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Uworld Journal > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q 
Gentamycin
Neomycin
Amikacin
Tobramycin
Streptomycinn
Paromycin
A

Aminoglycosides

Bactericidal, inhibit 30S, only works in aerobes

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2
Q

What effect does Omeprazole have on various drugs?

A

Omeprazole is a PPI which lowers the acidity of the stomach (increases pH)

This can affect the absorption of some drugs.

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3
Q
  • Diphenhydramine
  • Dimenhydrinate
  • Chlorpheniramine
A

First generation H1 blockers (antihistamines)

anti-allergy, induce drowsiness, anti-motion sickness

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4
Q
  • Loratadine
  • Fexofenadine
  • Desloratadine
  • Cetirizine
A

Second generation H1 blockers (antihistamines)

do not cross BBB

anti-allergy only

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5
Q

Cyclophosphamide mechansim of action

A

cross-links DNA at guanine N-7 -> inhibiting DNA replication

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6
Q
  • Sertraline
  • Paroxetine
  • Fluoxetine
  • Citalopram
A

SSRI - blocks re-uptake of serotonin only

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7
Q
  • Venlafaxine

- Duloxetine

A

SNRI - blocks re-uptake of serotonin and NE

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8
Q

Urinary urgency means =

What do you give to treat?

A

Urinary urgency means the bladder is over-contracting.

Give them a muscarinic receptor antagonist to relax the detrusor contraction.
ex)atropine, oxybutamine, tolterodine, solifenacin

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9
Q

Excess urination - elevated Ach or decreased Ach

A

elevated Ach

Parasympathetics make you Pee

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10
Q

Cilostazol =

A

phosphodiesteraes inhibitor - inhibits platelet aggregation + direct vasodilation

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11
Q

Reye syndrome of the liver on light microscopy =

A

microvesicular steatosis + reduced number of mitochondria + decreased amount of glycogen

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12
Q

acetaminophen toxicity on LM

A

centrilobular hepatic necrosis

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13
Q

Treatment for TCA overdose =

A

Sodium bicarbonate

Treats the cardiac toxicity by increasing pH and increasing intracellular Na therefore alleviating the VG Na blockade
(fixes the widening of the QRS)

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14
Q

D-penacillamine is a treatment for?

A

Copper overload

used for chelation

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15
Q

Deferoxamine is a treatment for?

A

Iron overload

used for chelation

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16
Q

EDTA and Dimercaprol are treatments for?

A

Lead overload

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17
Q

3 drugs for Absence seizures =

A
  • Ethosuximide = inhibits thalamic T type Ca channels
  • Valproate = increased Na channel inactivation + inhibits GABA transaminase
  • Lamotrigine = inhibits VG Na channels
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18
Q

Status Epilepticus treatments (first, second)

A

First: IV lorazepam = increased frequency of GABA-A channel opening - increases inward Cl current

Second: Phenytoin = increased Na channel inactivation - decreased Na current

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19
Q

How do opioids hyperpolarize neurons?

A

Increased K out, Decreased Ca in

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20
Q

Is glutamate excitatory or inhibitory?

A

excitatory!

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21
Q

Succimer is used for?

A

Lead chelation for children with lead toxicity

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22
Q

Clopidogrel, Parasugrel, Ticagrelor, Ticlopidine

A

ADP receptor inhibitors (P2-Y12 R)

Irreversible inhibition of platelet degranulation

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23
Q

Abciximab
Eptifibatide
Tirofiban

A

GPIIb/IIIa inhibitors -> inhibition of platelet aggregation

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24
Q

ACE inhibitor - hyperkalemia or hypokalemia?

