Pharmacology Flashcards
drug of choice = DOC (303 cards)
1
Q
inhibitors of ACh synthesis, storage, release
A
hemicholinium-3, vesamicol, botulinum toxin
2
Q
inhibitors of ACh degradation (AChE inhibitors)
A
edrophonium, neostigmine, pyridostigmine, ambenonium, physostigmine
diisopropyl flurophosphate
tacrine, donepezil, rivastigmine, galantamine
3
Q
muscarinic receptor AGONISTS
A
methacholine (asthma challenge test)
carbachol, bethanechol, cevimeline, pilocarpine
4
Q
nicotinic receptor AGONISTS
A
succinylcholine
5
Q
muscarinic recept ANTAGONISTS
A
atropine
scopolamine
pirenzepine, methscopolamine, glycopyrrolate
ipratropium, tiotropium
oxybutynin, propantheline, terodiline, tolterodine, fesoterodine, trospium, darifenacin, solifenacin
6
Q
nicotinic recept ANTAGONISTS
A
pancuronium, tubocurarine, vecuronium, rocuronium, mivacurium
trimethaphan, mecamylamine
7
Q
sodium channel inhibitors (antiepileptics)
A
phenytoin
carbamezepine
lamotrigine
lacosamide
8
Q
Ca channel inhibitors (antiepileptics)
A
ethosuxamide, valproic acid (inhib T-type Ca channel)
gabapentin, pregabalin (inhib HVA Ca channel)
9
Q
GABA channel potentiators (antiepileptics)
A
Benzos (diazepam, lorazepam, midazolam, clonazepam) [increase amount of Cl influx]
barbiturates (phenobarbital) [increase duration of Cl influx]
vigabatrin (irrev inhibit GABA transaminase)
10
Q
glutamate recept inhibitors (antiepileptics)
A
felbamate
rufinamide
11
Q
other antiepileptic drugs under investigation
A
tiagabine
topiramate
levetiracetam
zonisamide
12
Q
drug of choice for focal seizures
A
carbamazepine
13
Q
drug of choice for idiopathic generalized seizures (and mixed seizures)
A
valproic acid
14
Q
drugs of choice for absence seizures
A
ethosuxamide > valproic acid > lamotrigine > clonazepam
15
Q
glucocorticoid receptor AGONISTS
A
prednisone (preggos), prednisolone, methylprednisolone, dexamethasone (fetal), hydrocortisone (replacement therapy)
fluticasone, beclomethasone, flunisolide, triamcinolone, budesonide [inhaled]
16
Q
GC recept ANTAGONISTS
A
mifepristone (for ectopic ACTH synd)
17
Q
Inhibitors of GC synthesis
A
mitotane (DDT) aminoglutethimide metyrapone (dx of hypo-pit-adrenal axis) trilostane ketoconazole (inhib P450 enzymes)
18
Q
Minerocorticoid receptor AGONISTS
A
fludrocortisone
19
Q
MC recept ANTAGONISTS
A
spironolactone
eplerenone
20
Q
Adrenal sex steroid
A
Dehydroepiandrosterone (DHEA)
21
Q
inhibitor of fungal nucleic acid synthesis
A
flucytosine
22
Q
inhibitor of fungal MITOSIS
A
griseofulvin
23
Q
inhibitors of squalene epoxidase
A
terbafine, naftinfine (allylamines)
butenafine (benzylamines)
24
Q
inhibitors of 14-alpha sterol demethylase
A
Imidazoles:
ketoconazole
butoconazole, clotrimazole, econazole, miconazole, oxiconazole, sertaconazole, sulconazole [topical]
Triazoles:
fluconazole, itraconazole (inhibit P450)
posaconazole, terconazole, voriconazole
25
inhibitors of fungal membrane stability: polyenes
amophotericin B
| nystatin
26
inhibitors of fungal wall synthesis: echinocandins
caspofungin, micafungin, anidulafungin
27
tx of acute cryptococcal meningitis in HIV-positive patient
flucytosine + amphotericin B
28
tx of fungal inf of hair, skin, nails
griseofulvin
29
drug of choice for tx of candidiasis and cryptococcal meningitis
fluconazole
30
drug of choice for tx of invasive aspergillosis
