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Cheat Sheet > Pharmacology > Flashcards

Pharmacology Flashcards

0
Q

INH

A

INHIBITS MYCOLIC ACID SYNTHESIS (needed for making the wall and also virulence factors sufatides, wax D and cord factor). The mycolic acid is what makes mycobacteria acid fast when stained with carbolfuchsin dye and treated with acid alcohol decolorizing agent

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1
Q

Anti pseudomonals

A

Fluoroquinolones Cipro and Levo
PCNs piperacillin and ticarcillin
Cephs, 3rd gen ceftazidime and 4th gen cefepime
Aminoglycosides amikacin, Tobramycin and gentamicin
Monobactams like aztreonam
Carbapenems like imipenem and meropenem

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2
Q

Plague and Tularemia tx

A

Streoptomycin for Plague (Yersinia Pestis) and Tularemia (Francisella Tularensis), Its an aminiglycoside

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3
Q

Nucleoside Analog Antiviral

  • Those needing phosphorylation into nucleotides (Cell dependent versus viral thymidine kinase dependent)
  • Those who do not i.e. are nucleotide analogs
A 
-Those needing phosphorylation
   Cell dependent (Zidovudine, Lamivudine)
   Viral dependent (Acyclovir, Valacyclovir, Famiciclovir, Ganciclovir
-Those who do not
   Cidofovir and Tenofovir
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4
Q

Leukotrienes of the LOX pathway

Tell me about them and their function

A

Lipooxygenase pathway!!!
Leukotrienes go from B to E
-LTB4: NEUTROPHILS arrive B4 others (CHEMOTACTIC)
-LTC4, D4 and E4:- Are bronchoconstrictors, vasoconstrictors, permeability agents and smooth muscle contractors

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5
Q

arachidonic acid products- in 2-3 sentences

A
  1. Membrane phospholipid:- PLA2 enzyme breaks down PL to Arachidonic Acid (AA).
  2. AA has two enzyme pathways (LOX and COX1-2).
    If LOX (HPETES formed then leukotrienes), if COX (Endoperoxides PGG2 and PGH2 are formed THEN PG’s TXA2 and Prostacyclin PGI2)
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6
Q

LOX and COX pathways, what are similar drugs

Unique note about steroids

A

Zileuton is to NSAIDs/aspirin/acetaminophen and Cox2 inhibitors/steroids
-Steroids inhibit BOTH PLA2 and COX

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7
Q

Products of Endoperoxides

-Functions

A
  1. Prostacyclin or PGI2
    - PLT gathering inhibitor
    - Decreases ALL 3 tones (uterine, vascular and bronchial)
  2. Thromboxane or TXA2
    - Increases 2 Most important tones (vascular and bronchial)
    - Also increases platelet aggregation
    - DIRECT OPPOSITE OF PGI2
  3. Prostaglandins (PGE2, PGF2alpha)
    - Increase Uterine tone (Direct contrast to PGI2)
    - Decrease bronchial tone (Direct contrast to TXA2)
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8
Q

TXA2 synthesis depends mostly on which enzyme

A

COX 1

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9
Q

Where is COX 2 found

A

Differently expressed on vascular endothelium and inflammatory cells

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10
Q

COX II inhibitors use and toxicity

-name one

A
  • RA, OA, Gastritis + Ulcers
  • Increased thrombosis, sulfa allergy. NO EFFECT ON TXA2 and PLT function
  • Celecoxib
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11
Q

Dronates

  • What are they/how they work
  • Examples and use
A

aleDRONATE

  • Bisphosphonate, PYROPHOSPHATE analog *bind hydroxyapatite in bone, inhibit osteoclast bone resorption
  • Osteoporosis, hypercalcemia, paget disease
  • TOX (corrosive esophagitis hence take with water, be upright for 30 mins), (jaw osteonecrosis)
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12
Q

Acetaminophen

  • Differentiate from NSAIDs and aspirin
  • Mechanism
  • Use and toxicity mechanism
  • antidote
A

-It is ANTI pyretic and Analgesic BUT NOT ANTI INFLAMMATORY
-COX inhibitor in CNS, peripherally inactivated
-Use in kids with viral infx to avoid Reyes from aspirin
-Overdose leads to hepatic necrosis, its metabolite NAPQI depletes glutathione, forms toxic tissue adducts in liver
(Nacetylcysteine antidote that regenerates glutathione)

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13
Q

One clue for bone diseases, lab value, feature

  • Osteoporosis
  • Pagets disease
A
  • Osteoporosis:- decreased mass/density, everything normal

- Pagets disease:- increased activity, ALP up, deafness possible/increased hat size

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14
Q

Pyrophosphates (bisphosphonate) and its role in bone resorption

A
  • bisphosphonates resemble pyrophosphates which regulate bone turnover.
  • They inhibit osteoclast bone resorption, and they also inhibit mineralization of bone by osteoblasts
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15
Q

NSAIDS

  • Name some
  • Mechanism
  • Use
  • Tox
A
  • Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac
  • Inhibit COX 1 and 2. MOSTLY PG synthesis inhibitors
  • Use Indo to close PDA. Also anti (pyretic, inflammatory, analgesic)
  • Interstitial nephritis, renal ischemia (PG dilate afferent), gastric ulcer (protective PG)
16
Q

Aspirin

  • Mechanisms
  • Different doses and functions
  • Effect on hemodynamics
  • Other side effects (Kids, General Population acute vs chronic use and Super high toxicity)
A
  • COVALENT ACETYLATOR
  • MOSTLY PG and TXA2 synthesis inhibitors
  • 2400-4000mg (anti-inflammatory)
  • 300-2400mg (anti-pyretic and analgesic)
  • <300mg (anti platelet)
  • Increased bleeding time until PLTs turn over (7days)
  • Kids: Reyes Syndrome (rash, vomit, liver damage/ encephalopathy)
  • General: GI ulcer, CNVIII tinnitus, acute renal failure+ interstitial nephritis+ upper GI bleed with chronic use
  • Super high toxicity: respiratory center stimulation, hence hyperventilation and respiratory alkalosis
17
Q

Step wise asthma management

A
  1. Short acting beta 2 agonist
  2. Inhaled steroid (low concentration)
  3. Long acting beta 2 agonist
  4. Leukotriene receptor blocker (montelukast)
    Other more expensive:-
    Zileuton (LOX inhibitor)
    Omalizumab

Cheat Sheet (7 decks)

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