Pharmacology OLD Flashcards Preview

Step 1 > Pharmacology OLD > Flashcards

Flashcards in Pharmacology OLD Deck (500)
1

A common side effects of Interferon (INF) treatment is?

Neutropenia

2

Antimicrobial prophylaxis for a history of recurrent UTIs

TMP-SMZ

3

Antimicrobial prophylaxis for Gonorrhea

Ceftriaxone

4

Antimicrobial prophylaxis for Meningococcal infection

Rifampin (DOC), minocycline

5

Antimicrobial prophylaxis for PCP

TMP-SMZ (DOC), aerosolized pentamidine

6

Antimicrobial prophylaxis for Syphilis

Benzathine penicillin G

7

Are Aminoglycosides Teratogenic?

Yes

8

Are Ampicillin and Amoxicillin penicillinase resistant?

No

9

Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant?

No

10

Are Cephalosporins resistant to penicillinase?

No, but they are less susceptible than the other Beta lactams

11

Are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?

Yes

12

Clinical use of Isoniazid (INH)?

Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB

13

Common side effects associated with Clindamycin include?

Pseudomembranous colitis (C. difficile), fever, diarrhea

14

Common toxicities associated with Fluoroquinolones?

GI upset, Superinfections, Skin rashes, Headache, Dizziness

15

Common toxicities associated with Griseofulvin?

Teratogenic, Carcinogenic, Confusion, Headaches

16

Describe the MOA of Interferons (INF)

Glycoproteins from leukocytes that block various stages of viral RNA and DNA synthesis

17

Do Tetracyclines penetrate the CNS?

Only in limited amounts

18

Does Ampicillin or Amoxicillin have a greater oral bioavailability?

AmOxicillin has greater Oral bioavailability

19

Does Amprotericin B cross the BBB?

No

20

Does Foscarnet require activation by a viral kinase?

No

21

Foscarnet toxicity?

Nephrotoxicity

22

Ganciclovir associated toxicities?

Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity

23

How are Interferons (INF) used clinically?

Chronic Hepatitis A and B, Kaposi`s Sarcoma

24

How are Sulfonamides employed clinically?

Gram +, Gram -, Norcardia, Chlamydia

25

How are the HIV drugs used clinically?

Triple Therapy` 2 Nucleoside RT Inhibitors with a Protease Inhibitor

26

How are the Latent Hypnozoite (Liver) forms of Malaria (P. vivax, P.ovale) treated?

Primaquine

27

How can Isoniazid (INH)-induced neurotoxicity be prevented?

Pyridoxine (B6) administration

28

How can the t1/2 of INH be altered?

Fast vs. Slow Acetylators

29

How can the toxic effects of TMP be ameliorated?

With supplemental Folic Acid

30

How can Vancomycin-induced `Red Man Syndrome` be prevented?

Pretreat with antihistamines and a slow infusion rate

31

How do Sulfonamides act on bacteria?

As PABA antimetabolites that inhibit Dihydropteroate Synthase, Bacteriostatic

32

How do the Protease Inhibitors work?

Inhibt Assembly of new virus by Blocking Protease Enzyme

33

How does Ganciclovir`s toxicity relate to that of Acyclovir?

Ganciclovir is more toxic to host enzymes

34

How does resistance to Vancomycin occur?

With an amino acid change of D-ala D-ala to D-ala D-lac

35

How is Acyclovir used clinically?

HSV, VZV, EBV, Mucocutaneous and Genital Herpes Lesions, Prophylaxis in Immunocompromised pts

36

How is Amantadine used clinically?

Prophylaxis for Influenza A, Rubella; Parkinson`s disease

37

How is Amphotericin B administered for fungal meningitis?

Intrathecally

38

How is Amphotericin B used clinically?

Wide spectrum of systemic mycoses: Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor

39

How is Chloramphenical used clinically?

Meningitis (H. influenza, N. meningitidis, S. pneumoniae), Conserative treatment due to toxicities

40

How is Foscarnet used clinically?

CMV Retinitis in IC pts when Ganciclovir fails

41

How is Ganciclovir activated?

Phosphorylation by a Viral Kinase

42

How is Ganciclovir used clinically?

CMV, esp in Immunocompromised patients

43

How is Griseofulvin used clinically?

Oral treatment of superficial infections

44

How is Leishmaniasis treated?

Pentavalent Antimony

45

How is Ribavirin used clinically?

for RSV

46

How is Rifampin used clinically?

1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone when used of Leprosy 3. Used in combination with other drugs

47

How is Trimethoprim used clinically?

Used in combination therapy with SMZ to sequentially block folate synthesis

48

How is Vancomycin used clinically?

For serious, Gram + multidrug-resistant organisms

49

How would you treat African Trypanosomiasis (sleeping sickness)?

Suramin

50

In what population does Gray Baby Syndrome occur? Why?

Premature infants, because they lack UDP-glucuronyl transferase

51

Is Aztreonam cross-allergenic with penicillins?

No

52

Is Aztreonam resistant to penicillinase?

Yes

53

Is Aztreonam usually toxic?

No

54

Is Imipenem resistant to penicillinase?

Yes

55

Is Penicillin penicillinase resistant?

No - duh

56

IV Penicillin

Penicillin-G

57

Mnemonic for Foscarnet?

Foscarnet = pyroFosphate analog

58

MOA for Penicillin (3 answers)?

