IPRATROPIUM
less likely to cause tachycardia and cardiac arrhythmias

404

Muscarinic Antagonists for Parkinson's Disease

TRIhexyphenidyl
BENZtropine
BIPeriden

405

Treatment for organophosphate poisoning / nerve gas poisoning

Atropine + Pralidoxine

406

Motion sickness
Sea sickness

Scopolamine

407

Chronic obstructive pulmonary disease (COPD)

Ipratropium

408

Parkinson's disease

Benztropine

409

Sinus Bradycardia

Atropine

410

Induction of mydriasis and cycloplegia

Tropicamide

411

What are the signs and symptoms of organophosphate poisoning?
(MALATHIONE PESTICIDE)

DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation (skeletal muscle and CNS)
Lacrimation
Sweating
Salivation

412

Small cell cancer may present with a myasthenia-like paraneoplastic syndrome. What is this condition called?

LAMBERT-EATON SYNDROME

413

How does EDROPHONIUM differentiate myasthenic crisis from cholinergic crisis?

EDROPHONIUM

Improves muscle strength in myasthenic crisis

Weakens muscle strength in cholinergic crisis

414

Excessive activation of cholinoceptors (skeletal muscle weakness and parasympathetic signs) due to OVERmedication

Cholinergic Crisis

415

Acute worsening of symptoms due to infection, stress or UNDERmedication

Myasthenic Crisis

416

What is myasthenia gravis?

Autoimmune destruction of nicotonic ACH receptors, characterized by fluctuating muscle weakness
1. Ocular symptoms
2. Bulbar symptoms
3. Proximal muscle weakness

417

What is Sjogren syndrome?

Autoimmune disorder characterized by triad of
1. Xerostomia (dry mouth)
2. Xerophthalmia (dry eyes)
3. Rheumatoid arthritis

418

Bowel and bladder atony

Betanechol

419

Sjogren syndrome (Xerostomia, Xerophthalmia, & rheumatoid arthritis)

Pilocarpine

420

Diagnosis of myasthenia gravis
Differentiation of myasthenia and cholinergic crisis

Edrophonium

421

Treatment of myasthenia gravis

Reversal of nondepolarizing neuromuscular block

Neostigmine

422

Treatment of glaucoma

Physostigmine

423

Diagnosis of bronchial hyperreactivity

Methacoline

424

Treatment of Alzheimer's disease

Donepezil

425

Peripheral neuropathy

Vincristine

426

Bone marrow suppression

Vinblastine

427

For Hodgkins lymphoma, leukemias, Wilms tumor, Ewings sarcoma

Vincristine

428

For Hodgkins disease, testicular CA

Vinblastine

429

Inhibits topoisomerase 1

Camptothecins

430

Pyrimidine analog

5-Fluorouracil

Cytarabine

431

Inhibits thymidilate synthetase

5-Fluorouracil

432

For breast CA and GI carcinoma, colorectal CA, pancreatic CA, ovarian CA

5-Fluorouracil

433

Prevents elongation of DNA

Cytarabine

434

For AML ONLY

Cytarabine

435

For ALL and AML

6-Mercaptopurine

436

Pyrimidine analogs

Capecitabine, Cytarabine, Fluourouracil, Gemcitabine

437

Inhibits toposiomerase II

Etoposide, Teniposide, Poside
(Podophyllotoxins)

438

Promote microtubule assembly and stabilizatiom thus inhibiting cell division

Taxanes

439

Taxanes drugs

Docetaxel, Paclitaxel, Taxel

440

Promotes microtubule formation but prevents disassembly that malformed microtubules

Paclitaxel

441

For ovarian and breast ca

Paclitaxel

442

Estrogen antagonist

Tamoxifen

443

Treatment of ER + breast ca

Tamoxifen

444

Competitive inhibitor of estradiol

Tamoxifen

445

DOC for estrogen-receptor positive breast ca

Tamoxifen

446

Adverse effects of Tamoxifen

Hor flushes
Nausea, vomiting
Menstrual bleeding
Thromboembolic disease

447

Endometrial CA

Tamoxifen

448

Inhibits translocation of androgen receptor to the nucleus

Flutamide

449

For prostate CA

Flutamide

450

Side effects of Flutamide

Diarrhea, hot flushes, impotence, gynecomastia, reversible hepatotoxicity

451

Inhibits release of FSH and LH

Leuprolide

452

For prostate and endometriosis

Leuprolide