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USMLE Step 1 flashcards > Pharmacology > Flashcards

Pharmacology Flashcards

(83 cards)

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1
Q

Which immunosupresants agents cause nephrotoxicity? Which is their mechanism of action?

A
  • Cyclosporine, Tacrolimus

- Calcineurin inhibitors – prevents IL-2 transcription

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2
Q

Why the PT and INR remain normal after two days of initiate warfarin?

A

Long half-life of factor II (prothrombin)

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3
Q

what is the reason to avoid antiacids (calcium carbonate) when use fluoroquinolones and tetracyclines?

A

Can chelate and decreased effectiveness of other drugs

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4
Q

which are the praziquantel and albendazol mechanisms of action?

A
  • Praziquantel: increases the permeability of the membranes for calcium ions—induces contraction of the parasites, resulting in paralysis.
  • Albendazol: inhibiting its polymerization or assembly into microtubules, decreased production por ATP.
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5
Q

why desmopressin is the treatment of von Willebrand disease?

A

Increases vWf release form weibel palade bodies from endothelial cells

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6
Q
  1. Drugs with low solubility in blood =
  2. Drugs with high solubility in lipids =
    Give an example
A
  1. = Rapid induction and recovery times.
  2. = high potency = 1 /MAC
    Examples: nitrous oxide (N2O) has LOW blood and lipid solubility, and thus fast induction and low
    potency.
    Halothane, in contrast, has high lipid and blood solubility, and thus high potency and slow
    induction.
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7
Q

what is Imatinib?

A

Is tyrosine kinase inhibitor of BCR-ABL (Philadelphia chromosome fusion gene in CML) and c-kit
(common in GI stromal tumors).

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8
Q

which is the use of probenecid in neurosyphilis and gonorrhea?

A

in penicillin resistance cases, because increase the serum concentraction, inhibits organic anion transporters in kidney (penicillin are secreted by this transporters)

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9
Q

Clinical manifestations of hyperestrogenemia in cirrhotic patients

A
  • Spider angiomata
  • testicular atrophy
  • dupuytren contracture
  • Ginecomastia
  • palmar erythema
  • decreased body hair
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10
Q

Which is the reason to use paclitaxel in percutaneous coronary intervention?

A

paclitaxel binding to b-tubulin and prevents breakdown microtubules—- prevents stent restenosis by preventing intimal hyperplasia

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11
Q

Entacapone

A

Inhibit COMT (cathecol O- methyl transferase): increase bioavailability of levodopa by inhibiting peripheral inhibition

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12
Q

Bumetanide

A

Loop diuretic

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13
Q

Chlorlthalidone

A

thiazide diuretics: inhibit Na/ Cl cotransporter in distal convoluted tubule

Adverse effects: Hipokalemia, Hyponatremia, descreased insuline secretion and cause hypercholesterolemia

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14
Q

6- mercaptopurine

A

Is a cytotoxic purine analog— inhibits the novo synthesis of purines
Inhibited xantine oxidase
Do not give with allopurinol because increased toxicity or decreased effects

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15
Q

Calcipotriene

A

Psoriasis
Vit D analog: bind to the receptor and activated a nuclear transcription factor———- that inhibits keratiocyte proliferation

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16
Q

repaglinide

A

Meglitinides: secretagogous, insulin secretion— by clousing K+ channels

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17
Q

Foscarnet

A

pyrophosphate analog
used in CMV resistant to ganciclovir
could chelate calcium— hypocalcemia
Induced renal wasting of Mg —– Hypomagnesemia

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18
Q

Most common side effect of SSRI´s

A

sexual dysfunction

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19
Q

Most common side effectt of ethambutol

A

blurred vision secondary to optic neuropathy

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20
Q

blood/ gas partition

A

Anesthesic solubility in blood

If it is high= slower onset of action

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21
Q

Why nondyhidropyridine calcium channel blockers do not have effect in skeletal muscle?