voriconazole
31
only triazole whose absorption NOT affected by gastric acid
fluconazole
32
drug of choice for vulvovaginal candidiasis
terconazole
33
prophylaxis tx of invasive fungal infection
posaconazole
34
tx of mucocutaneous candidiasis
nystatin
35
tx of esophageal candidiasis
caspofungin, (micafungin, anidulafungin)
36
inhib of viral attachment/entry (and mechanism)
maraviroc (only blocks CCR5, not CXCR4)
| enfuvirtide (T-20) [inhib gp41-med fusion by binding HR1]
37
inhibitors of viral uncoating
block M2 channel proton
amantidine (also for Parkinson's)
rimantidine
38
Antiherpesvirus nucleoside and nucleotide analogues (plus dz/tox if applicable)
phosphorylated by viral kinases:
acyclovir, valacylovir (HSV, VZV)
pencicyclovir, famcicyclovir (HSV, VZV - shingles)
ganciclovir, valganciclovir (CMV) (neutropenia)
phosphorylated by cellular kinase:
cidofovir - must be coadmin w/ probenicid (CMV retinitis in those w/ HIV) (NEPHROtox)
vidarabine, idoxuridine, trifluridine (HSV keratitis)
39
anti-HIV and -HBV nucleoside/nucleotide analogues/SE
```
zidovudine (AZT)
stavudine (d4T)
zalcitabine (ddC)
Lamivudine (3TC) - [HBV]
emtricitabine (FTC) - 1x daily
didanosine (ddl)
Abacivir
^^all these ass. w/ neutropenia, anemia
```
tenofovir (HIV) (hepatotoxicity)
adefovir (HBV) (renal toxicity)
entecavir (HBV) (dose adjust in pts w/ mod renal insuff)
40
nonnucleoside DNA polymerase inhibitors/SE
foscarnet (renal impairment = dose-limiting)
41
NNRTIs/SE
efavirenz (1x daily), nevirapine, delavirdine, etravirine [rash!!]
42
inhib of viral integration - inhib HIV INTEGRASE!
raltegravir
43
inhib of viral integration - inhib HIV PROTEASE!/SE
saquinavir, ritonavir, amprenavir, fosamprenavir, indinavir, nelfinavir, lopinavir, atazanavir, tipranavir, darunavir
SE = fat distrib and metabolic abnormalities
44
inhibitors of viral release
inhib neuraminidase!! - Flu A, B
zanamivir
oseltamivir (prophylaxis/tx)
45
antiviral drugs w/ UNKNOWN mech of action (+ dz)
fomivirsen (2nd line CMV retinitis)
Ribavirin (RSV, HCV w/ IFN-alpha)
docosanol (HSV) - lacks cytotoxicity
46
antiviral drugs that modulate immune system
IFN-alpha
IFN-beta (tx of MS)
Imiquimod (w/ TLR-7 + 8 to boost innate immunity)
47
alpha1 receptor functions
Gq
increase vasc SM contraction (vasoconstriction) --> increases systolic/diastolic BP --> reflex bradycardia (DECREASED HR)
increase pupillary dilator muscle contraction (mydriasis - dilation)
increase intestinal and bladder sphincter muscle contraction
48
alpha2 receptor functions
```
Gi
decrease sympathetic outflow (inhib NE release)
decrease insulin release
decrease lipolysis
increase platelet aggregation
```
49
beta1 receptor functions
```
Gs
increase heart rate
increase contractility and conductance
increase renin release
increase lipolysis
```
50
beta2 receptor functions
```
Gs
vasodilation (decrease diastolic BP)
bronchodilation
increase HR
increase contractility
increase lipolysis
increase insulin release
decrease uterine tone (tocolysis)
ciliary muscle relaxation
increase aqueous humor production
```
51
M1 receptor functions
Gq
| CNS, enteric NS
52
M2 receptor functions
Gi
| decrease HR and contractility of atria at SA node (bradycardia)
53
M3 receptor functions
Gq
increase exocrine gland secretions (lacrimal, gastric gland, bronchial secretions, etc.)