A

Hyperkalemia due to inhibition of aldosterone - increased Na out, increased K in

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25
K sparing diuretics = (4)
Spironolactone - mineralocorticoid antagonist Eplerenone - mineralocorticoid receptor antagonist Triamterene - inhibits ENaC Amiloride - inhibits ENaC
26
Losartan Candesartan Valsartan
Angiotensin II Receptor Blockers (ARBs)
27
Diltiazem, Verapamil
Nondihydropyridine calcium channel blockers (L-type)
28
toxicity of: Cisplatin/Carboplatin
- acoustic nerve damage - nephrotoxicity mechanism of drug: cross links DNA
29
toxicity of: Vincristine
-peripheral neuropathy mechanism of drug: vinca alkaloid, binds beta-tubulin -> inhibits polymerization into microtubules -> inhibits formation of mitotic spindle
30
toxicity of: Bleomycin, Busulfan
-pulmonary fibrosis mechanism of Bleomycin: induces free radical formation -> DNA breaks mechanism of Busulfan: cross links DNA
31
toxicity of: Doxorubicin _ is used to prevent toxicity
-cardiotoxcity (dilated cardiomyopathy) mechanism of drug: generates free radicals + intercalates DNA -> breaks in the DNA -> inhibits replication Dexrazoxane (iron chelating agent) is used to prevent cardiotoxicity
32
toxicity of: Trastuzumab
-cardiotoxicity mechanism of drug: monoclonal antibody against HER-2 (c-erbB2)
33
toxicity of: Cyclophosphamide toxicity is reversible via administration of _ or _
-hemorrhagic cystitis (hematuria + suprapubic pain) mechanism of drug: cross links DNA at N7 guanine Partially reversible via mensa and N-acetylcystine
34
toxicity of: 5-FU, 6-MP, Methotrexate
-myelosuppression ``` 5FU = pyrimidine analog -> (-)thymidylate synthase 6MP = purine analog Methotrexate = folic acid analog -> (-)dihydrofolate reductase ```
35
What do you give to someone who has urinary retention?
Urinary retention means their bladder is not contracting. Give them a muscarinic agonist to help the detrusor contract.
36
Function of: mensa
Partially reverses toxicity of cyclophosphamide
37
Function of: Dexrazoxane
Iron chelating agent. Also to prevent cardiotoxicity from Doxorubicin.
38
Glusine Aspart Lispro used for?
Rapid acting insulin used for postprandial control
39
Neutral Protamine Hagedorn (NPH)
Intermediate acting insulin
40
Detemir Glargine used for?
Long acting insulin Used for basal control
41
Chlorpropamide | Tolbutamide
First generation sulfonylureas = close the K+ channel on pancreatic beta cells -> -> release endogenous insulin (+ C peptide)
42
Disulfiram-like reaction occurs with what class of drugs? (5)
- First generation sulfonylureas (Chlorpropamide, Tolbuamide) - Metronidazole - Certain Cephalosporins - Griseofulvin - Procarbazine Do not drink alcohol while taking these drugs. Disulfiram inhibits acetaldehyde dehydrogenase in the ethanol metatbolism pathway. Therefore, acetaldehyde accumulates resulting in the "hangover" symptoms. Disulfiram is given to alcoholics to condition them to stop drinking alcohol.
43
Glimepiride Glyburide Glipizide
Second generation syulfonylureas = close the K+ channel on pancreatic beta cells -> -> release endogenous insulin (+ C peptide)
44
Repaglinide | Nateglinide
Meglitinides = close the K+ channel on pancreatic beta cells -> -> release endogenous insulin (+ C peptide) Works just like sulfonylureas except these can be given to people with sulfa allergies
45
Pioglitazone | Rosiglitazone
Binds to PPAR-gamma (a nuclear transcription regulator)
46
Exenatide | Liraglutide
GLP-1 analogs = increase endogenous insulin release, decrease glucagon release
47
Linagliptin Saxagliptin Sitagliptin
Dipeptidyl Peptidase-4 inhibitors (DPP4) = increase endogenous insulin release, decrease glucagon release
48
Pramlintide used for?
Amylin analog = decreases gastric emptying, decreases glucagon release controls postprandial glucose spike
49
Canagliflozin
SGLT-2 inhibitor - works at the PCT
50
Acarbose Miglitol inhibitors of what enzyme? used for?
alpha-glucosidase inhibitors - work at the intestinal brush border controls postprandial glucose spike
51
Pegvisomant
Growth hormone receptor antagonist
52
Anastrozole Letrozole Exemestane
Inhibits aromatase enzyme -> decreases the peripheral conversion of androgens to estrogens Used in the treatment of ER+ breast cancers.