1)Binds penicillin-binding proteins 2) Blocks transpeptidase cross- linking of cell wall 3) Activates autolytic enzymes

59

MOA: Bactericidal antibiotics

Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole

60

MOA: Block cell wall synthesis by inhib. Peptidoglycan cross-linking (7)

Penicillin, Ampicillin, Ticarcillin, Pipercillin, Imipenem, Aztreonam, Cephalosporins

61

MOA: Block DNA topoisomerases

Quinolones

62

MOA: Block mRNA synthesis

Rifampin

63

MOA: Block nucleotide synthesis

Sulfonamides, Trimethoprim

64

MOA: Block peptidoglycan synthesis

Bacitracin, Vancomycin

65

MOA: Block protein synthesis at 30s subunit

Aminoglycosides, Tetracyclines

66

MOA: Block protein synthesis at 50s subunit

Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramins (quinupristin, dalfopristin)

67

MOA: Disrupt bacterial/fungal cell membranes

Polymyxins

68

MOA: Disrupt fungal cell membranes

Amphotericin B, Nystatin, Fluconazole/azoles

69

Name common Polymyxins

Polymyxin B, Polymyxin E

70

Name several common Macrolides (3)

Erythromycin, Azithromycin, Clarithromycin

71

Name some common Sulfonamides (4)

Sulfamethoxazole (SMZ), Sulfisoxazole, Triple sulfas, Sulfadiazine

72

Name some common Tetracyclines (4)

Tetracycline, Doxycycline, Demeclocycline, Minocycline

73

Name the common Aminoglycosides (5)

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

74

Name the common Azoles

Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole

75

Name the common Fluoroquinolones (6)

Ciprofloxacin, Norfloxacin, Ofloxacin, Grepafloxacin, Enoxacin, Nalidixic acid

76

Name the common Non-Nucleoside Reverse Transcriptase Inhibitors

Nevirapine, Delavirdine

77

Name the common Nucleoside Reverse Transcriptase Inhibitors

Zidovudine (AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudine (3TC)

78

Name the Protease Inhibitors (4)

Saquinavir, Ritonavir, Indinavir, Nelfinavir

79

Name two classes of drugs for HIV therapy

Protease Inhibitors and Reverse Transcriptase Inhibitors

80

Name two organisms Vancomycin is commonly used for?

Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis)

81

Oral Penicillin

Penicillin-V

82

Resistance mechanisms for Aminoglycosides

Modification via Acetylation, Adenylation, or Phosphorylation

83

Resistance mechanisms for Cephalosporins/Penicillins

Beta-lactamase cleavage of Beta-lactam ring

84

Resistance mechanisms for Chloramphenicol

Modification via Acetylation

85

Resistance mechanisms for Macrolides

Methylation of rRNA near Erythromycin`s ribosome binding site

86

Resistance mechanisms for Sulfonamides

Altered bacterial Dihydropteroate Synthetase, Decreased uptake, or Increased PABA synthesis

87

Resistance mechanisms for Tetracycline

Decreased uptake or Increased transport out of cell

88

Resistance mechanisms for Vancomycin

Terminal D-ala of cell wall replaced with D-lac; Decreased affinity

89

Side effects of Isoniazid (INH)?

Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome

90

Specifically, how does Foscarnet inhibit viral DNA pol?

Binds to the Pyrophosphate Binding Site of the enzyme

91

The MOA for Chloramphenicol is?

Inhibition of 50S peptidyl transferase, Bacteriostatic

92

Toxic effects of TMP include?

Megaloblastic anemia, Leukopenia, Granulocytopenia

93

Toxic side effects of the Azoles?

Hormone synthesis inhibition (Gynecomastia), Liver dysfunction (Inhibits CYP450), Fever, Chills

94

Toxicities associated with Acyclovir?

Delirium, Tremor, Nephrotoxicity

95

What additional side effects exist for Ampicillin?

Rash, Pseudomembranous colitis

96

What antimicrobial class is Aztreonam syngergestic with?

Aminoglycosides

97

What are Amantadine-associated side effects?

Ataxia, Dizziness, Slurred speech

98

What are Aminoglycosides synergistic with?

Beta-lactam antibiotics

99

What are Aminoglycosides used for clinically?

Severe Gram - rod infections.

100

What are common serious side effects of Aminoglycosides and what are these associated with?

Nephrotoxicity (esp. with Cephalosporins), Ototoxicity (esp. with Loop Diuretics)

101

What are common side effects of Amphotericin B?

Fever/Chills, Hypotension, Nephrotoxicity, Arrhythmias

102

What are common side effects of Protease Inhibitors?

GI intolerance (nausea, diarrhea), Hyperglycemia, Lipid abnormalities, Thrombocytopenia (Indinavir)

103

What are common side effects of RT Inhibitors?

BM suppression (neutropenia, anemia), Peripheral neuropathy

104

What are common toxicities associated with Macrolides? (4)

GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes

105

What are common toxicities associated with Tetracyclines?

GI distress, Tooth discoloration and Inhibition of bone growth in children, Fanconi`s syndrome, Photosensitivity

106

What are common toxicities related to Vancomycin therapy?

Well tolerated in general but occasionally, Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing=`Red Man Syndrome`

107

What are Fluoroquinolones indicated for? (3)

1.Gram - rods of the Urinary and GI tracts (including Pseudomonas) 2.Neisseria 3. Some Gram + organisms

108

What are major side effects of Methicillin, Nafcillin, and Dicloxacillin?

Hypersensitivity reactions

109

What are Methicillin, Nafcillin, and Dicloxacillin used for clinically?

Staphlococcus aureus

110

What are Polymyxins used for?

Resistant Gram - infections

111

What are the Anti-TB drugs?

Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH)

112

What are the clinical indications for Azole therapy?

Systemic mycoses

113

What are the clinical uses for 1st Generation Cephalosporins?

Gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK)

114

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 )

115

What are the clinical uses for 3rd Generation Cephalosporins?

1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB)

116

What are the clinical uses for Aztreonam?

Gram - rods: Klebsiella species, Pseudomonas species, Serratia species

117

What are the clinical uses for Imipenem/cilastatin?

Gram + cocci, Gram - rods, and Anerobes

118

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)

119

What are the major toxic side effects of Imipenem/cilastatin?

GI distress, Skin rash, and Seizures at high plasma levels

120

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)

121

What are the side effects of Polymyxins?

Neurotoxicity, Acute renal tubular necrosis

122

What are the side effects of Rifampin?

