USMLE First Aid 2013 Pharm w/antibios Flashcards Preview

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Flashcards in USMLE First Aid 2013 Pharm w/antibios Deck (401):
1

Nitrates (mechanism, use, toxicity)

Cause NO release -> vasodilation (veins >>> arteries); used in angina; fast tolerance, hypotension, flushing, headache Pharmacology Cardio

1

Adverse effects of statins

Hepatoxicity and muscle breakdown Pharmacology Cardio

2

Niacin (mechanism, use, toxicity)

Inhibits lipolysis and reduces VLDL secretion, lowering LDL and raising HDL; hyperlipidemia; flushing and hyperuricemia Pharmacology Cardio

3

Cholestyramine, colestipol, colesevelam (mechanism, use, toxicity)

Inhibits reabsorption of bile acids -> lower LDL with slight increase in HDL; unpigmented gallbladder stones and malabsorption Pharmacology Cardio

4

Ezetimibe

Prevents cholesterol reabsorption -> lower LDL Pharmacology Cardio

5

Fibrates (gemfibrozil + -fibrates) (mechanism, use, toxicity)

Upregulates LPL -> lower triglycerides, slightly inc. HDL and slightly dec. LDL; myositis and hepatoxicity Pharmacology Cardio

6

Digoxin and digitoxin (mechanism, use, toxicity)

Inhibits Na/K ATPase -> indirectly inhibits Na/Ca exchanger -> inc. calcium levels -> inc. contractility; stimulates the vagus; causes cholinergic symptoms and hyperkalemia Pharmacology Cardio

7

Class 1A antiarrhythmics

Quinidine, procainamide, and disopyramide; inc. AP duration and QT interval; can cause torsades de pointes, cinchonism (qunidine), procainamide (drug-induced lupus) Pharmacology Cardio

8

Class 1B antiarrhythmics

Lidocaine, mexiletine, and tocainide; dec. AP duration especially in depolarized/ischemia tissue; best following MI Pharmacology Cardio

9

Class 1C antiarrhythmics

Flecainide, propafenone; no effect on AP, used in ventricular tachycardias; do not use post-MI due to risk for arrhythmias Pharmacology Cardio

10

Class 1 antiarrhythmics (general mechanism and toxicity)

Blocks Na channels, decreasing the slope of phase 0 depolarization; toxicity exacerbated by hyperkalemia Pharmacology Cardio

11

Class 2 antiarrhythmics

Beta-blockers; reduces cAMP, slowing SA and AV node activity, increases PR interval; adverse effects include impotence, asthma exacerbation, sedation Pharmacology Cardio

12

Class 3 antiarrhythmics

Amiodarone, ibutilide, dofetilide, sotalol; K channel blockers; inc. AP duration and QT interval Pharmacology Cardio

13

Toxicity of amiodarone

Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction Pharmacology Cardio

14

Class 4 antiarrhythmics

Ca channel blockers; verapamil and diltiazem; dec. conduction velocity and inc. PR interval; cause constipation, flushing, and edema Pharmacology Cardio

15

Adeosine (mechanism, use, toxicity)

Inc. K efflux, hyperpolarizing the cell; used in supraventricular tachycardias; can cause flushing, hypotension, and chest pain Pharmacology Cardio

16

Magnseium (mechanism, use, toxicity)

Used in torsades de pointes and digoxin toxicity Pharmacology Cardio

17

Treatment for prolactinoma

Bromocriptine or cabergoline (dopamine agonists) Pharmacology Endocrine

18

Treatment of secondary hyperaldosteronism

Spironolactone (or other AT2 antagonist) Pharmacology Endocrine

19

Treatment of carcinoid syndrome

Octreotide (somatostatin analogues) Pharmacology Endocrine

20

Rapid-acting insulins (3)

Lispro, aspart, and glulisine Pharmacology Endocrine

21

Short-acting insulin (1)

Regular Pharmacology Endocrine

22

Intermediate-acting insulin (1)

NPH Pharmacology Endocrine

23

Long-acting insulins (2)

Glargine and detemir Pharmacology Endocrine

24

Metformin (mechanism, use, toxicity)

Biguanide; unknown mechanism; increases insulin sensitivity and glycolysis and decreases gluconeogenesis; can cause lactic acidosis (don't use in renal failure patients) Pharmacology Endocrine

25

Tolbutamide, chlorpropamide (mechanism, use, toxicity)

First-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes disulfuram-like effects Pharmacology Endocrine

26

Glyburide, glimepiride, glipizide (mechanism, use, toxicity)

Second-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes hypoglycemia Pharmacology Endocrine

27

Pioglitazone, rosiglitazone (mechanism, use, toxicity)

Thiazolidinediones; activates PPAR-gamma, increasing insulin sensitivity and adiponectin levels; causes weight gain, hepatotoxicity, and heart failure Pharmacology Endocrine

28

Acarbose, miglitol (mechanism, use, toxicity)

Alpha-glucosidase inhibitors; prevent sugar hydrolysis and absorption, reducing blood sugar levels Pharmacology Endocrine

29

Pramlintide (mechanism, use, toxicity)

Amylin analog; reduces glucagon secretion; causes hypoglycemia Pharmacology Endocrine

30

Exenatide, liraglutide (mechanism, use, toxicity)

GLP-1 analogues; increase insulin, decrease glucagon secretion; causes pancreatitis Pharmacology Endocrine

31

Linagliptin, saxagliptin, sitagliptin (mechanism, use, toxicity)

DPP-4 inhibitors; increase insulin, decrease glucagon secretion; causes mild urinary/respiratory infections Pharmacology Endocrine

32

Propylthiouracil (mechanism, use, toxicity)

Blocks thyroid peroxidase and 5'-deiodinase; used to treat hyperthyroidism; causes agranulocytosis, aplastic anemia, hepatotoxicity Pharmacology Endocrine

33

Methimazole (mechanism, use, toxicity)

Blocks thyroid peroxidase; used to treat hyperthyrodism; teratogenic Pharmacology Endocrine

34

Levothyroxine, triiodothyronine (mechanism, use, toxicity)

Thyroid hormone analogs; causes thyrotoxicosis Pharmacology Endocrine

35

Oxytocin (mechanism, use, toxicity)

Used to control uterine hemhorrage Pharmacology Endocrine

36

Demeclocycline (mechanism, use, toxicity)

ADH antagonist used to treat SIADH; can cause photosensitivty and bone/teeth abnormalities Pharmacology Endocrine

37

Glucocorticoids (mechanism, use, toxicity)

Inhibits phospholipase A2 activity and expression of COX-2; used for immune suppression; can cause Cushing's syndrome, adrenal insufficiency (if withdrawn quickly) Pharmacology Endocrine

38

Cimetidine and ranitidine (mechanism, use, toxicity)

H2 antagonists; used to treat hyperchloridia; cimeditine is a P-450 inhibitor and has antiandrogenic effects, both reduce creatinine secretion Pharmacology GI

39

#NAME?

Irreversibly inhibit the H/K pump; used to treat hyperchloridia; increased risk of C. difficile infection and hypomagnesemia Pharmacology GI

40

Bismuth, sucralfate (mechanism, use, toxicity)

Coats ulcer base and protects underlying tissue Pharmacology GI

41

Misoprostol (mechanism, use, toxicity)

PGE1 analog that decreases acid production and increases bicarb production; used to prevent NSAID ulcers; abortifacient Pharmacology GI

42

Octreotide (mechanism, use, toxicity)

Somatostatin analog; used to treat VIPoma and carcinoid syndrome Pharmacology GI

43

Toxicity of long-term antacid use

Hypokalemia Pharmacology GI

44

Infliximab (mechanism, use, toxicity)

Anti-TNF; used to treat IBD and RA; can cause activation of latent microbes Pharmacology GI

45

Sulfasalazine (mechanism, use, toxicity)

Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory); used to treat IBD; causes oligospermia Pharmacology GI

46

Ondansetron (mechanism, use, toxicity)

5-HT3 antagonist; used as an antiemetic Pharmacology GI

47

Metoclopramide (mechanism, use, toxicity)

D2 antagonist; used to increase gut muscle activity and as an antiemetic; causes parkinson signs Pharmacology GI