53
Misoprostol (3 main uses)
PGE1 agonist - increased production and secretion of gastric mucous - maintains PDA - off-label use of labor induction (ripens cervix) or pregnancy termination
54
Fomepizole
Inhibits alcohol dehydrogenase antidote for methanol or ethylene glycol poisoning
55
Rotenone
-inhibits complex I in the electron transport chain decreases proton gradient and thus blocks ATP synthesis indirectly rotenONE
56
Antimycin A
-inhibits complex 3 in the electron transport chain decreases proton gradient and thus blocks ATP synthesis indirectly "an-3-amycin"
57
Cyanide (CN) and CO
-inhibit complex IV (cytochrome oxidase) in the electron transport chain decreases proton gradient and thus blocks ATP synthesis indirectly
58
Oligomycin
Directly inhibits the mitochondrial ATP synthase -> increases proton gradient but no ATP is produced
59
2,4-Dinitrophenol
Increases permeability of the mitochondrial membrane therefore causing a decreased proton gradient but an increased O2 consumption as the electrons continue to travel down the chain to try to build up the proton gradient. No ATP synthesis due to the decreased proton gradient.
60
Calcitriol
active Vitamin D given to patients who are hypocalcemic
61
Alendronate, Risendronate
Bisphosphonates - structurally similar to pyrophosphate -inhibits osteoclasts -> decreases calcium release from bone
62
Cinacalcet
Calcimimetic - stimulates Calcium sensing receptor which decreases PTH release
63
ADHD treatment (2)
Stimulants (Methylphenidate, Dextroamphetamine, Methamphetamine) Clonidine (alpha-2 agonist)
64
Alcohol withdrawal treatment (1)
Long acting benzodiazepines
65
Bipolar disorder treatment (3)
Lithium Valproate Atypical anti-psychotics
66
Bulimia Nervosa treatment (1)
SSRI (Fluoxetine)
67
Depression treatment (1)
SSRI
68
Generalized anxiety disorder (2)
SSRI | SNRI
69
Obsessive Compulsive Disorder (2)
SSRI | Clomipramine (TCA)
70
Panic Disorder (3)
SSRI Venlafaxine (SNRI) Benzodiazepine
71
PTSD (2)
SSRI | Venlafaxine (SNRI)
72
Social phobias (4)
SSRI Venlafaxine (SNRI) To improve preformance: Beta-blockers, benzodiazepine
73
Tourette syndrome (3)
First generation anti-psychotics (Fluphenazine, Pimozide) Tetrabenazine (inhibits VMAT -> decreased availability of dopamine) Clonidine (alpha-2 agonist)
74
``` Haloperidol Triflupoerazine Fluphenazine Chlorpromazine Thioridazine ``` high potency vs low potency
First generation anti-psychotics (typicals) High potency = Triflupoerazine, Fluphenazine, Haloperidol "Try to Fly High" Low potency = Chorpromazine, Thioridazine "Cheating Thieves are Low"
75
``` Olanzapine Clozapine Quetiapine Risperidone Aripiprazole Ziprasidone ```
Second generation anti-psychotics (atypicals)
76
``` Amitriptyline Nortriptyline Imipramine Desipramine Clomipramine Doxepin Amoxapine ```
Tricyclic antidepressants - block re-uptake of NE and Serotonin, blocks H1 receptors, block alpha-1 receptors
77
- Tranylcypromine - Phenelzine - Isocarboxazid - Selegiline
Monoamine oxidase inhibitors - increases levels of amine neurotransmitters in the synaptic cleft (NE, Serotonin, Dopamine) Selegiline - is MOA-B selective MAO-A also breaks down tyramine in the GI tract
78
Cyproheptadine
5HT-2 receptor antagonist -treats serotonin syndrome
79
treatment for major depressive disorder that does NOT have sexual side effects
Buproprion - NE and dopamine reuptake inhibitor
80
Buspirone - mechanism - used to treat what
- Stimulates 5HT-1A receptors (non-benzodiazapine anoxytic) - Used to treat Generalized Anxiety Disorder Takes up to 2 weeks to take effect (slow onset) No risk of tolerance, dependence or withdrawal
81
Benzodiazepines that do not need the liver to be metabolized (3)
- Lorazepam - Oxazepam - Temazepam "LOT" These drugs undergo glucoronidation directly and therefore can be given to patients with impaired liver function
82
Long acting benzodiazepines (3)
- Chlordiazepoxide - Diazepam - Flurazepam Requires the liver to be metabolized
83
Short acting benzodiazepines (1)
-Triazolam Requires the liver to be metabolized
84
Statins mechanism of action
