Flashcards in Pharmacology OLD Deck (500)
A common side effects of Interferon (INF) treatment is?
Antimicrobial prophylaxis for a history of recurrent UTIs
Antimicrobial prophylaxis for Gonorrhea
Antimicrobial prophylaxis for Meningococcal infection
Rifampin (DOC), minocycline
Antimicrobial prophylaxis for PCP
TMP-SMZ (DOC), aerosolized pentamidine
Antimicrobial prophylaxis for Syphilis
Benzathine penicillin G
Are Aminoglycosides Teratogenic?
Are Ampicillin and Amoxicillin penicillinase resistant?
Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant?
Are Cephalosporins resistant to penicillinase?
No, but they are less susceptible than the other Beta lactams
Are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?
Clinical use of Isoniazid (INH)?
Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB
Common side effects associated with Clindamycin include?
Pseudomembranous colitis (C. difficile), fever, diarrhea
Common toxicities associated with Fluoroquinolones?
GI upset, Superinfections, Skin rashes, Headache, Dizziness
Common toxicities associated with Griseofulvin?
Teratogenic, Carcinogenic, Confusion, Headaches
Describe the MOA of Interferons (INF)
Glycoproteins from leukocytes that block various stages of viral RNA and DNA synthesis
Do Tetracyclines penetrate the CNS?
Only in limited amounts
Does Ampicillin or Amoxicillin have a greater oral bioavailability?
AmOxicillin has greater Oral bioavailability
Does Amprotericin B cross the BBB?
Does Foscarnet require activation by a viral kinase?
Ganciclovir associated toxicities?
Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity
How are Interferons (INF) used clinically?
Chronic Hepatitis A and B, Kaposi`s Sarcoma
How are Sulfonamides employed clinically?
Gram +, Gram -, Norcardia, Chlamydia
How are the HIV drugs used clinically?
Triple Therapy` 2 Nucleoside RT Inhibitors with a Protease Inhibitor
How are the Latent Hypnozoite (Liver) forms of Malaria (P. vivax, P.ovale) treated?
How can Isoniazid (INH)-induced neurotoxicity be prevented?
Pyridoxine (B6) administration
How can the t1/2 of INH be altered?
Fast vs. Slow Acetylators
How can the toxic effects of TMP be ameliorated?
With supplemental Folic Acid
How can Vancomycin-induced `Red Man Syndrome` be prevented?
Pretreat with antihistamines and a slow infusion rate
How do Sulfonamides act on bacteria?
As PABA antimetabolites that inhibit Dihydropteroate Synthase, Bacteriostatic
How do the Protease Inhibitors work?
Inhibt Assembly of new virus by Blocking Protease Enzyme
How does Ganciclovir`s toxicity relate to that of Acyclovir?
Ganciclovir is more toxic to host enzymes
How does resistance to Vancomycin occur?
With an amino acid change of D-ala D-ala to D-ala D-lac
How is Acyclovir used clinically?
HSV, VZV, EBV, Mucocutaneous and Genital Herpes Lesions, Prophylaxis in Immunocompromised pts
How is Amantadine used clinically?
Prophylaxis for Influenza A, Rubella; Parkinson`s disease
How is Amphotericin B administered for fungal meningitis?
How is Amphotericin B used clinically?
Wide spectrum of systemic mycoses: Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor
How is Chloramphenical used clinically?
Meningitis (H. influenza, N. meningitidis, S. pneumoniae), Conserative treatment due to toxicities
How is Foscarnet used clinically?
CMV Retinitis in IC pts when Ganciclovir fails
How is Ganciclovir activated?
Phosphorylation by a Viral Kinase
How is Ganciclovir used clinically?
CMV, esp in Immunocompromised patients
How is Griseofulvin used clinically?
Oral treatment of superficial infections
How is Leishmaniasis treated?
How is Ribavirin used clinically?
How is Rifampin used clinically?
1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone when used of Leprosy 3. Used in combination with other drugs
How is Trimethoprim used clinically?
Used in combination therapy with SMZ to sequentially block folate synthesis
How is Vancomycin used clinically?
For serious, Gram + multidrug-resistant organisms
How would you treat African Trypanosomiasis (sleeping sickness)?
In what population does Gray Baby Syndrome occur? Why?
Premature infants, because they lack UDP-glucuronyl transferase
Is Aztreonam cross-allergenic with penicillins?
Is Aztreonam resistant to penicillinase?
Is Aztreonam usually toxic?
Is Imipenem resistant to penicillinase?
Is Penicillin penicillinase resistant?
No - duh
Mnemonic for Foscarnet?
Foscarnet = pyroFosphate analog
MOA for Penicillin (3 answers)?
1)Binds penicillin-binding proteins 2) Blocks transpeptidase cross- linking of cell wall 3) Activates autolytic enzymes
MOA: Bactericidal antibiotics
Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole
MOA: Block cell wall synthesis by inhib. Peptidoglycan cross-linking (7)
Penicillin, Ampicillin, Ticarcillin, Pipercillin, Imipenem, Aztreonam, Cephalosporins
MOA: Block DNA topoisomerases
MOA: Block mRNA synthesis
MOA: Block nucleotide synthesis
MOA: Block peptidoglycan synthesis
MOA: Block protein synthesis at 30s subunit
MOA: Block protein synthesis at 50s subunit
Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramins (quinupristin, dalfopristin)
MOA: Disrupt bacterial/fungal cell membranes
MOA: Disrupt fungal cell membranes
Amphotericin B, Nystatin, Fluconazole/azoles
Name common Polymyxins
Polymyxin B, Polymyxin E
Name several common Macrolides (3)
Erythromycin, Azithromycin, Clarithromycin
Name some common Sulfonamides (4)
Sulfamethoxazole (SMZ), Sulfisoxazole, Triple sulfas, Sulfadiazine
Name some common Tetracyclines (4)
Tetracycline, Doxycycline, Demeclocycline, Minocycline
Name the common Aminoglycosides (5)
Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
Name the common Azoles
Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole
Name the common Fluoroquinolones (6)
Ciprofloxacin, Norfloxacin, Ofloxacin, Grepafloxacin, Enoxacin, Nalidixic acid
Name the common Non-Nucleoside Reverse Transcriptase Inhibitors
Name the common Nucleoside Reverse Transcriptase Inhibitors
Zidovudine (AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudine (3TC)
Name the Protease Inhibitors (4)
Saquinavir, Ritonavir, Indinavir, Nelfinavir
Name two classes of drugs for HIV therapy
Protease Inhibitors and Reverse Transcriptase Inhibitors
Name two organisms Vancomycin is commonly used for?
Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis)
Resistance mechanisms for Aminoglycosides
Modification via Acetylation, Adenylation, or Phosphorylation
Resistance mechanisms for Cephalosporins/Penicillins
Beta-lactamase cleavage of Beta-lactam ring
Resistance mechanisms for Chloramphenicol
Modification via Acetylation
Resistance mechanisms for Macrolides
Methylation of rRNA near Erythromycin`s ribosome binding site
Resistance mechanisms for Sulfonamides
Altered bacterial Dihydropteroate Synthetase, Decreased uptake, or Increased PABA synthesis
Resistance mechanisms for Tetracycline
Decreased uptake or Increased transport out of cell
Resistance mechanisms for Vancomycin
Terminal D-ala of cell wall replaced with D-lac; Decreased affinity
Side effects of Isoniazid (INH)?
Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome
Specifically, how does Foscarnet inhibit viral DNA pol?
Binds to the Pyrophosphate Binding Site of the enzyme
The MOA for Chloramphenicol is?
Inhibition of 50S peptidyl transferase, Bacteriostatic
Toxic effects of TMP include?
Megaloblastic anemia, Leukopenia, Granulocytopenia
Toxic side effects of the Azoles?
Hormone synthesis inhibition (Gynecomastia), Liver dysfunction (Inhibits CYP450), Fever, Chills
Toxicities associated with Acyclovir?
Delirium, Tremor, Nephrotoxicity
What additional side effects exist for Ampicillin?
Rash, Pseudomembranous colitis
What antimicrobial class is Aztreonam syngergestic with?
What are Amantadine-associated side effects?
Ataxia, Dizziness, Slurred speech
What are Aminoglycosides synergistic with?
What are Aminoglycosides used for clinically?
Severe Gram - rod infections.
What are common serious side effects of Aminoglycosides and what are these associated with?
Nephrotoxicity (esp. with Cephalosporins), Ototoxicity (esp. with Loop Diuretics)
What are common side effects of Amphotericin B?
Fever/Chills, Hypotension, Nephrotoxicity, Arrhythmias
What are common side effects of Protease Inhibitors?
GI intolerance (nausea, diarrhea), Hyperglycemia, Lipid abnormalities, Thrombocytopenia (Indinavir)
What are common side effects of RT Inhibitors?
BM suppression (neutropenia, anemia), Peripheral neuropathy
What are common toxicities associated with Macrolides? (4)
GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes
What are common toxicities associated with Tetracyclines?
GI distress, Tooth discoloration and Inhibition of bone growth in children, Fanconi`s syndrome, Photosensitivity
What are common toxicities related to Vancomycin therapy?
Well tolerated in general but occasionally, Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing=`Red Man Syndrome`
What are Fluoroquinolones indicated for? (3)
1.Gram - rods of the Urinary and GI tracts (including Pseudomonas) 2.Neisseria 3. Some Gram + organisms
What are major side effects of Methicillin, Nafcillin, and Dicloxacillin?
What are Methicillin, Nafcillin, and Dicloxacillin used for clinically?
What are Polymyxins used for?
Resistant Gram - infections
What are the Anti-TB drugs?
Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH)
What are the clinical indications for Azole therapy?
What are the clinical uses for 1st Generation Cephalosporins?
Gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK)
What are the clinical uses for 2nd Generation Cephalosporins?
Gram + cocci, Haemophilus influenza, Enterobacter aerogenes, Neisseria species, P. mirabilis, E. coli, K. pneumoniae, Serratia marcescens ( HEN PEcKS )
What are the clinical uses for 3rd Generation Cephalosporins?
1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB)
What are the clinical uses for Aztreonam?
Gram - rods: Klebsiella species, Pseudomonas species, Serratia species
What are the clinical uses for Imipenem/cilastatin?
Gram + cocci, Gram - rods, and Anerobes
What are the major structural differences between Penicillin and Cephalosporin?
Cephalosporin: 1) has a 6 member ring attached to the Beta lactam instead of a 5 member ring 2)has an extra functional group ( attached to the 6 member ring)
What are the major toxic side effects of Imipenem/cilastatin?
GI distress, Skin rash, and Seizures at high plasma levels
What are the major toxic side effects of the Cephalosporins?
1) Hypersensitivity reactions 2) Increased nephrotoxicity of Aminoglycosides 3) Disulfiram-like reaction with ethanol (those with a methylthiotetrazole group, e.g., cefamandole)
What are the side effects of Polymyxins?
Neurotoxicity, Acute renal tubular necrosis
What are the side effects of Rifampin?
Minor hepatotoxicity, Drug interactions (activates P450)
What are toxic side effects for Metronidazole?
Disulfiram-like reaction with EtOH, Headache
What are toxicities associated with Chloramphenicol?
Aplastic anemia (dose independent), Gray Baby Syndrome
What conditions are treated with Metronidazole?
Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella vaginalis), Trichomonas
What do Aminoglycosides require for uptake?
What do you treat Nematode/roundworm (pinworm, whipworm) infections with?
Mebendazole/Thiabendazole, Pyrantel Pamoate
What drug is given for Pneumocystis carinii prophylaxis?
What drug is used during the pregnancy of an HIV+ mother?, Why?
AZT, to reduce risk of Fetal Transmission
What drug is used to treat Trematode/fluke (e.g., Schistosomes, Paragonimus, Clonorchis) or Cysticercosis
What is a common drug interaction associated with Griseofulvin?
Increases coumadin metabolism
What is a mnemonic to remember Amantadine`s function?
Blocks Influenza A and RubellA; causes problems with the cerebellA
What is a prerequisite for Acyclovir activation?
It must be Phosphorylated by Viral Thymidine Kinase
What is a Ribavirin toxicity?
What is an acronym to remember Anti-TB drugs?
What is an additional side effect of Methicillin?
What is an occasional side effect of Aztreonam?
What is Clindamycin used for clinically?
Anaerobic infections (e.g., B. fragilis, C. perfringens)
What is clinical use for Carbenicillin, Piperacillin, and Ticarcillin?