Minor hepatotoxicity, Drug interactions (activates P450)

123

What are toxic side effects for Metronidazole?

Disulfiram-like reaction with EtOH, Headache

124

What are toxicities associated with Chloramphenicol?

Aplastic anemia (dose independent), Gray Baby Syndrome

125

What conditions are treated with Metronidazole?

Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella vaginalis), Trichomonas

126

What do Aminoglycosides require for uptake?

Oxygen

127

What do you treat Nematode/roundworm (pinworm, whipworm) infections with?

Mebendazole/Thiabendazole, Pyrantel Pamoate

128

What drug is given for Pneumocystis carinii prophylaxis?

Pentamidine

129

What drug is used during the pregnancy of an HIV+ mother?, Why?

AZT, to reduce risk of Fetal Transmission

130

What drug is used to treat Trematode/fluke (e.g., Schistosomes, Paragonimus, Clonorchis) or Cysticercosis

Praziquantel

131

What is a common drug interaction associated with Griseofulvin?

Increases coumadin metabolism

132

What is a mnemonic to remember Amantadine`s function?

Blocks Influenza A and RubellA; causes problems with the cerebellA

133

What is a prerequisite for Acyclovir activation?

It must be Phosphorylated by Viral Thymidine Kinase

134

What is a Ribavirin toxicity?

Hemolytic anemia

135

What is an acronym to remember Anti-TB drugs?

RESPIre

136

What is an additional side effect of Methicillin?

Interstitial nephritis

137

What is an occasional side effect of Aztreonam?

GI upset

138

What is Clindamycin used for clinically?

Anaerobic infections (e.g., B. fragilis, C. perfringens)

139

What is clinical use for Carbenicillin, Piperacillin, and Ticarcillin?

Pseudomonas species and Gram - rods

140

What is combination TMP-SMZ used to treat?

Recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia

141

What is combined with Ampicillin, Amoxicillin, Carbenicillin, Piperacillin, and Ticarcillin to enhance their spectrum?

Clavulanic acid

142

What is Fluconazole specifically used for?

Cryptococcal meningitis in AIDS patients and Candidal infections of all types

143

What is Imipenem always administered with?

Cilastatin

144

What is Ketoconazole specifically used for?

Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism

145

What is Metronidazole combined with for `triple therapy`? Against what organism?

Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori

146

What is Metronidazole used for clinically?

Antiprotozoal: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis Anaerobes: Bacteroides, Clostridium

147

What is Niclosamide used for?

Cestode/tapeworm (e.g., D. latum, Taenia species Except Cysticercosis

148

What is Nifurtimox administered for?

Chagas` disease, American Trypanosomiasis (Trypanosoma cruzi)

149

What is the chemical name for Ganciclovir?

DHPG (dihydroxy-2-propoxymethyl guanine)

150

What is the clinical use for Ampicillin and Amoxicillin?

Extended spectrum penicillin: certain Gram + bacteria and Gram - rods

151

What is the clinical use for Nystatin?

Topical and Oral, for Oral Candidiasis (Thrush)

152

What is the clinical use for Penicillin?

Bactericidal for: Gram + rod and cocci, Gram - cocci, and Spirochetes

153

What is the major side effect for Ampicillin and Amoxicillin?

Hypersensitivity reactions

154

What is the major side effect for Carbenicillin, Piperacillin, and Ticarcillin?

Hypersensitivity reactions

155

What is the major toxic side effect of Penicillin?

Hypersensitivity reactions

156

What is the memory aid for subunit distribution of ribosomal inhibitors?

Buy AT 30, CELL at 50`

157

What is the memory key for Isoniazid (INH) toxicity?

INH: Injures Neurons and Hepatocytes

158

What is the memory key for Metronidazole`s clinical uses?

GET on the Metro

159

What is the memory key for organisms treated with Tetracyclines?

VACUUM your Bed Room`

160

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

161

What is the MOA for Acyclovir?

Inhibit viral DNA polymerase

162

What is the MOA for Amphotericin B?

Binds Ergosterol, forms Membrane Pores that Disrupt Homeostatis

163

What is the MOA for Ampicillin and Amoxicillin?

Same as penicillin. Extended spectrum antibiotics

164

What is the MOA for Carbenicillin, Piperacillin, and Ticarcillin?

Same as penicillin. Extended spectrum antibiotics

165

What is the MOA for Clindamycin?

Blocks Peptide Bond formation at the 50S subunit, Bacteriostatic

166

What is the MOA for Methicillin, Nafcillin, and Dicloxacillin?

Same as penicillin. Act as narrow spectrum antibiotics

167

What is the MOA for Metronidazole?

Forms toxic metabolites in the bacterial cell, Bactericidal

168

What is the MOA for Nystatin?

Binds ergosterol, Disrupts fungal membranes

169

What is the MOA for Rifampin?

Inhibits DNA dependent RNA polymerase

170

What is the MOA for the Aminoglycosides?

Inhibits formation of Initiation Complex, causes misreading of mRNA, Bactericidal

171

What is the MOA for the Azoles?

Inhibit Ergosterol synthesis

172

What is the MOA for the Cephalosporins?

Beta lactams - inhibit cell wall synthesis, Bactericidal

173

What is the MOA for the Fluoroquinolones?

Inhibit DNA Gyrase (topoisomerase II), Bactericidal

174

What is the MOA for the Macrolides?

Blocks translocation, binds to the 23S rRNA of the 50S subunit, Bacteriostatic

175

What is the MOA for the Tetracyclines?

Binds 30S subunit and prevents attachment of aminoacyl-tRNA, Bacteriostatic

176

What is the MOA for Trimethoprim (TMP)?

Inhibits bacterial Dihydrofolate Reductase, Bacteriostatic

177

What is the MOA for Vancomycin?

Inhibits cell wall mucopeptide formation, Bactericidal

178

What is the MOA of Amantadine?