- inhibits HMG-CoA Reductase enzyme so less cholesterol is synthesized - increases LDL-receptors to pull more LDL molecules out of the serum (to try to get more cholesterol that way) best at lowering LDL levels out of all the lipid lowering agents MOST effective at preventing future cardiovascular events
85
Cholestyramine Colestipol Colesevelam
Bile acid resigns -prevents intestinal absorption of bile acids (so now the cells have to make more bile acids via cholesterol. the cholesterol-stores get used up quickly) -increases LDL-receptors to pull more LDL molecules out of the serum (to try to get more cholesterol that way)
86
Ezetimibe
-prevents intestinal absorption of cholesterol (so now the cells have to make more cholesterol. the cholesterol-stores get used up quickly) -increases LDL-receptors to pull more LDL molecules out of the serum (to try to get more cholesterol that way)
87
Gemfibrozil Clofibrate Bezafibrate Fenofibrate
Fibrates - activates PPAR-alpha -> upregulates LPL at extra-hepatic sites -> increased metabolism of VLDL and chylomicrons -> decreasing serum triglyceride levels - decrease VLDL released from the liver -> decreases circulating serum triglyceride levels - directly upregulates synthesis of HDL
88
Niacin (Vitamin B3)
- decrease VLDL released from the liver -> decreases circulating serum triglyceride levels - raises HDL levels MOST effective at raising HDL levels
89
Volatile anesthetics increase or decrease cerebral blood flow?
Increase cerebral blood flow but that is a bad thing because it increases intracerebral pressures
90
- Imipenem - Meropenem - Ertapenem - Doripenem
Carbapenem - broad spectrum beta-lactamase resistant - binds to PBPs - always administered with cilsastin
91
Cilastin
inhibitor of renal dihydropeptdiase I -administered with Carbapenems to decrease their inactivation
92
Aztreonam
Monobactams - beta-lactamase resistant - binds to PBP-3
93
- Cefazolin | - Cephalexin
First-generation Cephalosporins | -beta-lactam drug - binds to PBPs
94
- Cefoxitin - Cefaclor - Cefotetan - Cefuroxime
Second-generation Cephalosporins | -beta-lactam drug - binds to PBPs
95
- Cefotaxime - Ceftazidime - Ceftriaxone
Third-generation Cephalosporins - beta-lactam drug- binds to PBPs - resistant to beta-lactamases
96
-Cefepime
Fourth-generation Cephalosporins - beta-lactam drug- binds to PBPs - resistant to beta-lactamases - broad-spectrum
97
-Ceftaroline
Fifth-generation Cephalosporins - beta-lactam drug- binds to PBPs - broad-spectrum
98
Amoxicillin
- beta-lactam drug - binds to PBPs | - beta-lactamase sensitive - can be combined with beta-lactamase inhibitors (Clavulanic Acid) to prevent this
99
- Dicloxacillin - Nafcillin - Oxacillin
- beta-lactam drug - binds to PBPs | - beta-lactamase resistant due to their bulky R groups
100
- Piperacillin | - Ticarcillin
- beta-lactam drug - binds to PBPs - beta-lactamase sensitive - can be combined with beta-lactamase inhibitors to prevent this - good to use against Pseudomonas and anaerobic bugs (Bacterioides)
101
Clavulanic Acid Sulbactam Tazobactam
Beta-lactamase inhibitors
102
- Levofloxacin | - Moxifloxacin
Respiratory fluoroquinolones | -treat community-acquired pneumonia and walking pneumonia
103
``` Atazanavir Darunavir Fosamprenavir Indinavir Lopinavir Ritonavir Saquinavir ```
Protease inhibitors - prevent maturation of new viruses -end in "navir"
104
``` Abacavir Didanosine Emtricitabine Lamivudine Stavudine Tenoforvir Zidovudine ```
NTRI - competitively inhibits nucleotide binding to reverse transcriptase and terminates chain elongation because these agents (nucleosides) lack a 3'OH group -requires phosphorylation to be active Tenofovir - nucleotide, therefore it does not need to be phosphorylated to be active
105
Delavirdine Efavirenz Nevirapine
NNRTI - allosteric inhibition of reverse trascriptase therefore terminating chain elongation -do not require phosporylation to be active
106
Raltegravir
Integrase inhibitor - inhibits HIV integrating into the host cell chromosome
107
Simepravir
HCV protease inhibitor (NS3/4A protease inhibitor) | -do not use as monotherapy
108
Sofosbuvir
Inhibits HCV RNA-dependent RNA polymerase -> terminates chain elongation - nucleoside analog - do not use as monotherapy
109
Adenosine
rapid coronary dilation
110
Medication classes that should be avoided in hypertrophic cardiomyopathy (2)