increase gut peristalsis
increase bladder contraction
bronchoconstriction (increase airflow resistance)
increase pupillary sphincter muscle contraction (miosis)
ciliary muscle contraction (accomodation)
54
D1 receptor functions
Gs
| relaxes renal vasc SM
55
D2 receptor functions
Gi
| modulates transmitter release (esp in brain)
56
H1 receptor functions
```
Gq
increase nasal and bronchial mucus prod (allergy symptoms)
contraction of bronchioles
pruritus
pain
```
57
H2 receptor functions
Gs
| increase gastric acid secretion
58
V1 receptor functions
Gq
| increase vasc SM contraction
59
V2 receptor functions
Gs
| increase water permeability and reabsorption in collecting tubules of kidney
60
CCB used on vasc SM
amlodipine, nifedipine
61
first line therapy for HTN in preg
hydralazine w/ methyldopa
62
can cause cyanide toxicity (releases cyanide)
nitroprusside
63
drugs of choice in pts w/ CAD and CHF w/ HTN
cardioselective beta blockers
| A BEAM of beta-1 blockers
64
DOC in pts w/ isolated systolic HTN
CCB + thiazide diuretics (in non-diabetics)
| ACE inhib or ARB (diabetics)
65
CCB used on heart
verapamil
66
partial beta agonists contraindicated in angina
pindolol, acebutolol
67
decrease GI absorption of statins
bile acid resins (cholestyramine, colestipol, colesevelam)
68
class IA antiarrhythmics
quinidine, procainamide, disopyramide
increases AP duration, ERP, QT interval
"the Queen Proclaims Diso's Pyramid"
69
class IB antiarrhythmics
lidocaine, mexiletine, tocainide; (phenytoin can also fall into this class)
decreases AP duration
BEST POST-MI!! + in digitalis-induced arrhythmias
70
class IC antiarrhythmics
flecainide, propaferone
no change in AP duration
last-ditch drug
71
class II antiarrhythmics
metoprolol, propanolol, esmolol, atenolol, timolol
72
class III antiarrhythmics
amiodarone, ibutilde, dofetilide, sotalol
| "AIDS"
73
class IV antiarrhythmics
verapamil, diltiazem
74
"other" antiarrhythmics
adenosine, Mg
75
does not presdisp to Torsades de Pointes even though prolongs QT interval
amiodarone (half life > 80 days)
76
DOC in dx/abolishing paroxysmal SVT
adenosine
77
effects blocked by theophylline and caffeine
adenosine
78
DM tx: no risk of hypoglycemia
metformin, pioglitazone, rosiglitazone, acarbose, miglitol, voglibose
79
sulfa drugs
```
probenecid
furosemide
acetazolamide
celecoxib
thiazides
sulfonamide AB
sulfasalazine
sulfonylureas
```
"Sulfa Pills Frequently Cause Terrible Acute Symptoms"
pts w/ sulfa allergies --> fever, UTI, pruritic rash, Stevens-Johnson synd, hemolytic anemia, thrombocytopenia, agranulocytosis, urticaria (hives)
80
DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics
dantrolene
81
DOC for Pneumocystis jirovecii, Toxoplasma gondii, Nocardia, Stenotrophomonas meltophilia
TMP-SMX
82
Vd =
amount of drug in body/plasma drug concentration
83
half life =
0.7 x Vd / CL
84
loading dose =
Css x Vd/F (F=1 for IV dose)
85
maintenance dose =
Css x CL/F
86
reduces pain by decreasing levels of substance P in PNS
capsaicin
87
DOC for type II DM
metformin
88
P450 inducers
Momma Bear Steals Phen-phen and Refuses Greasy Carbs Chronically
```
modafinil
barbiturates
St.John's wort
phenytoin
rifampin
griseofulvin
carbamezapine
chronic alcohol use
```
89
P450 inhibitors
MAGIC RACKS in GQ
```
macrolides
amiodarone
grapefruit juice
isoniazid
cimetidine
ritonavir
acute alcohol abuse
ciprofloxacin
ketoconazole
sulfonamides
gemfibrozil
quinidine
```
90
AB to avoid in preg
```
Sulfonamides - Kernicterus
Aminoglycosides - otoxicity
Fluoroquinolones - cartilage damage
Clarithromycin - embryotoxic
Tetracyclines - discolored teeth, inhibition of bone growth
Ribavirin (antiviral) - teratogenic
Griseofulvin (antifungal) - teratogenic
Chloramphenicol - "gray baby"
```
"SAFe Children Take Really Good Care"
91
DOC for DVT and pulmonary thromboembolism
warfarin
92
DOC for Legionella
erythromycin
93
DOC for Treponema
penicillin
94
DOC for Mycoplasma
erythromycin or tetracyclines
95
drug infused at constant rate achieves steady state in?