Pseudomonas species and Gram - rods
What is combination TMP-SMZ used to treat?
Recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia
What is combined with Ampicillin, Amoxicillin, Carbenicillin, Piperacillin, and Ticarcillin to enhance their spectrum?
What is Fluconazole specifically used for?
Cryptococcal meningitis in AIDS patients and Candidal infections of all types
What is Imipenem always administered with?
What is Ketoconazole specifically used for?
Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism
What is Metronidazole combined with for `triple therapy`? Against what organism?
Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori
What is Metronidazole used for clinically?
Antiprotozoal: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis Anaerobes: Bacteroides, Clostridium
What is Niclosamide used for?
Cestode/tapeworm (e.g., D. latum, Taenia species Except Cysticercosis
What is Nifurtimox administered for?
Chagas` disease, American Trypanosomiasis (Trypanosoma cruzi)
What is the chemical name for Ganciclovir?
DHPG (dihydroxy-2-propoxymethyl guanine)
What is the clinical use for Ampicillin and Amoxicillin?
Extended spectrum penicillin: certain Gram + bacteria and Gram - rods
What is the clinical use for Nystatin?
Topical and Oral, for Oral Candidiasis (Thrush)
What is the clinical use for Penicillin?
Bactericidal for: Gram + rod and cocci, Gram - cocci, and Spirochetes
What is the major side effect for Ampicillin and Amoxicillin?
What is the major side effect for Carbenicillin, Piperacillin, and Ticarcillin?
What is the major toxic side effect of Penicillin?
What is the memory aid for subunit distribution of ribosomal inhibitors?
Buy AT 30, CELL at 50`
What is the memory key for Isoniazid (INH) toxicity?
INH: Injures Neurons and Hepatocytes
What is the memory key for Metronidazole`s clinical uses?
GET on the Metro
What is the memory key for organisms treated with Tetracyclines?
VACUUM your Bed Room`
What is the memory key involving the `4 R`s of Rifampin?`
1. RNA pol inhibitor 2. Revs up P450 3. Red/orange body fluids 4. Rapid resistance if used alone
What is the MOA for Acyclovir?
Inhibit viral DNA polymerase
What is the MOA for Amphotericin B?
Binds Ergosterol, forms Membrane Pores that Disrupt Homeostatis
What is the MOA for Ampicillin and Amoxicillin?
Same as penicillin. Extended spectrum antibiotics
What is the MOA for Carbenicillin, Piperacillin, and Ticarcillin?
Same as penicillin. Extended spectrum antibiotics
What is the MOA for Clindamycin?
Blocks Peptide Bond formation at the 50S subunit, Bacteriostatic
What is the MOA for Methicillin, Nafcillin, and Dicloxacillin?
Same as penicillin. Act as narrow spectrum antibiotics
What is the MOA for Metronidazole?
Forms toxic metabolites in the bacterial cell, Bactericidal
What is the MOA for Nystatin?
Binds ergosterol, Disrupts fungal membranes
What is the MOA for Rifampin?
Inhibits DNA dependent RNA polymerase
What is the MOA for the Aminoglycosides?
Inhibits formation of Initiation Complex, causes misreading of mRNA, Bactericidal
What is the MOA for the Azoles?
Inhibit Ergosterol synthesis
What is the MOA for the Cephalosporins?
Beta lactams - inhibit cell wall synthesis, Bactericidal
What is the MOA for the Fluoroquinolones?
Inhibit DNA Gyrase (topoisomerase II), Bactericidal
What is the MOA for the Macrolides?
Blocks translocation, binds to the 23S rRNA of the 50S subunit, Bacteriostatic
What is the MOA for the Tetracyclines?
Binds 30S subunit and prevents attachment of aminoacyl-tRNA, Bacteriostatic
What is the MOA for Trimethoprim (TMP)?
Inhibits bacterial Dihydrofolate Reductase, Bacteriostatic
What is the MOA for Vancomycin?
Inhibits cell wall mucopeptide formation, Bactericidal
What is the MOA of Amantadine?
Blocks viral penetration/uncoating; may act to buffer the pH of the endosome
What is the MOA of Aztreonam?
Inhibits cell wall synthesis ( binds to PBP3). A monobactam
What is the MOA of Foscarnet?
Inhibits Viral DNA polymerase
What is the MOA of Ganciclovir?
Inhibits CMV DNA polymerase
What is the MOA of Griseofulvin?
Interferes with microtubule function, disrupts mitosis, inhibits growth
What is the MOA of Imipenem?
Acts as a wide spectrum carbapenem
What is the MOA of Isoniazid (INH)?
Decreases synthesis of Mycolic Acid
What is the MOA of Polymyxins?
Bind cell membrane, disrupt osmotic properties, Are Cationc, Basic and act as detergents
What is the MOA of Ribavirin?
Inhibits IMP Dehydrogenase (competitively), and therefore blocks Guanine Nucleotide synthesis
What is the MOA of the RT Inhibitors?
Inhibit RT of HIV and prevent the incorporation of viral genome into the host DNA
What is the most common cause of Pt noncompliance with Macrolides?
What is treated with Chloroquine, Quinine, Mefloquine?
Malaria (P. falciparum)
What microorganisms are Aminoglycosides ineffective against?
What microorganisms are clinical indications for Tetracycline therapy?
Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borrelia burgdorferi (Lyme`s) Rickettsia Tularemia
What microorganisms is Aztreonam not effective against?
Gram + and Anerobes
What musculo-skeletal side effects in Adults are associated with Floroquinolones?
Tendonitis and Tendon rupture
What neurotransmitter does Amantadine affect? How does it influence this NT?
Dopamine; causes its release from intact nerve terminals
What organism is Imipenem/cilastatin the Drug of Choice for?
What organisms does Griseofulvin target?
Dermatophytes (tinea, ringworm)
What parasites are treated with Pyrantel Pamoate (more specific)?
Giant Roundworm (Ascaris), Hookworm (Necator/Ancylostoma), Pinworm (Enterobius)
What parasitic condition is treated with Ivermectin?
Onchocerciasis (`river blindness`--rIVER-mectin)
What populations are Floroquinolones contraindicated in? Why?
Pregnant women, Children; because animal studies show Damage to Cartilage
What should not be taken with Tetracyclines? / Why?
Milk or Antacids, because divalent cations inhibit Tetracycline absorption in the gut
What Sulfonamides are used for simple UTIs?