A

Because skeletal muscle is not dependent on extracellular calcium influx

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22
Q

Varenicline

A

partial agonist of alpha4beta2 nicotinic acetyl choline receptor, competes with nicotine
Reducing nicotine craving

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23
Q

Hydroxyurea

A

Inhibits ribonucleotide reductase

increased fetal Hb synthesis

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24
Q

Fibrates and gallstones

A

Inhibit 7 alpha hydroxylase — catalyzes bile acids synthesis

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25
Omalizumab
Anti IgG1 monoclonal antibody--- binds to IgE inhibit the action useful in severe asthma
26
Atropine poisoning
Anticholinergic syndrome, Hot, dry, red, blind and mad | antidote: physostigmine
27
Clordiazepoxide
long acting benzodiazepines with active metabolites---- as diazepam. Treatment in alcohol withdrawal
28
Finasteride
5alpha reductase inhibitor conversion of testosterone to dihydrotestosterone Treatment of BPH
29
fibrates
activating peroxisome proliferator activated receptor alpha (PPAR-alpha) ----- increased synthesis of lipoprotein lipase
30
Thiazides diuretics
inhibits Na/Cl cotransporter in distal convoluted tubule ---- decreasing reabsorption of Na and Cl-----decreased intravascular volumen-- activating RAA system--- increasing aldosterone---- increased K and H+ excretion--- hypokalemia and metabolic alkalosis
31
Dapsone
mechanism of action similar to sulfonamides useful in lepra treatment and P. jiroveci prophylaxis adverse effects: hemolysis in G6PD deficiency
32
glipizide vs glubiride and glimepiride
short acting low risk of hypoglycemia (best option of elderly people) glubiride and glimepiride long ancting more risk of hypoglycemia
33
How digoxin slows vetricular rate?
increasing parasympathetic tone --- inhibits Na/K ATPase pump and enhaces efferent parasympathetic ganglionic transmission----- increased vagal tone
34
Andrigenic alopecia treatment
5 alpha reductase inibitors: finasteride
35
Interaction between nitrates and phosphodiesterase inhibitors
Cyclic GMP accumulation
36
the arteriovennous concentration gradient in anesthesics mean?
tissue solubility | Large AV concentration= high solubility0 slow onset of action
37
Treatment in cyanide poisoning
- sodium nitrite - sodium thiosulfate - Hydroxycobalamine
38
Non nucleoside reverse transcriptase inhibitor
efavirenz Nevirapine *** Do not require activation via intracellular phosphorilation
39
Cocaine
Inhibited reuptake of monoamines: sympathetic stimulation
40
Halothane hepatitis
halogenates inhalated anesthesics (sevofluorane, desflorane, isoflorane)---------------metabolized by CYP 450 --- Reactive intermediates that could cause direct hepatocellular damage
41
trimethropine - methrotexate and pyrimetamine
inhibited dihydrofolate reductase
42
Clozapine
in schizophrenia resistant cases and associated with suicidatility adverse effects: agranulocytosis
43
Amatoxins
Mushrooms poisoning | Inhibit DNA Polymerase II------ Synthesized mRNA: apoptosis
44
Direct thrombin inhibitor
Argatroban, dabigatran, bivalirubin
45
Nitrates exert their action by.....
vasodilation of peripheral veins and arteries (predominantly venodiltation) decreased left ventricular wall stress (decreased preload) ---- decreased end dyastolic pressure decreased o2 demand of myocardial
46
adverse effects of thiazide diuretics
``` hypercalcemia----- decreased PTH hyponatremia Hypok Hypercholesterolemia Hyperglycemia hyperuricemia ```
47
Phencyclidine intoxication
PCP ---- hallucinogen, combative behavior, nystagmus, ataxia | Antagonist of NMDA receptor ------- excess release of excitatory neurotransmitters
48
MAO inhibitors
phenelzine tranylcypromine Selegiline
49
Which is the reason to avoid MAO inhibitors and SSRI´s
increased the risk of serotonine syndrome
50
Colchicine
inhibits microtubules polymerization and leukotriene B4 synthesis
51
Selective estrogen receptor modulators
tamoxifen: adjuvant therapy in breast cancer raloxifen: postmenopausal osteoporosis Competitive inhibitor of estrogen binding (agonist or antagonist activity) adverse effects: hot flashes, endometrial hyperplasia (tamoxifen only) and thromboembolism
52
neuraminidase inhibitors
inhibit viral particle release | Oseltamivir
53
Jimson weed
it is a plant: anticholinergic toxins
54
Cisplatin main adverse effect
ototoxicity: damaged stereocilia of hairy cells
55
which are the changes in HR and SBP with nitrates?
HR: increase--- reflex tachycardia BP: decrease--- main venodilation
56
Pilocarpine
Contract ciliary muscle of eye Cholicomimetic Glaucoma and sjogren sx