Blocks viral penetration/uncoating; may act to buffer the pH of the endosome

179

What is the MOA of Aztreonam?

Inhibits cell wall synthesis ( binds to PBP3). A monobactam

180

What is the MOA of Foscarnet?

Inhibits Viral DNA polymerase

181

What is the MOA of Ganciclovir?

Inhibits CMV DNA polymerase

182

What is the MOA of Griseofulvin?

Interferes with microtubule function, disrupts mitosis, inhibits growth

183

What is the MOA of Imipenem?

Acts as a wide spectrum carbapenem

184

What is the MOA of Isoniazid (INH)?

Decreases synthesis of Mycolic Acid

185

What is the MOA of Polymyxins?

Bind cell membrane, disrupt osmotic properties, Are Cationc, Basic and act as detergents

186

What is the MOA of Ribavirin?

Inhibits IMP Dehydrogenase (competitively), and therefore blocks Guanine Nucleotide synthesis

187

What is the MOA of the RT Inhibitors?

Inhibit RT of HIV and prevent the incorporation of viral genome into the host DNA

188

What is the most common cause of Pt noncompliance with Macrolides?

GI discomfort

189

What is treated with Chloroquine, Quinine, Mefloquine?

Malaria (P. falciparum)

190

What microorganisms are Aminoglycosides ineffective against?

Anaerobes

191

What microorganisms are clinical indications for Tetracycline therapy?

Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borrelia burgdorferi (Lyme`s) Rickettsia Tularemia

192

What microorganisms is Aztreonam not effective against?

Gram + and Anerobes

193

What musculo-skeletal side effects in Adults are associated with Floroquinolones?

Tendonitis and Tendon rupture

194

What neurotransmitter does Amantadine affect? How does it influence this NT?

Dopamine; causes its release from intact nerve terminals

195

What organism is Imipenem/cilastatin the Drug of Choice for?

Enterobacter

196

What organisms does Griseofulvin target?

Dermatophytes (tinea, ringworm)

197

What parasites are treated with Pyrantel Pamoate (more specific)?

Giant Roundworm (Ascaris), Hookworm (Necator/Ancylostoma), Pinworm (Enterobius)

198

What parasitic condition is treated with Ivermectin?

Onchocerciasis (`river blindness`--rIVER-mectin)

199

What populations are Floroquinolones contraindicated in? Why?

Pregnant women, Children; because animal studies show Damage to Cartilage

200

What should not be taken with Tetracyclines? / Why?

Milk or Antacids, because divalent cations inhibit Tetracycline absorption in the gut

201

What Sulfonamides are used for simple UTIs?

Triple sulfas or SMZ

202

When is HIV therapy initiated?

When pts have Low CD4+ (

203

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

204

Where does Griseofulvin deposit?

Keratin containing tissues, e.g., nails

205

Which Aminoglycoside is used for Bowel Surgery ?

Neomycin

206

Which antimicrobial classes inhibit protein synthesis at the 30S subunit? (2)

1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic

207

Which antimicrobials inhibit protein synthesis at the 50S subunit? (4)

1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic

208

Which individuals are predisposed to Sulfonamide-induced hemolysis?

G6PD deficient individuals

209

Which RT inhibitor causes Megaloblastic Anemia?

AZT

210

Which RT inhibitors cause a Rash?

Non-Nucleosides

211

Which RT inhibitors cause Lactic Acidosis?

Nucleosides

212

Which Tetracycline is used in patients with renal failure? / Why?

Doxycycline, because it is fecally eliminated

213

Why are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?

Due to the presence of a bulkier R group

214

Why is Cilastatin administered with Imipenem?

To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the renal tubules

215

List the mechanism, clinical use, & toxicity of 5 FU.

-S-phase anti-metabolite Pyr analogue -Colon, solid tumors, & BCC/ -Irreversible myelosuppression

216

List the mechanism, clinical use, & toxicity of 6 MP.

-inhibits HGPRT (pur. Syn.) - Luk, Lymph,

217

List the mechanism, clinical use, & toxicity of Cisplatin.

-Alkalating agent -testicular,bladder,ovary,& lung -Nephrotoxicity & CN VIII damage.

218

List the mechanism, clinical use, & toxicity of Cyclophosphamide.

-Alkalating agent -NHL, Breast, ovary, & lung. - Myelosuppression, & hemorrhagic cystitis.

219

List the mechanism, clinical use, & toxicity of Doxorubicin.

-DNA intercalator -Hodgkin`s, myeloma, sarcoma, and solid tumors -Cardiotoxicity & alopecia

220

List the mechanism, clinical use, & toxicity of Etoposide.

-Topo II inhibitor(GII specific) -Oat cell of Lung & prostate, & testicular -Myelosuppression & GI irritation.

221

List the mechanism, clinical use, & toxicity of Methotrexate.

-S-phase anti-metabolite folate analogue -Luk, Lymp, sarc, RA, & psoriasis / -Reversible myelosuppression

222

List the mechanism, clinical use, & toxicity of Prednisone.

-Triggers apoptosis -CLL, Hodgkin`s in MOPP -Cushing-like syndrome

223

List the mechanism, clinical use, & toxicity of Vincristine.

-MT polymerization inhibitor(M phase) -MOPP, lymphoma, Willm`s & choriocarcinoma -neurotoxicity and myelosuppression

224

Which cancer drugs inhibit nucleotide synthesis(3)?

- Methotrexate - 5 FU - 6 mercaptopurine

225

ACE inhibitors- clinical use?

hypertension, CHF, diabetic renal disease

226

ACE inhibitors- mechanism?

reduce levels of Angiotensin II, thereby preventing the inactivation of bradykinin (a potent vasodilator); renin level is increased

227

ACE inhibitors- toxicity?

fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)

228

Acetazolamide- clinical uses?

glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness

229

Acetazolamide- mechanism?

acts at the proximal convoluted tubule to inhibit carbonic anhydrase. Causes self-limited sodium bicarb diuresis and reduction of total body bicarb stores.