48

Can be used to prevent mast cell degranulation

Cromolyn sodium Pharmacology Heme/Onc

49

Treatment of lead poisoning

Dimercaprol and EDTA, succimer in kids Pharmacology Heme/Onc

50

Heparin (mechanism, use, toxicity)

Activates antithrombin, which inactivates thrombin and Xa; used for immediate coagulation and in pregnant women; some patients develop antibodies to platelet factor 4 (HIT) Pharmacology Heme/Onc

51

Enoxaparin, dalteparin (mechanism, use, toxicity)

Same actions as heparin, but has a longer half-life, does not have to be monitored as closely, and has a reduced risk of HIT Pharmacology Heme/Onc

52

Warfarin (mechanism, use, toxicity)

Inactivated gamma-carboxylation of factors II, VII, IX, X, C, and S; used for long-term and non-immediate anticoagulation; can cause tissue necrosis, teratogenic Pharmacology Heme/Onc

53

Alteplase, reteplase, tenecteplase (mechanism, use, toxicity)

Converts plasminogen to plasmin; used as a thrombolytic Pharmacology Heme/Onc

54

Aspirin (mechanism, use, toxicity)

Irreversibly inhibits COX-1 and COX-2; anti-platelet and anti-inflammatory; gastric ulcers, tinnitus, Reye's syndrome in childhood viral infections Pharmacology Heme/Onc

55

Clopidogrel, ticlodipine, prasugrel, ticagrelor (mechanism, use, toxicity)

Irreversibly blocks ADP receptors on platelets, preventing degranulation; used for acure coronary syndrome; ticlodipine causes neutropenia Pharmacology Heme/Onc

56

Cilostazol, dipyridamole (mechanism, use, toxicity)

Phosphodiesterase inhibitor, increases cAMP and decreases ADP, preventing platelet degranulation; nausea, headache, facial flushing, hypotension Pharmacology Heme/Onc

57

Abciximab, eptifibatide, tirofiban (mechanism, use, toxicity)

GPIIb/IIIa inhibitors, preventing platelet aggregation; bleeding, thrombocytopenia Pharmacology Heme/Onc

58

Methotrexate (mechanism, use, toxicity)

Inhibits dihydrofolate reductase, inhibiting DNA synthesis; myelosuppression, macrovesicular fatty change in liver Pharmacology Heme/Onc

59

5-fluorouracil (mechanism, use, toxicity)

Pyrimidine analog that is activated and inhibits thymidylate synthase, inhibiting DNA synthesis; myelosuppression, photosensitivity Pharmacology Heme/Onc

60

Cytarabine (mechanism, use, toxicity)

Pyrimidine analog that inhibits DNA polymerase; leukopenia, thrombocytopenia, megaloblastic anemia Pharmacology Heme/Onc

61

Azathioprine, 6-mercaptopurine, 6-thioguanine (mechanism, use, toxicity)

Purine analogs that are activated by HGPRT and inhibit purine synthesis; toxicity is increased with allopurinol, causes bone marrow, GI, and liver toxicity Pharmacology Heme/Onc

62

Dactinomycin (actinomycin D) (mechanism, use, toxicity)

DNA intercalator; used for childhood tumors; myelosuppression Pharmacology Heme/Onc

63

Doxorubicin (Adriamycin), daunorubicin (mechanism, use, toxicity)

Generates free radicals that cause DNA strand breaks; dilated cardiomyopathy, myelosuppression, alopecia Pharmacology Heme/Onc

64

Bleomycin (mechanism, use, toxicity)

Generates free radicals that cause DNA strand breaks; pulmonary fibrosis with minimal myelosuppression Pharmacology Heme/Onc

65

Cyclophosphamide, ifosfamide (mechanism, use, toxicity)

Crosslinks DNA (must be activated by liver); myelosuppression, hemhorragic cystitis (can be minimized with mesna) Pharmacology Heme/Onc

66

Carmustine, lomustine, semustine, streptozocin (mechanism, use, toxicity)

Used to treat CNS tumors Pharmacology Heme/Onc

67

Busulfan (mechanism, use, toxicity)

Alkylates DNA; pulmonary fibrosis, hyperpigmentation Pharmacology Heme/Onc

68

Vincristine, vinblastine (mechanism, use, toxicity)

Block microtubule polymerization; vincristine causes neurotoxicity, vinblastine causes bone marro suppression Pharmacology Heme/Onc

69

Paclitaxel (mechanism, use, toxicity)

Blocks microtubule breakdown; myelosuppression Pharmacology Heme/Onc

70

Cisplatin, carboplatin (mechanism, use, toxicity)

Crosslinks DNA; nephrotoxicity (minimize with chloride diuresis, amifostine), acoustic n. damage Pharmacology Heme/Onc

71

Etoposide, teniposide (mechanism, use, toxicity)

Inhibits topoisomerase II; myelosuppression, GI upset, alopecia Pharmacology Heme/Onc

72

Hydroxyurea (mechanism, use, toxicity)

Inhibits ribonucleotide reductase; used in cancers and HbSS disease; bone marrow suppression Pharmacology Heme/Onc

73

Prednisone (mechanism, use, toxicity)

Unknown but may trigger apoptosis in dividing cells; Cushingoid symptoms Pharmacology Heme/Onc

74

Tamoxifen, raloxifene (mechanism, use, toxicity)

Prevents estrogen receptor binding; used in breast cancer and prevention of osteoporosis; tamoxifen increases the risk of endometrial cancer due to agonist effects Pharmacology Heme/Onc

75

Trastuzumab (mechanism, use, toxicity)

Antibody against HER-2 receptor; cardiotoxicity Pharmacology Heme/Onc

76

Imatinib (mechanism, use, toxicity)

Antibody against bcr-abl tyrosine kinase Pharmacology Heme/Onc

77

Rituximab (mechanism, use, toxicity)

Antibody against CD20; used to treat non-Hodgkin's lymphoma and rheumatoid arthritis Pharmacology Heme/Onc

78

Vemurafenib (mechanism, use, toxicity)

B-raf kinase inhibitor (V600 mutation); used in metastatic melanoma Pharmacology Heme/Onc

79

Bevacizumab (mechanism, use, toxicity)

Antibody against VEGF Pharmacology Heme/Onc

80

Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac (mechanism, use, toxicity)

Reversible COX inhibitor; gastric ulcers, renal ischemia (due to constriction of afferent arteriole) Pharmacology Musculoskeletal

81

Celecoxib (mechanism, use, toxicity)

Reversible COX-2 inhibitor; anti-inflammatory without damage to gastric mucosa; sulfa allergy, thrombosis Pharmacology Musculoskeletal

82

Acetominophen (mechanism, use, toxicity)

COX inhibitor in the CNS (not anti-inflammatory); causes hepatic necrosis Pharmacology Musculoskeletal

83

Alendronate (mechanism, use, toxicity)

Pyrophosphate analog that inhibits osteoclasts; used to treat osteoporosis, hypercalcemia, and Paget's disease; corrosive esophagitis Pharmacology Musculoskeletal

84

Allopurinol (mechanism, use, toxicity)

Xanthine oxidase inhibitor, reduces production of uric acid Pharmacology Musculoskeletal

85

Febuxostat (mechanism, use, toxicity)

Xanthine oxidase inhibitor Pharmacology Musculoskeletal

86

Probenecid (mechanism, use, toxicity)

Inhibits reabsorption of uric acid in PCT Pharmacology Musculoskeletal

87

Colchine (mechanism, use, toxicity)

Inhibits microtubule polymerization, preventing neutrophil extravasation Pharmacology Musculoskeletal

88

Etanercept (mechanism, use, toxicity)

TNF-alpha receptor that binds free TNF-alpha Pharmacology Musculoskeletal

89

Infliximab, adalimumab (mechanism, use, toxicity)

Anti-TNF-alpha antibody Pharmacology Musculoskeletal

90

Latanoprost (mechanism, use, toxicity)

PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris Pharmacology Neurology

91

Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity)

Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis Pharmacology Neurology

92

Butorphanol (mechanism, use, toxicity)

Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full agonist Pharmacology Neurology

93

Tramadol (mechanism, use, toxicity)

Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures Pharmacology Neurology

94

First-line therapy for simple partial seizures

Carbamazepine Pharmacology Neurology

95

First-line therapy for complex partial seizures

Carbamazepine Pharmacology Neurology

96

First-line therapies for tonic-clonic seizures (3)

