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Flashcards in pharmacology Deck (81):
1

what drug would you give following a nuclear accident to protect thyroid from iodine 131?

potassium iodide
-competitively inhibits uptake of radioactive iodide

2

antibiotic that can precipitate serotonin syndrome

linezolid (weak MAOI) if used with other serotonergic drugs

3

pramipexole

DA agonist (for Parkinson's)

4

why do you need to wait 2 weeks before starting an SSRI after stopping an MAOI?

MAOIs irreversibly inhibit MAO (breaks down monoamine neurotransmitters) and it takes 2 weeks to resynthesizes MAO. If they are mixed, pt can get serotonin syndrome.

5

ACE inhibitor-induced angioedema

ACE is responsible for bradykinin degradation so it can build up when an inhibitor is used. Bradykinin is a potent vasodilator that increases vascular permeability

6

reason for only taking morning and afternoon dose of nitrates (skip evening dose)

around the clock administration rapidly creates tolerance
-nitrate-free period must be provided, usually at night

7

which vitamin can benefit children with measles?

vitamin A

8

exogenous steroids can cause....

suppression of the hypothalamic-pituitary-adrenal axis
-low ACTH, CRH leads to atrophy of adrenals

9

tx for myasthenia gravis

cholinesterase inhibitors
- physostigmine, neostigmine
- reduce breakdown of cholinesterase in synaptic cleft

10

selective coronary vasodilators

adenosine and dipyramidole

11

why is trazodone contraindicated in adolescent boys?

can cause priapism

12

ribavirin

MOA: nucleoside antimetabolite drug
USES: hep C, RSV

13

daptomycin

MOA: creates transmembrane channels to disrupt bacterial membranes
USES: MRSA
ADR: myopathy and CPK elevation

14

cause of death in TCA overdose

cardiac arrhythmias from inhibition of fast sodium channels in myocytes

15

tx for listeria

ampicillin

16

cladribine

purine analog that achieves high IC concentrations because it is resistant to degradation by adenosine deaminase
- for hairy cell leukemia

17

5 different types of drug-induced renal disase

1. ARF (dec renal flow) - ACEI
2. glomerular diasease - gold, heroin, pamidronate
3. tubular necrosis - AGs, cysplatin, amphtericin, foscarnet
4. tubular obstruction - sulfas, methotrexate, acyclovir
5. interstitial nephritis - methicillin, sulfas, NSAIDs, cephalosporins, allopurinol, lithium, cyclosporin

18

drug for narcolepsy

modafinil

19

rapid reversal of warfarin

fresh, frozen plasma
Vit K takes longer

20

tx for restless leg syndrome

DA agonists

21

which benzo is short-acting? intermediate?

short = triazolam ( < 6 hrs)
intermediate = lorazepam
rest are long ( > 24 hrs)

22

Lithium ADR

HORNET
HypOthyroidism
Renal function
Nephrogenic DI
Ebstein abnormality
Tremor

23

2 drugs for absence sz

ethosuximide or valproate

24

meds that can cause hyperkalemia (4)

ACE-I/ARB, digoxin (blocks Na/K pump), K-sparing diuretics, non-selective beta blockers

25

K sparing diuretics (3)

spironolactone/eplerenone, amiloride, triamterene

26

uses for MAOIs

atypical or refractory depression, hypochondriasis

27

tx for serotonin syndrome

cyproheptadine (serotonin receptor antagonist)

28

why add carbidopa to levodopa therapy?

it is a peripheral decarboxylase inhibitor and increases bioavailability of L-dopa in brain
- also limits peripheral side effects
- can worsen behavioral changes

29

diuretics that can slow the progression of diabetic nephropathy

ACE-I/ARB

30

MOA of DDAVP for von Wildebrand disease

increases vWF release from endothelial cells

31

contraindication for ACE-I

extensive atherosclerotic disease, bilateral renal a. stenosis (ACE needed to maintain GFR)

32

side effect of all nitrates

throbbing headaches

33

tx for beta blocker overdose

glucagon (increases HR and contractility independent of adrenergic receptors)

34

contraindication for sildafinil

nitrate use

35

complication of neonatal oxygen therapy

retinopathy

36

pioglitazone

thiazolidinediones (antidiabetics)
MOA: binds to PPAR-gamma receptor (steroid receptor) to increase levels of adiponectin to decrease insulin resistance

37

main MOA of nitroglycerin

venodilation that decrease preload and thus cardiac work

38

pharmacokinetics of lipophilic drugs

high volume of distribution
preferentially processed by liver
good penetration into CNS

39

bosenten

MOA: antagonist of endothelial receptors
USE: idiopathic pulmonary hypertension (symptom control)

40

drug of choice for myoclonic sz

valproic acid

41

chronic use of appetite suppressants can cause...