4-5 half-lives
96
DOC for hairy cell leukemia
cladribine (adenosine analog that is resistant to adenosine deaminase)
97
best agent to increase HDL levels?
niacin
98
best tx for high LDL
statins + ezetimibe
99
best agent for hypertriglyceridemia
fibrates
100
SE = increases TG levels
cholestyramine, colestipol, colesevelam
| bile acid resins
101
MOA of cromolyn
prevents mast cell degranulation
102
cromolyn used for?
PROPHYLAXIS of asthma, allergies, aspirin HST
103
anti-TB drug most effective in acidic environments + most useful against INTRAcellular organisms
pyrazinamide
104
pyrazinamide most effective against?
M.tuberculosis engulfed by macrophages
105
what is needed to convert INH to active metabolite?
KatG (bacterial catalase-peroxidase)
106
solo prophylaxis against TB?
INH
107
meningococcal prophylaxis and chemoprophylaxis in contacts of children w/ H.influenzae type B?
rifampin
108
toxicity = blurry yellow vision (think Van Gogh)
digoxin
109
thiazide diuretics cause what SE?
- hypokalemic metab alkalosis (bc increased aldost secretion)
- hyponatremia, hypomagenesemia
- sulfa allergy
```
hypergGlycemia
hyperLipidemia
hypercCalcemia
hyperUricemia
("Hyper Girls Like Crushing Uppers")
```
110
mannitol (osmotic diuretic) can cause what SE?
hypernatremia, pulmonary edema
111
mannitol is CI in pts w/ what?
anuria, CHF
112
carbidopa decreases what SE of L-dopa?
nausea, vomiting
113
carbidopa increases what SE of L-dopa?
anxiety, agitation, insomnia, confusion, delusions, hallucinations
114
leucovorin is a?
tetrahydrofolate derivative that does NOT req activation by dihydrofolate before it can function as cofactor for thymidylate synthase
N5-formyl-tetrahydrofolate
115
drug whose chemo effects overcome by leucovorin
methotrexate
116
drug whose chemo effects potentiated by leucovorin
5-FU
117
bortezomib MOA and indications?
proteasome inhibitor
tx for multiple myeloma and Waldenstrom's macroglobulinemia
118
tx for mod-severe allergic asthma?
omalizumab (anti-IgE Ab)
119
this drug has increased toxicity w/ allopurinol
azathioprine (6-MP, 6-TG)
| bc both metab by xanthine oxidase
120
antimetabolite not S-phase specific
gemcitabine (pyramidine analog)
121
methotrexate inhibits
dihydrofolate reductase
122
5-FU complexes w/ ________ that inhibits _______?
w/ folic acid (THF)
| inhibits thymidylate synthase
123
5-FU overdose rescue =
thymidine
124
malignant hyperthermia a SE of what drugs?
```
inhalation anesthetics (except N2O)
succinylcholine
```
125
chronotropic effects
increase RATE of contraction (HR)
126
inotropic effects
increase FORCE of contraction
127
inhibits dihydropteroate SYNTHASE
sulfonamides
128
inhibits dihydrofolate REDUCTASE
trimethoprim, pyrimethamine, methotrexate
129
tx for mild UTI that is safe in pregnancy?
nitrofurantoin (p.267 DIT)
130
most common medication used for UTI prophylaxis
TMP-SMX
131
cisplatin toxicity/prophylactic tx used to reduce toxicity?
nephrotoxicity;
| amifostine or chloride diuresis (bc cisplatin stays in nonreactive state when in higher chloride concentration)
132
1st line therapy in trigeminal neuralgia?
carbamazepine
133
1st line tx for acute gouty arthritis?
NSAIDs
| also Glucocorticoids in pts for whom NSAIDs are CI (ex. elderly pts w/ renal failure)
134
uricosuric drugs + xanthine oxidae inhibitors (allopurinol) used for?
PROPHYLACTIC therapy for prevention of acute gouty attacks (used in pts w/ more than 3 episodes of acute gouty arthritis and those w/ macroscopic tophi)
135
why can't allopurinol be used in acute gouty attacks?
can exacerbate acute arthritis!
136
antiarrhyhtmics that can cause Torsades de Pointes
```
quinidine
procainamide
disopyramide
ibutilide
dofetilide
sotalol
```
137
drugs that prolong PR interval
verapamil
| metoprolol
138
drugs that act on microtubules
```
vincristine/vinblastine
griseofulvin
mebendazole/albendazole/thiabendazole
paclitaxel/docetaxel
colchicine
```
139
DOC in cluster HA
inhaled 100% oxygen
140
competitive inhib do what to potency/efficacy?