Carbamazepine, phenytoin, valproate Pharmacology Neurology

97

First-line therapy for absence seizures

Ethosuximide Pharmacology Neurology

98

Phenytoin (mechanism, use, toxicity)

Increases Na channel inactivation and inhibits glutamate release; used for simple, complex, and tonic-clonic seizures and status epilecticus prophylaxis; nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenic, drug-induced lupus, P450 inducer Pharmacology Neurology

99

Carbamazepine (mechanism, use, toxicity)

Increases Na channel inactivation; first-line for simple, complex, and tonic-clonic seizures and trigeminal neuralgia; agranulocytosis, aplastic anemia, P450 inducer, SIADH, liver toxicity Pharmacology Neurology

100

Lamotrigine (mechanism, use, toxicity)

Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome Pharmacology Neurology

101

Gabapentin (mechanism, use, toxicity)

Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia Pharmacology Neurology

102

Topiramate (mechanism, use, toxicity)

Blocks Na channels and increases GABA secretion; used for simple, complex, and tonic-clonic seizures and migraine prevention; mental dulling, kidney stones, weight loss Pharmacology Neurology

103

Phenobarbital (mechanism, use, toxicity)

Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer Pharmacology Neurology

104

Valproate (mechanism, use, toxicity)

Increases Na channel inactivation and increases GABA levels; first-line for tonic-clonic seizures, used for simplex, complex, tonic-clonic, and myoclonic seizures; hepatotoxicity, neural tube defects, weight gain, tremor Pharmacology Neurology

105

Ethosuximide (mechanism, use, toxicity)

Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome Pharmacology Neurology

106

Benzodiazepines (mechanism, use, toxicity)

Increases frequency of GABA channel opening; first-line for status epilepticus (diazepam, lorazepam), used for eclampsia seizures (diazepam, lorazepam), anxiety, alcohol withdrawl, sleep walking, night terrors; sedation Pharmacology Neurology

107

Tiagabine (mechanism, use, toxicity)

Inhibits GABA reuptake; used for simple and complex seizures Pharmacology Neurology

108

Vigabatrin (mechanism, use, toxicity)

Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex seizures Pharmacology Neurology

109

Levetriacetam (mechanism, use, toxicity)

Unknown mechanism; used for simple, complex, and tonic-clonic seizures Pharmacology Neurology

110

Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity)

Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias Pharmacology Neurology

111

Triazolam, oxazepam, midazolam (mechanism, use, toxicity)

Short-acting benzodiazepines; more addictive potential Pharmacology Neurology

112

Barbituates vs. benzodiazepines (mechanism)

Increase duration vs. increase frequency Pharmacology Neurology

113

Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity)

BZ1 subtype GABA channel agonists; used to treat insomnia Pharmacology Neurology

114

Ketamine (mechanism, use, toxicity)

Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams Pharmacology Neurology

115

Order of sensory loss when using local anesthetics

Pain -> temperature -> touch -> pressure Pharmacology Neurology

116

Succinylcholine (mechanism, use, toxicity)

ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia Pharmacology Neurology

117

Tubocurarine, -curium drugs (mechanism, use, toxicity)

ACh antagonists; used as paralytics Pharmacology Neurology

118

Dantrolene (mechanism, use, toxicity)

Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome Pharmacology Neurology

119

Levodopa/carbidopa (mechanism, use, toxicity)

Converted to dopamine by dopa decarboxylase in CNS/inhibits peripheral dopa decarboxylase activity; used to treat parkinson symptoms; can cause arrhythmias and "on/off" phenomenon Pharmacology Neurology

120

Selegiline (mechanism, use, toxicity)

MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa Pharmacology Neurology

121

Donepezil, galantamine, rivastigmine (mechanism, use, toxicity)

ACh esterase inhibitors; used to treat Alzheimer's disease; cholinergic symptoms Pharmacology Neurology

122

Sumatriptan (mechanism, use, toxicity)

Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm Pharmacology Neurology

123

Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)

High potency antipsychotics that antagonize D2 receptors; used to treat schizoprehnia, psychosis, mania, and Tourette's; hyperprolactinemia, anti-cholinergic symptoms (dry mouth, constipation), extrapyramidal effects (dyskinesia), neuroleptic malignany syndrome, tardive dyskinesia (haloperidol) Pharmacology Psychiatry

124

Chlorpromazine, thioridazine (mechanism, use, toxicity)

Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette's; corneal deposits (chlorpromazine), retinal desporits (thioridazine) Pharmacology Psychiatry

125

Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity)

Atypical antipsychotics with unknown mechnism; used for schizophrenia, bipolar disorder, OCD, and others; weight gain (olanzapine, clozapine), agranulocytosis (clozapine), seizures (clozapine), prolonged QT (ziprasidone) Pharmacology Psychiatry

126

Lithium (mechanism, use, toxicity)

Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism, polyuria Pharmacology Psychiatry

127

Buspirone (mechanism, use, toxicity)

Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement Pharmacology Psychiatry

128

Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity)

Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures) Pharmacology Psychiatry

129

Venlafaxine, duloxetine (mechanism, use, toxicity)

Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension Pharmacology Psychiatry

130

-iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity)

TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects Pharmacology Psychiatry

131

Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity)

Inhibit breakdown of NE, serotonin, and dopamine; used for atypical depression, anxiety, and hypochondriasis; hypertensive crisis (tyramine in wine/cheese), don't use with other serotonin agonists Pharmacology Psychiatry

132

Bupropion (mechanism, use, toxicity)

Increases NE and dopamine; used for smoking sensation, depression; seizures Pharmacology Psychiatry

133

Mirtazapine (mechanism, use, toxicity)

Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain; Pharmacology Psychiatry

134

Maprotiline (mechanism, use, toxicity)

Blocks NE reuptake; used for depression; sedation, hypotension Pharmacology Psychiatry

135

Trazodone (mechanism, use, toxicity)

Inhibits serotonin uptake; used for insomnia; pripism Pharmacology Psychiatry

136

Mannitol (mechanism, use, toxicity)

Osmotic diuretic; used to treat drug overdose and increased ICP; pulmonary edema, CHF Pharmacology Renal

137

Acetazolamide (mechanism, use, toxicity)

Carbonic anhydrase inhibitor; used for glaucoma, metabolic alklalosis; hyperchloremic metabolic acidosis, ammonia toxicity, sulfa allergy Pharmacology Renal

138

Furosemide (mechanism, use, toxicity)

Inhibits NKCC channel, preventing urine concentration; used in hypertension, CHF, hypercalcemia; ototoxicity, hypokalemia, hypocalcemia, nephritis, gout, sulfa allergy Pharmacology Renal

139

Ethacrynic acid (mechanism, use, toxicity)

Inhibits NKCC channel; used in patients with furosemide (sulfa) allergy; hyperuricemia Pharmacology Renal

140

Hydrochlorothiazide (mechanism, use, toxicity)

Inhibits NaCl reabsorption in DCT and increases Ca reabsorption; hypertension and hypercalcinuria; hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy Pharmacology Renal

141

Spironolactone, eplerenone (mechanism, use, toxicity)

Aldosterone receptor antagonists; hyperaldosteronism, CHF, hypokalemia; hyperkalemia (arrhythmias), antiandrogen effects with spironolactone Pharmacology Renal

142

Triamterene, amiloride (mechanism, use, toxicity)

Block sodium channels in cortical collecting duct; hyperaldosteronism, CHF Pharmacology Renal

143

Captopril, enalapril, lisinopril (mechanism, use, toxicity)

ACE inhibitor, leads to reduced angiotensin II levels and decreases GFR; prevents heart remodeling, hypertension, CHF; cough, angioedema, transient creatinine increase, hyperkalemia Pharmacology Renal

144

Losartan, valsartan (mechanism, use, toxicity)

Angiotensin II receptor antagonists; similar to ACE inhibitors, but do not cause cough due to normal metabolism of bradykinin Pharmacology Renal

145

Leuprolide (mechanism, use, toxicity)

GnRH analog that acts as an agonist in pulsatile doses and an antagonist in continuous doses; used as an agonist for infertility and an antagonist for prostate cancer, fibroids, and precocious puberty; antiandrogenic Pharmacology Reproductive

