Uworld_Pharm Flashcards
(39 cards)
What are the absolute contraindications of OCPs?
- Prior history of Thromboembolic event or stroke
- History of an estrogen-dependent tumor.
- Over age 35 and heavy Smoker
- HyperTG
- Decompensated or active liver disease (fucked steroid metabolism)
- pregos
Major contraindication of ACEi (-pril)?
Bilateral renal artery stenosis (pt. with diffuse atherosclerosis)
b/c ACEi causes GFR to fall d/t constriction of EFFERENT arteriole.
MOA of Vincristine?
Vina alkaloids (vincristine, vinslastine) inhibit microtubule polyermization by binding to beta-tubulin.
(M-phase specific)
Inhibition of microtubule formation prevents synthesis of the mitotic spindle in dividing cells. Without the mitotic spindle, replicated chromosomes are unable to align and segregate into their respective daughter cells during mitosis. This leads to failure of division and cell death
ADR of Vincristine?
neurotoxic. Finger numbness and tingling.
How do bugs dev resistance to Gentamicin?
Aminoglycoside;
- aminoglycoside-modifying enxymes.
- mutated ribosomal subunit protein
- mutated porin proteins.
Impaired influx/increase efflux is a mech of resistance that be be developed to what class of ABX?
- Vancomycin
- Quinolones
- Tetracyclines
What are ADRs of the overuse of osmotic diuretics like mannitol?
- volume expansion (worsening pulmonary edema)
- dilution hyponatremia
- metabolic acidosis
- HyperKalemia
What is the MOA and use of Cholchicine?
Colchicine is a second-line agent for treating acute gouty arthritis. It inhibits tubulin polymerization and microtubule formation in leukocytes, reducing neutrophil chemotaxis and emigration to sites inflamed by tissue deposition of monosodium urate crystals.
Gastrointestinal mucosal function is also impaired by microtubule disruption, leading to diarrhea and, less commonly, nausea, vomiting, and abdominal pain.
Adenosine is used to Tx?
Adenosine is used to Tx paroxymal supraventicular tachycardia (PSVT).
adenosine slows conduction through the AV node by HYPERpolerzing the nodal pacemaker cells and conducting cells.
rapid onset less then 10 seconds.
ADRs of Adenosine?
- flushing
- chest burning (d/t bronchospasms)
- hypotension
- high-grade AV block
Lidocaine is used to Tx?
Ventricular arrhythmia
________ is a class III antiarrhythmic and is useful in both supraventricular (atrial, nodal, junctional) and ventricular tachyarrhythmia
Amiodarone
ADR of Aminodarone?
- photodermatitis (blue/grey skin discolaration)
- pulmonary fibrosis
- Thyroid issues (hyper or hypo)
Digoxin MOA and ADRs
Digoxin slows conduction through the AV node and is also a positive inotrope.
Digoxin/Digitalis causes a well-characterized toxicity; symptoms include fatigue, blurry vision, changes in color perception, nausea and vomiting, diarrhea, abdominal pain, confusion, and delirium.
MOA of Cromolyn and Nedocromil
inhibits mast cell degranulation and prevents the release of preformed chemical mediators.
Use to PREVENT acute asthma attacks. versus treatment.
MOA and use of Zileuton
Zileuton is a selective inhibitor of the lipoxygenase pathway that leads to decreased formation of leukotrienes. Zafirlukast and montelukast are leukotriene D4 receptor antagonists. These agents are typically used for chronic asthma prophylaxis.
MOA and use of Omalizumab
Anti-IgE antibody, omalizumab, inhibits IgE binding to mast cells, preventing mast cell degranulation. Omalizumab is used in some patients with severe persistent asthma to lower IgE levels and improve allergen-induced bronchial constriction.
In addition to BP control and statins, what other drug is used to prevent ischemic stroke? (TIA)
low-dose aspirin; low dose inhibits COX-1, preventing platelet synthesis of thromboxane A2, which impairs platelet aggregation and reduces vasoconstriction
Drug-induced SLE ~w/ what antibody and type of metabolism?
Anti-Histone antibodies
N-acetylation in the liver. (procainaminde, hydralazine, isoniazid)
Procainamide, hydralazine, and isoniazid aer metabolized via?
Phase II ACETYLATION in the liver.
MOA and use of Cholchicine?
Tx of acute gouty arthritis
Colchicine works primarily by inhibiting microtubular polymerization. It binds to the tubulin protein that helps form microtubules, preventing their aggregation. This in turn disrupts cytoskeletal-dependent functions such as chemotaxis, phagocytosis, and degranulation. Colchicine also reduces the formation of leukotriene B4. It does not have any effect on the metabolism or urinary excretion of uric acid. Important adverse effects of colchicine are nausea, abdominal pain, and diarrhea. Colchicine should not be used in elderly patients or those with severe renal dysfunction.
What drug is used for treatment of acute gouty arthritis in patients who cannot take nonsteroidal anti-inflammatory drugs. It inhibits leukocyte migration and phagocytosis by blocking tubulin polymerization.
Colchicine
Significant side effects of colchicine include nausea and diarrhea.
What diuertic should not be used in pt. with Hereditary Angioedema?
Angioedema can be hereditary (autosomal dominant) or acquired (associated with angiotensin-converting enzyme [ACE] inhibitor treatment). In hereditary angioedema, low C1 esterase inhibitor activity leads to increases in bradykinin activity. ACE inhibitors should not be used in these patients.
what drug is primarily a venodilator. It decreases preload which decreases myocardial oxygen demand and thereby treats angina pectoris.
Nitroglycerin