Triple sulfas or SMZ
When is HIV therapy initiated?
When pts have Low CD4+ (
When is Rifampin not used in combination with other drugs?
1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B
Where does Griseofulvin deposit?
Keratin containing tissues, e.g., nails
Which Aminoglycoside is used for Bowel Surgery ?
Which antimicrobial classes inhibit protein synthesis at the 30S subunit? (2)
1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic
Which antimicrobials inhibit protein synthesis at the 50S subunit? (4)
1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic
Which individuals are predisposed to Sulfonamide-induced hemolysis?
G6PD deficient individuals
Which RT inhibitor causes Megaloblastic Anemia?
Which RT inhibitors cause a Rash?
Which RT inhibitors cause Lactic Acidosis?
Which Tetracycline is used in patients with renal failure? / Why?
Doxycycline, because it is fecally eliminated
Why are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?
Due to the presence of a bulkier R group
Why is Cilastatin administered with Imipenem?
To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the renal tubules
List the mechanism, clinical use, & toxicity of 5 FU.
-S-phase anti-metabolite Pyr analogue -Colon, solid tumors, & BCC/ -Irreversible myelosuppression
List the mechanism, clinical use, & toxicity of 6 MP.
-inhibits HGPRT (pur. Syn.) - Luk, Lymph,
List the mechanism, clinical use, & toxicity of Cisplatin.
-Alkalating agent -testicular,bladder,ovary,& lung -Nephrotoxicity & CN VIII damage.
List the mechanism, clinical use, & toxicity of Cyclophosphamide.
-Alkalating agent -NHL, Breast, ovary, & lung. - Myelosuppression, & hemorrhagic cystitis.
List the mechanism, clinical use, & toxicity of Doxorubicin.
-DNA intercalator -Hodgkin`s, myeloma, sarcoma, and solid tumors -Cardiotoxicity & alopecia
List the mechanism, clinical use, & toxicity of Etoposide.
-Topo II inhibitor(GII specific) -Oat cell of Lung & prostate, & testicular -Myelosuppression & GI irritation.
List the mechanism, clinical use, & toxicity of Methotrexate.
-S-phase anti-metabolite folate analogue -Luk, Lymp, sarc, RA, & psoriasis / -Reversible myelosuppression
List the mechanism, clinical use, & toxicity of Prednisone.
-Triggers apoptosis -CLL, Hodgkin`s in MOPP -Cushing-like syndrome
List the mechanism, clinical use, & toxicity of Vincristine.
-MT polymerization inhibitor(M phase) -MOPP, lymphoma, Willm`s & choriocarcinoma -neurotoxicity and myelosuppression
Which cancer drugs inhibit nucleotide synthesis(3)?
- Methotrexate - 5 FU - 6 mercaptopurine
ACE inhibitors- clinical use?
hypertension, CHF, diabetic renal disease
ACE inhibitors- mechanism?
reduce levels of Angiotensin II, thereby preventing the inactivation of bradykinin (a potent vasodilator); renin level is increased
ACE inhibitors- toxicity?
fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)
Acetazolamide- clinical uses?
glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness
acts at the proximal convoluted tubule to inhibit carbonic anhydrase. Causes self-limited sodium bicarb diuresis and reduction of total body bicarb stores.
acetazolamide- site of action?
proximal convoluted tubule
hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy
ACIDazolamide` causes acidosis
Adenosine- clinical use?
DOC in diagnosing and abolishing AV nodal arrhythmias
ADH antagonists- site of action?
adverse effect of Nitroprusside?
cyanide toxicity (releases CN)
adverse effects of beta-blockers?
impotence, asthma, CV effects (bradycardia, CHF, AV block), CNS effects (sedation, sleep alterations)
adverse effects of Captopril?
fetal renal toxicity, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)
adverse effects of Clonidine?
dry mouth, sedation, severe rebound hypertension
adverse effects of ganglionic blockers?
severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
adverse effects of Guanethidine?
orthostatic and exercise hypotension, sexual dysfunction, diarrhea
adverse effects of Hydralazine?
nausea, headache, lupus-like syndrome, reflex tachycardia, angina, salt retention
adverse effects of Hydrochlorothiazide?
hypokalemia, slight hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyperglycemia
adverse effects of Loop Diuretics?
K+ wasting, metabolic alkalosis, hypotension, ototoxicity
adverse effects of Losartan?
fetal renal toxicity, hyperkalemia
adverse effects of Methyldopa?
sedation, positive Coombs` test
adverse effects of Minoxidil?
hypertrichosis, pericardial effusion, reflex tachycardia, angina, salt retention
adverse effects of Nifedipine, verapamil?
dizziness, flushing, constipation (verapamil), nausea
adverse effects of Prazosin?
first dose orthostatic hypotension, dizziness, headache
adverse effects of Reserpine?
sedation, depression, nasal stuffiness, diarrhea
pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits resulting in photodermatitis, neurologic effects, consitpation, CV (bradycardia, heart block, CHF), and hypo- or hyperthyroidism.
Beta Blockers- CNS toxicity?
sedation, sleep alterations
Beta Blockers- CV toxicity?
bradycardia, AV block, CHF
Beta Blockers- site of action?
Beta adrenergic receptors and Ca2+ channels (stimulatory)
Beta Blockers- BP?
new arrhythmias, hypotension
Ca2+ channel blockers- clinical use?
hypertension, angina, arrhythmias
Ca2+ channel blockers- mechanism?
block voltage dependent L-type Ca2+ channels of cardiac and smooth muscle- decreasing contractility
Ca2+ channel blockers- site of action?
Cell membrane Ca2+ channels of cardiac sarcomere
Ca2+ channel blockers- toxicity?
cardiac depression, peripheral edema, flushing, dizziness, constipation
Ca2+ sensitizers`- site of action?
Cautions when using Amiodarone?
check PFTs, LFTs, and TFTs
Antiarrhythmic class IA effects?
increased AP duration, increased ERP increased QT interval. Atrial and ventricular.
Antiarrhythmic class IB- clinical uses?
post MI and digitalis induced arrhythmias
Antiarrhythmic class IB- effects?
decrease AP duration, affects ischemic or depolarized Purkinje and ventricular system
Antiarrhythmic class IB- toxicity?
local anesthetic. CNS stimulation or depression. CV depression.