DECREASE potency (increase Km)
141
noncompetitive inhib do what to potency/efficacy?
DECREASE efficacy (decrease Vmax)
142
the lower the Km
the higher the potency
143
the higher the Vmax
the higher the efficacy
144
high efficacy drugs classes?
analgesic
antibiotics
antihistamines
decongestants
145
highly potent drug classes?
chemotherapeutic
antiHTN
antilipid
146
drug w/ low therapeutic index
digoxin
lithium
theophylline
warfarin
147
phase I drug metabolism?
reduction
oxidation
hydrolysis
can result in still active metabolite (can be more toxic)
uses CYP450!!
148
phase II drug metabolism?
conjugation: glucuronidation, acetylation, sulfation)
renally excreted
149
tx of OD of beta-blockers in arrhythmias
glucagon
150
1st gen cephalosporins
cefazolin
cephalexin
"PEcK"
151
2nd gen cephalosporins
cefoxitin
cefaclor
cefprozil
cefuroxime
"HENS PEcK"
152
3rd gen cephalosporins
ceftriaxone
cefotaxime
cefdinir
ceftazidime
153
4th gen cephalosporins
cefapime
154
ceftriaxone treats what?
meningitis and gonorrhea
| excreted in bile and long acting
155
ceftazidime treats what?
Pseudomonas
156
3rd gen cephalosporins cover what?
serious gram neg bacteria
| also S.pneumo!!
157
cefepime treats what?
Pseudomonas and gram +
158
aztreonam binds to?
PBP3
159
drug that inhibits ribonucleotide reductase
hydroxyurea
160
drug that inhibits dihydrofolate reductase
trimethoprim
| methotrexate
161
drug that inhibits thymidylate synthase
5-FU
162
drug that inhibits IMP dehydrogenase
mycophenolate
163
drug that inhibits PRPP amidotransferase
6-MP
164
drug aiding in dx of Prinzmetal's variant angina
ergonovine
165
low potency typical antipsychs
chlorpromazine
| thioridazine
166
high potency typical antipsychs
trifluperazine
fluphenazine
haloperidol
167
drugs used to tx Tourette's synd
fluphenazine, pimozide (high potency antipsychs)
| tetrabenazine (help degrade dopamine)
168
typical antipsychs block what receptor?
D2 receptors (which increases cAMP)
169
clozapine acts on what receptors?
D4
170
DOC for tx of psychosis induced by Parkinson meds
quietapine
171
specific sympt of chlorpromazine
corneal deposits
172
specific sympt of thioridazine
retinal deposits
173
lithium MOA?
inhib IP3 (phosphoinositol cascade)
174
buspirone facts?
stim 5-HT1A receptors
no addiction, tolerance or sedation!
no interaction w/ alcohol
takes 1-2 wks to take effect
175
SSRIs
fluoxetine
paroxetine
sertraline
citalopram
176
SNRIs
venlafaxine
| duloxetine (greater effect on NE)
177
SNRI MOA
inhib serotonin and NE reuptake
178
tx for fibromyalgia?
milnacipran or amitriptyline
179
can tx diabetic periph neuropathy
duloxetine
180
indication for imipramine
bedwetting
181
indication for clomipramine
OCD
182
which TCA has most anticholinergic SE?
3rd gen (amitriptyline)
use nortryptilline in elderly to decrease confusion, hallucination SE
183
which TCA is less sedating; but increases ________?
desipramine
| increases seizure threshold
184
TCA MOA
block reuptake of NE and serotonin
185
TCAs
amitriptyine, nortriptyline
imipramine, desipramine, clomipramine
doxepin
amoxapine
186
MAOIs
tranylcypromine
phenelzine
isocarboxazid
selegiline
187
selegiline inhibits what selectively?
MAO-B - used for dopamine (Parkinson's)
188
MAOI MOA/use
increased levels of NE, serotonin and dopamine by inhibiting MAO
can be used to tx atypical depression
189
ingestion of tyramine w/ MAOIs causes?
Hypertensive crisis
190
bupropion MOA + benefit
inhib NE and dopamine reuptake w/ greater effect on dopamine
| no sexual SE!