146

Finasteride (mechanism, use, toxicity)

5-alpha reductase inhibitor; used for BPH and male-pattern baldness Pharmacology Reproductive

147

Flutamide (mechanism, use, toxicity)

Testosterone receptor antagonist; used in prostate cancer Pharmacology Reproductive

148

Ketoconazole (mechanism, use, toxicity)

Inhibits 17,20-desmolase, stopping sex steroid synthesis; used to treat polycystic ovarian syndrome Pharmacology Reproductive

149

Clomiphene (mechanism, use, toxicity)

Partial estrogen agonist in the hypothalamus, increases release of LH and FSH, stimulating ovulation; used for infertility and PCOS Pharmacology Reproductive

150

Tamoxifen (mechanism, use, toxicity)

Estrogen receptor antagonist at the breast; used for breast cancer; partial agonist at the uterus, can cause endometrial hyperplasia Pharmacology Reproductive

151

Raloxifene (mechanism, use, toxicity)

Estrogen receptor agonist at bone, inhibits osteoclast activity and stimulates osteoblast activity; used to treat osteoporosis Pharmacology Reproductive

152

Anastrozole, exemestane (mechanism, use, toxicity)

Aromatase inhibitors; used in breast cancer Pharmacology Reproductive

153

Mifepristone (mechanism, use, toxicity)

Progesterone receptor antagonist, given with misoprostol for abortion; abortifacient; bleeding, abdominal pain Pharmacology Reproductive

154

Terbutaline (mechanism, use, toxicity)

Beta-2 agonist, inhibits uterine contractions Pharmacology Reproductive

155

Tamsulosin (mechanism, use, toxicity)

Alpha-1 antagonist; used to treat BPH Pharmacology Reproductive

156

Sildenafil, vardenafil (mechanism, use, toxicity)

Phosphodiesterase 5 inhibitors, causing inc. cGMP levels and smooth muscle relaxation; used in erectile dysfunction; impaired blue-green vision, contradindicated with nitrates Pharmacology Reproductive

157

Danazol (mechanism, use, toxicity)

Partial androgen receptor agonist; used to treat endometriosis and hereditary angioedema; weight gain, acne, hirsutism, low HDL, hepatoxicity Pharmacology Reproductive

158

Treat methemoglobinemia with

Methylene blue Pharmacology Respiratory

159

Diphenhydramine, dimenhydrinate, chlorpheniramine (mechanism, use, toxicity)

(First generation) H1 antagonists; used in allergies, motion sickness, insomnia; sedation, antiadrenergic, antiserotonergic, and antimuscarinic effects due to CNS penetration Pharmacology Respiratory

160

Loratadine, fexofenadine, desloratadine, cetrizine (mechanism, use, toxicity)

H1 antagonists; used in allergies; less fatigue than other antihistamines due to decreased CNS penetration Pharmacology Respiratory

161

Albuterol (mechanism, use, toxicity)

Short-acting beta-2 agonist; asthma Pharmacology Respiratory

162

Salmeterol, formoterol (mechanism, use, toxicity)

Long-acting beta-2 agonist; asthma; tremor, arrhythmias Pharmacology Respiratory

163

Theophylline (mechanism, use, toxicity)

Phosphodiesterase inhibitor, increases cAMP and causes bronchodilation; asthma; cardiotoxicity, neurotoxicity Pharmacology Respiratory

164

Ipratropium (mechanism, use, toxicity)

Muscarinic antagonist, prevents bronchoconstriction; asthma and COPD Pharmacology Respiratory

165

Beclomethasone, fluticasone (mechanism, use, toxicity)

Inhibit cytokine synthesis, reducing inflammation due to asthma Pharmacology Respiratory

166

Montelukast, zafirlukast (mechanism, use, toxicity)

Leukotriene receptor antagonists; especially useful in aspirin-induced asthma Pharmacology Respiratory

167

Zileuton (mechanism, use, toxicity)

Inhibits activity of 5-lipoxygenase, inhibiting leukotriene production; reduces inflammation Pharmacology Respiratory

168

Omalizumab (mechanism, use, toxicity)

Anti-IgE antibody; used in refractory allergic asthma Pharmacology Respiratory

169

Guaifenesin (mechanism, use, toxicity)

Thins respiratory secretions Pharmacology Respiratory

170

N-acetylcysteine (mechanism, use, toxicity)

Loosens mucus plugs; used in CF patients and as an antidote to acetominaphen posioning Pharmacology Respiratory

171

Bosentan (mechanism, use, toxicity)

Antagonizes endothelin-1 receptors, reducing vascular resistance in the pulmonary vessels; used in pulmonary hypertension Pharmacology Respiratory

172

Dextromethorphan (mechanism, use, toxicity)

Antagonizes NMDA receptors, inhibiting coughing; produces opioid effects in large doses and carries mild abuse potential Pharmacology Respiratory

173

Pseudoephedrine, phenylephrine (mechanism, use, toxicity)

Alpha-1 agonists that reduce edema and nasal congestion; rhinitis; hypertension, quick tolerance (recurrence of symptoms despite continued treatment) Pharmacology Respiratory

174

Difference in competitive vs noncompetitve inhibitors?

competitive = decrease potency, noncompetitive = decrease efficacy. Pharmacology General

175

What is Km?

Inverse relation of affinity of enzyme for its substrate. Pharmacology General

176

What is Vmax?

Direct proportion to enzyme concentration Pharmacology General

177

What is bioavailability?

Fraction of administered drug that reaches systemic circulation unchanged. Pharmacology General

178

Time to steady state depends on?

depends on half-life. Does not depend on frequency or size of dose. Pharmacology General

179

What is rate of elimination in zero order kinetics?

constant amount eliminated per time. Pharmacology General

180

Give three drugs that are zero order eliminated.

PEA - phenytoin, Ethanol, Aspirin. Pharmacology General

181

What is the rate of elimination for first order kinetics?

A constant FRACTION is eliminted, variable by concentration! Pharmacology General

182

How does ionization relate to urine pH?

Ionzied species are trapped in urine and not resorbed. Neutral can be resorbed. Pharmacology general

183

How do you treat overdose of weak acid? Give drug examples.

Treat with Bicarb to make neutral. Exp: phenobarbital, methotrexate, aspirin. Pharmacology general

184

How do you treat overdose of weak base? Give drug examples.

Treat with ammonium chloride. exp: amphetamines. Pharmacology general

185

What is phase I drug metabolism? What pt. population loses this?

Reduction, Oxidation, hydrolysis with CYP450. Often gives neutral products. Geriatrics lose this phase. Pharmacology general

186

What is phase II metaboloism? What population depend on this?

Conjugation (Glucuronidation, Acetylation, and Sulfation.) Gives charged products. Geriatrics depend on this, old people have GAS. Pharmacology general

187

What is efficacy?

maximal effect a drug can produce. Pharmacology general

188

What is potency?

amount of drug needed for the same effect. Pharmacology general

189

What happends to efficacy when a partial agonist and full agonist are mixed?

DECREASED efficacy. fight for same binding site, full agonist cant exert full effect. Pharmacology general

190

What is therapetuic index?

LD50/ED50. Median lethal dose divded by median effective dose. Safer drugs have a higher TI. pharmacology general

191

What is a therapeutic window?

Minimum effective dose to minimum toxic dose. Think of it as range of use. pharmacology general

192

What are the two types of Nicotonic receptors? What kind of messenger do they use?

1. Nicotinic - Ligang gated Na/K channels. Two nicotinic types: Nm(NMJ) and Nn(autonomic ganglia. 2. Muscarinic - G-proteins. 5 types, M1-M5. pharmacology general

193

Alpha-1 sympathetic receptor (G-protein class, major function)

q, increase: vasc. smooth muscle contraction, pupillary dilator muscle contraction, intestinal and bladder sphincter contaction. pharmacology autonomics

194

Alpha-2 sympathetic receptor(G-protein class, major function)

i, decrease: sympathetic outflow, insulin release, lipolysis. increase: platlet aggregation. pharmacology autonomics

195

Beta-1 sympathetic receptor(G-protein class, major function)

s, increase: heart rate, contractilty, renin release, lipolysis pharmacology autonomics

196

Beta-2 sympathetic receptor(G-protein class, major function)

s, vasodilation, brochodilation, increase: heart rate, contractility, lipolysis, insulin release, aqueous humor production. decrease: uterine tone, ciliary muscle tone. pharmacology autonomics

197

M-1 Parasymp receptor(G-protein class, major function)

q, CNS, enteric nervouse system. pharmacology autonomics

198

M-2 Parasymp(G-protein class, major function)

i, decease: heart rate, contractility of atria pharmacology autonomics

199

M-3 parasymp(G-protein class, major function)

increase: exocrine gland secretion (tears, gastric, etc), gut peristalsis, bladder contraction, bronchoconstriction, pupillary spinchter contraction, cilliary muscle contraction. pharmacology autonomics

200

What receptor is responsible for miosis and accomadation?