Antiarrhythmic class IC- effects?
NO AP duration effect. useful in V-tach that progresses to V-fib and in intractable SVT LAST RESORT
Antiarrhythmic class IC- toxicity?
Antiarrhythmic class II- effects?
decrease the slope of phase 4, increase PR interval (the AV node is particularly sensitive)
Antiarrhythmic class II- mechanism?
blocking the beta adrenergic receptor leads to decreased cAMP, and decreased Ca2+ flux
Antiarrhythmic class II- toxicity?
impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemia
Antiarrhythmic Class III- effects?
increase AP duration, increase ERP, increase QT interval, for use when other arrhythmics fail
Antiarrhythmic class IV- clinical use?
prevention of nodal arrhythmias (SVT)
Antiarrhythmic class IV- effects?
decrease conduction velocity, increase ERP, increase PR interval
Antiarrhythmic class IV- primary site of action?
AV nodal cells
Antiarrhythmic class IV- toxicity?
constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression), and torsade de pointes (Bepridil)
classes of antihypertensive drugs?
diuretics, sympathoplegics, vasodilators, ACE inhibitors, Angiotensin II receptor inhibitors
decrease Digitoxin dose in renal failure?
decrease Digoxin dose in renal failure?
Digitalis- site of action?
Digoxin v. Digitoxin: bioavailability?
Digitoxin>95% Digoxin 75%
Digoxin v. Digitoxin: excretion?
Digoxin v. Digitoxin: half life?
Digitoxin 168hrs Digoxin 40 hrs
Digoxin v. Digitoxin: protein binding?
Digitoxin 70% Digoxin 20-40%
Esmolol- short or long acting?
very short acting
Ethacrynic Acid- clinical use?
Diuresis in pateints with sulfa allergy
Ethacrynic Acid- mechanism?
not a sulfonamide, but action is the same as furosemide
Ethacrynic Acid- toxicity?
NO HYPERURICEMIA, NO SULFA ALLERGY; same as furosemide otherwise
Furosemide- class and mechanism?
Sulfonamide Loop Diuretic. Inhibits ion co-transport system of thick ascending loop. Abolishes hypertonicity of the medulla, thereby preventing concentration of the urine.
Furosemide- clinical use?
edematous states (CHF, cirrhosis, nephrotic syndrome, pulm edema), HTN, hypercalcemia
Furosemide- toxicity? (OH DANG)
Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout
Furosemide increases the excretion of what ion?
Ca2+ (Loops Lose calcium)
how do we stop angina?
decrease myocardial O2 consumption by: 1-decreasing end diastolic volume 2- decreasing BP 3- decreasing HR 4-decreasing contractility 5-decreasing ejection time
Hydralazine- class and mechanism?
vasodilator- increases cGMP to induce smooth muscle relaxation (arterioles>veins; afterload reduction)
Hydralazine- clinical use?
severe hypertension, CHF
compensatory tachycardia, fluid retention, lupus-like syndrome
Hydrochlorothiazide- clinical use?
HTN, CHF, calcium stone formation, nephrogenic DI.
Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion.
Hydrochlorothiazide- toxicity? (hyperGLUC, plus others)
Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia, sulfa allergy.
torsade de pointes
K+- clinical use?
depresses ectopic pacemakers, especially in digoxin toxicity
K+ sparing diuretics- clinical use?
hyperaldosteronism, K+ depletion, CHF
K+ sparing diuretics- site of action?
cortical collecting tubule
K+ sparing diuretics- toxicity?
hyperkalemia, endocrine effects (gynecomastia, anti-androgen)
loop diuretics (furosemide)- site of action?
thick ascending limb
Mannitol- clinical use?
ARF, shock, drug overdose, decrease intracranial/intraocular pressure
osmotic diuretic- increase tubular fluid osmolarity, thereby increasing urine flow
mannitol- site of action?
proximal convoluted tubule, thin descending limb, and collecting duct
pulmonary edema, dehydration
Mg+- clinical use?
effective in torsade de pointes and digoxin toxicity
name five Antiarrhythmic drugs in class II?
propanolol, esmolol, metoprolol, atenolol, timolol
name four HMG-CoA reductase inhibitors.
Lovastatin, Pravastatin, Simvastatin, Atorvastatin
name four Antiarrhythmic drugs in class IA.
Quinidine, Amiodarone, Procainamide, Disopyramide
name four Antiarrhythmic drugs in class III.
Sotalol, Ibutilide, Bretylium, Amiodarone
name three ACE inhibitors?
Captopril, Enalapril, Lisinopril
name three calcium channel blockers?
Nifedipine, Verapamil, Diltiazem
name three Antiarrhythmic drugs in class IB.
Lidocaine, Mexiletine, Tocainide
name three Antiarrhythmic drugs in class IC.
Flecainide, Encainide, Propafenone
name three Antiarrhythmic drugs in class IV.
Verapamil, Diltiazem, Bepridil
name three K+ sparing diuretics?
Spironolactone, Triamterene, Amiloride (the K+ STAys)
name two bile acid resins.
name two LPL stimulators.
Nifedipine has similar action to?
preferential action of the Ca2+ channel blockers at cardiac muscle?
cardiac muscle: Verapamil>Diltiazem>Nifedipine
preferential action of the Ca2+ channel blockers at vascular smooth muscle?
vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil
reversible SLE-like syndrome
cinchonism: HA, tinnitus, thrombocytopenia, torsade de pointes due to increased QT interval
Ryanodine- site of action?
blocks SR Ca2+ channels
torsade de pointes, excessive Beta block
competitive inhibirot of aldosterone in the cortical collecting tubule
thiazides- site of action?
distal convoluted tubule (early)
Triamterene and amiloride- mechanism?
block Na+ channels in the cortical collecting tubule
Verapamil has similar action to?
what two vasodilators require simultaneous treatment with beta blockers to prevent reflex tachycardia and diuretics to prevent salt retention?
Hydralazine and Minoxidil
which diuretics cause acidosis?
carbonic anhydrase inhibitors, K+ sparing diuretics
which diuretics cause alkalosis?
loop diuretics, thiazides
which diuretics decrease urine Ca2+?
which diuretics increase urine Ca2+?
loop diuretics, spironolactone
which diuretics increase urine K+?
all except the K+ sparing diuretics Spironolactone, Triamterene, Amiloride
which diuretics increase urine NaCl?
all of them
Acetaminophen has what two clinical uses and lacks what one clinical use of the NSAIDs?