230

acetazolamide- site of action?

proximal convoluted tubule

231

Acetazolamide- toxicity?

hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy

232

Acetazolamide causes?

ACIDazolamide` causes acidosis

233

Adenosine- clinical use?

DOC in diagnosing and abolishing AV nodal arrhythmias

234

ADH antagonists- site of action?

collecting ducts

235

adverse effect of Nitroprusside?

cyanide toxicity (releases CN)

236

adverse effects of beta-blockers?

impotence, asthma, CV effects (bradycardia, CHF, AV block), CNS effects (sedation, sleep alterations)

237

adverse effects of Captopril?

fetal renal toxicity, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)

238

adverse effects of Clonidine?

dry mouth, sedation, severe rebound hypertension

239

adverse effects of ganglionic blockers?

severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

240

adverse effects of Guanethidine?

orthostatic and exercise hypotension, sexual dysfunction, diarrhea

241

adverse effects of Hydralazine?

nausea, headache, lupus-like syndrome, reflex tachycardia, angina, salt retention

242

adverse effects of Hydrochlorothiazide?

hypokalemia, slight hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyperglycemia

243

adverse effects of Loop Diuretics?

K+ wasting, metabolic alkalosis, hypotension, ototoxicity

244

adverse effects of Losartan?

fetal renal toxicity, hyperkalemia

245

adverse effects of Methyldopa?

sedation, positive Coombs` test

246

adverse effects of Minoxidil?

hypertrichosis, pericardial effusion, reflex tachycardia, angina, salt retention

247

adverse effects of Nifedipine, verapamil?

dizziness, flushing, constipation (verapamil), nausea

248

adverse effects of Prazosin?

first dose orthostatic hypotension, dizziness, headache

249

adverse effects of Reserpine?

sedation, depression, nasal stuffiness, diarrhea

250

Amiodarone- toxicity?

pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits resulting in photodermatitis, neurologic effects, consitpation, CV (bradycardia, heart block, CHF), and hypo- or hyperthyroidism.

251

Beta Blockers- CNS toxicity?

sedation, sleep alterations

252

Beta Blockers- CV toxicity?

bradycardia, AV block, CHF

253

Beta Blockers- site of action?

Beta adrenergic receptors and Ca2+ channels (stimulatory)

254

Beta Blockers- BP?

decrease

255

Bretyllium- toxicity?

new arrhythmias, hypotension

256

Ca2+ channel blockers- clinical use?

hypertension, angina, arrhythmias

257

Ca2+ channel blockers- mechanism?

block voltage dependent L-type Ca2+ channels of cardiac and smooth muscle- decreasing contractility

258

Ca2+ channel blockers- site of action?

Cell membrane Ca2+ channels of cardiac sarcomere

259

Ca2+ channel blockers- toxicity?

cardiac depression, peripheral edema, flushing, dizziness, constipation

260

Ca2+ sensitizers`- site of action?

troponin-tropomyosin system

261

Cautions when using Amiodarone?

check PFTs, LFTs, and TFTs

262

Antiarrhythmic class IA effects?

increased AP duration, increased ERP increased QT interval. Atrial and ventricular.

263

Antiarrhythmic class IB- clinical uses?

post MI and digitalis induced arrhythmias

264

Antiarrhythmic class IB- effects?

decrease AP duration, affects ischemic or depolarized Purkinje and ventricular system

265

Antiarrhythmic class IB- toxicity?

local anesthetic. CNS stimulation or depression. CV depression.

266

Antiarrhythmic class IC- effects?

NO AP duration effect. useful in V-tach that progresses to V-fib and in intractable SVT LAST RESORT

267

Antiarrhythmic class IC- toxicity?

proarrhythmic

268

Antiarrhythmic class II- effects?

decrease the slope of phase 4, increase PR interval (the AV node is particularly sensitive)

269

Antiarrhythmic class II- mechanism?

blocking the beta adrenergic receptor leads to decreased cAMP, and decreased Ca2+ flux

270

Antiarrhythmic class II- toxicity?

impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemia

271

Antiarrhythmic Class III- effects?

increase AP duration, increase ERP, increase QT interval, for use when other arrhythmics fail

272

Antiarrhythmic class IV- clinical use?

prevention of nodal arrhythmias (SVT)

273

Antiarrhythmic class IV- effects?

decrease conduction velocity, increase ERP, increase PR interval

274

Antiarrhythmic class IV- primary site of action?

AV nodal cells

275

Antiarrhythmic class IV- toxicity?

constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression), and torsade de pointes (Bepridil)

276

classes of antihypertensive drugs?

diuretics, sympathoplegics, vasodilators, ACE inhibitors, Angiotensin II receptor inhibitors

277

decrease Digitoxin dose in renal failure?

NO

278

decrease Digoxin dose in renal failure?

YES

279

Digitalis- site of action?

Na/K ATPase

280

Digoxin v. Digitoxin: bioavailability?

Digitoxin>95% Digoxin 75%

281

Digoxin v. Digitoxin: excretion?

Digoxin=urinary Digitoxin=biliary

282

Digoxin v. Digitoxin: half life?

Digitoxin 168hrs Digoxin 40 hrs

283

Digoxin v. Digitoxin: protein binding?

Digitoxin 70% Digoxin 20-40%

284

Esmolol- short or long acting?

very short acting

285

Ethacrynic Acid- clinical use?

Diuresis in pateints with sulfa allergy

286

Ethacrynic Acid- mechanism?

not a sulfonamide, but action is the same as furosemide

287

Ethacrynic Acid- toxicity?

NO HYPERURICEMIA, NO SULFA ALLERGY; same as furosemide otherwise

288

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.

289

Furosemide- clinical use?

edematous states (CHF, cirrhosis, nephrotic syndrome, pulm edema), HTN, hypercalcemia

290

Furosemide- toxicity? (OH DANG)

Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout

291

Furosemide increases the excretion of what ion?

