Pharmacology Flashcards
(35 cards)
What is the 1st line treatment for oral candidiasis?
Nystatin
Works just like Amphotericin B
T or F: Tinnitus is one of the potential adverse effects of aspirin
True
A physician prescribe an inhaler that may cause episodes of tremor and palpitations?
• What 2 drugs would this likely be?
• what is the difference?
Salmeterol/Formoterol - long acting (up to 12 hours, but takes a bit to kick in )
Albuterol - shorter acting (3-6 hours)
What is the MOA and typical clinical use of Filgastrim?
MOA:
• G-CSF to promote bone growth to aid in bone marrow recovery after myelosuppressive therapy
What is the use of Edrophonium in myasthenia gravis?
• what drug(s) is/are often used as treatment?
It is an Ach esterase inhibitor with a short duration of action and is only used in the diagnosis of the disease.
Pyridostigmine is the Ach esterase inhibitor of choice in myasthenia gravis
What is the MOA of tamsulosin?
• use?
selective alpha-1 blocker that gets concentrated in the bladder and prostate
Drugs Prazosin, terazosin, and doxazosin work similarly
***Remember these drugs can cause 1st dose orthostatic hypotension, dizziness and HA
Hydralazine
• MOA
• Association with pregnancy?
• Adverse Effects?
MOA:
• Increases cGMP leading to smooth muscle relaxation and vasodilation
1st line tx for hypertension in pregnancy (even though I’ve also heard methyldopa)
Adverse Effects:
• Reflex Tachycardia, Lupus Like Syndrome
*To prevent reflex tachycardia give this drug with a Beta Blocker
What loop diuretic should be used in people allergic to sulfa drugs?
Ethracrynic acid
Works just like furosemide (Na/K/2Cl inhibition) but is MORE OTOTOXIC
What is Lamotrigine used for?
• how is it thought to work?
Blocks voltage-gate Na+ channels and is used as an ANTI-EPILEPTIC.
**Used more commonly in the outpatient setting than phenobarbital b/c phenobarbital (that acts on GABA) is heavily sedative
Amiodarone
• MOA
• Toxicity
MOA: Class III (potassium channel) antiarrythmic
•Blocks Calcium Channels that are used in phase III DEPOLARIZATION of the cardiac AP
Not being able to depolarize increases AP duration and QT interval
Toxicity: • HYPOTHYROIDISM (mimics thyroxine and acts as antagonist) •Pulmonary Fibrosis • Blue-gray Skin discoloration • Corneal Deposits • Hepatotoxicity
What drugs act as integrase inhibitors in HIV therapy?
RalTEGRAavir
ElviTEGRAavir
DoluTEGRAavir
These prevent HIV from inTEGRAting its genome into host chromosomes
How can you recognize protease inhibitors used in HIV therapy?
• Adverse effects?
-NAVIR = protease inhibitors
• Inhibit the protease that is needed to cleave HIV proteins into functional products (pol gene = protease)
These can cause Hyperglycemia, GI problems, Lipodystrophy (Cushing’s Like)
NEPHROPATHY is common Indinavir
What’s another name for vitamin B6?
• what TB therapy drug depletes this?
Pyridoxine = Vit B6
Isoniazid depletes B6 by creating adducts with B6
Isoniazid
MOA
ADVERSE EFFECTS
Metabolized by KatG (TB enzyme) to create free radical that forms adducts with B6 in the bacterium to INHIBIT MYCOLIC ACID SYNTHESIS
AE’S
• Hepatotoxic
• SLE
• B6 deficiency
Digoxin • MOA • Indication • Adverse Effects • Antidote
MOA
• Direct inhibition of Na+/K+ ATPase => Indirect inhibition of the Na/Ca exchanger that pumps Ca out of the cell => Increased Ca gradient and increased ionotropy
• Stimulates Vagus n. leading to decreased HR
Indication:
• HF, A-fib
Adverse Effects:
• N/V/D blurry yellow vision, arrhythmia, AV block
• Hyperkalemia (keeps K from getting into cells)
• DRUGS that displace Digoxin from its binding sites: VERAPAMIL, AMIODARONE, QUINIDINE.
Antidote:
• Mg
• Normalize K+
• Digoxin antibody (Fab)
What type of cardiomyopathy are loop diuretics indicated for?
• explain.
DILATED CARDIOMYOPATHY (90% of cardiomyopathy) calls for Loop Diuretics
• dilated cardiomyopathy is systolic dysfunction - reducing fluid reduces the stress put on the heart in systole
Which TB drug is known to cause aberrations in vision?
Ethambutolol
What is the MOA of imatinib?
Used in CML because it binds to the BCR-abl fusion protein
How do you treat Heparin TOXICITY?
Protamine Sulfate
Remember before surgery patients on warfarin are typically transferred to heparin
How do you treat Heparin Induced Thrombocytopenia (HIT)?
HIT - IgG antibodies against PF4 (heparin bound platelet factor 4) this leads to platelet activation and widespread hemolytic anemia. This typically take 5 days or so to develop (assuming there as been prior exposure?)
HEPARIN SHOULD BE CONTINUED (b/c clearly thrombosis is an issue)
THROMBIN (factor II) inhibitors like ARGOTROBAN, BIVALIRUDIN and LEPIRUDIN should be given to stop thrombosis
THIS IS VERY IMPORTANT
Always give Amphotericin B + __________ before fluconazole in cryptococcal infections
Flucytosine is given along with Amphotericin because it crosses the BBB
What is the first line treatment of pneumocystis jirovecii?
• what if the person is allergic?
1st line: TMX-SMX
2nd line: Pentamidine
What is Aminocaproic acid used for?
Used to reverse thrombolytic effects of Streptokinase urokinase, and tPA because it INHIBITS FIBRINOLYSIS
Basically only use this if you fucked up and gave too much clot buster and the patient starts bleeding out
Methimazole
• MOA
• Indication
• Contraindication
MOA:
• Inhibits thyroid peroxidase (similar to PTU)
Indication:
• Hyperthyroidism
Contraindication:
• Pregnancy (known teratogen, think cretenism)