Acetaminophen has antipyretic and analgesic properties, but lacks anti-inflammatory properties.
Can Heparin be used during pregnancy?
Yes, it does not cross the placenta.
Can Warfarin be used during pregnancy?
No, warfarin, unlike heparin, can cross the placenta.
Does Heparin have a long, medium, or short half life?
Does Warfarin have a long, medium, or short half life?
For Heparin what is the Structure
Large anionic polymer, acidic
For Heparin what is the Route of administration
Paranteral (IV, SC)
For Heparin what is the Onset of action
For Heparin what is the Mechanism of action
Activates antithrombin III
For Heparin what is the Duration of action
For Heparin what is the Ability to inhibit coagulation in vitro
For Heparin what is the Treatment for overdose
For Heparin what is the Lab value to monitor
aPTT (intrinsic pathway)
For Heparin what is the Site of action
For Warfarin what is the Structure
Small lipid-soluble molecule
For Warfarin what is the Route of administration
For Warfarin what is the Onset of action
Slow, limited by half lives of clotting factors
For Warfarin what is the Mechanism of action
Impairs the synthesis of vitamin K-dependent clotting factors
For Warfarin what is the Duration of action
Chronic (weeks or months)
For Warfarin what is the Ability to inhibit coagulation in vitro
For Warfarin what is the Treatment for overdose
IV vitamin K and fresh frozen plasma
For Warfarin what is the Lab value to monitor
For Warfarin what is the Site of action
Is toxicity rare or common whith Cromolyn used in Asthma prevention?
List five common glucocorticoids.
1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethasone
Secretion of what drug is inhibited by Probenacid used to treat chronic gout?
The COX-2 inhibitors (celecoxib, rofecoxib) have similar side effects to the NSAIDs with what one exception?
The COX-2 inhibitors should not have the corrosive effects of other NSAIDs on the gastrointestinal lining.
What are are the Sulfonylureas (general description) and what is their use?
Sulfonylureas are oral hypoglycemic agents, they are used to stimulate release of endogenous insulin in NIDDM (type-2).
What are five advantages of Oral Contraceptives (synthetic progestins, estrogen)?
1. Reliable (
What are five disadvantages of Oral Contraceptives (synthetic progestins, estrogen)?
1. Taken daily 2. No protection against STDs 3. Raises triglycerides 4. Depression, weight gain, nausea, HTN 5. Hypercoagulable state
What are five possible toxic effects of Aspirin therapy?
1. Gastric ulceration 2. Bleeding 3. Hyperventilation 4. Reye`s syndrome 5. Tinnitus (CN VIII)
What are five toxicities associated with Tacrolimus (FK506)?
1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.
What are four advantages of newer low-molecular-weight heparins (Enoxaparin)?
1. Better bioavailability 2. 2 to 4 times longer half life 3. Can be administered subcutaneously 4. Does not require laboratory monitoring
What are four clinical activities of Aspirin?
1. Antipyretic 2. Analgesic 3. Anti-inflammatory 4. Antiplatelet drug.
What are four clinical uses of glucocorticoids?
1. Addison`s disease 2. Inflammation 3. Immune suppression 4. Asthma
What are four conditions in which H2 Blockers are used clinically?
1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome
What are four H2 Blockers?
1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine
What are four Sulfonylureas?
1. Tolbutamide 2. Chlorpropamide 3. Glyburide 4. Glipizide
What are four thrombolytics?
1. Streptokinase 2. Urokinase 3. tPA (alteplase), APSAC (anistreplase)
What are four unwanted effects of Clomiphene use?
1. Hot flashes 2. Ovarian enlargement 3. Multiple simultaneous pregnancies 4. Visual disturbances
What are nine findings of Iatrogenic Cushing`s syndrome caused by glucocorticoid therapy?
1. Buffalo hump 2. Moon facies 3. Truncal obesity 4. Muscle wasting 5. Thin skin 6. Easy bruisability 7. Osteoporosis 8. Adrenocortical atrophy 9. Peptic ulcers
What are signs of Sildenafil (Viagra) toxicity?
Headache, flushing , dyspepsia, blue-green color vision.
What are the clinical uses for Ticlopidine, Clopidogrel?
Acute coronary syndrome; coronary stenting. Decreases the incidence or recurrence of thrombotic stroke.
What are the four conditions in which Omeprazole, Lansoprazole is used?
1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome
What are three clinical uses of the Leuprolide?
1. Infertility (pulsatile) 2. Prostate cancer (continuous: use with flutamide) 3. Uterine fibroids
What are three clinical uses of the NSAIDs?
1. Antipyretic 2. Analgesic 3. Anti-inflammatory
What are three common NSAIDS other than Aspirin?
Ibuprofen, Naproxen, and Indomethacin
What are three complications of Warfarin usage?
1. Bleeding 2. Teratogenicity 3. Drug-drug interactions
What are three possible complications of Heparin therapy?
1. Bleeding 2. Thrombocytopenia 3. Drug-drug interactions
What are three possible toxicities of NSAID usage?
1. Renal damage 2. Aplastic anemia 3. GI distress
What are three toxicities of Leuprolied?
1. Antiandrogen 2. Nausea 3. Vomiting
What are three toxicities of Propylthiouracil?
1. Skin rash 2. Agranulocytosis (rare) 3. Aplastic anemia
What are three types of antacids and the problems that can result from their overuse?
1. Aluminum hydroxide: constipation and hypophosphatemia 2. Magnesium hydroxide: diarrhea 3. Calcium carbonate: Hypercalcemia, rebound acid increase - All may cause hypokalemia
What are three unwanted effects of Mifepristone?
1. Heavy bleeding 2. GI effects (n/v, anorexia) 3. Abdominal pain
What are two Alpha-glucosidase inhibitors?
1. Acarbose 2. Miglitol
What are two clinical uses of Azathioprine?
1. Kidney transplantation 2. Autoimmune disorders (including glomerulonephritis and hemolytic anemia)
What are two conditions in which COX-2 inhibitors might be used?
Rheumatoid and osteoarthritis.
What are two Glitazones?
1. Pioglitazone 2. Rosiglitazone.
What are two mechanisms of action of Propythiouracil?