Ca2+ (Loops Lose calcium)

292

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

293

Hydralazine- class and mechanism?

vasodilator- increases cGMP to induce smooth muscle relaxation (arterioles>veins; afterload reduction)

294

Hydralazine- clinical use?

severe hypertension, CHF

295

Hydralazine- toxicity?

compensatory tachycardia, fluid retention, lupus-like syndrome

296

Hydrochlorothiazide- clinical use?

HTN, CHF, calcium stone formation, nephrogenic DI.

297

Hydrochlorothiazide- mechanism?

Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion.

298

Hydrochlorothiazide- toxicity? (hyperGLUC, plus others)

Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia, sulfa allergy.

299

Ibutilide- toxicity?

torsade de pointes

300

K+- clinical use?

depresses ectopic pacemakers, especially in digoxin toxicity

301

K+ sparing diuretics- clinical use?

hyperaldosteronism, K+ depletion, CHF

302

K+ sparing diuretics- site of action?

cortical collecting tubule

303

K+ sparing diuretics- toxicity?

hyperkalemia, endocrine effects (gynecomastia, anti-androgen)

304

loop diuretics (furosemide)- site of action?

thick ascending limb

305

Mannitol- clinical use?

ARF, shock, drug overdose, decrease intracranial/intraocular pressure

306

Mannitol- contraindications?

anuria, CHF

307

Mannitol- mechanism?

osmotic diuretic- increase tubular fluid osmolarity, thereby increasing urine flow

308

mannitol- site of action?

proximal convoluted tubule, thin descending limb, and collecting duct

309

Mannitol- toxicity?

pulmonary edema, dehydration

310

Mg+- clinical use?

effective in torsade de pointes and digoxin toxicity

311

name five Antiarrhythmic drugs in class II?

propanolol, esmolol, metoprolol, atenolol, timolol

312

name four HMG-CoA reductase inhibitors.

Lovastatin, Pravastatin, Simvastatin, Atorvastatin

313

name four Antiarrhythmic drugs in class IA.

Quinidine, Amiodarone, Procainamide, Disopyramide

314

name four Antiarrhythmic drugs in class III.

Sotalol, Ibutilide, Bretylium, Amiodarone

315

name three ACE inhibitors?

Captopril, Enalapril, Lisinopril

316

name three calcium channel blockers?

Nifedipine, Verapamil, Diltiazem

317

name three Antiarrhythmic drugs in class IB.

Lidocaine, Mexiletine, Tocainide

318

name three Antiarrhythmic drugs in class IC.

Flecainide, Encainide, Propafenone

319

name three Antiarrhythmic drugs in class IV.

Verapamil, Diltiazem, Bepridil

320

name three K+ sparing diuretics?

Spironolactone, Triamterene, Amiloride (the K+ STAys)

321

name two bile acid resins.

cholestyramine, colestipol

322

name two LPL stimulators.

Gemfibrozil, Clofibrate

323

Nifedipine has similar action to?

Nitrates

324

preferential action of the Ca2+ channel blockers at cardiac muscle?

cardiac muscle: Verapamil>Diltiazem>Nifedipine

325

preferential action of the Ca2+ channel blockers at vascular smooth muscle?

vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil

326

Procainamide- toxicity?

reversible SLE-like syndrome

327

Quinidine- toxicity?

cinchonism: HA, tinnitus, thrombocytopenia, torsade de pointes due to increased QT interval

328

Ryanodine- site of action?

blocks SR Ca2+ channels

329

Sotalol- toxicity?

torsade de pointes, excessive Beta block

330

Spironolactone- mechanism?

competitive inhibirot of aldosterone in the cortical collecting tubule

331

thiazides- site of action?

distal convoluted tubule (early)

332

Triamterene and amiloride- mechanism?

block Na+ channels in the cortical collecting tubule

333

Verapamil has similar action to?

Beta Blockers

334

what two vasodilators require simultaneous treatment with beta blockers to prevent reflex tachycardia and diuretics to prevent salt retention?

Hydralazine and Minoxidil

335

which diuretics cause acidosis?

carbonic anhydrase inhibitors, K+ sparing diuretics

336

which diuretics cause alkalosis?

loop diuretics, thiazides

337

which diuretics decrease urine Ca2+?

thiazides, amiloride

338

which diuretics increase urine Ca2+?

loop diuretics, spironolactone

339

which diuretics increase urine K+?

all except the K+ sparing diuretics Spironolactone, Triamterene, Amiloride

340

which diuretics increase urine NaCl?

all of them

341

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.

342

Can Heparin be used during pregnancy?

Yes, it does not cross the placenta.

343

Can Warfarin be used during pregnancy?

No, warfarin, unlike heparin, can cross the placenta.

344

Does Heparin have a long, medium, or short half life?

Short.

345

Does Warfarin have a long, medium, or short half life?

Long.

346

For Heparin what is the Structure

Large anionic polymer, acidic

347

For Heparin what is the Route of administration

Paranteral (IV, SC)

348

For Heparin what is the Onset of action

Rapid (seconds)

349

For Heparin what is the Mechanism of action

Activates antithrombin III

350

For Heparin what is the Duration of action

Acute (hours)

351

For Heparin what is the Ability to inhibit coagulation in vitro

Yes

352

For Heparin what is the Treatment for overdose

Protamine sulfate

353

For Heparin what is the Lab value to monitor

aPTT (intrinsic pathway)

354

For Heparin what is the Site of action

Blood

355

For Warfarin what is the Structure

Small lipid-soluble molecule

356

For Warfarin what is the Route of administration

Oral

357

For Warfarin what is the Onset of action

Slow, limited by half lives of clotting factors

358

For Warfarin what is the Mechanism of action

Impairs the synthesis of vitamin K-dependent clotting factors

359

For Warfarin what is the Duration of action

Chronic (weeks or months)

360

For Warfarin what is the Ability to inhibit coagulation in vitro

No

361

For Warfarin what is the Treatment for overdose

IV vitamin K and fresh frozen plasma

362

For Warfarin what is the Lab value to monitor

PT

363

For Warfarin what is the Site of action

Liver

364

Is toxicity rare or common whith Cromolyn used in Asthma prevention?