pulmonary hypertension
- phentermine, fenfluramine

42

primidone

USES: benign essential tremor, partial sz (it metabolizes into phenobarbital)
ADR: sedation

43

which fluoroquinolone is not effective against pseudomonas?

moxifloxacin

44

3 Ps of severe hyperthyroid

propranolol (beta-blockers), propylthiouracil, prednisolone

45

side effects of class 1A antiarrhymics

increased QT can lead to tornadoes
lupus-like syndrome
cinchonism
(procainamide, quinidine, disopyramide)

46

side effects of class 1B antiarrhythmics

CNS stuff (tremor, paresthesias, slurred speech, sz)
(lidocaine)

47

contraindications of class 1C antiarrhythmics

structural heart disease (MI, CAD, etc.)
pacemakers
heart block
(flecainide, propafenone)

48

side effects of K+ channel blockers

thyroid dysfunction
pulmonary fibrosis
photosensitivity, gray appearance
increase QT (no torsades)
(need to check PFTs, LFTs, TFTs)

49

contraindication of levodopa

B6 (found in multivitamins)
- increases peripheral metabolism/effectiveness

50

sumatriptan MOA

serotonin agonist
- inhibits trigeminal nerve activation and prevents vasoactive peptide release

51

drugs with decreased metabolism in slow acetylators

DIPH
- dapsone, INH, procainimide, hydralazine

52

most common side effect of streptokinase

hemorrhage (streptokinase is a thrombolytic)

53

drugs with anticholinergic side effects

atropine, TCADs, H1 antagonists, neuroleptics, antiparkinson drugs

54

tx for recurrent C. diff

fidaxomicin (minimal systemic absorption and bactericidal))

55

2 drugs for status epilepticus

lorazepam plus phenytoin

56

tx for esophageal varices

octreotide

57

ACE inhibitors reverse preferential constriction of...

efferent arteriole (Ang II constricts it)

58

rifampin MOA

blocks bacterial DNA-dependent RNA polymerase inhibiting transcription

59

med that slows progression of CHF and improves mortality

carvedilol (stable CHF only)
- reduces cardiac work by slowing ventricular rate and decreasing after load
* adding spironolactone to existing tx also improves mortality

60

formula for t1/2

= (Vd x 0.7)/clearance

61

med contraindicated in hereditary angioedema (low C1 esterase inhibitor)

ACE inhibitors (increase bradykinin)

62

ADR amphotericin B

nephrotoxicity
arrhythmias (low K and Mg due to increased permeability of distal tubule from nephrotoxicity)
- usually requires supplementation

63

drug that lessens effect of furosemide

NSAIDs
- furosemide stimulates PGE release (vasodilation of afferent arterioles) and NSAIDs inhibit PGE production

64

antiviral that doesn't require intracellular activation

foscarnet

65

med that can prevent recurrence of calcium oxalate stones

hydrochlorothiazide (reabsorb calcium from renal tubules)
- also citrate for tx

66

med superior to aspirin for peripheral artery disease

cilostazol (inhibits platelets and causes vasodilation)
- phosphodiesterase inhibitor

67

supplementation for orotic aciduria

uridine (inhibits carbamoyl phosphate synthetase II to improve symptoms)

68

what does a large blood/gas partition coefficient (anesthesia) mean?

indicates high blood solubility
- amt needed to saturate blood is greater
- leads to delayed rise in partial pressure which slows brain saturation
- therefore, longer onset time

69

calcipotriene

topical vit D analog used to treat psoriasis (also calcitriol)
- vit D receptor inhibits keratinocyte proliferation and stimulates differentiation

70

fomipezole

antidote in methanol or ethylene glycol poisoning
- antagonist of alcohol dehydrogenase

71

drug used to prevent nephrotoxicity with cisplatin

amifostine

72

role of beta blockers in hyperthyroidism

1. blocks peripheral T4 to T3 conversion
2. minimizes sympathetic outflow

73

supplement for MSUD

thiamine (needed for branched-chain alpha keto dehydrogenase)

74

ADR verapamil

constipation, gingival hyperplasia, AV node conduction abnormalities (ie: blocks)

75

rasburicase

MOA: recombinant version of urate oxidase that converts uric acid to allantoin (more soluble)
USE: to prevent tumor lysis syndrome

76

probenicid

MOA: increases uric acid excretion
USE: gout, hyperuricemia
CONTRA: good renal function needed

77

nitroprusside ADR

cyanide toxicity, tx with sodium thiosulfate (sulfur enhances metabolism to thiocyanate)

78

prevention of cerebral vascular spasm following SAH

calcium channel blockers, especially nimodipine

79

contraindication of beta blockers

DM, exacerbates hypoglycemia and masks symptoms

80

theophylline overdose

SZ (also abdominal pain and vomiting)

81

low Vd drug characteristics

3-5 L
- high molecular wt, high plasma binding protein, high charge, hydrophilic