Inhibits organification and coupling of thyroid hormone synthesis. Also decreases peripheral conversion of T4 to T3.
What are two processes Corticosteroids inhibit leading to decreased inflammation?
1. Phospholipase A2 is prevented from releasing arachidonic acid 2. Decreases protein synthesis thus lowering amount of Cyclooxygenase enzymes
What are two toxicities associated with Cyclosporine?
1. Predisposes to viral infections and lymphoma 2. Nephrotoxic (preventable with mannitol diuresis)
What are two toxicities of the Glitazones?
1. Weight gain 2. Hepatotoxicity (troglitazone)
What are two toxicities of the Sulfonylureas?
1. Hypoglycemia (more common with 2nd-generation drugs: glyburide, glipizide) 2. Disulfiram-like effects (not seen with 2nd-generation drugs).
What are two types of drugs that interfere with the action of Sucralfate and why?
Sucralfate cannot work in the presence of antacids or H2 blockers because it requires an acidic environment to polymerize.
What can result due to antacid overuse?
Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.
What enzyme does Zileuton inhibit?
What enzymes are inhibited by NSAIDs, acetaminophen and COX II inhibitors?
Cyclooxygenases (COX I, COX II).
What is a common side effect of Colchicine used to treat acute gout, especially when given orally?
GI side effects. (Note: Indomethacin is less toxic, more commonly used.)
What is a common side effect of Misoprostol?
What is a possible result of overdose of Acetaminophen?
Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.
What is a possible toxicity of Alpha-glucosidase inhibitors used in type-2 diabetes?
What is a possible toxicity of Ticlopidine, Clopidogrel usage?
Neutropenia (ticlopidine); reserved for those who cannot tolerate aspirin.
What is a sign of toxicity with the use of thrombolytics?
What is action of insulin in the liver, in muscle, and in adipose tissue?
1. In liver, increases storage of glucose as glycogen. 2. In muscle, stimulates glycogen and protein synthesis, and K+ uptake. 3. In adipose tissue, facilitates triglyceride storage.
What is are two clinical uses of Cyclosporine?
1. Suppresses organ rejection after transplantation 2. Selected autoimmune disorders.
What is the category and mechanism of action of Zafirlukast in Asthma treatment?
Antileukotriene; blocks leukotriene receptors.
What is the category and mechanism of action of Zileuton in Asthma treatment?
Antileukotriene; blocks synthesis by lipoxygenase.
What is the category of drug names ending in -ane (e.g. Halothane)
Inhalational general anesthetic.
What is the category of drug names ending in -azepam (e.g. Diazepam)
What is the category of drug names ending in -azine (e.g. Chlorpromazine)
Phenothiazine (neuroleptic, antiemetic).
What is the category of drug names ending in -azol (e.g. Ketoconazole)
What is the category of drug names ending in -barbital (e.g. Phenobarbital)
What is the category of drug names ending in -caine (e.g. Lidocaine)
What is the category of drug names ending in -cillin (e.g. Methicillin)
What is the category of drug names ending in -cycline (e.g. Tetracycline)
Antibiotic, protein synthesis inhibitor.
What is the category of drug names ending in -ipramine (e.g. Imipramine)
What is the category of drug names ending in -navir (e.g. Saquinavir)
What is the category of drug names ending in -olol (e.g. Propranolol)
What is the category of drug names ending in -operidol (e.g. Haloperidol)
What is the category of drug names ending in -oxin (e.g. Digoxin)
Cardiac glycoside (inotropic agent).
What is the category of drug names ending in -phylline (e.g. Theophylline)
What is the category of drug names ending in -pril (e.g. Captopril)
What is the category of drug names ending in -terol (e.g. Albuterol)
What is the category of drug names ending in -tidine (e.g. Cimetidine)
What is the category of drug names ending in -triptyline (e.g. Amitriptyline)
What is the category of drug names ending in -tropin (e.g. Somatotropin)
What is the category of drug names ending in -zosin (e.g. Prazosin)
What is the category, desired effect, and adverse effect of Isoproterenol in the treatment of Asthma?
Nonspecific beta-agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Adverse effect is tachycardia (Beta 1).
What is the category, desired effect, and period of use of albuterol in the treatment of Asthma?
Beta 2 agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Use during acute exacerbation.
What is the category, desired effect, and possible mechanism of Theophylline in treating Asthma?
Methylzanthine; desired effect is bronchodilation, may cause bronchodilation by inhibiting phosphodiesterase, enzyme involved in degrading cAMP (controversial).
What is the category, mechanism of action, and effect of Ipratroprium in Asthma treatment?
Muscarinic antagonist; competatively blocks muscarinic receptors, preventing bronchoconstriction.
What is the category, mechanism of action, and particular use of beclomethasone and prednisone in Asthma treatment?
Corticosteroids; prevent production of leukotrienes from arachodonic acid by blocking phospholipase A2. Drugs of choice in a patient with status asthmaticus (in combination with albuterol.)
What is the category, method of use, and adverse effects of Salmeterol in Asthma treatment?
Beta 2 agonist; used as a long-acting agent for prophylaxis. Adverse effects are tremor and arrhythmia.
What is the clincial use for Misoprostol?
Prevention of NSAID-induced peptic ulcers, maintains a PDA.
What is the clinical use for Clomiphene?
Treatment of infertility.
What is the clinical use for Heparin?
Immediate anticoagulation for PE, stroke, angina, MI, DVT.
What is the clinical use for Sildenafil (Viagra)?
What is the clinical use for Sucralfate?
Peptic ulcer disease.
What is the clinical use for Warfarin?
What is the clinical use of Mifepristone (RU486)?
What is the clinical use of Tacrolimus (FK506)?
Potent immunosuppressive used in organ transplant recipients.
What is the effect of the Glitazones in diabetes treatment?
Increase target cell response to insulin.
What is the enzyme inhibited, the effect of this inhibition, and the clinical use of the antiandrogren Finasteride?
Finasteride inhibits 5 Alpha-reductase, this decreases the conversion of testosterone to dihydrotestosterone, useful in BPH
What is the lab value used to monitor the effectiveness of Heparin therapy?
What is the lab value used to monitor the effectiveness of Warfarin therapy?
What is the main clinical use for the thrombolytics?
Early myocardial infarction.