- Vasodilators: Dihydropyridine calcium channel blockers, Nitroglycerine, ACE inhibitors - Diuretics
111
DVT treatment in pregnancy =
Enoxaparin (LMWH)
112
High risk drugs for drug-induced lupus = “Low grade fever + multiple joint pains + well demarcated erythematous rash on face and trunk + ANA positive + anti-histone positive”
- Hydralazine - Procainamide - Isoniazid - Minocycline - Quinidine
113
Patient who is aspirin intolerant is given _ to prevent further cardiovascular events
Clopidogrel - P2Y12 R inhibitor -> prevents platelet aggregation
114
Tetrodotoxin
Binds fast VG Na channels in cardiac and nerve tissue - inactivates channels - does not change the resting potential Poisoning - poorly prepared puffer fish
115
Ciguatoxin Main sfx
Opens VG Na channels -> depolarizaion Temperature-related dysthesia (cold feels hot and hot feels cold) is specific Poisoning - consumption of reef fish (barracuda, snapper, moray eel)
116
Scombroid poisoning
Bacterial histinide decarboxylase turns histidine -> histamine Histamine is not degraded by heat/cooking acute onset burning of the mouth, flushing, erythema, anaphylais-like
117
Scombroid poisoning treatment
anti-histamines caused by a histamine overload
118
Phenylephrine
alpha1 agonist > alpha2 agonist - increases MAP -> reflex bradycardia - increases diastolic P - increases systolic P used to treat hypovolemic/distributive shock
119
Norepinephrine
alpha1 agonist > alpha2 agonist > beta1 agonist - increases diastolic P - increases systolic P - increases MAP -> reflex bradycardia - increases cardiac contractility used to treat hypovolemic/distributive shock
120
Isoproterenol
beta1 agonist = beta2 agonist - increases cardiac contractility - decreases SVR - decreases diastolic P - decreases MAP - increases PP - increases HR
121
Dobutamine
beta1 agonist > beta2 agonist - increases systolic P - decreases diastolic P - increases PP - decreases SVR - increases HR - increases cardiac contractility - increases CO used to treat cardiogenic shock
122
Epinephrine
beta agonist > alpha agonist (at low doses) - increased cardiac contractility - increased HR - increased systolic P - decreased diastolic P - increased MAP - decreased SVR - increased PP (at high doses) alpha agonist > beta agonist
123
Amphetamines mechanism of action
-release stored catecholamines into the synapse
124
Reserpine
inhibits VMAT -> neurotransmitters cannot be stored in pre-synaptic vesicles -> depletion of neurotransmitter stores
125
Cocaine mechanism
inhibits DAT and NET -> increased concentration of NE and dopamine in the synapse
126
- Clonidine - alpha methyldopa - tizanidine
alpha2 agonists -> decreases sympathetic outflow
127
beta blockers from a-m
beta1 > beta 2 "cardioselective"
128
beta blockers from n-z
beta1 = beta2 "nonselective"
129
alpha + beta blockers (2)
- Carvedilol | - Labetalol
130
Beers Criteria (5 main categories)
Anticholinergics: - First generation antihistamines - GI antispasmodics Cardiovascular: - Antithrombotics - alpha blockers - central alpha agonists - antiarrythmics CNS: - TCA - Anti-psychotics - Barbiturates - Benzodiazepine Endocrine: - Sliding scale insulins - Sulfonylurease Pain: - Indomethacin - Muscle relaxants - Meperidine
131
Ranolazine
Used to treat angina refractory to other medical therapies Mechanism: inhibits the late phase of Na current -> decreasing the diastolic wall tension and O2 consumption No effect on HR or contractility May prolong QT interval
132
MI that is treated with coronary stenting is now in recovery. Patient keeps having repeated ventricular arrhythmias caused by the ischemic tissue. What drug is given? (2)
Class IB antiarrhythmics - Lidocaine - works especially well in ischemic ventricular tissue Class III antiarrhythmics - Amiodarone - has class I, II, III, IV activity
133
Antiarrhythmics that prolong QT
Class IA and Class III - Due to their effect on prolonging the ventricular action potential This is why these classes have an increased risk for Torsades des Pointes
134
What antiarrhythmic drugs can be used to treat WPW?
Class IA or III antiarrhythmics The drugs that decrease AV node conduction (II, IV) will not have an effect due to the WPW being an accessory pathway
135
Metolazone =