Parasympathetic M-3. pharmacology autonomics

201

What receptor is responsbile for mydriasis?

Sympathetic Alpha-1. pharmacology autonomics

202

Dopamine D-1 receptor(G-protein class, major function)

s, relaxes renal vascular smooth muscle pharmacology autonomics

203

Dopamine D-2 receptor(G-protein class, major function)

i, modulates transmitter release especially in brain. pharmacology autonomics

204

Histamine H-1 receptor(G-protein class, major function)

q, increase: mucus production, contraction of bronchioles, pruritus, pain. pharmacology autonomics

205

histamine H-2 receptor(G-protein class, major function)

a, increase gastric acid secretion pharmacology autonomics

206

vasopression V-1 receptor(G-protein class, major function)

q, increase: vascular smooth muscle contraction pharmacology autonomics

207

vasopression V-2 receptor(G-protein class, major function)

s, increase water permeability and reabsorption in kidneys. (V2 found in 2 kidneys). pharmacology autonomics

208

Which receptors work via Gq -> Phospholipase C ->Pip2->DAG + IP3?

H1,Alpha1,V1,M1,M3. (remember HAVe 1 M&M) pharmacology autonomics

209

DAG causes activation of what?

Protein Kinase C. pharmacology autonomics

210

IP3 causes increase in what?

Calcium -> smouth muscle contraction pharmacology autonomics

211

Which receptors work via Gi->Adenyly cyclase ->cAMP ->Protein Kinase A?

M2, Alpha2, D2. (remember MAD 2's.) pharmacology autonomics

212

Which receptors work via Gs->adenylyate cyclase ->cAMP->Protein Kinase A?

Beta1, Beta2, D1, H2,V2. pharmacology autonomics

213

What does protein kinase A do?

increase calcium release in heart and blocks myosin light chain kinase. pharmacology autonomics

214

What are the two classes of cholinomimetics?

1. direct agonsts 2. indirect agonists (anticholinesterases). pharmacology autonomics

215

Bethanechol(mechanism,use,toxicity)

Direct cholinomimetic. Postop or neurogenic ileus, urinary retention. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

216

Carbachol(mechanism,use,toxicity)

Direct Cholinomimetic. Identical to Ach. Glaucoma, pupillary contraction, relief of IOP. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

217

Pilocarpine(mechanism,use,toxicity)

Direct Cholinomimetic. Stimulates tears, salvia, sweat. Open and closed-angle glaucoma.COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

218

methacholine(mechanism,use,toxicity)

Direct Cholinomimetic. challenge test of asthma diagnosis. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

219

Neostigmine(mechanism,use,toxicity)

Indirect cholinomimetic agonist. NO cns penetration. Postop and neurogenic ileus, myasthenia gravis, reversal of NMJ block. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

220

pyridostigmine(mechanism,use,toxicity)

indirect cholinomimetic agonist. Long acting myasthenia gravis treatment. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

221

edrophonium(mechanism,use,toxicity)

indirect cholinomimetic agonist. Short acting, for myasthenia gravis diagnosis. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

222

Physostigmine(mechanism,use,toxicity)

indirect cholinomimetic agonist. for anti-cholinergic overdose, crosses BBB. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

223

Donepezil(mechanism,use,toxicity)

indirect cholinomimetic agonist. Alzheimers disease. COPD+asthma exacerbation, peptic ulcers. pharmacology autonomics

224

signs of cholinesterase inhibitor poisoning. treatment.

DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle +CNS, lacrimation, sweating, salvia.) tx: atropine + pralidoxime. pharmacology autonomics

225

Parathion(mechanism, treatment)

Irreversible cholinesterase inhibitor, ACH overdose. Tx: atropine + pralidoxime. pharmacology autonomics

226

Atropine, homatropine, tropicamide (mechanism, use, toxicity).

Muscarinic antagonist. produces mydriasis and cycloplegia. (Atropine also used for bradycardia). Causes hot as a hare, dry as bone, red as beet, blind as bat, mad as a hatter. pharmacology autonomics

227

Benztropine(mechanism,use,toxicity)

Muscarinic antagoist. Parkinsons disease (park my benz). Causes hot as a hare, dry as bone, red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

228

Scopolamine(mechanism,use,toxicity)

Muscarinic antagonist. Motion sickness. causes hot as a hare, dry as a cone, red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

229

Ipratropium,tiotropium (mechanism, use, toxicity)

Muscarinic antagonist. COPD, Asthma. Causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

230

Oxybutynin(mechanism,use,toxicity)

Muscarinic anatagonist. reduces urgency in mild cystitis and reduce bladder spasms. causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.

231

Glycopyrrolate(mechanism,use,toxicity)

Muscarinic anatagonist. IP: given in preop to reduce airway secretions. oral:reduce drooling, peptic ulcer. Can cause hot as a hare, dry as a bone red as a beet, blind as a bat, mad as a hatter. pharmacology autonomics

232

Jimson Weed(mechanism, toxicity)

muscarinic antagonist, causes gardner's pupil (mydriasis). pharmacology autonomics

233

Epinephrine(Mechanism, receptors bound, use, toxicity)

Direct Sympathomemetic. A1,A2,B1,B2. Anaphylaxis, open angle glaucoma, asthma, hypotension. pharmacology autonomics

234

Norepinephine(Mechanism, receptors bound, use, toxicity)

direct sympathomemetic. A1,A2, some B1. used in hypotension but it decrease renal perfusion. pharmacology autonomics

235

Isoproterenol(Mechanism, receptors bound, use, toxicity)

Direct sympathomemetic. B1, B2. Used in Torsade de pointe and bradyarryhmia. Can cause tachycardia and worsen cardiac ischemia. pharmacology autonomics

236

dopamine(Mechanism, receptors bound, use, toxicity)

Direct sympathomimetics. Receptors depend on dose. low = D1, med = D1,B2,B1, high = A1,A2,B1,B2,D1. Used in shock and heart failure (ionotropic and chronotropic). pharmacology autonomics

237

dobutamine(Mechanism, receptors bound, use, toxicity)

Direct sympathomimetic. Mostly B1, little a1,a2,b2. Used in heart failure and cardiac stresstest (ionotrpic and chronotropic) pharmacology autonomics

238

Phenylephrine(Mechanism, receptors bound, use, toxicity)

Direct sympathomimetic. A1, A2. Used in hypotension, to cause mydriasis, and rhinitis (decongestant). pharmacology autonomics

239

Albuterol, salmetrol, terbutaline (Mechanism, receptors bound, use, toxicity)

Direct sympathomimetic. Mostly B2, some b1. Sal = long term ashtma or copd. Albuterol for short term asthma. Terbutaline for to reduce premture uterine contractions. pharmacology autonomics

240

Ritodrine(Mechanism, receptors bound, use, toxicity)

Direct sympathomimetic. B2 only. Used to reduce premature uterine contractions. pharmacology autonomics

241

Amphetamine (mechanism, use)

indirect sympathomimetic. Releases stored catecholamines. Used for narcolepsy, obesity, ADD. pharmacology autonomics

242

Epinephrine(Mechanism, use, toxicity)

indirect sympathomimetic. Releases stored catecholamines. Used for nasal decongestion, urinary incontience, hypotension. pharmacology autonomics

243

Cocaine (mechanims, use).

direct sympathomimetic. Reuptake inhibitor. Causes vasoconstriction and local anesthesia. pharmacology autonomics

244

Why must B-Blockers be avoided in suspected cocaine intoxication?

mixing them can lead to unopposed A1 activation and extreme hypertenion. pharmacology autonomics

245

How does norepinephrine cause reflex bradycardia?

stimulates A1>B2. Causes increased vasoconstrciton -> increased BP. This causes reflex bradycardia and slowing of HR. pharmacology autonomics

246

How does isoproterenol cause reflex tachycardia?