191
mirtazapine MOA
alpha2-antag (increases release of NE and serotonin)
| also potent 5-HT2 and 5-HT3 recept antag
192
trazodone MOA/use/SE
inhibit serotonin reuptake
used primarily for insomnia
SE = priapism
193
demeclocycline is used in
SIADH bc ADH antagonist
194
Na-channel binding strength for Class I antiarrhythmics
IC > IA > IB
| IC = increased incidence of use dependence
195
class II antiarrhythmics MOA
decrease cAMP, Ca
decreases slope of phase 4 (slows HR)
increases PR interval
196
metoprolol can cause what SE
dyslipidemia
197
class II antiarrhythmics OD tx
glucagon
198
beta-blocker that can exacerbate prinzmetal's angina
propanolol
199
used in tx of WPW
procainamide
| amiodarone
200
class III antiarrhythmics MOA
increases AP, ERP, QT interval
| works on phase 3!!
201
class I antiarrhythmics MOA (as a class!)
decreases slope of phase 0
202
class IV antiarrhythmics MOA
decrease depolarization of latter part of phase IV
decreases depolarization of phase 0 --> increases ERP
decreases SA/AV nodal activity
increases PR
203
class IV antiarrhythmics CI in
pts w/ HF exacerbation
204
adenosine MOA
increases K+ out of cells --> hyperpolarization
decreases Ca
prolong PR interval
205
adenosine effects blocked by
theophylline (pts w/ COPD/asthma)
| caffeine
206
drug CI in closed-angle glaucoma
epinephrine
207
baclofen MOA
GABAb agonist
208
H1 blockers - 1st gen
can cross BBB - sedation!
| diphenydramine, dimenhydrinate, chlorpheniramine
209
H1 blockers - 2nd gen
can't cross BBB
| loratadine, fexofenadine, desloratadine, cetirizine
210
beta-2 agonists for prophylaxis of asthma
salmeterol
| formoterol
211
theophylline characteristics
inhib PDE --> decreases cAMP hydrolysis --> brochodil
narrow therapeutic index: cardiotox, neurotox (seizures)
blocks action of adenosine
tx OD w/ beta-blockers
212
inhaled GC effects/use
inhib synth of cytokines (by inhib phospholipase A2)
inactivate NF-KB --> decreased TNF-alpha prod (bc it's the TF that activates this cytokine)
1st line for CHRONIC asthma
213
montelukast, zafirlukast MOA/use
block leukotriene recept (D4 recept antagonists)
aspirin-induced asthma!!
also chronic asthma prophylaxis
214
zileuton MOA/use
5-LOX inhib (no leukotriene synth)
| chronic asthma prophylaxis
215
omalizumab MOA/use
Monoclonal anti-IgE Ab
| used in allergic asthma resistant to other tx
216
N-acetylcysteine in asthma/CF use:
mucolytic by cleaving disulfide bonds in mucus glycoproteins
| also prevents contrast-induced nephropathy
217
how does dextromethorphan cause cough suppression
antag NMDA glutamate receptors
218
bosentan MOA/use
for pulmonary arterial HTN
| competitively antag endothelin-1-receptors
219
pseudoephedrine, phenylephrine resp uses
constrict dilated arterioles in nasal mucosa (via alpha-agonist properties) --> reduce nasal congestion
open obstructed Eustachian tubes
pseudoephedrine --> also a stimulant
220
pseudoephedrine, phenylephrine resp SE
HTN, rebound nasal congestion if taken long term (all)
CNS stim/anxiety (pseudoephedrine)
tachyphylaxis - due to decreased NE from neg feedback causing vasodil + congestion (phenylephrine)
221
acetazolamide used in glaucoma by
blocking bicarb formation --> decreases formation of aqueous humor
222
acetazolamide SE
hyperchloremic metab acidosis, sulfa allergy, paresthesias
223
loop diuretics SE
```
Ototox
Hypokalemia/hypocalcemia
Dehydration
Allergy (sulfa)
Nephritis (acute)
Gout
```
"OH DANG!"
224
2 classes of diuretics causing ACIDEMIA
- acetazolamide
| - K+-sparing (hyperkalemia causing --> H/K exchange in plasma)
225
2 classes of diuretics causing ALKALEMIA
loop and thiazides
- vol contraction (bicarb reabsorb --> Cl- secreted)
- K+ loss
- low K+ states (H exchanged for Na, instead of K exchanged)
226
increased aldosterone can have what effect on heart
cardiac remodeling --> can worsen LV dysfunct in HF pts
227
ACE inhib 2 unique clinical applications
diabetic renal disease
| used Post-MI + in CHF pts (to prevent unfav heart remodeling as a result of chronic HTN)
228
ACE inhib SE
```
"CATCHH"
Cough (dry!!)