thiazide-type diuretic -> inhibits Na/Cl reabsorption in the early distal convoluted tubule
136
What diuretic is given to treat altitude sickness?
Acetazolamide - inhibits CA Causes metabolic acidosis (removal of HCO3) to counteract the respiratory alkalosis that occurs at high altitudes
137
Bumetadine | Torsemide
Loop diuretics - inhibits Na/K/2Cl cotransporter Also, in this class: Furosemide
138
Aliskiren
Direct renin inhibitor (blocks conversion of angiotensinogen to angiotensin I) Contraindicates in patients taking ACE-I or ARBs.
139
oxybutamine, tolterodine, solifenacin
Reduce bladder spasms and urge incontenence M3 antagonists -> decreases Ach activity
140
Guaifenesin
Expectorant - thins respiratory secretions, does not suppress cough reflex
141
What does N-acetylcysteine do in CF patients?
Mucolytic - loosens mucous plugs by disrupting disulfide bonds
142
Dextromethorphan
Antitussive - antagonizes NMDA glutamate receptors - synthetic codeine analog - mild abuse potential - may cause serotonin syndrome
143
Bosentan
endothelin receptor atangoinst -> decreases pulmonary vascular resistance -> vasodilation treats pulmonary hypertenon
144
Epoprostenol | Iloprost
Prostacyclin analogs - PGI2
145
Albuterol - beta1 or beta2 agonist?
Beta2 agonist -> relaxes bronchial smooth muscle
146
Ipratoprium | Tiotropium
muscarinic antagonist | -used to prevent bronchoconsriction
147
Zileuton
5-lipoxygenase inhibitor -> decreased production of leukotrienes
148
Timeline of glucocorticoid function in the treatment of asthma
Takes a few weeks to work The good thing is oral glucocorticoids do not have the same sfx profile as systemic glucocorticoids (weight gain, etc)
149
Side effect of albuterol for asthma treatment
Skeletal muscle tremors
150
Pramiprexole Bromocriptine Ropinirole
Dopamine receptor agonists - First line parkinsons treatment - Restless leg treatment Bromocriptine - Ergot Pramiprexole (DR-3), Ropinirole (DR-2) - Non-ergot
151
Amantadine
Increases dopamine release and decreases dopamine reuptake - Parkinson's treatment for motor symptoms Also used as an antiviral against Influenza A and Rubella
152
Pralidoxime
Given to patients with organophosphate poisoning to reverse the Muscarinic and Nicotinic receptor overstimulation. Only works if given early after the exposure. Mechanism: restores cholinesterases therefore they can breakdown Ach
153
Baclofen
GABA-B receptor antagonist Used in the treatment of spasticity seen in MS
154
Treatment and cause of Neuroleptic Malignant Syndrome
Cause: overdose of antipsychotic medications -diffuse muscle rigidity, high fever, hypertension, tachycardia, altered sensorium, rhabdomyolysis (elevated CK) Treatment: Dantrolene
155
Treatment resistant Schizophrenia is treated with
Clozapine - second generation antipsychotic
156
Treatment for the behavioral and psychotic manifestations of delerium?
Low dose antipsychotics (Haloperiodol)
157
Majority of overdose deaths in the U.S. are caused by _
Opioids - heroin and prescription analgesics
158
Function of methadone
- Long half life - Mu full agonist - Good oral bioavailability - Suppresses withdrawal and cravings
159
N-methyl-D-aspartate Receptor antagonist =
PCP (Phencyclidine)
160
TNF-alph inhibitors - used for OA or RA treatment?
RA
161
Treatment for dermatomyositis or polymyositis
steroids followed by long-term immunosuppressants (methotrexate)
162
Inhibition of xanthine oxidase by _a_, increases the concentration of the active metabolite of of _b_.
``` a = allopurinol b = azathioprine ``` azathioprine -> 6MP -> active metabolite -> inhibition of purine synthesis
163
``` Tubocurrarine Atracurium Micacurium Pancuronium Vecuronium Rocuronium ```
Competitive nondepolarizing antagonist of Nicotinic R - compete with Ach for receptors - to reverse blockade - cholinesterase inhibitors
164
Depolarizing neuromuscular blocking drug (1)
Succinylcholine - Ach R agonist -> sustained depolarization prevents muscle contraction - Phase I - prolonged depolarization, no antidote - Phase II - reploarized but blocked, receptors are available but desensitized, cholinesterase is antidote - sfx: hypercalcemia, hyperkalemia, malignant hyperthermia
165
HLAB57O1 allele corresponds with a negative reaction to _
Abacavir - stimulates a delayed type IV hypersensitivity reaction