What is the mecanism of action of Sucralfate?
Aluminum sucrose sulfate polymerizes in the acid environment of the stomach and selectively binds necrotic peptic ulcer tissue. Acts as a barrier to acid, pepsin, and bile.
What is the mecanism of action of the COX-2 inhibitors (celecoxib, rofecoxib)?
Selectively inhibit cyclooxygenase (COX) isoform 2, which is found in inflammatory cells nad mediates inflammation and pain; spares COX-1 which helps maintain the gastric mucosa.
What is the mecanism of action, effective period, and ineffective period of use for Cromolyn in treating Asthma?
Prevents release of mediators from mast cells. Effective only for the prophylaxis of asthma. Not effective during an acute attack.
What is the mechanism of action and clinical use of the antiandrogen Flutamide?
Flutamide is a nonsteroidal competitive inhibitor of androgens at the testosterone receptor, used in prostate carcinoma.
What is the mechanism of action and clinical use of the antiandrogens Ketoconazole and Spironolactone?
Inhibit steroid synthesis, used in the treatment of polycystic ovarian syndrome to prevent hirsutism.
What is the mechanism of action of Acetaminophen?
Reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally.
What is the mechanism of action of Allopurinol used to treat chronic gout?
Inhibits xanthine oxidase, decresing conversion of xanthine to uric acid.
What is the mechanism of action of Aspirin?
Acetylates and irreversibly inhibits cyclooxygenase (COX I and COX II) to prevent the conversion of arachidonic acid to prostaglandins.
What is the mechanism of action of Clomiphene?
Clomiphene is a partial agonist at estrogen receptors in the pituitary gland. Prevents normal feedback inhibition and increses release of LH and FSHfrom the pituitary, which stimulates ovulation.
What is the mechanism of action of Colchicine used to treat acute gout?
Depolymerizes microtubules, impairing leukocyte chemotaxis and degranulation.
What is the mechanism of action of Cyclosporine?
Binds to cyclophilins (peptidyl proline cis-trans isomerase), blocking the differentiation and activation of T cells mainly by inhibiting the production of IL-2 and its receptor.
What is the mechanism of action of Heparin?
Heparin catalyzes the activation of antithrombin III.
What is the mechanism of action of Mifepristone (RU486)?
Competitive inibitor of progestins at progesterone receptors.
What is the mechanism of action of Misoprostol?
Misoprostol is a PGE1 analog that increases the production and secretion of the gastic mucous barrier.
What is the mechanism of action of NSAIDs other than Aspirin?
Reversibly inhibit cyclooxygenase (COX I and COX II). Block prostaglandin synthesis.
What is the mechanism of action of Omeprazole, Lansoprazole?
Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.
What is the mechanism of action of Probenacid used to treat chronic gout?
Inhibits reabsorption of uric acid.
What is the mechanism of action of Sildenafil (Viagra)?
Inhibits cGMP phosphodiesterase, casuing increased cGMP, smooth muscle relaxation in the corpus cavernosum, increased blood flow, and penile erection.
What is the mechanism of action of the Alpha-glucosidase inhibitors?
Inhibit intestinal bursh border Alpha-glucosidases; delayed hydrolysis of sugars and absorption of sugars leading to decresed postprandial hyperglycemia.
What is the mechanism of action of the glucocorticoids?
Decrease the production of leukotrienes and protaglandins by inhibiting phospholipase A2 and expression of COX-2.
What is the mechanism of action of the H2 Blockers?
Reversible block of histamine H2 receptors
What is the mechanism of action of the Sulfonylureas?
Close K+ channels in Beta-cell membrane leading to cell depolarization causing insulin release triggered by increase in Calcium ion influx.
What is the mechanism of action of the thrombolytics?
Directly of indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots. (It is claimed that tPA specifically converts fibrin-bound plasminogen to plasmin.)
What is the mechanism of action of Ticlopidine, Clopidogrel
Inhibits platelet aggregation by irreversibly inhibiting the ADP pathway involved in the binding of fibrinogen.
What is the mechanism of action of Warfarin (Coumadin)?
Warfarin interferes with the normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors II, VII, IX, and X, Protein C and S via vitamin K antagonism.
What is the mechanism of Azathioprine?
Antimetabolite derivative of 6-mercaptopurine that interferes with the metablolism and synthesis of nucleic acid.
What is the mechanism of Leuprolide?
GnRH analog with agonist properties when used in pulsatile fashion and antagonist properties when used in continuous fashion, causing a transient initial burst of LH and FSH
What is the mechanism of Tacrolimus (FK506)?
Similar to cyclosporine; binds to FK-binding protein, inhibiting secretion of IL-2 and other cytokines.
What is the memory key for the action of Sildenafil (Viagra)?
Sildenafil fills the penis
What is the memory key for the effect of aluminum hydroxide overuse?
AluMINIMUM amount of feces.
What is the memory key for the effect of magnesium hydroxide overuse?
Mg = Must go to the bathroom.
What is the memory key to remember which pathway (extrinsic vs. intrinsic) and which lab value Warfarin affects?
WEPT: Warfarin affects the Extrinsic pathway and prolongs the PT.
What is the possible mechanism and effect of Metformin in treating diabetes?
Mechanism unknown; possibly inhibits gluconeogenesis and increases glycolysis; effect is to decrease serum glucose levels
What is the specific clinical use of Indomethacin in neonates?
Indomethacin is used to close a patent ductus arteriosus.
What is used to reverse the action of Heparin?
Protamine Sulfate is used for rapid reversal of heparinization (positively charged molecule that binds to negatively charged heparin).
What patients are at risk for life threatening hypotension when taking Sildenafil (Viagra)?
Those patients who are taking nitrates.
What process does Zafirlukast interfere with?
Leukotrienes increasing bronchial tone.
What type of gout is treated with Allopurinol?
What type of gout is treated with Colchicine?
What type of gout is treated with Probenacid?
What type of patient should not take Misoprostol and why?
Misoprostol is contraindicated in women of childbearing potential because it is an abortifacient.
Which H2 Blocker has the most toxic effects and what are they?
Cimetidine is a potent inhibitor of P450; it also has an antiandrogenic effect and decreases renal excretion of creatinine. Other H2 blockers are relatively free of these effects.
Why are the Sulfonylureas inactive in IDDM (type-1)?
Because they require some residual islet function.