Angioedema
Teratogen
Creatinine increase (bc of decreased GFR --> decreased FF)
Hyperkalemia
Hypotension
```
229
methotrexate indications/SE
```
cancers
ectopic preg
hydatidiform mole
RA
psoriasis
```
SE: myelosuppression (reversed w/ leucovorin), macrovesicular fatty change in liver, mucositis, teratogen
230
cyclophosphamide MOA/SE
covalently X-link DNA @ guanine N-7
bioactivated by liver
SE - hemorrhagic cystitis prevented w/ mesna (thiol groups bind acrolein)
231
used against brain tumors
nitrosureas (carmustine, other -mustines, streptozocin)
| cross BBB --> CNS!!! (therefore, CNS toxicity also)
232
busulfan
used in CML
used to ablate pt bone marrow before BMT
SE = pulm fibrosis, hyperpigmentation!
233
vinca alkaloids bind?
beta-tubulin in M phase + block polymerization of microtubules
234
vincristine SE
neurotox (periph neuritis)
235
vinblastine SE
bone marrow suppression
"vinblastine BLASTS bone"
236
paclitaxel MOA/indications
MOA - HYPERSTABILIZE polymerized microtubules --> can't break down spindles
**ANAPHASE can't occur
used for: ovarian/breast carcinomas
237
cisplatin SE
nephrotox (acute tubular injury; prevent w/ amifostine)
acoustic nerve damage
Chloride diuresis
238
etoposide, teniposide MOA
inhib topo II
239
hydroxyurea MOA/use
inhib ribonucleotide reductase
| used in melanoma, sickle cell
240
irinotecan, topotecan MOA
inhib topo I
241
trastuzumab aka ...
herceptin
Mab against HER2 (c-erbB2)
SE = cardiotox
242
bevacizumab
Mab against VEGF --> inhib angiogenesis
243
vemurafenib
inhib B-raf kinase w/ V600E mut
| for metastatic melanoma
244
cimetidine SE
inhib CYP450
antiandrogenic effects
crosses BBB (confusion, dizziness, HA)
decreases renal excretion of creatinine (also seen w/ ranitidine)
245
sucralfate req?
acidic environment to polymerize
246
misoprostol indications
```
NSAID-induced PUD
maintains PDA
induces labor (ripens cervix)
```
247
octreotide (somatostatin analog) indications
acute variceal bleeds
acromegaly
VIPoma
carcinoid tumors
248
hypercalcemia can stim what?
G-cells to produce gastrin
249
terbutaline
Beta2-agonist used to reduce premature uterine contractions
250
tx HTN in pt w/ renal dz?
clonidine
methyldopa
these are alpha2-agonists
251
give to pts on MAOIs who eat tyramine containing food
phentolamine
252
vascular alpha receptors are mostly what type
1B
253
tamsulosin blocks
alpha-1A, 1D receptors on prostate + does not reduce blood pressure as much
254
beta agonists do what to BP?
DECREASE (bc of beta2 effect)
255
drug class used cautiously in diabetics
beta-blockers (can mask hypoglycemia); use beta1-blockers instead!
256
beta-blockers effects:
1) decrease O2 consumpt (by decreasing HR, contractility)
2) reduce mortality in MI
3) decrease AV conduction (metoprolol, esmolol)
4) decrease CO
5) decrease renin secretion
6) slow progression of HF in CHF (but make sure not to decrease HR too much!!)