Stimulates B2>A1. This cause vasodilation and dropping of BP. B1 is stimulated and causes tachycardia. pharmacology autonomics

247

Clonidine, alpha-methyldopa(Mechanism, receptors bound, use)

Centrally acting alpha-2 agonists, this causes LESS peripheral sympathetic release.Used in hypertension, especially renal disease due to no increase in renal blood flow! pharmacology autonomics

248

Phenoxybenzamine(Mechanism, receptors bound, use, toxicity)

IRREVERSIBLE nonslective alpha blocker. Used in pheochromosytoma BEFORE surgery! toxic: orhtostatic hypotension, reflec tachycardia. pharmacology autonomics

249

phentolamine(Mechanism, receptors bound, use, toxicity)

REVERSBILE nonselective alpha blocker. give to patients on MAOI who each tyramine contraining foods. pharmacology autonomics

250

Prazosin, Terazosin, Doxazosin,Tamsulosin(Mechanism, receptors bound, use, toxicity)

Alpha-1 blocker. Used in hypertension, urinary rentention in BPH. tox:orthostatic hypotension, dizziness, headache. pharmacology autonomics

251

Mirtazapine (mechanism, use, toxicity)

Alpha-2 blocker. Used in depression. tox: sedation, hypercholesterolemia, increased apetite. pharmacology autonomics

252

Describe what occurs when you alpha-blockade epi vs. phenylephrine.

Before blockade: Both epi and phen RAISES BP. After alpha blockade: only epi raises, no change in phenyl. Why: Epi has B binding, phenyl does NOT. pharmacology autonomics

253

Give 6 applications of Beta-blockers in general.

Angina - decreases HR and contractility, decreasing oxygen use. MI - decrease mortality. SVT - decrease AV duction. Hypertension - decrease CO and renin secretion. CHF - slows progression. Glaucoma - decrease secretion of aqueous humor. pharmacology autonomics

254

give general toxicites of b-blockers

impotence, asthma exacerbation, bradycardia, seizures, sedation, hides hypoglycemia. pharmacology autonomics

255

What are the B1 selective b-blockers? When are they useful?

A BEAM. acebutolol, betaxolol, Esmolol, Atenolol, Metoprolol. Useful in comorbid pum. disease. pharmacology autonomics

256

What are the nonselective ( b1 = b2) b-blockers?

Please Try Not Being Picky. Propranolol, Timolol, Nadolol, Pindolol. B = B-blocker. pharmacology autonomics

257

what are the nonselective a and b-antagonists?

Carvedilol, labetalol. pharmacology autonomics

258

What are the partial B-agonists?

Pindolol, Acebutolol. pharmacology autonomics

259

Give treatment for acetaminophen overdose.

N-Acetylcysteine (replenishes glutathione). pharmacology overdose

260

Give treatment for salicylates overdose.

NaHCO3 (alkalinize urine) pharmacology overdose

261

give treatment for amphetamines overdose

NH4Cl (acidify urine) pharmacology overdose

262

Give treatment for antimuscarinic and anticholinergic overdose.

Phygostigmine and control the hyperhermia. pharmacology overdose

263

Give treatment for b-blocker overdose

Glucagon pharmacology overdose

264

Give treatment for digitalis overdose

(KLAM) normalize K, Lidocaine, Anti-dig fab fragments, Mg2 pharmacology overdose

265

give treatment for iron overdose.

deFEroxamine, deFErasirox. pharmacology overdose

266

give treatment for lead overdose

CaEDTA, dimercaprol, succimer, penicillamine pharmacology overdose

267

give treatment for mercury, arsenix, gold overdose

Dimercaprol, succiner pharmacology overdose

268

give treatment for copper, arsenic, gold overdose

penillamine pharmacology overdose

269

give treatment for cyanide

nitrite + thiosulfate, hydroxocobalamin pharmacology overdose

270

give methemoglobin treatment

Methylene blue, vitamin c pharmacology overdose

271

Give Carbon monocide treatment

100% oxygen or hyperbaric oxygen pharmacology overdose

272

give treatment for methanol, ethylene glycol overdose

Fomepizole>Ethanol, dialysis pharmacology overdose

273

give treatment for opiods overdose

naloxone/naltrexone pharmacology overdose

274

give treatment for benzodiazepine overdose

flumazenil pharmacology overdose

275

give treatment for TCA overdose

NaHCO3 (alkalinize plasma) pharmacology overdose

276

give treatment for heparin overdose

protamine pharmacology overdose

277

give treatment for warfarin overdose

Vitamin K, fresh frozen plasma pharmacology overdose

278

give treatment for tPA, Streptokinase, urokinase overdose

aminocaproic acid pharmacology overdose

279

give treatment for theophylline overdose

B-Blockers pharmacology overdose

280

give treatment for acetylcholinesterase inhibitors

atropine + pralidoxime pharmacology overdose

281

causes coronary vasospam

cocaine, sumatriptan, ergots pharmacology reactions

282

causes cutaneous flushing

(VANC) Vancomycin, Adenosine, Niacin, Ca blocker pharmacology reactions

283

causes dilated cardiomyopathy

doxorubicin, daunorubicin pharmacology reactions

284

causes torsades de pointes

class III (sotalol) and class Ia (quinidine) pharmacology reactions

285

causes agranulocytoisis

Clozapine, Carbamazepine, Colchine, Propylthiouracil, Methimazole, Dapsone pharmacology reactions

286

causes aplastic anemia

chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole pharmacology reactions

287

causes direct coombs positive hemolytic anemia

methyldopa, penicillin pharmacology reactions

288

causes gray baby syndomr

chloramphenicol pharmacology reactions

289

causes hemolysis in G6PD-defiect patients

(hemolysis IS PAIN)isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin pharmacology reactions

290

causes megaloblastic anemia

(females with PMS are on full BLAST mode) Phenytoin, Methotrexate, Sulfa drugs pharmacology reactions

291

Causes thrombotic complications

OCPs like estrogen pharmacology reactions

292

Causes cough

ACE inhibitors pharmacology reactions

293

causes pulmonary fibrosis

Bleomycin, amiodarone, Busulfan pharmacology reactions

294

causes acute cholestatic hepatits, jaundice

erthryomycin pharmacology reactions

295

causes focal to massice hepatic necrosis

Halothane, Amanita Phalloides, Valrpoic acid, Acetaminophen pharmacology reactions

296

causes hepatits

isoniazid pharmacology reactions

297

can lead to pseudomembranous colitis

clindamycin, ampicillin pharmacology reactions

298

can lead to adrenocortical insufficiency

glucocorticoid withdrawl via HPA suppression pharmacology reactions

299

can causes gynecomastia

`(Some drugs create awkward knockers) spironolactone, digitalis, cimetidine, chronic alcohol use, ketoconazole pharmacology reactions

300

causes hot flashes

estrogen, clomophene pharmacology reactions

301

causes hypergylcemia

niacin, tacrolimus, protease inhibitor, HCTZ, corticosteriods pharmacology reactions

302

causes hypothyroidism

lithium, amiodarone, suldonamides pharmacology reactions

303

causes fat redistribution

glucocoricoids, protease inhibitors pharmacology reactions

304

causes gingival hyperplasia

phenytoin, verpamil pharmacology reactions

305

causes gout

furosemide, thiazides, niacin, cyclosporine pharmacology reactions

306

causes myopathies

fibrates, niacin, colchine, hydroxychloroquine, interferon-alpha, penicillamine, statins, glucocorticoids pharmacology reactions

307

causes osteoporosis

corticosteroids, heparin pharmacology reactions

308

causes photosensitivty

(SAT for a PHOTO) Sulfonamides, amiodarone, tetracycline pharmacology reactions

309

causes rash/SJS

penicillin, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital pharmacology reactions