Rare.

365

List five common glucocorticoids.

1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethasone

366

Secretion of what drug is inhibited by Probenacid used to treat chronic gout?

Penicillin.

367

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.

368

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).

369

What are five advantages of Oral Contraceptives (synthetic progestins, estrogen)?

1. Reliable (

370

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

371

What are five possible toxic effects of Aspirin therapy?

1. Gastric ulceration 2. Bleeding 3. Hyperventilation 4. Reye`s syndrome 5. Tinnitus (CN VIII)

372

What are five toxicities associated with Tacrolimus (FK506)?

1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.

373

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

374

What are four clinical activities of Aspirin?

1. Antipyretic 2. Analgesic 3. Anti-inflammatory 4. Antiplatelet drug.

375

What are four clinical uses of glucocorticoids?

1. Addison`s disease 2. Inflammation 3. Immune suppression 4. Asthma

376

What are four conditions in which H2 Blockers are used clinically?

1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome

377

What are four H2 Blockers?

1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine

378

What are four Sulfonylureas?

1. Tolbutamide 2. Chlorpropamide 3. Glyburide 4. Glipizide

379

What are four thrombolytics?

1. Streptokinase 2. Urokinase 3. tPA (alteplase), APSAC (anistreplase)

380

What are four unwanted effects of Clomiphene use?

1. Hot flashes 2. Ovarian enlargement 3. Multiple simultaneous pregnancies 4. Visual disturbances

381

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

382

What are signs of Sildenafil (Viagra) toxicity?

Headache, flushing , dyspepsia, blue-green color vision.

383

What are the clinical uses for Ticlopidine, Clopidogrel?

Acute coronary syndrome; coronary stenting. Decreases the incidence or recurrence of thrombotic stroke.

384

What are the four conditions in which Omeprazole, Lansoprazole is used?

1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome

385

What are three clinical uses of the Leuprolide?

1. Infertility (pulsatile) 2. Prostate cancer (continuous: use with flutamide) 3. Uterine fibroids

386

What are three clinical uses of the NSAIDs?

1. Antipyretic 2. Analgesic 3. Anti-inflammatory

387

What are three common NSAIDS other than Aspirin?

Ibuprofen, Naproxen, and Indomethacin

388

What are three complications of Warfarin usage?

1. Bleeding 2. Teratogenicity 3. Drug-drug interactions

389

What are three possible complications of Heparin therapy?

1. Bleeding 2. Thrombocytopenia 3. Drug-drug interactions

390

What are three possible toxicities of NSAID usage?

1. Renal damage 2. Aplastic anemia 3. GI distress

391

What are three toxicities of Leuprolied?

1. Antiandrogen 2. Nausea 3. Vomiting

392

What are three toxicities of Propylthiouracil?

1. Skin rash 2. Agranulocytosis (rare) 3. Aplastic anemia

393

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

394

What are three unwanted effects of Mifepristone?

1. Heavy bleeding 2. GI effects (n/v, anorexia) 3. Abdominal pain

395

What are two Alpha-glucosidase inhibitors?

1. Acarbose 2. Miglitol

396

What are two clinical uses of Azathioprine?

1. Kidney transplantation 2. Autoimmune disorders (including glomerulonephritis and hemolytic anemia)

397

What are two conditions in which COX-2 inhibitors might be used?

Rheumatoid and osteoarthritis.

398

What are two Glitazones?

1. Pioglitazone 2. Rosiglitazone.

399

What are two mechanisms of action of Propythiouracil?

Inhibits organification and coupling of thyroid hormone synthesis. Also decreases peripheral conversion of T4 to T3.

400

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

401

What are two toxicities associated with Cyclosporine?

1. Predisposes to viral infections and lymphoma 2. Nephrotoxic (preventable with mannitol diuresis)

402

What are two toxicities of the Glitazones?

1. Weight gain 2. Hepatotoxicity (troglitazone)

403

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).

404

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.

405

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.

406

What enzyme does Zileuton inhibit?

Lipoxygenase

407

What enzymes are inhibited by NSAIDs, acetaminophen and COX II inhibitors?

Cyclooxygenases (COX I, COX II).

408

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.)

409

What is a common side effect of Misoprostol?

Diarrhea

410

What is a possible result of overdose of Acetaminophen?

Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.

411

What is a possible toxicity of Alpha-glucosidase inhibitors used in type-2 diabetes?

GI disturbances.

412

What is a possible toxicity of Ticlopidine, Clopidogrel usage?

Neutropenia (ticlopidine); reserved for those who cannot tolerate aspirin.

413

What is a sign of toxicity with the use of thrombolytics?

Bleeding.

414

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.

415

What is are two clinical uses of Cyclosporine?

1. Suppresses organ rejection after transplantation 2. Selected autoimmune disorders.

416

What is the category and mechanism of action of Zafirlukast in Asthma treatment?

Antileukotriene; blocks leukotriene receptors.

417

What is the category and mechanism of action of Zileuton in Asthma treatment?

Antileukotriene; blocks synthesis by lipoxygenase.

418

What is the category of drug names ending in -ane (e.g. Halothane)

Inhalational general anesthetic.

419

What is the category of drug names ending in -azepam (e.g. Diazepam)

Benzodiazepine.

420

What is the category of drug names ending in -azine (e.g. Chlorpromazine)

Phenothiazine (neuroleptic, antiemetic).

421

What is the category of drug names ending in -azol (e.g. Ketoconazole)

Antifungal.

422

What is the category of drug names ending in -barbital (e.g. Phenobarbital)

Babiturate.

423

What is the category of drug names ending in -caine (e.g. Lidocaine)

Local anesthetic.