7) decrease aqueous humor secretion (timolol)
257
tx for pts w/ HTN and bradycardia
partial beta blockers!
| pindolol, acebutolol
258
non-selective beta blockers w/ alpha1-blocking ability too:
labetalol
| carvedilol
259
hydroxychloroquine
tx for SLE
| SE = permanent retinal damage, myopathies
260
direct cholinergic agonists
bethanechol
carbachol
pilocarpine
methacholine
261
AChE inhibitors
```
neostigmine
physostigmine
pyridostigmine
donepezil
edrophonium
echothiophate
diisopropyl flurophosphate
```
262
stim alpha1, 2 + beta1, 2
epinephrine
263
stim alpha1, 2 + SOME beta1
epinephrine
264
beta agonist (beta1 = beta2)
isoproterenol
265
beta1-agonist
dobutamine
266
alpha-agonist (alpha1 > alpha2)
phenylephrine
267
beta2-agonist for premature contractions
ritodrine
268
ephedrine MOA
releases stored catechol
| -used for nasal decongest, urinary incontinence
269
alpha2-agonists
clonidine
| methyldopa
270
alpha-blockers
phenoxybenzamine
| phentolamine
271
alpha2-blocker
mirtazapine
272
tx of opioid withdrawal
methadone, buprenorphine
suboxone (a combo of naloxone + buprenorphine; harder to abuse)
neonatal opioid withdrawal - diluted tincture of opium solution
273
tx cocaine OD
benzos
haloperidol
NEVER BETA BLOCKERS!!
274
tx nicotine withdrawal (meds)
bupropion
| varenicline
275
tx for PCP, LSD
benzos
276
tx for heroin addiction
methadone (long-acting oral opiate)
| naloxone + buprenorphine = partial agonist; oral naloxone not easily abused
277
tx for delirium tremens w/ alcohol withdrawal
long-acting benzos preferred (unless pt has liver disease --> use short-acting benzos)
278
tx for anxiety
SSRI, SNRI, buspirone
279
tx for ADHD
methylphenidate, amphetamines
280
tx for bipolar disorder
Lithium
valproic acid, carbamazepine
atypical antipsych
281
tx for bulimia
SSRIs (fluoxetine esp)
282
tx for depression
SSRI, SNRI, TCA, buspirone
| mirtazapine (esp w/ insomnia)
283
tx for OCD
SSRI, clomipramine
284
tx for panic disorder
SSRI, venlafaxine, benzos
285
tx for PTSD
SSRI
286
tx for schizophrenia
antipsych
287
tx for social phobias
SSRIs
288
tx for Tourette's synd
antipsych
289
tx for drug-induced Parkinsonism
benztropine
| trihexyphenidyl
290
ziprasidone SE
prolong QT interval
291
lithium excretion
exclusively by kidney; most reabsorbed @ PCT following Na reabsorption
292
cyclosporine SE
nephrotox (by vasoconstriction of aff + eff arterioles), HTN, hyperlipidemia, hyperglycemia
293
drug used in lupus nephritis
azathioprine
294
alemtuzumab
anti-CD52 humanized Mab for tx of CLL
295
beta2 > beta1 agonist
terbutaline
296
probenecid actions
inhib reabsorpt of uric acid @ PCT
| inhib secretion of penicillin
297
TZD w/ increased risk of bladder cancer
pioglitazone
298
adiponectin does what?
is released by activation of PPAR-gamma (site of action of TZDs)
decreases insulin resistance
299
TZDs metabolized where?
liver
300
sitagliptan use req monitoring of what drug?
digoxin
301
drugs w/ anticholinergic properties
-ANTIHISTAMINES (H1 BLOCKERS)
chlorpheniramine, cyproheptadine, diphenhydramine, hydroxyzine
-ANTIDEPRESSANTS
amoxapine, amitriptyline, clomipramine, desipramine,
doxepin, nortriptyline, paroxetine, imipramine, protriptyline
-CARDIOVASCULAR MEDICATIONS
furosemide, digoxin, nifedipine, disopyramide
-Antidiarrheal Medications
diphenoxylate, atropine
-Antispasmodic Medications
belladonna, clidinium, chlordiazepoxide, dicyclomine, hyoscyamine, propantheline
-Antiulcer Medications
cimetidine, ranitidine
-ANTIPARKINSON MEDICATIONS
amantadine, benztropine, biperiden, trihexyphenidyl
-MUSCLE RELAXANTS
cyclobenzaprine, dantrolene, orphenadrine
-ANTIVERTIGO MEDICATIONS
meclizine, scopolamine
-ANTIPSYCHOTIC MEDICATIONS
chlorpromazine, clozapine, olanzapine, thioridazine
-URINARY INCONTINENCE
oxybutynin, probantheline, solifenacin, tolterodine, trospium
-PHENOTHIAZINE ANTIEMETICS
prochlorperazine, promethazine
302
DOC for myoclonic seizures
vaproic acid
303
DOC for simple/complex partial seizures
carbamazepine