166
Why is celecoxib better than other NSAIDs?
GI protective. Does not block COX1 therefore the Gastric mucosa protection (via prostaglandins) is maintained. Good for people who have a history of peptic ulcer disease.
167
What hyperlipidemia drug has the sfx of gouty arthritis?
Niacin (B3) -> decreases the renal excretion of uric acid
168
Main side effect of sulfonylureas? (2)
- weight gain - hypoglycemia - dangerous in the elderly 2nd generation glyburide and glimepiride are long acting - have a higher risk for hypoglycemia 2nd generation glipizide is short acting - has a slightly less risk for hypoglycemia
169
Is tamoxifen used to treat a post-menopausal woman with osteoporosis?
NO Tamoxifen is a SERM - can provide some bone protection in post-menopausal women who are also fighting ER+ breast cancer but due to its bad effects on the endometrium, it is not given as a first line osteoporosis treatment to non-breast cancer women - antagonist in breast - agonist in bone - partial agonist in endometrium
170
What drugs can be given to treat osteoporosis in post-menopausal women? (4)
Bisphosphonates - inhibit osteoclast activity Raloxifene - SERM - antagonist in breast - agonist in bone Denosumab - RANK-L monoclonal antibody Teraparatide - PTH analog
171
Patient with grave’s disease on long term antithyroid medication presents with a fever + sore throat. What is the main sfx concern?
Main SFX of thionamides (propylthiouracil/methimazole) is agranulocytosis -absolute neutrophil count is less than 500
172
Oral fidaxomicin
recurrent cases of C. diff infections | part of the macrolide family
173
Sulfasalazine
Combination drug of sulfapyridine (antibacterial) + 5-aminosalicylic acid (anti-inflammatory) First line for ulcerative colitis
174
Arsenic poisoning/overload treatment?
Dimercaprol chelation
175
Carcinoid treatment
- Octreotide - somatostatin analog | - Surgery
176
Treatment of lyme disease in pregnancy
Amoxicillin Normal (non-pregnancy) treatment of Lyme Disease is doxycycline but this has teratogenic effects (teeth staining)
177
Mifepristone (RU-486)
- progesterone antagonist (->necrosis of the uterine decidua) - glucocorticoid antagonist
178
Flutamide
competitive inhibitor at androgen receptors used in the treatment of prostate cancer
179
Minodixil
Direct arteriolar vasodilator Used for androgenic alopecia or severe refractory HTN sfx: sympathetic activation and RAAS activation
180
Clot busting of an ST elevated MI
Fibrinolytic drugs - useful if given within 6 hours of onset Two classes fibrin specific (attacks fibrin that is attached to a clot only) or non-fibrin specific (ex: Streptokinase) SFX: may cause re-perfusion arrhythmia but these are usually benign
181
Argatroban Lepirudin Hirudin
Direct thrombin inhibitors (Factor II) -Used to treat Heparin Induced Thrombocytopenia
182
Rasburicase
recombinant version of urate oxidase (uric acid -> allantoin) given to help prevent the hyperuricemia of tumor lysis syndrome
183
Antidote for cyanide poisoning
Inhaled amyl/sodium nitrite Cyanide inhibits cytochrome c oxidase in the ETC. Amyl nitrite oxidizes Hb Fe2+ -> Fe3+ (methemoglobin) which has a high affinity for cyanide and can bind it up so that the cyanide cannot bind to the ETC.
184
Triptans - mechanism - contraindications
serotonin (5HT 1b/1d) agonists) - inhibit release of vasoactive peptides - promote vasoconstriction - block pain pathways in brainstem should be avoided in patients with cardiac or cerebrovascular disease
185
Nitroprusside toxicity
Cyanide poisoning leading to sulfur depletion - CN -> (-) ETC cytochrome oxidase - altered mental status, seizures, cardovascular collapse, lactic acidosis, bright red blood - CN metabolism occurs by transferring a sulfur group onto it - Eventually sulfur stores are depleted, give sodium thiosulfate for antidote
186
Valproate teratogenicity
neural tube defects
187
Ramelteon
melatonin receptor agonist - safe in older adults - few side effects - melatonin receptors are in the chiasmatic nucleus
188
Phenylephrine Xylometazoline Oxymetazoline
topical treatment of allergic rhinitis alpha-agonists
189
Flumazenil
Antidote for Benzodiazepine, Nonbenzodiazepine hypnotic overdose - competitive antagonist at GABA benzodiazepine receptor - may precipitate seizures