424

What is the category of drug names ending in -cillin (e.g. Methicillin)

Penicillin.

425

What is the category of drug names ending in -cycline (e.g. Tetracycline)

Antibiotic, protein synthesis inhibitor.

426

What is the category of drug names ending in -ipramine (e.g. Imipramine)

Tricyclic antidepressant.

427

What is the category of drug names ending in -navir (e.g. Saquinavir)

Protease inhibitor.

428

What is the category of drug names ending in -olol (e.g. Propranolol)

Beta antagonist.

429

What is the category of drug names ending in -operidol (e.g. Haloperidol)

Butyrophenone (neuroleptic).

430

What is the category of drug names ending in -oxin (e.g. Digoxin)

Cardiac glycoside (inotropic agent).

431

What is the category of drug names ending in -phylline (e.g. Theophylline)

Methylxanthine.

432

What is the category of drug names ending in -pril (e.g. Captopril)

ACE inhibitor.

433

What is the category of drug names ending in -terol (e.g. Albuterol)

Beta-2 agonist.

434

What is the category of drug names ending in -tidine (e.g. Cimetidine)

H2 antagonist

435

What is the category of drug names ending in -triptyline (e.g. Amitriptyline)

Tricyclic antidepressant.

436

What is the category of drug names ending in -tropin (e.g. Somatotropin)

Pituitary hormone.

437

What is the category of drug names ending in -zosin (e.g. Prazosin)

Alpha-1 antagonist

438

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).

439

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.

440

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).

441

What is the category, mechanism of action, and effect of Ipratroprium in Asthma treatment?

Muscarinic antagonist; competatively blocks muscarinic receptors, preventing bronchoconstriction.

442

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.)

443

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.

444

What is the clincial use for Misoprostol?

Prevention of NSAID-induced peptic ulcers, maintains a PDA.

445

What is the clinical use for Clomiphene?

Treatment of infertility.

446

What is the clinical use for Heparin?

Immediate anticoagulation for PE, stroke, angina, MI, DVT.

447

What is the clinical use for Sildenafil (Viagra)?

Erectile dysfunction.

448

What is the clinical use for Sucralfate?

Peptic ulcer disease.

449

What is the clinical use for Warfarin?

Chronic anticoagulation.

450

What is the clinical use of Mifepristone (RU486)?

Abortifacient.

451

What is the clinical use of Tacrolimus (FK506)?

Potent immunosuppressive used in organ transplant recipients.

452

What is the effect of the Glitazones in diabetes treatment?

Increase target cell response to insulin.

453

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

454

What is the lab value used to monitor the effectiveness of Heparin therapy?

The PTT.

455

What is the lab value used to monitor the effectiveness of Warfarin therapy?

The PT.

456

What is the main clinical use for the thrombolytics?

Early myocardial infarction.

457

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.

458

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.

459

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.

460

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.

461

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.

462

What is the mechanism of action of Acetaminophen?

Reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally.

463

What is the mechanism of action of Allopurinol used to treat chronic gout?

Inhibits xanthine oxidase, decresing conversion of xanthine to uric acid.

464

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.

465

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.

466

What is the mechanism of action of Colchicine used to treat acute gout?

Depolymerizes microtubules, impairing leukocyte chemotaxis and degranulation.

467

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.

468

What is the mechanism of action of Heparin?

Heparin catalyzes the activation of antithrombin III.

469

What is the mechanism of action of Mifepristone (RU486)?

Competitive inibitor of progestins at progesterone receptors.

470

What is the mechanism of action of Misoprostol?

Misoprostol is a PGE1 analog that increases the production and secretion of the gastic mucous barrier.

471

What is the mechanism of action of NSAIDs other than Aspirin?

Reversibly inhibit cyclooxygenase (COX I and COX II). Block prostaglandin synthesis.

472

What is the mechanism of action of Omeprazole, Lansoprazole?

Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.

473

What is the mechanism of action of Probenacid used to treat chronic gout?

Inhibits reabsorption of uric acid.

474

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.

475

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.

476

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.

477

What is the mechanism of action of the H2 Blockers?

Reversible block of histamine H2 receptors

478

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.

479

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.)

480

What is the mechanism of action of Ticlopidine, Clopidogrel

Inhibits platelet aggregation by irreversibly inhibiting the ADP pathway involved in the binding of fibrinogen.

481

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.

482

What is the mechanism of Azathioprine?

Antimetabolite derivative of 6-mercaptopurine that interferes with the metablolism and synthesis of nucleic acid.

483

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

484

What is the mechanism of Tacrolimus (FK506)?

Similar to cyclosporine; binds to FK-binding protein, inhibiting secretion of IL-2 and other cytokines.

485

What is the memory key for the action of Sildenafil (Viagra)?

Sildenafil fills the penis

486

What is the memory key for the effect of aluminum hydroxide overuse?

AluMINIMUM amount of feces.

487

What is the memory key for the effect of magnesium hydroxide overuse?

Mg = Must go to the bathroom.

488

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.

489

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

490

What is the specific clinical use of Indomethacin in neonates?

Indomethacin is used to close a patent ductus arteriosus.

491

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).

492

What patients are at risk for life threatening hypotension when taking Sildenafil (Viagra)?

Those patients who are taking nitrates.

493

What process does Zafirlukast interfere with?

Leukotrienes increasing bronchial tone.

494

What type of gout is treated with Allopurinol?

Chronic gout.

495

What type of gout is treated with Colchicine?

Acute gout.

496

What type of gout is treated with Probenacid?

Chronic gout.

497

What type of patient should not take Misoprostol and why?

Misoprostol is contraindicated in women of childbearing potential because it is an abortifacient.

498

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.

499

Why are the Sulfonylureas inactive in IDDM (type-1)?

Because they require some residual islet function.

500

How do you treat coma in the ER (4)?

-Airway -Breathing -Circulation -Dextrose (thiamine & narcan) -ABCD