310

cause drug induced lupus

Hydralazine, isonizid, procainamine, phenytoin pharmacology reactions

311

causes teeth problems

tetracyclines pharmacology reactions

312

causes tendonitis, tendon rupture, tooth damage

fluoroquinolones pharmacology reactions

313

causes diabetes insipidus

lithium, demeclocycline pharmacology reactions

314

causes fanconi's syndome

expired tetracycline pharmacology reactions

315

causes hemorrhagic cystits

Cyclophosamide, ifosfamide pharmacology reactions

316

causes interstital nephritis

methicllin, NSAID, furosemide pharmacology reactions

317

causes SIADH

carbamazepine, cyclophosamide pharmacology reactions

318

causes cinchonism

Quinidine, qunine pharmacology reactions

319

causes parkinson-like syndome

antipsychotics, resperine, metoclopramide pharmacology reactions

320

causes seizures

(with seizures, I BITE My tongue) isoniazid, Buproprion, imipenem, Tramadol, Enflurane, Metoclopramide pharmacology reactions

321

causes tardive dyskinesia

antipsychotics pharmacology reactions

322

acts like an anti-muscarinic

Atropine, TCA, H1-blocker, neuoleptics pharmacology reactions

323

can cause a disulfiram like reaction

metronidazole, some cephalosporins, procarbazine, 1st gen sulphonoureas pharmacology reactions

324

can cause nephro/ototoxicity

aminoglycosides, vancomycin, loop dieuetics, cisplatin pharmacology reactions

325

list p450 inducers

(Momma Barb Steals Phen-phen and Refuses Greasy Carbs Chronically)Modafinil, Barbiturates, St. John wart, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use. pharmacology reactions

326

list p450 inhibitors

(MAGIC ROCKS in GQ) Macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir actue alcohol use, ciprofloxacin, ketoconazole, sulfonamides, gemfibrozil, quinidine. pharmacology reactions

327

lists the sulfa drugs

(Popular FACTSSS) probenacid, furosemide, acetazolamide, celecoxib, thiazide, sulfonamide antibiotics, sulfaasalazine, sulfonylureas pharmacology reactions

328

Difference between peniciliin G and V.

G = IV and IM. V = oral. pharmacology micro

329

Penicillin(mechanism,use,toxicity)

Bind penicillin-binding proteins(transpeptidases), block cross linking of peptidoglycans;most effective on G+, also N. Meningitidis, Treponema;hypersensitivy reaction, hemolytic anema. pharmacology micro

330

Oxacillin,Naficillin,Dicloxacillin(mechanism,use,toxicity)

bind transpeptidases, penicillanse resistant due to bukly r-group blocking B-Lactamse; S. Aureus, except MRSA; hypersensitivity and interstitial nephritis. pharmacology micro

331

Ampicillin, amoxicillin(mecanism,use,toxicity)

bind transpeptidases, wide spectrum and more penicillinase sensitive. combo with claculanic acid to protect from B-lactams;kills enterococci(HELPSS)H.iB, E.coli,Listera,Proteus,Salmonella,Shigella,enterococci;hypersensitivity reaction,rash,pseudomemrane colitis. pharmacology micro

332

Which has better bioavailibility; amoxicllin or ampicillin?

amOxicllin has better Oral bioavilability. pharmacology micro

333

What does clavulanic acid do?

B-lactamse inhibitor pharmacology micro

334

Ticarcillin,piperacillin(mechanism,use,toxicity)

transpeptidase inhibitor but extended spectrum;pseduomonas and g- rods, use with claculanic acid due to B-lactamse suspectibilty; hypersensitivity reaction. pharmacology micro

335

List the B-lactamse inhibitors

(CAST) Clavulanic Acid, Sulbactam,Tazobactem. pharmacology micro

336

Cephalosporin(mechanism,use,toxiciity)

inhibit cell wall synthesis but are less susceptible to B-lactamases, are bactericidal;use depends on generation, there are four;hypersensitivty reactions, vitamin K defiency, increased nephrotoxicity of aminoglycosides. pharmacology micro

337

give use of cefazolin, cephalexin.

1st generation cephalosporins. PEcK. Proteus, E.coli,Klebsiella. Cefazolin used preop to prevent A.aureus infections. pharmacology micro

338

give use of cefoxitin, cefaclor,cefuroxime`

2nd generation cephalosporins. HEN PEcKs. H.ib, Enterbacter, Neisseria, Proteus, E.coli,Klebsiella, Serratia. pharmacology micro

339

give use of ceftriaxone, cefotaxime,ceftazidime

3rd gen. cephalosporins. Serious gram - infections. Ceftriaxone = meningitis and gonorrhea. Ceftazidime = pseudomonas. pharmacology micro

340

give use of cefepime.

increased activity against pseudomonas and G+ bugs. pharmacology micro

341

Aztreonam(mechanism,use,toxicty)

a monobactem resistant to B-lactamases, prevents binding to PBP3 and is synergistic with aminoglycosides;gram - rods only;very nontoxic, some GI upset. pharmacology micro

342

what transpeptidase inhibitor can be used in penicillin allergy?

aztreonam. pharmacology micro

343

imipenem/cilastatin,meropenem,etrapenem,doripenem(mechanism,use,toxicity)

broad spectrum, B-lactamase resistent but imipenem needs cilastatin to inhibit renal dehydropeptidase. later carbepenems do not;G+ cocci,G- rods, anerobes. used only in life threating events;skin rash, CNS toxicity, seizures. pharmacology micro

344

Vancomycin(mechanism,use,toxicty)

inhibits cell wall binding peptidoglycan formation by binding D-ala percursors, is bacterialcidal; G+ only, especially for multidrug resistant onces;NOT - nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome. pharmacology micro

345

How is redman syndrome prevented in vancomycin use?

slow infusion and rate and antihistamines. pharmacology micro

346

How does vancomycin resistant occur?

amino acid change of D-ala D-ala to D-ala D-lac. pharmacology micro

347

List antibiotic protein synthesis inhibitors

AT 30, CCEL at 50. 30S = Aminoglycosides, Tetracyclines. 50S = Chloramphenicol, Clindamycin, Erythromycin, Linezolid. pharmacology micro

348

Gentamicin, neomycin, amikacin,tobramycin,streptomycin(mechanism,use,toxicity)

aminoglycosides, bacterialcidal, block translocation but require oxygen for uptake;ineffective in anaerobes,use in gram - rod infections and before bowel surgery; nephrotoxicty, NMJ block, ototoxicity, teratogen. pharmacology micro

349

how does resistenace to aminoglycosides occur?

transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. pharmacology micro

350

tetracycline, doxycycline, demecycline,minocycline(mechanism, use, toxicity)

bacteriostatic, prevents aminoacyl-tRNA binds;Borrela, M. Pneuomo, Rickettsia, Chlamysia; can't take with milk, antacids, iron because ions bind it, GI distress, discoloration of teeth, inhibition of bone growth, contraindication in pregnancy. pharmacology micro

351

how does resistance to tetracyclines occur?

decrease uptake into cells or increased efflux by pumps. pharmacology micro

352

Azithromycin, clarithromycin, erythromycin(mechanism,use,toxicity)

bacteriostatic, blocks translocation; atypical pneumonias, chlamydia, gram + cocci; MACRO: increased Motility, arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia. pharmacology micro

353

how does resitance to macrolides occur?

methylation of 23s rRNA binding site. pharmacology micro

354

Chloramphenicol(mechanism,use,toxicity)

Bacterialstatic, blocks peptidlytransferase; Meningitis in adults, used in power countries due to being cheap; dose dependent anemia, dose independent aplastic anemia, gray baby syndrome. pharmacology micro

355

what causes grey baby syndrome?

use of chloramphenicol in premature infants, they lack UDO-glucuronyl-transferase. pharmacology micro

356

How does resistance to chloramphenicol occur?

plasmid-encoded acetyltransferase. pharmacology micro

357

clindamycin(mechanism,use,toxicity)

Bacteriostatic. Blocks peptide transfer; anaerobic infections in lung infections and oral anerobes; C. Diff infection, fever, diarrhea. pharmacology micro

358

Sulfamethoxazole(SMX), sulfisoxazole, sulfadiazine(mechanism, use, toxicity)

Bacteriostatic, PABA metabolites inhibit dihydropteroate synthase; Gram +, G-, Nocardia, Chlamydia, UTI; hypersensitivty, hemolysis in G6PD, nephrotoxic, kernicterus, displaces other drugs from albumin. pharmacology micro