190
Beta blocker overdose treatment?
Glucagon
191
Copper, Arsenic, Gold OD treatment?
Penacillamine
192
Methemoglobin toxicity treatment
Methylene blue, Vitamin C
193
Salicylates toxicity treatment
NaHCO3 + dialysis | -alkalinizes the urine
194
Aminocaproic acid is used for?
tPA, Streptokinase, Urokinase reversal
195
Warfarin reversal?
- Vitamin K - delayed effect | - Fresh frozen plasma - immediate
196
Timolol acts where when treating open-angle glaucoma?
Acts on the the ciliary epithelium. - nonselective beta-blocker - decreases aqueous humor production
197
Acetazolamide works via what mechanism to treat open-angle glaucoma?
Decreases aqueous humor production from the ciliary epithelium
198
Lantanoprost, Travoprost work via what mechanism to treat open-angle glaucoma?
Prostaglandin agonists (PG2-alpha) Increase aqueous humor outflow and therefore decreases intraocular pressure
199
Pilocarpine, Carbachol work via what mechanism to treat open-angle glaucoma?
(direct) Cholinomemetics Increase aqueous humor outflow via contraction of ciliar muscles and opening of trabecular meshwork, therefore decreases intraocular pressure sfx: miosis, cyclospasm
200
Brimonidine's mechanisim for treatment of open-angle glaucoma
alpha-2 agonist | -acts at ciliary body - decreases aqueous humor synthesis
201
IL-2 can be used as treatment for what 2 cancers?
- Renal cell carcinoma | - Melanoma
202
Infliximab
- chimeric human/mouse antibody to TNF-alpha - used in treatment of RA, ankylosing spondylitis, Crohn's disease - anti-TNF-alpha
203
Gabapentin
Inhibits (active) VG Ca channels - GABA analogue - used to treat painful diabetic neuropathy, fibromyalgia, post-herpetic neuralgia, simple seizures - sfx: ataxia, confusion
204
First line treatment for trigeminal neuralgia
Carbamazepine = increaes Na channel inactivation | -sfx: myelosuppression/agranulocytosis
205
Etanercept
recombinant TNF receptor fusion protein (anti-TNF-alpha)
206
How does lactulose work?
acidifies the contents of the GI tract -> NH3 diffuses into GI and turns into NH4+ and now gets trapped
207
Mechanism: Inhibition of peptidoglycan synthesis via the blockade of transpeptidation enzymes Use: to prevent PID What drug?
Ceftriaxone transpeptidation enzymes = PBPs
208
Cyclosporine
Calcineurin inhibitor - blocks IL-2 transcription - binds to cyclophilin - used for transplant rejection prophylaxis, psoriasis, RA - sfx: nephrotoxic (dose dependent)
209
Tacrolimus (FK506)
Calcineurin inhibitor - blocks IL-2 transcription - binds to FKBP - used for transplant rejection prophylaxis - sfx: nephrotoxic
210
Metoclopramide mechanism? contraindications?
D2 receptor antagonist - prokinetic agent, does not influence colonic transport time - contraindicated in parkison's patients or patients with small bowel obstruction
211
Calcipotriol
Vitamin D analog used to treat psoriasis | -topical
212
Acitretin
Retinoid - used to treat psoriasis, acne, photoaging, some skin neoplasms - this is preferred for psoriasis - teratogenic - should not conceive for up to 3 years after stopping
213
Orlistat
Inhibits pancreatic and gastric lipase -> decreases breakdown and absorption of dietary fats Used for weightloss sfx: diarrhea, steatorrhea,
214
danazol
androgen used to suppress FSH and LH release by the pituitary
215
Treatment of sexual dysfunction caused by mumps induced orchitis
Testosterone orchitis -> leydig cell atrophy -> decreased production of T -> sexual dysfunction
216
Paclitaxel coated stent does what?
causes cell cycle arrest in the M phase -> inhibits cellular division -> prevents stent re-stenosis by preventing intimal hyperplasia
217
patient on furosemide who experiences excessive urination and occasional weakness and cramps
Furosemide sfx - increased dilute urine production - hypokalemia (and contraction metabolic alkalosis)
218
Vemurafenib
BRAF kinase inhibitor - used to treat metastatic or unresectable melanoma - specific for BRAF V600E
219
direct arterial vasodilators (2) | -sfx
- Hydralazine - Minodixil sfx: -reflex sympathetic and RAAS activation -> increases Na and fluid retention

Uworld Journal (12 decks)

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