57
Which is the effect of leuprolide in prostate cancer?
- is a GnRh analog - continuous GnRH effect for long term leuprolide use----- supresses LH release -------------- reduced production of testosterone. (similar effect of surgical orchiedectomy)
58
Anti TNF allpha agents
Infliximab: monoclonal antibody to TNF alpha Etanercept: recombinant TNF receptor fusion protein
59
Aspirin
NON selective irreversible inhibiting COX-1 (and COX-2) ---- inhibited the synthesis of TXA2 (potent stimulator of platelet aggregation)
60
Ehylene glycol poisoning
High aniongap metabolic acidosis flank pain, gross hematuria and oliguria calcium oxalate crystals
61
Drugs that are implicated in SLE drug induced
- procainamide - hydralazine - isoniazide - minocycline - TNF-Alplha inhibitors (etanercept)
62
Side effects of non dihydropyridine calcium channel blockers
dyltiazem and verapamil | constipation and AV block
63
methimazole and propylthiouracile
inhibit thyroid peroxidase (iodine organification and coupling of iodotyrosines) propylthiouracile also decreaseperipehral conversion T4 to active T3
64
Norepinephrine
adrenergic agonist alpha1: increased blood pressure (IP3 pathway) *** baroreceptor reflex (bradicardia) and beta1 recerptors: increase cAMP (Gs) increased cardiac contractility, increased heart rate RESULT: heart unchanged
65
Erythropoiesis stimulating agents adverse effects:
increase risk fir thrombosis embolic events--- increase blood viscosity Also develop hypertension (activation of erythropoietin receptors on vascular endothelium and smooth muscle cells
66
Ramelteon
melatonin agonist--- suprachiasmatic nucleus (useful in insomnia en erderly patients)
67
Inhalation anesthesics
Increased GABA, Potassium channels (hyperpolarization of neuronal membranes), nicotinic and glycine receptors - Myocardial depression - Lungs: except nitrous oxide are respiratory depressants, decrease tidal volume and minute ventilation (hypercapnia), suppresion of mucociliar clearance (athelectasis) - Brain: decrease vascular resistance --- increase cerebral blood flow - kidney: decrase glomerural filtration rate - liver: decrease hepatic blood flow
68
Which is the reason of hemin and glucosa treatment in acute intermitent porphyria?
Down reagulating ALA synthase | becasuse the attacks in AIP are because the acummulation of ALA and PBG
69
succinylcholine adverse effects
hyperkalemia, hypercalcemia and malignant hyperthermia
70
Cell cycle independent drugs
* * Cross. link DNA: interfere with replication - alkylating agents: nitrosoureas, cyclophosphamide, busulfan - platinum agents: cisplatin
71
Oxybutinin/tolterodine vs bethanecol
1. antagonist of muscarinic receptor (urinary urgency) | 2. Agonist of muscarinic receptor (pop ileus and urinary retention)
72
Renal ischemia with NSAIDS
PGS normally vasodilate the afferent renal arteriole | NSAIDS inhibits synthesis of PGS----------- vasoconstriction of afferent arteriole
73
Bile acid binding resins
Cholestyramine, colestipol and colesevelam Binding bile acids in Gi tract ----------inhibiting enterohepatic circulation -------------------decrease LDL levels, uptake of LDL. Side effects: impaired absortion in gut and increase hepatic production of TAG-----------Hypertryglyceridemia
74
Low distribution volume
3-5 L------ means high charged, the drug remains in the plasma
75
Relation between antihyoertensive drugs and K | ** Thiazide and ACE inhibitors
Thiazide: HypoK | ACE inhibitors: HyperK
76
inhibitation Cox 1 and 2
COX 1: acetylation inhibits generation of TMX A2 in platelets Cox 2: acetylation bloxks PGS production in inflammatory cells
77
Two specific symptoms of opiod withdrawal
Yawning and lacrimation
78
Nitrates and nitrites action mechanism
activate guanylyl cyclase--- increased cGMP --- myosin light chain dephosphorylation: relaxation
79
Imatinib
tyrosine kinase inhibitor of BCR-ABL---- useful in Chronic myeloid leukemia
80
lithium side effects
hypothyroidism Nephrogenic diabetes insipidus movements (tremor) ebstein anomaly (cardiac, tricuspid valve)
81
Ribavirin
treat for hep C and respiratory syncytial virus inhibited the synthesis of nucleotides: competitively inhibited inosine monophosphate dehydrogenase ---- interferes duplicate of viral genetic material
82
Thiazolinedione
Pioglitazone and Rosiglitazone Binds to PPAR-y nuclear transcription regulator (Decrease insuline resistance) Side effect: Na reabsorption (be careful in heart failure)
83
Reed sternberg cells
distinctive tumor giant cells seen in Hodgkin lymphoma | Binucleated, bilobed (mirror images)

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