359

how does resistance to sulfonamides occur?

altered bacterial dihydropteroate or increased PABA synthesis. pharmacology micro

360

Trimethoprim(mechanism,use,toxicity)

Bacteriostatic, inhibits bacterial dihydrofolate reductase, blocks folate synthesis; used in UTI, PCP (prophylacis and treatment), shigella, salmonella; megaloblastic anemia, leukopenia, granulocytopenia. pharmacology micro

361

ciprofloxacin, norfloxacin, levofloxacin, etc...(mechanism, use, toxicity)

bactericidal, inhibits DNA gyrase(topo II and IV);G- rods of urinary and GI tracts, Neisseria, some G+;( lones hurt the bones) tenonitis and tendon rupture, superinfections, don't give to kids or pregnant women due to cartilage damage. pharmacology micro

362

how does resistance to fluroquinolones occur?

mutation in DNA gyrase or efflux pumps. pharmacology micro

363

What groups are susceptible to fluorquinolone tendon rupture?

older than 60 or taking prednisone pharmacology micro

364

Metronidazole(mechanism, use, toxicity)

bacterialcidal, forms free radical toxic metabolites that damge bacterial DNA damage; (GET GAP) Giardia, Entamoeba, trichomonas, Gardnerella, Anaerobes, Pylori; causes disulfiram like reaction, headache, metallic taste. pharmacology micro

365

Isoniazid(mechanism,use,toxicity)

decrease synthesis of mycolic acids, bacterial catalase peroxidase(KatG) must activate INH; TB drug, only one used as prophylaxis and in latent TB; peripheral neuropathy, hepatoxic, lupis like drug interaction, pyridoxine antagonist. pharmacology micro

366

Rifampin(mechanism,use,toxicity)

inhibits DNA-dependent RNA polymerase; TB, Leprosy, prophylaxis in meningococcus and Hib type B; hepatotox, p450 inducer, orange body fluids. pharmacology micro

367

Pyrazinamide(mechanism, use, toxicity)

unknown; TB; hyperuricemia, hepatotoxic. pharmacology micro

368

Ethambutol(mechanism,use,toxicity)

decreased carbohydrate polymerization of TB cell wall, blocks arabinosyltransferase; TB; optic neuropathy(red-green color blindness_ pharmacology micro

369

Amphotericin B(mechanism, use, toxicity)

binds fungal ergosterol, causes holes in membranes; use in systemtic and CNS mycoses infections; fever/chills, hypotension, arrythmias, nephrotoxic, IV phlebitis, must supplement K and MG. pharmacology micro

370

nystatin(mechanism,use,toxicty)

binds fungal ergosterol;topical only due to high toxicity, used for oral thrush and topical diaper rash or vaginal candidiasis. pharmacology micro

371

Fluconazole, ketoconazole, clotrimazole, itraconazole, voriconazole(mechanism, use,toxicity)

inhibits fungal ergosterol synthesis by binding p450;Fluconazole for suppression of cryptococcus in AIDs patients, itraconazle for blasto, coccio, histo. pharmacology micro

372

Flucytosine(mechanism, use, toxicity)

inhibits fungal DNA and RNA synthesis by conversion to 5FU; used in systemic fungal infections, especially cryptococcus; bone marrow suppression. pharmacology micro

373

Caspofungin, micafungin(mechanism, use, toxicity)

inhibits fungal cell wall synthesis by inhibiting B-glucan synthesis; invasive aspergillosis, candida; flushing via histamine releae. pharmacology micro

374

terbinafine(mechanism,use,toxicity)

inhibits fungal squalene epoxidase; treat dermatophytes - toe nail infection especially;abnormal LFT, visual disturbances. pharmacology micro

375

Griseofulvin(mechanism,use,toxicity)

interferes with microtubules, stops mitosis in fungi;deposits in keratin so used in superficial infections, stops dermatophytes; teratogenic, carcinogenic, confusion, p450 inducer. pharmacology micro

376

Pyrimethamine use

toxoplasmosis pharmacology micro

377

suramin and melarsoprol use

trypanosoma brucei pharmacology micro

378

nifurtimox use

trypanosoma cruzi pharmacology micro

379

sodium stibogluconate use

leshmaniasis pharmacology micro

380

Chloroquine(mechanism,use,toxicity)

blocks formation of heme into hemozoin. Heme accumulates and is toxic to plasmodia;used on all species but falciparum(too much resitance); retinopathy pharmacology micro

381

quinidine use

lifethreatening malaria pharmacology micro

382

artemether/lumifantrine use

p. falciparum killing pharmacology micro

383

Zanamivir,oseltamivir(mechanism,use)

inihibits influenza neuraminidase, stops progeny release; treamt of influenze a and b pharmacology micro

384

Ribavarin(mechanism,use,toxicity)

inhibits sythesis of guanine nucleotides by competitvely inhibiting IMP dehydrogenase; RSV, chronic hep C; hemolytic anemia, severe teratogen pharmacology micro

385

Acyclovir,valacyclovir(mechanism, use, toxicity)

Guanosine analog, inhibits viral DNA polymerase; monophosphorylated by thymidine kinase in HSV/VZV so active in lesions and encephalitis, good for prophylaxis, pharmacology micro

386

Famciclovir use

used in herpes zoster active infections pharmacology micro

387

mechanism for resistance to acyclovir

mutated viral thymidine kinase pharmacology micro

388

Ganciclovir,valgangciclovir(mechanism,use,toxicity)

guanosine analog, 5'-monophosphate formed by CMV viral kinase, inhibits viral DNA polymerase;CMV infections;leukopenia,neutopenia,thrombocytopenia,renal toxicity pharmacology micro

389

mechanism for resistance to acyclovir

mutated CMV DNA polymerase or lack of viral kinase pharmacology micro

390

Foscarnet(mechanism,use,toxicity)

viral DNA polymerase inhibitor, binds to pyrofosphate binding site, doesn't need viral kinase activation;CMV retinitis when ganciclovir fails and acyclovir restitant HSV; nephrotoxic pharmacology micro

391

mechanism for resistance to foscarnet

mutated DNA polymerase pharmacology micro

392

cidofovir(mechanism,use,toxicity)

inhibits DNA polymerase, doesn't require activiation by viral kinase; CMV retenitis, acyclovir resistant HSV; nephrotoxic pharmacology micro

393

HAART consist of what?

[2 NRTI] +[1 NNRTI OR 1 protease inhibitor OR 1 integrase inhibitor] pharmacology micro

394

give mechanism and toxicity of protease inhibitors

all end in -NAVIR! stops HIV mRNA cleavage into functional parts; hyperglycemia, GI upset, lipodystrophy. pharmacology micro

395

Ritonavir does what to be a "booster"

inhibits cytochrome p-450, boosting concentration of other drugs. pharmacology micro

396

Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didansoine, stavudine(mechanism,use,toxicity

(NRTI)competitively blocks binding of nucleotide to reverse transcriptase, only tenofovir doesn't need to be activated;all NRTIs, zidovidine used in pregnancy to reduce fetal transmision; bone marrow suppression, lactic acidosis, peripheral neuropathy. pharmacology micro

397

Nevirapine, Efavirenz, Delavirdine(mechanism,use,toxicity)

(NNRTI) bind at a site different from NRTIs, no don't require activation don't compete with nucleotides; bonow marrow suppression, peripheral neuropathy, lactic acidosis, pharmacology micro

398

Raltegravir(mechanism,use,toxicity)

inhibits integrase, which stops HIV integration into host cells;HIV;hypercholesterolemia pharmacology micro

399

Interferons(mechanism,use,toxicity)

glycoproteins synthesized my virus infected cells, block RNA and DNA virus replication; INFa- chronic hep b and c, Kaposi sarcoma, IFN-b -MS, INF-gamma -NADPH oxidase defiency; neutropenia, myopathy. pharmacology micro

400

What antibiotics must be avoided in pregnancy?

SAFe Children Take Really Good Care. sulfonamides(kericterus), aminoglycosides(ototox), fluoroquinolones(cartilage damage), Clarithromycin(embryotoxic), Tetracycline(teeth,bone damage),Ribavarin(teratogenic),Griseofulvin(teratogenic),Chloramphenicol(grey baby) pharmacology micro